bluuebunny/crossref_metadata_2025 huggingface dataset:
Alain Savoyant saisi par le savoir
Authors: Pastré Pierre
Published: April 2021

La théorie de l’activité d’Alain Savoyant repose d’abord sur une distinction entre l’élaboration de l’action (savoir ce qu’il faut faire) et l’assimilation (savoir le faire) : sans élaboration l’action serait aveugle ; sans assimilation, elle serait irréelle, inefficiente. Mais Savoyant a surtout développé le volet de l’élaboration de l’action, en s’inspirant de Galpérine, tout en développant une position originale. En relisant ses textes théoriques, on peut identifier trois étapes dans l’élaboration de sa pensée. Ces trois étapes sont structurées autour de trois concepts : « base d’orientation », « théorie », « savoir ». C’est le concept de théorie qui est sans doute le plus intéressant dans la réflexion de l’auteur ; Savoyant récuse la distinction habituelle qui voit dans la théorie ce qu’il faudrait faire et dans la pratique ce que l’on fait réellement. Pour lui, la théorie est ce qui fonde l’activité en lui donnant son sens. La conception de la théorie que développe Savoyant, la distinction entre élaboration de l’action et assimilation introduisent des débats importants dans le cadre général de la conceptualisation de l’action.
Irisin serum increasing pattern is higher at moderate-intensity continuous exercise than at moderate-intensity interval exercise in obese females
Authors: Rejeki P.S. , Pranoto A. , Prasetya R.E. , Sugiharto S.
Published: April 2021

Lifestyle, unhealthy eating patterns, and low physical activity become trigger factors of obesity. Therefore, lifestyle modification with an exercise-based nonpharmacological approach is one of the strategies for combat obesity. This study aims to analyse the response of moderate-intensity interval and continuous exercise to irisin level increasing pattern on the obese female. A total of 21 obese females were enrolled in this study and given moderate-intensity interval exercise (MIIE) and moderate-intensity continuous exercise (MICE). ELISA was used to quantify the serum level of irisin in all samples. Statistical analysis was performed using one way-ANOVA and Tukey’s honestly significant difference (HSD) post hoc test. Mean irisin levels of pre-exercise at control (CON), MIIE, and MICE were 3.26±1.28l, 3.44±0.56 and 3.89±1.08 ng/ml, respectively (P=0.519). The mean irisin level of 10 min post-exercise was 2.99±0.86 ng/ml at CON, 4.82±1.01 ng/ml at MIIE, and 5.99±1.27 ng/ml at MICE (P=0.000). The mean irisin levels of 6 h post-exercise were 3.04±0.60, 4.56±0.87, and 5.73±1.02 ng/ml at CON, MIIE, and MICE, respectively (P=0.000). The mean irisin level of 24 h post-exercise was 3.04±0.91 ng/ml at CON, 4.64±0.69 ng/ml at MIIE, and 5.69±1.53 ng/ml at MICE (P=0.002). We conclude that the post-exercise serum irisin level increased in both MICE and MIIE subjects, and the post-exercise serum irisin level maintained higher in the MICE than in the MIIE in the obese female subjects.
Kinematics and kinetics of dogs completing jump and A-frame exercises
Authors: Blake S. , de Godoy R. Ferro
Published: April 2021

Many police dogs do not reach their expected retirement age as they are no longer able to cope with the physical demands of the job. Annual licensing requires police dogs to complete a series of agility tasks, including jumping and negotiating an A-frame obstacle, both of which are associated with higher injury rates in canine agility competitors. This study sought to measure conformational, kinematic, and kinetic parameters of actively employed police German Shepherd Dogs (GSDs), whilst completing a 55 cm jump hurdle, and a standard A-frame. Each dog completed three repetitions of each obstacle and was also recorded at both walk and trot. Contact pressures and forces were measured, whilst joint kinematics were recorded using reflective markers and a high-speed camera. Results found that static hip angle was significantly correlated with hip flexion at trot, during jump suspension and at the apex of the A-frame. Stifle and hock flexion were greatest during the suspension phase of jump (56.98±11.710° and 54.51±17.430°). Shoulder and elbow flexion were greatest at the apex of A-frame (104.34±16.744° and 75.72±20.804°), whilst carpal extension was highest upon landing from the jump (125.77±7.071°). Peak vertical force (PFz) when normalised for body mass (BM) increased when landing from A-frame (14.28 N/kg BM) as opposed to landing from the jump obstacle (12.055 N/kg·BM). Our results show that increased range of motion (ROM) is required during both jumping and negotiation of A-frame compared to walk and trot, but more significantly, greater forces are incurred upon landing from the A-frame than compared to jumping. It was also observed that dogs were subject to high degrees of torsion in the distal limbs upon landing from the A-frame due to trained behaviours. We conclude that use of agility equipment generates greater forces through the musculoskeletal system and requires a greater ROM than what is experienced at walk and trot, which may contribute to early retirement ages in police dogs.
Proposition: Continuing Education Must Impact on Practice
Authors: Brown Sarah Jo
Published: April 2021

