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1. Glycerol as a precursor for hepatic de novo glutathione synthesis in human liver

Author

Eunsook S. Jin, Craig R. Malloy, Gaurav Sharma, Erin Finn, Kelly N.Z. Fuller, Yesenia Garcia Reyes, Mark A. Lovell, Sarkis C. Derderian, Jonathan A. Schoen, Thomas H. Inge, and Melanie G. Cree

Subjects
Glycerol, Glycine, Glutamate, Cysteine, Liver, Glutathione, Medicine (General), R5-920, Biology (General), QH301-705.5
Abstract

Background: Glycerol is a substrate for gluconeogenesis and fatty acid esterification in the liver, processes which are upregulated in obesity and may contribute to excess fat accumulation. Glycine and glutamate, in addition to cysteine, are components of glutathione, the major antioxidant in the liver. In principle, glycerol could be incorporated into glutathione via the TCA cycle or 3-phosphoglycerate, but it is unknown whether glycerol contributes to hepatic de novo glutathione biosynthesis. Methods: Glycerol metabolism to hepatic metabolic products including glutathione was examined in the liver from adolescents undergoing bariatric surgery. Participants received oral [U–13C3]glycerol (50 mg/kg) prior to surgery and liver tissue (0.2–0.7g) was obtained during surgery. Glutathione, amino acids, and other water-soluble metabolites were extracted from the liver tissue and isotopomers were quantified with nuclear magnetic resonance spectroscopy. Results: Data were collected from 8 participants (2 male, 6 female; age 17.1 years [range 14–19]; BMI 47.4 kg/m2 [range 41.3–63.3]). The concentrations of free glutamate, cysteine, and glycine were similar among participants, and so were the fractions of 13C-labeled glutamate and glycine derived from [U–13C3]glycerol. The signals from all component amino acids of glutathione - glutamate, cysteine and glycine - were strong and analyzed to obtain the relative concentrations of the antioxidant in the liver. The signals from glutathione containing [13C2]glycine or [13C2]glutamate derived from the [U–13C3]glycerol drink were readily detected, and 13C-labelling patterns in the moieties were consistent with the patterns in corresponding free amino acids from the de novo glutathione synthesis pathway. The newly synthesized glutathione with [U–13C3]glycerol trended to be lower in obese adolescents with liver pathology. Conclusions: This is the first report of glycerol incorporation into glutathione through glycine or glutamate metabolism in human liver. This could represent a compensatory mechanism to increase glutathione in the setting of excess glycerol delivery to the liver.

Published
2023
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2. Brave new E‐world: Medical students’ preferences for and usage of electronic learning resources during two different phases of their education

Author

Erin Finn, Fred Ayres, Stephen Goldberg, and Michael Hortsch

Subjects
e‐learning, learning resources, preclinical medical education, technology‐enhanced learning, user preferences, USMLE, Biology (General), QH301-705.5
Abstract

Abstract E‐learning strategies have become an important part of biomedical education. However, why and how medical students select hardware tools and software formats during their preclinical education has not been sufficiently evaluated. These aspects should be considered when designing or offering new e‐learning modalities to learners. Two medical school classes at a major US medical school were surveyed about their use of e‐learning resources during their first year of medical school or their preparation for their first licensing examination (USMLE® Step 1), respectively. Their responses were analyzed for patterns and significant changes. Students’ answers indicated that computers and tablets were considered the most important hardware devices to support students’ learning. During the first year, students often preferred resources that were tailored to the specific courses in their curriculum. In contrast, some preferences changed when students prepared for the USMLE Step 1, with students shifting almost exclusively to a solitary learning strategy using commercial e‐learning resources. Across all phases of medical school education queried, peer advice was the major determinant influencing e‐learning resource selection with faculty only playing a minor role. Videos were the most popular e‐learning modality, and students cited efficient acquisition of knowledge and preparation for examinations as major reasons for e‐learning tool utilization. These factors should be considered when offering e‐learning resources to medical students during different phases of their preclinical training.

Published
2022
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3. Return to activity after excision of the symptomatic Os trigonum: A systematic review comparing arthroscopic versus open excision

Author

Sarah Langer, BS, Carly Goerhing, BS, Taha Mahmood, MS, Erin Finn, MS, Zayna Shaqildi, BS, Gil Paiz, BS, and Sean Busby, BS

Subjects
Os trigonum, Excision, Resection, Arthroscopic, Talus, Outcome, Surgery, RD1-811
Abstract

The os trigonum, an irregular, accessory ossicle at the posterior lateral process of the talus, is known to be one of the main causes of posterior ankle impingement. It is unclear if an arthroscopic technique offers a superior outcome over an open technique when surgical excision is indicated. The purpose of this study is to better understand the outcomes and complications after os trigonum excision using an open versus arthroscopic technique. Using PRISMA guidelines, a systematic review of studies published in PubMed, Cochrane Reviews, and CINAHL databases through November 2021 was conducted to identify articles that evaluated postoperative outcomes and complications following os trigonum excision. Studies involving concurrent procedures, arthroscopic approaches varying from the technique described by Van Dijk et. al (2000), and case studies (where n ≤ 2) were excluded 1996 unique articles were identified. 18 studies were included representing 242 patients undergoing the arthroscopic technique and 217 undergoing the open technique. The arthroscopic group returned to activity sooner than the open group (9.86 weeks versus 13.074 weeks, respectively; p-value

Published
2022
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4. A Novel Intronic Pathogenic Variant in With a Dominant Negative Mechanism Causes Attenuated Lipoid Congenital Adrenal Hyperplasia

Author

Erin Finn MD, Kimberly Kripps MD, Christina Chambers MD, Michele Rapp MS, Naomi J. L. Meeks MD, Fang Xu PhD, Wuyan Chen PhD, Austin A. Larson MD, and Natalie J. Nokoff MD, MSCS

Subjects
Medicine (General), R5-920, Pathology, RB1-214
Abstract

Lipoid congenital adrenal hyperplasia (LCAH) is typically inherited as an autosomal recessive condition. There are 3 reports of individuals with a dominantly acting heterozygous variant leading to a clinically significant phenotype. We report a 46,XY child with a novel heterozygous intronic variant in STAR resulting in LCAH with an attenuated genital phenotype. The patient presented with neonatal hypoglycemia and had descended testes with a fused scrotum and small phallus. Evaluation revealed primary adrenal insufficiency with deficiencies of cortisol, aldosterone, and androgens. He was found to have a de novo heterozygous novel variant in STAR : c.65-2A>C. We report a case of a novel variant and review of other dominant mutations at the same position in the literature. Clinicians should be aware of the possibility of attenuated genital phenotypes of LCAH and the contribution of de novo variants in STAR at c.65-2 to the pathogenesis of that phenotype.

