bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of caesarean section in diabetic vs. non diabetic females undergoing induction of labour at term
Authors: Quraishi Fozia Umber , Jabeen Saima , Yousaf Anum , Gulzar Rukhsana
Published: April 2021

Introduction: Gestational diabetes mellitus (GDM) is a common complication of pregnancy characterized by glucose intolerance recognized during pregnancy. Gestational diabetes is associated with adverse maternal and fetal outcome. Majority of patients with diabetes had induction of labour at term (≥37weeks) to prevent maternal and fetal morbidity especially shoulder dystocia, macrosomia and intrauterine fetal death at term

Objectives:

To find frequency of gestational diabetes (GDM) in patients undergoing induction of labour.

To compare the frequency of caesarean section in diabetic (GDM) and non-diabetic females undergoing induction of labour

Methodology:

Study Type; It was a descriptive case series conducted at the department of Obstetrics and Gynecology, Shalamar Hospital Lahore. Duration of study was six months after approval from IRB.

Sample size; Sample size of 214 cases undergoing induction of labour at term during study period; calculated with 95%confidence level and 3.4% margin of error and taking expected percentage of GDM is 6.9%.

Sampling Technique; purposive sampling

Methodology:

214 females who will fulfill the inclusion criteria were enrolled in the study from labour room of Department of Obstetrics and Gynecology, Shalamar Hospital Lahore. Induction of labour done with tab prostin 3mg single dose and patients having gestational diabetes were identified and frequency of caesarean section in Diabetic and non-diabetic calculated.

Results:

In current study, mean age of the patients was 27.8±4.4 years. Mean gestational age was 37.1±3.8 weeks and mean BMI was 28.6±4.1 kg/m2. Primigravida were 88 (41.1%) and multigravidas were 126 (58.9%). Gestational diabetes was found to be in 36 patients (16.8%). Caesarean section was performed in 77 patients (36%). Comparison of frequency of cesarean section in diabetic (GDM) and non-diabetic females undergoing induction of labour revealed majority of the caesarean sections performed in GDM patients (p=0.007).

Conclusion

In conclusion, our study found a higher incidence of cesarean section than normal delivery in pregnant women with gestational diabetes. Major factors for operational delivery in GDM population included: advanced maternal age and high BMI value.
Association of long term sodium valproate monotherapy and vitamin D3 levels in epileptic children
Authors: Shah Anum , Khan Imran Mahmood , Sherazi Sajid Hussain , Ashfaq Taniah , Shah Sajid Hussain
Published: April 2021

Objective: To determine the association of long term sodium valproate monotherapy and vitamin D3 levels in epileptic children

Methods: This cross-sectional study was conducted in the Department of Pediatrics, Children Hospital, Pakistan Institute of Medical Sciences, Islamabad for six months from 15th February 2019 to 14th August 2019. A total of one hundred and thirty (n=130) children and adolescents of either gender between age 3-18 years who had a history of two seizures at least 24 hours apart in their life and were on sodium valproate monotherapy for more than one year were enrolled in this study through non-probability, consecutive sampling. Serum vitamin D3 (25-hydroxy vitamin D) levels were measured in all the patients at the time of enrolment into the study. All the demographic data and laboratory investigations were entered on the predesigned proforma and analyzed through SPSS version 17.

Results: Vitamin D3 deficiency was found in 47 (36.2%) children which were significantly higher among patients with older age and longer duration of treatment (P<0.05) while gender and BMI of the patients did not show any significant difference (P>0.05).

Conclusion: Significant percentage of epileptic children on sodium valproate monotherapy was found to have vitamin D3 deficiency. Therefore we recommend routine screening of vitamin D3 deficiency in all the epileptic children on long-term sodium valproate therapy followed by vitamin D supplementation in deficient patients.
Percutaneous Nephrolithotomy: A Comparison of Tubeless versus the Standard technique
Authors: Amir Zein El , Shahiman Muhammad Ali , Qadeer Zeeshan , Mughal Rameez Ahmed , Ali Ashfaq
Published: April 2021

Objective: The proposed study aimed to assess the utility of tubeless PCNL in terms of efficacy and safety when compared with the standard tubed PCNL.

Materials & Methods: In this study 280 patients (age ranged 08-70 years) who underwent PCNL were included.

Results: The patients were from both genders i.e., 156 males and 124 females. Out of 280 patients, 140 had a 16 FR nephrostomy tube (Group A) whiles an equal number had 4.8F DJ Stent (Group B) for postoperative drainage. A comparison of the postoperative outcome among the two groups was made for a period of two years (November 2017 to October 2019). Neither any significant difference was found in the mean stone size, operative time, nor was stone-free status, nor any major complication observed. The mean hospital stay for group A and group B was 4.5 days (range 3 to 6) and 3.2 days (range 2 to 4) respectively. An early postoperative wound soakage was found in 18 (12.8%) cases of group A in contrast to the group B patients in whom only 2 (1.4%) had soakage.

