bluuebunny/crossref_metadata_2025 huggingface dataset:
Resenha à obra 'Formas não monetárias de reparação do dano moral'
Authors: Reis Guilherme Alberge
Published: April 2021

Em posição de humildade, espero estar à altura para resenhar “Formas Não Monetárias de Reparação do Dano Moral”, obra de um autor tão capacitado, e que, além de seus gabaritos acadêmicos, congrega inúmeras outras qualidades pessoais, notadamente a cordialidade, humanidade e dedicação com que abraça seus projetos. Cícero Dantas Bisneto é doutorando em Direito Civil pela Universidade de São Paulo, mestre em Direito Civil pela Universidade Federal da Bahia – oportunidade em que defendeu a dissertação que originou a obra objeto da presente resenha –, Juiz de Direito do Tribunal de Justiça do Estado da Bahia e associado titular do IBERC – por seu currículo, já fica evidente o tamanho de meu desafio. Em sua obra, “Formas não monetárias de reparação do dano moral”, imperdível para os estudiosos da Responsabilidade Civil, Cícero inicia com um escorço histórico, apresentando a evolução dos conceitos básicos da disciplina no direito comparado e no Brasil. Vai muito além do tema proposto, ao lançar necessárias reflexões sobre as funções da responsabilidade civil – explica por que houve uma importação inadequada dos punitive damages – e sobre princípios quase dogmáticos da matéria, como o da restitutio in integrum e a excessiva monetização das indenizações, para, ao final, construir um raciocínio apurado para se chegar à sua tese, cuidadosamente construída mediante o estudo de exemplos doutrinários e jurisprudenciais, segundo a qual formas não monetárias de reparação do dano moral seriam mais adequadas.
Reflexões acerca da mitigação de danos
Authors: Martins José Eduardo Figueiredo Andrade
Published: April 2021

A obra em apreço corresponde a uma versão revista e ampliada da tese de doutorado defendida por Daniel Dias no ano de 2016 na Faculdade de Direito da Universidade de São Paulo, o produto final de uma extensa pesquisa realizada pelo autor ao longo de anos, em uma incessante e incansável dedicação sobre o tema da mitigação dos danos na responsabilidade civil. Trata-se de obra de fôlego, com 410 páginas, em que são esmiuçadas as peculiaridades da adoção de uma norma em que o lesado seja obrigado a mitigar o seu próprio prejuízo. Em linhas gerais, a problemática que serve de pano de fundo é a seguinte: na ocorrência de um dano culposo, seja ele de natureza contratual ou extracontratual, a vítima é instada a mitigar os prejuízos considerados por ele evitáveis? Se a mitigação é devida, qual seu fundamento jurídico e quais são seus pressupostos?
Futbolcu Performanslarının VIKOR Yöntemi ile Değerlendirilmesi
Authors: AYDIN Merve , AVCI Selen , ALADAĞ Zerrin
Published: April 2021

Bir futbol takımı kurulurken asil ve yedek futbolcuların doğru seçilmesi, takımın uyumlu olması ve galibiyet elde edilmesi açısından oldukça önem taşımaktadır. Futbol takımı asil kadrosunun pozisyonları belirlidir ve farklı pozisyonlar farklı fiziksel becerileri gerektirmektedir. Bu çalışmanın amacı; söz konusu pozisyonlar dikkate alınarak Türkiye Milli Futbol Takımı futbolcularının geçmiş sezon verilerinin değerlendirilmesi doğrultusunda performanslara dayalı olarak yeni sezon futbolcu seçimleri için önerilerde bulunmaktır. Performans değerlendirilmesi için Çok Kriterli Karar Verme yöntemlerinden biri olan VIKOR (Vise Kriterijumska Optimizacija I Kompromisno Resenje) yöntemi kullanılmıştır. Değerlendirmede, belirli ağırlıklardaki “attığı gol sayısı, oynadığı maç sayısı, oyunda bulunduğu süre, profesyonel futbol kariyeri, takımın toplam gol sayısı, asist sayısı, kırmızı kart görme sayısı, sarı kart görme sayısı” kriterleri doğrultusunda aynı pozisyon için aday futbolcular değerlendirilmiş ve farklı karar verici tutumlarına göre asil kadro önerisinde bulunulmuştur. Sonuç olarak, VIKOR yönteminin spor faaliyetlerinde kullanılması, özellikle futbolcu performanslarının analitik olarak değerlendirilebilmesine olan katkısı ve karar verici tutumunun sonuçlara etkisi irdelenmiştir.
Lise Öğrencilerinin Çoklu Zekâ Alanları ve Sporda Yaşam Becerilerinin Çeşitli Değişkenler Açısından İncelenmesi
Authors: BOZDAĞ Berkan , SARI Hüseyin Gökhan
Published: April 2021

Bu araştırmanın genel amacı, lise öğrencilerinin çoklu zekâ alanları ile sporda yaşam becerileri arasındaki ilişkinin incelenerek, çeşitli değişkenlerle karşılaştırılmasıdır. Araştırma ilişkisel tarama modelindedir. Araştırmanın örneklemini, 2019-2020 eğitim-öğretim yılında Yozgat ilinde okuyan öğrenciler içerisinden kolay ulaşılabilir örnekleme yöntemi ile 538 lise öğrenci oluşturmuştur (200 kadın and 338 erkek). Araştırmada veri toplama aracı olarak, araştırmacı tarafından hazırlanan “Kişisel Bilgi Formu”, öğrencilerin çoklu zekâ alanlarını belirleyebilmek amacıyla “Çoklu Zekâ Ölçeği (ÇZÖ)’’ ve sporda yaşam becerilerini belirlemek amacıyla ‘‘Sporun Yaşam Becerilerine Etkisi Ölçeği (SYBÖ)’’ kullanılmıştır. Elde edilen verilerin sonucunda güven aralığı a=95, hata miktarı ise 0.05 olarak hesaplanmıştır. Araştırma sonucunda öğrencilerin çoklu zekâ alanlarının sporun yaşam becerileri üzerindeki etkilerin yordanmasına ilişkin regresyon analizi incelendiğinde; çoklu zekânın SYBE’nin anlamlı bir yordayıcısı olduğu tespit edilmiştir.
Yükseköğretim Kurumlarında İş Sağlığı ve Güvenliğine Yaklaşım, İstanbul Örneği
Authors: ÇABUK Ahmet , ONĞULU Dilan
Published: April 2021

