bluuebunny/crossref_metadata_2025 huggingface dataset:
Sky islands of the Cameroon Volcanic Line support the westernmost clade of five new Typoderus weevils (Coleoptera: Curculionidae: Molytinae)
Authors: Grebennikov Vasily V.
Published: April 2021

Abstract

The weevil genusTypoderusis for the first time reported west of the Congo basin. Analysis of 2,136 aligned positions from one mitochondrial and two nuclear fragments revealed a moderately supported clade of five new Cameroonian species:T. amphionsp. nov.(Mt. Oku),T. canthussp. nov. (Mt. Oku),T. clytiussp. nov.(Mt. Cameroon),T. iphitussp. nov.(Mt. Kupe) andT. telamonsp. nov.(Mt. Kupe). Molecular clock analysis of 20 DNA barcode fragments using a fixed substitution rate estimated divergences within this clade to be during the Middle to Late Miocene (10.5–5.4 million years ago, MYA), which pre-dates the onset of the Pliocene-Pleistocene global climatic fluctuations and corresponding cycles of African forest size fluctuation. Such relatively old dates are unexpected and might reflect four unavoidable shortcomings of the temporal analysis: 1. undersampled ingroup, 2. scarcity of comparative temporal data for other animal clades from the Cameroon Volcanic Line, 3. oversimplification of a fixed-rate molecular clock approach using a single maternally-inherited protein-coding marker and 4. possible overestimation of comparatively old ages when using largely saturated mitochondrial sequences. Two obscure weevil species from the Republic of the Congo are hypothesized to belong to the genusTypoderus:T. distinctus(Hoffmann, 1968)comb. nov.(from Anchonidium subgenus Neoanchonidium) andT. baloghi(Hoffmann, 1968)comb. nov.(from Anchonidium subgenus Subanchonidium). Three genus-group names are newly synonymized underTypoderus:EntypoderusVoss, 1965syn. nov.(the only non-nominative subgenus ofTypoderus),NeoanchonidiumHoffmann, 1968syn. nov.(subgenus ofAnchonidium) andSubanchonidiumHoffmann, 1968syn. nov.(subgenus ofAnchonidium). Habitus images and other supplementary information of all sequenced specimens are available online at dx.doi.org/10.5883/DS-VGDS005 and dx.doi.org/10.5883/DS-VGDS006.
An experimental study on phytochemical composition and memory enhancing effect of Ginkgo biloba seed extract
Authors: Tomova Teodora , Doncheva Nina , Mihaylova Anita , Kostadinov Ilia , Peychev Lyudmil , Argirova Mariana
Published: April 2021

Introduction: The Ginkgo biloba L. tree is considered as one of the oldest species on Earth. It is known as a “living fossil” dating back approximately 200 million years. Both the leaves and seeds of this tree have been used for millennia in traditional Chinese medicine.

Aim: To study the phytochemical profile of Gingko biloba seed extract (GBSE) and its memory enhancing effects.

Materials and methods: Liquid chromatography with mass detection (LC-MS) was performed for phytochemical analyses of the extracts. For the in vivo experiments, male Wistar rats were divided randomly into 5 groups (n=8): saline; piracetam;  GBSE 50; 100, and 200 mg/kg b.w. Y-maze, T-maze, step-down passive avoidance and novel object recognition test (NORT) were performed. The observed parameters were: percentage of spontaneous alternations (% SA), working memory index, latency of reaction and recognition index, respectively. Statistical analysis was done using SPSS 19.

Results: LC-MS analysis showed the presence of the flavonoids quercetin, kaempferol and isorhamnetin (as aglycones), the ginkgolides A, B, C, J, and bilobalide. In Y-maze task, the groups treated with 50 and 100 mg/kg of GBSE significantly increased the % SA during the memory test compared to saline (p<0.05). In T-maze test, the three experimental groups with GBSE significantly increased the working memory index in comparison with that of the control group (p<0.05). In step-down test, the animals receiving 100 mg/kg b.w. GBSE, notably increased the latency during both retention tests (p<0.05 and p<0.01, respectively). In NORT, only the animals with the middle dose of GBSE ameliorated the recognition index when compared to saline (p<0.05).

Conclusions: GBSE enhances spatial working memory, recognition memory, and short- and long-term recall in naïve rats due to the synergic effects of detected flavonoids and terpene lactones on brain functions. The brain structures involved are probably the hippocampus and prefrontal cortex.
FROM THE NATIONAL FEDERATION OF LICENSED PRACTICAL NURSES
Authors: Crowley Teresa M
Published: April 2021

Growing Up with the NFLPN Continuing Education Achievement Point Program*
Methods of Teaching - Revisited Brainstorming
Authors: Cooper Signe S
Published: April 2021

This is the third in a series of articles describing various methods of teaching. Readers are invited to submit short articles on strategies they have found useful in teaching adults.
Meeting Objectives Through Planned Seating Design
Authors: Johnson Suzanne Hall
Published: April 2021

Continuing Education Coordinators can design sealing arrangements which help participants to meet course objectives. This article reviews the advantages and disadvantages of different seating designs in helping participants to meet specific objectives.
Nursing Service Standards as Context for Self-Assessment
Authors: Chase Bea A
Published: April 2021

This article discusses the nature and importance of the ANA Standards for Nursing Services, and the problems inherent in assessing implementation of broadly written professional standards. It then presents a model questionnaire designed to assess the learning needs of nursing service administrators in terms of competencies needed for implementation of the ANA Standards. Results of an initial administration, and some implications of these results for graduate nurse education in Nursing Administration and particularly for continuing education programs are described.
Reduction in Nurses' Death Anxiety Following a Death Awareness Workshop
Authors: Murphy Patricia A
Published: April 2021

ABSTRACT

The purpose of this study was to measure the effects of a death awareness workshop on the death anxiety of 150 registered nurses. This quasi-experimental design used two groups of subjects. One group experienced the workshop while the other did not and served as a control group. Templer's Death Anxiety Scale was used to measure the dependent variable.

