Publications by authors named "Derek Park"

Background: In recent years, the use of Magnesium alloy implants have gained renewed popularity, especially after the first commercially available Conformité Européenne approved Magnesium implant became available (MAGNEZIX CS, Syntellix) in 2013.

Aim: To document our clinical and radiographical outcomes using magnesium implants in treating peri-articular elbow fractures.

Methods: Our paper was based on a retrospective case series design.

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Unlabelled: Standard-of-care treatment regimens have long been designed for maximal cell killing, yet these strategies often fail when applied to metastatic cancers due to the emergence of drug resistance. Adaptive treatment strategies have been developed as an alternative approach, dynamically adjusting treatment to suppress the growth of treatment-resistant populations and thereby delay, or even prevent, tumor progression. Promising clinical results in prostate cancer indicate the potential to optimize adaptive treatment protocols.

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Diabetic Foot in Primary and Tertiary (DEFINITE) Care is an inter-institutional and multi-disciplinary team (MDT) health systems innovation programme at a healthcare cluster in Singapore. We aim to achieve coordinated MDT care across primary and tertiary care for patients with diabetic foot ulcers (DFU), within our public healthcare cluster - an integrated network of seven primary care polyclinics and two acute care tertiary hospitals (1700-bed and 800-bed) with a total catchment population of 2.2 million residents.

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Introduction: Disseminated intravascular coagulation (DIC) is a rare condition that is known to affect patients with metastatic prostate adenocarcinoma. In an unsuspecting orthopaedic surgeon, DIC could lead to significant morbidity and mortality. This article highlights another such case and discusses management strategies to help improve clinical outcomes for these patients.

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We present a case series comprising three patients with concomitant septic arthritis of the knee and osteomyelitis of the femur. Early advanced imaging rendered the accurate diagnosis of the condition and the appropriate surgical approach and technique used to treat the infection. Repeated extensive surgical debridement, irrigation and insertion of antibiotic-impregnated cement rod into the femur were required, in addition to long term antibiotics.

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Background: Acetabular fractures are rare but are severe injuries that occur in younger patients with a significant economic impact. There is limited evidence describing the return to work rates in this group of patients. The aim of our study was to examine the rate and time to return to work (RTW) after surgical fixation of acetabular fractures.

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Article Synopsis
  • The study investigated mortality rates of patients with hip fractures treated conservatively versus surgically in a hospital's Hip Fracture Unit from January 2015 to October 2017.
  • Patients managed non-operatively exhibited significantly higher mortality rates at inpatient (6.01% vs. 0%), 30-day (8.58% vs. 0%), and 1-year (33.05% vs. 8.96%) checkpoints compared to those who received surgical intervention.
  • Co-morbidities were more prevalent in conservatively managed patients (average 5.2) compared to those who underwent surgery (average 4.0), suggesting that both treatment type and patient health status impact mortality outcomes.
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Deaths from cancer are mostly due to metastatic disease that becomes resistant to therapy. A mainstay treatment for many cancers is chemotherapy, for which the dosing strategy is primarily limited by patient toxicity. While this MTD approach builds upon the intuitively appealing principle that maximum therapeutic benefit is achieved by killing the largest possible number of cancer cells, there is increasing evidence that moderation might allow host-specific features to contribute to success.

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gene family mutations are the most prevalent in thyroid nodules with indeterminate cytology and are present in a wide spectrum of histological diagnoses. We evaluated differentially expressed genes and signaling pathways across the histological/clinical spectrum of -mutant nodules to determine key molecular determinants associated with a high risk of malignancy. Sixty-one thyroid nodules with mutations were identified.

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Introduction: Intertrochanteric hip fractures pose a significant health problem. The proximal femur nail anti-rotation (PFNA IIDePuySynthes) is the most commonly used implant for intramedullary nailing of unstable intertrochanteric fractures at our institution. We aim to identify the risk factors predisposing to mechanical failure of intertrochanteric hip fractures fixation with PFNAII in our Southeast Asian population.

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Objectives: Proximal femoral nail antirotation (PFNA) cut-in is a unique phenomenon seen in pertrochanteric hip fractures treated with the PFNA. Cut-in refers to the superomedial migration of the proximal femoral blade into the femoral head and hip joint. We recognize that cut-in is a completely separate entity from the well-described cut-out failure.

