The worldwide burden of kidney disease is rising, but public awareness remains limited, underscoring the need for more effective communication by stakeholders in the kidney health community. Despite this need for clarity, the nomenclature for describing kidney function and disease lacks uniformity. In June 2019, Kidney Disease: Improving Global Outcomes (KDIGO) convened a Consensus Conference with the goal of standardizing and refining the nomenclature used in the English language to describe kidney function and disease, and of developing a glossary that could be used in scientific publications. Guiding principles of the conference were that the revised nomenclature should be patient-centered, precise, and consistent with nomenclature used in the KDIGO guidelines. Conference attendees reached general consensus on the following recommendations: (i) to use “kidney“ rather than “renal” or “nephro-” when referring to kidney disease and kidney function; (ii) to use “kidney failure” with appropriate descriptions of presence or absence of symptoms, signs, and treatment, rather than “end-stage kidney disease”; (iii) to use the KDIGO definition and classification of acute kidney diseases and disorders (AKD) and acute kidney injury (AKI), rather than alternative descriptions, to define and classify severity of AKD and AKI; (iv) to use the KDIGO definition and classification of chronic kidney disease (CKD) rather than alternative descriptions to define and classify severity of CKD; and (v) to use specific kidney measures, such as albuminuria or decreased glomerular filtration rate (GFR), rather than “abnormal” or “reduced” kidney function to describe alterations in kidney structure and function. A proposed 5-part glossary contains specific items for which there was general agreement. Conference attendees acknowledged limitations of the recommendations and glossary, but they considered standardization of scientific nomenclature to be essential for improving communication. The worldwide burden of kidney disease is rising, but public awareness remains limited, underscoring the need for more effective communication by stakeholders in the kidney health community. Despite this need for clarity, the nomenclature for describing kidney function and disease lacks uniformity. In June 2019, Kidney Disease: Improving Global Outcomes (KDIGO) convened a Consensus Conference with the goal of standardizing and refining the nomenclature used in the English language to describe kidney function and disease, and of developing a glossary that could be used in scientific publications. Guiding principles of the conference were that the revised nomenclature should be patient-centered, precise, and consistent with nomenclature used in the KDIGO guidelines. Conference attendees reached general consensus on the following recommendations: (i) to use “kidney“ rather than “renal” or “nephro-” when referring to kidney disease and kidney function; (ii) to use “kidney failure” with appropriate descriptions of presence or absence of symptoms, signs, and treatment, rather than “end-stage kidney disease”; (iii) to use the KDIGO definition and classification of acute kidney diseases and disorders (AKD) and acute kidney injury (AKI), rather than alternative descriptions, to define and classify severity of AKD and AKI; (iv) to use the KDIGO definition and classification of chronic kidney disease (CKD) rather than alternative descriptions to define and classify severity of CKD; and (v) to use specific kidney measures, such as albuminuria or decreased glomerular filtration rate (GFR), rather than “abnormal” or “reduced” kidney function to describe alterations in kidney structure and function. A proposed 5-part glossary contains specific items for which there was general agreement. Conference attendees acknowledged limitations of the recommendations and glossary, but they considered standardization of scientific nomenclature to be essential for improving communication. The worldwide burden of kidney disease is rising, but public awareness remains limited, underscoring the need for effective communication by stakeholders in the kidney health community.1Plantinga L.C. Boulware L.E. Coresh J. et al.Patient awareness of chronic kidney disease: trends and predictors.Arch Intern Med. 2008; 168: 2268-2275Crossref PubMed Scopus (227) Google Scholar, 2Saran R. Robinson B. Abbott K.C. et al.US Renal Data System 2018 Annual Data Report: Epidemiology of Kidney Disease in the United States.Am J Kidney Dis. 2019; 73: A7-A8Abstract Full Text Full Text PDF PubMed Scopus (513) Google Scholar, 3James S.L. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018; 392: 1789-1858Abstract Full Text Full Text PDF PubMed Scopus (6082) Google Scholar, 4Global Burden of Disease 2017 Causes of Death CollaboratorsGlobal, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2018; 392: 1736-1788Abstract Full Text Full Text PDF PubMed Scopus (3582) Google Scholar Despite this need for clarity, the nomenclature for describing kidney function and disease lacks uniformity. Two decades ago, a survey of hundreds of published articles and meeting abstracts reported a broad array of overlapping, confusing terms for chronic kidney disease (CKD) and advocated adoption of unambiguous terminology.5Hsu C.Y. Chertow G.M. Chronic renal confusion: insufficiency, failure, dysfunction, or disease.Am J Kidney Dis. 2000; 36: 415-418Abstract Full Text Full Text PDF PubMed Scopus (114) Google Scholar Nevertheless, terms flagged by that analysis as problematic, such as “chronic renal failure” and “pre-dialysis,” still appear in current-day publications. A coherent, shared nomenclature could influence communication at all levels, including not only greater appreciation of the burden of disease, but also improved understanding about how patients feel about their disease, more effective communication between kidney disease specialists and other clinicians, more straightforward comparison and integration of datasets, better recognition of gaps in knowledge for future research, and more comprehensive public health policies for acute and chronic kidney disease. The international organization Kidney Disease: Improving Global Outcomes (KDIGO) has developed guidelines promulgating definitions and classifications for acute kidney injury (AKI), acute kidney diseases and disorders (AKD), and CKD, and guidelines for their evaluation and management.6Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work GroupKDIGO clinical practice guideline for acute kidney injury.Kidney Int Suppl. 2012; 2: 1-138Abstract Full Text Full Text PDF Scopus (2007) Google Scholar,7Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work GroupKDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease.Kidney Int Suppl. 2013; 3: 1-150Abstract Full Text Full Text PDF Scopus (1596) Google Scholar Developing consistent, patient-centered, and precise descriptions of kidney function and disease in the scientific literature is an important objective that KDIGO is now pursuing to align communication in clinical practice, research, and public health. Although some terms have been in use for decades, the increased exchange of information among stakeholders makes it timely to revisit nomenclature in order to ensure consistency. The goal is to facilitate communication within and across disciplines and between practitioner and patient communities, to ultimately improve outcomes through clarity and precision. In June 2019, KDIGO convened a Consensus Conference with the goal of standardizing and refining the nomenclature used in English-language scientific articles to describe kidney function and disease, and developing a glossary that could be used by journals. Prior to the conference, KDIGO posted an announcement of the conference on its website, including the Scope of Work and requested public comment.8Kidney Disease: International Global OutcomesConsensus Conference on Nomenclature for Kidney Function & Disease.https://kdigo.org/conferences/nomenclature/Date Scholar at the conference of kidney kidney at general and other of clinical kidney health research, and Guiding principles of the conference were that the revised nomenclature should be patient-centered, precise, and consistent with nomenclature used in the KDIGO guidelines The on general of acute and chronic kidney disease and kidney measures, rather than specific kidney diseases and of function and The Scope of Work developed to the conference a of for of causes of kidney disease and measures, and for and were considered the of of the and and and the nomenclature to describe kidney function and on general of acute and chronic kidney disease and general kidney measures, rather than specific kidney diseases and specific of function and for “renal” or and definitions and other descriptions of disease and disease kidney and of “kidney with KDIGO guideline to that articles in the English-language literature should rather than “renal” or “nephro-” when referring to kidney disease and kidney failure” with appropriate descriptions of presence or absence of symptoms, signs, and rather than definition and classification of AKD and rather than alternative descriptions to define and classify severity of AKD and definition and classification of CKD rather than alternative descriptions to define and classify severity of kidney as albuminuria or decreased rather than “abnormal” or “reduced” kidney function to describe alterations in kidney structure and acute kidney diseases and acute kidney CKD, chronic kidney glomerular filtration Kidney Disease: Improving Global in a acute kidney diseases and acute kidney CKD, chronic kidney glomerular filtration Kidney Disease: Improving Global Prior KDIGO have been but is about the of terms used to describe kidney function and disease on have kidney disease. KDIGO a of patient and on the to the conference of which the and the reported et and on terms used to describe kidney health of J Scholar KDIGO a survey of attendees to the conference, of which and their Nomenclature is as for specific and in the has the of international et of A for and Google Scholar The of nomenclature the of an of some be to that be more or Nomenclature be consistent with knowledge and to for the but to with in the et of A for and Google Scholar The KDIGO guidelines define kidney disease as or of the that have for and classify kidney disease to severity of and and Coresh J. et of kidney disease: to health 2013; Full Text Full Text PDF PubMed Scopus Google and classification of kidney J Kidney Dis. 2013; Full Text Full Text PDF PubMed Scopus Google Scholar A other have proposed J. et proposed nomenclature and for in acute and chronic kidney disease.Kidney 2008; 73: Full Text Full Text PDF PubMed Scopus Google Scholar, et for renal in acute kidney PubMed Scopus Google Scholar, et and disease of the a of the on Nomenclature and on of PubMed Google Scholar, S.L. et kidney disease: and KDIGO consensus Full Text Full Text PDF PubMed Scopus Google Scholar but have been on specific diseases or standardization have a or A nomenclature for of the The Renal of the International of Full Text PDF PubMed Scopus Google Scholar The of the and used for in recommendations nomenclature for kidney disease and function in the at the of the of Scholar kidney have nomenclature but not they shared among journals. Conference attendees that the KDIGO guideline for definitions and classifications of acute and chronic kidney disease the for nomenclature standardization Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work GroupKDIGO clinical practice guideline for acute kidney injury.Kidney Int Suppl. 2012; 2: 1-138Abstract Full Text Full Text PDF Scopus (2007) Google Scholar,7Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work GroupKDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease.Kidney Int Suppl. 2013; 3: 1-150Abstract Full Text Full Text PDF Scopus (1596) Google Scholar The and of the of as that is and patient and and that patient all clinical on the of in the United of the A System for the Scholar of the general principles for of the health is that is shared and information should have to their information and to clinical and patients should and is some that is in G.M. in the use of and language in the of 2019; PubMed Scopus Google Scholar In the terms used to describe kidney function and disease should be to with of in the of health of terms with to as use of terms that the future as rather than describe the A general definition of is or of of Scholar is and is a in which be to a that more precise management of clinical The in which a is to the clinical and has and in In the Kidney by the of to and kidney with or CKD; a kidney define disease and and that for Scholar has in it is that that in disease descriptions be nomenclature for kidney function and disease, rather than it A of with CKD and the United United and in and by to terms and used for kidney health. 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Conference attendees reached general consensus for of the a proposed glossary contains and specific items on which there was general among conference the glossary descriptions, and terms to with that which of the recommendations to and that when and how to terms to be consistent with nomenclature for other of the use of glossary terms in the at the conference and of Disease: Improving Global Outcomes (KDIGO) kidney function and disease terms to describe kidney function and kidney disease and and and when to to Kidney function and should be used when describing kidney disease and kidney with the “nephro-” in the of specific or Kidney the of acute kidney diseases and disorders and chronic kidney in the of specific Kidney the of and of the should not be with glomerular filtration rate function when describing specific renal renal kidney to of kidney which should be kidney to of kidney which should be insufficiency, kidney function in with kidney is Although it is used in the of this could be used to to kidney function in kidney renal function Kidney the of and of the by and of injury and structure when describing specific within the such as kidney to of kidney which should be kidney to of kidney which should be Causes of kidney of and CKD should be be or for and of should be should not be only presence of as and when to to Kidney or by is renal disease kidney disease renal insufficiency, kidney injury be revised by KDIGO guideline renal renal insufficiency, renal chronic renal chronic chronic insufficiency, kidney and or and with and be with of and with kidney not a for be revised by KDIGO AKD consensus is and by by to for CKD; 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2: 1-138Abstract Full Text Full Text PDF Scopus (2007) Google Scholar,7Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work GroupKDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease.Kidney Int Suppl. 2013; 3: 1-150Abstract Full Text Full Text PDF Scopus (1596) Google Scholar In the acute conference attendees with disease severity by and treatment, but they not consensus on use of the “kidney failure” rather than or use of “kidney for all of it be appropriate for to be in with the of the KDIGO Disease: International Global Conference on Acute Kidney 2019; Scholar Conference attendees that and of kidney or the be and and there or to was as for research, with the that it be in the future to classify kidney by the presence or absence of and The KDIGO Conference in Chronic Kidney Disease use of the for not to but to for of kidney et of the KDIGO Conference on in Chronic Kidney Disease: developing a to improving Full Text Full Text PDF PubMed Scopus Google Scholar also an that could be used of with was considered to be consistent with the attendees the that of this in nomenclature not the to in the United and that the KDIGO definition and classification for should be used rather than the definitions to the classification and the Acute Kidney Injury which were by the 2012 KDIGO guideline Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work GroupKDIGO clinical practice guideline for acute kidney injury.Kidney Int Suppl. 2012; 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Google Scholar The albuminuria and have been to their with for outcomes and kidney and CKD as a Disease: Improving Global Outcomes (KDIGO) CKD Work GroupKDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease.Kidney Int Suppl. 2013; 3: 1-150Abstract Full Text Full Text PDF Scopus (1596) Google Scholar The guideline specific terms for of and of CKD, its and is not The terms and not and their use is not they should be in the of that specific kidney as albuminuria or and decreased rather than “abnormal” or “reduced” kidney should be used to describe alterations in kidney structure and function all measures, it is important to and of and their the 2012 CKD guideline Disease: Improving Global Outcomes (KDIGO) CKD Work GroupKDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease.Kidney Int Suppl. 2013; 3: 1-150Abstract Full Text Full Text PDF Scopus (1596) Google Scholar of is to that of it be and is more in the but in albuminuria and it is important to describe the of for and and for and as as The terms and should not be used as it is important to the filtration and it is important to the filtration and and should be to of for and should be to such as and and the of filtration be by The albuminuria and in the 2012 CKD guideline be to with or CKD, but it is to be as to or not with albuminuria or and have that the of albuminuria or is but is on presence or absence of the The of the 2012 KDIGO guideline an alternative for J. et and of glomerular diseases a Kidney Disease: Improving Global Outcomes (KDIGO) 2019; Full Text Full Text PDF PubMed Scopus Google Scholar The 2012 and CKD KDIGO guidelines about of the definitions and classifications to Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work GroupKDIGO clinical practice guideline for acute kidney injury.Kidney Int Suppl. 2012; 2: 1-138Abstract Full Text Full Text PDF Scopus (2007) Google Scholar,7Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work GroupKDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease.Kidney Int Suppl. 2013; 3: 1-150Abstract Full Text Full Text PDF Scopus (1596) Google Scholar not to with CKD to or and for and in to in is use of terms to describe acute and chronic kidney disease and kidney disease Conference attendees with the goal of standardizing and refining the nomenclature used in English to describe kidney function and disease, and of developing a glossary that could be used by for of scientific reached general consensus on the recommendations and on a glossary that the recommendations to be and by journals.
