Publications by authors named "Patricia Miller"

Background And Aims: Individuals with steatotic liver disease (SLD) are at high cardiovascular disease (CVD) risk, but approaches to characterise and mitigate this risk are limited. By investigating relations, and shared metabolic pathways, of hepatic steatosis/fibrosis and cardiorespiratory fitness (CRF), we sought to identify new avenues for CVD risk reduction in SLD.

Methods: In Framingham Heart Study (FHS) participants (N = 2722, age 54 ± 9 years, 53% women), vibration-controlled transient elastography (VCTE) was performed between 2016-2019 to assess hepatic steatosis (continuous attenuation parameter [CAP]) and fibrosis (liver fibrosis measure [LSM]).

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Background: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility.

Purpose: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings.

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Objective: Many patients who undergo tarsal coalition excision have persistent postoperative pain. Most studies have utilized cat scan (CT) scan parameters of pes planovalgus and heel valgus but have found this to be an inconsistent predictor of outcomes. Plain radiographic parameters have been less utilized in trying to predict outcomes after coalition excision.

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Article Synopsis
  • The study investigates the use of ketorolac, an NSAID, for managing postoperative pain in patients after craniotomy for tumor resection, focusing on its impact on pain control, bleeding risks, and narcotic use.
  • A review of 1114 adult patients revealed that those receiving ketorolac were younger and had lower comorbidities, yet did not show a significantly higher rate of bleeding compared to those who did not receive the drug.
  • Patients on ketorolac experienced higher initial pain and opioid use, but overall, it was found to be a safe and effective pain management choice after surgery, suggesting the need for further research to confirm these findings.
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Introduction: Tarsal coalition is a disorder of the foot characterized by the abnormal union between 2 or more of the tarsal bones. A minority of patients will develop pain and limited motion when reaching adolescence, for whom surgical resection of the coalition may be necessary. The diagnostic value of clinical and radiologic signs remains unclear.

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Background: Fencing is a unique and increasingly popular sport, but limited data exist regarding related injuries.

Purpose: To examine the types of injuries incurred by fencing athletes, and to analyze associations between age, sex, and hand dominance with type and location of injury.

Study Design: Cross-sectional.

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Objective This study aimed to assess the reliability and reproducibility of the AO Spine Thoracolumbar Injury Classification System by using virtual reality (VR). We hypothesized that VR is a highly reliable and reproducible method to classify traumatic spine injuries. Methods VR 3D models were created from CT scans of 26 pediatric patients with thoracolumbar spine injuries.

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Objectives: The efficiency and validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) surveys were determined for pediatric orthopaedic trauma patients with posttraumatic stress disorder (PTSD) symptoms in a clinic setting.

Design: Prospective cohort study.

Setting: Single-institution, Level I trauma center.

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Aims: New tools are needed to identify heart failure (HF) risk earlier in its course. We evaluated the association of multidimensional cardiopulmonary exercise testing (CPET) phenotypes with subclinical risk markers and predicted long-term HF risk in a large community-based cohort.

Methods And Results: We studied 2532 Framingham Heart Study participants [age 53 ± 9 years, 52% women, body mass index (BMI) 28.

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Article Synopsis
  • The accessory navicular (AN) is a foot condition affecting 4% to 21% of people, where most don't experience symptoms, but those who do, particularly children, can suffer a decreased quality of life.
  • This study involved 298 patients under 19 who underwent surgery after failing nonoperative treatments, with a median time to surgical intervention of 5.2 months.
  • Factors linked to the failure of nonoperative management included older age, activity limitations, being female, higher BMI, right-side AN, and MRI findings like bone marrow edema, while most surgical patients reported pain relief and return to sports post-surgery.
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Background: The relation of cardiorespiratory fitness (CRF) to lifestyle behaviors and factors linked with cardiovascular health remains unclear. We aimed to understand how the American Heart Association's Life's Essential 8 (LE8) score (and its changes over time) relate to CRF and complementary exercise measures in community-dwelling adults.

Methods And Results: Framingham Heart Study (FHS) participants underwent maximum effort cardiopulmonary exercise testing for direct quantification of peak oxygen uptake (V̇O).

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Purpose: To identify the entry-level curricular content related to Indigenous health recommended for entry-level physiotherapy (PT) programs in Canada and other similar countries.

Methods: Scoping review. Four electronic databases were searched using the terms , , , and their derivatives.

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Background: Little is known about the prevalence of intraspinal pathology in children who toe walk, but magnetic resonance imaging (MRI) may be part of the diagnostic workup. The purpose of this study was to examine the role of MRI for children who toe walk with a focus on the rate of positive findings and associated neurosurgical interventions performed for children with said MRI findings.

Methods: A single-center tertiary hospital database was queried to identify a cohort of 118 subjects with a diagnosis of toe walking who underwent spinal MRI during a 5-year period.