Published
2021
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5. The Status of Blueberry Gall Midge in the Southeastern United States

Author

Oscar Liburd and Erin Finn

Subjects
IN458, Agriculture (General), S1-972, Plant culture, SB1-1110, Biology (General), QH301-705.5
Abstract

This document is ENY-825, one of a series of the Entomology and Nematology Department, Florida Cooperative Extension Service, Institute of Food and Agricultural Sciences, University of Florida. Published: September 2002. https://edis.ifas.ufl.edu/in458

Published
2002

7. Brave new E‐world: Medical students’ preferences for and usage of electronic learning resources during two different phases of their education

Author

Michael Hortsch, Erin Finn, Fred Ayres, and Stephen Goldberg

Subjects
Cancer Research, Physiology, Genetics, Molecular Medicine, Molecular Biology, Biochemistry, Biochemistry, Genetics and Molecular Biology (miscellaneous), Biotechnology
Abstract

E-learning strategies have become an important part of biomedical education. However, why and how medical students select hardware tools and software formats during their preclinical education has not been sufficiently evaluated. These aspects should be considered when designing or offering new e-learning modalities to learners. Two medical school classes at a major US medical school were surveyed about their use of e-learning resources during their first year of medical school or their preparation for their first licensing examination (USMLE® Step 1), respectively. Their responses were analyzed for patterns and significant changes. Students' answers indicated that computers and tablets were considered the most important hardware devices to support students' learning. During the first year, students often preferred resources that were tailored to the specific courses in their curriculum. In contrast, some preferences changed when students prepared for the USMLE Step 1, with students shifting almost exclusively to a solitary learning strategy using commercial e-learning resources. Across all phases of medical school education queried, peer advice was the major determinant influencing e-learning resource selection with faculty only playing a minor role. Videos were the most popular e-learning modality, and students cited efficient acquisition of knowledge and preparation for examinations as major reasons for e-learning tool utilization. These factors should be considered when offering e-learning resources to medical students during different phases of their preclinical training.

Published
2022

8. 983-P: Prediabetes A1C Is Associated with Metabolic Disease in Girls with PCOS and Obesity

Author

ERIN FINN, YESENIA GARCIA REYES, ANYA E. TAYLOR, AMANDA L. GARFIELD, CAMILO A. VIVAS, KELLY FULLER, BRYAN C. BERGMAN, KRISTEN J. NADEAU, and MELANIE CREE-GREEN

Subjects
Endocrinology, Diabetes and Metabolism, Internal Medicine
Abstract

Polycystic Ovary Syndrome (PCOS) is associated with metabolic diseases, including diabetes, and metformin is indicated if a1c is ≥5.7 demonstrating prediabetes/diabetes. To determine when to prescribe metformin, 2018 PCOS guidelines advise only an OGTT to screen, whereas ADA guidelines also include A1c. We sought to determine patterns of dysglycemia and metabolic disease in youth with PCOS and obesity. Data from girls (age 12-21 yrs, n=110) with obesity and untreated PCOS were examined. Metabolic assessments included fasting labs, 4-hour oral sugar tolerance test (OSTT, 75 g glucose, 25 g fructose) with Oral Minimal Modeling, liver fat assessment by MRI, and endogenous glucose release (Ra) with isotope tracers (N=31) . Data were divided by A1c ( Disclosure E.Finn: None. Y.Garcia reyes: None. A.E.Taylor: None. A.L.Garfield: None. C.A.Vivas: None. K.Fuller: None. B.C.Bergman: Research Support; Eli Lilly and Company. K.J.Nadeau: None. M.Cree-green: None. Funding National Institutes of Health (R01DK120612) , (K23DK107871) , (UL1 TR002535) , (P30 DK048520) , (K12HD057022) ;Doris Duke Foundation (CDSA) , (CDSA COVID extension) , (2015212) ; Childrens Hospital Colorado; Boettcher Web Waring Foundation

Published
2022

9. ODP424 Postprandial Adipose Insulin Resistance in Adolescent Girls with PCOS and Obesity

Author

Erin Finn, Meredith A Ware, Haseeb Rahat, Yesenia Garcia Reyes, Anya Taylor, Amanda Garfield, Bryan C Bergman, Kristen Nadeau, and Melanie Cree-Green

Subjects
Endocrinology, Diabetes and Metabolism
Abstract

Background Polycystic ovary syndrome (PCOS) is common and associated with metabolic disease, in particular glucose abnormalities and insulin resistance (IR). Fat metabolism is linked with IR, manifesting as decreased suppression of lipolysis following meals, inflammation, and ectopic fat accumulation. Our previous work demonstrated adipose IR during a hyperinsulinemic-euglycemic clamp and increased hepatic fat in adolescents with PCOS. We hypothesized that postprandial fat metabolism would be altered compared to controls with obesity. Design/Methodology Data from 133 girls aged 13-21 years with obesity (BMI >90th%ile) enrolled in 1 of 4 cross-sectional metabolic studies were included in this secondary analysis. PCOS was determined per NIH diagnostic standards. Controls had regular menses and were >1-year post-menarche. Metabolic assessments were identical across studies and included fasting labs (lipid panel, inflammatory markers, androgens, insulin sensitivity indices), 4-hour oral sugar tolerance test (OSTT, 75 grams glucose, 25 grams fructose), liver fat by MRI, and body composition by DXA. Glycerol production (Ra) D5 glycerol infusion to measure lipolysis was evaluated in a subset. Metrics of glucose, insulin, glycerol, free fatty acid (FFA), and glucagon during the OSTT were calculated including AUC, fasting, nadir, and peak. Adipo IR (fasting FAA x fasting insulin) was determined. Data between controls and girls with PCOS were compared by Student's t-tests with Welch correction. Spearman's correlations were used within groups to evaluate associations. Results Participants included 110 girls with PCOS (age 16.4±1.6 years; BMI 35.9±5.8 kg/m2) and 23 without PCOS (15.9±1.6; 34.6±6.7). Per design, markers of androgen excess including total testosterone (p Conclusions Adolescents with PCOS and obesity have increased adipose IR. Future focus and treatment of adipose IR may be a promising avenue to delay onset of metabolic syndrome complications in girls with PCOS and obesity. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

