bluuebunny/crossref_metadata_2025 huggingface dataset:
The Anthropologist in the Middle of a Tug-of-War
Authors: Berliner David
Published: March 2008

Among anthropologists of both sexes, there is an enduring cliché that female anthropologists have better access to women's worlds than their male counterparts. I work about female religiosity in a West African Muslim society, the Bulongic (Guinea-Conakry), and my presence as a man was never an issue with the Bulongic women. In fact, from the beginning, I had the feeling that through my presence, the women intended to reinforce the legitimacy of their ritual performances, which was violently contested by the old men of the village. In this article, I address my position in the middle of this tug-of-war between the men and the women. By describing the ways in which Bulongic women instrumentalized my presence as a white ethnologist sensitive to their religious practices, I hope to refine our understanding of the actual effects of gender in the field.
Latino Police Officers
Authors: Irlbeck Dawn
Published: March 2008

It is argued that increased employment of Latino officers will enhance policing in Latino communities based on assumptions that Latino officers share a common ethnic identity and have positive attitudes toward Latino community members based on identification with the coethnic communities they police. These assumptions, however, remain largely untested. Through interviews with 100% of Latino police officers in a large midwestern city, this study investigated the officers' ethnic identification and attachment to the Latino communities they police. Contrary to public policy assumptions, although most expressed a strong Latino identity and community attachment, many did not, and a small number self-identified as exclusively “White/Anglo.”
Characterization of primitive hematopoietic cells from patients with dyskeratosis congenita
Authors: Goldman Frederick D. , Aubert Geraldine , Klingelhutz Al J. , Hills Mark , Cooper Sarah R. , Hamilton Wendy S. , Schlueter Annette J. , Lambie Karen , Eaves Connie J. , Lansdorp Peter M.
Published: March 2008

Dyskeratosis congenita (DC) is an inherited bone marrow (BM) failure syndrome associated with mutations in telomerase genes and the acquisition of shortened telomeres in blood cells. To investigate the basis of the compromised hematopoiesis seen in DC, we analyzed cells from granulocyte colony-stimulating factor mobilized peripheral blood (mPB) collections from 5 members of a family with autosomal dominant DC with a hTERC mutation. Premobilization BM samples were hypocellular, and percentages of CD34+ cells in marrow and mPB collections were significantly below values for age-matched controls in 4 DC subjects. Directly clonogenic cells, although present at normal frequencies within the CD34+ subset, were therefore absolutely decreased. In contrast, even the frequency of long-term culture-initiating cells within the CD34+ DC mPB cells was decreased, and the telomere lengths of these cells were also markedly reduced. Nevertheless, the different lineages of mature cells were produced in normal numbers in vitro. These results suggest that marrow failure in DC is caused by a reduction in the ability of hematopoietic stem cells to sustain their numbers due to telomere impairment rather than a qualitative defect in their commitment to specific lineages or in the ability of their lineage-restricted progeny to execute normal differentiation programs.
Identification of a fibrin-independent platelet contractile mechanism regulating primary hemostasis and thrombus growth
Authors: Ono Akiko , Westein Erik , Hsiao Sarah , Nesbitt Warwick S. , Hamilton Justin R. , Schoenwaelder Simone M. , Jackson Shaun P.
Published: March 2008

A fundamental property of platelets is their ability to transmit cytoskeletal contractile forces to extracellular matrices. While the importance of the platelet contractile mechanism in regulating fibrin clot retraction is well established, its role in regulating the primary hemostatic response, independent of blood coagulation, remains ill defined. Real-time analysis of platelet adhesion and aggregation on a collagen substrate revealed a prominent contractile phase during thrombus development, associated with a 30% to 40% reduction in thrombus volume. Thrombus contraction developed independent of thrombin and fibrin and resulted in the tight packing of aggregated platelets. Inhibition of the platelet contractile mechanism, with the myosin IIA inhibitor blebbistatin or through Rho kinase antagonism, markedly inhibited thrombus contraction, preventing the tight packing of aggregated platelets and undermining thrombus stability in vitro. Using a new intravital hemostatic model, we demonstrate that the platelet contractile mechanism is critical for maintaining the integrity of the primary hemostatic plug, independent of thrombin and fibrin generation. These studies demonstrate an important role for the platelet contractile mechanism in regulating primary hemostasis and thrombus growth. Furthermore, they provide new insight into the underlying bleeding diathesis associated with platelet contractility defects.
Interventional microadhesiolysis: A new nonsurgical release technique for adhesive capsulitis of the shoulder
Authors: Ahn Kang , Lee Young-Jin , Kim Eun-Ha , Yang Seung-Min , Lim Tae-Kyun , Kim Yong-Soo , Jhun Hyung-Joon
Published: February 2008

Background

A nonsurgical intervention, interventional microadhesiolysis, was developed to release adhesions in joints and soft tissues. This paper introduces the procedure and evaluates the efficacy of the intervention for adhesive capsulitis of the shoulder.