The author proposes a conceptual framework for continuing education in nursing that is derived from one posed by Chater. The author's framework is presented in descriptive and model form. All major components of the framework are discussed. Dialogue between educators and practitioners is viewed as essential to assuring relevancy of continuing education offerings. Integration of continuing education learning into professional practice is the salient goal of continuing education. The integration process is explored.
Development and Delivery of a Refresher Course for Nurses
Authors: Eggland Carol A
Published: April 2021

Development of a refresher course for nurses based upon (1) planning and input from a community advisory committee, (2) results of a questionnaire sent to 600 unemployed nurses, and (3) application of adult education principles to the program design. Modifying the effects of the participants' anxiety about returning to nursing is explored. Course philosophy and content, scheduling, instructional strategies, and student evaluation are discussed.
The Meharry Way: Program of Guided Studies: RN to BSN*
Authors: Brown Audrey Burgess , Carter Annie J , Tomes Evelyn K , Wilson Betty L , Quattlebaum Barbara
Published: April 2021

Nontraditional education approaches in nursing have developed as a result (in part) of proposed changes in the educational criterion for entry into professional nursing practice and in the percentage of practicing nurses with graduate preparation. This article describes a pilot project-Program of Guided Studies: RN to BSN-currently in progress at Meharry Medical College in Nashville, Tennessee. The Department of Nursing Education at the College, in consultation with the coordinator of the New York Regents External Degree program in Nursing (NY RED: BSN), initialed the project in August 1978 to facilitate progression of registered nurses in the Middle Tennessee Area through the New York program. Fifteen students, all of whom were practicing in expanded or management roles in nursing responded to recruitment and participated in orientation, advisement, health assessment instruction, counseling, review sessions, and simulated clinical competency testing as required.
Processing A Task Group: A Continuing Education Committee At Work Planning A Conference
Authors: Callahan Judy , Fertig Susan , O'Dell Patti Angrisani , Marlowe Barbara
Published: April 2021

"Processing a Task Group: A Continuing Education Committee at Work Planning a Conference" was collectively written by four clinical nurse specialists who comprised the Continuing Education Committee of the Council of Clinical Specialists in Psychiatric Mental Health Nursing. The article focuses on the group process of the committee as they worked together to plan the First Southeastern Regional Conference for Clinical Specialists in Psychiatric Mental Health Nursing. You are taken through the beginning, working, and termination stages of a Task Group. Included are creative, maintenance, leadership, structuring norms, interpersonal relationships, goal achievement, and cohesion.
Nurses' Experiences with Dangerous Behavior: Implications for Training
Authors: Basque Loy O , Merhige Jean
Published: April 2021

A hospital survey of 67 psychiatric nurses indicated that the nurses encountered a variety of forms of both staff and patient behavior that can be interpreted as dangerous. Moreover, most of the nurses considered possible training in the prevention and management of violence to be at least somewhat helpful in their work. Several implications of the results are also explored including the need for training programs to focus on the experiences and attitudes about violence of the participants, the value of a multimedia approach to training, and the need for an interdisciplinary component to training programs.
Setting the Stage
Authors: Harsanyi Benne , Metzger Margaret , Popiel Elda S
Published: April 2021

This article was written by the subcommittee of the CNA Butterfly Committee. The committee members included Benne Etta Harsanyi, Margaret Metzger and Elda S. Popiel. The subcommittee planned this workshop for nurses without baccalaureate degrees in nursing. The workshop was designed as an orientation to the process of entering a collegiate program in nursing, the need for educational mobility, the advantages of obtaining a BSN, and some of the social issues affecting the educational and professional development of nurses.

This article discusses how the workshop was planned, implemented, and evaluated. Also described is why CNA believes in supporting nurses in their efforts toward educational mobility, and how the Butterfly Project came about.
Methods of Teaching-Revisited Audiotape Recordings
Authors: Cooper Signe S
Published: April 2021

The fourteenth in a series of articles on methods of teaching, this one describes the use of some auditory media. Readers are encouraged to submit articles describing their experiences with successful teaching strategies.
Evaluation of Maine's Telelecture Continuing Education Program: Part I
Authors: Rost Mary Ann , Barber Gerard M , Frank Thomas
Published: April 2021

In order to be responsive to the continuing education needs of nurses in rural Maine, a comprehensive formative evaluation process was developed. This process included a review of the literature, statwide nurse consumer and employer surveys, and a statewide advisory committee. This ongoing process led to the development of an interactive audio teleconference network capable of delivering quality continuing education courses to nurses throughout the state at, or near, the nurse's employment setting at low cost.
Cost-Benefit/Effectiveness Analysis for Continuing Education
Authors: Shipp Travis
Published: April 2021

The need for some systematic method of assessing the worth or impact of an educational program has led to the development of a Cost Benefit/Effectiveness model for continuing education. The model classifies costs and results as: monetarily quantifiable, nonmonetary quantifiable, and nonquantifiable. By arranging the costs and results systematically and by making the appropriate comparisons, it is possible to determine the relationship between costs of C/E and monetary payoffs and between participation in C/E and changes in job performance as well as the intangible but socially desirable outcomes of a C/E course or offering. The value of this type of evaluation is apparent to the nurse continuing educator who must be prepared to choose among several alternatives and defend those choices.
Management Development of the Head Nurse: The Program and Evaluation of the Program
Authors: De Friese Alice M
Published: April 2021

ABSTRACT

The purpose of continuing education is to build upon nurses' educational and experiential basis for the enhancement of their practice, administration, education or research, to the end of maintaining and improving the public's health.