Published
2022

11. A Novel Intronic Pathogenic Variant in STAR With a Dominant Negative Mechanism Causes Attenuated Lipoid Congenital Adrenal Hyperplasia

Author

Fang Xu, Michele Rapp, Kimberly A. Kripps, Christina D. Chambers, Austin Larson, Erin Finn, Naomi Meeks, Natalie J. Nokoff, and Wuyan Chen

Subjects
0301 basic medicine, Medicine (General), medicine.medical_specialty, Epidemiology, Lipoid congenital adrenal hyperplasia, 030209 endocrinology & metabolism, Primary Adrenal Insufficiency, Pathogenesis, 03 medical and health sciences, chemistry.chemical_compound, R5-920, 0302 clinical medicine, Internal medicine, Scrotum, Pathology, medicine, RB1-214, Sex organ, Safety, Risk, Reliability and Quality, Aldosterone, business.industry, Neonatal hypoglycemia, medicine.disease, Phenotype, 030104 developmental biology, medicine.anatomical_structure, Endocrinology, chemistry, business, Safety Research
Abstract

Lipoid congenital adrenal hyperplasia (LCAH) is typically inherited as an autosomal recessive condition. There are 3 reports of individuals with a dominantly acting heterozygous variant leading to a clinically significant phenotype. We report a 46,XY child with a novel heterozygous intronic variant in STAR resulting in LCAH with an attenuated genital phenotype. The patient presented with neonatal hypoglycemia and had descended testes with a fused scrotum and small phallus. Evaluation revealed primary adrenal insufficiency with deficiencies of cortisol, aldosterone, and androgens. He was found to have a de novo heterozygous novel variant in STAR: c.65-2A>C. We report a case of a novel variant and review of other dominant mutations at the same position in the literature. Clinicians should be aware of the possibility of attenuated genital phenotypes of LCAH and the contribution of de novo variants in STAR at c.65-2 to the pathogenesis of that phenotype.

Published
2021

12. Development Of A Low-Level Ar 39 Calibration Standard Quantified By Absolute Gas Counting Measurements

Author

Richard M Williams, Craig E Aalseth, Jill M Brandenberger, Anthony R Day, Erin Finn, Erin S Fuller, Eric W Hoppe, Paul H Humble, Martin E Keillor, Emily K Mace, Allan W Myers, Cory T Overman, Mark E Panisko, Allen Seifert, and Signe K White

Abstract

Argon-39 is an attractive environmental radiotracer for monitoring phenomena related to ground-water transport. With a half-life of 269 years, 39Ar provides continuity and overlap with other more commonly used radiotracers such as 3H and 14C. The age of a water sample is determined by comparing the 39Ar specific activity of the gas separated from ground- water with equilibrium 39Ar atmospheric levels (1.01 Bq/kg-ArNAT or 1.80×10−6 Bq/cc-ArSTP ). Such measurements require the use of low-level gas counting techniques which have been calibrated using well characterized 39Ar standards. This presentation describes the generation of 39Ar, via reactor irradiation of potassium carbonate, followed by quantitative analysis, based on length-compensated proportional counting, to yield standards that are approximately 60 and 3 times atmospheric background levels of 39Ar. Multiple measurements of the 60× standard, at various pressures, were performed in Pacific Northwest National Laboratory’s shallow underground counting laboratory in order to study the effect of gas density on beta-transport within the counters. In order to estimate the specific activity of the standard from measurements based on length-compensated proportional counting it is necessary to account for disintegrations that do not deposit sufficient energy in the counter to register above threshold. These losses are commonly referred to as the so-called Wall-Effect (betas reaching the wall before depositing sufficient energy for detection) and Threshold-Effect (total deposited energy below detection threshold). For this study both the Wall- and Threshold-Effect have been estimated using Monte-Carlo simulations and applied to the experimental measurements. An uncertainty model of the measurements and data analysis has been developed in accordance to the Guide to the Expression of Uncertainty in Measurements (GUM). The most challenging source of uncertainty to quantify is that from the Monte-Carlo simulations. The total expanded uncertainty (K=2) result for the 60×-background 39Ar standard, less any uncertainty contribution from the Monte-Carlo simulation, is 1.3% (approximately 95% confidence). Efforts to estimate the magnitude of the uncertainty from the simulation are discussed along with future directions for improved simulations. This presentation was used for the Low-Radioactivity Underground Argon Workshop held at Pacific Northwest National Laboratory in Richland, Washingtonon March 19 - 20, 2018.

Published
2018
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13. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Author

