bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of the Cost Effectiveness of One-Stage Versus Two-Stage Bilateral Total Hip Replacement
Authors: Lorenze Mark , Huo Michael H , Zatorski Laurine E , Keggi Kristaps J
Published: April 2021

ABSTRACT

Forty patients underwent 80 bilateral primary total hip replacements (THRs) under the same anesthesia (onestage). Forty other patients who underwent unilateral primary THRs during the same time interval were selected to match the first 40 patients with regard to age, sex, diagnosis, weight medical comorbidity, type of prosthesis used, and perioperative management protocol. An assumption was made in that each unilateral case represented the first side of bilateral THRs performed during two separate hospitalizations (two-stage).

Analysis of the total hospital charges submitted to the insurance companies was made between the groups. On average, there was a 24% reduction (P<.05) for each case if bilateral THRs were done in one stage. This was primarily due to a significant decrease (P<.05) in the length of hospital stay in the one-stage group. There was no difference between the two groups in the operative time, estimated blood loss, or perioperative complications.
Progressive Opening-Wedge Osteotomy for Severe Tibia Vara in Adults
Authors: de Pablos Julio , Herranz Pedro González , Barrios Carlos
Published: April 2021

ABSTRACT

Five patients with tibia vara were treated with progressive opening-wedge osteotomy. The maximum varus deviation of the mechanical axis of the tibia varied from 20° to 12°. The minimum postoperative follow-up was 26 months. Complete correction of the deformity was achieved without any major complications.

Progressive opening-wedge osteotomy offers several advantages over conventional osteotomy in adults. First, fibular osteotomy is unnecessary. Second, knee mobility is only slightly restricted immediately following surgery. Third, it is possible to adjust correction postoperatively, and finally, progressive opening-wedge osteotomy does not induce shortening of the lower limb. The most significant disadvantage is the need for prolonged external fixation. This technique should be reserved for patients with severe deformities (minimum of 15° varus) and mild or moderate osteoarthrosis.
Total Hip Arthroplasty in Patients With Cerebral Palsy
Authors: Weber Martin , Cabanela Miguel E
Published: April 2021

ABSTRACT

The records of 16 patients (16 hips) with cerebral palsy who underwent total hip arthroplasty were reviewed. There were no dislocations, and other complications were rare. Pain relief was good to excellent in 87%. Function, as assessed by ambulatory status, was improved in 79%. Reasonable longevity of the implants can be expected even in patients <50 years. Total hip arthroplasty is a valuable option for the cerebral palsy patient with incapacitating hip pain.
Skin Blood Flow Level and Stump Healing in Ischemic Amputations
Authors: Avci Sinan , Musdal Yaser
Published: April 2021

ABSTRACT

Skin blood flow was measured with xenon 1 33-htstamine mixture in 20 lower extremities of 18 patients before performing amputations. The amputation levels were chosen according to clinical criteria; 13 belowknee, 3 distal femoral, 1 midfemoral, 2 transmetatarsal, and 1 Syme's amputations were performed. Fourteen stumps had normal healing, 2 had delayed healing, and 3 had necrosis. All of the stumps with normal healing had a skin blood flow >1.76mL/100 g tissue/minute. Bleeding from the skin also was a good predictor of healing. Skin blood flow measurement may be helpful for level selection in ischemic amputations.
A Descriptive System for Lower Extremity Evaluation in Children: Data for the Newborn Infant
Authors: Brown George A , Swenson Darren R
Published: April 2021

ABSTRACT

An efficient and practical system for examination of thé lower extremities in newborn infants and children is presented. Measurements of hip rotation and abduction are performed in a supine position. During examination, the foot is held in passive correction or induced weight-bearing position to compare the tibia, forefoot, and hindfoot alignment.

Thirty-six newborn infants were examined randomly to establish standard measurements for newborns. The only statistically significant difference between male and female infants occurred in hip abduction and internal and external rotation of the hips during extension. This method of examination of the lower extremity in newbom infants is useful for routine evaluation in all children.
The Use of Elastic Nails for Intramedullary Fixation of Humeral Fractures and Nonunions
Authors: Marchetti P G , Vicenzi G , Impallomeni C , Landi S , Surdo V
Published: April 2021

ABSTRACT

From May 1993 to January 1997, a total of 130 humeral fractures and nonunions were treated using an "elastic" unreamed nail. The elastic nail consists of a cylindrical proximal component tapered for the application of the impactor-extractor, distally containing the proximal ends of four or five secondary nails preloaded to diverge and held together by a retaining system. The surgical approach is through the olecranic fossa apex. Once introduced, the proximal end of the nail locks automatically by diverging the secondary nails in the proximal humeral epiphysis. Distally, the elastic nail is locked with a crossbolt. The elastic nail enables stable fixation of fractures or nonunions and allows early rehabilitation.
Prevalence, Clinical Features, and Risk Factors of Osteonecrosis of the Femoral Head Among Adults With Sickle Cell Disease
Authors: Mukisi-Mukaza M , Elbaz A , Samuel-Leborgne Y , Kélard L , Le Turdu-Chicot C , Christophe-Duchange E , Mérault G
Published: April 2021