Continuing education evaluations traditionally have been formative and summative, determining the participants' perceptions and opinions about continuing education offerings or immediate assessment of changes in knowledge and attitudes. The purpose of this study was to determine whether nurses who attended a management development continuing education program had greater cognitive knowledge and were able to implement management models and theories into their practice following the program. The program was three to four days, depending on the size of the facility. Ten different Veterans Administration medical centers participated in the programs.

The investigator sent questionnaires to 191 nurse managers who had attended a Southwestern Regional Medical Education Center continuing education program. Responses from 111 managers were received. The data analysis indicates a high correlation between theories presented and theories/models implemented in management practice. In addition, data indicate that nurse managers who were able to apply theory in a practical manner felt this was due primarily to the continuing education program.

A model for the development of the new nurse manager (Sheridan, Bronstein, & Walker, 1984) was used in planning the program, and the Stake countenance model (Stake, 1973) was used in evaluating the program.
Collaborative Research-The Arizona Experience
Authors: Minckley Barbara B , Anderson Rhonda , Sands Delores
Published: April 2021

ABSTRACT

A far-sighted collaborative proposal for research development was created by one author (Dr. Sands) for the College of Nursing, Arizona State University, Tempe, Arizona and 24 participating nursing service divisions located in surrounding central Arizona hospitals and health care agencies. With subsequent funding from the Division of Nursing an innovative, hands-on continuing education sequence of research minicourses was presented in repeated 20-week cycles at seven locations. The method was successful in establishing an ongoing, research-productive network of nurse faculty and nurse clinicians who continue to work together and use one another's special areas of research expertise.
Home Study Refresher Courses for RNs and LPNs
Authors: Macdonald Karen , Freise Wilma
Published: April 2021

ABSTRACT

The home study refresher courses for registered nurses and licensed practical nurses have met a real need in this time of nursing shortage. The provision for self-paced study and self-arranged supervision of clinical practice allows the maximum flexibility to adjust to family responsibilities.
Application of World Class Service to World Class Nursing
Authors: Najmaie Hossain M , Modjeski Joan
Published: April 2021

ABSTRACT

U.S. nursing is in trouble. These numerous and multidimensional troubles include general job dissatisfaction, low morale, a severe nurse shortage, a high turnover rate, and a rapid cost increase. A brief study of the healthcare industry in other industrialized nations revealed that those nations do not face the same problems or at least their problems are not as severe. More specifically, the Japanese nursing industry has no shortage. This article addresses some of the United State's nursing problems and presents some solutions from World Class Service concepts to those problems. The concepts of flexible scheduling, simplification of processes and standardization, on-the-job training, employee involvement, and team building are discussed in the context of World Class Nursing. Finally, the importance of regarding all of the above mentioned concepts as an integral part of healthcare improvement efforts is emphasized.
Maximizing the Benefits of Management Education for Nurses
Authors: Gillies Dee Ann , Child David A
Published: April 2021

ABSTRACT

Funding from a Division of Nursing training grant supported the management education of 35 first- and middle-level nurse managers from a variety of hospitals, clinics, and home health agencies. Nurse administrators and scholars introduced nurse management approaches and techniques to the program participants in three workshops that featured lectures, group exercises, group discussions, and videotapes. Project staff provided ongoing counseling and support to participants by means of teleconferences and telephone coaching, with the result that participants applied many of their newly learned concepts and skills on the job.
Stress Management: A Program Designed to Facilitate Coping
Authors: Lewis Donna J , McLin Patricia A
Published: April 2021

ABSTRACT

Continual exposure to work-related stressors compounds nurses' workloads, increases their stress levels, and places increased demands on their abilities to adapt. Nurses need to learn and routinely use coping measures to prevent exhaustion and burnout. This article describes the assessment, plan, implementation, and evaluation of an in-house stress management continuing education program to aid staff members in halting the cyclic process of stress.
Continuing Nursing Education: A Perspective
Authors: Kathrein Mary Ann
Published: April 2021

