bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Partial Lateral Meniscectomy in Patients ≥60 Years
Authors: Barrett Gene R , Treacy Stephen H , Ruff Cynthia G
Published: April 2021

ABSTRACT

To determine the benefit, if any, of meniscectomy in an older population, all patients ≥60 years who underwent partial lateral meniscectomy were evaluated. Thirty-five patients (36 knees) were available for follow-up. The average patient age was 64.9 years. Patients were divided into two groups based on the degree of articular cartilage damage. Patients in group 1 had no damage worse than grade II and underwent arthroscopic partial meniscectomy only, while patients in Group 2 had grade III or IV damage and underwent arthroscopic debridement as well as partial meniscectomy. With an average follow-up of 36.8 months, the overall failure rate was 13.9%. Eighty-six percent of the patients reported the overall assessment of their knee as improved (94% and 80% in groups 1 and 2, respectively). While patients in group 2 tended to have less favorable results than patients in group 1, these results indicate that this procedure is warranted and that both groups benefited significantly from partial meniscectomy.
Video-Assisted Thoracic Diskectomy and Anterior Release: A Biomechanical Analysis of an Endoscopic Technique
Authors: Connolly P J , Ordway N R , Sacks Todd , Kolata R , Yuan H A
Published: April 2021

ABSTRACT

This study evaluates the residual biomechanical stability of the spine following multilevel anterior diskectomies and anterior longitudinal ligament release using video-assisted thoracoscopic surgery (VATS). Eighteen domestic pigs were randomly divided into three groups of six pigs. Group 1 underwent thoracic anterior release from T4-T9 using a left-sided VATS approach, group 2 underwent thoracic anterior release from T4-T9 via a traditional left thoracotomy (open), and group 3 did not undergo surgery and served as a control. After surgery, the animals were euthanized, and the thoracic spinal columns were harvested for biomechanical testing. Nondestructive testing was performed on all specimens in pure compression, flexion, extension, right lateral bending, and torsion.

Specimens from group 1 had significantly lower stiffness values (P<.05) than the contro) group for all five test modes. These data demonstrate that adequate anterior release of the thoracic spine can be obtained with the VATS technique. Further prospective clinical studies on VATS are required before the widespread application of this technique.
Reduced Acetabular Depth in Hip Instability in the Newborn
Authors: Reikerås Olav , Hinderaker Thore , Steen Harald
Published: April 2021

ABSTRACT

This study assessed the frequency of ultrasonographic hip instability and compared the results with clinical and morphological ultrasonographic evaluations of the hip in the newborn infant. Hip stability in 2016 consecutive births (1 074 boys and 942 girls) was assessed clinically and ultrasonographically. Ultrasonography included dynamic stability testing and morphologic evaluations. Compared with ultrasonography, clinical stability testing had a specificity of 0.998 and a sensitivity of 0.667. The incidence of instability was 0.007 for hips and 0.01 0 for babies. Acetabular depth in 3994 normal hips was 8.3±0.9 mm, femoral head diameter was 15.4±1.3 mm, and acetabular bony coverage of the femoral head was 54±4.3%. Hip instability was significantly associated with a reduced acetabular depth. As the femoral head diameter was within normal in the unstable hips, coverage was significantly reduced.
Osteonecrosis in Protease Inhibitor-Treated Patients
Authors: Bonfanti Paolo , Gabbuti Andrea , Carradori Silvia , Pusterla Luigi , Parazzini Fabio , Lindonio Simona , Quirino Tiziana
Published: April 2021

ABSTRACT

The introduction of protease inhibitors has proven a watershed in human immunodeficiency virus infection therapy and has initiated an era of highly active antiretroviral therapy. However, the numerous data on the effectiveness of these therapeutic regimens have been cited with an ever-growing number of communications concerning adverse reactions. In particular, the widescale use of protease inhibitors has underlined a series of events not evidenced in the controlled clinical studies that permitted the registration of these drugs. We are conducting a cohort multicenter study to evaluate the incidence of adverse events during treatment with protease inhibitors. To date, A cases of bilateral osteonecrosis of the femoral head have been reported out of 1073 person-years. While the pathogenesis of this event is unclear, it may be a long-term complication of protease inhibitor treatment.
Osteoid Osteoma and Osteoblastoma of the Sacrum
Authors: Biagini Roberto , Orsini Umberto , Demitri Silvio , Bibiloni Juan , Ruggieri Pietro , Mercuri Mario , Capanna Rodolfo , Majorana Blas , Bertoni Franco , Bacchini Patrizia , Briccoli Antonio
Published: April 2021

ABSTRACT

This retrospective study examined 10 patients with osteoid osteoma and ? patients with osteoblastoma localized in the sacrococcyx. In the sacrum, the diagnosis was delayed compared to other sites. Curettage through a posterior approach is the treatment of choice. Radiotherapy as well as embolization of feeding arteries may be used for the most aggressive lesions. Prognosis is generally good with a low incidence of local recurrence(<10%).
Selective Corticosteroid Injection into the Extensor Pollicis Brevis Tenosynovium for de Quervain's Disease
Authors: Sakai Naotaka
Published: April 2021