ABSTRACT

This prospective study examined the prevalence, clinical features, and risk factors of osteonecrosis of the femoral head among adult sickle cell disease patients in Guadeloupe. Screening of osteonecrosis of the femoral head was performed using radiography, bone scintigraphy, and tomodensitometry. One hundred thirteen adults with sickle cell disease (67 SS and 46 SC patients) comprised the study population. Forty-two (37.2%) patients had osteonecrosis of one or both hips (67 [29.6%] hips) without association to a particular genotype, although bilateral involvement was more frequent among SS patients. While the prevalence of femoral head osteonecrosis increased with age, patients of all ages were affected, particularly young SC adults. Osteonecrosis of the femoral head was diagnosed at preradiographic stages (stage I) in 30% of hips and was frequently asymptomatic (60% of all cases; 95% and 90% of stages I and II, respectively). Osteonecrosis of the femoral head was significantly associated with a history of leg ulcer and osteonecrosis of the humeral head. SS patients with higher hemoglobin levels had an increased risk of osteonecrosis of the femoral head.
Clinical and Pathologic Characteristics of Lumbar Disk Herniation in the Elderly
Authors: Akagi Shigeo , Saito Takanori , Kato Ishashi , Sasai Kunihiko , Ogawa Ryokei
Published: April 2021

ABSTRACT

The clinical and pathologic characteristics of lumbar disk herniation in 23 elderly patients (15 men and 8 women) who required surgical treatment were investigated. Average age at surgery was 67.3 years, and average follow-up was 23 months. Preoperatively, the predominant symptom was severe unilateral leg pain, and 1 3 patients were nonambulatory because of leg pain.

Operative treatment included wide laminectomy in 8, hemilaminectomy in 3, fenestration in 10, and osteoplastic laminectomy in 2 patients. Four (1 7%) patients had disk herniation at the L2-L3 or L3-L4 level. Sequestered herniation with or without migration was observed in 15 (65%) patients. Of 14 sequestered disk fragments examined histologically, 8 (57%) specimens contained cartilaginous or bony end plate with anulus fibrosus or nucleus pulposus. Postoperatively, results were rated as excellent in 1 1 patients and good in 1 2; no patient was rated as fair or poor.

Severe leg pain affecting activities of daily life is a predominant symptom of disk herniation in the elderly. For patients in whom conservative treatment has failed, operative treatment should be considered. In lumbar disk herniation in the elderly, the incidence of cephalad and lateral herniation is higher than in younger patients. In addition, sequestered and migrated herniations including end plate are frequent.
Bankart Operation for Recurrent Anterior Dislocation of the Shoulder Using Suture Anchor
Authors: Bhagia S M , Ali M S
Published: April 2021

ABSTRACT

Between June 1989 and December 1994, a total of 19 patients (20 shoulders) underwent open repair of Bankart lesions using suture anchors. Subscapularis muscle and anterior capsule were cut as one layer and sutured end to end without overlap. Coracoid osteotomy was not necessary. Average follow-up was 53.6 months (range: 24-90 months). Clinical evaluation using the Rowe functional grading system showed 15 shoulders had excellent results, 3 shoulders had good results, and 1 patient was lost to follow-up. There were no complications and no failures with recurrence of dislocation.
The Effect of Intramedullary Bone Plug on Femoral Stem Migration of Hydroxyapatite-Coated Hip Arthroplasty
Authors: Kligman M , Roffman M
Published: April 2021

ABSTRACT

This study investigated the effect of intramedullary corticocancellous bone plug on the fixation and stability of hydroxyapatite-coated femoral stems in total hip arthroplasty (THA). Intramedullary corticocancellous bone plug was used in 30 patients with hydroxyapatite-coated femoral stems (group A) and a consecutive series of 30 patients with hypdroxyapatite-coated stems without bone plug served as the control group (group B). Patients underwent clinical and radiographic follow-up for at least 2 years.

The addition of corticocancellous bone plug to the hydroxyapatite-coated stem significantly improved clinical and radiographic results. The mean Harris Hip Score at 3 and 6 months postoperatively was 92 and 94 in group A, and 84 and 87 points in group B (P<.004 and P<.001, respectively). There was no significant difference between groups at 1 year postoperatively and thereafter. The predominant cause for the difference was the thigh pain score, which was reduced at both 3 and 6 months in group A compared to group B (P<.01 and P<.05, respectively). There also were statistical differences between the two groups regarding radiographic signs. The evidence of endosteal bone formation in group A patients was superior at 3 and 6 months (P<.001 and P<.01, respectively). The appearance of a radiolucent line was significant in group B patients at 3 and 6 months (P<.001). Femoral stem migration of 3 mm was noted in three group B patients versus no group A patients (P<.05). These shortterm clinical and radiographic results suggest corticocancellous bone plug can provide early pain relief and durable implant fixation, but long-term follow-up should be considered.
Influence of Orthotopic Placement on the Incorporation and Mechanical Strength of a Loaded Structural Cortical Graft: An Experimental Study in Rabbits
Authors: Karachalios Theofilos , Scambardonis Dimitrios , Khaldi Lubna , Raptou Panagiota , Papagelopoulos Panayiotis J , Nikiforidis Panayiotis J , Lyritis George
Published: April 2021

ABSTRACT

The biological and mechanical behavior of loaded cortical autografts were evaluated in an experimental study using 40 adult male New Zealand rabbits divided into 4 groups. A double osteotomy was performed on all animals at the mid-diaphysis of the right ulna. The bone segment (5 mm) in between the osteotomies was considered a cortical autograft and fixed with an intramedullary Kirschner wire. The graft was fixed in an orthotopic manner in groups A and C, and rotated 1 80° in groups B and D. After the animals were sacrificed (at 2 months for groups A and B and at 4 months for groups C and D), bone mineral density, graft cross-sectional geometry, and SSI index were assessed.