Aaron Nauth, Aaron T. Creek, Abby Zellar, Abdel-Rahman Lawendy, Adam Dowrick, Ajay Gupta, Akhil Dadi, Albert van Kampen, Albert Yee, Alexander C. de Vries, Alexander de Mol van Otterloo, Alisha Garibaldi, Allen Liew, Allison W. McIntyre, Amal Shankar Prasad, Amanda W. Romero, Amar Rangan, Amber Oatt, Amir Sanghavi, Amy L. Foley, Anders Karlsten, Andrea Dolenc, Andrew Bucknill, Andrew Chia, Andrew Evans, Andrew Gong, Andrew H. Schmidt, Andrew J. Marcantonio, Andrew Jennings, Angela Ward, Angshuman Khanna, Anil Rai, Anke B. Smits, Annamarie D. Horan, Anne Christine Brekke, Annette Flynn, Aravin Duraikannan, Are Stødle, Arie B. van Vugt, Arlene Luther, Arthur W. Zurcher, Arvind Jain, Asgeir Amundsen, Ash Moaveni, Ashley Carr, Ateet Sharma, Austin D. Hill, Axel Trommer, B. Sachidananda Rai, Barbara Hileman, Bart Schreurs, Bart Verhoeven, Benjamin B. Barden, Bernhard Flatøy, Berry I. Cleffken, Berthe Bøe, Bertrand Perey, Birgit C. Hanusch, Brad Weening, Bram Fioole, Bram Rijbroek, Brett D. Crist, Brett Halliday, Brett Peterson, Brian Mullis, C. Glen Richardson, Callum Clark, Carlos A. Sagebien, Carmen C. van der Pol, Carol Bowler, Catherine A. Humphrey, Catherine Coady, Cees L. Koppert, Chad Coles, Chadi Tannoury, Charles J. DePaolo, Chris Gayton, Chris Herriott, Christina Reeves, Christina Tieszer, Christine Dobb, Christopher G. Anderson, Claire Sage, Claudine Cuento, Clifford B. Jones, Coks H.R. Bosman, Colleen Linehan, Cor P. van der Hart, Corey Henderson, Courtland G. Lewis, Craig A. Davis, Craig Donohue, Cyril Mauffrey, D.C. Sundaresh, Dana J. Farrell, Daniel B. Whelan, Daniel Horwitz, Daniel Stinner, Darius Viskontas, Darren M. Roffey, David Alexander, David E. Karges, David Hak, David Johnston, David Love, David M. Wright, David P. Zamorano, David R. Goetz, David Sanders, David Stephen, David Yen, Davide Bardana, Davy J Olakkengil, Deanna Lawson, Deborah Maddock, Debra L. Sietsema, Deeba Pourmand, Dennis Den Hartog, Derek Donegan, Diane Heels-Ansdell, Diane Nam, Dominic Inman, Dory Boyer, Doug Li, Douglas Gibula, Dustin M. Price, Dylan J. Watson, E. Mark Hammerberg, Edward T.C.H. Tan, Eelco J.R. de Graaf, Elise Berg Vesterhus, Elizabeth Roper, Elton Edwards, Emil H. Schemitsch, Eric R. Hammacher, Eric R. Henderson, Erica Whatley, Erick T. Torres, Erik G.J. Vermeulen, Erin Finn, Esther M.M. Van Lieshout, Eugene K. Wai, Evan R. Bannister, Evelyn Kile, Evert B.M. Theunissen, Ewan D. Ritchie, Farah Khan, Farhad Moola, Fiona Howells, Frank de Nies, Frank H.W.M. van der Heijden, Frank R.A.J. de Meulemeester, Frede Frihagen, Fredrik Nilsen, G. Ben Schmidt, G.H. Robert Albers, Garland K. Gudger, Garth Johnson, Gary Gruen, Gary Zohman, Gaurav Sharma, Gavin Wood, Geert W.M. Tetteroo, Geir Hjorthaug, Geir Jomaas, Geoff Donald, Geoffrey Ryan Rieser, Gerald Reardon, Gerard P. Slobogean, Gert R Roukema, Gijs A. Visser, Gilbert Moatshe, Gillian Horner, Glynis Rose, Gordon Guyatt, Graham Chuter, Greg Etherington, Gregory J. Della Rocca, Guri Ekås, Gwendolyn Dobbin, H. Michael Lemke, Hamish Curry, Han Boxma, Hannah Gissel, Hans Kreder, Hans Kuiken, Hans L.F. Brom, Hans-Christoph Pape, Harm M van der Vis, Harvinder Bedi, Heather A. Vallier, Heather Brien, Heather Silva, Heike Newman, Helena Viveiros, Henk van der Hoeven, Henry Ahn, Herman Johal, Herman Rijna, Heyn Stockmann, Hong A. Josaputra, Hope Carlisle, Igor van der Brand, Imro Dawson, Ivan Tarkin, Ivan Wong, J. Andrew Parr, J. Andrew Trenholm, J. Carel Goslings, J. David Amirault, J. Scott Broderick, Jaap P. Snellen, Jacco A.C. Zijl, Jaimo Ahn, James Ficke, James Irrgang, James Powell, James R. Ringler, James Shaer, James T. Monica, Jan Biert, Jan Bosma, Jan Egil Brattgjerd, Jan Paul M. Frölke, Jan Wille, Janakiraman Rajakumar, Jane E. Walker, Janell K. Baker, Janos P. Ertl, Jean Paul P.M. de Vries, Jean W.M. Gardeniers, Jedediah May, Jeff Yach, Jennifer T. Hidy, Jerald R. Westberg, Jeremy A. Hall, Jeroen van Mulken, Jessica Cooper McBeth, Jochem Hoogendoorn, Jodi M. Hoffman, Joe Joseph Cherian, John A. Tanksley, John Clarke-Jenssen, John D. Adams, John Esterhai, John F. Tilzey, John Murnaghan, John P. Ketz, John S. Garfi, John Schwappach, John T. Gorczyca, John Wyrick, Jonas Rydinge, Jonathan L. Foret, Jonathan M. Gross, Jonathan P. Keeve, Joost Meijer, Joris J.G. Scheepers, Joseph Baele, Joseph O'Neil, Joseph R. Cass, Joseph R. Hsu, Jules Dumais, Julia Lee, Julie A. Switzer, Julie Agel, Justin E. Richards, Justin W. Langan, Kahn Turckan, Kaili Pecorella, Kamal Rai, Kamran Aurang, Karl Shively, Karlijn van Wessem, Karyn Moon, Kate Eke, Katie Erwin, Katrine Milner, Kees Jan Ponsen, Kelli Mills, Kelly Apostle, Kelly Johnston, Kelly Trask, Kent Strohecker, Kenya Stringfellow, Kevin K. Kruse, Kevin Tetsworth, Khalis Mitchell, Kieran Browner, Kim Hemlock, Kimberly Carcary, Knut Jørgen Haug, Krista Noble, Kristin Robbins, Krystal Payton, Kyle J. Jeray, L. Joseph Rubino, Lauren A. Nastoff, Lauren C. Leffler, Laurents P.S. Stassen, Lawrence K. O'Malley, Lawrence M. Specht, Lehana Thabane, Leo M.G. Geeraedts, Leslie E. Shell, Linda K. Anderson, Linda S. Eickhoff, Lindsey Lyle, Lindsey Pilling, Lisa Buckingham, Lisa K. Cannada, Lisa M. Wild, Liz Dulaney-Cripe, Lodewijk M.S.J. Poelhekke, Lonneke Govaert, Lu Ton, Lucksy Kottam, Luke P.H. Leenen, Lydia Clipper, Lyle T. Jackson, Lynne Hampton, Maarten C. de Waal Malefijt, Maarten P. Simons, Maarten van der Elst, Maarten W.G.A. Bronkhorst, Mahesh Bhatia, Marc Swiontkowski, Margaret J. Lobo, Marilyn Swinton, Marinis Pirpiris, Marius Molund, Mark Gichuru, Mark Glazebrook, Mark Harrison, Mark Jenkins, Mark MacLeod, Mark R. de Vries, Mark S. Butler, Markku Nousiainen, Martijne van 't Riet, Martin C. Tynan, Martin Campo, Martin G. Eversdijk, Martin J. Heetveld, Martin Richardson, Mary Breslin, Mary Fan, Matt Edison, Matthew Napierala, Matthias Knobe, Matthias Russ, Mauri Zomar, Maurits de Brauw, Max Esser, Meghan Hurley, Melissa E. Peters, Melissa Lorenzo, Mengnai Li, Michael Archdeacon, Michael Biddulph, Michael Charlton, Michael D. McDonald, Michael D. McKee, Michael Dunbar, Michael E. Torchia, Michael Gross, Michael Hewitt, Michael Holt, Michael J. Prayson, Michael J.R. Edwards, Michael L. Beckish, Michael L. Brennan, Michael P. Dohm, Michael S.H. Kain, Michelle Vogt, Michelle Yu, Michiel H.J. Verhofstad, Michiel J.M. Segers, Michiel P.C. Siroen, Mike Reed, Milena R. Vicente, Milko M.M. Bruijninckx, Mittal Trivedi, Mohit Bhandari, Molly M. Moore, Monica Kunz, Morten Smedsrud, Naveen Palla, Neeraj Jain, Nico J.M. Out, Nicole Simunovic, Niels W.L. Schep, Oliver Müller, Onno R. Guicherit, Oscar J.F. Van Waes, Otis Wang, Pascal G. Doornebosch, Patricia Seuffert, Patrick J. Hesketh, Patrick Weinrauch, Paul Duffy, Paul Keller, Paul M. Lafferty, Paul Pincus, Paul Tornetta, Paul Zalzal, Paula McKay, Peter A. Cole, Peter D. de Rooij, Peter Hull, Peter M.N.Y.M. Go, Peter Patka, Peter Siska, Peter Weingarten, Philip Kregor, Philip Stahel, Philip Stull, Philippe Wittich, Piet A.R. de Rijcke, Pim Oprel, PJ Devereaux, Qi Zhou, R. Lee Murphy, Rachel Alosky, Rachel Clarkson, Raely Moon, Rajanikanth Logishetty, Rajesh Nanda, Raymond J. Sullivan, Rebecca G. Snider, Richard E. Buckley, Richard Iorio, Richard J Farrugia, Richard Jenkinson, Richard Laughlin, Richard P.R. Groenendijk, Richard W. Gurich, Ripley Worman, Rob Silvis, Robert Haverlag, Robert J. Teasdall, Robert Korley, Robert McCormack, Robert Probe, Robert V. Cantu, Roger B. Huff, Rogier K.J. Simmermacher, Rolf Peters, Roman Pfeifer, Ronald Liem, Ronald N. Wessel, Ronald Verhagen, Ronald Vuylsteke, Ross Leighton, Ross McKercher, Rudolf W. Poolman, Russell Miller, Ryan Bicknell, Ryan Finnan, Ryan M. Khan, Samir Mehta, Sandy Vang, Sanjay Singh, Sanjeev Anand, Sarah A. Anderson, Sarah A. Dawson, Scott B. Marston, Scott E. Porter, Scott T. Watson, Sebastiaan Festen, Shane Lieberman, Shannon Puloski, Shea A. Bielby, Sheila Sprague, Shelley Hess, Shelley MacDonald, Simone Evans, Sofia Bzovsky, Sondre Hasselund, Sophie Lewis, Stein Ugland, Stephanie Caminiti, Stephanie L. Tanner, Stephanie M. Zielinski, Stephanie Shepard, Stephen A. Sems, Stephen D. Walter, Stephen Doig, Stephen H. Finley, Stephen Kates, Stephen Lindenbaum, Stephen P. Kingwell, Steve Csongvay, Steve Papp, Steven E. Buijk, Steven J. Rhemrev, Steven M. Hollenbeck, Steven M. van Gaalen, Steven Yang, Stuart Weinerman, null Subash, Sue Lambert, Susan Liew, Sven A.G. Meylaerts, Taco J. Blokhuis, Tammo S. de Vries Reilingh, Tarjei Lona, Taryn Scott, Teresa K. Swenson, Terrence J. Endres, Terry Axelrod, Teun van Egmond, Thomas B. Pace, Thomas Kibsgård, Thomas M. Schaller, Thuan V. Ly, Timothy J. Miller, Timothy Weber, Toan Le, Todd M. Oliver, Tom M. Karsten, Tor Borch, Tor Magne Hoseth, Tor Nicolaisen, Torben Ianssen, Tori Rutherford, Tracy Nanney, Trevor Gervais, Trevor Stone, Tyson Schrickel, Tyson Scrabeck, Utsav Ganguly, V. Naumetz, Valda Frizzell, Veronica Wadey, Vicki Jones, Victoria Avram, Vimlesh Mishra, Vineet Yadav, Vinod Arora, Vivek Tyagi, Vivian Borsella, W. Jaap Willems, W.H. Hoffman, Wade T. Gofton, Wesley G. Lackey, Wesley Ghent, William Obremskey, William Oxner, William W. Cross, Yvonne M. Murtha, Zoe Murdoch, and Surgery