Conclusion: It was concluded that Tubeless PCNL as compared to the standard tubed PCNL was found more efficacious and safer and it should be adopted as a routine procedure.
Resenha da obra 'Responsabilidade civil e novas tecnologias'
Authors: Basan Arthur Pinheiro
Published: April 2021

É inegável que a evolução das novas tecnologias, especialmente a partir do desevolvimento crescente da sociedade da informação, revela não só uma uma gama de possibilidades aos humanos mas também inúmeras situações que expõe as pessoas a novos perigos. Partindo desse panorama, é possível destacar que a resposanbilidade civil talvez seja o instituto jurídico que mais se relaciona com as mudanças contextuais da sociedade, de modo que, em razão do advento de novas tecnologias e, consequentemente, dos variados riscos emergentes, exige-se uma releitura da dogmática civilística. Isso porque, a partir da ampliação dos riscos, agora muitas vezes virais, em rede, rapidamente propagados em uma sociedade hiperconectada, o Direito não pode se esquivar das suas funções primordiais, especialmente no que se refere a prevenção e a compensação das violações aos interesses concretamente merecedores de tutela. Por isso, a responsabilidade civil, como instituto dinâmico e aberto que é, ganha um destaque ampliado ao se enquadrar como uma das necessárias ferramentas capazes de adequar o desenvolvimento tecnológico aos fundamentos das sociedades minimamente civilizadas, pautadas em valores como segurança jurídica e justiça.
La indemnización derivada de la ocultación de la verdadera paternidad respecto del hijo que el marido creía ser suyo
Authors: De Verda y Beamonte José Ramón
Published: April 2021

En el presente trabajo se realiza un análisis crítico de la reciente jurisprudencia del Tribunal Supremo español, que niega la posibilidad de reparación del daño moral resultante de la ocultación de la verdadera paternidad respecto del hijo que el marido creía ser suyo. Se reafirma el carácter jurídico de las obligaciones conyugales y la posibilidad de aplicar normas generales de responsabilidad civil en el Derecho de familia.
Responsabilidade civil pela desistência do projeto parental após a criopreservação de embriões
Authors: Daneluzzi Maria Helena Marques Braceiro , Santiago Maria Carolina Nogueira Nomura
Published: April 2021

O presente artigo busca analisar a responsabilidade civil pela desistência do projeto parental oriundo de reprodução humana assistida homóloga, após a criopreservação de embriões, especialmente se um dos cônjuges/companheiro não tem mais a possibilidade de ter filhos biológicos. Trata ainda da aplicabilidade da teoria da perda de uma chance e da necessidade de as clínicas de reprodução assistida trabalharem melhor a questão do consentimento informado de seus pacientes, em casos de desistência do projeto parental. Foi utilizado o método dedutivo e pesquisa bibliográfica e jurisprudencial para a confecção do texto.
10-14 Yaş Grubu Sporcuların Denge, Çeviklik ve Durarak Uzun Atlama Performansları
Authors: ÖDEMİŞ Meriç
Published: April 2021

Bu araştırma 10-14 yaş aralığındaki badminton ve hentbol oynayan kız sporcularının denge, çeviklik ve durarak uzun atlama performanslarının incelenmesini ve bazı antropometrik özellikleri ile ilişkisini belirlemek olarak amaçlamıştır. Araştırmaya yaşları 12.4±1.17 yıl, antrenman yaşı 2,26±0.85 yıl, boy 154.6±8.07 cm, vücut ağırlıkları 46.11±12.92 kg, beden kütle indeksi ortalaması 19.1±4.24, olan badminton (n:13) ve hentbol (n:14) sporcularından oluşan toplam 27 kız sporcu katılmıştır. Katılımcılara statik denge ölçümü için denge hata puanlama testi (BESS), dinamik denge için Y denge testi, çeviklik için T testi ve durarak uzun atlama testi uygulanmıştır. Normalite testi için Shapiro Wilk testi uygulanmış ve veriler normal dağılım gösterdiğinden dolayı gruplar arası fark incelemesi için Independent T testi, değişkenler arası ilişki için Pearson Korelasyon analizi yapılmıştır. Statik denge, dinamik denge, çeviklik ve durarak uzun atlama performanslarında anlamlı bir farklılık olmadığı tespit edilirken, statik denge performansının sadece düz zemin üstünde anlamlı bir fark olduğu bulunmuştur. Araştırmaya katılan tüm sporcuların boy uzunluğu ve vücut ağırlığı ile denge performansı arasında ilişki bulunmamıştır. Bunun yanı sıra sporcuların boy ve bacak uzunluğu ile durarak uzun atlama performansı arasında anlamlı pozitif bir ilişki olduğu bulunmuştur. Ancak sporcuların durarak uzun atlama ile çeviklik performansları arasında ise negatif yönde çok anlamlı ilişki olduğu tespit edilmiştir.
A titkos információszerzés szükséges és lehetséges reformja
Authors: Nyeste Péter
Published: April 2021

In order to facilitate the ongoing criminal procedure reforms, the author presents a new concept for secret intelligence in Hungary.
A (magán)lakás meghatározásának jelentősége a hazai titkos információgyűjtés rendszerében
Authors: Solti István
Published: April 2021

By providing an overview of how Hungarian law defines private apartments, the author outlines the framework of secret intelligence.
THE CHOICE OF SURGICAL TACTICS FOR BOERHAAVE SYNDROME IN COMBINATION WITH BILATERAL PLEURAL EMPYEMA (CLINICAL CASE)
Authors: Gankov V. A. , Shestakov D. Yu. , Manshetov V. V. , Tseimakh E. A. , Kovalev E. V. , Bubenchikov S. P.
Published: April 2021