Mechanical testing of the grafted area was carried out using a three-point bending configuration, and the parameter fracture load was assessed. Graft union and incorporation also was studied in histologic sections. In group C (orthotopic graft placement - 4 months), bone specimens showed statistically significantly higher values for fracture load, total cross-sectional area, volumetric total bone mass and density, and polar SSI (P values «.05) compared to the other groups. In the same group, union and incorporation of the graft was complete, the cortex showed low porosity, and the collagen fibers were mature and properly oriented. Structural cortical bone autografts placed in an orthotopic manner recognize the new mechanical environment as optimal and thus their biological and mechanical behavior are enhanced. Loaded structural cortical grafts should be placed in an orthotopic manner when used for the management of cortical bone defects.
Ganglions of the Proximal Interphalangeal Joint
Authors: Busch Christopher C , Cable Brian M , Dabezies Eugene J
Published: April 2021

ABSTRACT

Ganglions of the proximal interphalangeal joint are uncommon. Six patients (nine ganglions) were treated surgically. The lesions presented on the ulnar aspect of the extensor mechanism between the lateral band and the central slip and communicated with the joint by means of a stalk. Mild degenerative joint disease was noted in each case. Surgical excision provided relief of symptoms, and no patient has experienced any recurrence to date.
Modified Operating Table for Knee Surgery
Authors: Alvine F G
Published: April 2021

The addition of a relatively simple elevated knee support system to an operating table offers the surgeon easy access to the back of the knee during arthroplasty.
Fracture-Dislocation of the Scapula
Authors: Pell Richard F , Whipple Richard R
Published: April 2021

Although a rare injury, scapular dislocation can occur as the result of low-energy trauma. We believe the injury sustained by our patient was the result of traction that not only strained the rhomboids but also concurrently fractured the scapula.
Arthroscopic Rotator Cuff Interval Capsular Closure
Authors: Van der Reis William , Wolf Eugene M
Published: April 2021

ABSTRACT

Closure of the rotator cuff interval is an important component of open stabilization techniques in shoulder surgery. This study describes a technique in which the deep layer of the capsule within the rotator cuff interval is closed arthroscopically. The effect of closure of this capsule within the rotator cuff interval on glenohumeral motion also is quantified.

Sutures were placed from the superior glenohumeral ligament to the middle glenohumeral ligament and tied intra-articularly in fresh-frozen cadaveric shoulders. Closure of the interval capsule resulted in statistically significant limitation of humeral elevation, external rotation, and extension. Arthroscopic closure of the deep layer of the rotator cuff interval capsule produced a visible superior shifting of the middle and inferior glenohumeral ligaments and imbricated the anterosuperior capsule of the shoulder. In addition, this procedure can be performed in conjunction with arthroscopic capsulolabral reconstruction.
Surgical Treatment of Comminuted Die-Punch Patellar Fracture
Authors: Sun Yan Qun , Stephen Mark , Meinhard Bruce P
Published: April 2021

The surgical treatment of comminuted die-punch patellar fracture can be challenging. Anatomic reduction and stable fixation can be achieved using an appropriate operative technique.
Evaluation of Lumbar Spine Bone Mineral Density in the Anteroposterior and Lateral Projections by Dual-Energy X-Ray Absorptiometry
Authors: Sapkas George S , Papagelopoulos Panayiotis J , Stathakopoulos Dimitrios P , Papadakis Stamatios A , Kiratzoulis John M , Stilianessi Eugenia
Published: April 2021

ABSTRACT

Dual-energy x-ray absorptiometry (DXA) is an established method for estimating bone mineral density (BMD) of the lumbar spine. In a prospective study, the sensitivity of BMD measurements between anteroposterior and lateral projections were evaluated in 204 postmenopausal women based on their DXA analysis. Patients were divided into two groups according to the absence or presence of lumbar scoliosis. Lateral projection DXA measurements were more sensitive than AP projection measurements for early detection of bone loss in postmenopausal women. Lateral projection DXA analysis is not recommended in spines with lumbar scoliosis.
Mid-Term Results in Total Hip Arthroplasty With the Basic Noncemented Hip Prosthesis
Authors: Mella-Sousa Mario , Aguilar-Cortés Francisco , Bocanegra Enrique , Domecq Gabriel , Moleon Miguel
Published: April 2021