Methods

Ten patients (five men and five women) with primary adhesive capsulitis of the shoulder were treated at a chronic pain management center in Korea. Three specially made needles are used in interventional microadhesiolysis: the Round, Flexed Round, and Ahn's needles. A Round Needle is inserted on the skin over middle of supraspinatus and advanced under the acromion and acromioclavicular joint (subacromial release). A Flexed Round Needle is inserted two-fingers caudal to the inferior border of the scapular spine and advanced over the capsule sliding on the surface of infraspinatus muscle-tendon fascia. The capsule is released while an assistant simultaneously passively abducts the shoulder to full abduction (posteroinferior capsule release). An Ahn's Needle is inserted on the skin over the lesser tubercle and advanced under the coracoid process sliding on the surface of the subscapularis muscle (subcoracoid release).

Results

After the patients underwent interventional microadhesiolysis, the self-rated pain score or severity declined significantly (p < .01), the shoulder range of motion increased significantly (p < .01), and joint effusion in the affected shoulder decreased or disappeared in nine of ten patients on magnetic resonance imaging compared to their initial status.

Conclusion

Our findings suggest that interventional microadhesiolysis is effective for managing adhesive capsulitis of the shoulder.
Influence of TRPV1 on Diabetes-Induced Alterations in Thermal Pain Sensitivity
Authors: Pabbidi Reddy M , Yu Shuang-Quan , Peng Siying , Khardori Romesh , Pauza Mary E , Premkumar Louis S
Published: March 2008

A common complication associated with diabetes is painful or painless diabetic peripheral neuropathy (DPN). The mechanisms and determinants responsible for these peripheral neuropathies are poorly understood. Using both streptozotocin (STZ)-induced and transgene-mediated murine models of type 1 diabetes (T1D), we demonstrate that Transient Receptor Potential Vanilloid 1 (TRPV1) expression varies with the neuropathic phenotype. We have found that both STZ- and transgene-mediated T1D are associated with two distinct phases of thermal pain sensitivity that parallel changes in TRPV1 as determined by paw withdrawal latency (PWL). An early phase of hyperalgesia and a late phase of hypoalgesia are evident. TRPV1-mediated whole cell currents are larger and smaller in dorsal root ganglion (DRG) neurons collected from hyperalgesic and hypoalgesic mice. Resiniferatoxin (RTX) binding, a measure of TRPV1 expression is increased and decreased in DRG and paw skin of hyperalgesic and hypoalgesic mice, respectively. Immunohistochemical labeling of spinal cord lamina I and II, dorsal root ganglion (DRG), and paw skin from hyperalgesic and hypoalgesic mice reveal increased and decreased TRPV1 expression, respectively. A role for TRPV1 in thermal DPN is further suggested by the failure of STZ treatment to influence thermal nociception in TRPV1 deficient mice. These findings demonstrate that altered TRPV1 expression and function contribute to diabetes-induced changes in thermal perception.
Animal model ofMycobacterium abscessuslung infection
Authors: Ordway Diane , Henao-Tamayo Marcela , Smith Erin , Shanley Crystal , Harton Marisa , Troudt JoLynn , Bai Xiyuan , Basaraba Randall J , Orme Ian M , Chan Edward D
Published: March 2008

Chronic lung disease as a result of Mycobacterium abscessus is an emerging infection in the United States. We characterized the lung immune responses in mice and guinea pigs infected with M. abscessus. C57BL/6 and leptin-deficient ob/ob mice challenged with a low-dose aerosol (LDA) of M. abscessus did not develop an infection. However, when challenged with a high-dose aerosol (HDA), C57BL/6 and ob/ob mice developed an established infection and a pulmonary immune response consisting of an early influx of IFN-γ+ CD4+ T cells; this immune response preceded the successful clearance of M. abscessus in both strains of mice, although mycobacterial elimination was delayed in the ob/ob mice. Infected guinea pigs showed an increased influx of lymphocytes into the lungs with bacterial clearance by Day 60. In contrast to the C57BL/6 and ob/ob mice and guinea pigs, IFN-γ knockout (GKO) mice challenged with a LDA or HDA of M. abscessus showed a progressive lung infection despite a robust influx of T cells, macrophages, and dendritic cells, culminating in extensive lung consolidation. Furthermore, with HDA challenge of the GKO mice, emergence of IL-4- and IL-10-producing CD4+ and CD8+ T cells was seen in the lungs. In conclusion, IFN-γ is critically important in the host defense against M. abscessus. As the number of effective drugs against M. abscessus is limited, the GKO mice provide a model for in vivo testing of novel drugs.
Interpolation of gravity and gravity gradient data by using the generalized sampling expansion: Theory
Authors: While James , Biegert Ed , Jackson Andrew
Published: February 2008

The generalized sampling expansion is a method that can be used to combine gravity and gravity gradient data so that the line spacing of a survey can be increased without introducing aliasing into the measured signal. This reduces acquisition costs because the costs of shipborne and airborne gravity and gravity gradient surveys are related to the line spacing of the survey. The generalized sampling expansion combines the Fourier spectra of several undersampled gravity and gravity gradient data sets to produce an unaliased result. To achieve that result, input data are assumed to be noise free, infinite in extent, regularly sampled, and band limited. Deviations from this ideal induce errors, but these can be alleviated to a degree. In theory, the generalized sampling expan-sion can reconstruct an unaliased signal sampled at three times conventional line spacing. Unfortunately, edge effects and the presence of noise limit the practical increase in line spacing to twice normal line spacing. Six methods, each using different gradient components, can be used to achieve this doubling of line spacing. Edge effects introduce short-wavelength errors into several possible applications of the generalized sampling expansion, a problem that can be reduced by filtering the output of an expansion and by trimming away residual errors at its boundary. When applied to a deliberately decimated data set derived from data collected over the Cannington ore deposit in Australia, the generalized sampling expansion method successfully reduced aliasing in the signal and produced a more accurate interpolation than was obtained with a gradient-enhanced Akima spline method.
Riemannian wavefield extrapolation: Nonorthogonal coordinate systems
Authors: Shragge Jeffrey Chilver
Published: February 2008

