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joint consensus

Christopher Nacca, Joseph A Gil, Rohit Badida, Joseph J Crisco, Brett D Owens
BACKGROUND: There is currently no consensus regarding the amount of posterior glenoid bone loss that is considered critical. Critical bone loss is defined as the amount of bone loss that occurs in which an isolated labral repair will not sufficiently restore stability. PURPOSE: The purpose is to identify the critical size of the posterior defect. STUDY DESIGN: Controlled laboratory study. METHODS: Eleven cadaveric shoulders were tested...
March 1, 2018: American Journal of Sports Medicine
Anussara Prayongrat, Kikuo Umegaki, Arjen van der Schaaf, Albert C Koong, Steven H Lin, Thomas Whitaker, Todd McNutt, Naruhiro Matsufuji, Edward Graves, Masahiko Mizuta, Kazuhiko Ogawa, Hiroyuki Date, Kensuke Moriwaki, Yoichi M Ito, Keiji Kobashi, Yasuhiro Dekura, Shinichi Shimizu, Hiroki Shirato
Particle beam therapy (PBT), including proton and carbon ion therapy, is an emerging innovative treatment for cancer patients. Due to the high cost of and limited access to treatment, meticulous selection of patients who would benefit most from PBT, when compared with standard X-ray therapy (XRT), is necessary. Due to the cost and labor involved in randomized controlled trials, the model-based approach (MBA) is used as an alternative means of establishing scientific evidence in medicine, and it can be improved continuously...
February 24, 2018: Journal of Radiation Research
Masakatsu Hihara, Takashi Matsushima, Yoshihito Tanaka, Yutaka Ogawa, Natsuko Kakudo, Kenji Kusumoto
Objective: When hands suffer burns, the tendons and digital bones are rarely injured because of the quick withdrawal reflex away from the heat source. Hence, a consensus of opinion regarding the treatment of severe hand burns with osseous blood flow deficiency has not been reached among clinicians. Methods: The patient was a 28-year-old woman whose fingers were accidentally soaked in heated cooking oil (160°C-170°C) for approximately 1 minute. The result was fourth-degree (extending to the tendon) digital burns of the distal end of the proximal interphalangeal joint with blood flow deficiency to the skin, tendon, and bone...
2018: Eplasty
E Laurent, G Gras, J Druon, P Rosset, S Baron, A Le-Louarn, E Rusch, L Bernard, L Grammatico-Guillon
OBJECTIVES: French reference centers for bone and joint infections (BJI) were implemented from 2009 onwards to improve the management of complex BJIs. This study compared BJI burden before and after the implementation of these reference centers. PATIENTS AND METHODS: BJI hospital stays were selected from the 2008 and 2013 national hospital discharge database using a validated algorithm, adding the new complex BJI code created in 2011. Epidemiology and economic burden were assessed...
March 8, 2018: Médecine et Maladies Infectieuses
Jonathan P Wiens, Gary R Goldstein, Mark Andrawis, Mijin Choi, Jennifer W Priebe
STATEMENT OF PROBLEM: Multiple definitions of centric relation (CR) have evolved over time that may have created confusion or impeded understanding. A recent attempt to achieve a singular definition by surveying the members of the Academy of Prosthodontics (AP) did not achieve majority consensus. PURPOSE: The purpose of this study was to identify those aspects or attributes within the existing definitions of CR in which there was agreement or disagreement among the members of the AP...
March 8, 2018: Journal of Prosthetic Dentistry
Michael Owen Kinney, Stephen J Hunt, Ciaran McKenna
INTRODUCTION: Paramedics are increasingly expected to take on wider roles in the management of epilepsy in the community by making nonconveyance decisions after patients have had seizures. Studies have identified barriers to the successful implementation of this clinical role. We sought to determine levels of confidence, training, perceived barriers, and self-identified learning needs and methods to address these needs regarding seizure management. METHODS AND MATERIALS: A questionnaire was developed by consensus and administered to 63 paramedic and prehospital clinicians at various mandatory training days occurring at the central headquarters of the regional ambulance service in Northern Ireland...
March 7, 2018: Epilepsy & Behavior: E&B
Kolja Gelse, Peter Angele, Peter Behrens, Peter Brucker, Jakob Fay, Daniel Günther, Peter Kreuz, Jörg Lützner, Henning Madry, Peter E Müller, Philipp Niemeyer, Geert Pagenstert, Thomas Tischer, Markus Walther, Wolfgang Zinser, Gunter Spahn
BACKGROUND: In clinical practice, there is still no definite treatment algorithm for focal, partial thickness cartilage lesions (grade II - III). It is well-established that debridement (shaving/lavage) of large degenerative cartilage lesions is not recommended, but there is no such recommendation in the case of focal, partial thickness cartilage defects. MATERIALS AND METHODS: The scientific rationale of cartilage shaving and joint lavage was investigated and a systematic analysis was performed of the literature on the clinical effect of cartilage debridement...
