Journal of Clinical Medicine

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8 pages, 617 KiB

Open AccessArticle

Characteristics and Injury Patterns in Electric-Scooter Related Accidents—A Prospective Two-Center Report from Germany

by Philipp Störmann, Alexander Klug, Christoph Nau, René D. Verboket, Max Leiblein, Daniel Müller, Uwe Schweigkofler, Reinhard Hoffmann, Ingo Marzi and Thomas Lustenberger

J. Clin. Med. 2020, 9(5), 1569; https://doi.org/10.3390/jcm9051569 - 22 May 2020

Cited by 111 | Viewed by 6179

Abstract

Since the introduction of rental E-scooters in Germany in mid-June 2019, the safety of this new means of transport has been the subject of extensive public debate. However, valid data on injuries and usage habits are not yet available. This retrospective two-center study [...] Read more.

Since the introduction of rental E-scooters in Germany in mid-June 2019, the safety of this new means of transport has been the subject of extensive public debate. However, valid data on injuries and usage habits are not yet available. This retrospective two-center study included a total of 76 patients who presented to the emergency department following E-scooter-related accidents. The mean age was 34.3 ± 12.4 years and 69.7% of the patients were male. About half of the patients were admitted by ambulance (42.1%). Fractures were found in 48.6% of patients, and 27.6% required surgical treatment due to a fracture. The upper extremities were the most commonly affected body region, followed by injuries to the lower extremity and to the head and face. Only one patient had worn a helmet. In-hospital treatment was necessary for 26.3% of the cases. Patients presented to the emergency department mainly during the weekend and on-call times. This is the first report on E-scooter-related injuries in Germany. Accidents with E-scooters can cause serious injuries and, therefore, represent a further burden to emergency departments. The use of E-scooters appears to be mostly recreational, and the rate of use of protective gear is low. Full article

(This article belongs to the Special Issue Effect of Lifestyle Habits on the Clinical Outcome in Trauma/Orthopedic Patients)

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14 pages, 1658 KiB

Open AccessArticle

Pulsed Electromagnetic Field Therapy Improves Osseous Consolidation after High Tibial Osteotomy in Elderly Patients—A Randomized, Placebo-Controlled, Double-Blind Trial

by Patrick Ziegler, Andreas K. Nussler, Benjamin Wilbrand, Karsten Falldorf, Fabian Springer, Anne-Kristin Fentz, Georg Eschenburg, Andreas Ziegler, Ulrich Stöckle, Elke Maurer, Atesch Ateschrang, Steffen Schröter and Sabrina Ehnert

J. Clin. Med. 2019, 8(11), 2008; https://doi.org/10.3390/jcm8112008 - 17 Nov 2019

Cited by 13 | Viewed by 5456

Abstract

Extremely low-frequency pulsed electromagnetic field (ELF-PEMF) therapy is proposed to support bone healing after injuries and surgical procedures, being of special interest for elderly patients. This study aimed at investigating the effect of a specific ELF-PEMF, recently identified to support osteoblast function in [...] Read more.

Extremely low-frequency pulsed electromagnetic field (ELF-PEMF) therapy is proposed to support bone healing after injuries and surgical procedures, being of special interest for elderly patients. This study aimed at investigating the effect of a specific ELF-PEMF, recently identified to support osteoblast function in vitro, on bone healing after high tibial osteotomy (HTO). Patients who underwent HTO were randomized to ELF-PEMF or placebo treatment, both applied by optically identical external devices 7 min per day for 30 days following surgery. Osseous consolidation was evaluated by post-surgical X-rays (7 and 14 weeks). Serum markers were quantified by ELISA. Data were compared by a two-sided t-test (α = 0.05). Device readouts showed excellent therapy compliance. Baseline parameters, including age, sex, body mass index, wedge height and blood cell count, were comparable between both groups. X-rays revealed faster osseous consolidation for ELF-PEMF compared to placebo treatment, which was significant in patients ≥50 years (∆_mean = 0.68%/week; p = 0.003). Findings are supported by post-surgically increased bone-specific alkaline phosphatase serum levels following ELF-PEMF, compared to placebo (∆_mean = 2.2 µg/L; p = 0.029) treatment. Adverse device effects were not reported. ELF-PEMF treatment showed a tendency to accelerate osseous consolidation after HTO. This effect was stronger and more significant for patients ≥50 years. This ELF-PEMF treatment might represent a promising adjunct to conventional therapy supporting osseous consolidation in elderly patients. Level of Evidence: I. Full article