Riemannian wavefield extrapolation (RWE) is used to model one-way wave propagation on generalized coordinate meshes. Previous RWE implementations assume that coordinate systems are defined by either orthogonal or semiorthogonal geometry. This restriction leads to situations where coordinate meshes suffer from problematic bunching and singularities. Nonorthogonal RWE is a procedure that avoids many of these problems by posing wavefield extrapolation on smooth, but generally nonorthogonal and singularity-free, coordinate meshes. The resulting extrapolation operators include additional terms that describe nonorthogonal propagation. These extra degrees of complexity, however, are offset by smoother coefficients that are more accurately implemented in one-way extrapolation operators. Remaining coordinate mesh singularities are then eliminated using a differential mesh smoothing procedure. Analytic extrapolation examples and the numerical calculation of 2D and 3D Green’s functions for cylindrical and near-spherical geometry validate the nonorthogonal RWE propagation theory. Results from 2D benchmark testing suggest that the computational overhead associated with the RWE approach is roughly 35% greater than Cartesian-based extrapolation.
Prediction of Archie’s cementation factor from porosity and permeability through specific surface
Authors: Olsen Casper , Hongdul Thanong , Lykke Fabricius Ida
Published: February 2008

Based on Archie’s cementation factor as measured on North Sea chalk and on published data, we explore how the cementation factor depends on other physical properties of the chalk. A relationship between cementation factor and specific surface with respect to bulk volume is obtained for chalk. This leads to how Archie’s cementation factor may be predicted from porosity and permeability for chalk as well as for sandstone. A common relationship between cementation factor and specific surface with respect to bulk volume calculated from porosity and permeability is obtained. As an alternative, the [Formula: see text]-factor in Archie’s equation is related to specific surface with respect to bulk volume, but the relationship is less clear than the simple relationship between cementation factor and specific surface.
Childhood sexual abuse and non-suicidal self-injury: meta-analysis
Authors: Klonsky E. David , Moyer Anne
Published: March 2008

Background

Many theorists posit that childhood sexual abuse has a central role in the aetiology of self-injurious behaviour. Studies that report statistically significant associations between a history of such abuse and self-injury are cited to support this view.

Aims

A meta-analysis was conducted to determine systematically the magnitude of the association between childhood sexual abuse and self-injurious behaviour.

Method

Forty-five analyses of the association were identified. Effect sizes were converted to a standard metric and aggregated.

Results

The relationship between childhood sexual abuse and self-injurious behaviour is relatively small (mean weighted aggregateϕ=0.23). This figure may be inflated owing to publication bias. In studies that statistically controlled for psychiatric risk factors, childhood sexual abuse explained little or no unique variance in self-injurious behaviour.

Conclusions

Theories that childhood sexual abuse has a central or causal role in the development of self-injurious behaviour are not supported by the available empirical evidence. Instead, it appears that the two are modestly related because they are correlated with the same psychiatric risk factors.
Self-harm in first-episode psychosis
Authors: Harvey Samuel B. , Dean Kimberlie , Morgan Craig , Walsh Elizabeth , Demjaha Arsime , Dazzan Paola , Morgan Kevin , Lloyd Tuhina , Fearon Paul , Jones Peter B. , Murray Robin M.
Published: March 2008

Background

Little is known about self-harm occurring during the period of untreated first-episode psychosis.

Aims

To establish the prevalence, nature, motivation and risk factors for self-harm occurring during the untreated phase of first-episode psychosis.

Method

As part of the æSOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study, episodes of self-harm were identified among all incident cases of psychosis presenting to services in south-east London and Nottingham over a 2-year period.

Results

Of the 496 participants, 56 (11.3%) had engaged in self-harm between the onset of psychotic symptoms and first presentation to services. The independent correlates of self-harm were: male gender, belonging to social class I/II, depression and a prolonged period of untreated psychosis. Increased insight was also associated with risk of self-harm.

Conclusions

Self-harm is common during the pre-treatment phase of first-episode psychosis. A unique set of fixed and malleable risk factors appear to operate in those with first-episode psychosis. Reducing treatment delay and modifying disease attitudes may be key targets for suicide prevention.
Cognitive-behavioural intervention for self-harm: randomised controlled trial
Authors: Slee Nadja , Garnefski Nadia , van der Leeden Rien , Arensman Ella , Spinhoven Philip
Published: March 2008

Background

Self-harm by young people is occurring with increasing frequency. Conventional in-patient and out-patient treatment has yet to be proved efficacious.

Aims

To investigate the efficacy of a short cognitive-behavioural therapy intervention with 90 adolescents and adults who had recently engaged in self-harm.

