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Markovic L, Wagner B, Crevenna R. Effects of pulsed electromagnetic field therapy on outcomes associated with osteoarthritis : A systematic review of systematic reviews. Wien Klin Wochenschr 2022; 134:425-433. [PMID: 35362792 PMCID: PMC9213303 DOI: 10.1007/s00508-022-02020-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022]
Abstract
Background Osteoarthritis (OA) is a chronic degenerative disease of multiple joints with a rising prevalence. Pulsed electromagnetic field (PEMF) therapy may provide a cost-effective, noninvasive, and safe therapeutic modality with growing popularity and use in physical medicine and rehabilitation. The purpose of this study was to synthesize the current knowledge on the use of PEMF in OA. Methods A systematic review of systematic reviews was performed. The PubMed, Embase, PEDro and Web of Science databases were searched based on a predetermined protocol. Results Overall, 69 studies were identified. After removing the duplicates and then screening title, abstract and full text, 10 studies were included in the final analysis. All studies focused on knee OA, and four studies also reported on cervical, two on hand, and one on ankle OA. In terms of the level of evidence and bias, most studies were of low or medium quality. Most concurrence was observed for pain reduction, with other endpoints such as stiffness or physical function showing a greater variability in outcomes. Conclusion The PEMF therapy appears to be effective in the short term to relieve pain and improve function in patients with OA. The existing studies used very heterogeneous treatment schemes, mostly with low sample sizes and suboptimal study designs, from which no sufficient proof of efficacy can be derived. A catalogue of measures to improve the quality of future studies has been drawn up.
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Affiliation(s)
- Lovro Markovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Barbara Wagner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
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2
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Pizzol D, Shin JI, Trott M, Ilie PC, Ippoliti S, Carrie AM, Ghayda RA, Lozano JMO, Muyor JM, Butler L, McDermott DT, Barnett Y, Markovic L, Grabovac I, Koyanagi A, Soysal P, Tully MA, Veronese N, Smith L. Social environmental impact of COVID-19 and erectile dysfunction: an explorative review. J Endocrinol Invest 2022; 45:483-487. [PMID: 34559402 PMCID: PMC8461150 DOI: 10.1007/s40618-021-01679-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/15/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND To date, no attempt has been made to collate literature on the relationship between the social environmental impact of COVID-19 and erectile dysfunction. The aim of this explorative review was to assess and compare the prevalence of erectile dysfunction (ED) in male healthcare workers and males during the COVID-19 pandemic. METHODS A systematic review of major databases from inception to February 2021 was conducted. Prevalence data were extracted, and a random-effects meta-analysis was undertaken. OUTCOMES The pooled prevalence of ED amongst healthcare workers working in COVID-19 specific environments, and non-healthcare during the COVID-19 pandemic. RESULTS Of 52 initial studies, six were included for the final analysis. The pooled prevalence of ED in healthcare workers working in a COVID-19 environment was 63.6% (95% CI 20.3-92.3%), and in non-healthcare workers during the COVID-19 pandemic was 31.9% (95% CI 19.5-47.6%). CONCLUSION The prevalence of ED in healthcare workers working in COVID-19 environments was higher than representative samples and is of concern. Sexual health (and by extension, overall health), should be a priority when considering ways to care for this population. Considering the social environmental impact of COVID-19 on sexual health and in particular on ED, it is important to provide adequate psychological support systems and to promote quality of life with particular attention to sexual health.
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Affiliation(s)
- D Pizzol
- Italian Agency for Development Cooperation, 33 Street, Amarat, Khartoum, Sudan.
| | - J I Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - M Trott
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - P-C Ilie
- Urology Department, The Queen Elizabeth Hospital King's Lynn, King's Lynn, UK
| | - S Ippoliti
- Urology Department, The Queen Elizabeth Hospital King's Lynn, King's Lynn, UK
| | - A M Carrie
- Urology Department, The Queen Elizabeth Hospital King's Lynn, King's Lynn, UK
| | - R A Ghayda
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - J M O Lozano
- Health Research Centre, University Almeria, Almeria, Spain
| | - J M Muyor
- Health Research Centre, University Almeria, Almeria, Spain
| | - L Butler
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - D T McDermott
- NTU Psychology, School of Social Science, Nottingham Trent University, Nottingham, UK
| | - Y Barnett
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - L Markovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
| | - P Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - M A Tully
- School of Health Sciences, Institute of Nursing and Health Research, Jordans Town, Northern Ireland, UK
| | - N Veronese
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - L Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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3
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Wagner B, Steiner M, Markovic L, Crevenna R. Successful application of pulsed electromagnetic fields in a patient with post-COVID-19 fatigue: a case report. Wien Med Wochenschr 2022; 172:227-232. [PMID: 35006516 PMCID: PMC8743351 DOI: 10.1007/s10354-021-00901-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
Background Post-COVID-19 fatigue is a frequent symptom in COVID-19 survivors, which substantially limits patients to achieve full recovery and potentially restrains return to work. The previous literature has not yet reported the use of pulsed electromagnetic fields in this indication. Methods Over the course of 5 weeks, 10 sessions of pulsed electromagnetic field treatment with a high magnetic flux density were applied to a patient suffering from post-COVID-19 fatigue syndrome. Fatigue, work ability, quality of life as well as anxiety, depression, stress level, and resilience were evaluated using validated patient-reported outcome measures. Results Fatigue, work ability, quality of life, and psychological well-being improved clearly over the course of the treatment and showed stable results 6 weeks later. Conclusion The use of pulsed electromagnetic field therapy with a device that allows sufficient penetration of the body tissue might be a promising physical modality to manage post-COVID-19 fatigue syndrome, which could reduce clinical and economic health consequences. Clinical sham-controlled studies are needed to evaluate the effect of pulsed electromagnetic fields in this indication.