March 9, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Amélie Levesque, Thibault Riant, Stéphane Ploteau, Jérôme Rigaud, Jean-Jacques Labat
Background: The evaluation of chronic pelvic and perineal pain (CPP) is often complex. The patient's description of the pain often appears to be disproportionate to the limited findings on physical examination and/or complementary investigations. The concept of central sensitization may allow better understanding and management of patients with CPP. Objective: The aim of this study was to elaborate a clinical evaluation tool designed to simply identify sensitization in pelvic pain...
March 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Peter M Hawkey, Roderic E Warren, David M Livermore, Cliodna A M McNulty, David A Enoch, Jonathan A Otter, A Peter R Wilson
The Working Party makes more than 100 tabulated recommendations in antimicrobial prescribing for the treatment of infections caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) and suggest further research, and algorithms for hospital and community antimicrobial usage in urinary infection. The international definition of MDR is complex, unsatisfactory and hinders the setting and monitoring of improvement programmes. We give a new definition of multiresistance. The background information on the mechanisms, global spread and UK prevalence of antibiotic prescribing and resistance has been systematically reviewed...
March 1, 2018: Journal of Antimicrobial Chemotherapy
Lorenzo Piemonti, Eelco J P de Koning, Thierry Berney, Jon S Odorico, James F Markmann, Peter G Stock, Michael R Rickels
Defined outcomes for beta cell replacement therapy in the treatment of diabetes are critically needed. Progress towards the clinical acceptance of pancreas and islet transplantation has been hampered by the lack of clear definitions of functional and efficacy outcomes, as well as a lack of consistently applied glycaemic control metrics, together with poor alignment with the field of artificial insulin delivery/artificial pancreas development. To address this problem, the International Pancreas & Islet Transplant Association (IPITA) collaborated with the European Pancreas and Islet Transplant Association (EPITA) to develop a consensus for a joint statement on the definition of function and failure of beta cell replacement therapies, which is summarised in this commentary...
March 6, 2018: Diabetologia
Valerio Celentano, Neil Smart, John McGrath, Ronan A Cahill, Antonino Spinelli, Andreas Obermair, Hirotoshi Hasegawa, Pawanindra Lal, Alex M Almoudaris, Charlotte R Hitchins, Gianluca Pellino, Matthew G Browning, Takashi Ishida, Federico Luvisetto, Pinar Cingiloglu, Katherine Gash, Rhiannon Harries, Deena Harji, Francesca Di Candido, Elisa Cassinotti, Frank D McDermott, James E A Berry, Nick J Battersby, Esther Platt, Nicholas J Campain, Barrie D Keeler, Luigi Boni, Sharmila Gupta, John P Griffith, Austin G Acheson, Tom D Cecil, Mark G Coleman
OBJECTIVE: Consensus statement by an international multispecialty trainers and trainees expert committee on guidelines for reporting of educational videos in laparoscopic surgery. SUMMARY OF BACKGROUND DATA: Instructive laparoscopy videos with appropriate exposition could be ideal for initial training in laparoscopic surgery, but there are no guidelines for video annotation or procedural educational and safety evaluation. METHODS: Delphi questionnaire of 45 statements prepared by a steering group and voted on over 2 rounds by committee members using an electronic survey tool...
March 5, 2018: Annals of Surgery
Yanfang Duan, Jing Qian, Kun Chen, Zhuo Zhang
RATIONALE: Pigmented villonodular synovitis (PVNS) is an idiopathic, proliferative disorder lesion of synovial tissue, which is regarded as a benign disease, but has a local invasion. Up to now, these are no consensus about the etiology and pathogenesis of PVNS. Because of the lack of typical clinical features, misdiagnosis and delayed diagnosis are not uncommon, magnetic resonance imaging (MRI) can assist diagnosis and histopathological examination is recognized as the gold standard for the final diagnosis...
January 2018: Medicine (Baltimore)
Takeo Nakayama
 Evidence-based medicine (EBM) can be defined as "the integration of the best research evidence with clinical expertise and a patient's unique values and circumstances". However, even with the best research evidence, many uncertainties can make clinical decisions difficult. As the social requirement of respecting patient values and preferences has been increasingly recognized, shared decision making (SDM) and consensus development between patients and clinicians have attracted attention. SDM is a process by which patients and clinicians make decisions and arrive at a consensus through interactive conversations and communications...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Jon S Patricios, Clare L Ardern, Michael David Hislop, Mark Aubry, Paul Bloomfield, Carolyn Broderick, Patrick Clifton, Ruben J Echemendia, Richard G Ellenbogen, Éanna Cian Falvey, Gordon Ward Fuller, Julie Grand, Dallas Hack, Peter Rex Harcourt, David Hughes, Nathan McGuirk, Willem Meeuwisse, Jeffrey Miller, John T Parsons, Simona Richiger, Allen Sills, Kevin B Moran, Jenny Shute, Martin Raftery
The 2017 Berlin Concussion in Sport Group Consensus Statement provides a global summary of best practice in concussion prevention, diagnosis and management, underpinned by systematic reviews and expert consensus. Due to their different settings and rules, individual sports need to adapt concussion guidelines according to their specific regulatory environment. At the same time, consistent application of the Berlin Consensus Statement's themes across sporting codes is likely to facilitate superior and uniform diagnosis and management, improve concussion education and highlight collaborative research opportunities...