Method

Participants (aged 15–35 years) were randomly assigned to treatment as usual plus the intervention, or treatment as usual only. Assessments were completed at baseline and at 3 months, 6 months and 9 months follow-up.

Results

Patients who received cognitive-behavioural therapy in addition to treatment as usual were found to have significantly greater reductions in self-harm, suicidal cognitions and symptoms of depression and anxiety, and significantly greater improvements in self-esteem and problem-solving ability, compared with the control group.

Conclusions

These findings extend the evidence that a time-limited cognitive-behavioural intervention is effective for patients with recurrent and chronic self-harm.
The dynamics of fluorescently labeled endogenousgurkenmRNA inDrosophila
Authors: Jaramillo Angela M. , Weil Timothy T. , Goodhouse Joseph , Gavis Elizabeth R. , Schupbach Trudi
Published: February 2008

During Drosophila oogenesis, the targeted localization of gurken (grk) mRNA leads to the establishment of the axis polarity of the egg. In early stages of oogenesis, grk mRNA is found at the posterior of the oocyte, whereas in the later stages grk mRNA is positioned at the dorsal anterior corner of the oocyte. In order to visualize the real-time localization and anchorage of endogenous grk mRNA in living oocytes, we have utilized the MS2-MCP system. We show that MCP-GFP-tagged endogenous grk mRNA localizes properly within wild-type oocytes and behaves aberrantly in mutant backgrounds. Fluorescence recovery after photobleaching (FRAP) experiments of localized grk mRNA in egg chambers reveal a difference in the dynamics of grk mRNA between young and older egg chambers. grk mRNA particles, as a population, are highly dynamic molecules that steadily lose their dynamic nature as oogenesis progresses. This difference in dynamics is attenuated in K10 and sqd1 mutants such that mislocalized grk mRNA in older stages is much more dynamic compared with that in wild-type controls. By contrast, in flies with compromised dynein activity, properly localized grk mRNA is much more static. Taken together, we have observed the nature of localized grk mRNA in live oocytes and propose that its maintenance changes from a dynamic to a static process as oogenesis progresses.
Loss of doctor-to-doctor communication: Lessons from the reconfiguration of mental health services in England
Authors: Chew-Graham Carolyn , Slade Mike , MontÂna Carolyn , Stewart Mairi , Gask Linda
Published: March 2008

Objective

To explore the tensions across the primary-secondary interface when referral from primary care is to a team and to inform service developments in other specialties.

Methods

A nested qualitative study within a randomized controlled trial of primary care and Community Mental Health Teams (CMHTs) in Croydon and Manchester, UK. For the qualitative study, interviews were carried out with general practitioners (GPs), psychiatrists and managers or clinical leads of the CMHTs.

Results

GPs described the need for access to specialist knowledge, which they perceived to lie with the psychiatrist, and referral to a team was not perceived to allow this access. A personal threshold was identified by GPs after which they referred the patient to secondary care. CMHTs and psychiatrists recognized that this personal threshold differed between GPs, but their criteria for accepting referrals did not seem to allow for a flexible response to referral requests, leading to the referral being labelled as ‘inappropriate’. The lack of direct doctor-to-doctor communication was perceived by respondents to contribute to a fragmentation of patient care. Strategies were described whereby the system was bypassed to achieve doctor-to-doctor communication, which undermined the team.

Conclusions

Development of intermediate or ‘Tier 2’ services beyond the mental health services, where the GP refers to a team rather than to a specialist (hospital consultant) could benefit from reflecting on experiences with mental health services. There is a danger that new community services for the physically ill will engender the same level of confusion and discontent described by GPs and other health professionals in this study who are concerned with mental health care. Flexibility is needed within care pathways, including the provision of direct doctor-to-doctor communication together with approaches to minimize the marginalization of non-medical professionals.
The effect of age and procedure on resource use for patients with cerebrovascular disease
Authors: Kuwabara Kazuaki , Matsuda Shinya , Imanaka Yuichi , Fushimi Kiyohide , Hashimoto Hideki , Ishikawa Koichi
Published: March 2008

Objective

Many studies have described the impact of population ageing on health care expenditures, but few have assessed its impact on specific diseases adjusted for severity and procedure. This study examined the relationship between an ageing population and resource use in patients with cerebrovascular disease (CVD).

Methods

A total of 13,856 CVD patients were treated in 82 academic and 92 community hospitals. Demographic variables, clinical variables, length of stay (LOS) and total charges were analysed by age group (under 65 years, 65-74 years and 75 years or older). The independent effects of age on LOS and total charge were determined using multivariate analysis.

Results

There were 5172 (37%) patients under 65 years of age, 4096 (30%) 65-74 years and 4588 (33%) 75 years or older. Intracranial infarction or ischaemia was diagnosed in 69% of the patients, haemorrhage in 23% and subarachnoid haemorrhage in 9%. The overall mortality was 6% (5% in under 65 years, 5% in 65-74 years and 9% in 75 years or older; P < 0.001). There were significant differences in the proportion of procedures performed in each age category. Age and procedure were significantly associated with LOS, particularly the latter. Age had no significant association with total charge, but procedure was highly associated.