ABSTRACT

The Basic (IQL-Biomet, Valencia, Spain) hip prosthesis was used in 430 implant procedures, of which 41 7 had mean follow-up of 6 years. Radiographic follow-up was performed at 1, 3, 6, and 12 months postoperatively, and annually thereafter. The average Harris hip score improved from 35.7 preoperatively to 90.9 postoperatively. Clinical results after 2 years of follow-up showed 6% thigh pain, which decreased to 2% at 6 years. Radiographic evaluation demonstrated 22 cases of calcar resorption, 1 4% of which had distal pedestal formation. Heterotopic ossification was noted radiographicaily in 36%. These mid-term results obtained with the Basic prosthesis are similar to the findings of other series and warrant its use.
Traumatic Combined Radial and Ulnar Axial Wrist Dislocation
Authors: Freeland Alan E , Rojas Sandra L
Published: April 2021

In axial wrist dislocation, the proximal and distal transverse arches are disrupted and the carpus and metacarpal bases are split longitudinally. Early reduction and stabilization of the dislocation combined with exploration and decompression provide the best results.
Impact of Preoperative Opioid Use on Patient Outcomes Following Primary Total Hip Arthroplasty
Authors: Singh Vivek , Kugelman David N. , Rozell Joshua C. , Meftah Morteza , Schwarzkopf Ran , Davidovitch Roy I.
Published: April 2021

The purpose of this study was to investigate whether preoperative opioid use had any effect on clinical outcomes and patient-reported outcome measures (PROMs) before and after primary, elective total hip arthroplasty (THA). The authors retrospectively reviewed 793 patients who underwent primary THA from November 2018 to March 2020 with available PROMs. Patients were stratified into two groups based on whether or not they were taking opioids preoperatively. Demographics, clinical data, and PROMs (Forgotten Joint Score-12 [FJS-12], Hip disability and Osteoarthritis Outcome Score for Joint Replacement [HOOS, JR], and Veterans RAND 12 [VR-12] Physical Component Score [PCS] and Mental Component Score [MCS]) were collected at various time periods. Demographic differences were assessed with chi-square and independent sample
t
tests. Clinical data and PROMs were compared using multilinear regressions. Seventy-five (10%) patients were preoperative opioid users and 718 (90%) were not. Preoperative opioid users had a longer stay (1.37 vs 1.07 days;
P
=.030), a longer surgical time (102.44 vs 90.20 minutes;
P
=.001), and higher all-cause postoperative emergency department visits (6.7% vs 2.1%;
P
=.033) compared with patients not taking opioids preoperatively. Preoperative HOOS, JR (46.63 vs 51.26;
P
=.009), VR-12 PCS (27.79 vs 31.53;
P
<.001), and VR-12 MCS (46.24 vs 49.33;
P
=.044) were significantly lower for preoperative opioid users, but 3-month and 1-year postoperative scores were not statistically different. At 3 months and 1 year, FJS-12 scores did not differ significantly. Mean improvement preoperatively to 1 year in HOOS, JR values exceeded the minimal clinically important difference, with preoperative opioid users experiencing a greater improvement (36.50 vs 33.11;
P
=.008). Preoperative opioid users had a longer stay, a longer surgical time, and higher all-cause emergency department visits compared with preoperatively opioid naïve patients. Although preoperative opioid users reported significantly lower preoperative PROMs, they did not statistically differ postoperatively, which indicates a larger delta improvement and similar benefits following THA. [
Orthopedics
. 2021;44(2):77–84.]
The Role of the Nursing School in the Academic Health Center: Report of a Study
Authors: Morris Alvin L , Hastings Douglas A , Crispell Kenneth R
Published: April 2021

Abstract

This paper highlights for the nursing education community selected data from a recently completed study of the organization and governance of academic health centers, conducted under the auspices of the Association of Academic Health Centers and funded by the W.K. Kellogg Foundation. It is hoped that the limited information presented here will stimulate interest in the larger study.

Presented and discussed are data derived from three different questionnaires used in the study. Top administrators in academic health centers were surveyed in order to produce information on the structural components and hierarchical relationships in contemporary academic health centers, the processes by which decisions are made and conflicts are resolved, and the conditions which administrators envision for their institutions in the future. Deans of nursing schools were part of the survey group, and their responses are examined along with those of deans of other health professional schools.
Deans in Nursing: How Do They See Their Future?
Authors: Hall Beverly A , de Tornyay Rheba , Mitsunaga Betty K
Published: April 2021

Abstract

One hundred thirty-one deans of autonomous schools of nursing were surveyed in regard to their future career plans. Only one quarter of the sample planned to stay in the deanship until retirement, but they indicated a high degree of satisfaction with their current career choice. The greatest impetus for leaving their position is dissatisfaction with the current position. Extrinsic rewards, such as salary, are not inducements for lateral mobility. Better opportunities for women in academia have created some ambiguity and confusion in regard to the career path beyond the deanship.
Using Structured Controversy to Promote Ethical Decision Making
Authors: Pederson Carol , Duckett Laura , Maruyama Geoffrey
Published: April 2021

ABSTRACT

This article describes the use of structured controversy as an educational strategy for helping students learn content and skills needed for dealing with difficult ethical situations that arise during the practice of nursing. Structured controversy, an innovative technique that encourages learners to deal with conflict constructively, is described, and research validating its benefits is reviewed. A comprehensive description of how structured controversy was operationalized, using the issue of whether or not to give nutrition and hydration to a dying patient, is included to provide other nursing educators with an illustration of how this strategy can be applied.
Diffusion of Associate Degree Nursing Programs Among U.S. Community Colleges
Authors: Geis Mary J
Published: April 2021

ABSTRACT

Examinations of the adoption and diffusion processes relative to innovations have focused on a variety of factors including the characteristics of the environment, the adoptive unit, and the innovation itself. This study explored the relationship between environmental factors, organizational characteristics, and the spread of 2-year associate degree nursing (ADN) programs among community colleges in the U.S. Data were secured from census materials, educational directories, community college catalogs, various other documents, and interviews with community college representatives.

