Publications by authors named "C Jacobs"

1,469 Publications

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Psychosocial factors 3-months after anterior cruciate ligament reconstruction predict 6-month subjective and objective knee outcomes.

J Orthop Res 2021 Jun 22. Epub 2021 Jun 22.

Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Kentucky, USA.

The objective of the study was to determine if psychological readiness for sport and knee self-efficacy assessed early (3 months) after anterior cruciate ligament reconstruction (ACLR) are predictive of self-reported functional outcomes, quadriceps strength, and knee mechanics while running at the time of return to sport training (6 months). Thirty athletes with unilateral ACLR completed the ACL Return to Sport after Injury (ACL-RSI) and Knee Self-Efficacy Scale (K-SES) 3 months after ACLR and completed self-reported functional outcomes, isometric quadriceps strength testing, and three-dimensional running gait analysis 6 months after ACLR. The 3-month ACL-RSI significantly correlated with the 6-month International Knee Documentation Committee (IKDC; r = 0.565, p = 0.001), Knee Injury and Osteoarthritis Outcome Score (KOOS) sport/recreational activities (KOOS ; r = 0.548, p = 0.002) and quality of life (KOOS ; r = 0.431, p = 0.017), and quadriceps strength (r = 0.528, p = 0.003). The 3-month K-SES significantly correlated with the 6-month IKDC (r = 0.528, p = 0.003), KOOS (r = 0.430, p = 0.018), KOOS (r = 0.411, p = 0.024), quadriceps strength (r = 0.465, p = 0.010), and knee flexion excursion (r = 0.472, p = 0.008). With multivariate modeling, both the ACL-RSI and K-SES were predictive of the IKDC (R  = 0.411; p = 0.001). Only the ACL-RSI was predictive of the KOOS (R  = 0.300; p = 0.002), KOOS (R  = 0.186; p = 0.017), and quadriceps strength (R  = 0.279; p = 0.003), whereas only the K-SES was predictive of knee flexion excursion (R  = 0.173; p = 0.022). Athletes with greater psychological readiness for sport and knee self-efficacy at 3 months demonstrated higher scores on self-reported functional outcomes, greater quadriceps strength, and greater knee flexion excursion at 6 months after ACLR. This study indicates that psychosocial measures may be important to include into early post-surgical evaluations to help guide and facilitate interventions to restore subjective and objective knee function.
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http://dx.doi.org/10.1002/jor.25120DOI Listing
June 2021

Serum 25-hydroxyvitamin D concentrations and mortality in dogs with blastomycosis.

Vet J 2021 Jun 10;274:105707. Epub 2021 Jun 10.

Department of Medical Sciences, University of Wisconsin-Madison, School of Veterinary Medicine, 2015 Linden Dr, Madison, WI, 53706, USA. Electronic address:

Blastomycosis is a prominent fungal disease in the United States. Vitamin D status has been found to be altered in critical illness and various infectious diseases. The objectives of this study were to compare serum 25-hydroxyvitamin D (25[OH]D) concentrations in dogs with blastomycosis and healthy controls, to assess the change in serum 25(OH)D concentrations in dogs with blastomycosis after 30 days of treatment, and to determine if baseline serum 25(OH)D concentrations in dogs with blastomycosis were associated with in-hospital, 30-day, or end-of-study mortality. In this prospective cohort study, 19 dogs newly diagnosed with blastomycosis had serum 25(OH)D concentrations measured with a commercially available validated radioimmunoassay at the time of diagnosis and 30 days after start of treatment. These values were compared to 24 healthy control dogs. Serum 25(OH)D concentrations at the time of diagnosis were lower in dogs with blastomycosis (median, 203 nmol/L; range, 31-590 nmol/L) than in clinically healthy control dogs (259.5 nmol/L, 97-829 nmol/L; P = 0.01). Despite clinical improvement, there was no significant change in serum 25(OH)D concentrations from baseline to 30-day follow-up. Dogs with baseline serum 25(OH)D concentrations <180.5 ng/mL nmol/L had a greater odds of death during hospitalization (odds ratio [OR], 15.0; 95% confidence interval [CI], 1.4-191.3; P = 0.04) and at 30 days follow-up (OR, 30.0; 95% CI, 2.5-366.7; P = 0.006). These findings highlight the need for further studies evaluating the prognostic value of vitamin D status in dogs with blastomycosis at diagnosis and throughout treatment and remission.
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http://dx.doi.org/10.1016/j.tvjl.2021.105707DOI Listing
June 2021

Women of reproductive age in a tertiary intensive care unit: indications, outcome and the impact of pregnancy-a retrospective cohort study.

BMC Womens Health 2021 06 19;21(1):248. Epub 2021 Jun 19.

Department of Obstetrics and Gynecology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Background: To evaluate the indications for admission and mortality rates of women of reproductive age admitted to a tertiary Intensive Care Unit (ICU) and to compare the outcomes of obstetric and non-obstetric admissions.

Methods: A retrospective cohort study was performed, including all women aged 17-41 years admitted to a level 3 ICU in the Netherlands, between January 1, 2000 and January 1, 2016. Primary outcome was indication for admission and mortality. Mortality, length of stay (LOS), need for mechanical ventilation and APACHE II score were compared between obstetric and non-obstetric admissions. The obstetric group was further analyzed for maternal and perinatal outcomes.