ABSTRACT

Selective corticosteroid injection into the extensor pollicis brevis tenosynovium was performed in 50 patients (7 men and 43 women; 53 hands) with de Quervain's disease. Mean patient age was 32.4 years and mean foUow-up was 4.1 years. Before selective injection into the extensor pollicis brevis tenosynovium, the extensor pollicis brevis tendon was palpated at the distal ulnar side of the first compartment, with dorsal and volar flexion of the first metacarpophalangeal joint. A 27-gauge needle was placed along the extensor pollicis brevis tendon and into the distal entrance of the extensor pollicis brevis tenosynovium selectively, and 10 mg of 40 mg/mL triamcinolone acetonide and 0.25 mL of 1% Xylocaine were combined and injected. Forty-six hands had relief of pain following a single injection. Six hands required a second injection and 1 hand required a third injection. Ultimately, all 53 hands had satisfactory results by selective extensor pollicis brevis injection alone, and no patients required surgical treatment.
Use of an Allograft Bone Button for Rotator Cuff Repair
Authors: Bonutti Peter M , Cremens Matthew J , Lee Frank S , Gray Timothy J
Published: April 2021

Abstract

Bone button anchors constructed from allograft bone were investigated as an alternative for rotator cuff repair. Bone button anchors were used in 59 consecutive procedures after mechanical pullout strength and cyclical loading bench testing. Sequential radiographs demonstrated that the anchors locked in cancellous bone and provided consistent fixation with no loosening or lysis in 1 year of clinical follow-up. Mechanical testing demonstrated mean pullout strength of 1 60.2 N (36 lbs), and the anchors did not migrate when cyclically loaded. Clinical results showed an allograft anchor is viable for rotator cuff tendon repair.
Platelet Concentrate Increases Bone Ingrowth into Porous Hydroxyapatite
Authors: Siebrecht Maikel A N , De Rooij Philippe P , Arm Douglas M , Olsson Martin L , Aspenberg Per
Published: April 2021

ABSTRACT

Platelets contain growth factors that are believed to stimulate early fracture repair. Autologous platelets can be sequestered, concentrated, and mixed with thrombin to yield a so-called autologous growth factor gel, which might enhance bone repair or bone graft incorporation. The effect of this platelet concentrate on total tissue and bone ingrowth into porous coralline hydroxyapatite was studied in a bone chamber rat model. Chambers with the platelet concentrate showed a significant increase in bone and total tissue ingrowth distance compared to untreated controls, indicating a platelet concentrate might enhance the clinical performance of porous hydroxyapatite in bone replacement.
The Role of Proximal Femoral Valgus Osteotomy in Legg-Calvé-Perthes Disease
Authors: Raney Ellen M , Grogan Dennis P , Hurley Mary E , Ogden John A
Published: April 2021

Abstract

Proximal femoral valgus osteotomy for Legg-CalvéPerthes disease was evaluated at an average 5 years postoperatively in 31 consecutive patients. The indications for osteotomy were hinge abduction and pain. The Iowa hip scores at follow-up for 21 patients averaged 93 points. Combined clinical and radiographic review for these patients yielded 6 (29%) excellent, 7 (33%) good, 5 (24%) fair, and 3 (14%) poor results. The 10 remaining patients had good pain relief and were satisfied but were unable to return for hip scale evaluation.
Abductor Reattachment With a Custom Proximal Femoral Replacement Prosthesis
Authors: Anderson Megan E , Hyodo Akira , Zehr Robert J , Marks Kenneth E , Muschler George F
Published: April 2021

Abductor attachment to an appropriately designed femorai prosthesis maintains abductor strength and provides ambulatory independence.
Coccidioides immitis Osteomyelitis: A Case Series Review
Authors: Holley Keith , Muldoon Michael , Tasker Sybil
Published: April 2021

Abstract

A retrospective chart review and telephone follow-up was conducted on patients who were treated for disseminated coccidioidomycosis involving bones or joints at the Naval Medical Center, San Diego, California from 1993-1999. Thirteen patients were identified, with average follow-up of 36 months. Six patients underwent surgical debridement and systemic medical therapy, and seven patients were treated medically only. All patients improved symptomatically with decreasing complement fixation titers at last follow-up. Five of the six patients treated with combined therapy are currently quiescent. Of those treated medically, four patients are quiescent; three were lost to follow-up. Coccidioidomycosis osteomyelitis remains a rare but difficult disease to treat, with a lifelong risk of recurrence. A combined medical and surgical approach has been shown to be effective, but medical therapy alone with intravenous amphotericin B followed by suppressive azole therapy may be effective in selected patients.
Denervation of the Sinus Tarsi for Chronic Post-Traumatic Lateral Ankle Pain
Authors: Dellon A Lee
Published: April 2021

Fractures and sprains that injure joints may also cause nerve damage. Indications for sinus tarsi denervation include pain refractory to conventional treatment after inversion sprains.
Subtalar Distraction Arthrodesis Using a Ramp Cage
Authors: Zion I , Shabat S , Marin L , London E , Matan Y , Howard C B , Nyska M
Published: April 2021