Subjects
Male, Bone Screws, Avascular necrosis, Kaplan-Meier Estimate, law.invention, Fracture Fixation, Internal, 0302 clinical medicine, Randomized controlled trial, Femur Head Necrosis, law, Fracture Fixation, Fracture fixation, Medicine and Health Sciences, 80 and over, Single-Blind Method, 030212 general & internal medicine, Non-U.S. Gov't, Aged, 80 and over, Fracture Healing, 030222 orthopedics, Hip fracture, Research Support, Non-U.S. Gov't, Hazard ratio, General Medicine, Equipment Design, Femur Head Necrosis/etiology, 3. Good health, Pulmonary embolism, Multicenter Study, Treatment Outcome, Randomized Controlled Trial, Fracture Fixation, Internal/adverse effects, Female, Reoperation, musculoskeletal diseases, medicine.medical_specialty, Femoral Neck Fractures/surgery, Internal/adverse effects, Bone healing, Research Support, N.I.H, 03 medical and health sciences, Research Support, N.I.H., Extramural, medicine, Journal Article, Humans, Adverse effect, Aged, business.industry, Extramural, medicine.disease, Femoral Neck Fractures, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Reoperation/statistics & numerical data, Quality of Life, business
Abstract

© 2017 Elsevier Ltd Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [

Published
2017

14. Reliability, Validity, and Responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index for Elderly Patients with a Femoral Neck Fracture