Introduction.Boerhaave syndrome is a rare, difficult to diagnose and formidable disease with a high mortality rate. For the treatment of this pathology, many variants of interventions have been proposed. Some surgeons prefer to use a thoracotomic access, others – a laparotomic transhiatal one. In the domestic literature there are scant observations of usement of minimally invasive technologies.Clinical observation.The patient was admitted to the surgical department for emergency indications. In the admission department spontaneous left side hydropneumothorax was diagnosted. Drainage of the left pleural cavity was performed. On the second day, a spontaneous rupture of the esophagus was diagnosed. Video-laparotranschiatal drainage of the posterior mediastinum, drainage of the left subhepatic space, Maydl jejunostomy was performed. In the postoperative period, intensive conservative therapy was carried out, massive lavage of the mediastinum and the left pleural cavity with antiseptic solutions. For a long time, there was a large drainage debit. Because of treatment the dynamics were positive. On the 45th day the drainage of the pleural cavity was removed. By the 66th day complete healing of the esophageal defect and removal of the mediastinal drainage.Discussion.Due to the difficulties in diagnosis, a spontaneous rupture of the esophagus was detected a day later. The applied surgical access and technique allowed to provide adequate drainage and sanitation of the posterior mediastinum and left pleural cavity. The subsequent tactics of managing the patient ensured his recovery. The trauma of the video-laparotranschiatal access is less, in comparison with open surgical interventions. We consider the experience of using video endoscopic technologies for Boerhaave syndrome positive and promising.
Regioselective synthesis of triazolo[3,4-e]purine derivatives and their anti-cancer activity against NCI-60 cell-lines
Authors: Kapadiya Khushal , Kavadia Kishor , Gohel Jyoti , Khunt Ranjan
Published: April 2021

Introduction: Due to the vast medicinal importance of purine nucleoside, a hybrid molecule of triazole with purine ring might explode a lead molecule in the pharma sector and based on the last decade’s studies suggested that the nitrogen-rich molecules possess a wide range of medicinal importance.

Aim: Due to the vast application of purine nucleoside itself in the field of cancer research, we synthesized triazolo[3,4-e]purines and screened them for their anti-cancer study against NCI-60 cell lines by the protocol used by NIH.

Materials and methods: The targeted molecules, 4-chloro-5a,6-dihydro-8-substitutedphenyl-1H-[1,2,4]triazolo[3,4-e]purine derivatives (4a-4h) were synthesized in a two-step procedure by nucleophilic substitution (SN) at C-2 chlorine followed by formation of the triazole ring by acid-catalyzed reaction in the polar protic solvent.

Results: It was observed that the regioselective approach followed in C-2 chlorine replacement instead of C-6 chlorine during SN reaction. One-dose response of selected three molecules (4a, 4b, and 4c) showed that 4b (K-562: 64.47 µM & SR: 63.38 µM; mean GI50: 99.09 µM) was found to be more potent than 4a and 4c.

Conclusions: We have described in this study the general synthetic method for triazolo[3,4-e]purines as an innovative class of potential anticancer agents. The dose-response curve in the sense of mean GI50 for three compounds across all 60 cell lines, 4b can be served as lead after necessary modification.
Enchantement, désarroi et apprentissage
Authors: O’Leary Charles J. , Alleaume Baptiste
Published: April 2021

Inspiré par l’expérience d’un large groupe non structuré, centré sur la personne, au cours duquel j’ai été moi-même bouleversé et ai été cause de bouleversement pour d’autres, j’établis des parallèles entre l’expérience de groupe et celle des personnes dans leurs relations intimes. Dans les deux situations, l’enchantement et le sentiment d’appartenance peuvent conduire à la frustration et à l’aliénation. La rencontre avec l’autre produit confusion et déception, lesquelles peuvent interférer avec le désir de comprendre et d’être compris. Sous la forme d’un journal écrit à la troisième personne, je décris mon dialogue interne au cœur d’un groupe de rencontre, qui montre une complexité similaire à celle que l’on trouve dans l’amitié, les familles et les couples. Au cours d’une interaction humaine intense, notre stabilité intérieure peut être secouée par l’incompréhension et le rejet apparent. Avec le regard que m’apporte mon travail de thérapeute de couple et de famille, je constate qu’apprendre passe aussi par des moments de désarroi : conflits apparemment insolubles, manque de compétence à la relation. L’expérience de nos difficultés en groupe fait écho à nos difficultés familiales. Aborder le groupe comme les relations intimes en tant qu’apprenti plutôt qu’en tant que détenteur de la vérité peut transformer le désarroi en une forme plus profonde d’enchantement.
Methods of Teaching-Revisited Informal Discussion
Authors: Cooper Signe S
Published: April 2021

This is the second 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.
Evaluation for Change
Authors: Ferris Laurice , Pierce Susan
Published: April 2021

Continuing advances in biomedical knowledge result in rapid changes in health care, which in turn necessitate lifelong learning for all health care professionals. Approaches to meeting this need for continuing education have been many and varied. Evaluation of the impact of both short and long term continuing education in the practice setting are not without problems and therefore rarely done. The absence of this evaluative data makes decisions about the best continuing education approach difficult. This article reports on an evaluation of both the effectiveness and continuing need for a six-month Cardiovascular Nurse Specialty Program.
Notes on Continuing Education
Authors: Warmuth Judith F
Published: April 2021

The Faculty of Continuing Education in Nursing from The University of Wisconsin-Extension discuss various aspects of continuing education in this bimonthly feature. Your reactions and suggestions for topics are welcome.
Continuing Educational Goals and Learning Needs of Community Nurses Who Care for Patients With Cancer
Authors: Wood Carol A , Dodge Richard K
Published: April 2021