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Affiliation(s)
- Barbara Wagner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Margarete Steiner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Lovro Markovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Markovic L, Seiler-Ramadas R, Grabovac I. Experiences of Trans and Non-Binary Patients during Medical Transitioning and Associations with the Patient-Physician Relationship in Austria. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Trans and non-binary (TNB) patients confront various issues in the healthcare system and with healthcare workers (HCWs) tasked with navigating complex systems to achieve optimal outcomes. The most time intensive and intimate contact TNB patients have is typically with physicians making the physician-patient relationship instrumental. This study aimed to explore the experiences of patient-physician relationship in TNB patients in Austria in order to identify caveats for future interventions.
Methods
We conducted an exploratory cross-sectional study using an online questionnaire consisting of 86 items including the Patient-Doctor Relationship Questionnaire 9 (PDRQ-9) distributed between June and October 2020 through various organizations working with TNB people. Austrian residents older than 18 who self-identified as TNB and were undergoing or finished medical transitioning were included. Descriptive statistics and linear regression models were applied.
Results
From a total of 91 participants, 58.3% identified as trans, 70.3% were assigned female at birth, and 87.7% were on hormone replacement therapy. Most (58.1%) perceived physicians as the most problematic HCWs, and 60.5% reported having never or rarely been taken seriously in healthcare settings. Linear regression model showed that PDRQ-9 score was associated with a diagnosis of a mental illness (beta=3.88, 95%CI 0.24 - 7.51), quality of life (beta=0.66, 95%CI 0.43 - 0.90), never being taken seriously (beta=11.69, 95%CI 2.91 - 20.47) and being misgendered (beta=-7.64, 95%CI -14.88 - -0.41) by HCWs.
Conclusions
TNB patients in Austria reported negative experiences in the healthcare system, mostly with physicians that often did not take their gender identity seriously or used inappropriate language. Future interventions should focus on increasing transgender care competencies across various components of medical education.
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Affiliation(s)
- L Markovic
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - R Seiler-Ramadas
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - I Grabovac
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
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5
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Seiler-Ramadas R, Markovic L, Llop Medina L, Baros S, Bajkusa M, Horvat M, Smith L, McDermott D, Grabovac I. Strategies to challenge discrimination and foster inclusivity for LGBT+Q+ youth in workplaces: a qualitative exploratory study in six European countries. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lesbian, gay, bisexual, trans and queer (LGBT+Q+) youth are highly vulnerable to work-based discrimination, which correlates with poor social, physical and mental health. The European Union funded WE-Project aims to empower LGBT+Q+ youth in Europe through work-based educational interventions. The first leg focused on exploring barriers and facilitators to workplace equality in Austria, Croatia, Serbia, Slovakia, Spain and the United Kingdom, gathering experiences of LGBT+Q+ youth and stakeholders.
Methods
Self-identifying LGBT+Q+ 15-26 year-olds were recruited via social media and diverse organisations for semi-structured interviews, while stakeholders from various institutions were invited to participate in focus group discussions based on standardised interview and discussion guidelines. Transcriptions were coded, categorised and thematically analysed, revealing five themes: societal discrimination influencing work-life, experiences of workplace discrimination, barriers to resolve discrimination, facilitators to overcome discrimination and creation of inclusive strategies.
Results
Overall 56 LGBT+Q+ youth interviewees and 38 stakeholders from 6 European countries were recruited. Facilitators overcoming workplace discrimination and inclusive strategies towards work-based equality for LGBT+Q+ youth were varyingly emphasised and included: clear policies, open communication, staff involvement and inclusive infrastructure, LGBT+Q+ quotas as well as education on diversity in schools and increasing visibility, legal recognition of partnerships, implementing youth centres, and access to counselling.
Conclusions
Results indicate several strategies to consider when designing interventions challenging work-based discrimination of LGBT+Q+ youth. Participating countries differ in social acceptance and legal protections of LGBT+Q+ youth, but experiences and voiced issues are similar, necessitating relevant anti-discrimination interventions throughout Europe.
