Total shoulder arthroplasty (TSA) has been demonstrated to be an effective treatment for multiple shoulder pathologies. The purpose of our study was to compare the relative value units (RVUs) per minute of surgical time for primary and revision TSA. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients that underwent primary TSA, one-component revision TSA, and two-component revision TSA between January 1, 2015 and December 31, 2017 using current procedure terminology codes. RVUs were divided by mean operative time for each procedure to determine the amount of revenue generated per minute. Rates were compared between the groups using a one-way analysis of variance with post-hoc Tukey test. Statistical significance was set at p<0.05. Results: When dividing compensation by surgical time, we found that two-component revision generated more compensation per minute compared to primary TSA (0.284±0.114 vs. 0.239±0.278 RVU per minute or $10.25±$4.11 vs. $8.64±$10.05 per minute, respectively; p=0.001). Conclusions: The relative value of revision TSA procedures is weighted to account for the increased technical challenges and time associated with these procedures. This study confirms that reimbursement is higher for revision TSA compared to primary TSA.

Vital to the prevention of work-related ill-health (WRIH) is the availability of good quality data regarding WRIH burden and risks. Physician-based surveillance systems such as The Health and Occupation Research (THOR) network in the UK are often established in response to limitations of statutory, compensation-based systems for addressing certain epidemiological aspects of disease surveillance. However, to fulfil their purpose, THOR and others need to have methodologic rigor in capturing and ascertaining cases. This article describes how data collected by THOR and analogous systems can inform WRIH incidence, trends, and other determinants. An overview of the different strands of THOR research is provided, including methodologic advancements facilitated by increased data quantity/quality over time and the value of the research outputs for informing Government and other policy makers. In doing so, the utility of data collected by systems such as THOR to address a wide range of research questions, both in relation to WRIH and to wider issues of public and social health, is demonstrated.
Administrative Personnel ; Humans ; Incidence ; Occupations*

Mycoplasma (M.) hyorhinis and M. hyosynoviae are pathogens known to cause disease in pigs post-weaning. Due to their fastidious nature, there is increased need for culture-independent diagnostic platforms to detect these microorganisms. Therefore, this study was performed to develop and optimize quantitative real-time PCR (qPCR) assays to rapidly detect M. hyorhinis and M. hyosynoviae in pen-based oral fluids as well as nasal and tonsillar fluids as proxies for samples used in swine herd surveillance. Two methods of genomic DNA extraction, automated versus manual, were used to compare diagnostic test performance. A wean-to-finish longitudinal study was also carried out to demonstrate the reproducibility of using pen-based oral fluids. Overall, pen-based oral and tonsillar fluids were more likely to be positive for both types of bacteria whereas only M. hyorhinis was detected in nasal fluids. DNA extraction protocols were shown to significantly influence test result. Although the initial detection time somewhat differed, both organisms were repeatedly detected in the longitudinal study. Overall, this study evaluated two qPCR methods for rapid and specific detection of either mycoplasma. Results from the present investigation can serve as a foundation for future studies to determine the prevalence of the two microorganisms, environmental load, and effectiveness of veterinary interventions for infection control.
Animals ; Diagnostic Tests, Routine/methods/*veterinary ; Female ; Longitudinal Studies ; Mouth/microbiology ; Mycoplasma Infections/diagnosis/microbiology/*veterinary ; Mycoplasma hyorhinis/*isolation & purification ; Mycoplasma hyosynoviae/*isolation & purification ; Nose/microbiology ; Palatine Tonsil/microbiology ; Real-Time Polymerase Chain Reaction/*veterinary ; Reproducibility of Results ; Swine ; Swine Diseases/*diagnosis/microbiology

Mycoplasma (M.) hyosynoviae is known to colonize and cause disease in growing-finishing pigs. In this study, two clinical isolates of M. hyosynoviae were compared by inoculating cesarean-derived colostrum-deprived and specific-pathogen-free growing pigs. After intranasal or intravenous inoculation, the proportion and distribution pattern of clinical cases was compared in addition to the severity of lameness. Tonsils were found to be the primary site of colonization, while bacteremia was rarely detected prior to the observation of clinical signs. Regardless of the clinical isolate, route of inoculation, or volume of inocula, histopathological alterations and tissue invasion were detected in multiple joints, indicating an apparent lack of specific joint tropism. Acute disease was primarily observed 7 to 10 days post-inoculation. The variability in the severity of synovial microscopic lesions and pathogen detection in joint cavities suggests that the duration of joint infection may influence the diagnostic accuracy. In summary, these findings demonstrate that diagnosis of M. hyosynoviae-associated arthritis can be influenced by the clinical isolate, and provides a study platform to investigate the colonization and virulence potential of field isolates. This approach can be particularly relevant to auxiliate in surveillance and testing of therapeutic and/or vaccine candidates.
Acute Disease ; Arthritis ; Bacteremia ; Colon ; Diagnosis ; Joints ; Mycoplasma hyosynoviae* ; Mycoplasma* ; Palatine Tonsil ; Swine* ; Tropism ; Virulence

Sex-linked dystonia parkinsonism (XDP, DYT3, "Lubag") is an adult-onset, progressive, debilitating movement disorder first described in Filipino males from Panay Island in 1975. XDP manifests predominantly as torsion dystonia, later combined with or sometimes replaced with parkinsonism. Within the Island of Panay, the preva-lence rate is highest in the province of Capiz, where 1:4000 men suffer from the disorder. There is a high degree of penetrance and generalization. While women often serve as carriers, XDP is not limited to men. An updated XDP Philippine registry (as of January 2010) has identified 505 cases, with 500 males and 5 females. While some report that females may carry a milder form of the disorder, in our experience, both sexes generally follow a similar progressive clinical course.

Human ; Male ; Female ; Aged ; Adult ; Dystonia ; Dystonia Musculorum Deformans ; Dystonic Disorders ; Genetic Diseases, X-linked ; Islands ; Parkinsonian Disorders ; Penetrance

BACKGROUND

Sleep is crucial for performance, overall health, and well-being. However, suboptimal sleep exists, particularly in the athletic population, due to factors that come with the responsibility of an athlete. The sleep health of athletes from combat sports like Amateur Boxing (AB), Wushu-Sanda (WS), and Pencak Silat (PS) have not received enough attention, even more so with the usage of Athlete Sleep Screening Questionnaire (ASSQ) to discover the presence of possible clinical sleeping problems. Such sports use the anaerobic energy system which produces their quick and explosive movements, but is afflicted by disturbed sleep.

OBJECTIVE

The primary objective of the study is to describe the sleep health of AB, WS, and PS Philippine National Athletes using the ASSQ. This study is a continuation of predecessor research which instead focused on combat sports Judo and Taekwondo. The secondary objective is to correlate socio-demographic variables, which include: age, gender, current level of education, years of training in sport, years of training as a national athlete, weekly training hours, and current phase of the season to sleep health without identifying causation.

METHODOLOGY

This cross-sectional descriptive correlational study will utilize the total enumeration sampling method from 41 Philippine National Athletes from three sports. The data gathering will utilize (1) the socio-demographic questionnaire and (2) ASSQ on mobile devices during face-to-face procedures. The study will employ descriptive statistics to outline the characteristics of the data, while Spearman’s rank correlation coefficient will be used to examine the relationship.

EXPECTED RESULTS

The study expects to identify the sleep health of combat sports athletes competing in AB, PS, and WS using the ASSQ. It also determines an association between sleep health and sociodemographic variables.