Conclusions

Ageing has no significant impact on total charge. Instead policy-makers should acknowledge the effect of procedures on health care costs, conduct economic evaluations and monitor use of procedures.
Improving access to primary care: Eight case studies of introducing Advanced Access in England
Authors: Pope Catherine , Banks Jon , Salisbury Chris , Lattimer Val
Published: March 2008

Objective

To examine the implementation of ‘Advanced Access’ as a means of improving access to primary care.

Methods

Qualitative case studies of eight English general practices undertaken as part of a mixed method study.

Results

There was considerable variation in the interpretation and implementation of Advanced Access. Practices claiming to operate this system often did not follow its key principles. Differences between practice access systems centred on the use of ‘same-day’ appointments. The association of Advanced Access with same-day appointment systems was problematic as it both created antagonism to, and diverged from, the Advanced Access model. Practice staff did not necessarily share the conceptualisation of demand that underpinned Advanced Access. Other policies and targets provided further incentives to diverge from the model and these factors were compounded by informal organizational behaviours, notably the exercise of discretion, which led to adaptation.

Conclusion

Advanced Access was diluted because it became confused with same-day appointment systems and other incentives and targets. Its guiding philosophy of ‘manageable demand’ appeared counter-intuitive to staff in the context of general practice, which made its implementation problematic. As a result, the system was adapted and modified.
The treatment of deep shoulder infection and glenohumeral instability with debridement, reverse shoulder arthroplasty and postoperative antibiotics
Authors: Cuff D. J. , Virani N. A. , Levy J. , Frankle M. A. , Derasari A. , Hines B. , Pupello D. R. , Cancio M. , Mighell M.
Published: March 2008

We retrospectively reviewed 21 patients (22 shoulders) who presented with deep infection after surgery to the shoulder, 17 having previously undergone hemiarthroplasty and five open repair of the rotator cuff. Nine shoulders had undergone previous surgical attempts to eradicate their infection. The diagnosis of infection was based on a combination of clinical suspicion (16 shoulders), positive frozen sections (> 5 polymorphonuclear leukocytes per high-power field) at the time of revision (15 shoulders), positive intra-operative cultures (18 shoulders) or the pre-operative radiological appearances. The patients were treated by an extensive debridement, intravenous antibiotics, and conversion to a reverse shoulder prosthesis in either a single- (10 shoulders) or a two-stage (12 shoulders) procedure.

At a mean follow-up of 43 months (25 to 66) there was no evidence of recurrent infection. All outcome measures showed statistically significant improvements. Mean abduction improved from 36.1° (sd 27.8) pre-operatively to 75.7° (sd 36.0) (p < 0.0001), the mean forward flexion from 43.1° (sd 33.5) to 79.5° (sd 43.2) (p = 0.0003), and mean external rotation from 10.2° (sd 18.7) to 25.4° (sd 23.5) (p = 0.0037). There was no statistically significant difference in any outcome between the single-stage and the two-stage group.
Low molecular weight heparin impairs tendon repair
Authors: Virchenko O. , Aspenberg P. , Lindahl T. L.
Published: March 2008

Thrombin has many biological properties similar to those of growth factors. In a previous study, we showed that thrombin improves healing of the rat tendo Achillis. Low molecular weight heparin (LMWH) inhibits the activity and the generation of thrombin. We therefore considered that LMWH at a thromboprophylactic dose might inhibit tendon repair.

Transection of the tendo Achillis was carried out in 86 rats and the healing tested mechanically. Low molecular weight heparin (dalateparin) was either injected a few minutes before the operation and then given continuously with an osmotic mini pump for seven days, or given as one injection before the operation. In another experiment ,we gave LMWH or a placebo by injection twice daily. The anti-factor Xa activity was analysed.

Continuous treatment with LMWH impaired tendon healing. After seven days, this treatment caused a 33% reduction in force at failure, a 20% reduction in stiffness and a 67% reduction in energy uptake. However, if injected twice daily, LMWH had no effect on tendon healing. Anti-factor Xa activity was increased by LMWH treatment, but was normal between intermittent injections.

Low molecular weight heparin delays tendon repair if given continuously, but not if injected intermittently, probably because the anti-factor Xa activity between injections returns to normal, allowing sufficient thrombin stimulation for repair. These findings indicate the need for caution in the assessment of long-acting thrombin and factor Xa inhibitors.
Variations in acetabular anatomy with reference to total hip replacement
Authors: Murtha P. E. , Hafez M. A. , Jaramaz B. , DiGioia A. M.
Published: March 2008

Three-dimensional surface models of the normal hemipelvis derived from volumetric CT data on 42 patients were used to determine the radius, depth and orientation of the native acetabulum. A sphere fitted to the lunate surface and a plane matched to the acetabular rim were used to calculate the radius, depth and anatomical orientation of the acetabulum. For the 22 females the mean acetabular abduction, anteversion, radius and normalised depth were 57.1° (50.7° to 66.8°), 24.1° (14.0° to 33.3°), 25 mm (21.7 to 30.3) and 0.79 mm (0.56 to 1.04), respectively. The same parameters for the 20 males were 55.5° (47.7° to 65.9°), 19.3° (8.5° to 32.3°), 26.7 mm (24.5 to 28.7) and 0.85 mm (0.65 to 0.99), respectively.

