Biomedical subjects

Patarawan Woratanarat

Publications and source records attributed to Patarawan Woratanarat.

6 recordsLinked to original sources

PubMed2006

Low back pain in pediatric athletes with unilateral tracer uptake at the pars interarticularis on single photon emission computed tomography.

STUDY DESIGN: Retrospective clinical study with radiographic and medical chart review. OBJECTIVE: To study the clinical characteristics and outcome of pediatric athletes with low back pain and unilateral tracer uptake on single photon emission computed tomography (SPECT) at the pars interarticularis but no defect on radiographs. SUMMARY OF BACKGROUND DATA: Some pediatric athletes with low back pain have no findings on plain radiographs but a unilateral SPECT uptake at the pars interarticularis. However, little is known about these patients. METHODS: Twenty-two pediatric athletes who had low back pain with increased tracer uptake on SPECT unilaterally at the pars interarticularis but no defect on plain radiograph were evaluated. The following criteria were used for evaluation: age, male-to-female ratio, duration of symptoms, vertebral level, and presence of spina bifida occulta or scoliosis. RESULTS: The average age was 12.3 +/- 2.5 years. The male-to-female ratio was 1.2:1. The average duration of symptoms was 21 +/- 23 weeks. Nineteen (86%) had increased uptake at L5. Six (27%) had spina bifida occulta and 8 (36%) had scoliosis. Eighteen (82%) patients showed an excellent outcome. The patients who presented with a longer history of symptoms or a concomitant spina bifida occulta had an increased risk of having occasional aching with vigorous activity when compared with the patients who did not (P < 0.05). CONCLUSIONS: Athletes who have low back pain and increased tracer uptake unilaterally at the pars interarticularis on SPECT are younger than those previously reported patients with spondylolysis proven by a defect on radiographs. Some of these lesions do progress to "frank" spondylolysis seen on radiographs, but favorable clinical outcomes from nonoperative treatment can be expected. Patients with a longer pain history or concomitant spina bifida occulta may need careful follow-up because they are at increased risk of having occasional low back pain.

Adolescent↗

PubMed2005

Lumbar spondylolysis in pediatric and adolescent soccer players.

BACKGROUND: Lumbar spondylolysis in young soccer players has not been studied extensively. PURPOSE: The purpose of this study was to review lumbar spondylolysis in young soccer players, describe the causes, and report the results of nonoperative treatment emphasizing the cessation of activity for 3 months. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The authors reviewed 57 child and adolescent soccer players (35 boys and 22 girls) with lumbar spondylolysis who came to their outpatient clinic for back pain evaluation. These patients received different modalities of nonoperative treatment, including cessation of sports and wearing a thoracolumbosacral orthosis. Soccer skills, field position, side of dominant leg, age, initiating event of low back pain, duration of symptoms, and nonoperative treatment were reviewed. Clinical outcome of treatment was assessed by the Steiner-Micheli criteria at the most recent follow-up (minimum 2 years). The Fisher exact test was used to compare all the data. RESULTS: Of the patients, 43% noticed that pain started after a high-velocity kick. Thirty-three (58%) of 57 patients had excellent results with no pain during sports, 20 (35%) good, 3 (5%) fair, and 1 (2%) poor. Subjects who ceased playing soccer for 3 months had better results than those who did not comply with this restriction. CONCLUSION: The authors recommend stopping sports for at least 3 months in cases of lumbar spondylolysis in young soccer players who hope to return to their previous level of play without back pain.

Adolescent↗

PubMed2005

Cost analysis of osteoporotic hip fractures.