Author

Paul T.P.W. Burgers, Rudolf W Poolman, Theodorus MJ Van Bakel, Wim E Tuinebreijer, Stephanie M Zielinski, Mohit Bhandari, Peter Patka, Esther MM Van Lieshout, P J Devereaux, Gordon H Guyatt, Thomas A Einhorn, Lehana Thabane, Emil H Schemitsch, Kenneth J Koval, Frede Frihagen, Kevin Tetsworth, Ernesto Guerra-Farfan, Stephen D Walter, Sheila Sprague, Marilyn Swinton, Taryn Scott, Paula McKay, Kim Madden, Diane Heels-Ansdell, Lisa Buckingham, Aravin Duraikannan, Heather Silva, Martin J Heetveld, Robert D Zura, Victoria Avram, Ajay Manjoo, Dale Williams, John Antoniou, Tim Ramsay, Earl R Bogoch, Andrew Trenholm, Stephen Lyman, Madhu Mazumdar, Kevin J Bozic, Mark Luborsky, Stuart Goodman, Susan Muray, Rob Korley, Richard Buckley, Paul Duffy, Shannon Puloski, Kimberly Carcary, Melissa Lorenzo, Michael D McKee, Jeremy A Hall, Aaron Nauth, Daniel Whelan, Timothy R Daniels, James P Waddell, Henry Ahn, Milena R Vicente, Jennifer T Hidy, Melanie T MacNevin, Hans Kreder, Terry Axelrod, Richard Jenkinson, Markku Nousiainen, David Stephen, Veronica Wadey, Monica Kunz, Katrine Milner, Ria Cagaanan, Melanie MacNevin, Peter J O’Brien, Piotr A Blachut, Henry M Broekhuyse, Pierre Guy, Kelly A Lefaivre, Gerard P Slobogean, Raman Johal, Irene Leung, Chad Coles, Ross Leighton, C. Glen Richardson, Michael Biddulph, Michael Gross, Michael Dunbar, J. David Amirault, David Alexander, Catherine Coady, Mark Glazebrook, David Johnston, William Oxner, Gerald Reardon, Ivan Wong, Kelly Trask, Shelley MacDonald, Andrew Furey, Craig Stone, Minnie Parsons, Trevor Stone, Mauri Zomar, Robert McCormack, Kelly Apostle, Dory Boyer, Farhad Moola, Bertrand Perey, Darius Viskontas, Karyn Moon, Raely Moon, Yves Laflamme, Benoit Benoit, Pierre Ranger, Michel Malo, Julio Fernandes, Karine Tardif, Julie Fournier, Pascal André Vendittoli, Vincent Massé, Alain G Roy, Martin Lavigne, Daniel Lusignan, Craig Davis, Philip Stull, Stewart Weinerman, Peter Weingarten, Steven Lindenbaum, Michael Hewitt, Rebecca Danielwicz, Janell Baker, Michael Mont, Donald E Delanois, Bhaveen Kapadia, Kimona Issa, Marylou Mullen, Andrew Sems, Barb Foreman, Javad Parvizi, Tiffany Morrison, Courtland Lewis, Stephanie Caminiti, Paul Tornetta, William R Creevy, Michelle J Lespasio, Hope Carlisle, Andrew Marcantonio, Michael Kain, Lawrence Specht, John Tilzey, John Garfi, Samir Mehta, John L Esterhai, Jaimo Ahn, Derek Donegan, Annamarie Horan, Kelly McGinnis, James Roberson, Thomas Bradbury, Greg Erens, Kyle Webb, Brian Mullis, Karl Shively, Andrew Parr, Janos Ertl, Ripley Worman, Mark Webster, Judd Cummings, Valda Frizzell, Molly Moore, Clifford B Jones, James R Ringler, Debra L Sietsema, Jane E Walker, Enes Kanlic, Amr Abdelgawad, Juan Shunia, Charles DePaolo, Susan Sutherland, Rachel Alosky, Robert Zura, Maria Manson, Gregg Strathy, Kathleen Peter, Paul Johnson, Meaghan Morton, James Shaer, Tyson Schrickel, Barbara Hileman, Marina Hanes, Elisha Chance, E. Matthew Heinrich, David Dodgin, Michele LaBadie, David Zamorano, Martin Tynan, Ran Schwarzkopf, John A Scolaro, Ranjan Gupta, Samuel Bederman, Nitin Bhatia, Bang Hoang, Douglas Kiester, Neil Jones, Gregory Rafijah, Damon Alavekios, Jason Lee, Akshay Mehta, Steven Schroder, Tom Chao, Vincent Colin, Phuc (Phil) Dang, Stephen Keun Heng, Gregory Lopez, Samuel Galle, Sohrab Pahlavan, Duy L Phan, Minal Tapadia, Christopher Bui, Nickul Jain, Tyler Moore, Nathan Moroski, Deeba Pourmand, Erik N Kubiak, Jeremy Gililland, David Rothberg, Christopher Peters, Christopher Pelt, Ami R Stuart, Kirby Corbey, Franklin D Shuler, James Day, Tigran Garabekyan, Felix Cheung, Ali Oliashirazi, Jonathon Salava, Linda Morgan, Timothy Wilson-Byrne, Mary Beth Cordle, Leon H.G.J. Elmans, Joost A.A.M. van den Hout, Adrianus JP Joosten, Ad FA van Beurden, Stefan BT Bolder, Denise Eygendaal, Adrianus F.C.M. Moonen, Rutger CI van Geenen, Eric A Hoebink, Robert Wagenmakers, Wouter van Helden, Hans-Peter W van Jonbergen, Herbert Roerdink, Joost M Reuver, Alexander FW Barnaart, Elvira R Flikweert, Rover Krips, J. Bernard Mullers, Hans Schüller, Mark LM Falke, Frans J Kurek, Adrianus CH Slingerland, Jan P van Dijk, Wouter H van Helden, Hugo W Bolhuis, Pieter HJ Bullens, Mike Hogervorst, Karin E de Kroon, Rob H Jansen, Ferry Steenstra, Eric EJ Raven, W. Peter J Fontijne, Saskia C Wiersma, Bastiaan Boetes, Edgar JT ten Holder, Huub JL van der Heide, Jochem Nagels, Enrike H.M.J. van der Linden-van der Zwaag, Stefan B Keizer, Jan-Willem A Swen, Peter HC den Hollander, Bregje JW Thomassen, Willem Jan Kleyn Molekamp, Frank R.A.J. de Meulemeester, Arthur EB Kleipool, Robert Haverlag, Maarten P Simons, Eduard L.A.R. Mutsaerts, Rob Kooijman, Roelf R Postema, René J.T.M. Bleker, Harald IH Lampe, Lein Schuman, John Cheung, Frank van Bommel, W. Paul Winia, Daniel Haverkamp, Harm van der Vis, Peter A Nolte, Michel PJ van den Bekerom, Tjitte de Jong, Arthur van Noort, Diederik A Vergroesen, Bernard G Schutte, Harm M van der Vis, Lijkele Beimers, Jasper de Vries, Arthur W Zurcher, G.H. Rob Albers, Maarten Rademakers, Stefan Breugem, Ibo van der Haven, Pieter Jan Damen, Gythe H Bulstra, Martin M Campo, Mathijs P Somford, Daniël Haverkamp, Susan Liew, Harvinder Bedi, Ashley Carr, Andrew Chia, Steve Csongvay, Craig Donohue, Stephen Doig, Elton Edwards, Max Esser, Richard Freeman, Andrew Gong, Doug Li, Russell Miller, Lu Ton, Otis Wang, Ian Young, Adam Dowrick, Zoe Murdoch, Claire Sage, Richard Page, David Bainbridge, Richard Angliss, Ben Miller, Andrew Thomson, Graeme Brown, Simon Williams, Kevin Eng, David Bowyer, John Skelley, Chatar Goyal, Sally Beattie, Enrique Guerado, Encarnacion Cruz, Juan Ramon Cano, Miguel Angel Froufe, Lluis Marull Serra, Samer Al-dirra, Cristina Martinez, Francisco José Tarazona Santabalbina, Jordi Teixidor Serra, Jordi Tomas Hernandez, Marc Aguilar Garcia, Vicente Molero Garcia, Sergi Barrera, Miriam Garrido, Lars Nordsletten, John Clarke-Jenssen, Geir Hjorthaug, Anne Christine Brekke, Elise Berg Vesterhus, Ingunn Skaugrud, Pradeep Tripathi, Sandesh Katiyar, Preksha Shukla, Marc Swiontkowski, Gordon Guyatt, Kyle Jeray, Stephen Walter, Helena Viveiros, Victoria Truong, Kaitlin Koo, Qi Zhou, Deborah Maddock, Nicole Simunovic, Julie Agel, Amar Rangan, Birgit C Hanusch, Lucksy Kottam, Rachel Clarkson, Gregory J Della Rocca, Gerard Slobogean, Jeffrey Katz, Brenda Gillespie, Gail A Greendale, Curtis Hartman, Craig Rubin, James Waddell, H. Michael Lemke, Amber Oatt, Richard E Buckley, Robert