ABSTRACT

This article takes a renewed look at continuing education (CE) within the discipline of nursing. Increasing complexity in the personal, professional, and social environments in which nursing is practiced, as well as changes in the present educational foundation of nurses all signal a need for a broader, more comprehensive concept of the content and process of CE. The continuing professional learning process (CPLP) is presented as a beginning attempt to view nursing CE from a more comprehensive perspective. The CPLP is a multifaceted, helical, on-going process of learning, patterned and directed by the learner. The CPLP, which incorporates the multiple contexts of nursing and nursing practice, and which may encompass learning of an informal, formal, or academic nature, has as its end the enhancement of the professional and the profession.
Using a Self-Care Framework for Continuing Education in Gerontological Nursing
Authors: Langland Rose Mary , Farrah Shirley J
Published: April 2021

ABSTRACT

Orem's (1985) Self-Care Deficit Nursing Theory (S-CDNT) was used as a framework for an 8-day continuing education course in gerontological nursing provided nine times throughout Missouri. Through the use of case studies, major elements of the theory were not only introduced, but also were related to practice by speakers who focused on self-care abilities and limitations, as well as self-care demands and agency. Evaluation data from each of the locations demonstrated a significant increase in participants' knowledge scores from pre- to posttest (p<.0001) using the Sign Rank Test. Participants perceived a substantial increase in both knowledge of theory-based gerontological nursing and theory-based practice. Followup evaluations after 6 months suggested that the use of S-CDNT as a framework for gerontological nursing content had a lasting impact on the development of a strong nursing perspective and on more positive attitudes toward gerontological nursing.
Continuing Professional Education: Individual Responsibility, Collective Consciousness
Authors: Palmer Anne
Published: April 2021

ABSTRACT

Continuing professional education in the United Kingdom is discussed and the influences examined. Within a framework of national, nursing, and local perspectives, the issues and implications for the various individual agencies and personnel are identified. An overview is provided to include agendas for action.
Continuing Education in South Africa
Authors: Grainger Linda D , Uys Leana R
Published: April 2021

ABSTRACT

An overview of continuing education in South Africa reveals that despite strong philosophical support a number of factors impede the development of an effective system of such education. Existing inadequacies have been exacerbated by the introduction in 1986 of a comprehensive program for entry into the profession, resulting in an overwhelming demand for continuing education for nurses who trained prior to that. Rural nurses in particular are disadvantaged, with nondegree continuing education being largely inaccessible. However, efforts to meet these needs are afoot, and two recent initiatives are described.
Development of a Cancer Prevention and Early Detection Program for Nurses Working With African Americans
Authors: Underwood Sandra Millon
Published: April 2021

ABSTRACT

Background: Many health care institutions expect nurses to assume leadership roles in the provision of cancer education and screening. However, all too often, nurses lack the knowledge and skills needed to effectively inform, screen, and counsel their clients. The challenges may be compounded when they are expected to provide cancer care to clients from cultural, racial, and ethnic backgrounds different from their own.

Method: The Cancer Prevention and Early Detection Program for Nurses Working with African Americans was developed to help fill this void. The program provides nurses with theoretical, clinical, and practical information regarding cancer prevention and early detection for use within clinical and community settings.

Results and Conclusions: The Cancer Prevention and Early Detection Program for Nurses Working with African Americans enhanced participants' abilities to provide cancer education, screening, and follow up, and it heightened their sensitivity and understanding of issues and trends influencing cancer prevention and early detection among African Americans.
Six Rules for Computers and Other Stumbling Blocks to Obtaining an Advanced Degree
Authors: Cole Barbara H , Brunk Quincealea
Published: April 2021

ABSTRACT

Background: The decision to return for an advanced degree in nursing, after many years outside the academic environment, can be fraught with uncertainty, doubt, and panic. The majority of returning students attempt to juggle career, family, community obligations, and school simultaneously. Nurse educators are in the perfect position to act as well-informed resource people, facilitators, and mentors for these returning students.

Method: The expression "experience is the best teacher" proved to be true. The first author's (B.C.) return to a master of science program after 18 years out of school provided the opportunity to "learn as you go." This article was written with the desire to help ease the transition and lessen the fear for others.

Results: The first author (B.C.) graduates in May 1999 with a MS as a Family Nurse Practitioner, enriched and stronger because of the experience, enthusiastic, and facing the future of the nursing profession with a positive and energetic outlook.

Conclusion: Provision of support; networking with other returning students; and understanding the basic tool in modern education, the computer, eases the return for an advanced degree. Nurse educators' involvement in educational growth, both individually and as proponents for nurses who are dependent on those educators' expertise, is vital to nursing and its evolution as a profession.
How to Work With an Interpreter
Authors: Pakieser Ruth A , McNamee Mary
Published: April 2021

ABSTRACT

Background: A trip to China provided two nursing educators an opportunity to teach Chinese nurses and, in the process, to discover principles for using an interpreter to translate from English into the students' language.

Conclusion: The authors present 16 tips for use by instructors who teach non-English-speaking learners. The principles apply for all situations of communicating with native speakers of another language using a translator.
Envisioning Health Care Using a StoryTech Process With Continuing Education Participants
Authors: Eggenberger Sandra K , Huntley Mary I
Published: April 2021

ABSTRACT

Background: Participants representing rural and regional health care providers, employees, and consumers were involved in a continuing education (CE) conference focused on envisioning tomorrow's health. The 1993 attendees were taught a process of envisioning health care 5 years into the future. The 1993 projected outcomes were reviewed with 1998 realities.