The orientation of the native acetabulum did not match the safe zone for acetabular component placement described by Lewinnek. During total hip replacement surgeons should be aware that the average abduction angle of the native acetabulum exceeds that of the safe zone angle. If the concept of the safe zone angle is followed, abduction of the acetabular component should be less than the abduction of the native acetabulum by approximately 10°.
Comparison of the information in arthroplasty registers from different countries
Authors: Labek G. , Stoica C. I. , Böhler N.
Published: March 2008

This article considers some of the problems of the interpretation of information from other national arthroplasty registers when setting up a new register. In order for the most useful information to be available from registers much international co-operation is required between all those responsible for the design of registers as well as those who gather, assess and publish the data.
Arthroscopy in primary synovial chondromatosis of the hip
Authors: Boyer T. , Dorfmann H.
Published: March 2008

Between 1985 and 2000, 120 patients underwent arthroscopic management for primary synovial chondromatosis of the hip. We report the outcome of 111 patients with a mean follow-up of 78.6 months (12 to 196). More than one arthroscopy was required in 23 patients (20.7%), and 42 patients (37.8%) went on to require open surgery. Outcomes were evaluated in greater detail in 69 patients (62.2%) treated with arthroscopy alone, of whom 51 (45.9%) required no further treatment and 18 (16.2%) required further arthroscopies. Of the 111 patients, 63 (56.7%) had excellent or good outcomes. At the most recent follow-up, 22 patients (19.8%) had undergone total hip replacement.

Hip arthroscopy proved beneficial for patients diagnosed with primary synovial chondromatosis of the hip, providing good or excellent outcomes in more than half the cases.
Stimulation of the local femoral inflammatory response to fracture and intramedullary reaming
Authors: Morley J. R. , Smith R. M. , Pape H. C. , MacDonald D. A. , Trejdosiewitz L. K. , Giannoudis P. V.
Published: March 2008

We have undertaken a prospective study in patients with a fracture of the femoral shaft requiring intramedullary nailing to test the hypothesis that the femoral canal could be a potential source of the second hit phenomenon. We determined the local femoral intramedullary and peripheral release of interleukin-6 (IL-6) after fracture and subsequent intramedullary reaming.

In all patients, the fracture caused a significant increase in the local femoral concentrations of IL-6 compared to a femoral control group. The concentration of IL-6 in the local femoral environment was significantly higher than in the patients own matched blood samples from their peripheral circulation. The magnitude of the local femoral release of IL-6 after femoral fracture was independent of the injury severity score and whether the fracture was closed or open.

In patients who underwent intramedullary reaming of the femoral canal a further significant local release of IL-6 was demonstrated, providing evidence that intramedullary reaming can cause a significant local inflammatory reaction.
The function of the hand after operations for obstetric injuries to the brachial plexus
Authors: Kirjavainen M. , Remes V. , Peltonen J. , Rautakorpi S. , Helenius I. , Nietosvaara Y.
Published: March 2008

Hand function was evaluated in 105 patients who had been operated on in early infancy for brachial plexus birth palsy. The mean follow-up after surgery was for 13.4 years (5.0 to 31.5). Fine sensation, stereognosis, grip and pinch strength and the Raimondi scale were recorded.

Fine sensation was normal in 34 of 49 patients (69%) with C5–6 injury, 15 of 31 (48%) with C5–7 and in 8 of 25 (32%) with total injury. Loss of protective sensation or absent sensation was noted in some palmar areas of the hand in 12 of 105 patients (11%). Normal stereognosis was recorded in 88 of the 105 patients (84%), whereas only 9 of the 105 (9%) had normal grip strength. The mean Raimondi scale scores were 4.57 (3 to 5) (C5–6), 4.26 (1 to 5) (C5–7) and 2.16 (0 to 5) in patients with total injury.

The location of impaired sensation was related to the distribution of the root injury. Avulsion type of injury correlated with poor recovery of hand function.
Posterolateral rotatory instability of the elbow
Authors: Charalambous C. P. , Stanley J. K.
Published: March 2008

Posterolateral rotatory instability is the most common type of symptomatic chronic instability of the elbow. In this condition the forearm complex rotates externally in relation to the humerus, causing posterior subluxation or dislocation of the radial head. The lateral ligament complex, radial head and coronoid process are important constraints to posterolateral rotatory instability, and their disruption is involved in the pathogenesis of this condition. The diagnosis relies on a high index of clinical suspicion, active and passive apprehension tests, and examination under anaesthesia. Surgical treatment has given consistently successful results. Open reconstruction of the lateral ligaments with a tendon graft has been the procedure of choice, with arthroscopic techniques emerging as a potential alternative.
Variation in the anatomy of the tibial plateau
Authors: Lankester B. J. A. , Cottam H. L. , Pinskerova V. , Eldridge J. D. J. , Freeman M. A. R.
Published: March 2008

From a search of MRI reports on knees, 20 patients were identified with evidence of early anteromedial osteoarthritis without any erosion of bone and a control group of patients had an acute rupture of the anterior cruciate ligament. The angle formed between the extension and flexion facets of the tibia, which is known as the extension facet angle, was measured on a sagittal image at the middle of the medial femoral condyle.

The mean extension facet angle in the control group was 14° (3° to 25°) and was unrelated to age (Spearman’s rank coefficient, p = 0.30, r = 0.13). The mean extension facet angle in individuals with MRI evidence of early anteromedial osteoarthritis was 19° (13° to 26°, SD 4°). This difference was significant (Mann-Whitney U test, p < 0.001).