(This article belongs to the Special Issue Effect of Lifestyle Habits on the Clinical Outcome in Trauma/Orthopedic Patients)

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10 pages, 895 KiB

Open AccessArticle

Medication-Taking Habit and Outcome of Glucosamine Sulfate for Osteoarthritis Patients Influenced by National Health Insurance Regulations in Taiwan

by Chia-Hao Hsu, Nin-Chieh Hsu, Chia-Lung Shih, Hsuan-Ti Huang, Chung-Hwan Chen and Pei-Hsi Chou

J. Clin. Med. 2019, 8(10), 1734; https://doi.org/10.3390/jcm8101734 - 19 Oct 2019

Cited by 2 | Viewed by 2781

Abstract

This study compared the dosage and different medication-taking habits of glucosamine sulfate (GS) for osteoarthritis patients and evaluated the influence of the National Health Insurance (NHI) prescription guidelines. The subjects were collected from the Taiwan NHI Research Database from 1 January 2004, to [...] Read more.

This study compared the dosage and different medication-taking habits of glucosamine sulfate (GS) for osteoarthritis patients and evaluated the influence of the National Health Insurance (NHI) prescription guidelines. The subjects were collected from the Taiwan NHI Research Database from 1 January 2004, to 31 December 2008, and 10,501 osteoarthritis patients were included. Then, 271 patients who continuously used nonsteroidal anti-inflammatory drug (NSAIDs) and started to receive glucosamine for the first time since 2005 (no glucosamine use in 2004) were compared with 593 age-matched patients who continuously used NSAIDs but never received any glucosamine drugs from 2004 to 2008. The mean treatment duration of the glucosamine-treated and NSAID-treated groups was 40.38 ± 7.89 and 45.82 ± 3.89 months, respectively. The most common medication-taking habit was 250 mg 3 times a day for 3 months and discontinued for 3 months. It was as indicated and covered by the NHI. Only 0.7% of patients used the recommended daily dosage of 1500 mg. Patients using GS surprisingly had a higher incidence rate of joint replacement surgery than those who did not use GS. The NHI prescription guidelines may cause patient selection bias, which decreases the efficacy of GS. Moreover, patients tend to have an altered medication-taking habit, with a daily dosage of 750 mg, which is lower than the recommended therapeutic dose. Full article

(This article belongs to the Special Issue Effect of Lifestyle Habits on the Clinical Outcome in Trauma/Orthopedic Patients)

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7 pages, 375 KiB

Open AccessArticle

Relationship between Sleep Duration and Osteoarthritis in Middle-Aged and Older Women: A Nationwide Population-Based Study

by Hye-Min Park, Yu-Jin Kwon, Hyoung-Sik Kim and Yong-Jae Lee

J. Clin. Med. 2019, 8(3), 356; https://doi.org/10.3390/jcm8030356 - 13 Mar 2019

Cited by 22 | Viewed by 3369

Abstract

(1) Background: Both long and short sleep durations have been associated with negative health outcomes, particularly in middle-aged and older adults. To date, there has been little research on the association between sleep and osteoarthritis. This study aimed to evaluate the relationship between [...] Read more.

(1) Background: Both long and short sleep durations have been associated with negative health outcomes, particularly in middle-aged and older adults. To date, there has been little research on the association between sleep and osteoarthritis. This study aimed to evaluate the relationship between sleep duration and radiographically confirmed osteoarthritis in middle-aged and older women. (2) Methods: This study included 5268 women aged ≥50 years from the Korea National Health and Nutrition Examination Survey. Sleep duration was categorized into four groups (≤5 h, 6 h, 7–8 h, and ≥9 h) using responses from a self-reported questionnaire, and 7–8 h was set as an appropriate sleep duration. Osteoarthritis was defined as Kellgren–Lawrence grade ≥2 in the knee or hip area in radiographic images with knee or hip joint pain. The odds ratios (ORs) and 95% confidence intervals (CIs) of osteoarthritis according to sleep duration were calculated using multiple logistic regression analyses. (3) Results: The prevalence of osteoarthritis according to sleep duration showed a U-shaped curve, with the nadir in the appropriate sleep category (7–8 h). Compared with the 7–8 h sleep duration, the ORs (95% CIs) of osteoarthritis in the short sleep duration (≤5 h/day) and long sleep duration (≥9 h/day) were 1.343 (1.072–1.682) and 1.388 (1.020–1.889), respectively, after adjusting for age, body mass index, current smoking, alcohol consumption, regular exercise, occupation, residential area, hypertension, type 2 diabetes, cardiovascular disease, and stroke. (4) Conclusions: Short and long sleep duration were positively associated with osteoarthritis in middle-aged and older women. Full article