Yükseköğretim kurumları lisansüstü, lisans ve ön lisans seviyesinde eğitim ve öğretimin gerçekleştirildiği kurumlar olup bünyesinde derslik, atölye, laboratuvar, sağlık, kültür ve spor faaliyetlerinin gerçekleştirildiği alanlar, mutfak, depo, büro gibi birçok kısımları içermektedir. Bu alanlarda kullanılan makine, teçhizat, aletin yanı sıra alanların fiziksel, kimyasal, psikolojik, ergonomik koşulları bulunmaktadır. Üniversite sınırları içerisinde bulunan tüm paydaşlar (Öğrenci, öğretim elemanı, idari personel, ziyaretçi, tedarikçi) tüm etkenlerden etkilenmektedir. İstanbul ili içerisinde faaliyette bulunan üniversitelerde eğitim ve öğretimde görev alan öğretim elemanlarına yönelik yapılan çalışma ile yükseköğretim kurumlarında iş sağlığı ve güvenliği eğitimlerinin verilme durumu, öğretim elemanlarının ramak kala olay ve iş kazasına maruz kalma durumu, ramak kala olay ve iş kazasının bildirilmesi ve yetkili birimlerce ramak kala olaya ve iş kazasına neden olan etkeni ortadan kaldırmaya yönelik çalışma yapma durumu belirlenmeye çalışılmıştır. Yükseköğretim kurumlarında iş sağlığı ve güvenliği konusunda çalışmaların etkin olarak yerine getirilmesi yükseköğretim kurumlarının tüm paydaşlar için sağlıklı ve güvenli hale getirilmesine olanak sağlayacaktır. Öğretim elemanlarının iş sağlığı ve güvenliği konusundaki risk algısının artması, iş sağlığı ve güvenliği çalışmalarına etkin olarak katılmasıyla sahip oldukları deneyimi direkt veya dolaylı olarak öğrencilere aktarmasıyla mezun olan öğrenciler iş yaşamlarında iş sağlığı ve güvenliğine dikkat edeceklerdir.
Contemporary insight into diffuse axonal injury
Authors: Angelova Polina , Kehayov Ivo , Davarski Atanas , Kitov Borislav
Published: April 2021

Diffuse axonal injury (DAI) is present in approximately 50% of the cases with severe traumatic brain injury. It is one of the leading causes of morbidity and mortality among children and young individuals worldwide. Generally, DAI occurs as a result of high-velocity accidents. Typically, it presents with loss of consciousness for at least 6 hours and neurological deficit dependent on the brain area that is affected by the injury. The final diagnosis is confirmed by neuroimaging studies such as computed tomography and magnetic resonance imaging. According to the injured brain site, DAI is classified into three grades: Grade I–DAI with axonal lesions in the cerebral hemispheres; Grade II–DAI with focal axonal lesions in the corpus callosum; Grade III–DAI with focal or multiple axonal lesions in the brainstem. Each of the three grades is associated with different outcome.Due to the high disability and mortality rate, DAI represents an important medical, personal and social problem. The aim of the current review is to address the unsolved issues connected with the pathogenesis, diagnostics, treatment and outcome of the diffuse axonal injury.
Evolutionary explanations for religion: An interdisciplinary critical review
Authors: Lindenfors Patrik , Svensson Jonas
Published: April 2021

Some form of religion exists in every documented society on earth. However, ‘religion’ is a multifaceted phenomenon commonly including aspects, such as rituals, myths, rules and regulations concerning ethical behaviour, social practices and some form of belief in the supernatural (e.g. gods, spirits or souls). Due to its pervasiveness, many researchers of biological and cultural evolution have suggested that religion needs a universal evolutionary explanation. However, most proposed explanations have either treated religion as a single all-encompassing entity or only focused on a single or a few aspects of religion. We propose, instead, to carry out an extensive review of such suggested evolutionary explanations with the express aim of pairing up proposed explanations with religious components in order to form a more comprehensive depiction of causation and how religion and human cognition both have evolved, each influenced by the other. We also propose to summarise predictions and hypotheses that spring from each explanation, with the express aim of stating how each may be evaluated and tested. Crucially, different aspects of religion may have different explanations and different explanations may apply to several aspects of religion. Proposed explanations will be summarised in a series of thematically oriented scientific articles, as well as in a summary monograph. Our dual competencies, in evolutionary theory and religious studies, provide us with a unique opportunity to evaluate these issues from both a natural and a humanistic point of view.
Teaching of Interpersonal Skills to Nurse Practitioner Students*
Authors: Sparks Susan M , Vitalo Patricia B , Cohen Barry F , Kahn Gary S
Published: April 2021