Method: Continuing education participants (N = 417) generated their design for a healthy future by responding to six story scenarios. Stories (2,502) related to quality of health care were analyzed in a three-step process.

Results: Findings from the concept analysis of stories obtained at the 1993 CE conference revealed a conceptual model for a desired health future for 1998, with four major concepts, five goals, and five guiding principles.

Conclusions: Visioning in a CE environment creates valuable direction for an improved health care future. A CE conference provides the seeds and opportunities for dialogue and partnership by people responsible for implementing action plans that potentially would create a healthy community.
Guaranteeing the Right to Treatment
Authors: Hoffman P Browning , Dunn Robert C
Published: April 2021

A proposal for the establishment of a new agency, using psychiatrists, lawyers, and judges as complementary guarantors of adequate treatment for the mentally ill.
ADHD Drugs May Slow Growth
Authors: Anonymous
Published: April 2021

2-year study finds children who took various stimulant medications grew less, gained less weight than children who did not take stimulants.
Mental Healthcare Parity Legislation Blocked in Congress
Authors: Anonymous
Published: April 2021

House will not schedule vote on scaled-down bill.
Biological Branding
Authors: Anonymous
Published: April 2021

Neuroimaging studies may form a basis for new marketing and advertising strategies.
Internet-of-Things Smart Home Technology to Support Aging-in-Place: Older Adults' Perceptions and Attitudes
Authors: Choi Yong K. , Thompson Hilaire J. , Demiris George
Published: April 2021

The purpose of the current study was to examine older adults' perceptions of Internet-of-Things (IoT) smart home devices as part of a real-world feasibility study and describe what factors affect adoption of these technologies. A total of 37 community-dwelling older adults enrolled in the 2-month study. Participants chose among different IoT devices to be installed in their home for the study period. Semi-structured interviews to explore perceptions of the technology were conducted. Older adults have unique preferences for specific types of IoT devices and their functionalities. Similarly, there were different degrees of acceptability across devices. In general, older adults had a positive attitude toward IoT smart home technologies to support their health management. Emergency preparedness was a key benefit of IoT devices identified by many older adults. In addition, convenience of a voice interface provided by a smart speaker was appreciated among participants. Older adults seemed to weigh the benefits and actual need for having the devices against potential infringements on privacy. Nurses and system designers should consider ethical and practical challenges related to the interconnected services of the IoT domain for older adults. [
Journal of Gerontological Nursing, 47
(4), 15–21.]
ARTHRODESIS FOR PARALYTIC SHOULDER: REVIEW OF TEN PATIENTS
Authors: Kalamchi Ali
Published: April 2021

ABSTRACT: Ten patients who had arthrodesis of their flail shoulders secondary to poliomyelitis were reviewed. The average age at the time of surgery was 15 years, 3 months, and follow-up range from one year eight months to seven years. Union occurred in each case, and no reoperations were required. Internal fixation was used for each patient, and this maintained the position of arthrodesis. AU patients were significantly improved. Optimal position of fusion seems to be in 30° of abduction, 30° of forward flexion, and 45° of internal rotation.
THE SURGICAL TECHNIQUE FOR FOREQUARTER AMPUTATION: A CLINICAL ANALYSIS OF TEN CASES
Authors: Wu Kent K , Guise Edwin R , Frost Harold M , Mitchell C Leslie
Published: April 2021

ABSTRACT: The surgical technique for forequarter amputation has been described in a step-by-step fashion. Our personal experience of ten cases has achieved a 40% overall cure rate. Soft somatic tissue sarcomas seem to have a much better five-year survival rate than the corresponding bone sarcoma (60% vs 0%). The disease-free state during the first postoperative year appears to be a very favorable indicator for long-term survival. We feel that surgery should be combined with prophylactic chemotherapy in order to prolong survival time and save lives.
MYOSITIS OSSIFICANS OF THE METACARPALS: AN UNUSUAL LESION REQUIRING CONSERVATIVE TREATMENT
Authors: Blatt Gerald , Kahanovitz Neil
Published: April 2021

ABSTRACT: Blunt trauma to the hand often results in swelling, pain and induration, with negative roentgenograms. Myositis ossificans of the metacarpals may be an infrequent sequelae of this type of injury. Consideration of the possible diagnosis and management of this entity by nonsurgical techniques is stressed.
INTRAPELVIC COMPLICATIONS OF HIP SURGERY: A CASE REPORT OF OBTURATOR NERVE ENTRAPMENT
Authors: Bowman Arthur J , Carpenter A Alden , Iovino Joseph , Ward Clifford
Published: April 2021