Results indicated that such factors as general population heterogeneity, change and wealth, and various measures of the need for nurses and nursing education were not useful predictors of the prevalence of ADN programs among the population of community colleges in a state. Two-year colleges that operated ADN programs were larger, wealthier, offered more occupational programs, and were more likely to be publicly controlled than were community colleges that had not adopted the ADN program feature.

Analysis of case materials suggested that at the community level, hospitals and hospital-sponsored nursing schools were important factors in the community college's decision to adopt or reject the ADN program feature.
Nursing Education Application of a Computerized Nursing Expert System
Authors: Lappe Joan M , Dixon Bette , Lazure Linda , Nilsson Patricia , Thielen Jackie , Norris Joan
Published: April 2021

ABSTRACT

Nurse educators are required to be knowledgeable about a wide variety of complex health care problems in order to provide quality education. At the same time, they are given a multitude of other responsibilities such as participating in scholarly activity, advising students, maintaining an active role in nursing practice, and performing community service. These educators must find innovative ways to present current lectures while at the same time meeting their other obligations. The use of Creighton Online Multiple Modular Expert System (COMMES), a computerized decision support consultant, was evaluated as a technique for faculty use in developing and organizing new lecture content. The study found that COMMES was beneficial as a systematic prompt for lecture content, as a tool for organizing content, and as a means to verify completeness of lecture material.
Graduate Home Health Education: A Survey of Home Health Educators and Agency Personnel
Authors: Bryant Sue , Cloonan Patricia
Published: April 2021

ABSTRACT

To determine if there is a body of essential content that should be common to master's-level home care programs, a purposive sample of 200 nurses involved in home health or community health nursing was selected. The respondents (N = 118), including faculty and educational administrators (N = 61) and supervisors and administrators of home health agencies (N = 57), were asked their perceptions of the knowledge needed and their priorities for curriculum content for master's-prepared home care specialists in both clinical and administrative roles. There was agreement in most content areas, but significant differences were found between faculty and agency personnel in their priorities for community health concepts, and in their evaluation of nursing theory and epidemiology as essential content in both roles. We believe these results have important implications for nurse educators. As schools prepare students for leadership roles in today's home care environment, it is critical that pertinent content be well integrated into the curriculum.
Perceptions and Responsibilities of Clinical Nurse Specialists as Educators
Authors: Radke Karen J , McArt Ebba
Published: April 2021

ABSTRACT

This study attempted to determine current involvement of clinical nurse specialists (CNS) in an educational function, their perceived adequacy for an educational role, and their future plans. About half of the 46 CNS who participated reported that acting as a consultant and providing assistance to nursing stafíj and serving as a role model for nursing students were either very important or of utmost importance. Only 33% indicated that it was very important, or of utmost importance, to assist with clinical and theoretical teaching of nursing students. Although more than 50% of the respondents had taken courses in education, many felt inadequately prepared for their role. Only seven identified teaching as a current professional goal, while six respondents identified teaching as a five-year professional goal. Study implications relative to curricular pathways, course content, and academic advisement are discussed, as well as the need for a renewed emphasis on research in nursing education.
Facilitators and Inhibitors of Practice: A Faculty Perspective
Authors: Nugent Katherine E , Barge Sara E , Bridges William C
Published: April 2021

ABSTRACT

Nurse educators are being encouraged to integrate the role of faculty practice into the role expectations of the educational institution. Schools of nursing are faced with the challenge of facilitating faculty who wish to adopt the practice role. There are limited studies documenting factors that facilitate or inhibit faculty who engage in practice. This article presents the findings of a Delphi procedure used to collect the consensus of practicing faculty concerning organizational and personal facilitators and inhibitors of faculty practice. In this study, 299 faculty representing 170 schools of nursing completed all three rounds of the Delphi. The findings present the top five factors identified by practicing faculty as personal and organizational facilitators and inhibitors of their practice.
Experience the Culture
Authors: Stevens Gail Lavine
Published: April 2021

ABSTRACT

The purpose of this article was to describe the Nicaraguan Venture BB BD experiential learning opportunity for graduate and undergraduate nursing studente at the University of Mobile. The recently dedicated Latin American Campus in San Marcos, Nicaragua, was the site chosen for this 10-day experience that provided learning opportunities in both hospital and community nursing for 13 students and 2 faculty. Experience was a powerful teacher for participante who learned to provide culturally competent care in this unique environment. Language was the most important limitation addressed. Flexibility in student opportunities, local community support, and student interprétera from the Latin American campus added to the success of the venture, which will be continued annually.
Actions Taken by Nursing Education Programs in the United States to Prevent Tuberculosis Transmission in Nursing Students
Authors: Moore Pamela V
Published: April 2021