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Affiliation(s)
- R Seiler-Ramadas
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - L Markovic
- Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Vienna, Austria
| | - L Llop Medina
- Polibienestar Institute, University of Valencia, Valencia, Spain
| | - S Baros
- Institute of Public Health, Belgrade, Serbia
| | - M Bajkusa
- Forum for Freedom in Education, Zagreb, Croatia
| | - M Horvat
- Department of Administrative and Environmental Law, Faculty of Law, Comenius University, Bratislava, Slovakia
| | - L Smith
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - D McDermott
- School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - I Grabovac
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
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6
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Zdravkovic A, Markovic L, Crevenna R. Commentary: Onco-Esthetics Dilemma: Is There a Role for Electrocosmetic-Medical Devices? Front Oncol 2021; 11:718277. [PMID: 34660283 PMCID: PMC8514748 DOI: 10.3389/fonc.2021.718277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/14/2021] [Indexed: 12/24/2022] Open
Affiliation(s)
- Andrej Zdravkovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Lovro Markovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
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7
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Seiler-Ramadas R, Markovic L, Staras C, Medina LL, Perak J, Carmichael C, Horvat M, Bajkusa M, Baros S, Smith L, McDermott DT, Grabovac I. "I Don't Even Want to Come Out": the Suppressed Voices of Our Future and Opening the Lid on Sexual and Gender Minority Youth Workplace Discrimination in Europe: a Qualitative Study. Sex Res Social Policy 2021; 19:1452-1472. [PMID: 34608404 PMCID: PMC8481111 DOI: 10.1007/s13178-021-00644-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/12/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION In Europe, young sexual and gender minority (SGM) people continue to face discrimination in the labour sector despite advances in legislation towards their acceptance and equal treatment. Non-discrimination policy strategies helping SGM individuals are not equally enforced in all contexts, making it difficult for many SGM individuals to disclose their identity, hence undermining their health and well-being. METHODS Qualitative semi-structured interviews were conducted between October 2020 and February 2021 with 55 SGM youth (18-27 years) having work experience from Austria, Croatia, Serbia, Slovakia, Spain and the UK. RESULTS From the analysis, three overarching themes were significant: (1) societal discrimination played a major role in sociocultural factors and policy considerations, (2) workplace discrimination had distinct factors and impacts on SGM individuals and (3) SGM inclusion should use strategies to ensure workplace diversity and equality. CONCLUSIONS SGM individuals from contexts of poor acceptance tended to hide their identity in the workplace, while transgender and non-binary individuals were prone to experience force-disclosure and discrimination in all aspects of employment. There is a lack of resolute reaction from policy makers in managing problems faced by SGM people in workplaces. New laws improving the status of SGM people need to be further adopted, staff training should be implemented, and managers are crucial in achieving an inclusive climate in the workplace.Policy ImplicationsIt is essential to implement policies on how to effectively handle problems faced by sexual and gender minority people in the workplace.
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Affiliation(s)
- Radhika Seiler-Ramadas
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Lovro Markovic
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Chase Staras
- School of Psychology & Sport Science, Anglia Ruskin University, Cambridge, UK
| | - Laura Llop Medina
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | | | - Christina Carmichael
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Matej Horvat
- Faculty of Law, Comenius University, Bratislava, Slovakia
| | | | - Sladjana Baros
- Centre for Disease Control and Prevention, Institute of Public Health of Serbia “Dr. Milan JovanovicBatut”, Belgrade, Serbia
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Daragh T. McDermott
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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8
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Friismose AI, Markovic L, Nguyen N, Gerke O, Schulz MK, Mussmann BR. Amide proton transfer-weighted MRI in the clinical setting - correlation with dynamic susceptibility contrast perfusion in the post-treatment imaging of adult glioma patients at 3T. Radiography (Lond) 2021; 28:95-101. [PMID: 34509365 DOI: 10.1016/j.radi.2021.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION We investigated the correlation between amide proton transfer-weighted magnetic resonance imaging (APTw MRI) and dynamic susceptibility contrast (DSC) perfusion in order to assess the potential of APTw MRI as an alternative to DSC in adult brain tumor (glioma) imaging. METHODS After Ethical Committee approval, forty adult patients, treated for histopathologically confirmed glioma (World Health Organization (WHO) grade II-IV), were prospectively imaged at 3 Tesla (3 T) with DSC perfusion and a commercially available three-dimensional (3D) APTw sequence. Two consultant neuroradiologists independently performed region of interest (ROI) measurements on relative cerebral blood volume (rCBV) and APTw maps, co-registered with anatomical images. The correlation APTw MRI-DSC perfusion was assessed using Spearman's rank-order test. Inter-observer agreement was evaluated by the intraclass correlation coefficient (ICC) and Bland-Altman (BA) plots. RESULTS A statistically significant moderately strong positive correlation was observed between maximum rCBV (rCBVmax) and maximum APTw (APTwmax) values (observer 1: r = 0.73; p < 0.01; observer 2: r = 0.62; p < 0.01). We found good inter-observer agreement for APTwmax (ICC = 0.82; 95% confidence interval (CI) 0.66-0.90), with somewhat broad outer 95% CI for the BA Limits of Agreement (LoA) (-1.6 to 1.9). ICC for APTwmax was higher than ICC for rCBVmax (ICC = 0.74; 95%; CI 0.50-0.86), but the difference was not statistically significant. CONCLUSION APTwmax values correlate positively with rCBVmax in patients treated for brain glioma. APTw imaging is a reproducible technique, with some observer dependence. Results need to be confirmed by a larger population analysis. IMPLICATIONS FOR PRACTICE APTw MRI can be a useful addition to glioma follow-up imaging and a potential alternative to DSC perfusion, especially in patients where contrast agent is contraindicated.