ABSTRACT: A case is presented in which a patient had persistent pain in one hip after bilateral total hip replacement for rheumatoid arthritis. The diagnosis was elusive until at intrapelvic exploration the obturator nerve was found to be markedly stretched over a large bolus of intrapelvic methylmethacrylate. The patient was completely relieved postoperatively after the cement mass was removed.
A Little Help From Your Friends
Authors: Hirsch Paul J , Hirsch Stuart A , Reedman Lynn
Published: April 2021

Intraoperative Bupivacaine for Meniscectomy
MULTICENTRIC OSTEOID OSTEOMA IN A CHILD
Authors: Jones Eric T
Published: April 2021

ABSTRACT: Osteoid osteoma is a common reactive lesion of bone which is a frequent consideration in the differential diagnosis of the adolescent with pain, especially pain relieved by aspirin. The case discussed mirrors the lesion's original description, and stresses the difficulty in establishing the diagnosis in the infant and child where it is less commonly encountered, and hence, less commonly considered.
BRACHIAL PLEXUS BIRTH PALSY
Authors: Aston James W
Published: April 2021

ABSTRACT: Eighty cases of obstetrically related brachial plexus palsy were followed over a five-year period. Serial muscle testing was done to establish classification and level of damage. Gentle passive exercises to the shoulder and elbow should be done prior to age 2 years, after which time no further spontaneous improvement is likely. Anticipating joint deformities on the basis of muscle imbalance evident at this age will allow the clinician to plan the proper reconstructive surgery.
EXPERIENCE WITH A SLIDING SCREW IN INTERTROCHANTERIC FRACTURES
Authors: Daum Wayne J , Burdge Robert E , O'Reilly D Elliott , Rao Aswath N
Published: April 2021

ABSTRACT: A retrospective study of our first year's experience with a sliding screw in intertrochanteric fractures was conducted. Forty-five patients with intertrochanteric fractures were admitted to St. Louis City Hospital in the year considered. All those who came to surgery were treated with a sliding screw. We were impressed by the ability of the sliding screw plate to adapt to the forces which, under other circumstances, cause the unstable I-T fractures to collapse or displace. The characteristics of unstable hip fractures are discussed.
PATELLAR COMPLICATIONS AFTER TOTAL KNEE ARTHROPLASTY
Authors: Shereff Michael J , Jaffe William L
Published: April 2021

Abstract: Resurfacing of trie patella with a prosthesis enhances the results of total knee replacement. This procedure may, however, serve as a source of potential complications. Two patients with postoperative problems associated with the patellar implant are described.
Treatment of Impending Pathological Fractures of the Femur with Flexible Intramedullary Nails
Authors: Dobozi William R , Dvonch Victoria M , Saltzman Martin L , Beigler David F , Belich Paul
Published: April 2021

ABSTRACT: Thirty-nine patients with fifty impending pathological fractures of the femur were prophylactically stabilized with flexible intramedullary nails. Indications included lesions causing unremitting pain and either measuring greater than 2.5 cm in diameter or involving more than 50% cortical destruction. Painful lesions not meeting these radiographic criteria were also considered for prophylactic nailing if radiation therapy failed to relieve pain. Ninety-five percent of patients experienced marked pain relief after nailing, and 92% were ambulatory with or without assistive devices at discharge. Complications included one fracture at the nail insertion site and three cases with nondisabling knee pain. There were no infections.
The Orthotic Treatment of Stable Ankle Fractures
Authors: Polakoff Donald R , Pearce Stephen M , Grogan Dennis P , Burkhead Wayne Z
Published: April 2021

ABSTRACT: Fifteen limbs with stable lateral malleolar fractures treated with an adjustable, functional orthosis were compared to 12 limbs managed with short leg walking casts. The limbs managed with the adjustable orthosis were clinically healed at an average of 3.3 weeks with no fracture tenderness and with the ability to bear full weight without pain. Range of motion in the orthotic group at the end of treatment was significantly better than the casted group. Patient compliance was excellent. The advantages of the orthotic treatment include a more physiologic gait pattern due to the rocker bottom sole, ease of application, lighter weight, removability for range of motion exercises and bathing, and adjustability to maintain a good fit as posttraumatic swelling resolves.
Resection Arthrodesis of the Knee for Sarcoma: Preliminary Results
Authors: Dunham William K , Calhoun Joanne C
Published: April 2021