Korley, Kelly Johnston, James Powell, David Sanders, Abdel Lawendy, Christina Tieszer, John Murnaghan, Diane Nam, Albert Yee, Daniel B Whelan, Lisa M Wild, Ryan M Khan, Cathy Coady, David Amirault, Glen Richardson, Gwen Dobbin, Ryan Bicknell, Jeff Yach, Davide Bardana, Gavin Wood, Mark Harrison, David Yen, Sue Lambert, Fiona Howells, Angela Ward, Paul Zalzal, Heather Brien, V Naumetz, Brad Weening, Eugene K Wai, Steve Papp, Wade T Gofton, Stephen P Kingwell, Garth Johnson, Joseph O’Neil, Darren M Roffey, Vivian Borsella, Todd M Oliver, Vicki Jones, Terrence J Endres, Samuel G Agnew, Kyle J Jeray, J. Scott Broderick, David R Goetz, Thomas B Pace, Thomas M Schaller, Scott E Porter, Stephanie L Tanner, Rebecca G Snider, Lauren A Nastoff, Shea A Bielby, Julie A Switzer, Peter A Cole, Sarah A Anderson, Paul M Lafferty, Mengnai Li, Thuan V Ly, Scott B Marston, Amy L Foley, Sandy Vang, David M Wright, Andrew J Marcantonio, Michael SH Kain, Richard Iorio, Lawrence M Specht, John F Tilzey, Margaret J Lobo, John S Garfi, Heather A Vallier, Andrea Dolenc, Chalitha Robinson, Michael J Prayson, Richard Laughlin, L. Joseph Rubino, Jedediah May, Geoffrey Ryan Rieser, Liz Dulaney-Cripe, Chris Gayton, John T Gorczyca, Jonathan M Gross, Catherine A Humphrey, Stephen Kates, Krista Noble, Allison W McIntyre, Kaili Pecorella, Craig A Davis, Stephen Lindenbaum, John Schwappach, Janell K Baker, Tori Rutherford, Heike Newman, Shane Lieberman, Erin Finn, Kristin Robbins, Meghan Hurley, Lindsey Lyle, Khalis Mitchell, Kieran Browner, Erica Whatley, Krystal Payton, Christina Reeves, Lisa K Cannada, David Karges, Leslie Hill, John Esterhai, Annamarie D Horan, Christine A Kaminski, Brynn N Kowalski, Jonathan P Keeve, Christopher G Anderson, Michael D McDonald, Jodi M Hoffman, Ivan Tarkin, Peter Siska, Gary Gruen, Andrew Evans, Dana J Farrell, James Irrgang, Arlene Luther, William W Cross, Joseph R Cass, Stephen A Sems, Michael E Torchia, Tyson Scrabeck, Mark Jenkins, Jules Dumais, Amanda W Romero, Carlos A Sagebien, Mark S Butler, James T Monica, Patricia Seuffert, Joseph R Hsu, James Ficke, Michael Charlton, Matthew Napierala, Mary Fan, Chadi Tannoury, Michael Archdeacon, Ryan Finnan, Toan Le, John Wyrick, Shelley Hess, Michael L Brennan, Robert Probe, Evelyn Kile, Kelli Mills, Lydia Clipper, Michelle Yu, Katie Erwin, Daniel Horwitz, Kent Strohecker, Teresa K Swenson, Andrew H Schmidt, Jerald R Westberg, Kamran Aurang, Gary Zohman, Brett Peterson, Roger B Huff, Joseph Baele, Timothy Weber, Matt Edison, Jessica McBeth, Janos P Ertl, J. Andrew Parr, Molly M Moore, Erin Tobias, Emily Thomas, Charles J DePaolo, Leslie E Shell, Lynne Hampton, Stephanie Shepard, Tracy Nanney, Claudine Cuento, Robert V Cantu, Eric R Henderson, Linda S Eickhoff, E. Mark Hammerberg, Philip Stahel, David Hak, Cyril Mauffrey, Douglas Gibula, Hannah Gissel, Corey Henderson, David P Zamorano, Martin C Tynan, Deanna Lawson, Brett D Crist, Yvonne M Murtha, Linda K Anderson, Colleen Linehan, Lindsey Pilling, Courtland G Lewis, Raymond J Sullivan, Elizabeth Roper, William Obremskey, Philip Kregor, Justin E Richards, Kenya Stringfellow, Michael P Dohm, Abby Zellar, Michiel JM Segers, Jacco AC Zijl, Bart Verhoeven, Anke B Smits, Jean Paul PM de Vries, Bram Fioole, Henk van der Hoeven, Evert BM Theunissen, Tammo S de Vries Reilingh, Lonneke Govaert, Philippe Wittich, Maurits de Brauw, Jan Wille, Peter M.N.Y.M. Go, Ewan D Ritchie, Ronald N Wessel, Eric R Hammacher, Gijs A Visser, Heyn Stockmann, Rob Silvis, Jaap P Snellen, Bram Rijbroek, Joris JG Scheepers, Erik GJ Vermeulen, Michiel PC Siroen, Ronald Vuylsteke, Hans LF Brom, Herman Rijna, Piet AR de Rijcke, Cees L Koppert, Steven E Buijk, Richard PR Groenendijk, Imro Dawson, Geert WM Tetteroo, Milko MM Bruijninckx, Pascal G Doornebosch, Eelco JR de Graaf, Maarten van der Elst, Carmen C van der Pol, Martijne van’t Riet, Tom M Karsten, Mark R de Vries, Laurents PS Stassen, Niels WL Schep, G Ben Schmidt, W H Hoffman, Frank H.W.M. van der Heijden, W. Jaap Willems, Cor P van der Hart, Kahn Turckan, Sebastiaan Festen, Frank de Nies, Nico JM Out, Jan Bosma, Albert van Kampen, Jan Biert, Arie B van Vugt, Michael JR Edwards, Taco J Blokhuis, Jan Paul M Frölke, Leo MG Geeraedts, Jean WM Gardeniers, Edward T.C.H. Tan, Lodewijk M.S.J. Poelhekke, Maarten C de Waal Malefijt, Bart Schreurs, Gert R Roukema, Hong A Josaputra, Paul Keller, Peter D de Rooij, Hans Kuiken, Han Boxma, Berry I Cleffken, Ronald Liem, Steven J Rhemrev, Coks HR Bosman, Alexander de Mol van Otterloo, Jochem Hoogendoorn, Alexander C de Vries, Sven AG Meylaerts, Michiel HJ Verhofstad, Joost Meijer, Teun van Egmond, Igor van der Brand, Martin G Eversdijk, Rolf Peters, Dennis Den Hartog, Oscar JF Van Waes, Pim Oprel, Martin Campo, Ronald Verhagen, G.H. Robert Albers, Rogier KJ Simmermacher, Jeroen van Mulken, Karlijn van Wessem, Steven M van Gaalen, Luke PH Leenen, Maarten W.G.A. Bronkhorst, Onno R Guicherit, J. Carel Goslings, Kees Jan Ponsen, Mahesh Bhatia, Vinod Arora, Vivek Tyagi, Ajay Gupta, Neeraj Jain, Farah Khan, Ateet Sharma, Amir Sanghavi, Mittal Trivedi, Anil Rai, null Subash, Kamal Rai, Vineet Yadav, Sanjay Singh, Amal Shankar Prasad, Vimlesh Mishra, D C Sundaresh, Angshuman Khanna, Joe Joseph Cherian, Davy J Olakkengil, Gaurav Sharma, Akhil Dadi, Naveen Palla, Utsav Ganguly, B. Sachidananda Rai, Janakiraman Rajakumar, Peter Hull, Sophie Lewis, Simone Evans, Rajesh Nanda, Rajanikanth Logishetty, Sanjeev Anand, Carol Bowler, Andrew Jennings, Graham Chuter, Glynis Rose, Gillian Horner, Callum Clark, Kate Eke, Mike Reed, Chris Herriott, Christine Dobb, Hamish Curry, Greg Etherington, Arvind Jain, Ash Moaveni, Matthias Russ, Geoff Donald, Patrick Weinrauch, Paul Pincus, Steven Yang, Brett Halliday, Trevor Gervais, Michael Holt, Annette Flynn, Marinis Pirpiris, David Love, Andrew Bucknill, Richard J Farrugia, Torben Ianssen, Asgeir Amundsen, Jan Egil Brattgjerd, Tor Borch, Berthe Bøe, Bernhard Flatøy, Sondre Hasselund, Knut Jørgen Haug, Kim Hemlock, Tor Magne Hoseth, Geir Jomaas, Thomas Kibsgård, Tarjei Lona, Gilbert Moatshe, Oliver Müller, Marius Molund, Tor Nicolaisen, Fredrik Nilsen, Jonas Rydinge, Morten Smedsrud, Are Stødle, Axel Trommer, Stein Ugland, Anders Karlsten, Guri Ekås, Hans-Christoph Pape, Matthias Knobe, Roman Pfeifer, Orthopedic Surgery and Sports Medicine, Graduate School, Other departments, Surgery, Other Research, Amsterdam Movement Sciences, Cardiothoracic Surgery, and Emergency Medicine