A three-phase national survey (N = 101) of the teaching of interpersonal skills (IPS) to nurse practitioner students revealed that: at least 78% have IPS courses; psychosocial history-taking is the most frequently emphasized skill; academic nonphysician clinicians are the predominant IPS teachers; live lectures, readings, and live simulations are the primary teaching methods; and indirect assessment is the most frequently used evaluation method. Prerecorded videotapes are used much more commonly than is video playback. The relative emphasis on the teaching of selected IPS and the methods used for teaching and evaluating IPS raise serious questions that warrant further assessment.
Integration of the Role of Clinical Nurse Specialist
Authors: Everson Sally J
Published: April 2021

The role of the Clinical Nurse Specialist has been difficult for health care systems to integrate because of the lack of clarity in role expectations between administration and the CNS. Clinical Specialists grouped in a Staff Development and Research Department with mutually negotiated expectations of accountability, responsibility, and authority are described as a method of role clarification with consultation/liaison as the process of role implementation.
Introduction
Authors: Strauss Mary Beth , Puetz Belinda E , Chodil Judith J , Abruzzese Roberta S , Wise Patricia S Yoder
Published: April 2021

"The Impact of Continuing Education on the Nursing Profession" was developed as a presentation for the 1982 American Nurses' Association 53rd Convention held in Washington, D.C. The Executive Committee of the Council on Continuing Education developed the presentation, parts of which were not presented at the convention. The intent of the Executive Committee in sharing the following material is to provide a broad overview of the state-of-the-art and some projections of the future and to examine a few key issues in greater depth. The Journal of Continuing Education in Nursing welcomes responses and comments.
Evaluation of Health Assessment Skills
Authors: Wilbur JoEllen
Published: April 2021

ABSTRACT

This article presents the reliability and validity data on a checklist used to evaluate health assessment skills. In 1982, the nurse practitioner faculty at a large midwestern university acknowledged that health assessment skills were basic to the preparation of all nurses and made the decision to require these skills for entry into the graduate program. Because of the varying ways in which health assessment skills are acquired, the faculty saw the need to standardize the expected level of performance. An objective, three-page instrument to measure student competence in performing and recording a health history and physical examination for a client of any age is administered prior to beginning the nurse practitioner sequence of courses. The 91 objective items for this instrument are based on the traditional outline for writing up a client history and physical examination. Criteria for the items are located in an accompanying manual. The student achieves a "Yes" rating on an item if all the components of the item are performed and written according to the criteria. Reliability of the tool was assessed by 12 faculty members who participated in a simulated evaluation. The tool has been used to evaluate the skills of 165 nurses. Of these, 149 nurses were enrolled in a continuing education course, and 16 nurses tested out of a health assessment course.
Helping Hospital Educators and Clinical Nurse Specialists Learn to Use and Develop Computer-Assisted Instruction
Authors: Whiteside Mary F , McCulloch Jayanna , Whiteside J Alan
Published: April 2021

ABSTRACT

The impact of computers on healthcare delivery and management is both significant and increasing. Coupled with its potential educational benefits, computer-assisted instruction (CAI) has much to offer healthcare professionals. However, the individuals directly responsible for training nurses and other personnel typically have little knowledge about how computers can be used for training purposes.

A series of workshops was designed for hospital educators and clinical nurse specialists to help them become computer literate and to provide them with the skills to evaluate, develop, and appropriately implement instructional software. Direct hands-on experience with hardware and software was emphasized during a series of formal seminars, guided individual instruction, and guided independent practice laboratory sessions.

This approach resulted in a significant increase in participants' knowledge about computers while maintaining their positive attitudes toward the instructional uses of computers. A well-designed staff development program can provide these crucial individuals with the skills and knowledge required to use microcomputers and CAI as effective teaching and learning tools.
Factors Associated with Critical Thinking Among Nurses
Authors: Howenstein Michelle A , Bilodeau Kristen , Brogna Mary Jo , Good Grace
Published: April 2021

ABSTRACT

The ability to think critically is increasingly hypothesized to play an important role in a nurse's ability to function competently in complex health care settings. This cross-sectional exploratory survey used secondary data (Gendrop, 1989) to assess the critical thinking ability of a convenience sample of 160 nurses from two urban hospitals. Four variables hypothesized to be associated with critical thinking ability were explored: age, level of education, years of nursing experience, and area of expertise in nursing. Critical thinking was assessed using the Watson Glaser Critical Thinking Appraisal Tool (WGCTA). Study findings suggest that age and years of experience were negatively correlated with critical thinking ability. However, the level of education was positively related to critical thinking. Future needs for research were identified and implications for nursing education and practice were provided.
Returning to School: Ten Considerations in Choosing a BSN Program
Authors: Krawczyk Rosemary
Published: April 2021

ABSTRACT

Ten factors, accreditation, cost, flexibility, location, method of earning credit, student profile, quality, progression to master's degree, resources and time, should be investigated before selecting a baccalaureate nursing program. A sample of 361 RNs enrolled in ten baccalaureate nursing programs identified and prioritized the ten factors. The most important factor was cost, followed by accreditation and flexibility. Asking questions in each of these areas enables the RN to make an informed decision before investing time, energy and money in a specific program. These ten factors can be guidelines used for assessing various program objectives. The subjective data are how each RN prioritizes the ten factors.
Clinical Ladders: Do They Reflect Levels of Competence?
Authors: Snyder Marsha Daniels
Published: April 2021

ABSTRACT

Staff nurses positioned within two discrete clinical ladder levels were surveyed for their responses to two components of clinical competence: job performance and problem-solving tactics. Although findings suggest that clinical ladders do not seem to provide clear delineation of competence levels, several interventions with staff nurses may increase clinical ladder viability: 1) opportunity to practice and utilize mixed and integrative problem-solving styles, 2) challenging work experiences, and 3) opportunity to mentor and be mentored.
Creating Mosaics: The Interrelationships of Knowledge and Context
Authors: Daley Barbara J
Published: April 2021

