Background: There is insufficient knowledge regarding the influence of concomitant injuries on the recovery of short-term subjective knee function after anterior cruciate ligament (ACL) reconstruction. Purpose: To determine whether patient characteristics, concomitant injuries, and graft choice during ACL reconstruction can predict which patients achieve acceptable knee function 1 year after reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: Data from 1 physical therapist–specific and 1 surgeon-specific register were used. Patients who had completed the Knee injury and Osteoarthritis Outcome Score (KOOS) at 1-year follow-up were included. Additional intraoperative information was extracted from a database. The primary outcome was achieving a patient-acceptable symptom state (PASS) for each subscale of the KOOS. Univariable and multivariable logistic regression models were used, with patient sex, age, and preinjury level of physical activity as covariates. Results: A total of 343 patients (51% females) were included. The proportion of patients achieving PASS 1 year after ACL reconstruction varied between 40% and 85% among the KOOS subscales. Younger age at reconstruction and male sex provided favorable odds of achieving acceptable knee function across the KOOS subscales. Patients without cartilage injury had increased odds of achieving PASS in the KOOS sport and recreation subscale; the increase was 1.63-fold (95% CI, 1.01-2.64; P = .045). Patients receiving patellar tendon autograft had a 0.41-fold (95% CI, 0.19-0.85; P = .017) decrease in odds of achieving PASS on the KOOS quality of life (QoL) subscale. In the multivariable analysis, increased odds of achieving PASS on the KOOS QoL subscale were associated with the absence of meniscal injury (odds ratio, 1.62; 95% CI, 1.04-2.54; P = .035), and increased odds were found for hamstring tendon autograft (OR, 2.63; 95% CI, 1.25-5.56; P = .011). Conclusion: More than half of the patients reported an acceptable symptom state on 4 of the 5 KOOS subscales 1 year after ACL reconstruction. A lack of consistency was noted related to the effect of concomitant knee injuries and graft choice on acceptable knee function. However, younger age and male sex were favorable, nonmodifiable characteristics that increased the odds of early acceptable function.
Abstract Background We report a case of isolated metastasis on the anterior clinoid process (ACP) mimicking meningioma. Clinical Presentation A 58-year-old male presented with headaches, right-sided visual disturbances, and blurred and double vision. The cause of double vision was partial weakness of the right III nerve, resulting from compression of the nerve by “hypertrophied” tumor-involved right anterior clinoid. Medical history revealed two primary malignant tumors—male breast cancer and prostate cancer (diagnosed 6 and 18 months prior, respectively). The patient was treated with chemotherapy and showed no signs of active disease, recurrence, or metastasis. Postcontrast head magnetic resonance imaging (MRI) showed extra-axial well-bordered enhancing mass measuring 1.6 × 1.1 × 1 × 1 cm (anteroposterior, transverse, and craniocaudal dimensions) on the ACP, resembling a clinoidal meningioma. Extradural clinoidectomy with tumor resection was performed via right orbitozygomatic pretemporal skull base approach. Visual symptoms improved. Follow-up MRI showed no signs of tumor residual or recurrence. Conclusion This is the first case report of a metastasis of any kind on ACP. Metastasis should be included as a part of the differential diagnosis of lesions of the anterior clinoid. Extradural clinoidectomy is a safe and effective method in the treatment of these tumors.
The article discusses the reception and circulation of programmed instruction at the Universidade Federal de Minas Gerais as an example of the appropriation of behavioral analysis in Brazil and sheds light on part of this appropriation in the 1960s and 1970s in the context of Brazil's higher education reform and of US social and intellectual influence. Results indicate that the indigenization of programmed instruction involved its circulation as an educational resource that emphasized the student's role and his autonomy from the teacher. Sources point to clashes that derived from preconceptions about both the teaching-learning process and US influence, key elements to understand the reception and circulation of programmed instruction in Brazil.