(This article belongs to the Special Issue Effect of Lifestyle Habits on the Clinical Outcome in Trauma/Orthopedic Patients)

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Review

Jump to: Research

22 pages, 1813 KiB

Open AccessReview

Translational Insights into Extremely Low Frequency Pulsed Electromagnetic Fields (ELF-PEMFs) for Bone Regeneration after Trauma and Orthopedic Surgery

by Sabrina Ehnert, Steffen Schröter, Romina H. Aspera-Werz, Wiebke Eisler, Karsten Falldorf, Michael Ronniger and Andreas K. Nussler

J. Clin. Med. 2019, 8(12), 2028; https://doi.org/10.3390/jcm8122028 - 20 Nov 2019

Cited by 41 | Viewed by 9483

Abstract

The finding that alterations in electrical potential play an important role in the mechanical stimulation of the bone provoked hype that noninvasive extremely low frequency pulsed electromagnetic fields (ELF-PEMF) can be used to support healing of bone and osteochondral defects. This resulted in [...] Read more.

The finding that alterations in electrical potential play an important role in the mechanical stimulation of the bone provoked hype that noninvasive extremely low frequency pulsed electromagnetic fields (ELF-PEMF) can be used to support healing of bone and osteochondral defects. This resulted in the development of many ELF-PEMF devices for clinical use. Due to the resulting diversity of the ELF-PEMF characteristics regarding treatment regimen, and reported results, exposure to ELF-PEMFs is generally not among the guidelines to treat bone and osteochondral defects. Notwithstanding, here we show that there is strong evidence for ELF-PEMF treatment. We give a short, confined overview of in vitro studies investigating effects of ELF-PEMF treatment on bone cells, highlighting likely mechanisms. Subsequently, we summarize prospective and blinded studies, investigating the effect of ELF-PEMF treatment on acute bone fractures and bone fracture non-unions, osteotomies, spinal fusion, osteoporosis, and osteoarthritis. Although these studies favor the use of ELF-PEMF treatment, they likewise demonstrate the need for more defined and better controlled/monitored treatment modalities. However, to establish indication-oriented treatment regimen, profound knowledge of the underlying mechanisms in the sense of cellular pathways/events triggered is required, highlighting the need for more systematic studies to unravel optimal treatment conditions. Full article

(This article belongs to the Special Issue Effect of Lifestyle Habits on the Clinical Outcome in Trauma/Orthopedic Patients)

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31 pages, 2358 KiB

Open AccessReview

Innate Immunity and Alcohol

by Shinwan Kany, Andrea Janicova and Borna Relja

J. Clin. Med. 2019, 8(11), 1981; https://doi.org/10.3390/jcm8111981 - 14 Nov 2019

Cited by 25 | Viewed by 5164

Abstract

The innate immunity has evolved during millions of years, and thus, equivalent or comparable components are found in most vertebrates, invertebrates, and even plants. It constitutes the first line of defense against molecules, which are either pathogen-derived or a danger signal themselves, and [...] Read more.

The innate immunity has evolved during millions of years, and thus, equivalent or comparable components are found in most vertebrates, invertebrates, and even plants. It constitutes the first line of defense against molecules, which are either pathogen-derived or a danger signal themselves, and not seldom both. These molecular patterns are comprised of highly conserved structures, a common trait in innate immunity, and constitute very potent triggers for inflammation mediated via extracellular or intracellular pattern recognition receptors. Human culture is often interweaved with the consumption of alcohol, in both drinking habits, its acute or chronical misuse. Apart from behavioral effects as often observed in intoxicated individuals, alcohol consumption also leads to immunological modulation on the humoral and cellular levels. In the last 20 years, major advances in this field of research have been made in clinical studies, as well as in vitro and in vivo research. As every physician will experience intoxicated patients, it is important to be aware of the changes that this cohort undergoes. This review will provide a summary of the current knowledge on the influence of alcohol consumption on certain factors of innate immunity after a hit, followed by the current studies that display the effect of alcohol with a description of the model, the mode of alcohol administration, as well as its dose. This will provide a way for the reader to evaluate the findings presented. Full article

(This article belongs to the Special Issue Effect of Lifestyle Habits on the Clinical Outcome in Trauma/Orthopedic Patients)

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11 pages, 872 KiB

Open AccessReview

Association of Nicotine with Osteochondrogenesis and Osteoarthritis Development: The State of the Art of Preclinical Research

by Xiaoyu Cai, Liang Gao, Magali Cucchiarini and Henning Madry

J. Clin. Med. 2019, 8(10), 1699; https://doi.org/10.3390/jcm8101699 - 16 Oct 2019

Cited by 6 | Viewed by 2765

Abstract

The deleterious effects of nicotine on various health conditions have been well documented. Although many orthopedic diseases are adversely affected by nicotine, little is known about its preclinical effects on chondrogenesis or osteogenesis, cartilage formation, osteoarthritis (OA), and osteochondral repair. A systematic review [...] Read more.