Journal of Palliative MedicineVol. 3, No. 1 Innovations in End-of-Life CareTaking a Spiritual History Allows Clinicians to Understand Patients More FullyDr. Christina Puchalski and Anna L. RomerDr. Christina Puchalski and Anna L. RomerPublished Online:19 Apr 2005https://doi.org/10.1089/jpm.2000.3.129AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byVerbalizing spiritual needs in palliative care: a qualitative interview study on verbal and non-verbal communication in two Danish hospices4 January 2022 | BMC Palliative Care, Vol. 21, No. 1Implementation of an Educational Toolkit to Increase Nurse Competence in Spirituality and Spiritual Care of Oncology Patients8 November 2022 | Journal of Holistic Nursing, Vol. 5Posicionamento sobre a Saúde Cardiovascular nas Mulheres – 2022Arquivos Brasileiros de Cardiologia, Vol. 119, No. 5Experiences of German health care professionals with spiritual history taking in primary care: a mixed-methods process evaluation of the HoPES3 intervention15 October 2022 | Family Practice, Vol. 29Religious and spiritual journeys of LGBT older adults in rural Southern Appalachia25 October 2021 | Journal of Religion, Spirituality & Aging, Vol. 34, No. 4The CASH assessment tool: A window into existential suffering19 May 2021 | Journal of Health Care Chaplaincy, Vol. 28, No. 4Integrating religion/spirituality into professional social work practice27 July 2022 | Journal of Religion & Spirituality in Social Work: Social Thought, Vol. 41, No. 4The Concept of Spirituality in the Health Sector: Contributions from the Study of Religion27 September 2022 | International Journal of Latin American Religions, Vol. 12Systematic review: The relationship between religion, spirituality and mental health in adolescents who identify as transgender13 September 2022 | Journal of Gay & Lesbian Mental Health, Vol. 26„Des Lebens Ruf an uns wird niemals enden“ – Sinnzentrierte Interventionen im Überblick30 August 2022 | Zeitschrift für Palliativmedizin, Vol. 23, No. 05Case discussion: The critically ill older adult in spiritual distressGeriatric Nursing, Vol. 47Australian Patient Preferences for the Introduction of Spirituality into their Healthcare Journey: A Mixed Methods Study3 August 2022 | Journal of Religion and Health, Vol. 27Religion, Spirituality, and Ethics in Psychiatric Practice30 March 2022 | Journal of Nervous & Mental Disease, Vol. 210, No. 8Spiritual distress in dialysis: A case report21 July 2022 | Progress in Palliative Care, Vol. 211Interprofessional communication training to address spiritual aspects of cancer care19 July 2022 | Journal of Health Care Chaplaincy, Vol. 29Spirituality in Serious Illness and HealthJAMA, Vol. 328, No. 2What is the role of spiritual care specialists in teaching generalist spiritual care? 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Maiko, Steven Ivy, Beth Newton Watson, Kianna Montz, and Alexia M. Torke27 March 2019 | Journal of Palliative Medicine, Vol. 22, No. 4Time to follow the evidence – Spiritual care in health careEthics, Medicine and Public Health, Vol. 9How and When Is Role Modeling Effective? 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Psikoterapilerdeki Dini İzler15 December 2018 | Cumhuriyet İlahiyat Dergisi, Vol. 22, No. 3Women's Perceptions of Using Short Films to Integrate Spirituality in TherapyJournal of Systemic Therapies, Vol. 37, No. 4Content Validation of Advanced Illness Criteria of a Palliative Care Screening Tool Lauren C. DiLello, Karen Mulvihill, Jennifer Delli Carpini, Riddhi Shah, Julia Hermanowski, and Damanjeet Chaubey29 October 2018 | Journal of Palliative Medicine, Vol. 21, No. 11Understanding, assessing, and in the spiritual of medical and October 2018 | Theology, Vol. 11, No. and of in Living with October 2018 | Journal of & Social Services, Vol. No. for the spirituality as October 2018 | Revista de Vol. 71, No. An of an aged psychiatry March 2018 | Psychiatry, Vol. 26, No. de de vida de de Vol. 25, No. support and with in Care in the Care A Narrative June | Journal of Care Medicine, Vol. No. Care in Cancer: in the of of Clinical Oncology Educational Vol. 3, No. religion/spirituality in clinical practice: A among social and and October | Journal of Clinical Psychology, Vol. 74, No. Spirituality in Care December | Journal of Religion and Health, Vol. 57, No. of to spiritual care at the of a phenomenological exploration from the of palliative care February 2018 | Journal for the Study of Spirituality, Vol. 8, No. Existential Distress in Pediatric Cancer December and Patient Spiritual in the through October of Spirituality in November Psychological/Psychiatric, Social, and Spiritual Problems and July and End-of-Life Care in Cancer in Oncology Nursing, Vol. No. Care in Hospice and Palliative Journal of Hospice and Palliative Care, Vol. 20, No. and Spirituality: Literature review and Journal of Counseling, Vol. 18, No. of the tool existential communication between and cancer August | European Journal of General Practice, Vol. 23, No. Education and of Christian Nursing, Vol. 34, No. Care Interventions in to and Therapy C. and D. September | Journal of Palliative Medicine, Vol. 20, No. in Patients with A Qualitative September | Journal of Research in Nursing and Vol. 14, No. theory on the and in an exploratory case study September | Vol. 69, No. of the of Spirituality and Palliative Care Research and of Pain and Symptom Management, Vol. No. of a spiritual care training program for staff on November | Palliative and Supportive Care, Vol. 15, No. 4Spiritual distress and spiritual care in advanced heart July | Reviews, Vol. and Spiritual Patient Simulation in Nursing, Vol. No. Vol. 42, No. 4The impact of a spiritual in patients with and and their support December | Vol. 26, No. 3The Importance of a Spiritual History in Healthcare Vol. No. About Substance Use DisordersJournal of Psychosocial Nursing and Mental Health Services, Vol. No. and Spiritual Beliefs of April | Journal of Religion and Health, Vol. No. Care Perceptions of and With of Hospice & Palliative Nursing, Vol. 19, No. in Substance Use What to Know to Practice30 November | in Mental Health Nursing, Vol. 38, No. End-of-Life Care to Religious and Vol. No. of Social Education, Vol. 53, No. Nursing Care and of Christian Nursing, Vol. 34, No. 1The of taking a religious and spiritual July | Psychiatry, Vol. 24, No. religion and spirituality in Vol. No. the role of religious in the at the of of Vol. No. care spiritual March | Supportive Care in Cancer, Vol. 24, No. Spiritual Care and the Role of An Review of Literature and April | Journal of Religion and Health, Vol. No. of the Spiritual Needs of of with Is in the June | Journal of Palliative Medicine, Vol. 19, No. Impact of a Tool for Comprehensive Assessment of Palliative Care on Assessment at and of Pain and Symptom Management, Vol. No. from Healthcare Students to Understand Spiritual Assessment in Clinical Practice29 October | Journal of Religion and Health, Vol. No. Spirituality in January | Journal of Religion and Health, Vol. No. 3Development and of to Assess Nurse Provision of Spiritual August 2014 | Journal of Holistic Nursing, Vol. 34, No. and Validation of the Practice Assessment September 2014 | Research on Social Practice, Vol. 26, No. and the Medical A of July | Journal of Health Care Chaplaincy, Vol. 22, No. history taking in palliative care: A controlled September | Palliative Medicine, Vol. 30, No. Is Is Using A and the Life With American in Spiritual March | Journal of in Mental Health, Vol. 11, No. and spiritual in September | International Journal of and Mental Health, Vol. No. 1The of Hospital to and Patients’ Spiritual A May | Journal for the Study of Spirituality, Vol. No. 1The and to March End-of-Life Spiritual March in Holistic Patient Journal of Nursing, Vol. No. of spiritual assessment for older September 2014 | and Vol. No. und der der Care, Vol. No. Spirituality and A for Holistic January | Journal of Religion and Health, Vol. No. and Belief, in Care spiritual history tool by C. M. Puchalski as an for an interdisciplinary in January | Journal for of and Social Vol. 21, No. the of Spiritual A Pain and Palliative Care Service Quality of Pain and Symptom Management, Vol. No. of Spiritual Assessment in September | Vol. No. the of Christian Nursing, Vol. 32, No. 4Spiritual care: is the assessment tool for palliative Journal of Palliative Nursing, Vol. 21, No. und Spiritualität in der September | Vol. 60, No. of September of spirituality assessment in palliative care patients in November 2014 | Progress in Palliative Care, Vol. 23, No. 4The for Spiritual A Mixed-Methods July | Oncology Nursing Vol. 42, No. 4The Integration of Religion and Spirituality in Social Practice: A May | Social Vol. 60, No. 3The and Educational of a Spiritual Life Review for Patients with and June 2014 | Journal of Cancer Education, Vol. 30, No. in Geriatric Palliative in Geriatric Medicine, Vol. No. An for Spiritual Well-Being May | Journal of Religion & Spirituality in Social Work: Social Thought, Vol. 34, No. Spiritual Assessment March | Journal of Health Care Chaplaincy, Vol. 21, No. American on Mental Health, and Help April | and Vol. 60, No. of Christian Nursing, Vol. 32, No. the Spiritual Needs and of Oncology Patients in Nursing Practice, Vol. 29, No. Care Training to Healthcare Professionals: A Systematic April | Journal of Pastoral Care & Counseling: Advancing theory and professional practice through scholarly and reflective publications, Vol. 69, No. analysis of spiritual
The Journal of Bone and Joint Surgery. British volumeVol. 70-B, No. 1 ArticlesFree AccessPelvic ring fractures: should they be fixed?M TileM TileSearch for more papers by this authorPublished Online:1 Jan 1988https://doi.org/10.1302/0301-620X.70B1.3276697AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byPreoperative CT simulation of iliosacral screws for treating unstable posterior pelvic ring injury8 March 2022 | BMC Musculoskeletal Disorders, Vol. 23, No. 1Functional outcome of unstable pelvic fractures treated in a level III hospital in a developing country: a 10-year prospective observational study4 April 2022 | Journal of Orthopaedic Surgery and Research, Vol. 17, No. 1Percutaneous posterior transiliac plate versus iliosacral screw fixation for posterior fixation of Tile C-type pelvic fractures: a retrospective comparative study16 June 2022 | BMC Musculoskeletal Disorders, Vol. 23, No. 1Equestrian-Related Pelvic Trauma in Women of Childbearing Age — a Review of the Experience of a National Pelvic & Acetabular Referral Centre27 July 2022 | SN Comprehensive Clinical Medicine, Vol. 4, No. 1CT of Sacral Fractures: Classification Systems and ManagementRadioGraphics, Vol. 42, No. 7Moving forward with the management of minimally displaced lateral compression pelvic ring injuries18 June 2022 | European Journal of Orthopaedic Surgery & Traumatology, Vol. 32, No. 7Biomechanical Comparison of 4 Transsacral Fixation Constructs in a Type 61C, Zone II Pelvic Fracture ModelJournal of Orthopaedic Trauma, Vol. 36, No. 10Rami Comminution Is Associated With Displacement of Minimally Displaced Lateral Compression Type 1 Injuries on Lateral Stress RadiographsJournal of Orthopaedic Trauma, Vol. 36, No. 10Surgical management of paediatric pelvic fractures: a prospective case series and early experience from a level one Egyptian trauma centre23 July 2022 | International Orthopaedics, Vol. 46, No. 10A Review on Management of Insufficiency Fractures of the Pelvis and AcetabulumOrthopedic Clinics of North America, Vol. 53, No. 4Lumbo-sacral Junction Instability by Traumatic Sacral Fractures: Isler’s Classification Revisited – A Narrative Review22 February 2022 | Global Spine Journal, Vol. 12, No. 8Prolonged ileus in traumatic pelvic ring injury patients who underwent arterial angio-embolization: A retrospective studyMedicine, Vol. 101, No. 39Surgical Versus Non-surgical Treatment of Unstable Lateral Compression Type I (LC1) Injuries of the Pelvis With Complete Sacral Fractures in Non-fragility Fracture Patients: A Systematic ReviewCureus, Vol. 15Analysis of Postoperative Gait, Hip Strength, and Patient-Reported Outcomes After OTA/AO 61-B and 61-C Pelvic Ring InjuriesJournal of Orthopaedic Trauma, Vol. 36, No. 9Dual-Energy CT and Cinematic Rendering to Improve Assessment of Pelvic Fracture InstabilityRadiology, Vol. 304, No. 2Mortality and functional outcomes of fragility fractures of the pelvis by fracture type with conservative treatment: a retrospective, multicenter TRON study1 December 2021 | European Journal of Trauma and Emergency Surgery, Vol. 48, No. 4Pelvic Fracture Urethral Distraction DefectUrologic Clinics of North America, Vol. 49, No. 3Paediatric pelvic fractures – an updated literature review3 July 2022 | ANZ Journal of Surgery, Vol. 36Sakrumfrakturen beim geriatrischen Patienten1 June 2022 | Zeitschrift für Gerontologie und Geriatrie, Vol. 55, No. 4Evolution of the AO Spine Sacral and Pelvic Classification System: a systematic reviewJournal of Neurosurgery: Spine, Vol. 78Nonoperative Management of Minimally Displaced Lateral Compression Type 1 Pelvic Ring Injuries With and Without Occult InstabilityJournal of Orthopaedic Trauma, Vol. 36, No. 6Reliability and reproducibility analysis of the AOSpine Sacral Fractures Classification System by spinal and pelvic surgeonsInjury, Vol. 53, No. 6Outcomes and complications of the INFIX technique for unstable pelvic ring injuries with high-velocity trauma: a systematic review and meta-analysis11 January 2021 | Archives of Orthopaedic and Trauma Surgery, Vol. 142, No. 5Anatomic reduction of the sacroiliac joint in unstable pelvic ring injuries and its correlation with functional outcome30 September 2020 | European Journal of Trauma and Emergency Surgery, Vol. 48, No. 2Emergency Department Stress Radiographs of Lateral Compression Type-1 Pelvic Ring Injuries Are Safe, Effective, and Reliable17 December 2021 | Journal of Bone and Joint Surgery, Vol. 104, No. 4Ligaments stabilizing the sacrum and sacroiliac joint: a comprehensive review25 August 2021 | Neurosurgical Review, Vol. 45, No. 1Pelvic ring and acetabular fracture: Concepts of traumatological forensic interestInjury, Vol. 53, No. 2Danger zone - The spermatic cord during anterior plating of the symphysis pubisInjury, Vol. 53, No. 2The pectineal ligament is a secondary stabilizer in anterior pelvic ring fractures - a biomechanical studyInjury, Vol. 53, No. 2Inter- and intra-observer agreement using the new AOSpine sacral fracture classification, with a comparison between spine and pelvic trauma surgeonsInjury, Vol. 53, No. 2Accuracy of Radiographic Displacement Measurement in a Pelvic Ring Injury Model13 September 2021 | Journal of the American Academy of Orthopaedic Surgeons, Vol. 30, No. 2The Influence of Regional Differences on the Reliability of the AO Spine Sacral Injury Classification System8 January 2022 | Global Spine Journal, Vol. 67Computer and magnetic resonance imaging for pelvic fractures in children12 May 2021 | Medical Visualization, Vol. 25, No. 4Nonoperative Treatment of Select Lateral Compression Type II Pelvic Ring Injuries (OTA/AO 61B2.2) Results in a Low Rate of Radiographic DisplacementJournal of Orthopaedic Trauma, Vol. 36, No. 1BibliographyManagement of Open Tile C Pelvic Fractures and Their Outcomes: A Retrospective Study of 30 Cases1 September 2022 | Therapeutics and Clinical Risk Management, Vol. Volume 18A nomogram to predict arterial bleeding in patients with pelvic fractures after blunt trauma: a retrospective cohort study8 February 2021 | Journal of Orthopaedic Surgery and Research, Vol. 16, No. 1Three‐dimensional‐printed customized prosthesis for pubic defect: clinical outcomes in 5 cases at a mean follow‐up of 24 months30 April 2021 | BMC Musculoskeletal Disorders, Vol. 22, No. 1Which factors influence treatment decision in fragility fractures of the pelvis? - results of a prospective study13 August 2021 | BMC Musculoskeletal Disorders, Vol. 22, No. 1Comparison of lumbopelvic fixation and iliosacral screw fixation for the treatment of bilateral sacral fractures16 October 2021 | Journal of Orthopaedic Surgery and Research, Vol. 16, No. 1Minimally displaced acetabulum fractures in geriatric patients: a comparison of open, percutaneous and non-operative treatment from the German Pelvic Injury Register data8 April 2020 | European Journal of Trauma and Emergency Surgery, Vol. 47, No. 6Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses19 September 2020 | European Journal of Trauma and Emergency Surgery, Vol. 47, No. 6A retrospective study about functional outcome and quality of life after surgical fixation of insufficiency pelvic ring injuries13 December 2021 | BMC Musculoskeletal Disorders, Vol. 22, No. 1Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation28 October 2021 | Journal of Clinical Medicine, Vol. 10, No. 21Verification of High-Rate Vertical Loading Laboratory Skeletal Fractures by Comparison with Theater Injury Patterns15 October 2021 | Annals of Biomedical Engineering, Vol. 49, No. 11Reproductibilité intra- et inter-examinateur de la classification AO/OTA 2018 des ruptures de l’anneau pelvien à haute énergie : une étude rétrospectiveRevue de Chirurgie Orthopédique et Traumatologique, Vol. 107, No. 6Inter- and intraobserver reliability assessment of the 2018 AO/OTA classification for high-energy pelvic ring injuries: A retrospective studyOrthopaedics & Traumatology: Surgery & Research, Vol. 107, No. 6Management and outcomes of open pelvic fractures: An updateInjury, Vol. 52, No. 10One sacroiliac screw for posterior ring fixation in unstable pelvic fractures1 November 2021 | Acta Orthopaedica Belgica, Vol. 87, No. 3Endovascular management of haemorrhage in pelvic traumaSurgery in Practice and Science, Vol. 6The FFP-classification: From eminence to evidenceInjury, Vol. 94The Influence of Surgeon Experience and Subspeciality on the Reliability of the AO Spine Sacral Classification SystemSpine, Vol. Publish Ahead of PrintAssociation Between Stability and Urologic Lesions in Pelvic Ring Fractures. A Case Series Report6 January 2020 | Journal of Investigative Surgery, Vol. 34, No. 7Pelvic Ring Fractures and Lower Urinary Tract Injuries8 January 2020 | Journal of Investigative Surgery, Vol. 34, No. 7Validation of the AO Spine Sacral Classification SystemJournal of Orthopaedic Trauma, Vol. Publish Ahead of PrintLateral compression type 1 (LC1) pelvic ring injuries: a spectrum of fracture types and treatment algorithms16 April 2021 | European Journal of Orthopaedic Surgery & Traumatology, Vol. 31, No. 5An independent inter- and intraobserver agreement assessment of the AOSpine sacral fracture classification systemThe Spine Journal, Vol. 21, No. 7Incidence and Clinical Features of Urethral Injuries with Pelvic Fractures in Males: A 6-Year Retrospective Cohort Study at a Single Institution in South KoreaJournal of Trauma and Injury, Vol. 34, No. 2Short-Term Functional Outcomes and Quality of Life after B2.1 Type Pelvic Fractures for Surgically and Non-Surgically Treated Young Patients21 May 2021 | Medicina, Vol. 57, No. 6Pelvic and acetabular trauma in amateur equestrian enthusiasts – A retrospective reviewThe Surgeon, Vol. 120Bilateral vertical shear sacroiliac joint dislocations treated with bilateral triangular Osteosynthesis in a young female: A case reportTrauma Case Reports, Vol. 61Factors Associated With Failure of Superior Pubic Ramus ScrewsJournal of Orthopaedic Trauma, Vol. 35, No. 4Medium-Term Patient-Reported Quality of Life and Activities of Daily Living in Surgically Treated Trauma Patients With Pelvic, Acetabular or Combined Pelvic and Acetabular Fractures in a Retrospective Single-Center StudyJournal of Orthopaedic Trauma, Vol. 35, No. 4Relevant Clinical Findings of Patients with Extraperitoneal Bladder Injury Associated with Pelvic Fracture Who Underwent Operative Management: A 6-Year Retrospective StudyJournal of Acute Care Surgery, Vol. 11, No. 1Comparison of One-Year Functional Outcomes and Quality of Life between Posterior Pelvic Ring Fixation and Combined Anterior-Posterior Pelvic Ring Fixation after Lateral Compression (B2 Type) Pelvic Fracture26 February 2021 | Medicina, Vol. 