Subtalar distraction bone block arthrodesis has been described to treat late complications of displaced calcaneal fractures. A "ramp cage" can be used to restore the talocalcaneal relationship by providing stable correction in the coronal and sagittal dimensions.
Giant-Cell Tumors of Bone and Progesterone Receptors
Authors: Demertzis Nikolaos , Kotsiandri Fani , Giotis Ioulia , Apostolikas Nikiphoros
Published: April 2021

Abstract

Estrogen receptors, progesterone receptors, and cathepsin D were determined in 10 patients with giant-cell bone tumor. Progesterone receptors were expressed in 5 of 10 patients tested, whereas low levels of estrogen receptors were found in 1 patient. Cathepsin D levels were elevated in 5 of 5 samples studied. High values of progesterone receptors correlated with low tumor grade. Cathepsin D levels correlated negatively with tumor grade but positively with local tumor expansion. Giantcell bone tumor expressing progesterone receptors may manifest benign behavior. Cathepsin D may be involved in tumor expansion, possibly through its effect on bone resorption.
Comparison of Different Anti-Inflammatory Agents in Suppressing the Monocyte Response to Orthopedic Particles
Authors: Mulhall Kevin J , Curtin William A , Given H Frederick
Published: April 2021

Abstract

Three different anti-inflammatory agents - diclofenac, dexamethasone, and N-acetylcysteine - were compared to evaluate their effectiveness in suppressing monocytemacrophage cell culture activation and mediator release (tumor necrosis factor-α [TNF-α] and interleukin-1β [IL-1β]) in response to polymethylmethacrylate particulate debris. N-acetylcysteine and diclofenac were most effective in suppressing TNF-a and IL-1 β expression by the : monocyte-macrophages, Dexamethasone reduced TNF-α expression but was hot as effective in suppressing IL-1β expression. N-acetylcysteine and idexamethasone had no effect on cell viability whereas diclofenac at the highest concentrations decreased cell viabilities. N-acetyleystene and diclofenac, but less so dexamethasone, are effective in suppressing wear debris-related cell activation and mediator release and thus potentially represent therapeutic or preventive modalities for periprostatic Osteolysis.
Retention of Basic Cardiac Life Support Content: The Effect of Two Teaching Methods
Authors: Friesen Laurel , Stotts Nancy A
Published: April 2021

ABSTRACT

Does the method of instruction affect retention of Basic Cardiac Life Support (BCLS) knowledge and skill? This was the primary question addressed in a study conducted in a university school of nursing. The teaching methods studied were a lecture-demonstration-return demonstration method and a self-paced method.

The sample consisted of 63 baccalaureate nursing students who were assigned to one of the two teaching methods. American Heart Association instructional materials and cognitive and performance tests were used with both treatment groups. Initial mastery and retention were tested during week two and eight respectively.

Cognitive knowledge was retained at a mastery level by both groups at eight weeks. In addition, there was no difference in retention of performance skills based on teaching methods. However, neither group was able to demonstrate retention of performance skills at a mastery level.

Additional data indicate the self-paced subjects spent less time in BCLS learning activities. While the self-paced instructional package was more costly on a one-time basis, repeated applications would decrease the cost/student.
An Estimate of the Cost of Educating a BN Graduate and Graduates of Other Disciplines at a Canadian University: A Case Study
Authors: Roberts Patricia M
Published: April 2021

ABSTRACT

Nursing educators are often told that their courses and programs are too expensive. This study was planned because there is little published information available on the cost of nursing education in comparison with other disciplines. After the academic requirements for an honours or professional degree in each of 28 disciplines (excluding Medicine) were listed, and the cost/student of the courses calculated, the individual course costs were summated to provide the cost of each degree. It was found that the cost of the BN degree ($45 thousand) was, for example, not significantly different from the mean cost of an honours Arts degree ($44 ±7.5 thousand) and was well below the mean of an honours Science degree ($59 ± 19.4 thousand). It was therefore concluded that, at this University, the BN was not expensive, and that nurse educators at other universities should be skeptical of unsubstantiated claims to the contrary.
The Meaning of Health for Graduate Nursing Students
Authors: Hanna Kathleen M
Published: April 2021

ABSTRACT

The purpose of this study was to examine the meaning of health for graduate nursing students based on their life experiences. The qualitative descriptive approach of phenomenology was utilized to define the meaning of health for graduate nursing students. The sample consisted of 29 graduate nursing students. From the participants' responses, 68 descriptive expressions were obtained. Based on these expressions and identified elements, a definition of health was proposed that reflected an awareness of a physical as well as a mental state.
The Effect of Concept Teaching in Preparing Nursing Students for Clinical Practice
Authors: Kinnick Virginia
Published: April 2021