The results indicate that the workshop did decrease the nurses' death anxiety. The discussion of the findings and recommendations for further study are presented.
Personal Accounts of Satisfying and Unsatisfying Nursing Experiences as a Needs Assessment Strategy
Authors: MacDonald R Isabel , Grogin Esther R
Published: April 2021

ABSTRACT

This article describes the assessment process by which learning needs of a select group of nurses in a forensic psychiatric setting were identified and used for continuing education (CE) program planning. To determine whether a gap existed between what the nurses currently knew and what they needed to know in order to have a sense of accomplishment, their personal accounts of satisfying and unsatisfying nursing experiences were analyzed. The factors that influenced these experiences were categorized according to a theory of basic human needs, and learning needs were identified from those categories. Implications for the planning of content and methodology of CE programs for the study group were then developed.
Effective Teacher Characteristics Identified by Adult Learners in Nursing
Authors: Eason Frances Rogers , Corbett Robin Webb
Published: April 2021

ABSTRACT

What characteristics should adult education nursing faculty use to get and maintain the attention and interest of learners? There is a dearth of research or literature available to guide nursing faculty in "grabbing" the learner's interest or attention. Thus, the outcome of this project identified 20 attributes as effective teacher characteristics perceived by learners. Further, these attributes were used to generate a checklist to enhance an educator's ability to hone in on salient characteristics desired by nursing continuing education learners. This checklist, "Be Prepared to Teach," will assist the educator to utilize both professional and personal characteristics perceived as effective by adult learners.
Maintaining Clinical Excellence in a Weekend Alternative Program: The Role of the Divisional Clinical Manager
Authors: Elliott Dolores , Gould Marie T , Hickey Mary , Stablein Dona
Published: April 2021

ABSTRACT

Many innovative management changes designed to promote clinical excellence and scholarship were undertaken by the nursing executive team at our 821-bed tertiary care teaching hospital. Included in diese changes was the creation of the divisional clinical manager (DCM). The purpose of this article is to describe how diese weekend managers employees contribute to the overall objectives of providing consistent supervision, clinical support and a rich continuing education program.
Teaching Reliability and Validity: Rin with Classroom Applications
Authors: Froman Robin D , Owen Steven V
Published: April 2021

ABSTRACT

In addition to the basic role of educating and facilitating learning, in recent years, staff development educators and continuing educators also have assumed a major role of facilitating research in many institutions. As more emphasis is placed on bedside research, stimulating staff interest has been a challenge. This article describes a fun way to help staff members acquire or refocus on skills and concepts essential to clinical research.
Educating Nurses in Political Process: A Growing Need
Authors: Winter Kathleen
Published: April 2021

ABSTRACT

If we are to advance the profession of nursing, we must educate nurses to become key participants in the formulation of health policy. If we fail to do this, others will make decisions that affect our practice without our input. A growing number of nurses are recognizing the need to increase our power, and we understand that political participation provides a pathway to power. We must continue to increase the number of nurses who are politically astute and active in order to achieve our goal. The most effective way to accomplish this is to educate large numbers of staff nurses for this vital role. This article suggests educational strategies and methods that can be utilized in continuing education programs to begin the political education process.
The Art of Contracting With Speakers: An Overlooked Strategy
Authors: Cox Helen C , Burson Shelley Z
Published: April 2021

ABSTRACT

In producing quality continuing education courses, contracting with and establishing rapport with speakers is as important as marketing the course itself. Presented in this article are four phases of working with speakers: initial phase, midpoint phase, course presentation phase, and post-course phase. Not only do these phases assist the continuing education program staff in developing a highly organized and well-planned program, but also they offer numerous benefits to speakers so that they can feel comfortable with all arrangements. Thus, the learning atmosphere is one in which the speaker can relax and fully enjoy the continuing education experience.
Financial Management for Nurse Managers-The Bottom Line for Renewal
Authors: Consolvo Carol Ann , Peters Maribeth
Published: April 2021

ABSTRACT

Cost-effective health care has become the hospital motto for the 1990s. A great majority of costs can be controlled on individual nursing units, but many clinically expert nurse managers lack skills in financial management. Our goal was to teach such skills in a framework in which cost was balanced with quality. The three-day course emphasized leadership skills and management styles, change and renewal, solutions to problems of nurse turnover, and specific financial strategies. Evaluations of the course were positive and demonstrated one way in which valuable nurse managers can learn new skills to keep up with current needs.
CE News
Authors: Anonymous
Published: April 2021