57, No. 3Patient-reported Outcome in Surgically Treated Pelvic Ring Injuries at 5 Years Post-surgery19 September 2019 | Scandinavian Journal of Surgery, Vol. 110, No. 1Application of Pelvic Circumferential Compression Devices in Pelvic Ring Fractures—Are Guidelines Followed in Daily Practice?21 March 2021 | Journal of Clinical Medicine, Vol. 10, No. 6Interobserver reliability of the Tile classification system for pelvic fractures among radiologists and surgeons8 September 2020 | European Radiology, Vol. 31, No. 3An Automated Deep Learning Method for Tile AO/OTA Pelvic Fracture Severity Grading from Trauma whole-Body CT21 January 2021 | Journal of Digital Imaging, Vol. 34, No. 1The ‘nightstick’ ischial fracture: a unique oddity of the pelvic injury family26 February 2021 | BMJ Case Reports, Vol. 14, No. 2Treatment of Pelvic Fractures15 September 2020The History of Pelvic Fracture Treatment26 November 2020Classification of Pelvic Ring Injuries26 November 2020Biomechanics of the Pelvis26 November 2020Principles of Treatment of Pelvic Ring Injuries26 November 2020Ilium Fractures26 November 2020Retrograde Pubic Rami Screw26 November 2020Ilio-Iliacal Osteosynthesis26 November 2020Posterior pelvic ring injury of straddle fractures: Incidence, fixation methods, and clinical outcomesAsian Journal of Surgery, Vol. 44, No. 1Integrity of the pectineal ligament in MRI correlates with radiographic superior pubic ramus fracture displacement28 April 2020 | Acta Radiologica, Vol. 62, No. 1A systematic review of the transiliac internal fixator (TIFI) for posterior pelvic injuries26 July 2021 | SICOT-J, Vol. 7An Interpretable Approach to Automated Severity Scoring in Pelvic Trauma21 September 2021External Fixation in Pelvi-Acetabular Implantology3 December 2021Three-dimensional-printed customized prosthesis for pubic defect: prosthesis design and surgical techniques13 July 2020 | Journal of Orthopaedic Surgery and Research, Vol. 15, No. 1Radiostereometric Analysis Allows Assessment of the Stability and Inducible Displacement of Pelvic Ring Disruptions during Healing: A Case Series24 October 2020 | Journal of Clinical Medicine, Vol. 9, No. 11Minimal-invasive Stabilisierung bei Frakturen des Sakrums21 August 2020 | Der Unfallchirurg, Vol. 123, No. 10A Water Slide Accident Resulting in an Open Book Pelvic Injury and Subsequent Pulmonary Embolus: A Case Report5 August 2020 | Case Reports in Orthopedic Research, Vol. 3, No. 2Description and Reliability of the AOSpine Sacral Classification System21 April 2020 | Journal of Bone and Joint Surgery, Vol. 102, No. 16MRI Evaluation of the Posterior Pelvic Bony and Soft Tissue Injuries With Tile C Displaced Pelvic Fractures in Young Children20 March 2020 | Journal of Pediatric Orthopaedics, Vol. 40, No. 7Early fixation strategies for high energy pelvic ring injuries – the Zurich algorithmInjuryResults of open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable pelvic ring injuries: retrospective study of 36 patients5 March 2020 | European Journal of Orthopaedic Surgery & Traumatology, Vol. 30, No. 5The Lateral Stress Radiograph Identifies Occult Instability of Lateral Compression Pelvic Ring Injuries Without SedationJournal of Orthopaedic Trauma, Vol. Publish Ahead of PrintFlegmasia cerúlea dolens posquirúrgica inmediata en el tratamiento de una fractura de pelvis. Reporte de Caso2 May 2020 | Revista de la Asociación Argentina de Ortopedia y Traumatología, Vol. 85, No. 2Long-term total hip arthroplasty rates in patients with acetabular and pelvic fractures after surgery: A population-based cohort study3 April 2020 | PLOS ONE, Vol. 15, No. 4Dual-energy CT as an innovative method for diagnosing fragility fractures of the pelvic ring: a retrospective comparison with MRI as the gold standard14 October 2019 | Archives of Orthopaedic and Trauma Surgery, Vol. 140, No. 4Radiologische Diagnostik von Beckenringfrakturen27 February 2020 | Der Radiologe, Vol. 60, No. 3High-energy Lateral Compression Type 1 Injuries of the PelvisJournal of the American Academy of Orthopaedic Surgeons, Vol. 28, No. 4CT-guided fixation of pelvic fractures after high-energy trauma, by interventional radiologists: technical and clinical outcome18 October 2019 | European Radiology, Vol. 30, No. 2Pelvic fractures in children (pelvic ring and acetabulum)Orthopaedics & Traumatology: Surgery & Research, Vol. 106, No. 1Combined 3D Printed Template to Guide Iliosacral Screw Insertion for Sacral Fracture and Dislocation: A Retrospective Analysis19 February 2020 | Orthopaedic Surgery, Vol. 12, No. 1Pelvic Vertical Shear Injuries and Sacroiliac Joint Disruptions2 January 2020Percutaneous removal of sacroiliac screw following iatrogenic neurologic injury in posterior pelvic ring injury: A case reportInternational Journal of Surgery Case Reports, Vol. 66Kinesiology of the pelvisPelvis16 April 2020Vertical shear pelvic ring injuries: do transsacral screws prevent fixation failure?1 September 2020 | OTA International: The Open Access Journal of Orthopaedic Trauma, Vol. 3, No. 3Outcome of pubic rami fractures with or without concomitant involvement of the posterior ring in elderly patients12 June 2018 | European Journal of Trauma and Emergency Surgery, Vol. 45, No. 6Modified less invasive anterior subcutaneous fixator for unstable Tile-C-pelvic ring fractures: a biomechanical study29 March 2019 | BioMedical Engineering OnLine, Vol. 18, No. 1Decision-making, therapy, and outcome in lateral compression fractures of the pelvis – analysis of a single center treatment15 May 2019 | BMC Musculoskeletal Disorders, Vol. 20, No. 1Operative Treatment of Pediatric Pelvic and Acetabulum FracturesJournal of Orthopaedic Trauma, Vol. 33, No. 8Surgery for Unilateral Sacral Fractures: Are the Indications Clear?Journal of Orthopaedic Trauma, Vol. 33, No. 12Is a Fracture of the Transverse Process of L5 an Indicator of the Presence and/or Severity of a Pelvic Fracture?Spine Surgery and Related Research, Vol. 3, No. 4Minimally Invasive Screw Fixation of Unstable Pelvic Fractures Using the “Blunt End” Kirschner Wire Technique Assisted by 3D Printed External TemplateBioMed Research International, Vol. 2019COMPARISON OF X-RAY AND CT METHODS FOR ASSESSING SACRAL SHAPE VARIANTS AND IDENTIFYING A SECURE SACROILIAC SCREW FIXATION CORRIDOR14 May 2020 | Journal of Musculoskeletal Research, Vol. 22, No. 03n04Pelvic TraumaYoung–Burgess classification: Inter-observer and inter-method agreement between pelvic radiograph and computed tomography in emergency polytrauma management8 July 2019 | Hong Kong Journal of Emergency Medicine, Vol. 71Management of male pelvic fracture urethral injuries: Review and current topics20 March 2019 | International Journal of Urology, Vol. 26, No. 6Interactive Flying Frustums (IFFs): spatially aware surgical data visualization12 March 2019 | International Journal of Computer Assisted Radiology and Surgery, Vol. 14, No. 6Ultrasound-guided supra-acetabular pelvic external fixator (US-SA FIX)Injury, Vol. 50AOSpine—Spine Trauma Classification System: The Value of Modifiers: A Narrative Review With Commentary on Evolving Descriptive Principles8 May 2019 | Global Spine Journal, Vol. 9, No. 1_supplTreatment of Partial Traumatic HemipelvectomyJournal of Bone and Joint Surgery, Vol. 101, No. 9Minimally invasive internal fixator for unstable pelvic ring injuries with a pedicle screw–rod system: a retrospective study of 23 patients after 13.5 months8 December 2018 | Archives of Orthopaedic and Trauma Surgery, Vol. 139, No. 4Complex Open Pelvic Fracture in an 8-Year-Old Girl Treated With INFIX—A Case StudyJAAOS: Global Research and Reviews, Vol. 3, No. 4Conventional plate fixation method versus pre-operative virtual simulation and three-dimensional printing-assisted contoured plate fixation method in the treatment of anterior pelvic ring fracture3 May 2018 | International Orthopaedics, Vol. 43, No. 2Levels of evidence in pelvic trauma: a bibliometric analysis of the top 50 cited papers12 May 2018 | Irish Journal of Medical Science (1971 -), Vol. 188, No. 1A biomechanical study comparing minimally invasive anterior pelvic ring fixation techniques to external fixationInjury, Vol. 50, No. 2Unstable Pelvic Ring Injuries: How Soon Can Patients Safely Bear Weight?Journal of Orthopaedic Trauma, Vol. 33, No. 2Long-Term Patient-Reported Functional Outcome of Polytraumatized Patients With Operatively Treated Pelvic FracturesJournal of Orthopaedic Trauma, Vol. 33, No. 2Pediatric Pelvic Injuries29 June 2019Fractures du bassin chez l'enfant (anneau pelvien et cotyle)Biomechanical evaluation of location and mode of failure in three screw fixations for a comminuted transforaminal sacral fracture modelJournal of Orthopaedic Translation, Vol. 16American College of Surgeons Committee on Trauma verification level affects trauma center management of pelvic ring injuries and patient mortalityJournal of Trauma and Acute Care Surgery, Vol. 86, No. 1Sciatic Nerve Palsy After Distal Femoral Traction for Vertically Unstable Pelvic Fracture in a Neurologically Intact Patient1 September 2019 | JAAOS: Global Research and Reviews, Vol. 3, No. 9Intramedullary Stabilization of Pubic Ramus Fractures in Elderly Patients With a Photodynamic Bone Stabilization System (IlluminOss)25 April 2019 | Geriatric Orthopaedic Surgery & Rehabilitation, Vol. 10Open pelvic fracture: the killing fracture?13 April 2018 | Journal of Orthopaedic Surgery and Research, Vol. 13, No. 1Minimally invasive treatment for anterior pelvic ring injuries with modified pedicle screw-rod fixation: a retrospective study17 September 2018 | Journal of Orthopaedic Surgery and Research, Vol. 13, No. 1Clinical and radiographic outcome of isolated sacroiliac joint dislocationsMinerva Ortopedica e Traumatologica, Vol. 69, No. 4Vertical shear pelvic injury: evaluation, management, and fixation strategies26 March 2018 | International Orthopaedics, Vol. 42, No. 11High-Energy Pelvic Ring Disruptions with Complete Posterior Instability3 October 2018 | Journal of Bone and Joint Surgery, Vol. 100, No. 19Paediatric pelvic ring injuriesOrthopaedics and Trauma, Vol. 32, No. 5Quantitative MDCT assessment of binder effects after pelvic ring disruptions using segmented pelvic and March 2018 | European Radiology, Vol. 28, No. Use of External Fixation for the Management of the Unstable Anterior Pelvic of Orthopaedic Trauma, Vol. 32, No. and of Tile C pelvic ring injuries using a external fixation December | European Journal of Orthopaedic Surgery & Traumatology, Vol. 28, No. of After Operative Treatment of Pelvic Ring InjuriesJournal of Orthopaedic Trauma, Vol. 32, No. 7Biomechanical of fixation techniques in sacrum type II fracture with December | Journal of Orthopaedic Vol. 36, No. for Injury after Pelvic Ring Vol. No. of Fractures Using a Clinical and Operative June 2018 | Journal of Orthopaedics, Trauma and Rehabilitation, Vol. No. 1The trauma from a A case study the of vertical Science International, Vol. Posterior Pelvic for Unstable Sacral Fractures: A Fixation of Orthopaedic Trauma, Vol. 32, No. compression type pelvic ring fractures in young patients do May | European Journal of Trauma and Emergency Surgery, Vol. 44, No. analysis of anterior ring fixation of the ramus in type C pelvis April | European Journal of Trauma and Emergency Surgery, Vol. 44, No. of life after pelvic ring fractures: A studyInjury, Vol. 49, No. fractures of the pelvic and Trauma, Vol. 32, No. in Trauma Emergency Vol. 34, No. of and bilateral sacroiliac joint of Neurosurgery: Spine, Vol. 28, No. fixation of and & Traumatology: Surgery & Research, Vol. 104, No. 1Pelvic Ring Injury May for Spine November Fractures in the and How to of the Fracture Vol. 31, No. screws CT to sacroiliac joint in C pelvic Outcomes at 5 of November 2018 | SICOT-J, Vol. 4Minimally invasive treatment of unstable pelvic ring injuries with modified pedicle screw–rod June | Journal of International Medical Research, Vol. 46, No. supra-acetabular in pelvic external fixation: of a surgical technique and Vol. of an anterior pelvic internal fixator to disruptions of the anterior pelvic of and September | The Bone & Joint Journal, Vol. No. of pelvic ring as a in – A case by of Clinical and Trauma, Vol. following anterior pelvic of a traumatic pubic symphysis treated with open reduction and internal of Clinical and Trauma, Vol. e do de Vol. 52, No. of pelvic ring fractures and de Ortopedia Vol. 52, No. and of after acetabular fractures October | Vol. 101, No. reduction internal fixation versus percutaneous iliosacral screw fixation for unstable posterior pelvic ring & Traumatology: Surgery & Research, Vol. No. Stress Pelvic Ring Without DisplacementJournal of Orthopaedic Trauma, Vol. 31, No. of in Analysis on Pelvic Biomechanical March | Orthopaedic Surgery, Vol. 9, No. spine and for or A Case for Care in the August of the internal fixator as an of pelvic ring March outcome of patients with unstable pelvic ring January | Journal of Orthopaedic Surgery, Vol. 25, No. en - Vol. 49, No. AND A FOR November | Journal of in and Vol. 16, No. MDCT Instability in Pelvic Ring Journal of Vol. No. de la Vol. 40, No. of the posterior Vol. 40, No. of Pelvic Ring and Acetabular in Vol. No. Surgery on with Pelvic Ring A Case of Trauma and Injury, Vol. No. Fixation of Pelvic Ring Injuries of Anterior Failure and of Bone and Joint Surgery, Vol. No. of Failure After Plating on Functional Outcome and of Orthopaedic Trauma, Vol. 30, No. internal fixation versus plate fixation for open pelvic ring injuries: a biomechanical study17 April | European Journal of Trauma and Emergency Surgery, Vol. 42, No. in sacral fracture and & Traumatology: Surgery & Research, Vol. 102, No. 1Pelvic ring injuries: management and of Clinical and Trauma, Vol. No. is the internal fixation in pelvic fracture with injury and anterior sacroiliac joint December | Medical Journal of Vol. No. Pelvic in Orthopaedics, Vol. 25, No. Fixation for Pelvic in Orthopaedics, Vol. 25, No. of the sacroiliac joint with unstable fractures of the pelvis and in a a case of Orthopaedic Science, Vol. 20, No. 6The internal fixator an innovative surgical technique for of fragility fractures of the Vol. Sacroiliac Screw Fixation of the Posterior Pelvic Clinics of North America, Vol. 46, No. and factors associated with in patients after pelvic Vol. No. pelvic injury in Journal of Traumatology, Vol. 18, No. iliosacral screw fixation after posterior ring fractures of the pelvis in elderly Vol. 46, No. study of the sacroiliac fracture fixation with and pedicle Vol. 23, No. paediatric pelvic of pelvic ring failure and the of of the May | The Bone & Joint Journal, Vol. No. classification, and of pelvic fracture urethral April 2019 | Journal of Urology, Vol. 13, No. 1Pelvic Ring November and about the Hip and of Pelvic Ring Fractures in November | Journal of Vol. Versus Care in the Treatment of Pelvic Vol. No. of a new of sacroiliac joint
Journal of Women's HealthVol. 29, No. 4 CommentaryFree AccessSex and Gender Disparities in the COVID-19 PandemicJewel Gausman and Ana LangerJewel GausmanWomen & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.Search for more papers by this author and Ana LangerAddress correspondence to: Ana Langer, MD, Women & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 651 Huntington Avenue, FXB Building 6th Floor Office 643B, Boston, MA 02115 E-mail Address: [email protected]Women & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.Search for more papers by this authorPublished Online:17 Apr 2020https://doi.org/10.1089/jwh.2020.8472AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail In the case of the ongoing COVID-19 pandemic, sex-disaggregated data suggest that fewer women are dying from the disease than men.1 However, taking this observation at face value oversimplifies the biological, behavioral, and social and systemic factors that may cause differences to emerge with regard to how women and men experience both the disease and its consequences. As governments react with swift and severe measures in their ongoing fight to control the pandemic's spread, it is important to understand how these actions may disproportionately increase the risks for women both directly and indirectly with regard to sex and gender.Pregnant women are often among the most vulnerable groups during public health emergencies. In some cases, pregnant women face increased biological susceptibility to adverse health outcomes, as in the case of some respiratory infections. With other emergent coronaviruses, such as those responsible for severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS), pregnant women who became infected were found to be more likely than nonpregnant women to experience severe complications.2 It is still too early to tell whether this will be the case with COVID-19.In the ongoing pandemic, other factors may have a ripple effect that put women at increased risk even if the disease itself does not. As made clear during the 2014 Ebola outbreak, the consequences of large-scale infectious disease outbreaks on uninfected pregnant women can be dire. Routine prenatal care appointments, if not interrupted or discontinued, may put women at increased risk of exposure to the virus. Overwhelmed hospitals struggling to function with staff and supply shortages may not be able to provide the high quality of care that all pregnant women and their newborns deserve, let alone respond to emergency obstetric complications. Furthermore, there is also a risk that life-saving treatments or vaccines will be denied to pregnant women over concern for fetal safety or a lack of data.3,4The fear of infection, concern for the well-being of friends and loved ones, uncertainty, disruption, and social isolation that have become part and parcel of daily life for many around the world will undoubtedly have profound effects on mental health on the population at large, but being pregnant during a global pandemic is likely to be even more frightening for many women. Although containment strategies, such as those that require women to deliver without a companion present, including partners and doulas, that have already been put into place in some cities in the United States,5 or those that separate newborns from their mothers immediately after birth if the mother is infected with COVID-196 may be clinically important to reduce transmission, they may also have profound short- and long-term mental health implications for women. Among women who have young children, previous research in Ethiopia, India, and Vietnam found that women who experience family-related stressful life events, such as illness or death within the household and financial uncertainty, are more likely to experience episodes of severe mental distress.7 With the ongoing need to social distance, family and community networks may struggle and pregnant and postpartum women may feel even more vulnerable and isolated over a lack of social support.The adverse effects of the pandemic in relation to women's reproductive health are not limited to pregnancy or motherhood. As movement restrictions are put into place, supply chains are disrupted, and businesses are shuttered, some women may be at increased risk of unintended pregnancy should it become difficult to obtain their regular contraceptive method or emergency contraceptives, if needed. Furthermore, some states within the United States have begun to impose restrictions on certain medical procedures that they deem to be elective, including abortion, suggesting they must be delayed until after the pandemic is over.8 Spikes in domestic violence during times of crisis are another area of grave concern for women's health, and as governments continue to put into place more extreme measures to enforce social distancing, for some women, more time at home may mean more time spent with an abusive partner. Fewer social interactions may also mean less accountability for perpetrators and fewer opportunities for others to intervene.Gender-related factors may also increase the impact of the COVID-19 pandemic on women globally. Women constitute a disproportionately high percentage of caregivers in both the formal and informal sectors.9 A large proportion of frontline health care professionals (nurses, community health workers, health technicians, etc.) is women who face a higher risk of infection, morbidity, and death as a result of their profession.9 At the same time, women more frequently serve as the primary caregivers within a household, which may further increase their risk of exposure. In the United States, 65% of unpaid family caregivers are estimated to be women and 80% of them care for someone aged 50 years or older.10 Outside of their caregiving role, women are overrepresented in the informal employment sector. In low-and middle-income countries, two-thirds of women who work do so as part of the informal economy with limited access to health care for themselves and their families.9 Containment and mitigation policies that limit women's ability to perform their duties without offering effective alternatives, such as closing of daycare facilities for their children or not providing paid sick leave, may result in unnecessary exposure to disease and increased family vulnerability.It is urgent that we adopt a gender lens to study the pandemic and its effects, including the policies and actions that are put into place at the global, country, and local levels. This may be especially important in disadvantaged populations and resource-poor communities, where women are especially vulnerable. The public health community must ensure that existing health and social services meant to support women in the face of their unique needs do not disappear in lieu of the all-encompassing focus on stopping the pandemic. Furthermore, we argue that special attention needs to be paid to ensure that informal caregivers are supported, informed, and protected. To avoid making existing gender disparities larger as a result of the pandemic, a special body at the U.S. Centers of Disease Control and Prevention is urgently needed to track sex disaggregated data and analyze policies related to COVID-19 using a gender lens.Author Disclosure StatementNo competing financial interests exist.Funding InformationNo funding was received for this article.References1. Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med 2020;pii: S2213-2600(20)30117-X. Medline, Google Scholar2. Favre G, Pomar L, Musso D, Baud D. 2019-nCoV epidemic: What about pregnancies? Lancet 2020;395:e40. Crossref, Medline, Google Scholar3. Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus disease 2019 (COVID-19) and pregnancy: What obstetricians need to know. Am J Obstet Gynecol 2020;pii: S0002-9378(20)30197-6. Medline, Google Scholar4. Weigel G. Novel coronavirus "COVID-19": Special considerations for pregnant women. Available at: https://www.kff.org/womens-health-policy/issue-brief/novel-coronavirus-covid-19-special-considerations-for-pregnant-women/?utm_source=Global+Health+NOW+Main+List Accessed March 17, 2020. Google Scholar5. Caron C, Syckle KV. Laboring alone: Some hospitals bar partners because of virus fears. The New York Times. 2020. Google Scholar6. American College of Obstetricians and Gynecologists. Practice advisory: Novel coronavirus 2019 (COVID-19). Available at: https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Advisories/Practice-Advisory-Novel-Coronavirus2019?IsMobileSet=false Accessed March 13, 2020. Google Scholar7. Gausman J, Austin SB, Subramanian S, Langer A. Adversity, social capital, and mental distress among mothers of small children: A cross-sectional study in three low and middle-income countries. PLoS One 2020;15:e0228435. Crossref, Medline, Google Scholar8. Tavernise S. Texas and Ohio include abortion as medical procedures that must be delayed. The New York Times. 2020. Google Scholar9. Langer A, Meleis A, Knaul FM, et al. Women and health: The key for sustainable development. Lancet 2015;386:1165–1210. Crossref, Medline, Google Scholar10. Feinberg L, Reinhard SC, Houser A, Choula R. Valuing the invaluable: 2011 update, the growing contributions and costs of family caregiving. Washington, DC: AARP Public Policy Institute, 2011:32. 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S. and May 2022 | Journal of Women's Health, Vol. 31, No. of women in clinical A for and Clinical Vol. and urban towards pandemic May 2022 | Vol. the The of during a January 2022 | & Psychology, Vol. 32, No. and During the and of the COVID-19 Pandemic in April 2022 | Frontiers in Vol. to Greater With the COVID-19 and to Journal of Health Psychology, Vol. 29, No. of to the of SARS-CoV-2 With Anxiety and A Study of March 2022 | International Journal of Public Health, Vol. in the Impact of COVID-19 Pandemic in in The Gender in Vol. No. 3Women's health and access COVID-19 Outlook, Vol. 70, No. of to COVID-19 Outcomes in a Longitudinal of February 2022 | Vol. No. as March 2022 | Saúde Vol. No. COVID-19 wave in during the of and its with higher February 2022 | PLOS ONE, Vol. 17, No. well-being and during the COVID-19 pandemic in the United A February 2022 | The Social Science Vol. to and February 2022 | Psychology, Vol. women's during the COVID-19 pandemic in June 2021 | and An International Vol. No. an and at the same in work and during the coronavirus April 2021 | International Journal of Psychology, Vol. No. and local A in the time of November 2021 | International Journal of Psychology, Vol. No. and the During June 2021 | & Vol. 26, No. of Medical Care among in the United States during the COVID-19 May 2022 | Journal of Public Health Research, Vol. 11, No. the Gender Disparities in COVID-19 and January 2022 | & Vol. with public health for COVID-19: a study of mothers with young children in the United February 2022 | Journal of in Vol. No. Perspectives on January and Among Adults During the to COVID-191 February in and and during the COVID-19 pandemic health and and Vol. in the COVID‐19 Effects of on December 2021 | British Journal of Vol. No. effects of the on for an emerging January 2022 | & Vol. No. Distress among Dental during the COVID-19 December 2021 | International Journal of Environmental Research and Public Health, Vol. 19, No. physical and social of health during the COVID-19 lockdown: a for of depression, and stress in the population during social isolation to the COVID-19 a cross-sectional study28 April 2021 | BMC Vol. No. and but same mortality of severe disease in March 2021 | BMC Medicine, Vol. No. Factors with and among community October 2021 | and Health, Vol. 17, No. differences in a of COVID-19 patients during the first and pandemic August 2021 | of Sex Vol. 12, No. in December 2021 | Journal of Clinical Medicine, Vol. 10, No. November 2021 | of Coronavirus Anxiety in Women on and Birth One of Coronavirus October 2021 | Journal of and Research, Vol. No. in and among Young Adults During Social to March 2021 | The Journal of Sex Research, Vol. No. of COVID-19 short- and long-term Disparities in and October 2021 | PLOS ONE, Vol. 16, No. analysis of on 2021 | Journal of in Medicine, Vol. No. of and Among COVID-19 by States in Women An September 2021 | and Vol. No. of COVID-19 using Public Gender and COVID-19: a Social Media of 2021 | Journal of Research, Vol. 5, No. for COVID-19 and its impact on in the Research on and Economics, Vol. No. differences in mental health of Canadian during the COVID-19 of and Health, Vol. No. Use and Relationship to Stress, and Perceived During the COVID-19 Pandemic in August 2021 | Frontiers in Public Health, Vol. and Lessons for August 2021 | PLOS ONE, Vol. 16, No. in How women in the United States in of of during the pandemic of March 2021 | Journal of Psychology, Vol. No. of in severe COVID-19 and Vol. No. the gender June 2021 | Journal of Perinatal Medicine, Vol. No. and the Related Factors in for COVID-19 at 2021 | International Journal of Health and Sciences, Vol. No. Gender Disparities and A Vol. No. impact of COVID‐19 on women to A of December | & Vol. No. of the and During the Covid-19 2021 | Frontiers in Psychology, Vol. in a January 2021 | Vol. No. responses to COVID-19 to Abuse & Vol. in and Practice During Social Among Young Adults in the May 2021 | Medicine, Vol. No. SARS-CoV-2 pandemic: A Health, Vol. and and after the pandemic April 2021 | Clinical and Research, Vol. No. on in August | Vol. 13, No. An to COVID-19 February 2022 | Journal of Women and Social Vol. No. in the and Outcomes of With May 2021 | Journal of Medicine, Vol. 16, No. of COVID-19: and May 2021 | Frontiers in Public Health, Vol. in the of February 2022 | Journal of Human Vol. No. and of the COVID-19 pandemic from the of in May 2021 | Journal of Social Work, Vol. No. the Pandemic: December April health disparities in vulnerable populations of psychiatric patients during the COVID-19 Journal of Vol. 11, No. 4The Gender of to in March 2021 | Feminist Economics, Vol. No. in Risk Factors and Mental Health During the of the COVID-19 Pandemic: A of U.S. Women A. 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VIEWPOINTPerception of effort during exercise is independent of afferent feedback from skeletal muscles, heart, and lungsSamuele MarcoraSamuele MarcoraPublished Online:01 Jun 2009https://doi.org/10.1152/japplphysiol.90378.2008This is the final version - click for previous versionMoreSectionsPDF (55 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations perception of effort, also known as perceived exertion or sense of effort, is a major feature of fatigue (7), and it is widely used to monitor and prescribe exercise intensity (18). However, despite its importance, the neurophysiological bases of this atypical sensation are poorly understood. A model popular among physiologists investigating central regulation of exercise performance is that perceived exertion results from the complex integration of different inputs to the central nervous system (CNS). These inputs include afferent feedback from the peripheral organs most active during aerobic exercise (i.e., skeletal muscles, heart, and lungs) and other interoceptors, with or without additional inputs from the CNS itself, such as knowledge of the exercise task endpoint (3, 6, 28).The purpose of this article is to challenge this view by reviewing evidence that perception of effort during dynamic whole body exercise is independent of afferent feedback from small-diameter muscle afferents, heart, and lungs. For isolated and/or isometric exercise, the reader is referred to other reviews demonstrating that the sense of effort is independent of sensory inputs from muscle spindles and Golgi tendon organs (15, 24).Definitions.The common assumption that afferent feedback contributes significantly to perception of effort may derive from a too broad operational definition. Indeed, if subjects are instructed that rating of perceived exertion (RPE) refers to the discomfort experienced during exercise, then muscle pain, thermal discomfort, and thirst can be appropriately included in the perceptual rating because hedonicity is one of the four dimensions of any sensation (quality, intensity, duration, and hedonicity) (3). However, these and other unpleasant sensations experienced during exercise have their own specific neurophysiological mechanisms and verbal descriptors (i.e., quality) and can be differentiated from perception of effort (e.g., Ref. 19). Therefore, we believe that a narrower definition of exertion as “the effort expended in performing a physical activity” (Oxford Dictionary of Sports Science and Medicine) is physiologically more appropriate. Furthermore, this definition is in line with the verbal descriptors chosen by Borg for his RPE scale (“heavy/hard” and “light/easy”) (18) rather than ratings of hedonicity (“pleasant/unpleasant,” “feeling good/feeling bad,” “comfortable/uncomfortable”) (3).Perceived exertion and afferent feedback from skeletal muscles.Skeletal muscles are richly innervated by group III and IV fibers that provide afferent feedback related to metabolic, ionic, thermal, and mechanical stress (12). These small-diameter afferent fibers project, through lamina I neurons, to various spinal and supraspinal sites including the sensory cortex (5). Given the existence of such sensory system and the well-known increases in muscle metabolic by-products, potassium, temperature, and mechanical stress during intense exercise (12), it seems logical to assume that perception of effort is based on these afferent stimuli (Fig. 1A). Furthermore, there are high correlations between markers of metabolic stress (e.g., blood lactate concentration and %V̇o2max) with RPE during incremental exercise (18). However, the presence of the sensory machinery and a high correlation between the proposed metabolic stimuli and perceived exertion does not necessarily mean that the two are causally related. Indeed, several experimental studies in which perception of effort and metabolic stress have been dissociated argue against such common assumption.Fig. 1.Simplified afferent feedback (A) and corollary discharge (B) models of perceived exertion.Download figureDownload PowerPointFor example, when skeletal muscle weakness is induced by a small dose of curare (a drug that blocks transmission at the neuromuscular junction without affecting afferent pathways) there is a significant increase in RPE during cycling exercise (9). In theory, recruitment of glycolytic fibers due to the selective effect of curare on oxidative fibers may increase metabolic stimuli and perception of effort. However, the small increase in blood lactate concentration (0.36 mM) compared with the disproportionate increase in perceived exertion (4.8 points on Borg's 15-point RPE scale) argue against this hypothesis. Similarly, changes in afferent feedback from prefatigued locomotor muscles cannot explain the significant increase in perceived exertion we measured during a high-intensity cycling test (14). Indeed, we induced a significant reduction in locomotor muscle force using an eccentric exercise protocol known to affect primarily type II fibers without any metabolic stress or changes in muscle receptors sensitivity. Increased afferent feedback related to inflammation (which manifests itself at perceptual level as delayed-onset muscle soreness) was also controlled by performing the high-intensity cycling test 30 min after the intermittent 100 drop jumps.So what is the neural signal underlying perception of effort in these experimental conditions? The findings reviewed above support the hypothesis suggested more than 150 years ago that perception of effort is a “sensation of innervation” (24). Basically, it is proposed that the sense of effort is centrally generated by forwarding neural signals, termed corollary discharges or efference copies, from motor to sensory areas of the cerebral cortex (Fig. 1B). Therefore, it is not surprising that the increase in central motor command necessary to exercise at the same workload with muscles weakened by partial neuromuscular blockade or locomotor muscle fatigue is perceived as increased effort. Despite this kind of experimental evidence in favor of the corollary discharge model of perceived exertion (15), lack of a neurobiological mechanism and the discovery of muscle receptor function by Sherrington made most people believe that these receptors were responsible for all sensations related to muscle contraction (24). However, in recent years, corollary discharge pathways have been described in animals, including a single interneuron forwarding inhibitory signals from motor to sensory areas of the male singing cricket nervous system (23). This important discovery provides a “proof-of-principle” for the existence of neurons and pathways serving other corollary discharge functions including perception of effort.Lastly, convincing evidence against the widespread assumption that perceived exertion arises from afferent muscle feedback is provided by experiments using epidural anesthesia. Indeed, despite a marked reduction in sensory inputs from the lower limbs, RPE during cycling exercise is either unchanged or increased by spinal blockade (13, 27). The latter effect is due to the muscle weakness induced by the epidural anesthesia used in these studies and the compensatory increase in central neural drive to the motoneurons innervating the locomotor muscles. Even when this reduction in muscle strength is taken into account by exercising at the same relative intensity, RPE is not reduced by blockade of sensory inputs from the lower limbs (16). This is strong experimental evidence against the notion that somatosensory feedback from active muscles is important for perception of effort during exercise (6).Perceived exertion and afferent feedback from the heart.The correlation between perception of effort and heart rate (HR) during incremental exercise is so strong that the 6–20 RPE scale was originally developed by Borg to reflect the range of HR found in young and fit subjects (60 beats/min at rest, 200 beats/min during maximal exercise) (18). There is also evidence consistent with an afferent cortical representation of cardiac action (10), which is not surprising given the existence of both sympathetic and vagal afferent pathways from the heart (8), and chest wall mechanoreceptors (4). Indeed, some subjects can accurately report cardiac activity (4), and the crushing, burning, and squeezing sensations of angina pectoris are far too familiar to patients with ischemic heart disease (8). However, various studies in which cardiac function has been manipulated experimentally do not support a causal relationship between HR and perception of effort (18). For example, RPE during cycling exercise is unchanged or even increased when HR is reduced by calcium channel and β-adrenergic blockade (17). Therefore, it seems that normal subjects do not attend to afferent cardiac signals when rating perceived exertion. Furthermore, cardiac transplant patients (who have a denervated heart) report normal perception of effort during an incremental exercise test (1). Indeed, RPE is recommended by the American Heart Association for prescription of exercise intensity after transplantation (22).Perceived exertion and afferent feedback from the lungs.Dyspnea, from the Greek “difficult breathing,” is a major component of overall perceived exertion (18) and it has been extensively investigated because of its clinical relevance (20). As for the discomfort associated with intense exercise, the word “dyspnea” can refer to several sensations with different verbal descriptors and neurophysiological mechanisms. Inhibitory and excitatory afferent inputs from central and peripheral chemoreceptors and mechanoreceptors in the chest wall, lungs, and airways are thought to play an important role in generating air hunger, chest tightness, and unsatisfied inspiration (20). However, the dyspnea experienced during aerobic exercise by healthy individuals without restricted breathing and normal blood gases largely reflects the sense of respiratory effort (11, 20, 21). This respiratory sensation is generated by corollary discharges of the central motor commands to the respiratory muscles (11, 20), and it is clearly independent of feedback from pulmonary vagal afferents. Indeed, patients with double lung transplantation can estimate the magnitude of inspiratory resistive loads based on their normal sense of effort (31). Similar results have been obtained in healthy subjects with anesthetized airways (2). Importantly, the common neurophysiological mechanism shared by perceptions of effort referred to breathing and locomotor muscle contraction justifies their integration in the overall rating of perceived exertion.Conclusions.Although essential for a variety of other physiological and perceptual processes such as cardiorespiratory regulation (12) and sense of position and movement (24), afferent feedback from skeletal muscles, heart, and lungs does not contribute significantly to perception of effort during exercise, which is the conscious awareness of the central motor commands to the locomotor and respiratory muscles. Preliminary imaging studies in humans (30), lesion studies in animals (29), and psychopharmacological studies in both humans (26) and animals (25) suggest that the anterior cingulate cortex, insular cortex, thalamus, dopamine, and endogenous opioids are