Continuing education is a means by which nurses stay informed and learn new and maintain old competencies. In order to define both the educational goals and the problems encountered by nurses caring for patients with cancer in Vermont, a questionnaire survey was conducted. Respondents were asked to express a degree of interest and willingness to attend proposed educational programs, as well as to indicate whether or not they had encountered specified difficulties in working with cancer patients. The most heavily favored topics were those related to helping the patient adapt to illness. The most commonly cited difficulty in working with cancer patients was the lack of, or poor communication with doctors. Negative attitudes of coworkers caused more frustration to nurses than negative attitudes from employers.
Dorothy H. Coye
Authors: Wise Patricia S Yoder
Published: April 2021

Dorothy H. Coye formerly was Director of Nursing Education at William Beaumont Hospital in Royal Oak, Michigan. Dorothy retired on December 1, 1983.*
Benefits and Costs of Continuing Nursing Education: An Analytical Survey
Authors: Turner Phyllis
Published: April 2021

ABSTRACT

Federal and statutory requirements demand and professional associations, health care agencies, and individual nurses expect benefits from nurses' participation in continuing nursing education (CNE). These benefits include: competence; improved quality of care; personal benefits, such as self-satisfaction; and social benefits, such as shorter hospital stays for patients. However, it is not clear from the literature whether CNE provides what is expected. Also, the costs of CNE are not clear.

In this research, 244 registered nurses rated the benefits and identified the costs of CNE via a mailed survey. Personal benefits, accruing to the individual nurse, were rated highest and economic benefits were rated lowest. All cost data were positively skewed (many low costs). Opportunity cost (time lost from work) was higher than either direct (tuition) or indirect (travel, books/supplies, child care, and meals) cost. Employers were found to pay more of the cost of CNE than the individual nurse. No significant relationships were identified between the costs and the benefits of CNE.
A Tiger By the Tail: Tackling Barriers to Differentiated Practice
Authors: Brchan Marge Scudder , Hegge Margaret J , Stenvig Thomas E
Published: April 2021

ABSTRACT

Nurses in South Dakota are moving forward with new models for nursing practice. Consensus-building efforts led to the development of a conference focused on differentiated nursing practice. The Nominal Group Process was an effective tool for the identification of strategies to implement new models of nursing practice. The concept of differentiated practice has significant implications for continuing nursing educators as they work with existing nurses to create a new pattern for nursing.
Distance Education: Joining Forces to Meet the Challenge
Authors: Maltby Hendrika , Drew Linda , Andrusyszyn Mary Anne
Published: April 2021

ABSTRACT

This paper describes a unique initiative between Manitoba Health and Brandon University to meet the current challenge of distance education for community health nurses employed by Manitoba Health. In November 1988, a strategy paper was approved, allowing Manitoba Health to contract with Brandon University to facilitate access to university courses. Incentives to encourage Manitoba Health employees to take advantage of these courses included reimbursement for work time and travel and hotel costs to attend associated laboratory sessions provided at off-campus sites (distance education). These incentives provided employees with evidence of tangible support for continuing education. This pioneering venture between two complex organizations demonstrated commitment to further education as well as the ability to initiate a collaborative enterprise.
A Summer Institute on Computer Applications for Nursing Management: Background, Curriculum, and Evaluation
Authors: Abraham Ivo , Evers Georges , Hasman Arie , Tanghe Huibert , Silkens Reinhilde , Hein Fransje
Published: April 2021

ABSTRACT

Nursing managers are faced with a growing number of computer applications for nursing management, yet they may lack the educational preparation to assist them in using these technologies for problem-solving and decision-making. This article describes a Summer Institute on informatics applications for nursing management taught by an international and multidisciplinary team of faculty members, and offered at the University of Limburg (Maastricht, The Netherlands). A discussion of professional, scientific, and educational issues serves as the foundation for curriculum content and instructional format. Evaluation data from both offerings are reviewed and underscore the professional relevance and didactic quality of the Summer Institute. The Summer Institute is presented as a possible model of continuing education in computer applications for nursing management transferable to Western European and North American countries.
An Emergency Pursuit Game: A Method for Teaching Emergency Decision-Making Skills
Authors: Schmitz Brenda D , MacLean Susan L , Shidler Helen M
Published: April 2021

ABSTRACT

Continuing education programs are used to enhance nurses' emergency decision-making knowledge and skills. Often, these programs are viewed as necessary but boring. An Emergency Pursuit game was developed to provide a novel, challenging, motivating, and cost-effective teaching/learning method. The game is played by teams of nurses who compete for points by answering questions concerning emergency drugs, cardiac arrhythmias, emergency policies and procedures, and non-arrest medical emergencies. Many benefits are realized from a continuing educational program using the Emergency Pursuit game. Of greatest importance is the improved proficiency and performance by nurses during clinical emergency situations.
Mentorship: Maslow and Me
Authors: Valadez Ana M , Lund Christine A
Published: April 2021

ABSTRACT

The Department of Veterans Affairs Nursing Service developed a leadership training program that utilizes a preceptor for a trainee. The relationship these two establish determines the level of development the trainee can achieve. The working relationship between preceptor and trainee in this setting surpassed the task-oriented aspects of the preceptorship program and can better be described as that achieved through mentorship. The cadre of competencies are comparable to Maslow's (1970) hierarchy of needs and are viewed as interacting and cyclical. The goal of the training program is to develop a leader that is capable of self-actualization in an advanced leadership role. The authors' personal experiences are used to demonstrate how the principles of mentorship are applied in the training setting.
Those Who Have Will, Those Who Haven't Won't: Caring for HIV-Positive Patients
Authors: Dols Cynthia Lee , Bradley-Magnuson LynnDee
Published: April 2021