Objective To explore family physicians' attitudes, previous experience and self-assessed preparedness to respond or to assist in mass casualty incidents in Croatia. Methods The cross-sectional survey was carried out during January 2017. Study participants were recruited through a Facebook group that brings together family physicians from Croatia. They were asked to complete the questionnaire, which was distributed via google.docs. Knowledge and attitudes toward disaster preparedness were evaluated by 18 questions. Analysis of variance, Student t test and Kruskal-Wallis test t were used for statistical analysis. Results Risk awareness of disasters was high among respondents (M = 4.89, SD=0.450). Only 16.4 of respondents have participated in the management of disaster at the scene. The majority (73.8%) of physicians have not been participating in any educational activity dealing with disaster over the past two years. Family physicians believed they are not well prepared to participate in national (M = 3.02, SD=0.856) and local community emergency response system for disaster (M = 3.16, SD=1.119). Male physicians scored higher preparedness to participate in national emergency response system for disaster (p=0.012), to carry out accepted triage principles used in the disaster situation (p=0.003) and recognize differences in health assessments indicating potential exposure to specific agents (p=0,001) compared to their female colleagues. Conclusion Croatian primary healthcare system attracts many young physicians, who can be an important part of disaster and emergency management. However, the lack of experience despite a high motivation indicates a need for inclusion of disaster medicine training during undergraduate studies and annual educational activities.
Objective: To determine the incidence of systemic inflammatory response of the organism in surgical patients and its impact on the outcome of treatment. Methods: A prospective study was conducted on 60 patients undergoing abdominal surgical procedures, between January 2014 and December 2015 in the Surgery Clinic at the University Clinical Center Tuzla. Two groups of thirty were formed by the method of consecutive sampling. The first group consisted of subjects who were prepared for elective abdominal surgery (laparoscopic cholecystectomy), and the second group subjects underwent an emergency surgery due to acute abdomen (laparoscopic cholecystectomy). Results The body temperature difference was statistically significant between the two investigated groups in all stages (c2: t0=3,486; t1=3,098; t2=2,453, t: t0=-11,210; t1=-7,360; t2=-4,927, p < 0,05). Non-elective surgery group had a statistical significant difference of the heart rate at all stages (c2: t0=3,873; t1=3,357; t2=3,227, t: t0=-16,524; t1=-10,407; t2=-9,842, p < 0,05). There is a statistically significant difference in the pCO2 values in all stages between groups (c2: t0=2,582; t1=1,678; t2=1,162, t: t0=4,323; t1=2,653; t2=2,229, p < 0,05). The SIRS score has a good positive correlation with the length of treatment, while the correlation with the outcome of treatment has no statistical significance. Conclusion Inflammation scores monitoring in surgical patients is important for the surgical treatment success analysis. By modifying the therapy and influencing the inflammatory response, the results of treatment are improved.
<p style="text-align: justify;">The paper analyzes the behavior of the plastic container during the buckling, ie during the load effect on the containers. The analysis was experimentally performed on several different types of containers. The container material is polypropylene. Experimental determination of pressure force and corresponding deformation was performed in the<br />laboratory at the Faculty of Technical Engineering Bihać. The analysis includes experimental testing on assembled containers and on container side. Places where deformation occurs on the container sides are shown.</p>
<p style="text-align: justify;">This paper deals with the resistance of the shed of a steel hall in Drvar according to technical regulations for snow from 1961 and EC1 regulations. The paper aims to check the reliability of the shed with probabilistic approach. That also implies calibration of the steel hall construction analyzed with classic deterministic method. Statical system of the shed of a steel hall is a beam with a given span, Figure 1. Steel sections are hot rolled INP sections with specified statistic parameters. The length of the beam span is λ = 2,4 m. The reliability indexes have to be analyzed in point 1(relevant statical forces and displacements for ULS and SLS) and according to equations of limit states.</p>
<p style="text-align: justify;">The aim of this paper was to investigate the connection between student motivation and Content and Integrated Language Learning (CLIL) approach at the technically-oriented faculties of the University of Zenica. The past few decades have been marked with ongoing debates on what teaching approaches are most motivating for foreign language learners. It has been agreed upon that student-centered approaches are the most efficient ones. CLIL is one of them. Inherently, CLIL uses foreign language for teaching a particular content, in our case – the engineering one. For the purpose of the research, a questionnaire was conducted among the CLIL students, subsequent to their conference - CLIL 2017, which is the last stage of the CLIL approach to English language teaching at the aforementioned faculties. We hypothesized that the CLIL approach bolsters student<br />motivation for English language learning more than the ex-cathedra approach. The questionnaire proved the hypothesis true as the results indicated high level of motivation in students. In addition, students expressed great satisfaction with the CLIL in terms of its effect on their foreign language proficiency as well as the knowledge in the content matter<br />related to engineering. Also, students seem to be well aware of the fact that good knowledge of English language and good knowledge of engineering content create a solid basis for employment.</p>
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