important for perception of effort and related decision making, e.g., disengaging from a time to exhaustion test (14). Additional studies on the origin [primary motor cortex or upstream? (24)], neural pathways, and sensory processing of corollary discharges related to perceived exertion are warranted. Similarly, the role played by other neurocognitive processes (e.g., response inhibition and conflict monitoring) and activation-dependent plasticity in setting perception of effort during prolonged exercise needs to be established.REFERENCES1 Braith RW, Wood CE, Limacher MC, Pollock ML, Lowenthal DT, Phillips MI, Staples ED. Abnormal neuroendocrine responses during exercise in heart transplant recipients. Circulation 86: 1453–1463, 1992.Crossref | PubMed | ISI | Google Scholar2 Burki NK, Davenport PW, Safdar F, Zechman FW. The effects of airway anesthesia on magnitude estimation of added inspiratory resistive and elastic loads. Am Rev Respir Dis 127: 2–4, 1983.Crossref | ISI | Google Scholar3 Cabanac M. Exertion and pleasure from an evolutionary perspective. In: Psychobiology of Physical Activity, edited by Acevedo EO and Ekkekakis P. Champaign, IL: Human Kinetics, 2006, p. 79–89.Google Scholar4 Cameron OG. Interoception: the inside story—a model for psychosomatic processes. Psychosom Med 63: 697–710, 2001.Crossref | ISI | Google Scholar5 Craig AD. How do you feel? Interoception: the sense of the physiological condition of the body. Nat Rev Neurosci 3: 655–666, 2002.Crossref | PubMed | ISI | Google Scholar6 Dempsey JA, Amann M, Romer LM, Miller JD. Respiratory system determinants of peripheral fatigue and endurance performance. Med Sci Sports Exerc 40: 457–461, 2008.Crossref | PubMed | ISI | Google Scholar7 Enoka RM, Stuart DG. Neurobiology of muscle fatigue. J Appl Physiol 72: 1631–1648, 1992.Link | ISI | Google Scholar8 Foreman RD. Mechanisms of cardiac pain. Annu Rev Physiol 61: 143–167, 1999.Crossref | PubMed | ISI | Google Scholar9 Gallagher KM, Fadel PJ, Stromstad M, Ide K, Smith SA, Querry RG, Raven PB, Secher NH. Effects of partial neuromuscular blockade on carotid baroreflex function during exercise in humans. J Physiol 533: 861–870, 2001.Crossref | PubMed | ISI | Google Scholar10 Gray MA, Taggart P, Sutton PM, Groves D, Holdright DR, Bradbury D, Brull D, Critchley HD. A cortical potential reflecting cardiac function. Proc Natl Acad Sci USA 104: 6818–6823, 2007.Crossref | ISI | Google Scholar11 Grazzini M, Stendardi L, Gigliotti F, Scano G. Pathophysiology of exercise dyspnea in healthy subjects and in patients with chronic obstructive pulmonary disease (COPD). Respir Med 99: 1403–1412, 2005.Crossref | ISI | Google Scholar12 Kaufman MP, Hayes SG, Adreani CM, Pickar JG. Discharge properties of group III and IV muscle afferents. Adv Exp Med Biol 508: 25–32, 2002.Crossref | PubMed | ISI | Google Scholar13 Kjaer M, Hanel B, Worm L, Perko G, Lewis SF, Sahlin K, Galbo H, Secher NH. Cardiovascular and neuroendocrine responses to exercise in hypoxia during impaired neural feedback from muscle. Am J Physiol Regul Integr Comp Physiol 277: R76–R85, 1999.Link | ISI | Google Scholar14 Marcora SM, Bosio A, de Morree HM. Locomotor muscle fatigue increases cardiorespiratory responses and reduces performance during intense cycling exercise independently from metabolic stress. Am J Physiol Regul Integr Comp Physiol 294: R874–R883, 2008.Link | ISI | Google Scholar15 McCloskey DI. Kinesthetic sensibility. Physiol Rev 58: 763–820, 1978.Link | ISI | Google Scholar16 Mitchell JH, Reeves DR Jr, Rogers HB, Secher NH. Epidural anaesthesia and cardiovascular responses to static exercise in man. J Physiol 417: 13–24, 1989.Crossref | PubMed | ISI | Google Scholar17 Myers J, Atwood JE, Sullivan M, Forbes S, Friis R, Pewen W, Froelicher V. Perceived exertion and gas exchange after calcium and β-blockade in atrial fibrillation. J Appl Physiol 63: 97–104, 1987.Link | ISI | Google Scholar18 Noble BJ, Robertson RJ. Perceived Exertion. Champaign, IL: Human Kinetics, 1996.Google Scholar19 O'Connor PJ, Cook DB. Exercise and pain: the neurobiology, measurement, and laboratory study of pain in relation to exercise in humans. Exerc Sport Sci Rev 27: 119–166, 1999.PubMed | Google Scholar20 O'Donnell DE, Banzett RB, Carrieri-Kohlman V, Casaburi R, Davenport PW, Gandevia SC, Gelb AF, Mahler DA, Webb KA. Pathophysiology of dyspnea in chronic obstructive pulmonary disease: a roundtable. Proc Am Thorac Soc 4: 145–168, 2007.Crossref | Google Scholar21 O'Donnell DE, Chau LK, Webb KA. Qualitative aspects of exertional dyspnea in patients with interstitial lung disease. J Appl Physiol 84: 2000–2009, 1998.Link | ISI | Google Scholar22 Pina IL, Apstein CS, Balady GJ, Belardinelli R, Chaitman BR, Duscha BD, Fletcher BJ, Fleg JL, Myers JN, Sullivan MJ. Exercise and heart failure: a statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention. Circulation 107: 1210–1225, 2003.Crossref | PubMed | ISI | Google Scholar23 Poulet JF, Hedwig B. New insights into corollary discharges mediated by identified neural pathways. Trends Neurosci 30: 14–21, 2007.Crossref | PubMed | ISI | Google Scholar24 Proske U. What is the role of muscle receptors in proprioception? Muscle Nerve 31: 780–787, 2005.Crossref | PubMed | ISI | Google Scholar25 Salamone JD, Correa M, Farrar A, Mingote SM. Effort-related functions of nucleus accumbens dopamine and associated forebrain circuits. Psychopharmacology (Berl) 191: 461–482, 2007.Crossref | PubMed | ISI | Google Scholar26 Sgherza AL, Axen K, Fain R, Hoffman RS, Dunbar CC, Haas F. Effect of naloxone on perceived exertion and exercise capacity during maximal cycle ergometry. J Appl Physiol 93: 2023–2028, 2002.Link | ISI | Google Scholar27 Smith SA, Querry RG, Fadel PJ, Gallagher KM, Stromstad M, Ide K, Raven PB, Secher NH. Partial blockade of skeletal muscle somatosensory afferents attenuates baroreflex resetting during exercise in humans. J Physiol 551: 1013–1021, 2003.Crossref | PubMed | ISI | Google Scholar28 St. Clair Gibson A, Lambert EV, Rauch LH, Tucker R, Baden DA, Foster C, Noakes TD. The role of information processing between the brain and peripheral physiological systems in pacing and perception of effort. Sports Med 36: 705–722, 2006.Crossref | ISI | Google Scholar29 Walton ME, Kennerley SW, Bannerman DM, Phillips PE, Rushworth MF. Weighing up the benefits of work: behavioral and neural analyses of effort-related decision making. Neural Netw 19: 1302–1314, 2006.Crossref | PubMed | ISI | Google Scholar30 Williamson JW, Fadel PJ, Mitchell JH. New insights into central cardiovascular control during exercise in humans: a central command update. Exp Physiol 91: 51–58, 2006.Crossref | PubMed | ISI | Google Scholar31 Zhao W, Martin AD, Davenport PW. Magnitude estimation of inspiratory resistive loads by double-lung transplant recipients. J Appl Physiol 94: 576–582, 2003.Link | ISI | Google ScholarAUTHOR NOTESAddress for reprint requests and other correspondence: S. Marcora, School of Sport, Health and Exercise Sciences, Bangor Univ., George Bldg., Normal Site, Holyhead Road, Bangor, Gwynedd, LL57 2PZ United Kingdom (e-mail: [email protected]) Download PDF Previous Back to Top Next FiguresReferencesRelatedInformation Cited ByA lab-based comparison of differential ratings of perceived exertion between a run and jump protocol involving low or high impacts on the lower extremities25 April 2022 | European Journal of Sport Science, Vol. 23, No. 5Effects of Sex and Cuff Pressure on Physiological Responses during Blood Flow Restriction Resistance Exercise in Young Adults13 December 2022 | Medicine & Science in Sports & Exercise, Vol. 55, No. 5Application of the Ratings of Perceived Exertion-Clamp Model to Examine the Effects of Joint Angle on the Time Course of Torque and Neuromuscular Responses During a Sustained, Isometric Forearm Flexion to Task Failure17 November 2022 | Journal of Strength and Conditioning Research, Vol. No. of changes physiological during a time to | European Journal of Vol. and heart rate responses to of April | European Journal of Vol. and muscle during of April | European Journal of Vol. of a perceived effort cycling November 2022 | European Journal of Vol. No. of fatigue and neuromuscular of performance during prolonged | Vol. No. the model to among associated with perceived and performance in and | European Journal of Vol. Exertion Responses to Exercise for and of A | of Sport Science, Vol. No. of Muscle and of A with November 2022 | Sports Vol. No. control of respiratory and during November 2022 | European Journal of Vol. No. Neural in 2022 | Journal of Science in Sport and Exercise, Vol. No. of effort and the of physical A to motor | in Vol. and Human 2022 | Sports Vol. No. effect of on physical performance and effort perception during maximal dynamic exercise in Vol. effects of muscle on of endurance A and & Vol. of the Task to December 2022 | and Vol. of and in 2022 | Journal of Sports Vol. No. effects of on exercise performance and physiological of exercise performance during cycling A & Vol. No. during the the November Effect of Resistance Blood Flow Restriction on A and November 2022 | Sports A Vol. the and the and the November 2022 | Journal of and Vol. No. of breathing air during cycling on and performance in the Journal of Sports Medicine and Physical Vol. No. when it The effects of on at high 2022 | Journal of Sports Sciences, Vol. No. of on and exercise performance in | European Journal of Sport Science, Vol. No. patients with neurocognitive are more and 2022 | and Research, Vol. No. I feedback the effects of fatigue on endurance exercise of Sport and Exercise, Vol. Perceived for and Resistance Exercise | Sports A Vol. No. of Perceived Exertion or April | Journal of Strength and Conditioning Research, Vol. No. be the to the and performance in fatigue A and 2022 | in Vol. and perceptual mechanisms of fatigue task in response to and M. and 2022 | Journal of Vol. No. the of and on the of April 2022 | and Vol. No. of on and During a | Journal of Strength and Conditioning Research, Vol. No. of on perceived exertion during endurance A with of Exercise Science & Vol. 20, No. Model for and of 2022 | Journal of and Vol. No. effects of pain induced by blood in one on exercise and and inhibition of the in and Vol. No. of action on the for action April 2022 | Journal of Sport and Exercise Vol. A of to Human 2022 | in Vol. as a 2022 | Journal of Vol. No. central fatigue after a December | Journal of Medicine & Science in Vol. No. to the Effect of on during and 2022 | Vol. No. effects of exercise intensity and on the relationship between the component of and peripheral 2022 | Vol. No. that Neuromuscular not a in with | Medicine & Science in Sports & Exercise, Vol. No. of the intensity of fatigue and on perceptual regulation and performance during physical 2022 | Vol. No. on and in | for Exercise and Sport, Vol. No. effort for is associated with | Journal of Vol. No. and by and movement descriptors in with during 2022 | Vol. and perceptual responses during at and in normal and | Journal of Vol. No. and a on Neural and Vol. the of Perceived Exertion and Heart to in and of Strength and Conditioning Research, Vol. No. of for November workload during in comparison between heart rate and perceived exertion based 2022 | & Sport - 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The Journal of Bone and Joint Surgery. British volumeVol. 86-B, No. 3 Aspects of Current ManagementFree AccessPosterior dislocation of the shoulderN. CicakN. CicakOrthopaedic SurgeonSearch for more papers by this authorPublished Online:1 Apr 2004https://doi.org/10.1302/0301-620X.86B3.14985AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited bySurgical management of bilateral concomitant posterior fracture-dislocation of the shoulderTrauma Case Reports, Vol. 41Posterior shoulder dislocation with associated reverse Hill–Sachs lesion: clinical outcome 10 years after joint-preserving surgery3 June 2022 | Archives of Orthopaedic and Trauma Surgery, Vol. 39Posterior Shoulder InstabilityTreatment of chronic locked posterior dislocation of the shoulder with the modified McLaughlin procedureJournal of Shoulder and Elbow Surgery, Vol. 31, No. 1Principles of Radiological Examination28 September 2022Posterior Instability4 October 2022Mid-Term outcomes following fresh-frozen humeral head osteochondral allograft reconstruction for reverse Hill Sachs lesion: a case series8 September 2021 | BMC Musculoskeletal Disorders, Vol. 22, No. 1Management of Locked Posterior Shoulder Dislocation with Reverse Hill–Sachs Lesions via Anatomical Reconstructions11 October 2021 | Orthopaedic Surgery, Vol. 232Traumi della spalla e del braccioEMC - Urgenze, Vol. 25, No. 3Arthroscopic Knotless Subscapularis Bridge Technique for Reverse Hill-Sachs Lesion With Posterior Shoulder InstabilityArthroscopy Techniques, Vol. 10, No. 1A Modified Reverse Remplissage Procedure for Management of a Locked Posterior Shoulder DislocationCase Reports in Orthopedics, Vol. 2020Shoulder Dislocations in the Emergency Department: A Comprehensive Review of Reduction TechniquesThe Journal of Emergency Medicine, Vol. 58, No. 4Missed posterior shoulder fracture dislocations: a new protocol from a London major trauma centre18 March 2020 | BMJ Open Quality, Vol. 9, No. 1New Reduction Technique for Traumatic Posterior Glenohumeral Joint Dislocations24 January 2020 | Clinical Practice and Cases in Emergency Medicine, Vol. 4, No. 1Glenohumeral Joint16 April 2020Conservative Treatment in Posterior Dislocation16 June 2020Surgical Treatment of Humeral Head Defect in Shoulder Posterior Instability16 June 2020Shoulder and proximal humerusIndications for Reverse Shoulder ArthroplastyAll-Arthroscopic McLaughlin's Procedure in Patients with Reverse Hill–Sachs Lesion Caused by Locked Posterior Shoulder Dislocation31 December 2019 | Joints, Vol. 07, No. 03The dual subscapularis procedure: a modified Hawkins’ technique for neglected posterior fracture/dislocation of the shoulder19 March 2019 | European Journal of Orthopaedic Surgery & Traumatology, Vol. 29, No. 5Remplissage With Bankart Repair in Anterior Shoulder Instability: A Systematic Review of the Clinical and Cadaveric LiteratureArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 35, No. 4McLaughlin artroscópico modificado no tratamento de luxação glenoumeral posterior – nota técnica10 May 2019 | Revista Brasileira de Ortopedia, Vol. 54, No. 02Posterior Shoulder Dislocation During Morning PT: A Case Report13 June 2018 | Military Medicine, Vol. 184, No. 3-4The aetiology of posterior glenohumeral dislocations and occurrence of associated injuriesa systematic reviewM. J. Kelly, A. E. Holton, A. J. Cassar-Gheiti, S. A. Hanna, J. F. Quinlan, D. C. Molony2 January 2019 | The Bone & Joint Journal, Vol. 101-B, No. 1Luxación posterior inveterada de hombro asociada a lesión de Hill-Sachs reversa tratada con modificación de la técnica de McLaughlinActa Ortopédica Mexicana, Vol. 33, No. 5Inestabilidad posterior del hombroActa Ortopédica Mexicana, Vol. 33, No. 5National Athletic Trainers' Association Position Statement: Immediate Management of Appendicular Joint DislocationsJournal of Athletic Training, Vol. 53, No. 12痙攣により生じた肩関節後方脱臼骨折の1例Orthopedics & Traumatology, Vol. 67, No. 3Posterior shoulder dislocation in a 10-year-old child: Case reportAnnals of Medicine and Surgery, Vol. 33Arthroscopic Management of Locked Posterior Shoulder DislocationsArthroscopy Techniques, Vol. 7, No. 9Posterior Shoulder Dislocation Associated With the Head (Splitting) and Humeral Neck Fracture: Impact of Understanding Radiologic Signs and Experience With an Extended Deltopectoral ApproachTechniques in Hand & Upper Extremity Surgery, Vol. 22, No. 2A treatment algorithm for locked posterior dislocation of shoulderJournal of Arthroscopy and Joint Surgery, Vol. 5, No. 2Reverse-Hill-Sachs-Läsion bei dorsal verhakter Schulterluxation16 October 2017 | Arthroskopie, Vol. 31, No. 1Posterieure instabiliteit30 November 2017Posterior Shoulder InstabilityPosterior shoulder dislocation with associated reverse Hill-Sachs lesion: treatment options and functional outcome after a 5-year follow up13 November 2017 | BMC Musculoskeletal Disorders, Vol. 18, No. 1Dimple on the shoulder after a ski injury23 October 2017 | Emergency Medicine Journal, Vol. 34, No. 11Posterior shoulder dislocation with a reverse Hill–Sachs lesion treated with frozen femoral head bone allograft combined with osteochondral autograft transfer23 June 2016 | Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 25, No. 10Transfer of the lesser tuberosity for reverse Hill-Sachs lesions after neglected posterior dislocations of the shoulder: A retrospective clinical study of 13 casesActa Orthopaedica et Traumatologica Turcica, Vol. 51, No. 5Risk of Engagement of Bipolar Bone Defects in Posterior Shoulder Instability28 June 2017 | The American Journal of Sports Medicine, Vol. 45, No. 12EXPERIENCE IN USE OF MODIFIED MCLAUGHLIN PROCEDURE FOR NEGLECTED LOCKED POSTERIOR SUBLUXATION OF THE HUMERAL HEAD30 September 2017 | Vestnik travmatologii i ortopedii imeni N.N. Priorova, No. 3Experience in Use of Modified McLaughlin Procedure for Neglected Locked Posterior Subluxation of the Humeral Head15 September 2017 | N.N. Priorov Journal of Traumatology and Orthopedics, Vol. 24, No. 3Treatment of The Posterior Unstable ShoulderThe Open Orthopaedics Journal, Vol. 11, No. 1Luxación glenohumeral posteriorFMC - Formación Médica Continuada en Atención Primaria, Vol. 24, No. 7Complete avulsion of the rotator cuff footprint in an irreducible traumatic posterior glenohumeral fracture-dislocation due to infraspinatus interpositionJournal of Shoulder and Elbow Surgery, Vol. 26, No. 8Orthopedic Pearls and PitfallsPhysician Assistant Clinics, Vol. 2, No. 3Rekonstruktion anteromedialer Humeruskopfimpressionsfrakturen mit knöchernen Auto- oder Allografts26 April 2017 | Obere Extremität, Vol. 12, No. 2Step-by-Step Technique for Segmental Reconstruction of Reverse Hill-Sachs Lesions Using Homologous Osteochondral AllograftTechniques in Hand & Upper Extremity Surgery, Vol. 21, No. 2Treatment of Locked Posterior Shoulder Dislocation With Bone DefectOrthopedics, Vol. 40, No. 3Posterior shoulder fracture–dislocation: an update with treatment algorithm25 August 2016 | European Journal of Orthopaedic Surgery & Traumatology, Vol. 27, No. 3Pitch-side management of acute shoulder dislocations: a conceptual review12 March 2017 | BMJ Open Sport & Exercise Medicine, Vol. 2, No. 1Glenohumeral Instability9 February 2018Dislocations and Fracture Dislocations of the Shoulder Girdle11 October 2017Shoulder: Glenohumeral Instability20 April 2017Locked Posterior Shoulder Dislocation (LPSD)9 May 2017Posterior Shoulder Instability in the Young Patient9 May 2017Orthopedics & Traumatology, Vol. 66, No. 2Modified technique for reconstructing reverse Hill–Sachs lesion in locked chronic posterior shoulder dislocation19 August 2016 | European Journal of Orthopaedic Surgery & Traumatology, Vol. 26, No. 8A systematic and technical guide on how to reduce a shoulder dislocationTurkish Journal of Emergency Medicine, Vol. 16, No. 4Balloon-guided inflation osteoplasty in the treatment of Hill-Sachs lesions of the humeral head: case report of a new technique1 February 2016 | Patient Safety in Surgery, Vol. 10, No. 1Locked Posterior Dislocation of Shoulder With Fracture of the Lesser Tuberosity of the Humerus: A Case Report and Review of the Literature5 November 2016 | Archives of Trauma Research, Vol. 6, No. 2Traumatic posterior shoulder dislocation with a large engaging Hill-Sachs lesion: splinting techniqueThe American Journal of Emergency Medicine, Vol. 34, No. 3Defect Characteristics of Reverse Hill-Sachs Lesions8 January 2016 | The American Journal of Sports Medicine, Vol. 44, No. 3Bone block procedures in posterior shoulder instability24 April 2015 | Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 24, No. 2Evaluation of Bone Loss and the Glenoid Track30 December 2015Sideline Management of Joint DislocationsCurrent Sports Medicine Reports, Vol. 15, No. 3Posterior Glenohumeral DislocationBilateral posterior shoulder dislocation after electrical shock: A case reportAnnals of