1.Does Knee Arthroscopy for Treatment of Meniscal Damage with Osteoarthritis Delay Knee Replacement Compared to Physical Therapy Alone?
Ronald A. NAVARRO ; Annette L. ADAMS ; Charles C. LIN ; John FLEMING ; Ivan A. GARCIA ; Janet LEE ; Mary Helen BLACK
Clinics in Orthopedic Surgery 2020;12(3):304-311
Background:
To determine patient factors that lead to treatment of meniscal tears with osteoarthritis (OA) with knee arthroscopy (KA) or physical therapy only (PT-only); and to assess differences in clinical outcomes including the time to knee arthroplasty.
Methods:
Patients aged ≥ 45 years with OA at meniscal tear diagnosis were followed up from the date of surgery (KA) or first PT visit (PT-only) until partial/total knee replacement surgery, death, disenrollment, or end of study. Demographic and clinical characteristics were compared and used to derive propensity scores. A Cox proportional hazards model was used to estimate the risk of knee replacement surgery and greater healthcare utilization associated with KA vs. PT-only.
Results:
Among 7,026 patients (KA, 69%; PT-only, 31%), 27% had partial or total knee replacement surgery during follow-up.PT-only patients were older and more likely to be women and had more comorbidities. After accounting for differences between groups, the cumulative incidence of knee replacement was modestly but significantly higher for those who received KA than those who underwent PT-only (hazard ratio, 1.30; 95% confidence interval, 1.17–1.44; p < 0.001), although there was no significant difference in health service utilization, narcotic medication dispenses, or knee injections after initiating treatment.
Conclusions
For patients with meniscal damage complicated by OA, those who underwent KA were 30% more likely to have partial or total knee replacement surgery at any given time than those who had PT alone.
2.Evaluation of prototype IgA rapid test on diagnosis of early active syphilis
Yan HAN ; Wanhui WEI ; Yueping YIN ; Anderson DAVID ; Hongchun WANG ; Garcia L MARY ; Van HUY ; Xiaoyu ZHU ; Kai CHEN ; Xiangsheng CHEN
Chinese Journal of Dermatology 2018;51(5):372-375
Objective To evaluate the application of Burnet Institute-made prototype IgA rapid test,a kind of point-of-care (POC) testing,in the diagnosis of early syphilis.Methods Totally,455 stored serum samples in the Reference Laboratory of Sexually Transmitted Disease,the Institute of Dermatology were used to evaluate the application of the prototype IgA rapid test (IgA-POC) in the diagnosis of early syphilis.According to resluts of Treponema pallidum hemagglutination assay (TPHA),rapid plasma reagin card test (RPR),and enzyme-linked immunosorbent assay for IgM antibodies (IgM-ELISA),these stored samples were divided into 3 groups:uninfected group,previously infected group and early active syphilis group.IgA-POC test was performed in the 3 groups to evaluate its diagnostic performance for active syphilis,and researchers were blind to the group information.Results The prototype IgA-POC test had a sensitivity of 92.6% (147/163) for the early active syphilis group,a specificity of 72.22% (104/144) for the previously infected group,and a specificity of 97.97% (145/148) for the uninfected group.The total specificity of the prototype IgA-POC test was 85.27%,which met the minimum requirement of WHO for the POC test.The prototype IgA-POC test showed a significantly higher sensitivity for the diagnosis of early active syphilis compared with the IgM-ELISA (59.51%,Z =6.88,P < 0.05),but a significantly lower specificity for the diagnosis of previous syphilis infection compared with the IgM-ELISA (98.61%,Z =6.18,P < 0.05).Moreover,no significant difference in the specificity for the diagnosis of non-infection was observed between the prototype IgA-POC test and IgM-ELISA (Z =1.16,P =0.25).Conclusion The prototype IgA-POC test has better capacity for the diagnosis of early active syphilis compared with the IgM-ELISA,so it can be applied to the screening of early active syphilis.
3.Memoirs of yesterday: The lived experience of individuals with separated parents
Zahro Vevien S. Quijote ; Bernadette May P. Jamora ; Cher Lynn B. Lauglaug ; Mary Nathalie T. Flores ; Laurence L. Garcia
Philippine Journal of Nursing 2023;93(2):35-46
Separation issues have been rampant, and a significant rise in union dissolution cases in the Philippines has been observed. This
certain occurrence should be given particular attention because it may alter the individual's way of living, particularly in perceiving
and dealing with relationships. This study explores the lived experience of individuals who have undergone parental separation.
The study utilized a Hermeneutic Phenomenological Design, which involved ten (10) respondents using a semi-structured key
informant interview guide. The respondents were selected based on criteria as follows: (1) Have parents who have decided on the
dissolution of marriage (annulled or informal) living separately; (2) 18 years of age and above; (3) Residents of Central Visayas;
permanent or transient in Cebu City and; (4) Able to understand and express ideas in Cebuano dialect or English language. An
Interpretative Phenomenological Analysis anchored on van Manen's six-step interpretive phenomenological approach with
management and analysis done manually created a poem titled “Memoirs of Yesterday,” which incorporates three (3) major
themes: (1) Into the Tunnel: Etiology of Separation, (2) The Darkness in the Tunnel: effects of the dissolution of marriage to
children- emotional, psychological and academic status and (3) The Light After the Tunnel: attitude of the child and parent towards
relationships and separation. The study implies that nurses should recognize the importance of assessing family concerns in
rendering holistic and individualized client care. Thus, nurses should use assessed needs in advocating for the creation of more
programs on awareness and counseling to families and, most especially, children.
Hermeneutics
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Surveys and Questionnaires