Publications by authors named "Steiger R"

Background: There is evidence that iron metabolism may play a role in the underlying pathophysiological mechanism of migraine. Studies using (=1/ ) relaxometry, a common MRI-based iron mapping technique, have reported increased values in various brain structures of migraineurs, indicating iron accumulation compared to healthy controls.

Purpose: To investigate whether there are short-term changes in during a migraine attack.

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Background: The pathogenesis of spontaneous cervical artery dissection remains unclear, and no established predictors of recurrence exist. Our goal was to investigate the potential association between cervical artery tortuosity, a characteristic of patients with connective tissue disorder, and spontaneous cervical artery dissection.

Methods: The ReSect study (Risk Factors for Recurrent Cervical Artery Dissection) is an observational study that invited all spontaneous cervical artery dissection patients treated at the Innsbruck University Hospital between 1996 and 2018 for clinical and radiological follow-up.

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Background: Given growing demand for hip and knee arthroplasty and unsustainable resource requirements, safe and efficient models of care are critical. This study aims to determine the impact on healthcare costs of implementing an enhanced short-stay model of care (ESS-MOC) for arthroplasty at a national level.

Methods: A budget impact analysis was conducted for the years 2023-2030 in the setting of Australian publicly and privately funded hospitals performing hip or knee arthroplasty.

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Article Synopsis
  • - The study investigates the urgent need for effective ways to diagnose and track Alzheimer’s disease (AD) by focusing on memory issues and brain changes, particularly in those with mild to moderate AD dementia (ADD).
  • - Researchers followed 104 ADD patients over several years using MRI scans and cognitive tests to analyze brain structure and cognitive decline, finding a strong link between gray matter loss in the temporal lobe and difficulties with word learning.
  • - The findings indicate that certain brain atrophy patterns, specifically in the temporal lobe, combined with specific cognitive test deficits, could help predict quicker cognitive decline in AD patients.
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Introduction: Collecting patient-reported outcomes in a systematic fashion is important to understand recovery trajectories and compare performance between different services and fields of care. These outcomes can be collected through a variety of means, but studies comparing different follow-up methods in patients with a variety of injury types are scarce. This study aimed to compare follow-up data from three injury registries to quantify patient preference for telephone versus online follow-up, determine factors associated with choosing online follow-up, and compare response rates based on the patient's preferred follow-up method.

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Background And Objectives: Smoking, poor diabetic control and excessive body mass index (BMI) increase the risk of infection following joint replacement. This study investigated Australian general practitioners' (GPs) perception of these modifiable risk factors in patients with end-stage osteoarthritis.

Method: A structured online survey tool was developed and widely distributed to Australian GPs.

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Importance: Structured education and exercise therapy programs have been proposed to reduce reliance on total knee replacement (TKR) surgery and improve health care sustainability. The long-term cost-effectiveness of these programs is unclear.

Objectives: To estimate the lifetime cost-effectiveness of implementing a national structured education and exercise therapy program for individuals with knee osteoarthritis with the option for future TKR compared with usual care (TKR for all).

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Background: Mild cognitive impairment (MCI) confers a high annual risk of 10-15 % of conversion to Alzheimer's disease (AD) dementia. MRI atrophy patterns derived from automated ROI analysis, particularly hippocampal subfield volumes, were reported to be useful in diagnosing early clinical stages of Alzheimer's disease.

Objective: The aim of the present study was to combine automated ROI MRI morphometry of hippocampal subfield volumes and cortical thickness estimates using FreeSurfer 6.

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Article Synopsis
  • Functional tests like the 6-minute walk test (6MWT) are essential in tracking recovery, especially in orthopedic surgeries, but traditional testing often occurs in controlled settings, limiting use.
  • A study involved patients using smart watches to record their own 6MWT at home, comparing results to formal testing sessions at 6 and 12 weeks after surgery.
  • Results indicated a strong correlation between self-administered and formally tested 6MWT scores, suggesting that patient-recorded tests can effectively monitor rehabilitation progress remotely.
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Background: Obesity is a known risk factor for the development of osteoarthritis and the subsequent need for joint replacement. Weight loss has been shown to reduce pain, disability, and the need for joint replacement, particularly in patients with knee osteoarthritis. The aim of this study was to investigate pre-operative weight change in patients with hip, knee, and shoulder osteoarthritis at a regional, public hospital in Australia, to identify opportunities for pre-operative weight-loss intervention.

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Objective: We have previously reported that the interleukin-23 p19 subunit (IL-23p19) is required for experimental inflammatory arthritic pain-like behavior and disease. Even though inflammation is often a characteristic feature of osteoarthritis (OA), IL-23 is not usually considered as a therapeutic target in OA. We began to explore the role of IL-23p19 in OA pain and disease utilizing mouse models of OA and patient samples.