Medicine and Surgery, Vol. 4, No. 4Proximal humerus derotational osteotomy for internal rotation instability after locked posterior shoulder dislocation: early experience in four patients8 May 2015 | Patient Safety in Surgery, Vol. 9, No. 1New technique in reconstructing humeral head defect in locked posterior dislocation of the shoulder: a case series of nine patients1 July 2015 | European Orthopaedics and Traumatology, Vol. 6, No. 3Luxación de hombro posterior y bilateral en contexto de crisis convulsivaSEMERGEN - Medicina de Familia, Vol. 41, No. 3Posterior capsular release and coracoid transfer for cases of neglected locked anterior shoulder dislocation in tramadol addicts14 September 2014 | European Orthopaedics and Traumatology, Vol. 6, No. 1Acute Shoulder Trauma: What the Surgeon Wants to KnowRadioGraphics, Vol. 35, No. 2Influence of Defect Size and Localization on the Engagement of Reverse Hill-Sachs Lesions2 February 2015 | The American Journal of Sports Medicine, Vol. 43, No. 3Reverse shoulder arthroplasty in acute fractures provides better results than in revision procedures for fracture sequelae31 December 2014 | International Orthopaedics, Vol. 39, No. 2Acute Posterior Dislocations and Posterior Fracture–Dislocations of the Shoulder10 June 2015Neglected Posterior Dislocations and Treatment Modalities10 June 2015Posterior Shoulder Instability in the Contact AthleteReconstruction of Humeral Head Defect in Locked Posterior Dislocation Shoulder. A Case Series of Nine PatientsOpen Journal of Orthopedics, Vol. 05, No. 02Konservative Therapie der akuten verhakten posterioren Schultergelenkluxation20 September 2013 | Der Unfallchirurg, Vol. 117, No. 12Operative Versorgung der posterioren Schulterluxation9 March 2014 | Der Unfallchirurg, Vol. 117, No. 12Bilateral Posterior Fracture Dislocation of the Shoulder Following an Epileptic Seizure17 October 2014 | MOJ Orthopedics & Rheumatology, Vol. 1, No. 2Posterior Shoulder Instability with a Reverse Hill-Sachs Defect: Repair with Use of Combined Arthroscopic Labral Repair and Fracture DisimpactionJBJS Case Connector, Vol. 4, No. 3Tratamiento artroscópico de lesión tipo Hill-Sachs inversa sin uso de material de osteosíntesis para su fijación: Reporte de casoRevista Colombiana de Ortopedia y Traumatología, Vol. 28, No. 2Acute Traumatic Posterior Shoulder DislocationJournal of the American Academy of Orthopaedic Surgeons, Vol. 22, No. 3Acute Posterior Dislocations and Posterior Fracture–Dislocations of the Shoulder26 December 2014Neglected Posterior Dislocations and Treatment Modalities14 October 2014Addendum: schouderluxatie1 April 2014Fused 99mTc-HDP SPECT/MR Imaging of Reverse Hill-Sachs DeformityClinical Nuclear Medicine, Vol. 39, No. 1Excellent results of lesser tuberosity transfer in acute locked posterior shoulder dislocation26 September 2012 | Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 21, No. 12Lussazioni posteriori della scapolo-omerale: diagnosi e terapia1 January 2014 | Aggiornamenti CIO, Vol. 19, No. 2Locked posterior dislocation of the shoulder joint: Report of two casesFormosan Journal of Musculoskeletal Disorders, Vol. 4, No. 4Posterieure schouderluxatie bij een claviculafractuur1 November 2013 | Nederlands Tijdschrift voor Traumatologie, Vol. 21, No. 5Posterior Shoulder Instability in the Contact AthleteClinics in Sports Medicine, Vol. 32, No. 4Traumatic Shoulder Injuries: A Force Mechanism Analysis—Glenohumeral Dislocation and InstabilityAmerican Journal of Roentgenology, Vol. 201, No. 2Modified arthroscopic McLaughlin procedure for treatment of posterior instability of the shoulder with an associated reverse Hill-Sachs lesion7 October 2012 | Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 21, No. 7Modified McLaughlin Technique for Neglected Locked Posterior Dislocation of the ShoulderOrthopedics, Vol. 36, No. 7Posterior shoulder dislocationReliability of a New Standardized Measurement Technique for Reverse Hill-Sachs Lesions in Posterior Shoulder DislocationsArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 29, No. 3Bilateral locked posterior shoulder dislocation after an undiagnosed brain tumorCurrent Orthopaedic Practice, Vol. 24, No. 2WITHDRAWN: Posterior dislocation of the shoulder: a case reportJournal of Clinical Orthopaedics and TraumaTraumatic bilateral posterior dislocation of the shoulder: a case reportOpen Medicine, Vol. 8, No. 6Uncommon Indications for Reverse Total Shoulder ArthroplastyClinics in Orthopedic Surgery, Vol. 5, No. 4Orthopedic Pitfalls of the Upper Extremity15 November 2012Recurrent Posterior Shoulder Instability After Rifle ShootingOrthopedics, Vol. 35, No. 11Shoulder and Proximal Humerus22 October 2012Shoulder Resurfacing for Acute Locked Posterior Dislocation Allows Early Rehabilitation6 February 2017 | Shoulder & Elbow, Vol. 4, No. 4Bilateral Neglected Posterior Fracture–Dislocation of the ShouldersOrthopedics, Vol. 35, No. 10Eine neue Repositionstechnik für die verhakte hintere Schulterluxation9 December 2011 | Der Unfallchirurg, Vol. 115, No. 8Delayed Diagnosis of Bilateral Scapula Fractures in a Patient with Cardiac Syncope1 July 2012 | Shoulder & Elbow, Vol. 4, No. 3Bilateral Talar Avulsion Fractures Secondary to Seizure: A Case ReportThe Journal of Foot and Ankle Surgery, Vol. 51, No. 3Anatomical Reconstruction of Reverse Hill-Sachs Lesions Using the Underpinning TechniqueOrthopedics, Vol. 35, No. 5Acute bilateral posterior dislocation of the shoulder: One-stage reconstruction of both humeral heads with cancellous autograft and cartilage preservationChirurgie de la Main, Vol. 31, No. 1Recurrent, Locked Posterior Glenohumeral Dislocation Requiring Hemiarthroplasty and Posterior Bone Block With Humeral Head AutograftOrthopedics, Vol. 35, No. 2Acute Posterior Dislocations22 June 2011Failed Arthroscopic Repair of a Large Reverse Hill-Sachs Lesion Using Bone Allograft and Cannulated Screws: A Case ReportArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 28, No. 1Posterior Shoulder Dislocation: Systematic Review and Treatment AlgorithmArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 27, No. 11Lateral Clavicular Autograft for Repair of Reverse Hill-Sachs DefectThe Open Orthopaedics Journal, Vol. 5, No. 1Bilateral posterior shoulder dislocation with defect secondary to hypoglycemic comaJournal of Orthopaedic Science, Vol. 16, No. 1Shoulder and humerusGlenohumeral instabilityClosed Reduction of Bilateral Posterior Shoulder Dislocation with Medium Impression Defect of the Humeral Head: A Case Report and Review of Its TreatmentCase Reports in Medicine, Vol. 2011Die dorsal verhakte Schulterluxation6 November 2010 | Obere Extremität, Vol. 5, No. 4Articular cartilage and labral lesions of the glenohumeral joint: diagnostic performance of 3D water-excitation true FISP MR arthrography17 December 2009 | Skeletal Radiology, Vol. 39, No. 5Chronic locked posterior shoulder dislocation with severe head involvement20 March 2009 | International Orthopaedics, Vol. 34, No. 1ShoulderSHOULDERLes luxations invétérées de l’épauleRéférencesBilateral Traumatic Locked Posterior Dislocation of the Shoulder - A Case Report -The Journal of the Korean Shoulder and Elbow Society, Vol. 12, No. 2Reconstruction of Humeral Head Defect for Locked Posterior Shoulder DislocationOrthopedics, Vol. 32, No. 9Rehabilitation and Functional Outcomes in Collegiate Wrestlers Following a Posterior Shoulder Stabilization ProcedureJournal of Orthopaedic & Sports Physical Therapy, Vol. 39, No. 7Modified MacLaughlin procedure in the treatment of neglected posterior dislocation of the shoulder16 March 2009 | MUSCULOSKELETAL SURGERY, Vol. 93, No. S1Tratamiento quirúrgico de la inestabilidad posterior del hombroEMC - Técnicas Quirúrgicas - Ortopedia y Traumatología, Vol. 1, No. 1Reconstruction of a missed posterior locked shoulder fracture-dislocation with bone graft and lesser tuberosity transfer: a case report5 August 2008 | Journal of Medical Case Reports, Vol. 2, No. 1Acute Traumatic Posterior Shoulder Dislocation: MR FindingsRadiology, Vol. 248, No. 1Arthroscopy-assisted reduction of impression fracture of the humeral head: A case reportJournal of Shoulder and Elbow Surgery, Vol. 17, No. 3Diagnostik und Behandlungsregime der traumatischen dorsalen Schulterluxation2 June 2007 | Der Unfallchirurg, Vol. 110, No. 12Posterior shoulder subluxation most likely caused by retching in the lateral head-down position for prevention of aspirationJournal of Clinical Anesthesia, Vol. 19, No. 8Allografts in the Treatment of Athletic Injuries of the ShoulderSports Medicine and Arthroscopy Review, Vol. 15, No. 3Anatomical reconstruction for Reverse Hill-Sachs lesions after posterior locked shoulder dislocation fracture: a case series of six patients24 May 2007 | Archives of Orthopaedic and Trauma Surgery, Vol. 127, No. 7Emergency Department Management of Selected Orthopedic InjuriesEmergency Medicine Clinics of North America, Vol. 25, No. 3One-stage operation for locked bilateral posterior dislocation of the shoulderA. Ivkovic, I. Boric, N. Cicak1 June 2007 | The Journal of Bone and Joint Surgery. British volume, Vol. 89-B, No. 6Closed Reduction for Traumatic Posterior Dislocation of the Shoulder Using the ‘Lever Principle’: Two Case Reports and a Review of the Literature4 December 2016 | Journal of Orthopaedic Surgery, Vol. 14, No. 3The success of closed reduction in acute locked posterior fracture-dislocations of the shoulderJournal of Shoulder and Elbow Surgery, Vol. 15, No. 6Humeral head impression fracture in acute posterior shoulder dislocation: new surgical technique5 January 2006 | Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 14, No. 7Traitement chirurgical de la luxation post-traumatique gléno-humérale postérieureJournal de Traumatologie du Sport, Vol. 23, No. 2Traitement chirurgical de l'instabilité postérieure de l'épauleEMC - Techniques chirurgicales - Orthopédie - Traumatologie, Vol. 1, No. 1POSTERIOR SHOULDER DISLOCATIONS AND FRACTURE-DISLOCATIONSThe Journal of Bone and Joint Surgery-American Volume, Vol. 87, No. 3 Vol. 86-B, No. 3 Metrics History Published online 1 April 2004 Published in print 1 April 2004 InformationCopyright © 2004, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download
HomeCirculationVol. 83, No. 1An updated coronary risk profile. A statement for health professionals. Free AccessAbstractPDF/EPUBAboutView PDFSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessAbstractPDF/EPUBAn updated coronary risk profile. A statement for health professionals. K M Anderson, P W Wilson, P M Odell and W B Kannel K M AndersonK M Anderson Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. , P W WilsonP W Wilson Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. , P M OdellP M Odell Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. and W B KannelW B Kannel Office of Scientific Affairs, American Heart Association, Dallas, TX 75231. Originally published1 Jan 1991https://doi.org/10.1161/01.CIR.83.1.356Circulation. 1991;83:356–362 Previous Back to top Next FiguresReferencesRelatedDetailsCited By Hespe C, Giskes K, Harris M and Peiris D (2022) Findings and lessons learnt implementing a cardiovascular disease quality improvement program in Australian primary care: a mixed method evaluation, BMC Health Services Research, 10.1186/s12913-021-07310-6, 22:1, Online publication date: 1-Dec-2022. Lemke E, Vetter V, Berger N, Banszerus V, König M and Demuth I (2022) Cardiovascular health is associated with the epigenetic clock in the Berlin Aging Study II (BASE-II), Mechanisms of Ageing and Development, 10.1016/j.mad.2021.111616, 201, (111616), Online publication date: 1-Jan-2022. Wong N, Budoff M, Ferdinand K, Graham I, Michos E, Reddy T, Shapiro M and Toth P (2022) Atherosclerotic cardiovascular disease risk assessment: An American Society for Preventive Cardiology clinical practice statement, American Journal of Preventive Cardiology, 10.1016/j.ajpc.2022.100335, 10, (100335), Online publication date: 1-Jun-2022. Coller J, Gong F, McGrady M, Shiel L, Liew D, Stewart S, Owen A, Krum H, Reid C, Prior D and Campbell D (2021) Risk factors for asymptomatic echocardiographic abnormalities that predict symptomatic heart failure, ESC Heart Failure, 10.1002/ehf2.13695, 9:1, (196-212), Online publication date: 1-Feb-2022. Mittal M, McEniery C, Supramaniam P, Cardozo L, Savvas M, Panay N and Hamoda H (2022) Impact of micronised progesterone and medroxyprogesterone acetate in combination with transdermal oestradiol on cardiovascular markers in women diagnosed with premature ovarian insufficiency or an early menopause: a randomised pilot trial, Maturitas, 10.1016/j.maturitas.2022.01.012, 161, (18-26), Online publication date: 1-Jul-2022. Adikari D, Gharleghi R, Zhang S, Jorm L, Sowmya A, Moses D, Ooi S and Beier S (2022) A new and automated risk prediction of coronary artery disease using clinical endpoints and medical imaging-derived patient-specific insights: protocol for the retrospective GeoCAD cohort study, BMJ Open, 10.1136/bmjopen-2021-054881, 12:6, (e054881), Online publication date: 1-Jun-2022. Disouza J, Patil K, Kakade P and Patravale V (2022) Dietary Fibers and Nutraceuticals in Prevention of Hypertension Research Anthology on Recent Advancements in Ethnopharmacology and Nutraceuticals, 10.4018/978-1-6684-3546-5.ch040, (778-809) Barton T, Low D, Bakker E, Janssen T, de Groot S, van der Woude L and Thijssen D (2021) Traditional Cardiovascular Risk Factors Strongly Underestimate the 5-Year Occurrence of Cardiovascular Morbidity and Mortality in Spinal Cord Injured Individuals, Archives of Physical Medicine and Rehabilitation, 10.1016/j.apmr.2020.07.013, 102:1, (27-34), Online publication date: 1-Jan-2021. Sadat Halder M and Kumar De S (2021) A RETROSPECTIVE COHORT STUDY TO UNDERSTAND THE AGE, GENDER AND RISK FACTORS PATTERN IN PATIENTS ATTENDING FOR CARDIAC REHABILITATION (CR) AFTER CORONARY ARTERY BYPASS GRAFTING (CABG) SURGERY, INDIAN JOURNAL OF APPLIED RESEARCH, 10.36106/ijar/5702089, (57-60), Online publication date: 1-Jul-2021. Black J, Campbell J, Parker S, Sharman J, Nelson M, Otahal P, Hamilton G and Marwick T (2021) Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic, Medical Journal of Australia, 10.5694/mja2.50960, 214:6, (266-271), Online publication date: 1-Apr-2021. Wen J (2021) Stem Cell Therapies for Cardiac Disease: Which Cell Types Are the Best ICBBS 2021: 2021 10th International Conference on Bioinformatics and Biomedical Science, 10.1145/3498731.3498762, 9781450384308, (196-203), Online publication date: 29-Oct-2021. Mishra P, Mishra B, Lyytikäinen L, Hilvo M, Juonala M, Kähönen M, Hutri-Kähönen N, Fotiadis D, Raitakari O, Laaksonen R and Lehtimäki T (2021) Assessment of plasma ceramides as predictor for subclinical atherosclerosis, Atherosclerosis Plus, 10.1016/j.athplu.2021.09.005, 45, (25-31), Online publication date: 1-Nov-2021. Okami Y, Ueshima H, Nakamura Y, Kondo K, Kadota A, Okuda N, Ohkubo T, Miyamatsu N, Okamura T, Miura K and Okayama A (2021) Risk Factors That Most Accurately Predict Coronary Artery Disease Based on the Duration of Follow-up ― NIPPON DATA80 ―, Circulation Journal, 10.1253/circj.CJ-20-0739, 85:6, (908-913), Online publication date: 25-May-2021. Wilson R, Aminian A and Tahrani A (2021) Metabolic surgery: A clinical update, Diabetes, Obesity and Metabolism, 10.1111/dom.14235, 23:S1, (63-83), Online publication date: 1-Feb-2021. Steger A, Dommasch M, Müller A, Sinnecker D, Huster K, Gotzler T, Gotzler O, Hapfelmeier A, Ulm K, Barthel P, Hnatkova K, Laugwitz K, Malik M and Schmidt G (2020) Polyscore of autonomic parameters for risk stratification of the elderly general population: the Polyscore study, EP Europace, 10.1093/europace/euaa359, 23:5, (789-796), Online publication date: 21-May-2021. Li Y, Sperrin M, Ashcroft D and van Staa T (2021) Consistency of ranking was evaluated as new measure for prediction model stability: longitudinal cohort study, Journal of Clinical Epidemiology, 10.1016/j.jclinepi.2021.06.026, 138, (168-177), Online publication date: 1-Oct-2021. Albaugh V, Kindel T, Nissen S and Aminian A (2021) Cardiovascular Risk Reduction Following Metabolic and Bariatric Surgery, Surgical Clinics of North America, 10.1016/j.suc.2020.12.012, 101:2, (269-294), Online publication date: 1-Apr-2021. Eftychidis I, Sakellari I, Anagnostopoulos A and Gavriilaki E (2021) Endothelial dysfunction and vascular complications after allogeneic hematopoietic cell transplantation: an expert analysis, Expert Review of Hematology, 10.1080/17474086.2021.1968823, 14:9, (831-840), Online publication date: 2-Sep-2021. Vaes B, Indestege P, Serneels T, Hegendörfer E, van Peet P, Poortvliet R, Wallemacq P, Gussekloo J and Degryse J (2020) Biomarkers versus traditional risk factors to predict cardiovascular events in very old adults: cross-validated prospective cohort study, BMJ Open, 10.1136/bmjopen-2019-035809, 10:6, (e035809), Online publication date: 1-Jun-2020. Wong N (2020) Cardiovascular risk assessment: The foundation of preventive cardiology, American Journal of Preventive Cardiology, 10.1016/j.ajpc.2020.100008, 1, (100008), Online publication date: 1-Mar-2020. Anžič Drofenik A, Vrtovec M, Božič Mijovski M, Sever M, Preložnik Zupan I, Kejžar N and Blinc A (2020) Progression of coronary calcium burden and carotid stiffness in patients with essential thrombocythemia associated with JAK2 V617F mutation, Atherosclerosis, 10.1016/j.atherosclerosis.2020.01.001, 296, (25-31), Online publication date: 1-Mar-2020. van Bussel E, Hoevenaar-Blom M, Poortvliet R, Gussekloo J, van Dalen J, van Gool W, Richard E and Moll van Charante E (2020) Predictive value of traditional risk factors for cardiovascular disease in older people: A systematic review, Preventive Medicine, 10.1016/j.ypmed.2020.105986, 132, (105986), Online publication date: 1-Mar-2020. Kim Y, Noh K, Byun S, Lee S, Kim T, Sunwoo L, Lee K, Kang S, Park K and Park S (2020) Effects of Hypertension, Diabetes, and Smoking on Age and Sex Prediction from Retinal Fundus Images, Scientific Reports, 10.1038/s41598-020-61519-9, 10:1, Online publication date: 1-Dec-2020. Palazón-Bru A, Ferri-Rufete D, Mares-García E, Durazo-Arvizu R, Divisón-Garrote J, Carbayo-Herencia J, Artigao-Rodenas L, Simarro-Rueda M, Molina-Escribano F, Ponce-García I, Gil-Guillén V and Pérez-Sempere Á (2020) Clusters of Cardiovascular Risk Factors and Their Impact on the 20-Year Cardiovascular Risk in a General Population, Journal of Cardiovascular Nursing, 10.1097/JCN.0000000000000637, 35:2, (210-216), Online publication date: 1-Mar-2020. Jamthikar A, Gupta D, Saba L, Khanna N, Viskovic K, Mavrogeni S, Laird J, Sattar N, Johri A, Pareek G, Miner M, Sfikakis P, Protogerou A, Viswanathan V, Sharma A, Kitas G, Nicolaides A, Kolluri R and Suri J (2020) Artificial intelligence framework for predictive cardiovascular and stroke risk assessment models: A narrative review of integrated approaches using carotid ultrasound, Computers in Biology and Medicine, 10.1016/j.compbiomed.2020.104043, 126, (104043), Online publication date: 1-Nov-2020. Torralbas-Ortega J, Paños-Martínez M, Patró-Moncunill E, Santiago-Barragán A, Cobo J, Escayola-Maranges A, Granero-Lázaro A and Marti-Mestre M (2020) Efficacy of a Short Psychoeducational Group Intervention for the Prevention of Cardiovascular Risk in Patients With Severe Mental Disorder, Journal of Nervous & Mental Disease, 10.1097/NMD.0000000000001081, 208:3, (222-229), Online publication date: 1-Mar-2020. Wang J, Smail-Crevier R, Nannarone M, Manuel D, MacQueen G, Patten S, Lashewicz B and Schmitz N (2020) The accuracy of depression risk perception in high risk Canadians, Journal of Affective Disorders, 10.1016/j.jad.2020.01.099, 265, (410-415), Online publication date: 1-Mar-2020. Vuksan V, Sievenpiper J, Jovanovski E, Jenkins A, Komishon A, Au-Yeung F, Zurbau A, Ho H, Li D and Smircic-Duvnjak L (2020) Effect of soluble-viscous dietary fibre on coronary heart disease risk score across 3 population health categories: data from randomized, double-blind, placebo-controlled trials, Applied Physiology, Nutrition, and Metabolism, 10.1139/apnm-2019-0728, 45:7, (801-804), Online publication date: 1-Jul-2020. Warner E, Nannarone