COCESD Honors Excellence
Preceptorship Policy: A Tool for Success
Authors: Kramer Nikki
Published: April 2021

ABSTRACT

A preceptor policy can form the basis for all elements of a successful program. This article identifies the essential components of a nurse preceptorship program and the responsibilities of the nurse preceptor, preceptee, nurse manager, and staff development educator. Guidelines are included for selecting a nurse-preceptor.
Introductions: Necessary Formality or Poetic Prelude?
Authors: Galarowicz LeaRae
Published: April 2021

ABSTRACT

Whether we are introducing a program, a speaker, or an issue, our purpose is to convey information, spark interest, and create an attitude, preferably a positive one. Many of us tackle the challenge of introductions lightly, exerting no more time and energy than minimally necessary. Is this lack of preparation detrimental to our purpose? This article suggests that introductions can significantly affect the success of a gathering. Specific ways to enrich an introduction are presented.
Concept Maps: Linking Nursing Theory to Clinical Nursing Practice
Authors: Daley Barbara J
Published: April 2021

ABSTRACT

The purpose of this article is to offer a different methodology for teaching and learning in continuing nursing education and staff development This article describes a qualitative research study that analyzed how linkages are made between theoretical material and clinical nursing practice. Findings indicate that nursing students did not link the elements of nursing process together, that clinical preparation was not linked to theoretical material, that the meaning students made of the information was different than the instructors' and that concepts from the basic sciences were not incorporated into student meaning structures. Implications for the use of concept maps as an educational strategy in continuing nursing education are drawn.
Teaching Nursing Delegation: Analyzing Nurse Practice Acts
Authors: Johnson Suzanne Hall
Published: April 2021

ABSTRACT

Teaching delegation to nurses, especially for those nurses who have mostly practiced in primary nursing, is challenging. Many staff development and continuing education instructors are teaching delegation principles to nurses today because good delegation skills are needed to effectively implement current skill-mix and patient-focused care changes. In these courses, nurses almost always want guidelines on what they can and cannot delegate to unlicensed assistive personnel and LPN/LVNs. The best foundation for teaching what can and cannot be delegated is the nursing practice act in the state, even though analyzing state practice acts can be cumbersome. Analyzing practice acts as the basis for teaching delegation principles is a critical requirement for today's staff development/continuing educator.
Nurse Administrators' Perceptions of the Impact of Continuing Nursing Education in Underserved Areas
Authors: Sherwood Gwen
Published: April 2021

ABSTRACT

Qualitative inquiry can provide new dimensions to existing knowledge about how nurses use information from continuing education participation in practice. This study offers descriptions from the perspective of nurse administrators in an underserved area and a time of shrinking resources of nurses' application and use of knowledge gained from continuing education participation. Summarized within a model of change, learning was expressed in personal and professional dimensions including stimulus for innovation, educational and career mobility, networking, sharing knowledge, problem-solving, and improving patient care. Change indicators were the infrastructure linking the implementation in professional practice.
Using Metacognition to Promote Certification Success: The Testing Health Promotion Plan
Authors: Beitz Janice M
Published: April 2021

ABSTRACT

Metacognition, the process of knowing one's personal learning behaviors, is a powerful force in the educational repertoire of nursing staff development faculty who seek to promote optimal learning outcomes for practicing nurses. Metacognition also supports major goals of educational evaluation which include improvements in learning, instruction, and performance. In this article, metacognition is scrutinized from the perspectives of learning theory and memory processing. Implications for promoting successful certification results are presented.
Domains off Learning: Interdependent Components of Achievable Learning Outcomes
Authors: Menix Kristi D
Published: April 2021

ABSTRACT

"Domains of learning" refers to the three separate, yet interdependent components of learning outcomes achievable by human learners. These domains-cognitive, affective, and psychomotor-represent various categories and levels of learning complexity and are commonly referred to as educational taxonomies. The cognitive domain refers to knowledge attainment and mental/intellectual processes. The affective domain characterizes the emotional arena reflected by learners' beliefs, values and interests. The psychomotor domain reflects learning behavior achieved through neuromuscular motor activities. Educators use the domains to assist in determination of learning objectives essential to planning, implementing and evaluating teaching-learning processes and outcomes of human learners across the life span. Actual instances of domain use from programs, interviews and the literature complement the theoretical notions presented in this article.
Defining Home Health Care Nursing: Implications for Continuing Nursing Education
Authors: Daley Barbara J , Miller Maggie
Published: April 2021

ABSTRACT

The purpose of this qualitative interpretivist study was to analyze and articulate the characteristics of nursing practice in the home health care context. Researchers sought to describe expert home health care nursing practice and how it developed. Twenty-one nurses, at various stages of practice development, were asked to write three clinical narratives describing their home health care practice. Data were analyzed to elicit themes and characteristics of nursing practice in the home health care context. Findings indicate that in the context of home health care, expert nursing practice develops along a continuum, until nurses can integrate physiological data with environmental and family data to provide seamless, intuitive, and highly complex nursing care. The results of this research can assist continuing education and staff development providers as they develop educational programs designed to facilitate professional development of new graduates and newly employed nurses in home health care.
The North Carolina AHEC Self-Paced RN Refresher Program: An Evaluation of the First Two Years
Authors: Alden Kathryn Rhodes , Carrozza Michael A
Published: April 2021