ABSTRACT

Nurses' willingness to care for HIV-positive patients continues to be an issue since the inception of the HIV pandemic. This descriptive correlational study found that while nurses' fear of contagion has decreased their willingness to care has not increased in the same proportion. Furthermore, while formal education demonstrated no impact on the willingness of nurses to care for HIV-positive patients, provisions of hands-on care was significantly correlated with willingness to care for HIV-positive patients.
The 12 ½ Minute Learning Session: Some Examples and Analysis of Impact
Authors: de la Cruz Lourdes A D , Bickerton Margaret
Published: April 2021

ABSTRACT

Staff nurses experience time demands that frequently prevent them from attending inservice offerings. The 12 ½ minute learning session is an innovative approach designed to meet the learning needs of the psychiatric nursing staff in spite of time constraints. The guiding principles for these sessions are: 1) "We learn what we care about," 2) preparation for sessions conveys commitment, and 3) accountability for learning is the individual's responsibility but opportunities for learning are shared. Identified outcomes of these groups are the "earthquake effect" or the shifting of one's footing; opportunity for effective debunking or uncovering of habitual patterns; and "bushfire effect" or contagiousness of enthusiasm.
Creative Teaching Strategies
Authors: Irvin Susan M
Published: April 2021

ABSTRACT

Today's nursing students feel pressured to complete research-based professional papers. Reasons that these assignments cause feelings of anxiety may be due to learners' poor writing/thinking skills, low literacy levels, lack of attention when traditional strategies are used, or expectations of entertaining teaching methods. Creative teaching strategies, using a story-telling and personification approach, may assist nurse educators to improve students' attention, retention and comprehension of primary concepts in their nursing courses.
Research Utilization and the Continuing/Staff Development Educator
Authors: Mottola Carol A
Published: April 2021

ABSTRACT

Current health care imperatives and the continuous explosion of information and technology present new challenges for continuing/staff development educators as the nursing profession reinvents itself during the current crisis in health care. This turbulent health care environment necessitates utilization of current research findings to maintain the continued efficient and effective functioning of nursing staff. Familiarity with recent research utilization projects and models and barriers perceived to impede research utilization can assist the continuing/staff development educator to bridge the gap between knowledge generation and knowledge utilization.
Preceptorships in High-Risk Perinatal Nursing for Rural Nurses: A Pilot Project
Authors: L'Esperance Carol , DiGregorio Rena , Wallerstedt Cheryl
Published: April 2021

ABSTRACT

A need existed in New Mexico to enhance the skills of nurses in rural areas in the management of high-risk perinatal patients. However, barriers prohibited initiating such a program, including: a) program development and approval; b) legal and insurance issues; c) determining financial responsibility; and d) application and selection process. Resolving these problems came in the form of a collaborative effort among three departments at the University of New Mexico. A preceptor program of clinical and classroom experiences was developed for nurses outside of the Albuquerque metropolitan area. Evaluations of the program at six months revealed that program participants had implemented changes in their nursing practice. Revisions of the program and plans for the future are discussed.
Patient Stories: A Way to Enhance Continuing Education
Authors: Stamler Lynnette Leeseberg , Thomas Barbara
Published: April 2021

ABSTRACT

Using breast health and illness, this article reviews relevant research literature and compares it for congruency with patient stories. Inconsistencies and issues found are related to desired outcomes and decision-making. Patients may view cancer treatment as an unbroken continuum from pre-diagnosis to completion of treatment. While moving through the continuum, they interact with nursing professionals in several roles and locations. Strategic suggestions acknowledge the need to incorporate health professionals, patients and families in the continuing education activity. Nurses working in continuing education have the opportunity to improve care along the treatment continuum and reduce the distance between research and practice. Implications for nursing practice and continuing education are identified. Suggestions for enhancing continuing education related to this continuum are made.
'SINGLE-SIDE' GRAFT HIP RECONSTRUCTION IN THE DEFICIENT ACETABULUM: A CASE REPORT DEMONSTRATING A SURGICAL TECHNIQUE
Authors: Hennessy Michael J , Turner Roderick H
Published: April 2021

ABSTRACT: This paper presents a modification of bone graft technique in total hip arthroplasty in the deficient acetabulum. A crescent of autogenous femoral head is secured by screw fixation from a single-side to achieve bony support for the acetabulum. This modification allows hip arthroplasty in indicated patients with a minimum of additional surgical exposure. A case report illustrates the technique.
METASTATIC BRONCHOGENIC CARCINOMA TO THE FINGER SIMULATING ACUTE OSTEOMYELITIS
Authors: Wu Kent K , Winkelman Ned Z , Guise Edwin R
Published: April 2021

ABSTRACT: A case of metastatic bronchogenic carcinoma to the distal phalanx of the ring finger was initially misdiagnosed as osteomyelitis. The presence of constitutional symptoms, past history of malignancy, the milder and relatively protracted clinical course, the negative culture and lack of response to surgical drainage and antibiotics should make the diagnosis of hand metastasis a distinct possibility. Amputation of the involved digit is an effective palliative treatment and the other foci of metastases should also be treated with systemic chemotherapy.
THE RESULTS OF TREATMENT OF NONUNIONS WITH ELECTRICAL STIMULATION
Authors: Khasigian Harry A
Published: April 2021

ABSTRACT: Bioelectric effects on bone have recently stimulated much interest and research. This paper reviews the current literature regarding the electrical stimulation of bone, and introduces an independent prospective study from Rancho Los Amigos Hospital reviewing our results with its use on nonunions.