ABSTRACT

Measures to prevent tuberculosis include education and skin testing of at-risk groups, including health care workers. This study focused on policies and practices related to tuberculosis in nursing education programs, especially skin testing and instruction. Data were collected from a stratified random sample of nursing administrators in associate and baccalaureate degree programs in the United States using an instrument adapted from a medical school study. Several factors may have contributed to fewer skin test conversions in nursing programs than in medical schools. Although most nursing education programs considered skin testing a priority, there were inconsistencies related to skin testing type and process when compared with recent Centers for Disease Control and Prevention guidelines. Major content gaps related to multidrug-resistant tuberculosis and the differences between pulmonary and extrapulmonary symptomatology were found.
Integrating Self-Care Into Nursing Education
Authors: Meadows Lois Casden
Published: April 2021

ABSTRACT

The didactic and clinical components of the mental health curriculum content within a school of nursing in the southeastern United States were revised to integrate a self-care focus. The major learning modalities used were group procese dynamics and a structured psychoeducation approach. A six-hour per quarter credit course was divided into three parts: theory, laboratory, and clinical. Studente averaged 3 hours in class, 2 hours in a simulated college laboratory, and 7 hours at a clinical site per week for one quarter. Theoretical concepts were taught during class time; self-care activities and concepts were taught in the college laboratory; and clinical time was devoted to practicing self-care through patient-nurse interactions and group work. Nurse educators may use this study to guide curriculum development in fostering caring models of nursing education.
A Postpartum Home Follow-Up Project by Student Nurses Using Marker Model Standards
Authors: Brodsky Phyllis L
Published: April 2021

ABSTRACT

This article describes a Postpartum Follow-Up Project, in which junior nursing students made two postpartum follow-up home visits to evaluate maternal and newborn health status, provide education, and enrich their own clinical experiences. Marker Model Standards of Care and Patient Teaching Protocols were used by students to direct provision of care. By participating in this project, students were able to meet foUow-up care needs of mothers having short lengths of stay and were able to expand their learning experiences. Students felt these visits were beneficial, and client evaluations indicated the students' visits were helpful to them.
Competencies of Liberal Education in Post-RN Baccalaureate Students: A Longitudinal Study
Authors: Gulls Angela , Lellan Marian Mac , Perry Anne
Published: April 2021

ABSTRACT

The purpose of this longitudinal study was to examine the relationship among liberal education competencies as demonstrated in the professional and personal lives of post-RN students and time spent in a BScN program. The six competencies identified by Dressel (1979) and used by Bottome (1988) to define the liberally educated person provided the framework for this study. The Dressel competencies have been validated in the literature aa being representative of the universe of competencies that are anticipated outcomes of baccalaureate nursing education.

Results indicated that after 5 years of part-time study at the baccalaureate level, significant differences were found in the competencies of liberal education as demonstrated in the professional and personal lives of poet-RN learners. The competencies aa demonstrated in the professional lives of post-RN learners developed consistently over time, while the development of competencies as demonstrated in the personal lives of learners lagged behind. The study contributes to the small but growing body of literature which explores the impact of a liberal education on post-RN learners.
A New Module in Caring for Older Adults: Problem-Based Learning and Practice Portfolios
Authors: Matthews-Smith Gerri , Oberski Iddo , Gray Morag , Carter Diana , Smith Lorraine
Published: April 2021

ABSTRACT

It is not often that educators have the chance to design a new educational program on the basis of up-to-date and locally relevant research findings. We describe the process by which we designed a new module, aimed at registered nurses who care for older adults in the community. The content of the new module was derived from an analysis of educational needs of the potential student population. The mode of delivery was strongly studentcentered, using problem-based learning. Assessment was through the building up by students of a practice portfolio. This paper focuses on a description of the new module and how it relates to the findings of the educational needs analysis.

The National Board for Nursing, Midwifery and Health Visiting for Scotland put out a tender in 1995 for a community research project on "Educational Provision for Evolving Roles in Community Health Care" (Nursing Times, June, 9, 1995) with the aim of piloting and evaluating an "innovative program which meets changing needs in community health care." A joint bid by Napier University and the University of Glasgow not only proposed to pilot and evaluate the educational program, but also first to develop the content of the program itself through an educational needs analysis. In this paper, we will first provide an outline of the research that underpinned the educational program. Then, we will describe how the results of the needs analysis were implemented into an innovative educational module. Finally, we will give a brief summary of the new module.
Student and Faculty Perceptions of Effective Clinical Instructors in ADN Programs
Authors: Gignac-Caille Anne Marie , Oermann Marilyn H
Published: April 2021

ABSTRACT

The purpose of this study was to identify the perceptions of associate degree nursing (ADN) students and faculty of characteristics of effective clinical teachers and determine whether there were differences between these two groups. A survey was conducted of 292 students in various levels of their ADN programs and 59 faculty members from the same five programs, which were randomly selected from across Michigan. Data were collected using the Nursing Clinical Effectiveness Inventory, which includes 48 characteristics of effective clinical instructors arranged in five subscales.