ABSTRACT: The surgical removal of malignant bone tumors of the knee requires the generous removal of large segments of femur and tibia with large cuffs of surrounding musculature. This type of resection does not leave the necessary muscles and soft tissue for a functioning knee joint, either through the use of a large custom-made total knee replacement or a large cadaver homograft. Arthrodesis of the knee with an intramedullary rod and segmental bone grafting is a method to reconstruct the large defects remaining after this type of resective surgery. The technique may also have good application in the salvage of failed total knee replacements. Fifteen patients have undergone resection of sarcomas in the bones of the knee area followed by reconstruction with an intramedullary rod and grafting of the gap left by the resected sarcoma. Tumor has been controlled locally in all but one case, which involved prior contamination before our treatment of the patient. Twenty-six of the 28 segmental grafts, which averaged 21.6 cm, have gone to primary bone union. There have been two infections, two fractures-one of the graft and one of the donor site-and two patients with excessive shortening of the grafted segment. The limiting factor in the length of the resection possible is the narrow diameter at the isthmus of the femur and length of the fibular graft available. Updated techniques have decreased the incidence of surgical complications. It appears from this study and experimental studies that large autografts will heal in the face of preoperative and postoperative Adriamycin chemotherapy. It is our conclusion that resection arthrodesis of the knee is a functional reconstructive method for patients requiring extensive resection of sarcoma of the mid to distal femur and proximal tibia.
Slipped Capital Femoral Epiphysis: An Assessment of Treatment Modalities
Authors: Bloom Martin L , Crawford Alvin H
Published: April 2021

ABSTRACT: Fifty-five patients underwent operative treatment of slipped capital femoral epiphyses at Children's Hospital Medical Center in Cincinnati, Ohio, between January 1975 and April 1980. Charts and x-rays were available for review in 45 of these patients with 68 affected hips; the incidence of bilaterality was 51%. Sixty-five of the 68 hips were managed by pinning. Problems with pin placement were recognized in 15.4% of these hips. Three patients were treated by subtrochanteric osteotomy, without complications. Since May 1980, all patients treated on the University Service, Children's Hospital Medical Center for slipped capital femoral epiphysis have undergone open epiphysiodesis utilizing a cosmetic "bikini" incision. Twenty-two hips in 14 patients were so managed without significant complications. This should be considered the treatment of choice for slips involving change greater than 30° in the head shaft angle.
The Significance of Calcified Regional Lymph Nodes at the Time of Diagnosis of Osteosarcoma
Authors: Tobias Joseph D , Pratt Charles B , Parham David M , Green Alexander A , Rao Bhaskar
Published: April 2021

ABSTRACT: The presence of lymph node metastases from osteosarcoma was rare at diagnosis, occurring in only four of 176 patients (2.3%) at St. Jude Children's Research Hospital. An additional patient presented with calcified lymph nodes, which were demonstrated to contain no evidence of metastatic osteosarcoma. These patients did not differ in race, sex or age at diagnosis from other osteosarcoma patients. Each of the four patients with lymph node metastases of osteosarcoma had tumors composed predominantly of the osteoblastic type. Regional nodal metastases, whether alone or in conjunction with other metastatic disease, were a poor prognostic factor. Despite aggressive therapy, median survival was 8 ½ months from diagnosis, which did not differ significantly from the survival achieved by other osteosarcoma patients who had other hematogenous metastases. Key indexing terms: Osteosarcoma; Metastasis; Lymph nodes.
Salvage Procedures in Failed Hip Arthroplasties
Authors: Kim Y Y , Bae D K , Lee J S , Kwak B M , Yoon Y S , Earmme Y Y
Published: April 2021

ABSTRACT: Results and observations based on a series of 90 patients who underwent revision hip arthroplasty are reported, including engineering notes on the removal of cement within the femur and assessment of the mechanisms of failure of the original arthroplasties. The authors state a preference for performing revision in two stages, and leaving original cement in the bottom of the femoral canal.
Osteoarthropathy in Thalassemia Minor
Authors: Redman D Scott , Nelson Carl L
Published: April 2021

ABSTRACT: Osteoarthropathy associated with thalassemia minor is rare. The arthritic changes are usually thought to be secondary to bone infarction or erythropoiesis, with decreased trabeculation of the femoral head followed by microfacture and arthritic changes. This report presents the radiographic changes in the hip of a patient with thalassemia minor and discusses the etiology.
Prescription Options for the Below Knee Amputee: A Review
Authors: Abrahamson Mark A , Skinner Harry B , Effeney David J , Wilson Leigh A
Published: April 2021

ABSTRACT: In 1973 a workshop sponsored by the National Academy of Sciences recommended that "efforts to develop prescription criteria for use of the numerous variants of the BK prosthesis should be intensified." This paper provides a review of the important considerations in the prescription of a below-knee prosthesis. It is intended that this information would assist the physician to make better informed decisions regarding the specific type of prosthesis for a particular patient. No attempt has been made to describe all prosthetic options since a majority of amputees are fit with only a few prescriptions. Thus, socket design, suspension, shank type, and foot specification may be optimized for individual patients through mutual agreement of the prosthetist and the knowledgeable physician. This paper will present some of the more difficult prescription solutions to the various fitting problems that are representative of our nation's amputee population. This is done with the knowledge that there may be other and equally successful solutions to these problems. Several illustrative examples are provided.
Magnetic Resonance Imaging in a Patient with Soft Tissue Sarcoma of the Leg
Authors: Gebhardt Mark C , Rosenthal Daniel I , Mankin Henry J , Brady Thomas J
Published: April 2021