ABSTRACT

This qualitative interpretivist study analyzed the interrelationships between the knowledge gained through continuing nursing education programs and the context of nurses' clinical practice. The content of nursing continuing education programs offered 9-12 months previously was reviewed. Forty semi-structured, tape-recorded interviews were conducted with nurses from hospitals, nursing homes and home care agencies to determine their use of this new knowledge. Findings indicate that nurses used information from continuing education programs to construct a knowledge base and that this process was affected by the structural, human resources, political and symbolic frames of the context in which nurses practice.
The Provision of Staff Development Programs in Adult Day Care Centers
Authors: Hensley A Dawn , Travis Shirley S
Published: April 2021

ABSTRACT

Background: Little is known about staff development activities in adult day care (ADC) programs. Therefore, this descriptive study was used to compare existing center programs with research- and practice-derived "model staff development program" for orientation, inservice education, and continuing education opportunities.

Method: A multi-step mail survey design was used to study licensed adult day care programs in Virginia (n=38). The design produced a 92% (n=35) response rate among eligible respondents.

Results: Thirty-seven percent (n=13) of the responding administrators described staff development activities that met the criteria for a model program. Despite limited financial support, Virginia centers are making an effort to provide comprehensive staff development opportunities for their staff

Conclusion: Centralized or regionalized programming may be two viable solutions for addressing unmet staff training issues for these community-based agencies. Moreover, because their staff tend to be interdisciplinary in nature, educational programming for an interdisciplinary audience will be in order.
Student Perceptions of Academic Advising in an RN-to-BSN Program
Authors: Trent Barbara A
Published: April 2021

ABSTRACT

Background: This study evaluated academic advisement from the perspectives of RN-to-BSN students in relation to the advisement elements of function, style, and outcome.

Method: Using multistage sampling, data were collected from 323 students enrolled in either a beginning, mid-way, or final course in the RN-to-BSN curriculum.

Results: All aspects of advisor style were perceived to have been employed and important. None of the outcomes were perceived to have been achieved nor important. There was a significant difference (p<0.05) between students from ADN and Diploma educational backgrounds in relation to their perceptions of the importance of advisement functions and outcomes. Students rated their perceptions in accordance with andragogical learning principles that stressed the importance of individuality. The researcher developed Academic Advisement Questionnaires have content validity and reliability for internal consistency at 0.94 by Cronbach's coefficient alpha.

Conclusion: Advisement in RN-to-BSN educational programs can positively influence student retention rates by providing advisement that is conducive to the needs and values of adult learner students.
An Exploration of Civilian Nurses' Knowledge of the Military Culture
Authors: Mushale Augustina , Bakerjian Debra
Published: April 2021

Background:

In fiscal year 2019, approximately $78 million was spent on veteran medical care alone apart from other civilian costs. Some veterans state their health care providers do not understand the military culture, which makes them uncomfortable seeking care in the private sector.

Method:

A nonexperimental cross-sectional study was conducted using a convenience sample of 127 RNs who completed an electronic survey of the Military Culture Certificate Program.

Results:

The total overall mean on the Knowledge and Awareness subscale was 4.38 of 6, representing a modest level of military knowledge. The Confidence in Skills and Abilities subscale also scored at a modest level, with an overall mean of 81.3 of 100. Although the nurses demonstrated modest knowledge levels of military culture and confidence skills, there were low scores in veteran referral to the appropriate resources.

Conclusion:

It is essential to educate nurses regarding how and where to refer veterans to the appropriate resources. Further studies should expand on this work.

[
J Contin Educ Nurs
. 2021;52(4):176–183.]
Ethics in Psychiatry: A Question of Allegiance
Authors: Freedman Alfred M
Published: April 2021

ETHICAL ASPECTS OF PSYCHIATRY: AN AMERICAN PSYCHIATRISTS VIEW
What Is Psychiatry and What Is Ethics?
Authors: Blomquist Clarence D D
Published: April 2021

ETHICAL ASPECTS OF PSYCHIATRY: A SWEDISH PSYCHIATRISTS VIEW
Personal Reflections
Authors: Rome Howard P
Published: April 2021

Recent Advances In Sleep Research
The Narcoleptic Syndrome
Authors: Karacan Ismet , Moore Constance A , Williams Robert L
Published: April 2021

The word narcolepsy refers to a syndrome of unknown origin that is characterized by abnormal sleep tendencies, including excessive daytime sleepiness and often disturbed nocturnal sleep, and pathologic manifestations of REM [rapid-eye-movement] sleep. The REM sleep abnormalities include sleep-onset REM periods and the dissociated REM sleep inhibitory processes, cataplexy, and sleep paralysis. Excessive daytime sleepiness, cataplexy, and less often sleep paralysis and hypnagogic hallucinations are the major symptoms of the disease.
OPERATIVE MANAGEMENT OF HEMOPHILIC ARTHROPATHY-AN OVERVIEW
Authors: Greer Robert B
Published: April 2021

ABSTRACT: The availability of highly purified factor VIII and factor IX concentrates, as well as improvements in total joint design and operative technique, have resulted in increases in elective joint surgery in patients with hemophilia. This article presents some guidelines for medical management of these patients, and some cautionary notes based on experience and available literature.
CLOSED NEEDLE BIOPSY OF THE LUMBAR SPINE: A SAFE AND EASY METHOD
Authors: Cozen Lewis
Published: April 2021