ABSTRACT

This experimental study compared three strategies for concept teaching, using concepts basic to interpretation of electronic fetal monitor patterns. Generic baccalaureate nursing students from two different universities were randomly assigned to one of three treatment groups. After the treatments were conducted (instruction), students' ability to identify concepts on fetal monitor patterns was tested before they entered the clinical setting, and again 6 to 7 weeks later, at the end of their clinical experience. The treatment group receiving instruction using all teaching variables prescribed in the Tennyson-Cocchiarella model for concept attainment (Group 3), had a significantly higher mean at p<.05 on the first test than the other two groups. Differences were maintained on the second test. In fact, the mean of Group 3 was the same on the first test (prior to entering the clinical setting) as the means of the other two groups after completion of the clinical experience.
Community Health Nursing Clinicals: An Examination of the Present and Ideas for the Future
Authors: McEwen Melanie
Published: April 2021

ABSTRACT

As part of a curriculum revision for a baccalaureate school of nursing, a nationwide survey examined how schools of nursing structure community health nursing (CHN) clinical experiences. Results indicate that a wide variety of settings and agencies (public health departments, schools, clinics, home health, and many more) are being used. Use of preceptors, use of multiple and single agencies, observational visits, time scheduled, projects, and faculty philosophy of CHN were examined. Although many settings, courses, and projects are traditional, this study reveals that some nursing schools are responding to changes in health care and population needs and are structuring CHN clinicals accordingly. Ideas for clinical courses for the future are offered.
Empowering Faculty Through Intrapreneurship: A Change Model
Authors: Nugent Katherine E , Lambert Vickie A
Published: April 2021

ABSTRACT

Institutions of nursing education are faced with socioeconomic issues that threaten to endanger the quality of education. Major issues such as budget cutbacks, changes in student populations, and decreasing numbers of professors mandate change if educational institutions are to survive. At the same time, health care reform provides nurse educators with an unprecedented opportunity to restructure curriculum. This article suggests that a method for meeting the challenge for educational reform while facing socioeconomic constraints is through intrapreneurship.
Schooling For Oppression: A Critical Hermeneutical Analysis of the Lived Experience of the Returning RN Student
Authors: Rather Marsha L
Published: April 2021

ABSTRACT

Although registered nurses (associate degree and diploma graduates) represent one of the fastest growing cohorts in baccalaureate schools of nursing, we know little about what they find meaningful about their schooling experience. The purpose of this phenomenological study was to unveil common meanings embedded in the lived experience of RNs returning to school for their baccalaureate degree. Returning RNs (RRNs) from three BSN programs (N = 15) participated in extended, unstructured interviews. The audiotaped interviews were transcribed verbatim and the resulting texts were analyzed hermeneutically to identify common meanings, relational themes across texts, and constitutive patterns expressing relationships between themes. Heideggerian phenomenology was the philosophical background for the analysis; secondary critical hermeneutical analysis utilized feminist scholarship and the work of critical social theorists. One relational theme that emerged - "Schooling For Oppression" - describes how the contested ideology of professionalism, and traditional behavioral teaching strategies, were used to prescribe the thoughts, values, and behavior of the RRNs.
Computer-Assisted Instruction: A Learner's Viewpoint
Authors: Thede Linda Q , Taft Susan , Coeling Harriet
Published: April 2021

ABSTRACT

Computer-assisted instruction (CAI) is becoming increasingly common in nursing. Insight into factors that facilitate or impede this process was gained through interviews with nursing students who had used one of four computer programs. Content analysis of these interviews found that the CAI experience includes many components. Three overall categories of comments emerged, pertaining to (a) the learner, (b) the learning environment, and (c) software design, including interactive features, how the learning design uses these features to achieve the learning objectives, and the content. This paper discusses elements that facilitate or hinder learning in each area and illustrates each with quotes from the interviews. This article also suggests positive actions that can increase learning through CAI use.
Perceived Benefits of Peer Leadership as Described by Junior Baccalaureate Nursing Students
Authors: Bos Sara
Published: April 2021

ABSTRACT

Nursing students often do not get the chance to practice the skills they need as nurses prior to graduation. Many of the required skills are difficult to teach using traditional classroom or clinical teaching methods. Peer leadership is one teaching method that may provide alternative learning opportunities for enhancing these professional nursing skills, and it encompasses the notions of peer teaching and peer supervision simultaneously. The purpose of this study was to describe what junior baccalaureate nursing students perceived as the benefits of a peer leadership experience, using Loving's Competence Validation Model as the theoretical framework. Twelve junior nursing students participated during their adult medical-surgical rotation and completed self-evaluations following the peer leadership experience. From analysis of these self-evaluations, responses were categorized into five perceived benefits: practice in prioritizing, enhancement of critical thinking skills, enhancement of technical skills, realization of peers as resources, and development of management skills.
Alternative and Complementary Therapies in Nursing Curricula
Authors: Reed Fay Carol , Pettigrew Amy C , King Margaret O
Published: April 2021

ABSTRACT

The growing interest in and use of alternative and complementary therapies by health care professionals and laypersons, the incorporation of these therapies in medical curricula and practice, and the greater acceptance of the legitimacy of such treatment methods require that nurse educators consider how this content may be incorporated into curricula. The authors propose that preIicensure students learn the premises that support such healing practices and develop skill in eliciting and evaluating patients' use of alternative therapies. In-depth study of one or more complementary therapies may be the focus of continuing education or elective courses. Students in graduate programs may investigate the safety and efficacy of nonorthodox therapies.
Influencing Aspects in Nursing Education on Swedish Nursing Students' Choices of First Work Area as Graduated Nurses
Authors: Fagerberg Ingegerd , Winblad Bengt , Ekman Sirkka-Liisa
Published: April 2021