March 2, 2018: British Journal of Sports Medicine
Andreas Plate, Laura Stadler, Reto Sutter, Alexia Anagnostopoulos, Dario Frustaci, Reinhard Zbinden, Sandro F Fucentese, Annelies S Zinkernagel, Patrick O Zingg, Yvonne Achermann
OBJECTIVES: The antimicrobial peptide α-defensin has recently been introduced as potential "single" biomarker with a high sensitivity and specificity for the preoperative diagnosis of periprosthetic joint infections (PJIs). However, most studies assessed the benefits of the test with exclusion of patients with rheumatic diseases. We aimed to evaluate the α-defensin test in a cohort study without exclusion of cases with inflammatory diseases. METHODS: Between June 2016 and June 2017, we prospectively included cases with a suspected PJI and an available lateral flow test α-defensin (Synovasure®) in synovial fluid...
February 26, 2018: Clinical Microbiology and Infection
Nathalia Costa, Manuela L Ferreira, Marita Cross, Joanna Makovey, Paul W Hodges
OBJECTIVE: To systematically review the definitions for "flare" in musculoskeletal conditions, the derivation processes, and validation of definitions for the 12 most burdensome musculoskeletal conditions. METHODS: A literature search was conducted in MEDLINE, EMBASE, CINAHL, AMED, PsycInfo and Lilacs to identify studies that investigated derivation or validation of a flare definition, which we considered as a phrase or group of domains. RESULTS: Reports of derivation of flare definitions were identified for 9/12 musculoskeletal conditions...
January 31, 2018: Seminars in Arthritis and Rheumatism
Rachel Rosen, Yvan Vandenplas, Maartje Singendonk, Michael Cabana, Carlo DiLorenzo, Frederic Gottrand, Sandeep Gupta, Miranda Langendam, Annamaria Staiano, Nikhil Thapar, Neelesh Tipnis, Merit Tabbers
This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) 2009 clinical guidelines for the diagnosis and management of gastroesophageal reflux disease (GERD) in infants and children and is intended to be applied in daily practice and as a basis for clinical trials. Eight clinical questions addressing diagnostic, therapeutic and prognostic topics were formulated...
March 2018: Journal of Pediatric Gastroenterology and Nutrition
Behic Akyuz, Ahmet Veysel Polat, Mesut Ozturk, Kerim Aslan, Leman Tomak, Mustafa Bekir Selcuk
OBJECTIVE: The purpose of this study was to assess the feasibility of 3-T susceptibility-weighted imaging (SWI) for detecting intraarticular hemosiderin accumulation in patients with hemophilia. SUBJECTS AND METHODS: Forty-one joints in 24 patients with hemophilia were imaged with conventional MRI and SWI sequences. Two experienced musculoskeletal radiologists and one general radiologist (reader 3) interpreted the images for hemosiderin accumulation. The final decision was determined in consensus by readers 1 and 2 using both conventional MRI and SWI sequences...
February 22, 2018: AJR. American Journal of Roentgenology
Randy A Taplitz, Erin B Kennedy, Eric J Bow, Jennie Crews, Charise Gleason, Douglas K Hawley, Amelia A Langston, Loretta J Nastoupil, Michelle Rajotte, Kenneth Rolston, Lynne Strasfeld, Christopher R Flowers
Purpose To provide an updated joint ASCO/Infectious Diseases Society of American (IDSA) guideline on outpatient management of fever and neutropenia in patients with cancer. Methods ASCO and IDSA convened an Update Expert Panel and conducted a systematic review of relevant studies. The guideline recommendations were based on the review of evidence by the Expert Panel. Results Six new or updated meta-analyses and six new primary studies were added to the updated systematic review. Recommendations Clinical judgment is recommended when determining which patients are candidates for outpatient management, using clinical criteria or a validated tool such as the Multinational Association of Support Care in Cancer risk index...
February 20, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
A de Koning, J W Schoones, D van der Heijde, F A van Gaalen
Axial spondyloarthritis (axSpA) is a common inflammatory arthritis of the sacroiliac joints and the spine. The best-known and most studied form of axSpA is ankylosing spondylitis. In this review, we provide a brief overview of the pathophysiology of axSpA. In addition, we performed a quantitative text analysis of reviews on the pathogenesis of axSpA published in the last ten years to establish the current consensus in various fields of research into the pathogenesis of axSpA. There appears to be broad consensus on genetic risk factors and the involvement of the immune system in the initiation phase of the disease although little consensus was found on which specific immune cells drive disease...
February 20, 2018: European Journal of Clinical Investigation
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