ABSTRACT

The North Carolina Area Health Education Centers (AHEC) Self-Paced RN Refresher Program was designed to promote reentry into practice for inactive nurses. The program consists of a didactic self-study correspondence course and a clinical practicum whereby the refresher nurse works one-on-one with a nurse preceptor. At the end of the first two years, the program was evaluated to determine its effectiveness in terms of participant satisfaction and return to nursing practice and to describe the nurse refresher population demographically. Participants reported a high degree of satisfaction; 69% of nurses who completed the program returned to nursing practice. The typical refresher student is a female Caucasian in her forties, married, and graduated from a diploma nursing program.
Sexuality in Aging: Implications for Nursing Facility Staff
Authors: Steinke Elaine E
Published: April 2021

ABSTRACT

Sexuality is an area that is frequently overlooked by staff who work with the elderly in nursing facilities. The nursing literature supports a need for education of nursing facility staff about sexual issues and concerns of facility residents. This article describes the effect of an educational intervention on one sample of facility staff and recommends strategies for the education and practice of staff members employed in nursing facilities.
Mundanatories No More
Authors: Markiewicz Terry , Wells Nancy L
Published: April 2021

ABSTRACT

Mandated educational programs are often a source of dread for instructor and participant alike. The nurse educator, the Clinical Nurse Specialist for Intravenous (IV) Therapy and Nutritional Support, and the Clinical Program Manager for IV Therapy devised a self-paced program to validate the competence of Licensed Practical Nurses (LPNs) in caring for patients receiving IV therapy. The program consisted of learning stations which utilized a variety of formats to satisfy the objectives of the program. The LPN could see, hear about, read about, and ask questions related to IV therapy. Participants could take as much or as little time as was needed to review the stations. Documentation of competence was the completed quiz which became part of the LPN's personnel file. As an added incentive, the returned quiz was also used as an entry form to win door prizes. Compliance for the program was about 71%. Areas for improvement were identified. Feedback concerning the program from participants and planning team alike was very positive.
Surveying Public Health Nurses' Continuing Education Needs: Collaboration of Practice and Academia
Authors: Kelly Carole , Cowell Julia Muennich , Stevens Rachel
Published: April 2021

ABSTRACT

In the last twenty years, entry level requirements for public health nursing have shifted to less and less educational preparation. Many agencies hire registered nurses with associate degree or diploma preparation who have no experience. The shift in entry level requirements has challenged public health nursing administrators and educators to examine continuing education needs to meet knowledge deficits among public health nurses. The study reported here presente findings from a national survey of 56 state and territorial health departments. The results clarify the continuing education needs and issues related to the educational gaps of public health nurses of the 1990s.
A Holistic Model for Moving Toward Excellence in Chaotic Times
Authors: Evans Judith A
Published: April 2021

ABSTRACT

Background: Staff development experts in a tertiary-care hospital were searching for a holistic approach to facilitating improved outcomes.

Method: Staff development experts, clinical nurse specialists, and clinical managers developed a model that provides a framework for educators to integrate their energies with those of other leaders in order to create a holistic approach to the goal of achieving excellence.

Results: The model that is proposed links strategies for change with outcome evaluation.

Conclusions: The model provides a conceptual lens that helps nurse leaders focus on organizational assessment, strategies to improve the work environment, and the evaluation of outcomes. The model is useful for guiding practice as well as research.
Refresher Courses for the 21st Century
Authors: Porta Bridget A , Pearson Gayle A
Published: April 2021

ABSTRACT

One hundred eighty-one (n=181) nurses who completed the Rutgers Nurse Refresher course between the years of 1991 and 1994 were surveyed to determine the outcome of the course in relation to successor return to nursing practice. Of the number of nurses who responded (n=111), 78 nurses (70.2%) returned to practice as RNs. Nurses who completed the course in 1991 and 1992 had higher employment rates as RNs than those nurses who completed the course in 1993 and 1994. Of the 78 nurses who found employment as RNs, 55 nurses (71%) found employment in other-than-hospital settings. An increase in employment in long-term care and other settings, such an physician offices and school nursing was found when the data were analyzed by setting and year of course completion. Findings of the survey are discussed in relationship to changes in health care delivery as well as recommendations for curriculum revision.
Comparing the Effectiveness of Two Methods of Delivering Continuing Education to School Nurses
Authors: Blaber Christine , Jordans Ruta , Weyl Estelle
Published: April 2021

ABSTRACT

On-site continuing education opportunities for school nurses are limited due to school nurses' geographic dispersion, yet the need is great. This study was designed to create, deliver, and evaluate two methods of providing a continuing education course on comprehensive school health programming for middle school and high school nurses: a 4-day on-site workshop and a six-module home-study course. The home-study course was less expensive to deliver than the workshop, but participants were less likely to complete it. The 4-day workshop had a higher rate of completion and led to greater networking and a stronger sense of self-efficacy among participants.
Advancing Excellence in Community Health Nursing Through Evidence-Based National Standards of Practice
Authors: Belita Emily , Schofield Ruth , Currie Genevieve , Dietrich Leurer Marie , Dosani Aliyah , Cusack Cheryl , Danaher Audrey , Dilworth Katie , Etowa Josephine , Filion Francoise , Joseph Cheyenne , Lukewich Julia , MacDonald Jo-Ann , Reid-Haughian Cheryl
Published: April 2021

Background:

Current standards of practice are necessary to ensure safe nursing practice in Canada and across the world. This article aimed to describe and present findings from the rigorous review process undertaken to update the 2011 Canadian Community Health Nursing Standards of Practice.