ABSTRACT

It is difficult to recruit RNs to positions in various areas of elder care. The aim of this study is to understand the meaning of Swedish nursing students' reasoning during education about where in the health care system they would like to work as RNs after graduation. The students were interviewed using the same guide at the end of each of their three academic years. In the second and the third year the students kept diaries about their clinical education. A phenomenological-hermeneutic method of analysis was used, and eight themes appeared vital for the students' choice of work area after graduation. The deeper interpretations of the results imply that the students received contradictory messages during the education in elder care. Students found that nurses working in this field were often isolated with no apparent support system, which in turn reinforced their own ambivalence and reluctance towards future work in elder care.
Self-Directed Learning: Faculty and Student Perceptions
Authors: Lunyk-Child Ola I , Crooks Dauna , Ellis Patricia J , Ofosu Cottie , O'Mara Linda , Rideout Elizabeth
Published: April 2021

ABSTRACT

This article reports the results of a qualitative study that explored faculty and student perceptions of selfdirected learning (SDL) and investigated factors that facilitate or impede it. This study was conducted at McMaster University with faculty and students in a 4year undergraduate nursing program. Data were collected from 47 faculty and 17 students by means of focus groups that were audiotaped and transcribed. Content analysis was conducted to identify common themes in faculty and student transcripts. The themes that emerged provide insight into the educational strategy of selfdirected learning and can be summarized by the following major points: (1) commitment to SDL requires students and faculty to understand the value of empowering learners to take increased responsibility for decisions related to learning; (2) students engaged in self-directed learning undergo a transformation that begins with negative feelings (i.e., confusion, frustration, and dissatisfaction) and ends with confidence and skills for lifelong learning; and (3) faculty development is important to ensure high levels of competency in facilitating self-directed learning.
Perceptions of the Maternal-Child Clinical Rotation: The Male Student Nurse Experience
Authors: Patterson Barbara J , Morin Karen H
Published: April 2021

ABSTRACT

Although male student nurses have expressed their discomfort with beginning their maternal-child clinical experience, little actually is known about the nature and quality of their experience. Ib address this gap, a phenomenological study was conducted to investigate the experiences of 8 male student nurses who had completed their maternal-child rotation. Three theme clusters emerged: preconceptions about the maternal-child rotation, enduring the clinical experience, and surviving the clinical rotation. Students began their rotations with mixed feelings (e.g., dread, anxiety, apprehension, unknowing, fear of rejection). Maternal-child nursing was viewed by male students as a woman's domain, in which they were visitors. The students expressed concerns about meeting clinical objectives and personal goals because of their gender and possible misinterpretations of their care. Consequently, they undertook special precautions when performing postpartum assessments. Faculty played a significant role in clients' responses to the students and in providing a supportive learning environment. Faculty need to be cognizant of students' feelings as they plan clinical experiences. Identification of student concerns prior to the experience may be beneficial for enhancing the learning environment.
Evaluation of Classroom-Based, Web-Enhanced, and Web-Based Distance Learning Nutrition Courses for Undergraduate Nursing
Authors: Buckey Kathleen M
Published: April 2021

ABSTRACT

A traditional classroom-based course was transitioned during three semesters to a Web-enhanced and then a Web-based course. This nutrition course was part of the core curriculum for 58 undergraduate nursing students. Evaluation data were collected and analyzed to compare the effectiveness of the traditional classroom, Web-enhanced, and Web-based courses. Areas of evaluation included midterm and final examination scores and course grades, as well as student self-reports of instructor preparation, instructor-student interaction, testing, course objectives and assignments, textbooks, and strengths and weaknesses of the course. No differences were found in student learning outcomes. Although the Web-based course received the lowest mean course evaluation score, which was significantly different from the scores of the other two instructional methods, the students' qualitative comments revealed both positive and negative aspects of online instruction.
From the Tower Into the Trenches: A Nurse Educator's Reflections on the Knowledge of Experience
Authors: Didham Paula
Published: April 2021

ABSTRACT

I have been in the tower for a long time. I have been teaching nursing for more than 20 years, and only now, after spending 6 months in the trenches as a staff nurse, have I begun to realize how far removed I had become from the real world of nursing. In this article, I will first discuss the experiences that motivated me to take a leave of absence from my teaching position in Canada for a staff nurse position in an acute care hospital in Florida. Then I will share my early reflections about what I learned as a staff nurse in Florida and how I interpreted this experience in the context of my own teaching practice and in the context of nursing education.
Mentoring for Research Skill Development
Authors: Records Kathie , Emerson Roberta J
Published: April 2021

ABSTRACT

The nursing shortage is significantly affecting the nursing academic environment. A self-perpetuating cycle of insufficient numbers of faculty with inadequate preparation for academia could lead to a profound decline in the nursing profession. Institutions often implement mentoring plans for new tenure track faculty, and the challenge is even greater in environments that are not research intensive. This article describes the implementation of the research arm of an institutional mentoring plan for new tenure track faculty. The plan was designed to facilitate new faculty's attainment of tenure, while expediting the development of a satisfying career in academia.