We have basically followed Brighton's technique for electrical stimulation. This consists of percutaneous Teflon coated Steinmann pin electrodes inserted directly into the area of nonunion. An external power pack delivers 20 ma continuously for three months. We have differed from Brighton in that four of eight patients were immobilized by a Hoffman external fixation device. The Hoffman device was left in place six months.

Eight patients have undergone treatment. Four patients (3 tibias and 1 femur) had Hoffman stabilization and have successfully completed treatment. They had all failed previous multiple surgical treatments. One other patient healed with only dummy electrode implantation. The other three cases were unable to complete the entire three months of stimulation due to complications, and remained as nonunions.

The results of our study have been encouraging. Electrical stimulation of bone may soon be added to the armamentarium of the practicing orthopedic surgeon.
UNICOMPARTMENTAL MODULAR TOTAL KNEE ARTHROPLASTY
Authors: Wolfgang Gary L
Published: April 2021

ABSTRACT: Currently there is a difference of opinion regarding the advisability of unicompartmental total knee replacement. This report describes eight cases from a series of 100 consecutive total knee arthroplasties; results averaged 85.5 by the Cleveland Clinic knee evaluation forms. The followup period averages 37.4 months, with a range of 21 to 60 months. Indications for this procedure, provided disease is limited to a single compartment, include osteonecrosis, failed hemiarthroplasty, and traumatic arthritis. Postoperative pain, settling of tibial components, and rapid deterioration of the opposite compartment have not occurred.
PYOGENIC ARTHRITIS DUE TO BACTEROIDES FRAGILIS INFECTION
Authors: Childers J C
Published: April 2021

ABSTRACT: The second reported case of pyogenic arthritis due to Bacteroides fragilis infection is presented. Some aspects of diagnosis and management are discussed.
FAT GRAFT INTERPOSITION: AN ADJUNCT TO RESECTION OF CALCANEONAVICULAR BAR: A CASE REPORT
Authors: Russo Vincent , Mears Dana C
Published: April 2021

ABSTRACT: A case of bilateral calcaneonavicular coalition is presented. Treatment included post-resectional interpostion of fat. Technique and results are discussed.
GEOMETRIC TOTAL KNEE REPLACEMENT: AN EIGHT YEAR EXPERIENCE AT THE NEW ENGLAND BAPTIST HOSPITAL
Authors: Hopson Clark N , Lawsing James F , Borden Lester S , Stillwell William Thomas , Snyder Mark A , Potter Theodore
Published: April 2021

ABSTRACT: Total knee arthoplasty has been accepted as a valuable adjunct in the treatment of knees severely compromised by disease or trauma. One hundred nine geometric total knee replacements were reviewed to determine the efficacy of the device in the relief of pain, the correction of deformity and instability, and the restoration of functional motion in the diseased knee.1
LOW CERVICAL CHORDOMA: REPORT OF TWO CASES WITH DOCUMENTATION BY COMPUTED TOMOGRAPHY AND REVIEW OF THE LITERATURE
Authors: Prete Pamela , Thorne Roger P
Published: April 2021

ABSTRACT: Chordoma is a slow-growing neoplasm of the axial skeleton. Two cases of lower cervical chordoma are reported, along with a review. Despite combined high voltage radiation therapy and radical surgery chordoma invariably recurs, producing bone erosion and destruction of vital contiguous structures with resulting high morbidity and mortality rates. Computed tomography appears very useful in detecting the early soft tissue involvement and assessing the adequacy of therapy of this spinal malignancy.
HYPERLIPIDEMIA AND IDIOPATHIC ASEPTIC NECROSIS OF THE FEMORAL HEAD IN ADULTS
Authors: Lee Casey K , Corcoran Stephen F , Parsons John R
Published: April 2021

ABSTRACT: Hyperlipidemia has been suggested frequently as the etiology and pathophysiology of idiopathic aseptic necrosis of the femoral head in adults. This article reports an investigation of the incidence of hyperlipidemia in patients with idiopathic aseptic necrosis of the femoral head. Data collected included serum levels of alpha, beta, and prebeta lipoproteins, triglycerides, and cholesterol from an experimental group of 13 patients with confirmed aseptic necrosis of the femoral head and from a control group of eight randomly selected patients. Levels of lipoprotein in the experimental group were compared with levels of the corresponding lipoprotein in the control group. A statistical analysis of these results indicated that the group with idiopathic aseptic necrosis of the femoral head showed no increased incidence of hyperlipidemia when compared with a control group.
NEONATAL FRACTURE-SEPARATION OF THE DISTAL HUMERAL CHONDROEPIPHYSIS: A CASE REPORT
Authors: Berman Joseph M , Weiner Dennis S
Published: April 2021

ABSTRACT: A recent experience with a most unusual case of birth injury at Akron Children's Hospital Medical Center has prompted this report in an effort to emphasize the rarity of the lesion, the difficulty in both roentgenographic and clinical scrutiny, the mechanics of the injury, and the unusual direction of displacement. Injury to an unossified epiphysis always demands a high index of suspicion; we stress this fact in our report. In this case marked instability at the separation site necessitated open reduction, although closed reduction and immobilization generally have been successful in other reported cases. The authors present a hypothesis about the mechanism of the injury within the birth canal.
Evaluation of Exertional Leg Pain: Claudication or Neuromuscular Pain
Authors: Greenfield Gerald Q , Andersen Charles A
Published: April 2021