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Affiliation(s)
- A I Friismose
- Radiology Department, Odense University Hospital, Odense, Denmark.
| | - L Markovic
- Radiology Department, Odense University Hospital, Odense, Denmark
| | - N Nguyen
- Radiology Department, Odense University Hospital, Odense, Denmark
| | - O Gerke
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - M K Schulz
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark
| | - B R Mussmann
- Radiology Department, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN, Odense Patient Data Exploratory Network, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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9
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Jordakieva G, Markovic L, Rinner W, Santonja I, Lee S, Pilger A, Perkman T, Grabovac I, Schernhammer E, Crevenna R, Papantoniou K, Godnic-Cvar J. Workability, quality of life and cardiovascular risk markers in aging nightshift workers: a pilot study. Wien Klin Wochenschr 2021; 134:276-285. [PMID: 34487198 PMCID: PMC9023427 DOI: 10.1007/s00508-021-01928-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/21/2021] [Indexed: 12/27/2022]
Abstract
Background In aging healthcare professionals, multiple stressors such as night work may affect life and work satisfaction and risk for chronic diseases (e.g. cardiovascular disease [CVD]). In this pilot study we compared workability, quality of life (QoL), and CVD risk markers between night shift and day workers. Methods We included 70 hospital employees (mean age 52 ± 4 years, 91.4% female): 32 rotating night shift workers (> 3 nights/month) and 38 permanent day workers. In addition to sociodemographic, lifestyle, and sleep characteristics, we assessed i) workability index (WAI), ii) QoL (World Health Organization Quality of Life [WHOQOL-Bref]) and iii) CVD risk markers, i.e. carotid ultrasound measurements, and biomarkers (NTproBNP, CRP, IL‑6, LDL, ferritin, copper, zinc, and selenium). WAI, QoL, and CVD risk markers were compared between night and day workers. In a subgroup of participants (N = 38) with complete data, we used quantile regression analysis to estimate age and multivariate adjusted differences in biomarker levels. Results We found no differences in the domains of QoL (physical health, psychological, social relationships, and environment) and WAI scores between night and day workers. Night shift workers were less likely to report excellent workability than day workers, although differences were not statistically significant. Night shift workers reported more sleep problems (73.1% vs. 55.6%) and tended to have lower zinc levels and higher inflammatory markers (CRP, IL‑6, ferritin), but differences were not significant after adjusting for potential confounders. Conclusions Workability, QoL and CVD markers did not significantly differ between rotating night shift and day workers in this small pilot study. Sleep problems and inflammatory marker levels carry implications for occupational health. Supplementary Information The online version of this article (10.1007/s00508-021-01928-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Galateja Jordakieva
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Lovro Markovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Walter Rinner
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Isabel Santonja
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1st floor, Vienna, Austria
- Center of Virology, Medical University Vienna, Vienna, Austria
| | - Seungjune Lee
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Alexander Pilger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Perkman
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1st floor, Vienna, Austria
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard, Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1st floor, Vienna, Austria.
| | - Jasminka Godnic-Cvar
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
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10
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Markovic L, McDermott DT, Stefanac S, Seiler-Ramadas R, Iabloncsik D, Smith L, Yang L, Kirchheiner K, Crevenna R, Grabovac I. Experiences and Interactions with the Healthcare System in Transgender and Non-Binary Patients in Austria: An Exploratory Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:ijerph18136895. [PMID: 34199049 PMCID: PMC8297154 DOI: 10.3390/ijerph18136895] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022]
Abstract
Medical care of transgender and non-binary (TNB) patients if often a complex interdisciplinary effort involving a variety of healthcare workers (HCWs) and services. Physicians not only act as gatekeepers to routine or transitioning therapies but are also HCWs with the most intimate and time-intensive patient interaction, which influences TNB patients' experiences and health behaviors and healthcare utilization. The aim of this study was to investigate the physician-patient relationship in a sample of TNB individuals within the Austrian healthcare system, and explore its associations with sociodemographic, health-, and identity-related characteristics. A cross-sectional study utilizing an 56-item online questionnaire, including the Patient-Doctor Relationship Questionnaire 9 (PDRQ-9), was carried out between June and October 2020. The study involved TNB individuals 18 or older, residing in Austria, and previously or currently undergoing medical transition. In total, 91 participants took part, of whom 33.0% and 25.3% self-identified as trans men and trans women, respectively, and 41.8% as non-binary. Among participants, 82.7% reported being in the process of medical transitioning, 58.1% perceived physicians as the most problematic HCWs, and 60.5% stated having never or rarely been taken seriously in medical settings. Non-binary participants showed significantly lower PDRQ-9 scores, reflecting a worse patient-physician relationship compared to trans male participants. TNB patients in Austria often report negative experiences based on their gender identity. Physicians should be aware of these interactions and reflect potentially harmful behavioral patterns in order to establish unbiased and trustful relations.
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Affiliation(s)
- Lovro Markovic
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (L.M.); (R.S.-R.); (D.I.); (I.G.)
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, 1090 Vienna, Austria;
| | - Daragh T. McDermott
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham NG1 4FQ, UK;
| | - Sinisa Stefanac
- Institute of Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence:
| | - Radhika Seiler-Ramadas
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (L.M.); (R.S.-R.); (D.I.); (I.G.)
| | - Darina Iabloncsik
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (L.M.); (R.S.-R.); (D.I.); (I.G.)
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK;
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Kathrin Kirchheiner
- Department of Radiation Oncology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, 1090 Vienna, Austria;
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (L.M.); (R.S.-R.); (D.I.); (I.G.)