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The immune system is a robust and often untapped accomplice of many standard cancer therapies. A majority of tumors exist in a state of immune tolerance where the patient's immune system has become insensitive to the cancer cells. Because of its lymphodepleting effects, chemotherapy has the potential to break this tolerance.

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Clonal hematopoiesis of indeterminate potential (CHIP) is a recently identified process where older patients accumulate distinct subclones defined by recurring somatic mutations in hematopoietic stem cells. CHIP's implications for stem cell transplantation have been harder to identify due to the high degree of mutational heterogeneity that is present within the genetically distinct subclones. In order to gain a better understanding of CHIP and the impact of clonal dynamics on transplantation outcomes, we created a mathematical model of clonal competition dynamics.

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Purpose: In an upcoming clinical trial at the Moffitt Cancer Center for women with stage 2/3 estrogen receptor-positive breast cancer, treatment with an aromatase inhibitor and a PD-L1 checkpoint inhibitor combination will be investigated to lower a preoperative endocrine prognostic index (PEPI) that correlates with relapse-free survival. PEPI is fundamentally a static index, measured at the end of neoadjuvant therapy before surgery. We have developed a mathematical model of the essential components of the PEPI score to identify successful combination therapy regimens that minimize tumor burden and metastatic potential, on the basis of time-dependent trade-offs in the system.

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. The reverse camber shoe is commonly used after hallux valgus corrective surgery to offload the forefoot but is associated with back pain and poor compliance. Recent designs of postoperative shoes may obviate the need for a reverse camber.

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Background: Shockwave treatment is increasingly used for plantar fasciitis and Achilles tendinopathy. To be effective it is believed that high pressure must be achieved in the tissues. We report on the first human cadaveric experiments to characterize pressure from radial shockwave therapy (rSWT) for plantar fasciitis.

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Background: Supracondylar fractures are common in children and are associated with significant morbidity. The purpose of our study was to assess and compare the clinical and radiological outcome of management of supracondylar fractures by both wire configurations, along with identifying factors that predispose to complications.

Materials & Methods: We retrospectively reviewed all paediatric cases admitted with a supracondylar fracture over a five year period.

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Pseudomonas syringae pv. phaseolicola (Pph) is a significant bacterial pathogen of agricultural crops, and phage Φ6 and other members of the dsRNA virus family Cystoviridae undergo lytic (virulent) infection of Pph, using the type IV pilus as the initial site of cellular attachment. Despite the popularity of Pph/phage Φ6 as a model system in evolutionary biology, Pph resistance to phage Φ6 remains poorly characterized.

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Purpose: To report the early results of the Oxinium Genesis II prosthesis with an oxidised zirconium femoral component in 55 patients.

Methods: 71 knees in 21 men and 34 women aged 32 to 75 (mean, 55) years were evaluated; 16 of the patients had bilateral staged total knee replacements with a mean interval of 9 (range, 6-16) months between surgeries. The indications for surgery included osteoarthritis (n=57), rheumatoid arthritis (n=13) and revision from a unicompartmental knee replacement for osteoarthritis (n=1).

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Dynamic semirigid stabilization of the lumbar spine was introduced in 1994 in an attempt to overcome the drawbacks of fusion. It is supposed to preserve motion at the treated levels, while avoiding hypermobility and thus spondylosis at the adjacent levels. Although the early reports showed promising results, the long term effects are still debated.

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Background: Flexor digitorum longus (FDL) is a commonly used donor tendon for transfer to substitute for a dysfunctional tibialis posterior in the management of adult acquired flatfoot deformity. The tendon transfer is attached to the navicular bone via a drill hole. Interference-fit screws are an alternative means of securing a transferred tendon allowing for a shorter length of graft and less extensive dissection.

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Viruses that infect fungi have a ubiquitous distribution and play an important role in structuring fungal communities. Most of these viruses have an unusual life history in that they are propagated exclusively via asexual reproduction or fission of fungal cells. This asexual mode of transmission intimately ties viral reproductive success to that of its fungal host and should select for viruses that have minimal deleterious impact on the fitness of their hosts.

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