A wide variation in the extension facet angle was found in the normal control knees and an association between an increased extension facet angle and MRI evidence of early anteromedial osteoarthritis. Although a causal link has not been demonstrated, we postulate that a steeper extension facet angle might increase the duration of loading on the extension facet during the stance phase of gait, and that this might initiate failure of the articular cartilage.
Ninety-day mortality after elective total hip replacement
Authors: Parry M. , Wylde V. , Blom A. W.
Published: March 2008

Thromboprophylaxis after elective orthopaedic surgery remains controversial. Recent guidelines from the National Institute for Clinical Excellence (NICE) have suggested that low molecular weight heparin should be given to all patients undergoing total hip replacement. The British Orthopaedic Association is currently debating this guideline with NICE, as it is not clear whether published evidence supports this view. We present the early mortality in our unit after total hip replacement using aspirin as chemical thromboprophylaxis. The 30-day and 90-day mortality after primary total hip arthroplasty was zero. We compare this with that reported previously from our unit without using chemical thromboprophylaxis. With the introduction of routine aspirin thromboprophylaxis, deaths from cardiovascular causes have dropped from 0.75% to zero.

These results demonstrate that there is a strong argument for the routine administration of aspirin after elective total hip replacement.
Traumatic transepiphyseal separation of the upper femoral epiphysis following seizures in two children with cerebral palsy
Authors: Ballal M. S. , Dawoodi A. , Sampath J. , Bass A.
Published: March 2008

Transepiphyseal separation of the neck of the femur following grand mal seizures is described in two children with cerebral palsy. Closed reduction and percutaneous fixation was followed by a period in a hip spica. Although the incidence of avascular necrosis of the femoral head is high following such injury, this has not occurred in these patients at a follow-up of 18 months.
The results of a proximally-coated cementless femoral component in total hip replacement
Authors: Kim Y.-H.
Published: March 2008

This study reviewed the results of a cementless anatomical femoral component to give immediate post-operative stability, and with a narrow distal section in order not to contact the femoral cortex in the diaphysis, ensuring exclusively metaphyseal loading.

A total of 471 patients (601 hips) who had a total hip replacement between March 1995 and February 2002 were included in the study. There were 297 men and 174 women. The mean age at the time of operation was 52.7 years (28 to 63). Clinical and radiological evaluation were performed at each follow-up. Bone densitometry was carried out on all patients two weeks after operation and at the final follow-up examination. The mean follow-up was 8.8 years (5 to 12).

The mean pre-operative Harris hip score was 41 points (16 to 54), which improved to a mean of 96 (68 to 100) at the final follow-up. No patient complained of thigh pain at any stage. No acetabular or femoral osteolysis was observed and no hip required revision for aseptic loosening of either component. Deep infection occurred in two hips (0.3%) which required revision. One hip (0.2%) required revision of the acetabular component for recurrent dislocation. Bone mineral densitometry revealed a minimal bone loss in the proximal femur.

This cementless anatomical femoral component with metaphyseal loading but without distal fixation produced satisfactory fixation and encourages proximal femoral loading.
Evaluation of patients with a painful total knee replacement
Authors: Mandalia V. , Eyres K. , Schranz P. , Toms A. D.
Published: March 2008

Evaluation of patients with painful total knee replacement requires a thorough clinical examination and relevant investigations in order to reach a diagnosis. Awareness of the common and uncommon problems leading to painful total knee replacement is useful in the diagnostic approach. This review article aims to act as a guide to the evaluation of patients with painful total knee replacement.
Reconstruction of type II pelvic resection with a new peri-acetabular reconstruction endoprosthesis
Authors: Falkinstein Y. , Ahlmann E. R. , Menendez L. R.
Published: March 2008

We report our early experience with a new peri-acetabular reconstruction endoprosthesis used for pelvic reconstruction after tumour resection. The outcome of 21 patients who underwent limb salvage following type II pelvic resection and reconstruction using the peri-acetabular reconstruction prosthesis between 2000 and 2006 was retrospectively reviewed. This prosthesis was designed to use the remaining part of the ilium to support a horizontally placed acetabular component secured with internal fixation and bone cement. Into this device a constrained acetabular liner is positioned which is articulates with a conventional femoral component to which a modular extension and modular head are attached. The mean follow-up was 20.5 months (1 to 77). The most common complications were deep infection, superficial wound infections, and dislocation. The mean musculoskeletal tumor society functional outcome score for the survivors was 20.1(11 to 27).