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Markovic L, Schönherr D, Zandonella M, Gil-Salmeron A, Smith L, McDermott D, Yang L, Dorner TE, Mües H, Grabovac I. Associations between workplace characteristics and 'outness' in LGBTI workers in Austria. Occup Environ Med 2021; 79:10-16. [PMID: 34039754 DOI: 10.1136/oemed-2020-107345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/01/2021] [Accepted: 05/07/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals are often subjected to negative attitudes in the workplace, which may lead to non-disclosure of their sexual orientation and/or gender identities. We aimed to determine the prevalence of workplace disclosure of sexual or gender identity (ie, 'outness'; being 'out') and to examine its associations with workplace characteristics in LGBTI workers in Austria. METHODS This cross-sectional study analysed sociodemographic, work-related and well-being-related data from self-identifying gender and/or sexual minority participants elicited by an online questionnaire between February and June 2017. From the initial 1268 respondents, 1177 (93%) provided complete data and were included in the subsequent analyses. RESULTS The largest proportion of the sample were 26-35 years old (39.1%), cisgender gay men (40.0%) in full-time employment (63.9%). Overall, 51.7% of the sample were 'out' at the workplace. Being bisexual (OR=0.46, 95% CI 0.27 to 0.81), the provision of antidiscrimination guidelines in the workplace (OR=0.53, 95% CI 0.32 to 0.90), living alone (OR=0.50, 95% CI 0.32 to 0.79) and in shared households (OR=0.49, 95% CI 0.25 to 0.96) were associated with a decreased likelihood of being 'out' at work.Factors associated with being 'out' at work were being middle aged (36-45 years old; OR=1.74, 95% CI 1.07 to 2.85), having been in employment for >10 years (OR=2.03, 95% CI 1.08 to 3.81), an LGBTI-friendly work environment (OR 1.61, 95% CI 1.36 to 1.91), labour-management antidiscrimination contract (OR=2.02, 95% CI 1.23 to 3.32) and work council protections (OR=1.56, 95% CI 1.04 to 2.36). CONCLUSIONS Instating antidiscrimination protections might facilitate 'outness' of LGBTI workers and lead to a better promotion of diversity in the workplace.
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Affiliation(s)
- Lovro Markovic
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria .,Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - Daniel Schönherr
- SORA Institute for Social Research and Consulting, Ogris & Hofinger GmbH, Vienna, Austria
| | - Martina Zandonella
- SORA Institute for Social Research and Consulting, Ogris & Hofinger GmbH, Vienna, Austria
| | | | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Daragh McDermott
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology & Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Thomas E Dorner
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.,Health Promotion Facility Sitzenberg-Reidling, Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria
| | - Hanna Mües
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
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12
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Markovic L, Grabovac I. Associations between workplace characteristics and “outness” in LGBTIQ workers in Austria. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) individuals are often subjected to negative attitudes at the workplace, which may lead to non-disclosure of their sexual and/or gender identities. We aimed to determine the prevalence of workplace disclosure of sexual or gender identity (i.e. “outness”; being “out”) and to examine its associations with workplace characteristics in LGBTIQ workers in Austria.
Methods
Sociodemographic, work- and wellbeing-related data were gathered using an online questionnaire between February and June 2017. From the initial 1268 respondents, 1054 (83%) provided complete data and were included in the analysis.
Results
Participants were mostly 26-35 years old (39.1%), educated (43.9% tertiary level), urban (53.8%), cisgender gay men (40.0%) with a full-time employment (63.9%). Overall, 51.7% were “out” at the workplace. Being bisexual (OR = 0.46, 95%CI 0.27-0.81), having anti-discrimination guidelines (OR = 0.53, 95%CI 0.32-0.90), living alone (OR = 0.50, 95%CI 0.32-0.79 and in shared households (OR = 0.49, 95%CI 0.25-0.96) were associated with lesser likelihood of being “out” at work. Furthermore, being “out” at work was associated with middle age (36-45-year-olds; OR = 1.74, 95%CI 1.07-2.85), duration of employment >10 years (OR = 2.03, 95%CI 1.08-3.81), LGBT friendly work environment (OR 1.61, 95%CI 1.36-1.91), anti-discrimination policies enacted (OR = 2.02, 95%CI 1.23-3.32), and work council protections (OR = 1.56, 95%CI 1.04-2.36).
Conclusions
Approximately half of participants reported being “out” at work. An LGBTIQ-friendly work environment, presence of work council protections and of enacted anti-discrimination policies were linked with higher workplace outness. Instating discrimination protections might facilitate “outness” and therefore visibility of LGBTIQ workers, leading to better health outcomes and productivity.