ABSTRACT: Exertional leg pain may be secondary to a variety of problems. A systematic approach to patients with such pain allows early, accurate diagnosis. Noninvasive techniques allow the differentiation between claudication due to vascular disease and that due to spinal stenosis.
Povidone-Iodine-Halothane Interaction
Authors: Herrick Richard T , Herrick Stella
Published: April 2021

ABSTRACT: A patient with no history of halogen sensitivity, having used povidone-solution previously without adverse effect, developed contact dermatitis when concurrently exposed to Hafothane. The area of dermatitis was localized to those areas on which the povidone-iodine solution was allowed to dry and remained in place while exposed to the Halothane intraoperatively. All symptoms disappeared upon removal of the solution, and did not reoccur upon challenge with povidone-iodine without concurrent exposure to Halothane, or when exposed to Halothane, intraoperatively, without Concurrent exposure to dried povidone-iodine solution.
A System for Accurate Closed Reduction and External Fixation of Fractures
Authors: Wang D , Dewar M
Published: April 2021

ABSTRACT: A new external reduction and fixation system has been developed in which the two processes are carried out by two pieces of apparatus - a reducer and a fixator. Schanz pins are inserted into the fractured bone in the conventional way and the reducer, which is free-standing, is placed adjacent to the limb and attached to the pins. During reduction the proximal bone segment remains stationary while the distal segment is moved to realign the bone. Its movements are carried out mechanically by the reducer and each plane is dealt with separately, the bone segment being moved both linearly and in rotation in that plane. Each movement is obtained by turning one of the three handles on the reducer, and is smoothly and rapidly accomplished with complete control. Once the best possible alignment has been achieved a simple, lightweight, single-side fixator is attached to the pins. The reducer is then unfastened and removed.
External Fixation and Arthrodesis
Authors: Vidal J , Orst G , Reboul C , Puente Jorge , Buscayret C , Connes H
Published: April 2021

ABSTRACT: Arthrodesis of joint is widely employed in case of infected nonunion especially after failed total knee replacement. Instead of the conventional methods of immobilization including plaster cast or internal fixation we think that the use of the external fixation is highly satisfactory, providing an excellent method of immobilization and allowing an early weight-bearing gait. In our series of more than 200 applications the Hoffmann external fixation has proved to be indicated most in arthrodesis of the knee, but has also been used in arthrodesis of the hip and in arthrodesis of the lower and upper extremities.
The External Fixation Treatment of Distal Articular Fractures of the Radius
Authors: Ricciardi L , Diquigiovanni W
Published: April 2021

ABSTRACT: A series of 48 wrist fractures treated with external fixation is reviewed. It is stressed that the external fixator allows nursing care and treatment of soft tissue lesions without compromising reduction of the fractures. The authors suggest application of external fixation to wrist fractures in all patients with comminuted fractures of son tissue problems.
The Use of Osteotaxis as a Limb Salvage Procedure in Severe Compound Injuries of the Upper Extremity
Authors: Santavirta Seppo , Karaharju Erkki , Korkala Olli
Published: April 2021

ABSTRACT: Osteotaxis has been proven to offer a means for limb stabilization even in the most severe cases of upper extremity injuries, especially in cases where extensive soft tissue injuries contraindícate internal fixation or plaster cast treatment. Our policy has been to use the osteotaxis treatment only in these severe cases; we do not consider the frame to be a competing procedure with other commonly practiced modes of injury treatment. Our recent experience using the frame to salvage the function of traumatized upper extremities involves ten patients. In some of the cases there were additional carpal or cubital luxations, as well as carpal fractures. Average time in frame was eight weeks. It seems that osteotaxis offers a good means for limb function salvage in compound injuries of the upper extremity with a possibility for satisfactory result.
Peroneal Intraneural Ganglion
Authors: Roffman Moshe , Mendes David G , Ullman Gabriel
Published: April 2021

ABSTRACT: An intraneural cyst is a rare condition. This paper describes one such case, discusses the clinical picture and possible etiology, and reviews the methods of treatment reported in the literature.
A Comparison of Grafting Materials in Experimental Bone Grafts
Authors: Dahners L E , Jacobs R R , Kliethermes J L , Wetzel L H , Rhoades C E
Published: April 2021

ABSTRACT: The abilities of seven different materials to stimulate healing of experimental defects in the ulna and scapula of the adolescent rabbit were compared. The results were evaluated radiographically and with vital fluorescent stain histology. By average radiographic score (ARS), defects implanted with autogenous iliac crest (ARS = 2.79) did significantly better (P<.01) than controls with nothing implanted (ARS = 2.00). Models implanted with hydroxyapatite (ARS = 1.75), collagen (ARS = 1.62), or frozen lyophilized cortical allograft (ARS = 2.21) were not significantly different (P>.05) from the control. Killing of graft cells with 5000 rads of cobalt-60 radiation did not significantly (P>.05) change the score for autogenous iliac crest (ARS = 2.56). The performance of demineralized allograft matrix (ARG = 2.84) was virtually the same as autogenous crest. Indexing terms: Demineralized bone, hydroxyapatite, alloimplant, osteogenesis.
Treatment of Open Fractures with External Fixation
Authors: Aslanoglu Orhan , Ayas Ínanç , Kaymak Özcan , Atik O Sahap , Kunak Feridun
Published: April 2021