We recommend the use of the peri-acetabular reconstruction prosthesis for reconstruction of large defects after type II pelvic resection, as this design has a greater inherent stability over other available prostheses.
Snapping pes syndrome
Authors: Bollen S. R. , Arvinte D.
Published: March 2008

We present a series of four patients with what we have termed the snapping pes syndrome. This is a painful clicking and catching experienced at the posteromedial corner of the knee when moving from flexion to extension. Clinical examination and real time ultrasound are the most useful diagnostic tools. If medical treatment is unsuccessful surgical excision of both the semitendinous and gracilis tendons is indicated for relief of persistent symptoms.
Urological Cancer Information on the Web: How Accurate is It?
Authors: Kok K , Parikh AR , Clarke A , Kaisary AV , Butler PEM
Published: March 2008

The world wide web is the fastestgrowing health information medium. In 2001, 52 million adults in America accessed the web to obtain such information.1 Cancer has been shown to be among the top three health topics searched for on the internet. A survey performed by American oncologists estimated that approximately 30% of their patients use the internet to obtain information. Other surveys have shown that up to 50% of cancer patients use the net for this purpose. The internet is also seen as an important source of information for family members and caregivers of cancer patients.
Out-of-hours Demand For Vascular Radiology
Authors: Wolowczyk L , Beckitt T , Baird RN , Subramaniam M , Smith FC , Lamont PM
Published: March 2008

The Vascular Society of Great Britain and Ireland recognises the importance of interventional vascular radiology as part of the multidisciplinary approach to the provision of emergency vascular services. However, arranging emergency rotas for vascular radiolo gy is not easy because of the small numbers of interventional radiologists who may also be required to cover other specialities.
Surgical training in China
Authors: Lu Yong-Ming
Published: March 2008

Many of the problems in the structure of surgical training in our society seem to occur in China as well. Drs Lu and Fau have shown that there is diversity of training opportunities and facilities among Chinese hospitals. Communication skills are becoming as necessary in the East as they are in Western medical practice. It is interesting to note the perceived unmet demand for GPs within China. Our own trainees may feel that they are now contributing to the costs of their training with falling (stolen) study leave budgets but trainee surgeons' salaries in China are a mere fraction of those in the UK. Thankfully, in the UK we don't reduce the training time for those with postgraduate degrees. Perhaps worthwhile exchanges between Chinese and UK surgical trainees may be more feasible following last year's council visit to China?
Surgeons Urge Caution Over Operation Videos For Patients
Authors: Woodnick Mel
Published: March 2008

One of the trends of modern health care is the growing desire of patients for more information. As a result, some surgeons are giving patients the opportunity to view video footage of the type of operation they are to undergo before surgery. Is this beneficial to the patient or could it lead to patients refusing much-needed treatment?
Setting recognised standards for aesthetic dentistry
Authors: Drake Sharon
Published: March 2008

The Faculty of General Dental Practice (UK) has developed a new accredited training programme in aesthetic dentistry. Running from April 2008, the advanced postgraduate certificate in aesthetic dentistry is an 18-month master's level course, aimed at general dental practitioners (GDPs) who wish to follow a training pathway that leads to a formal assessment and a recognised qualification. The programme will be delivered by experienced practitioners and is designed to bring together the fundamental elements of a modern aesthetic dental practice, combining a high level of theoretical and clinical teaching.
Faculty launches first UK orthodontic therapy course
Authors: Mitchell Laura
Published: March 2008

Few can have failed to notice the interest in both the dental and the lay press in the first orthodontic therapy course run under the auspices of the Faculty of Dental Surgery (FDS). All of the trainees on the Yorkshire course seem to have been in print at some stage (and some on several occasions) and it is evident that all seem to be relishing their new role and the challenges it brings. A second intake is planned for July 2008. The Yorkshire course is now to be joined by a second course based in South Wales, which will take 12 trainees and will commence in the summer of 2008.
The College Library Collection at Your Fingertips
Authors: Paine Wendy
Published: March 2008

Looking for a book or journal on a particular topic or by a particular author? The library's online catalogue is the place to start. Growing all the time, the catalogue holds details of nearly 67,000 titles (93,000 items) held in the library, with many more titles published pre-1850 yet to be added. Records for most recently published books include summaries, tables of content and book jacket images.
'i Know Where I'd Rather Be': Hospital at Home
Authors: Towell Elaine
Published: March 2008

Tr eating patients at home has been commonplace in Europe, Australia and the US for decades and now it seems the practice is gaining momentum in the UK. With hospitals under pressure to cut costs by reducing hospital stays and the shift towards care closer to home, Trusts are turning to 'hospital at home' services, which concentrate on providing nurse-led care to support early discharge following surgery. Advocates of the schemes cite faster recovery times and re duced risk of hospital-acquired infections among the benefits. In addition, with bed days costing up to a thousand pounds a day depending on the ward, financial gain is high.
Achieving a balance – feast and famine
Authors: Ribeiro Bernard
Published: March 2008

In 1986 a report by the UK health departments, the Joint Consultants Committee and chairmen of regional health authorities, Achieving A Balance ,1 proposed an integrated package of measures to achieve a gradual reform of hospital staffing in the interests of patients and doctors by reducing registrar numbers. The steering group, which emerged to implement these proposals, reflected a wide range of professional interests – royal colleges, the central committee on hospital medical services, the British Medical Association and its hospital junior staff committee, academic medicine and representatives of health authorities and the health departments.
The Date of the Life of the Patriarch Ignatius Reconsidered
Authors: Tamarkina Irina
Published: February 2008

Many Byzantine texts are still provoking fierce debates over their dates of composition. The recent examples falling only into the 9th c. include the Bibliotheca of Photius, the Chronicle of George the Monk and the Life of the patriarch Nicephore by Nicetas the Deacon. In this article we will venture to call into question the accepted date of the no less well-known and important text, the Life of the patriarch Ignatius by Nicetas David the Paphlagonian.