Doctoral education does not necessarily provide graduates with all the tools required to be successful researchers. However, specific guidance may be provided in the developing of a research program; creating networks and selecting consultants; preparing presentations and publications; and developing grantsmanship skills, particularly for institutions without established research centers.
Congenital Primary Upper Eyelid Entropion
Authors: Zak Thaddeus A
Published: April 2021

ABSTRACT

A case of primary congenita) upper eyelid entropion (PCUEE) is reviewed. The author proposes a congenital shortness of the levator muscle with anomalous insertion onto the tarsal plate as the etiology, and a new simplified surgical correction is described. The classification of PCUEE as a syndrome with multiple congenital anomalies is supported, and the need for a complete systemic evaluation is stressed.

Congenital primary upper eyelid entropion is an exceedingly rare condition. In 1969, Hiles and Wilder1 reviewed the 13 known cases in the ophthalmic literature, and presented a new case. They suggested the possibility that congenital upper eyelid entropion was part of a syndrome involving multiple systemic anomalies.

Surgical correction of the ectropion is usually necessitated by corneal erosion secondary to trichiasis,2·3 and a multifarious assortment of surgical procedures has been described.4,8

The following is a case report of primary congenital upper eyelid entropion which corroborates the categorization as a syndrome, suggests a pathophysiologic abnormality of the eyelid as the etiology, and describes a new, simplified technique of surgical repair.
Proteus Syndrome: Ocular Complications
Authors: Burke J P , Bowell R , O'Doherty N
Published: April 2021

ABSTRACT

Proteus syndrome Is a recently recognized hamartoneoplastic malformation syndrome of uncertain etiology and variable expression, whose cardinal manifestations are pigmented nevi, hemihypertrophy, macrodactly, llpomata, and cerebroid-gyriform configuration ot the skin on the soles of the feet. The characteristic features may be present at birth but become more apparent with time. In the past this syndrome has been confused with other overgrowth disorders such as neurofibromatosis, Klippel-Trenaunay-Weber syndrome, Maffucci syndrome, and Bannayan syndrome. The ophthalmic features of the proteus syndrome require clarification. We review the ocular findings in 16 previously described cases and describe the findings unique to our patient, in particular, unilateral epibulbar and suspected posterior segment hamartomas.
Ophthalmic Findings of Hydranencephaly
Authors: Herman David C , Bartley George B , Bullock John D
Published: April 2021

ABSTRACT

Hydranencephaly is a rare developmental disorder in which the cerebral hemispheres are replaced by a cystic space filled with cerebrospinal fluid and covered by intact meninges. Ophthalmic findings include pupillary abnormalities, strabismus, nystagmus, ptosis, optic nerve hypoplasia, chorioretinitis, retinal vessel attenuation, and incomplete anterior chamber cleavage.
Optokinetic Asynunetry in Esotropia
Authors: Demer Joseph L , von Noorden Gunter K
Published: April 2021

ABSTRACT

Laboratory evidence suggests that the interruption of binocularity produced by early onset strabismus inhibits normal development of cortical inputs to the brainstem optokinetic pathway, producing an asymmetry in monocular optokinetic responses. It has been proposed that this optokinetic asymmetry can be useful in evaluating the presence of binocular vision.1

We studied 134 strabismic and 16 orthotopic patients to determine the clinical prevalence of asymmetric optokinetic responses. Cooperative children and adults were tested. For each subject, the observer made a judgment about the presence or absence of symmetry in the nasally directed versus temporally directed monocular optokinetic responses to motion of a hand-held drum.

Clinical evidence of significantly greater nasally than temporally directed optokinetic responses was observed in 58% of esotropie patients who developed strabismus before the age of 6 months; in 22% of esotropie patients with onset between 6 and 12 months of age; in 9% of esotropie patients with onset between 12 and 24 months of age; and in only 5% of esotropie patients with onset of esotropia after the age of 24 months. No asymmetry was observed in any of the exotropic patients or in the hypertropic patient and was present in only 6% of orthotropic patients. Statistical analysis indicates that in this population the finding of monocular optokinetic asymmetry in an esotropie patient implies an 85% chance that the onset of esotropia occurred in the first 6 months of life. Quantitative electro-oculographic recording demonstrated that the clinical evaluation of optokinetic asymmetry can detect high degrees of asymmetry, but may miss subtle ones. Dissociated vertical deviation and latent nystagmus were not consistently associated with asymmetry of the monocular optokinetic responses.