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Affiliation(s)
- L Markovic
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
| | - I Grabovac
- Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria
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Serbecic N, Beutelspacher S, Markovic L, Roy AS, Shetty R. Repeatability and reproducibility of corneal biomechanical parameters derived from Corvis ST. Eur J Ophthalmol 2019; 30:1287-1294. [PMID: 31744320 DOI: 10.1177/1120672119864554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate repeatability and reproducibility of newly calculated biomechanical parameters of the cornea, developed by our research group. METHODS One eye from each of the 23 healthy subjects was measured three times consecutively, three times at different daytimes and on three different days. The within-subject standard deviation and coefficient of variation, as well as the intraclass correlation coefficient, were calculated for every parameter in each group. RESULTS Excellent repeatability and reproducibility (coefficient of variation < 5%, intraclass correlation coefficient > 0.75) was found for corrected values measured at A1, HC, and A2 time points (2nd A2 Time, 2nd A1 Time, 2nd HC Time, 2nd HC Def Amp and 2nd A1 Def Amp). Corneal-specific stiffness parameters, which showed good repeatability and reliability, were DA_cor (coefficient of variation = 4.02%, intraclass correlation coefficient = 0.919), KcLinear (coefficient of variation = 4.03%, intraclass correlation coefficient = 0.895), areaForceCornea (coefficient of variation = 3.34%, intraclass correlation coefficient = 0.853) and E2 (coefficient of variation = 4.1%, intraclass correlation coefficient = 0.78). Overall, most parameters fell into the category of good reliability (high intraclass correlation coefficient) and poor reproducibility (low coefficient of variation), including all the parameters describing extraocular deformation (DA_ext, AEPvED, AUC EDef, areaForceExtra, Kg and μg). Comparing the coefficient of variation values for intrasession, intersession and daytime measurements, there were no indices for diurnal changes. CONCLUSION Most parameters showed good repeatability and reliability. The extraocular stiffness parameters showed poor reproducibility. KcLinear can serve as a very reliable and repeatable indicator of corneal stiffness.
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Affiliation(s)
- Nermin Serbecic
- Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
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Todorovic J, Nesovic Ostojic J, Opric D, Dundjerovic D, Bozic V, Markovic L. Is lymphocytic thyroiditis a unique type or merely a type of Hashimoto's thyroiditis? Minerva Med 2014; 105:303-312. [PMID: 24867187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Objective of the study was to clarify the role of apoptosis in the pathogenesis of lymphocytic thyroiditis (LT) and the existence of difference between Hashimoto's thyroiditis (HT) and LT. METHODS We evaluated levels of antithyroglobulin and antithyroperoxidase antibodies, the apoptosis by in situ Cell Death Detection-TUNEL and the expression of Bcl2 and Bax by immunohistochemistry in thyroid tissues from 16 patient with HT, 10 with LT and 10 with euthyroid goiter-EG (control group). RESULTS It was found that apoptosis of thyrocytes in HT (mean 3.05%, SD 1.29%) and LT (mean 2.70%, SD 1.17%) was statistically significantly higher than EG (mean 0.56%, SD 0.23%), but the difference in the percentage of thyrocytes between HT and LT was not statistically significant. In HT the percentage of apoptotic infiltrating lymphocytes (mean 0.59%, SD 0.23%) was smaller than in EG (mean 2.26%, SD 1.42%), but it showed no significant difference in comparison to LT. The expression of Bax in infiltrating lymphocytes in HT (mean 0.72%, SD 0.34%) was statistically significantly higher than LT (mean 0.11%, SD 0.06%). The level of thyroglobulin was lower in HT compared to LT (P<0.01) and compared to EG (P<0.01). The level of antithyroglobulin/antithyroperoxidase antibodies was higher in HT compared to LT (P<0.01) and compared to EG (P<0.01). There was no statistically significant difference in the level of thyroglobulin and level of antibodies between LT and EG. CONCLUSION These results suppose that apoptosis represents one of significant mechanisms in the pathogenesis of both HT and LT and that LT probably differs from HT.
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Affiliation(s)
- J Todorovic
- Department of Pathophysiology Medical Faculty University of Belgrade Belgrade, Serbia -
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Jordan RA, Lucaciu A, Fotouhi K, Markovic L, Gaengler P, Zimmer S. Pilot pathfinder survey of oral hygiene and periodontal conditions in the rural population of The Gambia (West Africa). Int J Dent Hyg 2011; 9:53-9. [DOI: 10.1111/j.1601-5037.2009.00435.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Markovic L, Fotouhi K, Lorenz H, Jordan RA, Gaengler P, Zimmer S. Effects of Bleaching Agents on Human Enamel Light Reflectance. Oper Dent 2010; 35:405-11. [DOI: 10.2341/09-078-l] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
In dental bleaching, the micromorphological alterations of hard tissues have been well investigated, but little is known about the optical changes involved. The results of the current study showed that enamel, irrespective of maturation, is subjected to a shift in reflectance towards blue within the color space and enhanced reflection. This effect was demonstrated in different bleaching agent concentrations and protocols.
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Clough TM, Jago ER, Sidhu DP, Markovic L. Fractures of the capitellum: a new method of fixation using a maxillofacial plate. Clin Orthop Relat Res 2001:232-6. [PMID: 11249170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Isolated capitellar fractures are rare, intraarticular fractures requiring an aggressive management regimen. Several treatment options have been described for the Type 1 fracture. A new technique of direct anatomic reduction and fixation of the fracture using a maxillofacial plate is reported. Advantages of this new technique are highlighted, and results with its use in treating patients of all ages are described.
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Affiliation(s)
- T M Clough
- Burnley General Hospital, United Kingdom
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Abstract
A total of 51 patients with bilateral simultaneous Charnley total hip arthroplasties were studied for wear behavior. The mean observation time was 14.7 years. Fourteen hips had been revised during follow-up. The mean wear rate was 0.071 mm/y for left hips and 0.081 mm/y for right hips. There were considerable side differences for individual patients and little agreement between the wear measurements of left and right hips. Linear wear was increased in men, in patients with high body weight. Linear wear after hip arthroplasty is not side related.