M, Smail-Crevier R, Manuel D, Lashewicz B, Patten S, Schmitz N, MacQueen G and Wang J (2020) The relationship between depression risk perception and self-help behaviours in high risk Canadians: a cross-sectional study, BMC Public Health, 10.1186/s12889-020-08983-0, 20:1, Online publication date: 1-Dec-2020. Wallisch C, Heinze G, Rinner C, Mundigler G, Winkelmayer W and Dunkler D (2020) Re-estimation improved the performance of two Framingham cardiovascular risk equations and the Pooled Cohort equations: A nationwide registry analysis, Scientific Reports, 10.1038/s41598-020-64629-6, 10:1, Online publication date: 1-Dec-2020. Kim J, Yu M, Kim Y, Min S, Ha J, Lee J, Kim D, Oh K, Joo K, Ahn C, Kim Y and Lee H (2019) Ratio of triglyceride to high-density lipoprotein cholesterol and risk of major cardiovascular events in kidney transplant recipients, Clinical and Experimental Nephrology, 10.1007/s10157-019-01776-9, 23:12, (1407-1417), Online publication date: 1-Dec-2019. Gomez-Sanchez L, Gomez-Marcos M, Patino-Alonso M, Recio-Rodriguez J, Gomez-Sanchez M, González-Sánchez J, Alonso-Domínguez R, Sánchez-Aguadero N, Maderuelo-Fernandez J, Ramos R, Garcia-Ortiz L and Rodriguez-Sanchez E (2019) Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study, Medicina Clínica (English Edition), 10.1016/j.medcle.2019.01.035, 153:9, (351-356), Online publication date: 1-Nov-2019. Lee K, Yong H, Lee J, Kang E and Na J (2018) Is the epicardial adipose tissue area on non-ECG gated low-dose chest CT useful for predicting coronary atherosclerosis in an asymptomatic population considered for lung cancer screening?, European Radiology, 10.1007/s00330-018-5562-4, 29:2, (932-940), Online publication date: 1-Feb-2019. Gibson C, Kerneis M, Yee M, Daaboul Y, Korjian S, Mehr A, Tricoci P, Alexander J, Kastelein J, Mehran R, Bode C, Lewis B, Mehta R, Duffy D, Feaster J, Halabi M, Angiolillo D, Duerschmied D, Ophuis T and Merkely B (2019) The CSL112-2001 trial: Safety and tolerability of multiple doses of CSL112 (apolipoprotein A-I [human]), an intravenous formulation of plasma-derived apolipoprotein A-I, among subjects with moderate renal impairment after acute myocardial infarction, American Heart Journal, 10.1016/j.ahj.2018.11.008, 208, (81-90), Online publication date: 1-Feb-2019. ter Wee M and Lissenberg-Witte B (2019) To Predict or not to Predict? A Quick Guide on How to Conduct Medical Research, 10.1007/978-90-368-2248-0_7, (189-227), . Wang J, MacQueen G, Patten S, Manuel D, Lashewicz B and Schmitz N (2019) A randomized controlled trial to examine the impacts of disclosing personalized depression risk information on the outcomes of individuals who are at high risk of developing major depression: a research protocol, BMC Psychiatry, 10.1186/s12888-019-2270-9, 19:1, Online publication date: 1-Dec-2019. Gavriilaki E, Gkaliagkousi E, Sakellari I, Anyfanti P, Douma S and Anagnostopoulos A (2019) Early Prediction of Cardiovascular Risk after Hematopoietic Cell Transplantation: Are We There Yet?, Biology of Blood and Marrow Transplantation, 10.1016/j.bbmt.2019.07.012, 25:10, (e310-e316), Online publication date: 1-Oct-2019. Sarfo F, Nichols M, Gebregziabher M, Tagge R, Asibey S, Jenkins C and Ovbiagele B (2019) Evaluation of Vascular Event Risk while on Long-term Anti-retroviral Suppressive Therapy [EVERLAST]: Protocol for a prospective observational study, eNeurologicalSci, 10.1016/j.ensci.2019.100189, 15, (100189), Online publication date: 1-Jun-2019. van Bronswijk S, Lemmens L, Keefe J, Huibers M, DeRubeis R and Peeters F (2018) A prognostic index for long-term outcome after successful acute phase cognitive therapy and interpersonal psychotherapy for major depressive disorder, Depression and Anxiety, 10.1002/da.22868, 36:3, (252-261), Online publication date: 1-Mar-2019. Dimberg L, Eriksson B and Hashem M (2019) Myocardial infarction and death findings from a 22-year follow-up of a cohort of 980 employed Swedish men, Public Health, 10.1016/j.puhe.2019.07.006, 175, (148-155), Online publication date: 1-Oct-2019. Cifkova R (2019) Arterial Hypertension and Cardiovascular Risk Management of Hypertension, 10.1007/978-3-319-92946-0_3, (57-74), . Rojas C, Ramírez H, Salazar L, Kalergis A, Gálvez A and Escobar‐Vera J (2019) Characterization of LDLR rs5925 and PCSK9 rs505151 genetic variants frequencies in healthy subjects from northern Chile: Influence on plasma lipid levels , Journal of Clinical Laboratory Analysis, 10.1002/jcla.23001, 33:9, Online publication date: 1-Nov-2019. Kotalik A, Eaton A, Lian Q, Serrano C, Connett J and Neaton J (2019) A win ratio approach to the re-analysis of Multiple Risk Factor Intervention Trial, Clinical Trials, 10.1177/1740774519868233, 16:6, (626-634), Online publication date: 1-Dec-2019. An Y, Yun S, Yang I, Kim D and Yang D (2019) Predictive Performance of Ultrasound-Determined Non-Alcoholic Fatty Pancreas Disease Severity for Intermediate and High Risk of Coronary Heart Disease, Journal of the Korean Society of Radiology, 10.3348/jksr.2019.80.6.1190, 80:6, (1190), . Sakaki J, Melough M, Lee S, Pounis G and Chun O (2019) Polyphenol-Rich Diets in Cardiovascular Disease Prevention Analysis in Nutrition Research, 10.1016/B978-0-12-814556-2.00010-5, (259-298), . Gomez-Sanchez L, Gomez-Marcos M, Patino-Alonso M, Recio-Rodriguez J, Gomez-Sanchez M, González-Sánchez J, Alonso-Domínguez R, Sánchez-Aguadero N, Maderuelo-Fernandez J, Ramos R, Garcia-Ortiz L and Rodriguez-Sanchez E (2019) Reclassification by applying the Framingham equation 30 years to subjects with intermediate cardiovascular risk. MARK study, Medicina Clínica, 10.1016/j.medcli.2019.01.033, 153:9, (351-356), Online publication date: 1-Nov-2019. Chen G, Gao L and Li X (2019) Effects of exercise training on cardiovascular risk factors in kidney transplant recipients: a systematic review and meta-analysis, Renal Failure, 10.1080/0886022X.2019.1611602, 41:1, (408-418), Online publication date: 1-Jan-2019. Rosenblit P (2019) Extreme Atherosclerotic Cardiovascular Disease (ASCVD) Risk Recognition, Current Diabetes Reports, 10.1007/s11892-019-1178-6, 19:8, Online publication date: 1-Aug-2019. Disouza J, Patil K, Kakade P and Patravale V (2019) Dietary Fibers and Nutraceuticals in Prevention of Hypertension Nutraceutical and Functional Foods in Disease Prevention, 10.4018/978-1-5225-3267-5.ch007, (192-232) Charles‐Schoeman C, DeMasi R, Valdez H, Soma K, Hwang L, Boy M, Biswas P and McInnes I (2019) Risk Factors for Major Adverse Cardiovascular Events in Phase III and Long‐Term Extension Studies of Tofacitinib in Patients With Rheumatoid Arthritis , Arthritis & Rheumatology, 10.1002/art.40911, 71:9, (1450-1459), Online publication date: 1-Sep-2019. Sánchez-Acevedo M, Acosta-Chí Z, Sabino-Moxo B, Márquez-Domínguez J and Canton-Croda R (2019) Big Data Analysis for Cardiovascular Diseases Coronary and Cardiothoracic Critical Care, 10.4018/978-1-5225-8185-7.ch004, (60-77) Plante T, Juraschek S, Zakai N, Tracy R and Cushman M (2019) Comparison of Frequency of Atherosclerotic Cardiovascular Disease Events Among Primary and Secondary Prevention Subgroups of the Systolic Blood Pressure Intervention Trial, The American Journal of Cardiology, 10.1016/j.amjcard.2019.08.028, 124:11, (1701-1706), Online publication date: 1-Dec-2019. Nakas G, Bechlioulis A, Marini A, Vakalis K, Bougiakli M, Giannitsi S, Nikolaou K, Antoniadou E, Kotsia A, Gartzonika K, Chasiotis G, Bairaktari E, Katsouras C, Triantis G, Sionis D, Michalis L and Naka K (2019) The importance of characteristics of angina symptoms for the prediction of coronary artery disease in a cohort of stable patients in the modern era, Hellenic Journal of Cardiology, 10.1016/j.hjc.2018.06.003, 60:4, (241-246), Online publication date: 1-Jul-2019. Buettner R and Schunter M (2019) Efficient machine learning based detection of heart disease 2019 IEEE International Conference on E-health Networking, Application & Services (HealthCom), 10.1109/HealthCom46333.2019.9009429, 978-1-7281-0402-7, (1-6) Albarqouni L, Doust J, Magliano D, Barr E, Shaw J and Glasziou P (2019) External validation and comparison of four cardiovascular risk prediction models with data from the Australian Diabetes, Obesity and Lifestyle study, Medical Journal of Australia, 10.5694/mja2.12061, 210:4, (161-167), Online publication date: 1-Mar-2019. Liu Y, Li Q, Chen S, Wang X, Zhou Y, Tan N and Chen J (2018) A Simple Modified Framingham Scoring System to Predict Obstructive Coronary Artery Disease, Journal of Cardiovascular Translational Research, 10.1007/s12265-018-9837-6, 11:6, (495-502), Online publication date: 1-Dec-2018. Hermansson J and Kahan T (2017) Systematic Review of Validity Assessments of Framingham Risk Score Results in Health of Therapies in Online publication date: M, V, J, E, C, G, L and A (2018) levels in and as markers of and adipose tissue BMC Online publication date: 1-Dec-2018. H, T, D and E (2018) Risk Factors for Heart Disease International on Medical and (1-6) J, B, Wang J, S, S, C, S, C and MacQueen G (2018) for of the study, BMC Psychiatry, Online publication date: 1-Dec-2018. A, M, and M (2017) of in research the review of the of the Framingham Journal of Medical Online publication date: C, J, J, C, J, E, J, D and F (2018) Online publication date: T, G and E (2018) The of in for Primary Prevention of Cardiovascular Diseases in Current Cardiovascular Risk Reports, Online publication date: M, D, M, M and M (2018) a review of and Biomedical Online publication date: R and L (2018) The of Cardiovascular Disease Risk is the Best Risk for the Journal of and in Medical and Online publication date: H (2018) Risk Prediction in Biomedical . L, S, T, C, A, S, D, H, J, Jenkins D, C and Sievenpiper J (2018) Dietary and Cardiovascular Disease: A Systematic Review and of Trials, in Cardiovascular Online publication date: H (2018) Risk Prediction of Cardiovascular Research and Medicine, . Most J, L, S, H, E and L (2018) improvement in health in healthy individuals and American Journal of and Metabolism, Online publication date: J, B, F, I, M, M, M, E, N, A, M, L, T, D, J and Neaton J (2018) Which with high from of A of the trial, The Online publication date: J, C, E, N, E and N (2018) Risk Factors in Cardiovascular Disease Risk Online publication date: R, K, R, W and L (2018) The of the model for prognostic in health a review, and Research, Online publication date: 1-Dec-2018. S and I (2018) Clínica Online publication date: M, I and D (2017) The cardiovascular of of and International Journal of and Nutrition, Online publication date: T and S (2018) assessment of to health in patients with cardiovascular disease in BMC Health Services Research, Online publication date: 1-Dec-2018. C, L, A, A, M, M, V, A, M, N, A and A (2018) Is With a Risk of Atherosclerosis in Patients on Journal of Online publication date: Sánchez-Acevedo M, Acosta-Chí Z, Sabino-Moxo B, Márquez-Domínguez J and Canton-Croda R (2018) Big Data Analysis for Cardiovascular Diseases Big Data Management and the of for Health V, J, S, J, J, S and R (2018) Cardiovascular Risk Prediction Underestimate Risk in Online publication date: X, Wang X, Y, Chen S, Zhang R, Li L, Yu B and J (2017) Impact of Smoking and Smoking on as by The American Journal of Cardiology, Online publication date: S, J and R (2017) Cardiovascular Disease and Blood Pressure & Online publication date: J, I, M, D, B, R and de A (2017) of in a general population Clínica Online publication date: Marini A, Naka K, Vakalis K, Bechlioulis A, Bougiakli M, Giannitsi S, Nikolaou K, Antoniadou E, Gartzonika C, Chasiotis G, Bairaktari E, Katsouras C, Triantis G, Sionis D and Michalis L (2017) of coronary artery disease in patients for stable or acute coronary Hellenic Journal of Cardiology, Online publication date: V, A, P, R and S (2017) of a in Fibers and at Low in in and Nutrition . M, K, D and M (2017) E de Medicina Online publication date: E, R, C, T, S, W and N and of that and the risk of cardiovascular Diabetes, Obesity and Metabolism, 19:1, Online publication date: Jenkins D, B, F, M, P, A, A, W, M, de R, C, N, Jenkins A, S and N (2017) Effect of Current Dietary on and Cardiovascular Risk Journal of the American of Cardiology, Online publication date: S, L, Y, F, Zhang S, Li D, W, Zhang X, D and X (2017) of and traditional risk factors the performance of coronary heart disease Online publication date: O, D and G Efficacy of on for Cardiovascular Disease Risk Reduction among a Review of the Journal of and Health Online publication date: Most J, V, L and L (2017) in An update, Ageing Research Online publication date: J, K, E, C, T, B, N, T, Li Q, A and Peiris D (2017) of for with cardiovascular Australian Journal of Primary Health, 23:5, . Lee S, Yun S, Kim D, H and Park Y (2017) Severity of disease on and risk of coronary heart Journal of Clinical 45:7, Online publication date: H and L (2017) An early risk of coronary heart using model International Conference on of Data and Online publication date: J The and Medical Online publication date: E, N and A (2017) for of Research
First defined by Jameton in 1984 as a phenomenon that occurs when nurses cannot carry out what they believe to be ethically appropriate actions because of institutional constraints, moral distress has recently gained attention as an important problem experienced by multiple healthcare disciplines.1 Although it is not a new topic, recent attention to moral distress (specifically, an article in the New York Times by surgeon Pauline W. Chen, “When doctors and nurses can’t do the right thing,”2 and a fourfold increase in articles on the topic in MEDLINE in the past two years) has highlighted its presence and effect on healthcare providers and on the delivery of healthcare. While the majority of published research has been in nursing journals, current work has expanded to other disciplines, including medicine, psychology, pharmacy, and respiratory therapy.3 It is increasingly clear that moral distress is not solely a nursing issue, but one that potentially influences all healthcare professionals. Jameton described moral distress as having two parts: initial distress and reactive distress.4 Initial distress occurs in the moment, as a situation unfolds (from this point forward, we will use the phrase moral distress to refer to this acute phase). After the situation that elicited moral distress ends, reactive distress (now referred to as moral residue) remains. Hence, moral distress and moral residue are closely related but separate concepts. Thus far, distinctions between the two have largely not been addressed empirically or conceptually; however, the two phenomena have differing characteristics and their interrelationship poses important implications for members of healthcare teams. The aim of this article is to propose a preliminary model that we call the crescendo effect, which describes the interrelationship between moral distress and moral residue. Our intent is to spark debate, encourage further study, and provide additional insight for ethics consultants as they analyze clinical situations. While the crescendo effect model arose from an empirical study of experienced nurses and physicians in a neonatal intensive care unit (NICU),5 mounting evidence from other disciplines and settings indicates that the phenomenon is shared across many specialties. We will provide examples from these sources and settings in this article.
BOOK REVIEW InternationalJournal of Technology Assessment in Health Care. A newjournal edited by Egon Jonnson and Stanley J. Reiser. Quarterly, Cambridge University Press, London. Perhaps no specialty faces more acutely the problem of safely and effectively using new techniques and technologies, and the need to objectively and critically evaluate their performance, than intensive-care medicine. The new International Journal of Technology Assessment in Health Care has as its aims the "generation, evaluation, diffusion, and use of health care technology." The journal is intended for a diverse audience including health-care providers, decision makers in government, industry, health-care organizations, and scholarly disciplines of ethics, economics, law, history, sociology, and engineering. Does this journal have claim to the attention of the busy clinician who cares for critically ill patients ? Each issue is planned to contain a special section focused on a particular topic, general articles, and regular feature sections. The inaugural issue's special topic is technology and health care for the elderly, and this section includes articles on "Intensive Care for the Elderly," "Medical Technology for the Elderly inJapan," "End-stage Renal Failure and the Aged in the United Kingdom," "Orthopedic Technology for the Elderly," "Pacemakers," "Visual Rehabilitation for the Elderly through Improved Surgical Technology," "Neuronal Replacement after Traumatic or Age-dependent Brain Damage," "Audio-visual Programs in the Reality-Orientation Training of Alzheimer's Victims," and "Aspects of Psychological Aging and Technology." Two general essays in this issue are "Medical Technology Assessment: The Evaluation of Coronary Artery Bypass Graft Surgery Using Data Synthesis Techniques," and "Diagnosing Suspected Stroke: A Cost Effectiveness Analysis." The section on technology assessment reports on findings from the United States Office of Technology Assessment, the Clinical Efficacy Assessment Project of the American College of Physicians, the National Institutes of Health's Consensus Development Conference on Fresh Frozen Plasma, and the Swedish Medical Council and Swedish Planning and Rationalization Institute's Consensus Statement on Sight Improving Surgery. The emerging technology section has two articles on extracorporeal shock wave lithotripsy. Issues will contain regular sections on world perspectives, statistics, reviews, short reports, meetings and announcements, and a section entided the sorcerer's apprentice that will consider less formal topics including "parodies, satires, and other humorous items." Permission to reprint a book review printed in this section may be obtained only from the author. Perspectives in Biology and Medicine, 31, 1 ¦ Autumn 1987 \ 151 The article on "Intensive Care for the Elderly" by BryanJennett, M.D., of the University of Glasgow lists five categories of illness that bring adult patients to intensive-care units: myocardial infarction; postoperative care; respiratory, renal , or hepatic failure; coma; and hemorrhage or shock. He reviews studies of the outcome of intensive care and concludes "what such studies of outcome of intensive care indicate is that in patients whose outcome can be influenced, the details of the regimes and technologies matter less than the advantage that accrues from attracting the intensive attention of doctors and nurses." While it may be true that alternative therapeutic regimes can achieve similar outcomes, it is the intensivist's skillful attention to detail that achieves these outcomes. A framework for discussing controversial ethical issues in intensive-care decision making is outlined based on the principles of beneficence, nonmaleficence, patient autonomy, andjustice. The article is followed by two commentaries. David Barnard, Ph.D., of the Institute for Medical Humanities, University of Texas Medical Branch, elaborates on the partial truth of the equivalence of technical and moral excellence in medicine. A second commentary byJohannes O. Vang, M.D., Ph.D., of the Office of Health Technology Assessment of the World Health Organization places the economic cost of intensive care in the context of other technologies for health care and criticizes Dr. Jennett for omitting questions of discomfort, suffering, and dignity in intensive care. The article and commentaries are interesting and thought provoking, but their brevity limits their ability to elucidate the complex issues involved in intensive care. I would prefer longer articles with more attention to the subdeties that physicians face in their use of technologies for individual patients. Future issues will cover advanced technology and health care in the home, nuclear magnetic resonance, prenatal care, use and abuse of routine...