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Introduction: We aimed to systematically review contemporary evidence on the barriers and enablers to implementing and sustaining short-stay arthroplasty programs for elective primary total hip and knee replacement from the perspectives of patients, health professionals, carers, healthcare administrators, funders and policymakers and to map the findings to the Theoretical Domains Framework (TDF).

Methods: Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and the Cochrane Central Register of Controlled Trials were searched (up to 19 August 2023). Primary qualitative or mixed-methods studies reporting on perspectives relating to the review aims that utilised a short-stay programme were eligible for inclusion.

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Importance: Despite increased use of antibiotic-loaded bone cement (ALBC) in joint arthroplasty over recent decades, current evidence for prophylactic use of ALBC to reduce risk of periprosthetic joint infection (PJI) is insufficient.

Objective: To compare the rate of revision attributed to PJI following primary total knee arthroplasty (TKA) using ALBC vs plain bone cement.

Design, Setting, And Participants: This international cohort study used data from 14 national or regional joint arthroplasty registries in Australia, Denmark, Finland, Germany, Italy, New Zealand, Norway, Romania, Sweden, Switzerland, the Netherlands, the UK, and the US.

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One of the main causes of the dismal prognosis in patients who survive the initial bleeding after aneurysmal subarachnoidal hemorrhage is the delayed cerebral ischaemia caused by vasospasm. Studies suggest that cerebral magnesium and pH may potentially play a role in the pathophysiology of this adverse event. Using phosphorous magnetic resonance spectrocopy (31P-MRS), we calculated the cerebral magnesium (Mg) and pH levels in 13 patients who suffered from aSAH.

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Article Synopsis
  • Prediction models are increasingly utilized in healthcare to assess risk factors and predict outcomes, contributing to enhanced clinical practices.
  • The paper focuses on recent advancements in supervised machine learning (ML) techniques applied to data from post-operative hip and knee replacements.
  • It aims to summarize key findings from relevant studies, discussing the methodologies, data sources, limitations, and the overall accuracy of predictive analytics in this field.
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  • The Australian Orthopedic Association National Joint Replacement Registry aims to improve the identification of prostheses that have a higher than expected revision rate, but their current method doesn't differentiate well between conventional and complex designs.
  • A study was conducted using data from over 640,000 total knee replacements to calculate the cumulative percent revision (CPR) rates for different prosthesis designs, leading to the development of a modified comparator group excluding complex designs.
  • The results indicated that using the modified comparator helped identify more issues with conventional prostheses while revealing fewer shortcomings in complex designs, suggesting a need for improved classification in future analyses.*
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  • The study explores a new method for assessing cervical vessel tortuosity, which could help in diagnosing subclinical connective tissue disorders, using magnetic resonance angiography (MRA) images from patients with spontaneous cervical artery dissection (sCeAD).
  • Two independent users were able to segment arteries with less than 0.5% variability, demonstrating that the new method is reliable and more accurate than traditional visual assessments of vessel tortuosity.
  • This approach has potential implications for clinical practice and future research on the relationship between cervical artery issues and connective tissue disorders.
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Aims: It is unclear whether mortality outcomes differ for patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) surgery who are readmitted to the index hospital where their surgery was performed, or to another hospital.

Methods: We analyzed linked hospital and death records for residents of New South Wales, Australia, aged ≥ 18 years who had an emergency readmission within 90 days following THA or TKA surgery between 2003 and 2022. Multivariable modelling was used to identify factors associated with non-index readmission and to evaluate associations of readmission destination (non-index vs index) with 90-day and one-year mortality.

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Background: Short-stay joint replacement programmes are used in many countries but there has been little scrutiny of safety outcomes in the literature. We aimed to systematically review evidence on the safety of short-stay programmes versus usual care for total hip (THR) and knee replacement (KR), and optimal patient selection.

Methods: A systematic review and meta-analysis.

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Background: The capacity to meet anticipated growth in joint replacement demand requires safe, efficient models of care. While short-stay joint replacement programs are being used internationally, they have not been widely implemented in many countries. Importantly, the critical challenges that need to be addressed ahead of large-scale program implementation remain unclear.

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Article Synopsis
  • The study examines variations in hip replacement prosthesis performance, highlighting some devices have unexpectedly high revision rates that need further evaluation.
  • It aims to improve the comparison method for assessing hip implant success by developing a more refined comparator group, aligning with contemporary surgical practices.
  • Analysis of over 413,000 hip replacements revealed that using a modernized comparator group resulted in a lower 10-year cumulative percent revision rate, indicating better overall device performance.
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  • Monoblock ceramic cups, like the DeltaMotion, are designed for total hip arthroplasty (THA) to provide better movement and stability, particularly for young and active patients.
  • A study analyzed data from over 486,000 THA procedures to compare the DeltaMotion cup with modular designs, focusing on revision rates and issues like dislocation and ceramic breakage.
  • The DeltaMotion cup showed lower overall revision rates and significantly fewer problems related to dislocation and ceramic breakage compared to modular bearings, indicating its effectiveness despite being discontinued.
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