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Affiliation(s)
- A Joshi
- Centre for Hip Surgery, Wrightington Hospital, Wigan, Lancashire, England
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Joshi AB, Markovic L, Ilchmann T. Polyethylene wear and calcar osteolysis. Am J Orthop (Belle Mead NJ) 1999; 28:45-8. [PMID: 10048358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
We have examined retrospectively the correlation between linear wear of the polyethylene socket and calcar height loss (osteolysis) in 266 patients with 410 total hip arthroplasties who were followed up for a minimum of 10 years. A positive correlation existed between wear and osteolysis. The correlation was stronger in patients with osteoarthrosis. Simultaneous bilateral hip arthroplasty showed no difference in the relationship between polyethylene wear and calcar height loss when comparing the right and left hip. There was poor correlation between calcar height loss and wear in patients with rheumatoid arthritis. Our findings support the theory that femoral osteolysis in the total hip arthroplasty is related to the amount of liberated particles generated by the wear of components. The poor correlation found in cases with rheumatoid arthritis could be related to suppression of the immune response in these patients.
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Affiliation(s)
- A B Joshi
- Centre For Hip Surgery, Wrightington Hospital, Lancashire, England
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Ilchmann T, Markovic L, Joshi A, Hardinge K, Murphy J, Wingstrand H. Migration and wear of long-term successful Charnley total hip replacements. ACTA ACUST UNITED AC 1998. [DOI: 10.1302/0301-620x.80b3.0800377] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We analysed in-vivo migration and wear over a long period of all-polyethylene acetabular cups which had not been affected by mechanical loosening. The selection criteria of regular radiological follow-up, good clinical outcome (Charnley score of 5 or 6), continued walking without crutches and no radiological signs of loosening of the acetabular cups were fulfilled by 25 Charnley total hip arthroplasties. Mean migration, measured by the Nunn method, was 0.6 mm in the medial and 0.2 mm in the cranial direction. The mean yearly rate of wear was 0.05 mm and 0.04 mm, with six and two cups having no detectable wear, as measured by the Livermore and Charnley-Cupic methods, respectively. The maximal detected wear was 3.7 mm. There were no changes in the rate of wear with time. Computerised Ein Bild Röntgen Analyse (single-image radiological analysis) measurements of 20 hips indicated plastic deformation of the cups. We conclude that long-term successful cups do not migrate and have a very low rate of wear which was not affected by ageing of the polyethylene. There was no evidence that polyethylene wear alone caused mechanical loosening of the cup but high rates of wear seem to have an adverse prognostic value in terms of the long-term survival of the prosthesis.
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Affiliation(s)
- T. Ilchmann
- Department of Orthopaedics, Lund University Hospital, S-221 85 Lund, Sweden
| | - L. Markovic
- Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire WN6 9EP, UK
| | - A. Joshi
- Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire WN6 9EP, UK
| | - K. Hardinge
- Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire WN6 9EP, UK
| | - J. Murphy
- Centre for Hip Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire WN6 9EP, UK
| | - H. Wingstrand
- Department of Orthopaedics, Lund University Hospital, S-221 85 Lund, Sweden
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Ilchmann T, Markovic L, Joshi A, Hardinge K, Murphy J, Wingstrand H. Migration and wear of long-term successful Charnley total hip replacements. J Bone Joint Surg Br 1998; 80:377-81. [PMID: 9619922 DOI: 10.1302/0301-620x.80b3.8455] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We analysed in-vivo migration and wear over a long period of all-polyethylene acetabular cups which had not been affected by mechanical loosening. The selection criteria of regular radiological follow-up, good clinical outcome (Charnley score of 5 or 6), continued walking without crutches and no radiological signs of loosening of the acetabular cups were fulfilled by 25 Charnley total hip arthroplasties. Mean migration, measured by the Nunn method, was 0.6 mm in the medial and 0.2 mm in the cranial direction. The mean yearly rate of wear was 0.05 mm and 0.04 mm, with six and two cups having no detectable wear, as measured by the Livermore and Charnley-Cupic methods, respectively. The maximal detected wear was 3.7 mm. There were no changes in the rate of wear with time. Computerised Ein Bild Röntgen Analyse (single-image radiological analysis) measurements of 20 hips indicated plastic deformation of the cups. We conclude that long-term successful cups do not migrate and have a very low rate of wear which was not affected by ageing of the polyethylene. There was no evidence that polyethylene wear alone caused mechanical loosening of the cup but high rates of wear seem to have an adverse prognostic value in terms of the long-term survival of the prosthesis.
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Affiliation(s)
- T Ilchmann
- Department of Orthopaedics, Lund University Hospital, Sweden
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Abstract
One hundred sixty-one dislocations after cemented total hip arthroplasty, with a mean follow-up period of 8 years after dislocation, were reviewed with the aim of establishing the prognosis. There were 84% single and 16% recurrent dislocations. Closed reduction was successful in 81% of cases. Thirty-seven percent of dislocations were early (within 5 weeks), 36% occurred in patients who had had previous surgery, and in 47% there was nonunion of the trochanter. There was a two-way interaction between these factors, and all factors were significant for recurrent dislocation. Twenty-six (16%) recurrent dislocations required surgery. The most common causes of recurrent dislocation demonstrated at operation were component malposition (58%) and failure of the abductor mechanism (42%). In total, 96% of cases were successfully treated.