Method:

A revision process included a scoping review of the literature, focus groups, and a modified Delphi method.

Results:

Through the inclusive consultation process, 495 community health nurses enhanced the content of the standards with respect to cultural safety, cultural humility, Indigenous health and ways of knowing, health equity, and evidence-informed practice.

Conclusion:

This comprehensive revision process can guide other nursing specialty groups developing or revising specialized practice standards in Canada and across the world.

[
J Contin Educ Nurs
. 2021;52(4):168–175.]
Ethical Problems in Psychiatric Practice
Authors: Ehrhardt Helmut E
Published: April 2021

ETHICAL ASPECTS OF PSYCHIATRY: A GERMAN PSYCHIATRISTS VIEW
Ethical Aspects of Enforced Medical Treatment in Patients with Psychiatric Illness
Authors: Blum Austin W. , Patron Romero Victor G. , Shima Carolyn
Published: April 2021

Caring for patients who lack decision-making capacity raises a host of ethical challenges. These challenges may be amplified when a patient's lack of capacity is related to serious mental illness. In this article, we suggest an approach to the care of psychiatrically ill patients who are unable to make reasoned medical decisions. Special consideration is paid to the question of when it is appropriate to override a patient's treatment preferences.[Psychiatr Ann. 2021;51(3):118–122.]
Assessment of Need for Guardianship: What Is the Role of the Psychiatrist?
Authors: Matrick Andrew , Babb Emma , Dinwiddie Stephen H.
Published: April 2021

Decisional incapacity is a common complication of many psychiatric illnesses, including (but not limited to) conditions such as severe mood disorders, schizophrenia and related conditions, traumatic or other acquired brain injuries, and severe neurocognitive disorders. Although in treatment settings it is most frequently recognized in the context of medical decision-making, decisional incapacity may manifest in many ways that involve the patient's ability to live autonomously.[Psychiatr Ann. 2021;51(3):112–117.]
MAJOR TENDON REPAIRS WITH DACRON VASCULAR GRAFT SUTURE
Authors: Frazier Calvin H , Clark Edwin M
Published: April 2021

ABSTRACT: Achilles and patellar tendon tears in nine patients were repaired with 5 mm Dacron vascular grafts. There have been no failures with this method of fixation. In the patients we studied this method permitted earlier mobilization of joints.
LIPOHEMARTHROSIS: ITS OCCURRENCE WITH OCCULT CORTICAL FRACTURE OF THE KNEE
Authors: Train John S , Hermann George
Published: April 2021

ABSTRACT: Three patients with fat fluid levels in the knee following trauma were shown to have small cortical fractures. None of the fractures was visible in routine roentgenograms. Because of the finding of the lipohemoarthrosis in each case, additional roentgenograms were taken until small cortical fractures could be visualized.
THE ORTHOPEDIC SURGEON AND HEMOCHROMATOSIS
Authors: Bellamy Ray E
Published: April 2021

ABSTRACT: In many communities the orthopedic surgeon who also functions as the rheumatologist may have the best opportunity to make an early diagnosis of hemochromatosis by recognizing the characteristic features of this form of arthritis, which is associated with skin pigmentation, liver disease, or diabetes. Elevated serum iron levels and saturation of serum iron-binding capacity suggest the diagnosis, and a highly elevated serum ferritin level confirms it. Physicians who treat patients with arthritis, performing hand, bunion, or joint replacement surgery, need to be alert for this disorder.
PROXIMAL TIBIAL EPIPHYSEAL FRACTURE
Authors: Greenfield Gerald Q
Published: April 2021

ABSTRACT: This article presents a case of fracture of the proximal tibial epiphysis. The diagnostic value of stress roentgenograms is discussed, featuring the use of tomography. Potential complications and treatment options also are discussed.
SOLITARY OSTEOCHONDROMA OF THE CERVICAL SPINE
Authors: Goldberg Michael J , Belsky Mark R , Brader Donna , Prager Robert J
Published: April 2021

ABSTRACT: Solitary osteochondroma of the cervical spine is extremely rare. We reviewed the literature on this disorder, studied a case of an osteochondroma arising from the bony margin of the foramen transversarium of the sixth cervical vertebra, and concluded that osteochondroma should be considered in the differential diagnosis of a palpable mass in the neck. Despite the benign histologic nature of osteochondromata, those located in the cervical spine in proximity to vital vascular and neurologic structures should be excised surgically.
PHENOL BLOCK OF THE TIBIAL NERVE IN THE HEMIPLEGIC PATIENT
Authors: Petrillo Claudio R , Chu Dong S , Davis Sanders W
Published: April 2021