ABSTRACT: Numerous articles have been written about methods of closed biopsy of the spine. One of the most recent is by Moore et al,1 who describes his method as used at the Los Angeles General Hospital. The method described in this report is a simple and safe method for closed biopsy of the lumbar vertebra.
POSTERIOR ILIOPSOAS TRANSFER: A TREATMENT FOR SOME MYELODYSPLASTIC HIPS
Authors: Wissinger H Andrew , Tumer Yucel , Donaldson William F
Published: April 2021

ABSTRACT: A retrospective study of our 16-year experience in utilizing posterior iliopsoas transfer as treatment for the neurogenic dislocated hip is presented. Fifty-four surgically treated hips are compared with 20 hips treated nonoperatively. Maintenance of location was achieved in 84% of the operated hips. All of the postoperative dislocations can be explained by failure of the surgeon to adhere to the essentials of tendon transfer.
Destructive Arthropathy in Chondrocalcinosis: A Case Report
Authors: Richardson Bruce C , Genant Harry K
Published: April 2021

ABSTRAGT: A case of Chondrocalcinosis with unusually severe destruction of the ankle joint, as well as erosions in the knees, hands and shoulders, is presented. The role of calcium pyrophosphate dihydrate (CPPD) crystals in destructive arthropathy is discussed, with the recommendation that in cases of chondrocalcinosis with destructive arthropathy, examination for conditions leading to deposit of CPPD crystals should be considered.
The Use of 2% Glutaraldehyde as a Disinfectant for Arthroscopes Used in Septic Joints
Authors: Shoji Hiromu , Gutierrez Michael M , Aldridge Kenneth E
Published: April 2021

ABSTRACT: The objective of this study was to determine the effectiveness of 2% glutaraldehyde as a sterilant for arthroscopes that had been used in septic joints. The first part of the experiment determined the minimum inhibitory concentration and the minimum lethal concentration of the disinfectant for five organisms frequently found in joint infections. The second phase of the study determined the ability of the 2% glutaraldehyde to sterilize grossly contaminated stainless-steel rods, used as substitutes for the arthroscope. The results showed the 2% glutaraldehyde to be an efficient disinfectant when used at full strength. Any dilution to one-quarter strength or greater proved to severely diminish the bacteriocidal capability of the solution. The results suggest that the solution is a viable alternative to ethylene oxide sterilization of arthroscopes after being used in septic joints, although further in vivo studies are necessary for definitive clinical use.
Limb Lengthening in Children
Authors: Cambras Rodrigo Alvarez , Puente Juan Jose Jorge , Perez Humberto Barreda , Angulo Miguel Angel Rodriguez , Concepcion Tomas Padron
Published: April 2021

ABSTRACT: Of 73 limb lengthening patients, 35 were treated with distraction of the growth epiphysis, and 38 under diaphyseal-metaphyseal corticotomy. In all cases the lineal fixator and T-shaped fixator with spadai triplanar system invented by the author were used, achieving lengthenings up to 18 cm, the average being 6 cm. The anatomic and functional results show the efficiency of the method as well as the advantages of this external fixator, which can be used as neutralize^ distractor, compressor or bone carrier.
Pin Tract Histological Study: Preliminary Clinical Investigations
Authors: Hardy N , Burny F , Deutsch G A
Published: April 2021

ABSTRACT: Histological examination was performed at the time of retrieval of external fixation pins, using a special instrument designed for biopsy of the soft tissues of the pin tract (70 samples). The reactions were evaluated in five stages, depending on the intensity of the inflammation. We also graded the edema.

The importance of the inflammatory reaction depends on the thickness oí the soft tissues, being more important in the femur and the humerus than in what we considered superficial bones. We did not observe any relationship between the histological reactions and the mechanical anchorage of the pins. For the usual duration of implantation, the inflammatory reaction does not seem to be time related.
External and Internal Fixation as Complementary Procedures in the Treatment of Trauma
Authors: Vidal J , Orst G
Published: April 2021

ABSTRACT: The use of combined internal and external fixation in the treatment of certain orthopedic traumas may seem a contradictory association, but can in fact be a quite judicious association In certain specific cases described by the authors, when basic principles of traumatology are strictly respected.
Closed Flexible Intramedullary Fixation for Pathologic Lesions in Long Bones
Authors: Moehring H David
Published: April 2021

ABSTRACT: Nine patients with 11 extremities involved with neoplastic metastases were treated with flexible intramedullary rods for stabilization and pain relief. Seven of the nine patients had sustained a fracture, and two patients received prophylactic flexible intramedullary rods for impending fracture. Good pain relief and satisfactory stabilization were accomplished in all but one patient. Methyl methacrylate was not used, and all lesions were treated closed, save for one patient who received good initial pain relief and satisfactory stability but ultimately had tumor recurrence, infection, and loss of fixation. We feel this technique is especially valuable in treating the very ill and terminal patient who might otherwise not tolerate prolonged anesthesia or extensive operative procedures.
Treatment of Single Compartment Osteoarthritis of the Knee Using Modular Arthroplasty: A Review of the Literature and Presentation of 29 Cases
Authors: Tabor Owen B
Published: April 2021

ABSTRACT: Twenty-nine knees with degenerative arthritis, generally confined to a single weightbearing compartment, were treated by modular arthroplasty. A mean followup of 20 months at formal evaluation and 30 months at time of reporting revealed satisfactory results in 89%. Anticipated complications of loosening, deterioration of the opposite compartment or patella, progressive lucent lines by x-ray, particle arthritis, or instability have been rare. Loss of knee stability or infection, requiring bracing or arthrodesis, has not occurred. One case of thrombophlebitis occurred and responded to anticoagulant treatment. We have revised two knees, both successfully. Technical problems of high tibial osteotomy are reviewed and compared to reported results with uni-arthroplasty in an effort to balance the generally negative attitude held by many surgeons concerning modular replacement of a single compartment of the knee.
Avascular Necrosis and Collapse of the Lunate Following a Volar Perilunate Dislocation: A Case Report and Review of this Complication in Dislocations of the Wrist
Authors: Mueller James J
Published: April 2021