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Affiliation(s)
- A Joshi
- Centre of Hip Surgery, Wrightington Hospital, Lancashire, United Kingdom
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Abstract
Dual infection with HIV and hepatitis B virus (HBV) is not an uncommon feature. Immunity impairment due to HIV infection can be the cause of a higher rate of HBV replication with less intensive liver damage and less effective immune response to HBV. Many HIV-infected patients have an elevated level of circulating immune complexes (CIC) in serum, throughout all stages of illness evolution. The aim of our study was to estimate p24 and HBsAg content of CIC in dually infected patients, and the prevalence of major classes of complexed antibodies (IgM and IgG). We examined 146 samples of sera from 105 HIV positive patients of the Institute for Infectious and Tropical Diseases during 1992 and 1993. On those sera we performed p24Ag and HbsAg detection, with and without prior dissociation of CIC, we determined serum level of CIC and immunoglobulin classes IgM and IgG level in sera and in polyethilenglycol (PEG) precipitates of sera. Acid dissociation of immune complexes revealed a high proportion of HIV antigen positive sera in all stages of HIV disease progression. HbsAg in serum of HIV positive patients was also found coupled in immune complexes much more frequently than in the HIV negative control group. In many instances both antigens were simultaneously found coupled in CIC. Immune complexes detected have been shown to contain both IgM and IgG immunoglobulins, while IgM antibodies were associated to immune complexes in higher proportion than IgG, compared to total serum immunoglobulins.
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Affiliation(s)
- M Stanojevic
- Institute of Infectious and Tropical Diseases CCS, Belgrade, Yugoslavia
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Abstract
We compared the outcome of total knee arthroplasty in 19 patients who had had previous patellectomy with the results in a matched series of arthroplasties performed on knees in which the patella was intact. The mean follow-up was 63 months (21 to 114). In the study group, the outcome was poor in five patients. There was instability in the coronal plane in three patients and persistent pain in four. Three supracondylar fractures occurred. The overall complication rate was 36%. In the control group, pain was relieved in every case and there were no complications. Total knee arthroplasty has a higher complication rate and inferior results if the knee has undergone prior patellectomy.
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Joshi AB, Lee CM, Markovic L, Murphy JC, Hardinge K. Total knee arthroplasty after patellectomy. J Bone Joint Surg Br 1994; 76:926-9. [PMID: 7983121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We compared the outcome of total knee arthroplasty in 19 patients who had had previous patellectomy with the results in a matched series of arthroplasties performed on knees in which the patella was intact. The mean follow-up was 63 months (21 to 114). In the study group, the outcome was poor in five patients. There was instability in the coronal plane in three patients and persistent pain in four. Three supracondylar fractures occurred. The overall complication rate was 36%. In the control group, pain was relieved in every case and there were no complications. Total knee arthroplasty has a higher complication rate and inferior results if the knee has undergone prior patellectomy.
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Affiliation(s)
- A B Joshi
- Centre for Hip Surgery, Wrightington Hospital for Joint Disease, Wigan, Lancashire, UK
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Abstract
The different stages of frog virus 3 (FV 3) morphogenesis have been investigated in chick embryo fibroblasts infected at an optimal temperature for virus growth (29 degrees C). The metabolic requirements for morphogenesis were determined by adding inhibitors of macromolecular synthesis at different periods in the virus growth cycle. The effect of a non-permissive temperature for FV 3 replication (37 degrees C) was also studied in shift up experiments. The following results were obtained: (I) when DNA replication was inhibited, neither immature nor mature virus particles appeared; (2) continuous protein synthesis was required for every stage of virus morphogenesis. However, the assembly of virions into paracrystalline arrays seemed to be a passive phenomenon. (3) Continuous mRNA transcription was not necessary for assembly of capsid constituents, although most of these capsids appeared empty; there was also a striking increase in the number of aberrant virus structures. (4) If infected cells were shifted to a non-permissive temperature, virus maturation was completely inhibited.
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Tripier F, Braunwald J, Markovic L, Kirn A. Budding of frog virus 3 (FV3) studied by means of sequential immunocytochemical labeling. J Ultrastruct Res 1976; 56:249-57. [PMID: 785020 DOI: 10.1016/s0022-5320(76)90001-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Tripier F, Markovic L, Braunwald J, Kirn A. [New data on the structure and the budding of FV3 (frog virus 3) (author's transl)]. Ann Microbiol (Paris) 1975; 126:447-60. [PMID: 1241755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The freeze-etching technique when applied to FV3 suspensions revealed the perfectly icosahedral structure of the viral nucleocapsids. This allowed a fine substructure suggesting the existence of numerous subunits of small dimensions to be detected at their surface. Observations of the replicas of infected cells obtained by freeze-etching revealed modifications of the external face of the cytoplasmic membrane occurring at the level of the budding viral particles; in these zones parallel stripes appeared, whose elementary structure is constant (13,5 nm). Observations of the infected cells with the scanning microscope enabled the spreading of the budding process on all the cells of a same culture to be studied. By counting the number of budding particles per mum2, it was possible to demonstrate the heterogeneity of the budding process at the surface of the cells.
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Tripier F, Braunwald J, Markovic L, Kirn A. Budding of frog virus 3 studied by immunological and cytochemical methods in electron microscopy. Intervirology 1974; 3:305-18. [PMID: 4475038 DOI: 10.1159/000149768] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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