ABSTRACT: Selective blocks of the tibial nerve with aqueous solution of 5% phenol, after localization of the nerve by electrical stimulation, were performed in 30 patients with acquired hemiplegia for treatment of severe spasticity of the foot plantar flexors and ankle clonus. Ankle clonus disappeared in all patients and resistance to passive stretch was reduced substantially immediately after the procedure; orthotic fitting and ambulation training then were possible. Longterm followup (averaging 12.9 months) showed the gait to be improved and spasticity decreased in all patients; there were no indications for further treatment of plantar flexor spasticity. Fixed equinus deformity was prevented in all cases. The only significant complication was the development of paresthesias in eight patients (26.6%) The simplicity of the procedure, the functional results observed immediately, its longlasting effect, and the lack of serious complications, warrant its more widespread use in the treatment and prevention of deformities in the spastic foot of the hemiplegic patient. However, there should be further study about prevention of paresthesias, which occurred in a significant percentage of patients in this study.
VASTUS MEDIALIS OBLIQUE: AN ANATOMIC AND PHYSIOLOGIC STUDY
Authors: Bose Kamal , Kanagasuntheram R , Osman M B H
Published: April 2021

ABSTRACT: The lower part of the vastus medialis, which originates chiefly from the tendon of the adductor magnus, has been designated as the "vastus medialis oblique." This muscle is peculiar to man. The fibers of the muscle are mostly horizontal; therefore they are in a unique position to stabilize the patella against the femur in the later stages of extension of the knee. This article details the anatomic and physiologic features of the vastus medialis oblique.
Early, Design-Related Failure in Total Knee Arthroplasty A Case Report
Authors: Cook Stephen D , Barrack Robert L , Renz Eric A , Edmunds J Ollie , Haddad Ray J
Published: April 2021

ABSTRACT: The analysis of retrieved implant devices can provide information unavailable through any other method. With the variety of implant designs rapidly increasing, retrieval and analysis of failed cases is an important means of evaluating existing designs, as well as suggesting modifications that might improve implant performance. This paper describes a case in which design considerations, rather than mechanical or material failure, appeared to be a major contributing factor.

Sixteen months after insertion of a Howmedica Kinematic Rotating Hinge knee, the patient complained of barometric pain in the knee. Roentgenograms at that time showed the metallic axle component to be protruding laterally. Upon retrieval the polyethylene bumper-lock component exhibited deep scalloping on its surface, which unlocked the axle and allowed it to slide out.
The Os Vesalianum: An Unusual Cause of Lateral Foot Pain A Case Report and Review of the Literature
Authors: Smith Angela D , Carter John R , Marcus Randall E
Published: April 2021

ABSTRACT: We describe a case of a symptomatic os Vesalianum, a rarely found accessory ossicle of the foot, which should be considered as a possible source of lateral foot pain. The condition should be differentiated from the fifth metatarsal epiphysis and the os peronei in patients who have the roentgenographic finding of an ossicle immediately posterolateral to the base of the fifth metatarsal.
Restoration of Movement by Electrical Stimulation: A Contemporary View of the Basic Problems
Authors: PhD M
Published: April 2021

ABSTRACT: The biomechanics of movement are reviewed from the standpoint of restoration of joint function of paralyzed patients by functional electrical stimulation. The physiological processes active in both generating and maintaining well-regulated movement are analyzed in conjunction with current stimulation interface techniques, and some problems are identified. The need for improvements in the external control of motor unit recruitment, synergy and proprioceptive/kinesthetic feedback are presented from a bioengineering perspective.
The Influence of Intermittent Micromovement Upon the Healing of Experimental Fractures
Authors: Kenwright John , Goodship Allen , Evans Mervyn
Published: April 2021

ABSTRACT: The preliminary results are presented of an investigation into the influence of intermittent axial cyclical loading, applied for a very short period each day (500 cycles over 17 minutes), upon experimental fracture healing in sheep tibiae. The application of the intermittent stimulus is associated with the earlier appearance of external callus seen within two weeks of osteotomy. There is also a significant increase in fracture stiffness to bending appearing at eight to ten weeks from osteotomy in the cyclically loaded group. Post mortem torsional stiffness assessed at 12 weeks from osteotomy is significantly greater in the loaded group.
Standardized Method to Measure the Fixation Quality of a Pin: Theoretical Derivation and Preliminary Results
Authors: Cornelissen M , Burny F , Van der Perre G , Donkerwolcke M
Published: April 2021

ABSTRACT: A vibration method to measure the quality of anchorage of an external fixation pin is proposed. Attention is paid to the interpretation and standardization of the measurements to obtain reliable results. The preliminary results of a series of in viva measurements on tibial and radial pins are presented. The progress with time and correlation with the maximum torque moment at the time of retrieval are shown.
Serial Strain Gauge Measurement of Bone Healing in Hoffmann® External Fixation
Authors: Nishimura Norihisa
Published: April 2021

ABSTRACT: In order to better assess callus strength for postoperative management of Hoffmann external fixation patients, the author attempted to estimate the amount of strain when bending or compressing the fracture site with a strain gauge glued to the middle of a connecting rod. Calculations in a computer architectural model of a plane beam structure show that the amount of strain on a connecting rod would decrease hyperbolically when the mechanical properties of the callus increased. Strength testing in a cadaveric crural bone confirms the importance of callus volume. The serial strain gauge measurement technique was applied to a series of 23 cases treated with Hoffmann external fixation, 20 of which achieved bone healing. On the basis of the bone healing curve obtained with the strain gauge measurements, the healing process is classified into five types.
Hoffmann® External Fixation of Fractures of the Radius and Ulna: A Prospective Study of Fifty-three Patients
Authors: Andrianne Y , Donkerwolcke M , Hinsenkamp M , Quintin J , Rasquin C , El Banna S , Burny F
Published: April 2021