Subjects
Male, medicine.medical_specialty, WOMAC, Abstracting and Indexing, Osteoarthritis, Cronbach's alpha, Surveys and Questionnaires, medicine, Humans, Orthopedics and Sports Medicine, Clinical significance, Femoral neck, Aged, 80 and over, Ontario, business.industry, Reproducibility of Results, Construct validity, General Medicine, medicine.disease, RELIABILITY VALIDITY, Femoral Neck Fractures, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Clinical trial, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], medicine.anatomical_structure, Physical therapy, Female, Surgery, business
Abstract

Item does not contain fulltext BACKGROUND: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture. METHODS: Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older. RESULTS: The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%). CONCLUSIONS: The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations. CLINICAL RELEVANCE: The results are based on two clinical trials. The questionnaires used concern pure, clinically relevant issues (ability to walk, climb stairs, etc.). Moreover, the results can be used for future research comparing clinical outcomes (or treatments) for populations with a femoral neck fracture.

Published
2015

15. The Status of Blueberry Gall Midge in the Southeastern United States

Author

Erin Finn and Oscar E. Liburd

Subjects
biology, Botany, Midge, Gall, biology.organism_classification
Abstract

This document is ENY-825, one of a series of the Entomology and Nematology Department, Florida Cooperative Extension Service, Institute of Food and Agricultural Sciences, University of Florida. Published: September 2002.

Published
1969

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