ABSTRACT: Kienbock's disease occurs as a complication in less than 1% of volar perilunate dislocations of the wrist. One such case is reported here. The choice of open or closed treatment appears not to affect the incidence of avascular necrosis in this injury. Thus it is concluded that treatment should be dictated by the associated fractures or evidence of persistent scapholunate dissociation.
Human Histology of the Bone-Porous Metal Implant Interface
Authors: Bobyn J Dennis , Engh Charles A
Published: April 2021

ABSTRACT: Histological study of the bone-implant interface was performed on two retrieved femurs implanted with porous-surfaced metal arthroplasty components. The first case (87-year-old woman, 40day implant period) revealed limited new bone formation but some biological fixation in the proximal medial and distal lateral regions. The second case 82-year-old man, 6½-month implant period) demonstrated more convincing evidence of bone ingrowth and adaptive bone modeling. In general, the development of biological fixation was less pronounced than observed in animal models, probably as a result of factors such as patient age, disease process, and low activity level.
Vasomotor Abnormalities as Post-Polio Sequelae: Functional and Clinical Implications
Authors: Bruno Richard L , Johnson Julia C , Berman William S
Published: April 2021

ABSTRACT: Persons who had poliomyelitis report cold and discolored extremities and decreased muscle strength when exposed to mildly cool ambient temperatures. Bilateral digital cutaneous blood flow, skin temperature and median nerve latencies and amplitudes were measured at 30°C, 25°C and 20°C in five post-polio subjects and agematched controls. Cutaneous blood flow was lowest on the more affected side in the post-polio subjects but vasoconstriction with decreasing T^sub a^ was equal bilaterally in both groups. With decreasing T^sub a^, median motor nerve latencies became clinically abnormal and "giant" sensory nerve potential amplitudes were seen in a majority of the postpolio subjects. It is concluded that an impairment of sympathetic vasoconstrictor outflow in post-polios allows passive dilatation and engorgement of the cutaneous venous capacitance beds. This promotes uncontrolled heat loss and causes cooling of nerve and muscle that is responsible for the impairment of muscle functioning and the abnormal electrophysiological findings.
Growth Modification in the Treatment of Scoliosis
Authors: Piggott Harry
Published: April 2021

ABSTRACT: Structural deformities, of which scoliosis is a notable example, imply a skeletal length discrepancy which may involve all three dimensions. Once the deformity is established, secondary mechanisms come into action. Physiological treatment concerns modifying spinal growth and the convex side can be retarded, the concave side stimulated, the neurocentral physis arrested to correct rotation, and the forces acting along the ribs can be altered. Thus stapling, epiphysiodesis, posterior fusion, combined convex side epiphysiodesis, and convex side posterior fusion, convex side tether, costodesis, and concave side rib head excision have all been tried. Of these, combined anterior and posterior fusion of the convexity is the most effective, particularly for congenital hemivertebrae without rotation.
Indomethacin: An Adjunct to Surgical Excision of Immature Heterotopic Bone Formation in a Patient With a Severe Head Injury: A Case Report
Authors: Ritter Merrill A
Published: April 2021

ABSTRACT: This case reports heterotopic ossification which produced ankylosis around the hip joint in a young adult treated with steroids for moderate cognitive defects secondary to brain trauma. It is associated with a high recurrence rate, especially if the bone is immature. The patient's heterotopic bone was surgically excised nine months post-injury, augmented with six weeks of indomethacin, and followed for three years.
Post-Traumatic Arthrosis of the Index Carpometacarpal Joint: A Rationale for Treatment and Report of Two Cases
Authors: Konsens Richard M , Seitz William H
Published: April 2021

ABSTRACT: Although a relatively rare entity, post-traumatic arthrosis of the carpometacarpal joint of the index finger can be a disabling problem. Its diagnosis must be differentiated from other sources of local pathology. A rationale to the diagnosis and treatment of this entity is presented, demonstrating the usefulness of test injections of xylocaine, an intra-articular injection of a steroid preparation when a relatively congruous joint exists, and arthrodesis of the joint when an incongruous joint is encountered.
FLEXION-EXTENSION MRI OF THE UPPER RHEUMATOID CERVICAL SPINE
Authors: Bell Gordon R , Stearns Kim L
Published: April 2021

ABSTRACT

Seven rheumatoid arthritis patients with involvement of the upper cervical spine were evaluated with a dynamic MRI study. Lateral Tl weighted images of the upper C-spine were obtained in the flexion, extension, and neutral positions. The indications for performing the dynamic MRI were radiographic instability of the upper C-spine, myelopathy, superior migration of the odontoid process, obliteration of bony landmarks on plain radiographs, and to detennine the contribution of pannus on cord configuration. The dynamic MRI clearly delineated the relationship between the odontoid, foramen magnum, and cervical spinal cord as the neck was moved through a range of motion. This aided in the selection of operative candidates in four cases, and was instrumental in determining fusion levels. In three cases with suspected myelopathy secondary to cord impingement, MRI showed no significant cord compression, and aided in the decision to treat the patients conservatively. Lateral flexion-extension MRI is the diagnostic study of choice in dynamically evaluating the upper rheumatoid C-spine.
A STUDY ON PLATELET FUNCTION IN IDIOPATHIC SCOLIOSIS
Authors: Suk Se Il , Kim In Kwon , Lee Choon Ki , Koh Young Do , Yeom Jin Sup
Published: April 2021

