Purpose
To validate the AO Spine Subaxial Injury Classification System with participants of various experience levels, subspecialties, and geographic regions.
Methods
A live webinar was organized in 2020 for validation of the AO Spine Subaxial Injury Classification System. The validation consisted of 41 unique subaxial cervical spine injuries with associated computed tomography scans and key images. Intraobserver reproducibility and interobserver reliability of the AO Spine Subaxial Injury Classification System were calculated for injury morphology, injury subtype, and facet injury. The reliability and reproducibility of the classification system were categorized as slight (ƙ = 0–0.20), fair (ƙ = 0.21–0.40), moderate (ƙ = 0.41–0.60), substantial (ƙ = 0.61–0.80), or excellent (ƙ = > 0.80) as determined by the Landis and Koch classification.
Results
A total of 203 AO Spine members participated in the AO Spine Subaxial Injury Classification System validation. The percent of participants accurately classifying each injury was over 90% for fracture morphology and fracture subtype on both assessments. The interobserver reliability for fracture morphology was excellent (ƙ = 0.87), while fracture subtype (ƙ = 0.80) and facet injury were substantial (ƙ = 0.74). The intraobserver reproducibility for fracture morphology and subtype were excellent (ƙ = 0.85, 0.88, respectively), while reproducibility for facet injuries was substantial (ƙ = 0.76).
Conclusion
The AO Spine Subaxial Injury Classification System demonstrated excellent interobserver reliability and intraobserver reproducibility for fracture morphology, substantial reliability and reproducibility for facet injuries, and excellent reproducibility with substantial reliability for injury subtype.
Background
Several chemotherapy agents are associated with the development of non‐ischemic cardiomyopathy (NIC). When chemotherapy‐induced cardiomyopathy (CHIC) is associated with left bundle branch block (LBBB) and a left ventricular ejection fraction (LVEF) 35% or lower, cardiac resynchronization therapy (CRT) is often utilized to improve cardiac function and relieve symptoms.
Objective
To determine the echocardiographic and clinical outcomes of CRT in patients with CHIC.
Methods
The study included 29 patients with CHIC (CHIC group) and 58 patients with other types of NIC (control group) who underwent CRT implantation between 2004 and 2017. The primary endpoints were changes in LVEF, left ventricular end‐systolic diameter (LVESD), and left ventricular end‐diastolic diameter (LVEDD) at 6–18 months after CRT. The secondary outcomes included changes in left ventricular global longitudinal strain (GLS), systolic strain rate (SRS), early diastolic strain rate (SRE), and overall survival.
Results
Out of 29 patients with CHIC, 62.1% received chemotherapy for lymphoma, 13.7% for breast cancer, and 24.1% for sarcoma. The agent implicated in 93.1% of the patients was an anthracycline. Half of the patients had LBBB. The mean baseline LVEF was 28% ± 8%. The mean baseline QRS duration was 146 ± 26 ms. Twenty‐eight patients had post‐CRT follow‐up data. CRT was associated with improvement in echocardiographic outcomes in the CHIC group and the control group. There was no difference in overall survival between the two groups (log‐rank p = .148).
Conclusion
CRT improves left ventricular function and reverses remodeling in patients with CHIC.
Coronary artery disease is one of the major reasons for all deaths worldwide and there has been a persistent rise of young myocardial infarction (MI) in past years [1]. The most common etiology for young MI accounts for lifestyle modification which includes sedentary life style, change in dietary habits, stressful and long working hours, strong family history, smoking, and development of other comorbid conditions such as diabetes and hypertension at an early age [2]. In recent times, there has been an upward trend in youngsters regarding body building and use of various protein powders and anabolic steroids for faster results. Androgenic anabolic steroids causing improvement in physical performance is a leading cause of acute MI and sudden cardiac death [3]. The commonly used anabolic steroids include stanozolol and testosterone when used in physiological doses acts as replacement therapy for improvement in appetite, libido, mood, and treatment of hypogonadism without any significant adverse effect. However, supraphysiological doses have been reported to increase the incidence of cardiovascular risks by regulating the expression of platelet thromboxane A2 receptors in humans [4]. A similar association has been reported by use of protein
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.