ABSTRACT: The absence of statistical studies concerning external fixation in adult forearm fractures prompted this prospective clinical study of 53 patients with 84 fractured bones treated by external elastic fixation, using a half-frame configuration. The radial nerve is the main anatomical obstacle to be considered. Whenever possible, closed methods of reduction are used. The rate of pseudarthrosis (6% of the treated bones) is comparable or even lower than the greatly varying figures published in the literature. External fixation seems capable of restoring and maintaining the precise anatomical configuration of the forearm bones.
Osteochondroma of the First Rib with Pseudarthrosis with the Clavicle: A Rare Cause for Shoulder Pain: A Case Report
Authors: Cain Paul R , Fu Freddie H
Published: April 2021

ABSTRACT: Shoulder pain with abduction is a common clinical sign associated with an impingement syndrome. This article describes a patient with an osteochondroma of the first rib that formed a pseudarthrosis with the clavicle, which limited its rotation, leading to pain with abduction of the shoulder. The available literature concerning this rare phenomenon is discussed, and the recommended treatment outlined.
Functional Evaluation of Tendon Interposition Arthroplasty of the Trapeziometacarpal Joint
Authors: Wilchinsky Mark E , Malek Nabil
Published: April 2021

ABSTRACT: The carpometacarpal joint of the thumb is a frequent site of pain and disability secondary to arthritis. Surgical treatment for this disease has included arthrodesis, excision, total joint replacement, ligament reconstruction, and tendon or synthetic interposition arthroplasty. The aim of treatment is a functional, pain-free thumb. This study includes 11 patients operated upon utilizing tendon interposition arthroplasty; three patients had bilateral surgery. The primary disease was osteoarthritis in nine patients and rheumatoid arthritis in two. Average followup length postoperatively was 53 months. All patients experienced increased function and alleviation of pain after surgery. Average key pinch measured 8.4 pounds in the osteoarthritic female group. Palmar and radial abduction as well as opposition were full postoperatively. This study shows that tendon arthroplasty provides a painless, well-functioning thumb. Its main advantages over other procedures are the acceptable range of motion obtained, a short postoperative immobilization period, and the ease of its surgical technique. Indexing terms: tendon arthroplasty; osteoarthritis; rheumatoid arthritis; trapeziometacarpal joint.
Electromyographic Control of Functional Electrical Stimulation in Selected Patients
Authors: Graupe D , Kohn K H , Basseas S , Naccarato E
Published: April 2021

ABSTRACT: The paper describes initial results of above-lesion electromyographic (EMG) controlled functional electrical stimulation (FES) of paraplegics. Such controlled stimulation is to provide upper-motor-neuron paraplegics (T5 to T12) with self-controlled standing and some walking without braces and with only the help of walkers or crutches. The above-lesion EMG signal employed serves to map the posture of the patient's upper trunk via a computerized mapping of the temporal patterns of that EMG. Such control also has an inherent safety feature in that it prevents the patient from performing a lower-limb movement via FES unless his trunk posture is adequate.
Biomechanical Analysis of Patient Using FES Peroneal Brace and Further Developments
Authors: van Griethuysen C M , Day G A
Published: April 2021

ABSTRACT: The effect of functional electrical stimulation on gait and postural sway of hemiplegics was studied. Patients utilizing the Underknee Peroneal Stimulator were studied and compared to patients receiving conventional physiotherapy and to normal subjects. Several patients treated with electrical stimulation showed marked improvement in postural sway and ankle control during locomotion. Additional studies on the effect of various stimulation waveforms and pain sensation in a computer-controlled double blind evaluation are discussed.
Posteromedial Dislocation of the Elbow: A Case Report
Authors: Tully John G , Shah Ravindra
Published: April 2021

ABSTRACT: A case is presented in which closed reduction of a dislocated elbow could not be maintained when the forearm was placed in supination. The medial aspect of the patient's posteromedial dislocation was then recognized as significant. Adapting Rangs principles in pediatric patients, the authors again reduced the dislocation, but placed the forearm in pronation, this time maintaining the reduction.
Magnetic Resonance Imaging: Skeletal Applications
Authors: Helms Clyde A , Moon Kirk L , Genant Harry K , Chafetz Neil
Published: April 2021

ABSTRACT: It has been assumed that magnetic resonance imaging (MRI) would have limited utility in visualizing bones, due to the lack of hydrogen atoms in cortical bone. Nonetheless, that same lack makes it possible to clearly distinguish cortical bone from soft tissue and from marrow. Thus, roles are described for magnetic resonance imaging in depicting bone and soft tissue tumors, the spine (including the spinal cord and vertebral discs), and appendicular soft tissue, as well as the detection of avascular necrosis in the hip.
The Use of External Fixation in the Reconstruction of Complex Posterior Cruciate Injuries
Authors: Staeheli John W , Frassica Frank J , Sim Franklin H
Published: April 2021