ABSTRACT: The results of external fixation of 57 open fractures of the tibia are presented. We applied external fixation following the debridement, reposition, and stabilization of the fracture, with minimal osteosynthesis by Kirschner wires or screws. In case of infection, we treated pseudarthrosis by posterior grafting. The duration of the application of external fixation was five to 24 weeks (average: 13.5 weeks). The results show that the application of external fixation in the treatment of open fractures has many advantages.
Fat Embolism Syndrome After Bilateral Total Knee Replacement
Authors: Roberson James R , Bryan Richard S
Published: April 2021

ABSTRACT: An elderly patient who underwent bilateral total knee arthroplasty suffered the relatively uncommon complication of the fat embolism syndrome; treatment was successful.
External Control of Rate, Recruitment, Synergy and Feedback in Paralyzed Extremities
Authors: Solomonow M , King A , Shoji H , D'Ambrosia R
Published: April 2021

ABSTRACT: An electrical stimulation technique is presented that provides external control of the movement processes by integrating them in a multi-loop electronic control system approximating the normal neuromuscular system.
The Development of a Computerized Upper Limb Electrical Stimulation System
Authors: Nathan R H
Published: April 2021

ABSTRACT: The conceptual design of a total system for computerized electrical stimulation of the upper limb has been developed. Details of the voice input command system and of the control system are presented; the former is designed for simplicity of use by the operator, while the latter, based on the hierarchial arrangement of the human motor control system, relieves the operator of the need to input all but the most simple of guidance commands. State of the art design of feedback sensors is discussed. Ongoing research on the biomechanics of the forearm muscles is reported: their direction of isometric moment generation, the controllability of five forearm muscles in generating moving isometric moment vectors at the two-degree-of-freedom wrist joint in closed loop with a digital microcomputer, and their fatigue properties under electrical stimulation.
Long Term Outpatient Intravenous Antibiotic Therapy for Orthopedic Patients
Authors: Menon Jayasanker , Bowen Thomas M , Neri Carlotta
Published: April 2021

ABSTRACT: This study evaluates the feasibility of outpatient intravenous antibiotic therapy in orthopedic patients. A team was organized to run the outpatient antibiotic therapy program and criteria were outlined for the selection of patients. A total of 16 patients were treated in this manner. A substantial reduction in health care cost was achieved without sacrificing quality. We conclude that outpatient intravenous antibiotic therapy is safe and effective in controlling infection and that it decreases the health care cost.
Closed Loop Control For Restoration of Movement in Paralyzed Muscle
Authors: Petrofsky Jerrold S , Phillips Chandler A , Stafford Donald E
Published: April 2021

ABSTRACT: A basic closed loop control system is described for controlling movement of paralyzed skeletal muscle in humans. The system is based around a Z80 microprocessor with 20K of memory. The system involves sensors to detect the amount of movement in muscle or the tension generated by that muscle, a computer-controlled stimulator, and electrodes placed on the surface of the skin above skeletal muscle for sequential activation of the muscle with electrical stimulation. Applications are described in the system for two types of control; hand control in quadriplegics, and standing and walking in both paraplegics and quadriplegics. Both systems offer a unique challenge to the design engineering in terms of being able to control movement in skeletal muscle for rehabilitation.
Complex Dislocation of First Metatarsophalangeal Joint
Authors: McGuire R A , Reinert C M
Published: April 2021

ABSTRACT: Dislocation of the first metatarsophalangeal joint is rare. Closed reduction is often impossible due to soft tissue interposition. A case is presented and the literature is reviewed with emphasis on normal and pathologic anatomy. Treatment recommendation is open reduction performed as soon as possible following injury if the dislocation cannot be reduced by closed methods.
The Analgesic Effect of Calcitonin in Active Paget's Disease of Bone and in Metastatic Bone Disease
Authors: Gennari C , Bocchi L , Orso C A , Francini G , Civitelli R , Maioli E
Published: April 2021

ABSTRACT: In a clinical study of 25 pagetic patients, it was found that calcitonin has analgesic activity independent of its metabolic efficacy on bone turnover. A separate study in 21 patients demonstrates greater analgesia from doses of salmon calcitonin than from human calcitonin or placebo.
The Usefulness of the Serum Bactericidal Test in Orthopedic Infections
Authors: Stratton Charles W
Published: April 2021

ABSTRACT: The serum bactericidal test is proposed as a means to monitor the effectiveness of antibiotic therapy in orthopedic cases. Preliminary results of a multicenter study of the test in osteomyelitis suggest that trough titers yield the best indication of successful treatment.
Prophylactic Antibiotics in Orthopedic Surgery
Authors: Schurman David J , Woolson Steven T
Published: April 2021

ABSTRACT: This article justifies the use of antibiotics prophylactic to orthopedic surgery. Principles of timing, amount and method of administration, and selection of type of antibiotic are explored.
PERCUTANEOUS COMPUTED TOMOGRAPHY STABILIZATION OF MODERATE TO SEVERE SLIPPED CAPITAL FEMORAL EPIPHYSIS
Authors: Ebraheim Nabil A , Rusin Joseph J , An Howard S , Coombs Robert J , Jackson W Thomas , Munk Richard L
Published: April 2021

ABSTRACT

A percutaneous computed tomography (CT) guided pinning of experimentally reproduced slipped capital femoral epiphysis in five cadavers and one patient - who had bilateral pinning for moderate and severe grade chronic slip - was conducted. Prior investigations of cadavers revealed that this procedure can be performed in selected cases. The details of the technique are illustrated in this article.