ABSTRACT

Because platelets and muscle cells share the same contractile proteins - actin and myosin - platelets may serve as a model for muscle research. To study the functional abnormalities and ultrastructural changes of platelets and to determine whether or not abnormalities in muscle contractile proteins and collagen play an important role in the pathogenesis of idiopathic scoliosis, the bleeding time, the platelet aggregation test, and the titers of platelet plasminogen activator inhibitors were measured and the electron microscopic findings were examined in 52 idiopathic scoliosis patients aged 7 to 28 years and in 49 normal individuals aged 8 to 38 years as a control group. We found no statistically significant difference between the two groups in the bleeding time, the platelet aggregation test, and the titers of platelet plasminogen activator inhibitors. In the electron microscopic findings, no specific abnormalities were found in platelets of idiopathic scoliosis patients. We concluded that idiopathic scoliotic patients have normal morphology and function of platelets, and there is no important role of contractile proteins in the pathogenesis of idiopathic scoliosis. In addition, since the bleeding time was in the normal range, no evidence of subendothelial collagen dysfunction was found in the idiopathic scoliosis patients.
CEMENTLESS TOTAL HIP ARTHROPLASTY WITH PCA PROSTHESIS
Authors: Hwang Sung Kwan , Ahn Jae In , Kim Ho Sung
Published: April 2021

ABSTRACT

Eighty-one cases of cementless porous-coated total hip arthroplasties in 74 patients were analyzed. Hip rating scores as described by Harris were used, and AP and lateral radiographs were made serially: preoperatively, 3 months, 6 months, 1 year, and 2 years postoperatively. The average postoperative hip rating score was 91 points (range: 76 to 100 points) at 1 year and 93 points (range: 74 to 100 points) at 2 years. The overall clinical results were satisfactory in these patients at both 2 and 4 years. However, slight to mild thigh pain was observed in 16 (19.8%) of 81 hips at 2 years, and 10 (21.3%) of 47 hips at 4 years postoperatively. Moderate to severe limp was seen in 11 (13.6%) of 81 hips at 2 years and seven (14.9%) of 47 hips at 4 years postoperatively.
ELBOW ARTHROSCOPY FOR LOOSE BODIES
Authors: O'Driscoll Shawn W
Published: April 2021

ABSTRACT

Arthroscopy is highly useful for the diagnosis and treatment of loose bodies of the elbow. Not all loose bodies are detected radiographic cally, and often there are multiple loose bodies, sometimes both anteriorly and posteriorly. When not complicated by an underlying disorder such as arthritis, loose bodies can be removed from any part of the elbow to provide excellent results in a predictable manner. This article describes techniques developed for the safe and effective application of this procedure in the elbow.
CURRENT PROCEDURES FOR BANKING ALLOGRAFT HUMAN BONE
Authors: Scarborough Nelson L
Published: April 2021

ABSTRACT

The demand for bone and soft tissues for surgical usage has increased rapidly as the efficacy and safety of these materials has been demonstrated. Advances in technology and procedures used to prepare the tissues have also grown in sophistication and remain a dynamic area. How tissue banks screen donors and prepare allografts impacts on the risks and benefits of these materials. Surgeons should understand how tissue banks supplying their graft materials work and have confidence in this treatment option. They will then be prepared to educate their patients to help them make informed decisions concerning allograft usage.
TREATMENT OF MULTIPLE PTERYGIUM SYNDROME
Authors: McCall Richard K , Budden John
Published: April 2021

ABSTRACT

Multiple pterygium syndrome is a rare, inherited disorder manifested by growth retardation, facial or genital anomalies, and widespread musculoskeletal deformities. Pterygia are the predominant hallmark of the syndrome. Five children with multiple pterygium syndrome were treated from 1978 to 1987. Treatment involved both upper and lower pterygia and contractures. The results of treatment and modalities used are discussed and a protocol suggested.
ARTHROSCOPIC MANAGEMENT OF ROTATOR CUFF DISEASE
Authors: Beach William R , Caspari Richard B
Published: April 2021

ABSTRACT

The etiology of rotator cuff disease is controversial, but is not always secondary to cuff impingement between the humeral head and the coracoacromial arch. Rotator cuff disease, and not impingement syndrome, more accurately describes this process. The spectrum of rotator cuff disease begins with rotator cuff inflammation (Stage I) and progresses to tendinitis (Stage II) and partial or full thickness tears (Stage III). Refractory Stage II and III disease without rotator cuff tears undergoes subacromial bursectomy and acromioplasty. Partial thickness tears are debrided with an acromioplasty, bursectomy, and removal of inferior clavicular osteophytes. Full thickness tears are treated arthroscopically or open, depending on the tear size and the patient expectations. In general, tears from 0 to 5 cm in active patients undergo subacromial decompression and a mini-open repair. Low demand patients with 0 to 5 cm tears or tears greater than 5 cm are treated with subacromial decompression and rotator cuff debridement.
ADVANCES IN ELBOW ARTHROSCOPY
Authors: Angelo Richard L
Published: April 2021

ABSTRACT

Arthroscopy of the elbow is a very precise and demanding technique. Because of the proximity of neurovascular structures to the recommended portals, a thorough knowledge of regional and intraarticular anatomy is essential. The high degree of congruency of the articular surfaces and the relatively small capsular volume make sound arthroscopic skills a necessity. With proper precautions, the technique is safe and affords the opportunity to obtain valuable diagnostic information and to perform selected procedures without the morbidity of an arthrotomy.
OSTEOSYNTHESIS OF THE CERVICAL SPINE WITH AN ANTERIOR PLATE
Authors: Ebraheim Nahil A , DeTroye Robert J , Rupp Robert E , Taha Jamal , Brown Jeffrey , Jackson W Thomas
Published: April 2021