ABSTRACT: Proper immobilization of the knee after repair or reconstruction of the posterior cruciate ligament is difficult because of the tendency of the tibia to sag posteriorly, placing tension on the repaired structures. We describe the use of external fixation to immobilize the knee after repair or reconstruction of the posterior cruciate ligament. In seven patients, external fixation devices were used postoperatively for immobilization. Ail three patients with acute injury had repair of the avulsed ligament and associated ligamentous injuries. Of the four patients with chronic injury, three underwent reconstructive surgery because of significant injury to other ligaments. The average length of immobilization in the fixator was 45.4 days. The range of motion at last followup averaged 5.7° to 103.5°, and followup was from six to 20 months. Two patients had three complications: one had decreased flexion and the other had a pin tract infection and lacked flexion beyond 90°. All patients were satisfied with the result of surgery: three patients had a 1 + posterior drawer and four had a stable posterior cruciate ligament at folfowup examination. External fixation may be useful in complex knee injuries involving rupture of the posterior cruciate ligament.
Concurrent Variation of Burning Phantom Limb and Stump Fain With Near Surface Blood Flow in the Stump
Authors: Sherman Richard A , Bruno Glenda M
Published: April 2021

ABSTRACT: Thermographic recordings of body temperature were performed on 30 consecutive amputees who reported stump and/or phantom limb pain. Each subject participated in between two and four recording sessions. Whenever possible, subjects came for recording sessions when their pain intensity was different from that of previous sessions. We found that a consistent inverse relationship occurred between intensity of pain and stump temperature relative to that of the intact limb for burning, throbbing, and tingling descriptions of both phantom and stump pain. Heat emanating from the limbs is an accurate reflection of near-surface blood flow. For subjects giving these descriptions of pain, tensing the limb was followed by a decrease in blood flow and an increase in pain. Neither of these relationships held for other descriptions of either phantom or stump pain.
Long-Term Results of Valgus Tibial Osteotomy
Authors: Pachelli Anthony F , Kaufman Eugene E
Published: April 2021

ABSTRACT: Valgus tibial osteotomy is a well-recognized procedure for medial compartment arthritis of the knee. The femorotibial angle must be adequately realigned; most unsatisfactory outcomes result from undercorrection. This study of 27 patients (38 knees) with a valgus tibial osteotomy for unicompartmental arthritis of the knee emphasizes the importance of correct alignment. Alignment outside the acceptable range did accelerate deterioration in these patients, followed for an average of 53 months.

in 25 of the 38 knees (66%) results were good to excellent. An alignment of 6° or more of valgus produced an excellent to good result in 21 of 23 knees (91%). Alignment of less than 6° of valgus yielded excellent to good results in 4 of 15 knees (27%).

Although at the end of one year, 31 of the 38 knees were rated as excellent to good, these knees progressively deteriorated. The knees in 6° or more of valgus seldom deteriorated while those in less than 6° of valgus deteriorated more frequently. A valgus tibial osteotomy is an excellent procedure provided the tisiofemoral angle is realigned to 6° or more of valgus.
SUPPRESSIVE ANTIBIOTIC THERAPY IN CHRONIC PROSTHETIC JOINT INFECTIONS
Authors: Tsukayama Dean T , Wicklund Barbara , Gustilo Ramon B
Published: April 2021

ABSTRACT

Thirteen patients with chronic total joint infections (eight knees, five hips) were treated with suppressive antibiotic therapy and retention of the prosthesis following surgical debridement and 4 to 6 weeks of intravenous antibiotic therapy. These patients faced poor functional outcome after prosthesis removal. After a mean follow up of 37.6 months (range: 24 to 55), only three patients have retained their prostheses. Ten patients required prosthesis removal for recurrent infection a mean of 21.6 months (range: 6 to 48) after starting suppressive therapy. In addition, 38% of patients experienced adverse effects which led to changes in the antibiotic regimen. Suppressive antibiotic therapy in the treatment of chronic prosthesis infections has limited clinical efficacy and is associated with a substantial risk of adverse effects.
RIGID INTERNAL FIXATION FOR SHOULDER ARTHRODESIS
Authors: Stark David M , Bennett James B , Tullos Hugh S
Published: April 2021

ABSTRACT

Fifteen patients underwent a shoulder arthrodesis utilizing standard dynamic compression plate fixation, but with limited postoperative immobilization with only an abduction pillow. In each ease, the position of the extremity relative to the scapula and trunk was recorded immediately postoperatively, at regular intervals until fusion, and at follow-up evaluations. Thirteen of 15 shoulders fused without change of intraoperative position after an average postoperative period of 4 months. One patient lost position in the early postoperative period secondary to inadequate fixation, but subsequently fused. Another who demonstrated a persistent nonunion at IVi years was subsequently explored and underwent a bone graft Four patients complained of residual symptomatic hardware, with two requiring surgical removal of the plate and screws. AU but one patient were satisfied with the clinical result at follow up. Only two patients were within 5° of the preoperatively determined position of 30° abduction, 30° forward flexion, and 30° internal rotation. However, almost all were able to function satisfactorily. The authors concluded that shoulder arthrodesis utilizing rigid internal fixation without postoperative cast or brace immobilization maximizes patient comfort without compromising the success of arthrodesis. However, control of arm position remains inexact and additional modifications are needed to ensure fusion position and to minimize disability.