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Objective: To describe femoroacetabular posterior translation (FAPT) using dynamic hip ultrasonography (DHUS), and to determine the inter- and intra-rater reliability of hip ultrasound measurements of FAPT.

Materials And Methods: The study design was a feasibility study of 13 healthy young adults (26 hips) using test-retest analysis. The data was collected prospectively over a 2-week time period.

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Objective: Proximal femoral growth disturbance (PFGD) is a significant complication associated with surgical treatment of infant hip dislocation. Contrast-enhanced magnetic resonance imaging (CEMRI) has been utilized to assess perfusion in these hips and avoid PFGD. Contrast-enhanced ultrasound (CEUS) is an imaging technique utilized to evaluate perfusion in other organs.

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Background: There is growing evidence of increased venous thromboembolism (VTE) incidence in children with trauma or infection. The purpose of this study was to conduct a systematic review of existing literature related to VTE in the pediatric orthopaedic population, to estimate the overall incidence of VTE and identify risk factors associated with this condition.

Methods: A systematic review of the available literature was performed to identify articles that described VTE in pediatric orthopaedic surgery or admission.

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Background: Anterior distal femoral hemiepiphysiodesis (ADFH) using 2 percutaneous screws is an effective technique for the treatment of fixed knee flexion deformities in children with neuromuscular disorders. The role of sagittal screw position on the outcome of the procedure is unknown.

Methods: This is a retrospective case series of patients who underwent ADFH at a single pediatric hospital from 2013 to 2020.

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Objectives: To investigate the association of reported legal performance enhancing substance (PES) use and consideration of banned PES use among sport-specialised and non-sport-specialised young athletes.

Methods And Design: Cross-sectional study of 1049 young athletes enrolled in an injury prevention programme from 2013 to 2020. We used logistic regression modelling to determine the independent association between sports specialisation.

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Context: Psychological skills training improves performance in athletes. However, authors of few studies have looked at the efficacy and satisfaction of mental skills training programs for collegiate athletes.

Objective: To evaluate the satisfaction of collegiate athletes with a 6-session mental skills course and to assess changes in mental toughness and coping skills before and after the course.

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Background: There is limited evidence supporting the value of morphological parameters on post-reduction magnetic resonance imaging (MRI) to predict long-term residual acetabular dysplasia (RAD) after closed or open reduction for the treatment of developmental dysplasia of the hip (DDH).

Methods: We performed a retrospective study of 42 patients (47 hips) undergoing open or closed reduction with a minimum 10 years of follow-up; 39 (83%) of the hips were in female patients, and the median age at reduction was 6.3 months (interquartile range [IQR], 3.

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Background: Metabolite signatures of long-term alcohol consumption are lacking. To better understand the molecular basis linking alcohol drinking and cardiovascular disease (CVD), we investigated circulating metabolites associated with long-term alcohol consumption and examined whether these metabolites were associated with incident CVD.

Methods: Cumulative average alcohol consumption (g/day) was derived from the total consumption of beer, wine, and liquor on average of 19 years in 2428 Framingham Heart Study Offspring participants (mean age 56 years, 52% women).

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Background During exercise, a healthy arterial system facilitates increased blood flow and distributes it effectively to essential organs. Accordingly, we sought to understand how arterial stiffening might impair cardiorespiratory fitness in community-dwelling individuals. Methods and Results Arterial tonometry and maximum effort cardiopulmonary exercise testing were performed on Framingham Heart Study participants (N=2898, age 54±9 years, 53% women, body mass index 28.

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While frailty is a prominent risk factor in an aging population, the underlying biology of frailty is incompletely described. Here, we integrate 979 circulating proteins across a wide range of physiologies with 12 measures of frailty in a prospective discovery cohort of 809 individuals with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation. Our aim was to characterize the proteomic architecture of frailty in a highly susceptible population and study its relation to clinical outcome and systems-wide phenotypes to define potential novel, clinically relevant frailty biology.

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Article Synopsis
  • The study aimed to evaluate whether children with elbow flexion contractures (EFC) due to brachial plexus birth injury (BPBI) are at higher risk for developing shoulder contractures needing surgery.
  • Researchers analyzed data from clinical evaluations of children under 2 years old with BPBI, comparing 72 cases of EFC to 230 controls, finding significant differences in shoulder range of motion and the likelihood of developing shoulder contracture.
  • The findings suggest that EFC can help identify children at risk for shoulder contractures, highlighting the importance of early referral to specialized clinics to prevent complications.
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Background: Radiographic measurements of limb alignment in skeletally immature patients with anterior cruciate ligament (ACL) tears are frequently used for surgical decision-making, preoperative planning, and postoperative monitoring of skeletal growth. However, the interrater and intrarater reliability of these radiographic characteristics in this patient population is not well documented.

Hypothesis: Excellent reliability across 4 raters will be demonstrated for all digital measures of length, coronal plane joint orientation angles, mechanical axis, and tibial slope in skeletally immature patients with ACL tears.

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