The deleterious effects of nicotine on various health conditions have been well documented. Although many orthopedic diseases are adversely affected by nicotine, little is known about its preclinical effects on chondrogenesis or osteogenesis, cartilage formation, osteoarthritis (OA), and osteochondral repair. A systematic review was conducted examining the current scientific evidence on the effects of nicotine on chondrogenesis or osteogenesis in vitro, possible consequences of prenatal nicotine exposure (PNE) on cartilage and OA susceptibility in the offspring, and whether nicotine affects OA development and osteochondral repair in vivo, always focusing on their underlying mechanisms. The data reveal dose-dependent effects on articular chondrocytes and on the chondrogenesis and osteogenesis of medicinal signaling cells in vitro, with lower doses often resulting in positive effects and higher doses causing negative effects. PNE negatively affects articular cartilage development and induces OA in the offspring without or with nicotine exposure. In contrast, protective effects on OA development were only reported in monosodium iodoacetate-induced small animal models. Finally, nicotine repressed MSC-based osteochondral repair in vivo. Future studies need to investigate dose-dependent clinical effects of smoking on cartilage quality in offspring, OA susceptibility and progression, and osteochondral repair more in detail, thus identifying possible thresholds for its pathological effects. Full article

(This article belongs to the Special Issue Effect of Lifestyle Habits on the Clinical Outcome in Trauma/Orthopedic Patients)

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18 pages, 4807 KiB

Open AccessReview

Efficacy of Different Energy Levels Used in Focused and Radial Extracorporeal Shockwave Therapy in the Treatment of Plantar Fasciitis: A Meta-Analysis of Randomized Placebo-Controlled Trials

by Ying-Chun Wang, Shu-Jung Chen, Peng-Ju Huang, Hsuan-Ti Huang, Yuh-Min Cheng and Chia-Lung Shih

J. Clin. Med. 2019, 8(9), 1497; https://doi.org/10.3390/jcm8091497 - 19 Sep 2019

Cited by 32 | Viewed by 7533

Abstract

The objective of this study was to assess the efficacy of different energy levels used in extracorporeal shockwave therapy (ESWT) in the treatment of plantar fasciitis using a systematic review and meta-analysis. We searched PubMed, Embase, and Cochrane library, from inception to March [...] Read more.

The objective of this study was to assess the efficacy of different energy levels used in extracorporeal shockwave therapy (ESWT) in the treatment of plantar fasciitis using a systematic review and meta-analysis. We searched PubMed, Embase, and Cochrane library, from inception to March 2019 for randomized controlled trials that compared ESWT with placebo in patients with plantar fasciitis. The risk of bias for selected articles was assessed based on the Cochrane Handbook Systematic Review of Interventions. The pooled data were estimated by the mean difference or odds ratio. The meta-analysis showed that the high-energy ESWT group had a better success rate than the control group only at a three-month follow-up, but no significant difference between groups was observed for the other follow-up visits (1 and 12 months). In addition, no significant differences in visual analog scale (VAS) scores between groups were observed for all the follow-up visits (one-month and three-month). On the contrary, the medium-energy ESWT group had significantly better success rates than the control group for all the follow-up visits (3, 6, and 12 months). In addition, the medium-energy ESWT group had significant improvement in VAS scores compared with the control group for all the follow-up visits (1, 3, 6, and 12 months) after removing the extreme values. The low-energy ESWT group had significant improvement in VAS scores compared with the control group for all the follow-up visits (3 and 12 months). Otherwise, focused ESWT seems to be more effective than radial ESWT when compared with the control group. Use of local anesthesia can reduce the efficacy of low- and high-energy ESWTs. Our meta-analysis suggested that medium-energy ESWT in the treatment of plantar fasciitis was more effective than the control group. A limited number of trials related to low- and high-energy ESWTs were included in our meta-analysis. More research is required to confirm the efficacy of low- and high-energy ESWTs in future studies. Full article

(This article belongs to the Special Issue Effect of Lifestyle Habits on the Clinical Outcome in Trauma/Orthopedic Patients)

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