It may be concluded that clinically evident asymmetry of monocular optokinetic response is strong evidence for esotropia of early onset, while the absence of such asymmetry does not rule out early onset. Other manifestations of infantile esotropia, such as latent nystagmus and dissociated vertical deviation, are not invariably associated with optokinetic asymmetry.
Implantation in Children
Authors: Gimbel Howard V , Ferensowicz Maria , Raanan Marsha , DeLuca Maryclare
Published: April 2021

ABSTRACT

With the development of posterior chamber lenses and continuous curvilinear capsulorhexis, and with the availability of viscoelastic agents, the use of intraocular lenses (IOLs) in children is becoming more popular. Since 1982, we have implanted posterior chamber IOLs (PC-IOLs) in the capsular bags of 61 cataractous eyes of 46 children and adolescents. The goal was in-the-bag placement facilitated by the use of a small capsulectomy, and, since 1984, by the use of the continuous curvilinear capsulorhexis. Forty-four cataracts were congenital, 13 were traumatic, and 4 were developmental. Cataract extraction with IOL implantation was performed in 16 (26%) preschool cases (ages 2 through 5), in 31 (51%) child cases (ages 6 through 12), and 14 (23%) adolescent cases (ages 13 through 18). Surgical and postoperative complications were minimal. Visual results were good. Fifty-six percent of preschoolers, 87% of children, and 86% of adolescents achieved 20/40 or better best corrected vision, with 79% of the total cohort achieving 20/40 or better. Overall, 35% achieved an uncorrected visual acuity of 20/40 or better. All but two cases had improvement in best corrected vision; if 20720 was not attained, the cause was mainly due to deprivation amblyopia. Forty-eight percent of patients were within a diopter of emmetropia.
Laser Therapy for Retinopathy of Prematurity
Authors: Preslan Mark W
Published: April 2021

ABSTRACT

Nine patients were treated with indirect ophthalmoscope argon laser photocoagulation for threshold retinopathy of prematurity (ROP). A total of 16 eyes were treated at an average postconceptional age of 36.31 weeks. All eyes demonstrated regression of threshold ROP. Follow up was between 1 and 14 months postoperatively. Laser photocoagulation for ROP may be an effective alternative in treating high risk levels of ROP.
A Cluster of Patients With Inferior Rectus Restriction Following Local Anesthesia for Cataract Surgery
Authors: Hamilton Stephen M , Elsas Frederick J , Dawson Terry L
Published: April 2021

ABSTRACT

During a 5-month period, four patients developed contracture of the inferior rectus muscle following local anesthesia for cataract surgery in the practice of one ophthalmologist. Two anesthesiologists administered retrobulbar anesthesia. All patients had persistent vertical diplopia caused by a large hypotropia of the operated eye. Forced auction testing revealed marked restriction to elevation of the eye. In two patients, MRI demonstrated segmental thickening of the inferior rectus muscle, just posterior to the globe. All patients had normal thyroid function tests. No patient had a previous history of strabismus.

Three of the four have had strabismus surgery consisting of recession of the markedly restricted inferior rectus muscle on an adjustable suture. These three patients have regained fusion and are now asymptomatic.
Screening for Retinopathy of Prematurity: Are a Lid Speculum and Scleral Indentation Necessary?
Authors: Dhillon Baljean , Wright Elizabeth , Fleck Brian W
Published: April 2021

ABSTRACT

We wanted to investigate the value of using a lid speculum and scleral indentation in performing binocular indirect ophthalmoscopy (BIO) in neonates at risk of retinopathy of prematurity (ROP). We performed a prospective masked comparison of BIO examinations using either a lid speculum and scleral indentation (SI) or no scleral indentation (NSIX in our neonatal intensive care unit. We did 57 consecutive BIO examinations of infants weighing less than 1500 g and/or having a gestational age of less than 32 weeks.

With NSI, zone I ROP was reliably seen in 53 of 57 examinations; the superior, nasal, and temporal aspects of zone Il were seen in 45 of 57 examinations; inferior zone II, in 22 of 57 examinations; and zone III in 1 of 57 examinations. SI facilitated complete peripheral fundus examination in all cases but had to be abandoned in two infants due to acute changes in oxygen saturation levels. Five infants developed threshold disease, and in two of them details of the active ROP ridge were missed with NSI.

The gentle use of an eyelid speculum and globe rotation allows rapid and relatively atraumatic assessment of the peripheral fundus, even in babies who are being ventilated. Although threshold ROP may be diagnosed by observation of posterior retinal vessel dilation and tortuosity ("plus" disease), accurate grading of ROP is likely to require Sl. In the absence of clearly developed "plus" disease, borderline or prethreshold disease may occasionally be missed using BIO with NSI. SI is necessary to examine the inferior midperipheral retinal vasculature (zone II) and the far peripheral temporal retina (zone III) and is associated with few complications. BIO with SI allows early identification of neonates with normal retinal vascularization who require no further ROP screening.
Dimensions of the Pediatric Crystalline Lens: Implications for Intraocular Lenses in Children
Authors: Bluestein EttaLeah C , Wilson M Edward , Wang Xiao-Hong , Rust Philip F , Apple David J
Published: April 2021