Results: 3461 women (median age 32 years) were included, with an overall mortality rate of 13.3%. The obstetric group consisted of 265 women (7.7%). The non-obstetric group (n = 3196) was admitted most often for cardiovascular disease (19.6%), followed by oncologic disease (15%). Mortality was the highest in women with oncologic disease (23.9%). The obstetric group had lower mortality compared to the non-obstetric group (4.9% vs. 14%, p < 0.001), despite higher APACHE II score (14 vs. 11, p < 0.001) and a higher ventilation rate (47.9% vs. 39%, p = 0.004). Major surgical or endovascular interventions, besides caesarean section, were performed in 46% of the obstetric group. Perinatal death occurred in 17.2% and of the surviving infants, 63.2% were born preterm and 45.1% required Neonatal Intensive Care Unit admission.

Conclusions: Cardiovascular disease is the most important indication for admission and oncologic disease is associated with highest mortality in women of reproductive age. Obstetric patients constitute a small percentage of all ICU admissions in a tertiary ICU center. They have lower mortality rates than non-obstetric young female patients, despite a more severe initial presentation. Nevertheless lasting maternal morbidity and perinatal mortality and morbidity is frequent.
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http://dx.doi.org/10.1186/s12905-021-01396-0DOI Listing
June 2021

Age at the Time of Surgery Is Not Predictive of Early Patient-Reported Outcomes After Periacetabular Osteotomy.

J Arthroplasty 2021 May 25. Epub 2021 May 25.

Washington University in St. Louis, Department of Orthopaedic Surgery, St. Louis, MO.

Background: The clinical success of periacetabular osteotomy (PAO) for the treatment of symptomatic acetabular dysplasia is well-documented. Conflicting evidence exists regarding the correlation of age with clinical outcomes. Hip disability and Osteoarthritis Outcome Score - global (HOOSglobal) is a recently validated patient-reported outcome measure following PAO. The purpose of this study is to asses HOOSglobal and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at early follow-up based on age at the time of PAO.

Methods: A prospective multicenter cohort of 391 patients undergoing PAO with minimum 2-year follow-up (average 4.71 years) were identified. Patients were categorized into 4 age groups: <20 years (N = 131), 20-29 (N = 102), 30-39 (N = 65), and ≥40 (N = 34). A 4 × 2 repeated measures analysis of variance (Age Group × Time) was used to compare preoperative and postoperative HOOSglobal and WOMAC scores between age groups. A multiple linear regression was used to identify predictors of postoperative HOOSglobal scores.

Results: HOOSglobal and WOMAC scores increased across all age groups; however, a statistically greater increase in preoperative to postoperative HOOSglobal and WOMAC scores was found in those ≥40 years compared to those <20 (P< .002), 20-29 (P = .01), and 30-39 years (P = .02). Higher preoperative HOOSglobal scores were predictive of greater postoperative HOOSglobal scores (P < .001) but age (P = .65), gender (P = .80), body mass index (P = .50), and Tönnis Classification (P = .07) were not independent predictors of 1-year outcomes.

Conclusion: The absence of differences in early postoperative patient-reported outcomes across multiple age ranges emphasizes that PAO in the setting of symptomatic acetabular dysplasia can be successful regardless of patient age alone. Therefore, age alone might not be an appropriate selection criterion when evaluating surgical candidates for PAO.

Level Of Evidence: II.
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http://dx.doi.org/10.1016/j.arth.2021.05.029DOI Listing
May 2021

FACTORS ASSOCIATED WITH INPATIENT ENDOSCOPY DELAY AND ITS IMPACT ON HOSPITAL LENGTH-OF-STAY AND 30-DAY READMISSION.

Clin Gastroenterol Hepatol 2021 Jun 8. Epub 2021 Jun 8.

Backgrounds And Aims: Inpatient endoscopy delay (IED) negatively impacts the delivery of high-quality care. We aimed to identify factors associated with IED and evaluate its effect on hospital length-of-stay (LOS) and re-admission.

Methods: Retrospective analysis of all inpatient endoscopies performed between November 2017 to November 2019 at a tertiary care center. IED was defined as the number of days elapsed between anticipated versus actual procedure day. Data was extracted from the endoscopy documentation sofware and via electronic chart review. Multivariate logistic regressions were modeled to determine variables associated with IED and hospital re-admission.

Results: A total of 4239 inpatients (mean age 58.3 years; 50.3% women) underwent endoscopic procedures during the study period of which 819 patients (19.3%) experienced a delay. IED resulted in a median prolonged LOS of 2 days (interquartile range 1-2 days). Patients with IED were less likely to have an etiology identified on endoscopy (OR:0.73; 95%CI:0.63-0.86;p<0.001). The two most common causes for delays were poor bowel preparation (n=218;27%) and lack of endoscopy personnel/unit availability (n=197;24.4%). Independent predictors of IED included: older age (OR:1.1;95%CI:1.01-1.03;p=0.03), female sex (OR:1.20;95%CI:1.03-1.40;p=0.02), use of antithrombotics (OR:1.30;95% CI:1.08-1.57;p=0.006), opioids (OR:1.23;95% CI:1.04-1.44;p=0.012), being on contact isolation (OR: 1.38;95%CI:1.09-1.75;p=0.008), and colonoscopy (OR:1.50;95%CI: 1.27-1.77;p<0.001). Conversely, inpatients admitted to a dedicated GI medicine service were less likely to have IED (OR:0.79;95% CI:0.65-0.96;p=0.02). IED was the only independent predictor of 30-day readmission (OR:1.22;95%CI:1.02-1.47;p=0.03).

Conclusion: IED occured frequently, unfavorably prolonged LOS and was an independent risk factor for 30-day readmission. We provide a comprehensive analysis of actionable variables associated with IED that can be targeted to improve inpatient endoscopy delivery.
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http://dx.doi.org/10.1016/j.cgh.2021.06.009DOI Listing
June 2021