Students identified "demonstrates clinical skills and judgment" as the most important characteristic of effective clinical instructors, while faculty identified "explains clearly" as the most important characteristic. There was agreement on 6 of the top 10 characteristics identified by both groups. Both groups rated "directs student to useful literature in nursing" as the least important characteristic of effective clinical instructors.

The students' and faculty's perceptions of effective clinical instructors differed by subscales, with students identifying evaluation characteristics as most important (mean = 4.73, SD = .42) and faculty identifying interpersonal relationships as most important (mean = 4.72, SD = .31). Ai test indicated a significant difference between student and faculty means for the interpersonal relationships subscales, with faculty rating this group of characteristics as more important than students did (t = 2.49, p = .014).
Lymphocyte Cytotoxicity Testing in Patients and Families with Retinoblastoma
Authors: Rogers Gary L , Vo Phung , Smiley Nasser
Published: April 2021

Abstract

This study tested lymphocyte cytotoxicity from patiente with retinoblastoma. Lymphocytes were tested against two permanent cell lines, WERI and Y-79. Normal volunteers served as controls. The lymphocyte reactivity of both patients with retinoblastoma and their mothers showed significant elevation compared with the controls. This strongly suggests that transplacental sensitization had occurred in utero and that the tumor was present prior to birth. Two children suspected of having retinoblastoma was tested and found to have elevated cytotoxicity titers but were later shown to have nematode inflammatory reaction. Both of their mothers' lymphocytes were not reactive to the tumor cell line. These results indicate that retinoblastoma can be present in utero with sensitization of the mother to the tumor. This test, with further refinement, may be applicable as a screening test in the differential diagnosis of retinoblastoma.
Loss of Accommodation and the Near Response in Wilson's Disease
Authors: Curran Robert E , Hedges Thomas R , Boger William P
Published: April 2021

Abstract

Two cases of Wilson's disease (hepatolenticular degeneration) are presented: an 11 year-old with no neurological involvement and a marked loss of accommodation and a 24-year-old with moderate neurological involvement and a complete loss of the near response. The possible neuroanatomical explanations for these findings are discussed.
Amniotic Band Syndrome and Strabismus
Authors: BenEzra David , Frucht Yosef , Paez Juan H , Zelikovitch A
Published: April 2021

Abstract

Three patients with various manifestations of the amniotic band syndrome associated with strabismus are presented and discussed. All three cases demonstrate a paralytic strabismus due to a unilateral paresisparalysis of the medial rectus in one case and of the superior rectus in another. The third case showed a bilateral lateral rectus paralysis. In two cases, the strabismus was accompanied by other ocular manifestations, while in one patient strabismus and amblyopia were the sole ophthalmological findings. In two of the cases, a direct association between the mesodermal bands and the strabismus could be established, while in one case this association might have been incidental. Careful ophthalmological followup and treatment of these cases prevented needless loss of vision while appropriate muscle surgery restored decent cosmetic appearance in one case.
Recurrent Esotropia Following Early Successful Surgical Correction of Congenital Esotropia
Authors: Freeley Douglas A , Nelson Leonard B , Calhoun Joseph H
Published: April 2021

Abstract

A study was conducted using a group of congenital esotropee who had an adequate surgical alignment prior to 18 months of age, to determine how many of them would redevelop esotropia. In the group that redeveloped the condition, a high percentage of the esotropia was accommodative in nature and was therefore able to be corrected with spectacles. Both the initial refractive error and changes in refractive error were noted to be significant. This study emphasizes the importance of monitoring the refractive state continuously, especially in children with subnormal fusion.
Cycloplegic Refraction After Echothiophate Iodide
Authors: Raab Edward L
Published: April 2021

ABSTRACT

Retinoscopy under cycloplegia using cycle pen to late (Cyclogyl) hydrochloride was performed on 18 patients (36 eyes) with partial or complete accommodative esodeviation, during and after treatment with echothiophate (Phospholine) iodide. Measurements were clinically comparable on both occasions, regardless of concentration of echothiophate, duration of administration, or interval from discontinuance until refraction. It appears to be unnecessary to discontinue echothiophate iodide in order to obtain reliable cycloplegic retinoscopic measurements.
Topographical Distribution of Electroretinographic Potentials Monitored by Skin-Electrodes
Authors: Zhang Guohui , Nao-i Nobuhisa , Honda Yoshihito
Published: April 2021

abstract

electroretinographic recordings were made from 20 different akin points by akin-electrodes when the eye was fixed in a straight forward, lateral and nasal gaze. three dimensional distributions of the percent amplitude of the b-wave were made using a microcomputer. the best recordings were obtained upon lateral gaze from skin points on the lower eye ud or near the lateral canthus. the skin- electrode erg recording from these skin points upon lateral gaze may provide a useful diagnostic tool, especially in young children.
Recurrent Intraoperative Choroidal Effusion in Sturge-Weber Syndrome
Authors: Shihab Zuhair M , Kristan Ronald W
Published: April 2021