ABSTRACT

As surgeons gain more experience with the implantation of posterior chamber intraocular lenses (IOLs) into the capsular bag in children, the minimum age for which implantation is advised may continue to be lowered. Accurate sizing of an IOL intended for i n-t he-bag fixation may depend on knowledge of the size of the capsular bag. In order to develop a growth curve for the normal crystalline lens and hence the capsular bag, 50 pediatrie autopsy eyes ranging in age from 1 day to 16 years were obtained postmortem and measured within 24 hours after enucleation. Mean crystalline lens diameter was 6.00 mm at birth, 6.80 mm at 2 months, 7.1 mm at 3 months, 7.66 mm at 6 to 9 months, 8.4 mm at 21 months, 8.5 mm at 2 to 5 years, and 9.3 mm at 16 years. The postlensectomy capsular bag size at each respective age is 1 mm larger. While age was a predictor of crystalline lens size, corneal diameter and gtobe axial length were better predictors of crystalline lens size. These data and accompanying linear regressions may be helpful in designing appropriate IOLs for pediatrie patients.
The Computer-Based Ophthalmic Recordkeeping (COR) System
Authors: Miller Joseph M
Published: April 2021

ABSTRACT

Purpose: The Computer-assisted Ophthalmic Recordkeeping (COR) System is described. Advantages and disadvantages of data entry during the patient encounter and computerized formatting of the examination report are discussed.

Methods: The COR System allows direct computer entry of patient data by the provider. During a patient encounter, text data are stored In a central computer and are accessible from any workstation. Upon completion, the report is printed.

Results: While source data entry is expensive, it reduces transcription costs, increases access to patient records, improves legibility of the patient record, and reduces transcription turnaround time.

Conclusion: Electronic preparation of the ophthalmic record allows immediate access to the text component, faster reporting to the referring physician, and enhanced capability of measuring outcomes.
Subjective and Objective Outcomes of Strabismus Surgery in Children
Authors: Mruthyunjaya Prithvi , Simon John W , Pickering J Dawn , Lininger Lloyd L
Published: April 2021

ABSTRACT

Background: The negative psychosocial impact of strabismus in adults has been well documented. Despite the increasingly recognized importance of outcomes research, parents' satisfaction with strabismus treatment in childhood and their assessment of its functional impact and "quality of life" impact have not been investigated.

Methods: A survey instrument was designed to assess parents' perceptions of preoperative, surgical, and postoperative phases of the clinical experience, including the long-term impact of surgery on their children.

Results: Overall satisfaction with the surgical result was rated "good" or "very good" in 85% of 77 children under age 6. The correlation between subjective satisfaction and objective alignment within 10 prism diopters (?) of orthophoria was significant (P<.001). Parents of children under age 4 noted improved eye contact (61%) and appearance (94%). Parents of older children noted improved interactions with others (47%) and self-esteem (55%). Coordination was considered improved in 56% of the entire group. Subjective satisfaction and psychosocial benefits often occurred even in cases deemed objectively unsuccessful.

Conclusion: Surgical correction of strabismus in childhood is clearly perceived by parents to be both successful and important to them and their children.
Transnasal Endoscopic Approach to Expose the Medial Rectus From the Annulus of Zinn to the Penetration of Tenon's Capsule
Authors: McKeown Craig A , Metson Ralph B , Dunya Ibrahim M , Shore John W , Joseph Michael P
Published: April 2021

ABSTRACT

Conventional strabismus surgery employs a conjunctival incision to gain access to Tenon's space where a wide variety of procedures are routinely performed on the tendon and anterior aspect of the extraocular muscles. Recently, transnasal endoscopic surgical techniques have gained acceptance as effective means of decompressing the medial wall and floor of the orbit in patients with thyroid-related orbitopathy.The orbital surface of the medial rectus and inferior rectus are exposed from the annulus of Zinn to a position close to where the muscles penetrate Tenon's capsule. In theory, this technique also provides the exposure necessary to locate and retrieve a "lost" medial rectus when the usual subTenon's approach fails to recover the muscle. Cadaver studies demonstrate the feasibility of exposure and suture placement in the stump of a lost medial rectus with passage of the suture through Tenon's capsule to transmit the force of the muscle to the globe, provided that the lost muscle is retrieved before severe contracture develops.
The Range and Variability of Ophthalmological Parameters in Normal Children Aged 4½ to 5½ Years
Authors: Lam Simon R , LaRoche G Robert , De Becker Inge , Macpherson Heather
Published: April 2021

ABSTRACT

Background: Some standards for childhood ophthalmological variables exist. However, for most parameters, the range of variation found in normal children remains poorly defined.

Methods: We have determined the range of normal function for a number of commonly measured ophthalmological variables in 162 children, classified normal by Gold Standard ophthalmological examination. This group is representative of almost 12 000 normal children aged 41/2 to 5V2 in Nova Scotia.

Results: In 56.8% of eyes the visual acuity was 6/4.5. The use of a chart with crowding bars was more discriminating between differences in higher levels of acuity and highlighted differences in acuity between the two eyes. Randot stereoacuity showed a uniform, non-Gaussian distribution of scores. Cycloplegic refractive errors were distributed about a modal value of between +0.5 and +1.0 diopter. Forty percent of eyes had no detectable astigmatism. Ninety-seven percent of subjects had no heterophoria. Fusional vergence data are presented.

Conclusion: Our results document the complete normal range for selected ophthalmological parameters in normal preschoolers. The values obtained were in general better than expected.