Abstract

Osteosynthesis with an anterior plate is indicated for stabilization of the cervical spine. It is used for reconstruction of the vertebral body following corpectomy and for cervical instability due to fractures, fracturedislocations, and post-laminectomy. In these situations, a well-keyed anterior graft or posterior fusion alone may be inadequate to attain stability. The authors retrospectively review 25 cases of osteosynthesis Of the cervical spine using the AO H-plate. All the patients were stable enough postoperatively to allow early mobilization with a cervicothoracic orthosis. Average follow up was 31.2 months. All the grafts fused; however, complications occurred in 36% of the cases. The majority of these complications did not affect the long-term clinical result. This method involves potential risks to the spinal cord, esophagus, carotid structures, and laryngeal nerve. It should therefore be used in carefully selected cases.
A MODEL OF CORTICAL WINDOW HEALING IN THE RABBIT
Authors: Fyda Thomas M , Callaghan John J , Fulghum Christian S , Seaber Anthony V , Myers Barry S
Published: April 2021

ABSTRACT

A rabbit femur cortical window model was developed to study the time-dependent mechanical and radiographic changes with various treatments of surgically created windows. In the present experiment the timedependent differences in torsional whole bone strength between femora treated with window replacement and those treated without replacement were evaluated. The 3.175 mm diameter windows were surgically created with a power trephine at the lateral femoral isthmus unilaterally, with the contralateral femur serving as a paired control. In one group of animals the window was reconstructed by replacement of the excised cortical plug while in the other group the window was left unreplaced. Each group was divided into three subgroups sacrificed at 3, 6, and 9 weeks postoperatively. Lateral radiographs were obtained immediately prior to sacrifice. After sacrifice bilateral femora were harvested and loaded to failure on a torsional testing apparatus to obtain values for ultimate torque, maximum angle of deformation, and energy capacity expressed as percent of paired control. Replacement resulted in significantly greater whole bone strength (P<.041), and strength increased significantly with time (F<.006). Radiographic appearance correlated significantly with both treatment and time, but not strength. The model was sensitive to both treatment-dependent and time-dependent effects, demonstrating potential for evaluation of other cortical window treatments.
TRICON HYBRID TOTAL KNEE ARTHROPLASTY: A REVIEW OF 81 KNEES FOLLOWED FOR 2 TO 4 YEARS
Authors: Briggs J Richard , Augenstein Jan S
Published: April 2021

ABSTRACT

The authors discuss the results of 81 total knee arthroplasties in 65 patients performed between April 1987 and April 1989 using a Tricon hybrid system, consisting of the Tricon M bio-ingrowth femoral prosthesis and the Tricon C cemented tibial component. The Tricon metal-backed patella was used until February 29, 1988, when the all-plastic Tricon C patella was introduced. With an average follow up of 24 months (range: 12 to 48), 38 arthroplasties using this hybrid system were rated as excellent (47%) and 38 were rated as good (47%). The Hospital for Special Surgery scores, which averaged 53 preoperatively, averaged 80 at the most recent follow-up assessment. At the most recent follow-up assessment, 79% of osteoarthritis patients and 56% of rheumatoid arthritis patients have no pain at rest, while 19% of osteoarthritis patients and 44% of rheumatoid arthritis patients have mild pain at rest. Sixty-four percent of osteoarthritis patients and 33% of rheumatoid arthritis patients have no pain while walking, whereas 26% of osteoarthritis patients and 56% of rheumatoid arthritis patients have mild pain while walking. Postoperative complications included fragmentation of the patella in five patients, all occurring with the metal-backed patella. Five patients also experienced patellar subluxation (two metal-backed and three all-polyethylene). One patient had deep venous thrombosis which was treated successfully by re-hospitalization and heparin therapy; one patient with chronic heart disease expired 4 days postoperatively. Use of the Tricon hybrid system has resulted in 94% of all patients having a good or excellent result an average of 24 months postoperatively. Moreover, problems of patellar fracture and subluxation have not occurred since we began using the all-plastic patella.
CERVICAL SPINAL FRACTURES IN ALPINE SKIERS
Authors: Kip Phelps , Hunter Robert E
Published: April 2021

ABSTRACT

A 5-year review of skiing injuries in the Aspen/Snowmass area revealed 18 cervical fractures. This represents a yearly average of 3.6 fractures (range: 2 to 5). There were 16 men and 2 women identified, with an average age of 40.8 years (range: 20 to 73). Using estimates of skier days and total injuries, cervical fractures represented approximately 0.1% of all skiing injuries. Six of 18 injuries (33%) were avulsion injuries of the spinous processes and were treated symptomatically with a soft collar. However, five patients had neurologic involvement secondary to fracture displacement, two with lasting quadriparesis. In addition, there was one death attributed to cervical fracture. Forty-four percent of the patients had associated injuries, most commonly facial and head (33%). The three oldest patients (average age: 67 years, range: 57 to 73) had three of the more serious injuries. Two of these patients were the quadriplegics, and a third required halo stabilization of bilateral C2 facet fractures. Typically, those patients who were involved in collisions with immovable objects (trees or fences) had more severe injuries and a greater chance of neurologic involvement.
Factors Influencing Polyethylene Wear
Authors: Berry Daniel J
Published: April 2021

Materials Limitations