Editor- Thank you for giving us the opportunity to respond to the letter received regarding the Joint Royal College of Physicians Training Board (JRCPTB) curriculum for Acute Internal Medicine (AIM) that has previously been circulated for comment and consideration of implementation in August 2022. Dr Williamson is correct in asserting that the proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions. It does aim to produce a workforce that reflects the current trends of increasing patient attendances to both primary care and emergency departments- one that has a high level of diagnostic reasoning, the ability to manage uncertainty, deal with co-morbidities and recognise when specialty input is required in a variety of settings, including ambulatory and critical care. Contrary to the situation described in the correspondence, the new curriculum does not move away from each trainee being required to develop a specialist skill, such as medical education, management, stroke medicine or focused echocardiography. Trainees will still need to acquire competency in a specialist skill for their final 36 months of their training programme, usually after they have completed their Point of Care Ultrasound (POCUS) certification. The thinking behind introducing mandatory POCUS in the curriculum is that: POCUS is in the proposed curricula for intensive care medicine, respiratory medicine and emergency medicine, therefore we feel that in order to recruit the best trainees it is imperative POCUS training is offered as standard As evidenced by the trainee surveys, they often do not get allocated time to develop their specialist skill, especially in the early years of Higher Specialty Training before they often have decided on a particular skill. The introduction of mandatory POCUS training should legtimise time off the ward to obtain this skill early in training. POCUS is becoming more and more standardised in 21st Century acute care alongside the reducing costs of Ultrasound probe e.g. Philips Lumify and Butterfly iQ which are compatible with smart phones POCUS has been heralded as the fifth pillar of examination (observation, palpation, percussion, auscultation, insonation)1 The proposed curriculum therefore facilitates trainees to have regular dedicated time to develop interests inside or outside acute medicine to supplement their professional experience and training. This will also enable trainees to have time away from the ‘front door’ high intensity acute care. Mandatory POCUS will continue to set AIM training apart from other physician training programmes and continue to attract high quality trainees to apply to the specialty. Formal feedback seen at the SAC meeting in October 2019 to the draft curriculum (personal correspondence from JRCPTB) showed a positive response from nine individuals, an ambivalent one from two people, and only two against the introduction of formal POCUS training in the curriculum. Point of Care Ultrasound will likely be a welcome addition to the curriculum and will benefit patients, trainees and front door services up and down the country. Concerns regarding supervision are being addressed by the POCUS working group, in anticipation of the lead in period of well over two years. It is anticipated that most trainees can achieve POCUS sign off (e.g. Focused Acute Medical Ultrasound) in 6 to 12 months (personal correspondence Nick Smallwood from POCUS working group). With ongoing concerns regarding recruitment and retention in Acute Internal Medicine we agree strongly that with POCUS inclusion, we have a further selling point for AIM training.
Research Articles| May 29 2008 The Prevention of Acute Gastric Ulcer in the Rat by α-Methyldopa Subject Area: Pharmacology B. Djahanguiri; B. Djahanguiri From the Department of Experimental Medicine and Pharmacology, Faculty of Medicine, University of Tehran, Tehran Search for other works by this author on: This Site PubMed Google Scholar S. Hemmati; S. Hemmati From the Department of Experimental Medicine and Pharmacology, Faculty of Medicine, University of Tehran, Tehran Search for other works by this author on: This Site PubMed Google Scholar D. Sadeghi; D. Sadeghi From the Department of Experimental Medicine and Pharmacology, Faculty of Medicine, University of Tehran, Tehran Search for other works by this author on: This Site PubMed Google Scholar A. Firouzabadi A. Firouzabadi From the Department of Experimental Medicine and Pharmacology, Faculty of Medicine, University of Tehran, Tehran Search for other works by this author on: This Site PubMed Google Scholar Medicina et Pharmacologia Experimentalis (1967) 17 (5): 427–433. https://doi.org/10.1159/000137111 Article history Published Online: July 01 1967 Received: October 19 1967 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation B. Djahanguiri, S. Hemmati, D. Sadeghi, A. Firouzabadi; The Prevention of Acute Gastric Ulcer in the Rat by α-Methyldopa. Medicina et Pharmacologia Experimentalis 1 May 1967; 17 (5): 427–433. https://doi.org/10.1159/000137111 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsMedicina et Pharmacologia Experimentalis Search Advanced Search Article PDF first page preview Close Modal Journal Section: Paper This content is only available via PDF. Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. 1967 You do not currently have access to this content.
Editor- I note with interest that the Joint Royal College of Physicians Training Board curriculum for Acute Internal Medicine (AIM) has been reviewed and circulated for comment and consideration of implementation in August 2022. The proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions. It aims to produce a workforce that reflects the current trends of increasing patient attendances to bothprimary care and emergency departments- one that has a high level of diagnostic reasoning, the ability to manage uncertainty, deal with comorbidities and recognise when specialty input is require in a variety of settings, including ambulatory and critical care. The new curriculum moves away from each trainee being required to develop a specialist skill, such as medical education, echocardiography or endoscopy throughout their training1, to trainees acquiring competencies in a specialist theme for their final 24 to 30 months of their training programme after they have completed their Point of Care Ultrasound certification. The current curriculum allows trainees to have regular dedicated time to develop interests inside or outside acute medicine to supplement their professional experience and training. This often allows trainees time away from the ‘front door’, can be welcomed break from high intensity acute care and uniquely offers trainee physicians flexibility in their training programmes and curriculum requirements. This sets acute medicine training apart from other physician training programmes and can attract trainees to apply to the specialty. It also addresses Shape of Training recommendations, which suggest more flexibility and choice in career structure for postgraduate doctors.2 Point of Care Ultrasound will undoubtedly be a welcome addition to the curriculum and will benefit patients, trainees and front door services up and down the country.3 However, concerns regarding supervision and maintenance of competency exist.4 More importantly, time spent gaining competency in this before pursuing an interest in an additional area or procedure will offer trainees less time to attain accreditation in some of the existing specialist skills currently available. With ongoing concerns regarding recruitment and retention in Acute Internal Medicine5 we should be careful that we do not lose a unique selling point that acute internal medicine training offers.
From the beginning, the reporting of the results of National Acute Spinal Cord Injury Studies (NASCIS) II and III has been incomplete, leaving clinicians in the spinal cord injury (SCI) community to use or avoid using methylprednisolone in acute SCI on the basis of faith rather than a publicly developed scientific consensus. NASCIS II was initially reported by National Institutes of Health announcements, National Institutes of Health facsimiles to emergency room physicians, and the news media. The subsequent report in the New England Journal of Medicine implied that there was a positive result in the primary efficacy analysis for the entire 487 patient sample. However, this analysis was in fact negative, and the positive result was found only in a secondary analysis of the subgroup of patients who received treatment within 8 hours. In addition, that subgroup apparently had only 62 patients taking methylprednisolone and 67 receiving placebo. The NASCIS II and III reports embody specific choices of statistical methods that have strongly shaped the reporting of results but have not been adequately challenged or or even explained. These studies show statistical artifacts that call their results into question. In NASCIS II, the placebo group treated before 8 hours did poorly, not only when compared with the methylprednisolone group treated before 8 hours but even when compared with the placebo group treated after 8 hours. Thus, the positive result may have been caused by a weakness in the control group rather than any strength of methylprednisolone. In NASCIS III, a randomization imbalance occurred that allocated a disproportionate number of patients with no motor deficit (and therefore no chance for recovery) to the lower dose control group. When this imbalance is controlled for, much of the superiority of the higher dose group seems to disappear. The NASCIS group's decision to admit persons with minor SCIs with minimal or no motor deficit not only enables statistical artifacts it complicates the interpretation of results from the population actually sampled. Perhaps one half of the NASCIS III sample may have had at most a minor deficit. Thus, we do not know whether the results of these studies reflect the severely injured population to which they have been applied. The numbers, tables, and figures in the published reports are scant and are inconsistently defined, making it impossible even for professional statisticians to duplicate the analyses, to guess the effect of changes in assumptions, or to supply the missing parts of the picture. Nonetheless, even 9 years after NASCIS II, the primary data have not been made public. The reporting of the NASCIS studies has fallen far short of the guidelines of the ICH/FDA and of the Evidence-based Medicine Group. Despite the lucrative "off label" markets for methylprednisolone in SCI, no Food and Drug Association indication has been obtained. There has been no public process of validation. These shortcomings have denied physicians the chance to use confidently a drug that many were enthusiastic about and has left them in an intolerably ambiguous position in their therapeutic choices, in their legal exposure, and in their ability to perform further research to help their patients.
The objectives of this article are to systematically review i) the extent of medicine use in postpartum women, and ii) the impact of maternal medicine use (excluding contraceptives and galactogogues) on breastfeeding outcomes (initiation and/or duration). PubMed, Medline (Ovid), Scopus (Elsevier), Cinahl (EBSCO), PsycINFO (Ovid), Embase (Ovid) and Web of Science (ISI) databases were searched to find original studies on medicine use in women after the birth. Additional studies were identified by searching Google Scholar, Wiley Online Library, Springer Link, selected journals and from the reference list of retrieved articles. Observational studies with information about postpartum women's use of any type of medicine either for chronic or acute illnesses with or without breastfeeding information were included. The majority of relevant studies suggest that more than 50 % of postpartum women (breastfeeding or not) required at least one medicine. Due to the lack of uniform medication use reporting system and differences in study designs, settings and samples, the proportion of medicine use by postpartum women varies widely, from 34 to 100 %. Regarding the impact of postpartum women's medicine use on breastfeeding, a few studies suggest that women's use of certain medicines (e.g. antiepileptics, propylthiouracil, antibiotics) during lactation can reduce initiation and/ or duration of breastfeeding. These studies are limited by small sample size, and with one exception, all were conducted in Canada more than a decade ago. Large scale studies are required to establish the relationship between maternal medicine use and breastfeeding, considering type of illness, period of use and total duration of medicine use.
BACKGROUND: Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: To compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research. SEARCH METHODS: We identified trials from the Cochrane Airways Group Specialised Register of trials (CAGR), which is derived from systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), and PsycINFO, and through handsearching of respiratory journals and meeting abstracts. This update to the original review incorporates the results of database searches up to January 2017. SELECTION CRITERIA: ) > 45 mmHg (6 kPa). Primary review outcomes were mortality during hospital admission and need for endotracheal intubation. Secondary outcomes included hospital length of stay, treatment intolerance, complications, changes in symptoms, and changes in arterial blood gases. DATA COLLECTION AND ANALYSIS: Two review authors independently applied the selection criteria to determine study eligibility, performed data extraction, and determined risk of bias in accordance with Cochrane guidelines. Review authors undertook meta-analysis for data that were both clinically and statistically homogenous, and analysed data as both one overall pooled sample and according to two predefined subgroups related to exacerbation severity (admission pH between 7.35 and 7.30 vs below 7.30) and NIV treatment setting (intensive care unit-based vs ward-based). We reported results for mortality, need for endotracheal intubation, and hospital length of stay in a 'Summary of findings' table and rated their quality in accordance with GRADE criteria. MAIN RESULTS: . Treatment intolerance was significantly greater in the NIV group than in the usual care group (risk difference (RD) 0.11, 95% CI 0.04 to 0.17; N = 6 studies). Results of analysis showed a non-significant trend towards reduction in dyspnoea with NIV compared with usual care (standardised mean difference (SMD) -0.16, 95% CI -0.34 to 0.02; N = 4 studies). Subgroup analyses revealed no significant between-group differences. AUTHORS' CONCLUSIONS: Data from good quality randomised controlled trials show that NIV is beneficial as a first-line intervention in conjunction with usual care for reducing the likelihood of mortality and endotracheal intubation in patients admitted with acute hypercapnic respiratory failure secondary to an acute exacerbation of chronic obstructive pulmonary disease (COPD). The magnitude of benefit for these outcomes appears similar for patients with acidosis of a mild (pH 7.30 to 7.35) versus a more severe nature (pH < 7.30), and when NIV is applied within the intensive care unit (ICU) or ward setting.
OBJECTIVES: The Society of Critical Care Medicine and four other major critical care organizations have endorsed a seven-step process to resolve disagreements about potentially inappropriate treatments. The multiorganization statement (entitled: An official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units) provides examples of potentially inappropriate treatments; however, no clear definition is provided. This statement was developed to provide a clear definition of inappropriate interventions in the ICU environment. DESIGN: A subcommittee of the Society of Critical Care Medicine Ethics Committee performed a systematic review of empirical research published in peer-reviewed journals as well as professional organization position statements to generate recommendations. Recommendations approved by consensus of the full Society of Critical Care Medicine Ethics Committees and the Society of Critical Care Medicine Council were included in the statement. MEASUREMENTS AND MAIN RESULTS: ICU interventions should generally be considered inappropriate when there is no reasonable expectation that the patient will improve sufficiently to survive outside the acute care setting, or when there is no reasonable expectation that the patient's neurologic function will improve sufficiently to allow the patient to perceive the benefits of treatment. This definition should not be considered exhaustive; there will be cases in which life-prolonging interventions may reasonably be considered inappropriate even when the patient would survive outside the acute care setting with sufficient cognitive ability to perceive the benefits of treatment. When patients or surrogate decision makers demand interventions that the clinician believes are potentially inappropriate, the seven-step process presented in the multiorganization statement should be followed. Clinicians should recognize the limits of prognostication when evaluating potential neurologic outcome and terminal cases. At times, it may be appropriate to provide time-limited ICU interventions to patients if doing so furthers the patient's reasonable goals of care. If the patient is experiencing pain or suffering, treatment to relieve pain and suffering is always appropriate. CONCLUSIONS: The Society of Critical Care Medicine supports the seven-step process presented in the multiorganization statement. This statement provides added guidance to clinicians in the ICU environment.
BACKGROUND: Traditional approaches to mechanical ventilation use tidal volumes of 10 to 15 ml per kilogram of body weight and may cause stretch-induced lung injury in patients with acute lung injury and the acute respiratory distress syndrome. We therefore conducted a trial to determine whether ventilation with lower tidal volumes would improve the clinical outcomes in these patients. METHODS: Patients with acute lung injury and the acute respiratory distress syndrome were enrolled in a multicenter, randomized trial. The trial compared traditional ventilation treatment, which involved an initial tidal volume of 12 ml per kilogram of predicted body weight and an airway pressure measured after a 0.5-second pause at the end of inspiration (plateau pressure) of 50 cm of water or less, with ventilation with a lower tidal volume, which involved an initial tidal volume of 6 ml per kilogram of predicted body weight and a plateau pressure of 30 cm of water or less. The primary outcomes were death before a patient was discharged home and was breathing without assistance and the number of days without ventilator use from day 1 to day 28. RESULTS: The trial was stopped after the enrollment of 861 patients because mortality was lower in the group treated with lower tidal volumes than in the group treated with traditional tidal volumes (31.0 percent vs. 39.8 percent, P=0.007), and the number of days without ventilator use during the first 28 days after randomization was greater in this group (mean [+/-SD], 12+/-11 vs. 10+/-11; P=0.007). The mean tidal volumes on days 1 to 3 were 6.2+/-0.8 and 11.8+/-0.8 ml per kilogram of predicted body weight (P<0.001), respectively, and the mean plateau pressures were 25+/-6 and 33+/-8 cm of water (P<0.001), respectively. CONCLUSIONS: In patients with acute lung injury and the acute respiratory distress syndrome, mechanical ventilation with a lower tidal volume than is traditionally used results in decreased mortality and increases the number of days without ventilator use.
Journal Article Acute Nonlymphocytic Leukemia in Germ Cell Tumor Patients Treated With Etoposide-Containing Chemotherapy Get access Dean F. Bajorin, Dean F. Bajorin Genitourinary Oncology Service, Division of Solid Tumor Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Cente; and Department of Medicine, Cornell University Medical CollegeNew York, N.Y. Correspondence to : Dean F. Bajorin, M.D., Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021. Search for other works by this author on: Oxford Academic PubMed Google Scholar Robert J. Motzer, Robert J. Motzer Genitourinary Oncology Service, Division of Solid Tumor Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Cente; and Department of Medicine, Cornell University Medical CollegeNew York, N.Y. Search for other works by this author on: Oxford Academic PubMed Google Scholar Eduardo Rodriguez, Eduardo Rodriguez Cytogenetics Service, Department of Pathology, Memorial Sloan-Kettering Cancer CenterNew York, N.Y. Search for other works by this author on: Oxford Academic PubMed Google Scholar Barbara Murphy, Barbara Murphy Genitourinary Oncology Service, Division of Solid Tumor Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Cente; and Department of Medicine, Cornell University Medical CollegeNew York, N.Y. Search for other works by this author on: Oxford Academic PubMed Google Scholar George J. Bosl George J. Bosl Genitourinary Oncology Service, Division of Solid Tumor Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Cente; and Department of Medicine, Cornell University Medical CollegeNew York, N.Y. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 85, Issue 1, 6 January 1993, Pages 60–62, https://doi.org/10.1093/jnci/85.1.60 Published: 06 January 1993 Article history Received: 04 November 1992 Accepted: 05 November 1992 Published: 06 January 1993
BACKGROUND: This is an update of the original Cochrane review published in Issue 2, 2007. Some antiepileptic medicines have a place in the treatment of neuropathic pain (pain due to nerve damage). This updated review adds five new additional studies looking at evidence for Lamotrigine as an effective treatment for acute and chronic pain. OBJECTIVES: To assess analgesic efficacy and adverse effects of the antiepileptic drug lamotrigine in acute and chronic pain. SEARCH STRATEGY: Randomised controlled trials (RCTs) of lamotrigine in acute, and chronic pain (including cancer pain) were identified from MEDLINE, EMBASE and CENTRAL up to January 2011. Additional studies were sought from the reference list of the retrieved papers. SELECTION CRITERIA: RCTs investigating the use of lamotrigine (any dose, by any route, and for any study duration) for the treatment of acute or chronic pain. Assessment of pain intensity or pain relief, or both, using validated scales. Participants were adults aged 18 and over. Only full journal publication articles were included. DATA COLLECTION AND ANALYSIS: Dichotomous data (ideally for the outcome of at least 50% pain relief) were used to calculate relative risk with 95% confidence intervals. Meta-analysis was undertaken using a fixed-effect model. Numbers needed to treat to benefit (NNTs) were calculated as the reciprocal of the absolute risk reduction. For unwanted effects, the NNT becomes the number needed to harm (NNH) and was calculated. MAIN RESULTS: Twelve included studies in 11 publications (1511 participants), all with chronic neuropathic pain: central post stroke pain (1), chemotherapy induced neuropathic pain (1), diabetic neuropathy (4), HIV related neuropathy (2), mixed neuropathic pain (2), spinal cord injury related pain (1), and trigeminal neuralgia (1); none investigated lamotrigine in acute pain. The update had five additional studies (1111 additional participants). Participants were aged between 26 and 77 years. Study duration was 2 weeks in one study and at least 6 weeks in the remainder; eight were of eight week duration or longer. There is no convincing evidence that lamotrigine is effective in treating acute or chronic pain at doses of about 200-400 mg daily. Almost 10% of participants taking lamotrigine reported a skin rash. AUTHORS' CONCLUSIONS: The additional studies tripled participant numbers providing data for analysis, and new, more stringent criteria for outcomes and analysis were used; conclusions about lamotrigine's lack of efficacy in chronic pain did not change. Given availability of more effective treatments including antiepileptics and antidepressant medicines, lamotrigine does not have a significant place in therapy based on available evidence.
Acute Medicine JournalOfficial Journal of the Society for Acute Medicine SUBSCRIBE VERIFIABLE CPD Acute Medicine Journal A quarterly peer-reviewed medical journal, cited in MEDLINE. It is the premier publication for disseminating research and education for healthcare professionals in emergency, acute and urgent care. CPD Assessments Verifiable CPD Activity Latest Articles See More Latest … Home Read More #