ABSTRACT

The formation of a massive choroidal effusion without hemorrhage during a trabeculectomy procedure was documented inai 7-year-old male with Sturge-Weber syndrome, most probably representing the youngest patient in the literature with this intraoperative complication. The occurrence of similar signs during a previous trabeculectomy procedure in the same eye, suggested the possible recurrent nature of this entity. Preparation of a posterior sclerotomy site before entering the eye during intraocular surgery in patients with Sturge-Weber Syndrome might help in the immediate management and in preventing complications due to the formation of massive choroidal effusion.
Angiomatous Malformation of the Retrolaminar Optic Nerve
Authors: Margo Curtis E , Kincaid Marilyn C
Published: April 2021

ABSTRACT

A vascular abnormality of the optic nerve was found incidentally in two infants whose eyes were enucleated because of the clinical suspicion of retinoblastoma. The lesion consisted of numerous thin-walled vascular channels within pial septa of the retrolaminar optic nerve. Although it is unclear if this angiomatous malformation could disturb vision, the lesion may be more common than can be inferred from the small number of reported cases.
Enlarged Pupillary Membranes
Authors: Mader Thomas H , Wergeland Floyd L , Chismire Kevin J , Stephan Mark J
Published: April 2021

ABSTRACT

Pupillary membranes are very commonly found on routine microscopic examination of the anterior segment and are usually of no clinical significance. We describe a 4-year-old child with grossly enlarged pupillary membranes that formed a mesh-like arc over the entire pupillary aperture in both eyes. Although these membranous strands were very prominent, the child had normal visual acuity.
Vitreous Cyst Combined With Bilateral Juvenile Retinoschisis
Authors: Lusky M , Weinberger D , Kremer I
Published: April 2021

ABSTRACT

Vitreous cyst, an uncommon finding, was first described by Tansley in 1899.1 Since then only a few reports dealing with congenital or acquired vitreous cyst have been reported. We report the case of a 16-year-old girl with a unilateral developmental vitreous cyst combined with bilateral retinoschisis. The pathogenesis and histopathology of these phenomena remain unclear, although a few assumptions about the common pathogenesis are discussed. According to our knowledge, this is the first description of vitreous cyst and retinoschisis in the same eye.
Immunohistochemical Diagnosis of a Totally Necrotic Retinoblastoma: A Clinicopathologic Case
Authors: Kremer I , Hartmann B , Haviv D , Krakovsky D , Ishak R Bar
Published: April 2021

ABSTRACT

An 8-month-old girl underwent enucleation of her right eye because of a calcified retrolental white mass filling the entire vitreous cavity. The conventional histological examination revealed a totally necrotic unidentifiable tumor, with scattered foci of calcification. In addition, we found two islands of viable small round cells, suspected to be retinoblastoma cells, which were located in the optic nerve behind the lamina cribrosa. These cells stained positively for neuron-specific enolase (NSE), but not for glial-fibrlllary-acidic-protein (GFAP), supporting the diagnosis of retinoblastoma. Because one of the latter foci of viable tumor cells was located at the cut end of the optic nerve, the baby was treated by external beam irradiation.
Ophthalmologic Features of Prader-Willi Syndrome
Authors: Hered Robert W , Rogers Steven , Zang Ying-Fen , Biglan Albert W
Published: April 2021

ABSTRACT

Forty-six patients with Prader-Willi syndrome were examined to determine the incidence and character of ocular abnormalities. All patients met clinical criteria for this syndrome including infantile hypotonia, hypogonadism, truncal obesity, intellectual impairment, dysmorphic facies, and short stature. Thirty-two patients had best corrected visual acuities between 6/6 and 6/9 in each eye. Seven patients (15%) had myopia greater than -3.75 diopters. Nineteen (41%) patients had astigmatism of 1.25 diopters or greater. Amblyopia of strabismic, an isometropic, or ametropic etiology was present in 11 (24%) of the patients. Strabismus was present in 25 (54%) patients: 22 (48%) patients had esotropia and three (7%) had exotropia. Nine patients either received or required strabismus surgery. Thirty-three percent of the patients examined for iris transillumination defects had this finding. This study represents the first large series of patients with Prader-Willi syndrome to undergo detailed ophthalmologic evaluation. Recognition of this syndrome is important because of the high incidence of potentially treatable ocular problems.
Adjustable Suture Strabismus Surgery for Acquired Vertical Deviations
Authors: Keech Ronald V , Heckert Richard R
Published: April 2021

ABSTRACT

Forty-seven patients undergoing 51 adjustable suture strabismus procedures for acquired vertical deviations were evaluated for preoperative and adjustment factors wnfcfi might influence the postoperative alignment. The type of deviation, surgical procedure, previous surgery, immediate postadjustment alignment, and immediate postadjustment versions were assessed. Oblique muscle surgery in addition to an adjustable vertical reclus muscle significantly decreased the success rate (p = .0303). Other less important factors were a previous history of strabismus surgery and a moderate limitation of versions following the adjustment. A slight over- or undercorrection after adjustment did not affect the success.
Vertical Effect of the Adjustable Harada-Ito Procedure
Authors: Elsas Frederick J
Published: April 2021

ABSTRACT

The adjustable Harada-Ito procedure, as described by Metz, was performed on four patients. A hypotropia of 10 to 12 prism diopters (PD), in addition to lncyclotorsion, was induced in two patients In whom the superior oblique tendon was split 6 mm, only enough to permit mobilization to its new location. Splitting the tendon for 15 mm eliminated the induced hypotropia while preserving incyclotorsion.