OBJECTIVE: To assess the total costs of hip fracture treatment subsequently incurred in 1 year MATERIAL AND METHOD: A cohort study was conducted from January 1, 2002 to December 31, 2004. All new osteoporotic hip fracture patients were enrolled with informed consent. A total cost was estimated, and multivariate analysis was performed to determine factors related to costs. RESULTS: A total of 37 patients were included. Average age was 75 +/- 11.8 years. Four of them (11%) died. Median total cost of hip fracture treatment in 1 year was 116,458.6 Baht (range 21,428.5-5,070,665.0). Median direct cost was 59,881.6 Baht (range 21,428.5-595,520.4). Direct cost per live-year saved was 118,168. 3 Baht. Preoperative status was the only factor related to direct cost. CONCLUSION: Cost incurred from hip fracture in 1 year was high. The appropriate solution to prevent hip fracture might bring about good health in the Thai elderly and reduce its cost in the future.

Aged↗

PubMed2005

Floor activity score.

OBJECTIVE: To propose an instrument to measure the amount of floor activities performed by an individual. MATERIAL AND METHOD: A list of 12 questionnaires relating to floor activities is proposed. A cross-sectional survey of the response to the questionnaires was tried on 3 communities representing rural, urban and metropolitan areas. The total number of enrolled people was 733. The scores of the questionnaires were tested for statistical difference (p< 0.05) among the communities by Chi-square and ANOVA nonparametric tests. RESULTS: The total scores among the three communities were significantly different. The rural civilians achieved the highest score, whereas the metropolitan area had the lowest score. CONCLUSION: The proposed instrument measuring floor activities is able to discriminate the activities of civilians in rural, urban and metropolitan areas.

Activities of Daily Living↗

PubMed2004

Meniscal lesions in the anterior cruciate insufficient knee: the accuracy of clinical evaluation.

OBJECTIVE: The purpose of this study was to find out the accuracy of certain symptoms and examination findings that are used to diagnose meniscal injury associated with a torn anterior cruciate ligament. STUDY DESIGN: Cross-sectional study. MATERIAL AND METHOD: The authors studied one hundred consecutive patients with anterior cruciate ligament insufficiency who were scheduled for surgery. During preoperative admission, one of the authors (KT) examined the patients and recorded the demographic data, duration of symptoms, and the clinical findings including Ballottement sign, joint line tenderness, Childress' sign, Merke's sign, Steinmann I sign, McMurray test, and Apley test. All patients underwent arthroscopically assisted anterior cruciate reconstruction by the senior author (PC). Specific meniscal procedures were performed according to the surgeon's preference at the time of surgery. Predictive results of preoperative examination tests for meniscal tears were compared with the findings at surgery and analyzed using arthroscopic findings as the gold standard. RESULTS: There were one hundred patients included in the present study. Out of 100 patients, 75% had meniscal tears and 6% had both meniscal and cartilage lesions. The most sensitive test was Childress' sign (68%), which also had the highest accuracy (66%). The most specific tests were Steinmann I sign and Apley test (100%). CONCLUSION: Childress' sign was more accurate than other tests for detecting meniscal lesions in anterior cruciate insufficient knees. Steinmann I sign and Apley test had the highest specificity.

Adolescent↗

PubMed2002

Incidence of hip fracture in Chiang Mai.

The reported incidence of hip fracture varies to a large extent across regions. Most studies relied on hospital data under the assumption that nearly all cases of hip fracture get access to hospital care. As in many developing countries, a number of hip fracture cases in Thailand might not seek care in hospitals due to geographical, socio-cultural and financial barriers. Therefore, using hospital data alone, could lead to under estimation of the magnitude of hip fracture. This study was undertaken to obtain such information using a combined method of hospital discharge survey and a cross sectional community survey. It resulted in an estimated incidence of 151.2 per 100,000 (95% CI 136.7-167.2) from the hospital survey and 185.2 per 100,000 (95% CI 138.1-247.6) from the community survey. In comparison to developed countries, age-adjusted incidence of hip fracture in this study was markedly lower than that reported from developed countries. It was argued that different degree of urbanization might explain the discrepancy. This implicated promotion of physical activity as a public health measure to prevent hip fracture.

Aged↗