ABSTRACT: A patient with a high grade malignant fibrous histiocytoma of the leg is presented. Staging studies included a 99mTc diphosphonate bone scan, an arteriogram, a computed tomogram (CT) and a proton (
p 1
H) magnetic resonance imaging (MRI) study. By manipulating imaging parameters to enhance contrast between normal and neoplastic tissues, the latter technique more accurately delineated the extent of the soft tissue sarcoma than the other imaging modalities. Although spatial resolution of MRI is inferior to that of CT, it is likely that MRI will provide important information relative to surgical staging and preoperative planning that is not available from current imaging techniques. Key indexing terms: Magnetic resonance imaging; Nuclear magnetic resonance imaging; Soft tissue sarcoma; Surgical staging; Musculoskeletal neoplasms.
Metastatic Tumor of the Hand from Malignant Cystosarcoma Phylloides of the Breast: A Case Report
Authors: Patel M R , Anand V S , Desai S S
Published: April 2021

ABSTRACT: In this case report, a malignant cystosarcoma phylloides of the breast metastasized to the pulp of the little finger in a 47-year-old woman. It initially masqueraded as a whitlow. The diagnosis was helped by radionuclide bone scanning, which showed multiple areas of increased focal uptake including the terminal phalanx of the fifth finger, and the diagnosis was established by a frozen section biopsy of the tumor. The patient underwent a palliative fifth ray resection. She died within six weeks of surgery from extensive pulmonary and osseous metastases. Review of literature revealed only one other case of malignant cystosarcoma phylloides of the breast that metastasized to the hand and was initially misdiagnosed as a whitlow.2
Chronic Anterior Dislocation of the Proximal Interphalangeal Joint
Authors: Freeman Ben H , Haskin J Stewart , Hay Edward L
Published: April 2021

ABSTRACT: Anterior dislocation of the proximal interphalangeal joint is a complex injury involving specific pathomechanics. Progression of this injury to a chronic stage is associated with considerable morbidity in the form of pain, instability, and loss of motion in the involved joint. Surgical reconstruction is complicated and results of delayed intervention are compromised. Two cases of anteriorly dislocated interphalangeal joints, unrecognized as such early and allowed to progress to a chronic stage, presented to us as boutonniere deformities. Descriptions of clinical presentation, surgical findings, and treatment results in these cases attest to the disabling potential of this injury. Emphasis is therefore placed on early recognition of the anteriorly dislocated proximal interphalangeal joint so that appropriate treatment can be initiated and progression to a chronic stage prevented.
Experience with the Bipolar Prosthesis in Hip Arthroplasty: A Clinical Study
Authors: Bowman Arthur J , Walker Michael W , Kilfoyle Richard M , O'Brien Paul I , McConville John F
Published: April 2021

ABSTRACT: Hip arthroplasty using a bipolar prosthesis was performed in 73 patients (75 hips) with femoral neck fracture, osteoarthritis, rheumatoid arthritis, or degenerative arthritis. Bipolar hip arthroplasty is more conservative than conventional total hip arthroplasty, because methyl methacrylate usually is not needed to fix the bipolar prosthesis to bone. Overall results were 67.1% good to excellent, 20.5% fair, and 12.3% poor; among the arthritic patients, the results were 72.9% good to excellent, 19.1% fair, and 8.5% poor. Complications included one deep wound infection and one arterial embolus; no dislocations occurred.
An Anatomical Study of the Lunate Bone in Kienbock's Disease
Authors: Fu Beddie H , Imbriglia Joseph F
Published: April 2021

ABSTRACT: Three cases of Kienböcks disease in which the lunate could be excised in toto afford an unusual opportunity for study of the lunate. Findings are detailed, and compared with literature on the etiology of Kienbock's disease.
A Technique for Recording the EMG of Electrically Stimulated Skeletal Muscle
Authors: Solomonow Moshe , Baratta Richard , Miwa Takashi , Shoji Hiromu , D'Ambrosia Robert
Published: April 2021

ABSTRACT: A technique for recording the myoelectric activity of electrically stimulated muscle through its motor nerve without the interference of stimuli artifacts has been developed and tested. The technique consists of a wide band differential amplifier with fine intramuscular wire electrodes. The amplified signal is passed through a Chebyshev low pass filter with eight poles at a frequency of 550 Hz. A stimulus calibration study shows that low frequency stimuli had negligible effect on the EMG when set below three times suprathreshold. A test procedure shows artifact-free EMG during action potential rate stimulation as well as during superimposed high frequency recruitment stimulation.
Brucella Sacroiliitis: A Case Report
Authors: Moehring H David
Published: April 2021

ABSTRACT: Brucellosis is an uncommon infectious disease in the United States though it remains endemic in many parts oí the world. Signs and symptoms of the disease are highly variable, with musculoskeletal complaints occurring frequently. The combination of an uncommon infection presenting with protean man isfestations often results in missed or delayed diagnosis in the Western world.
Osteoid Osteoma of the Foot: Presentation Following Trauma
Authors: Ambrosia John M , Kernek Clyde B
Published: April 2021

ORTHOPEDIC GRAND ROUNDS
A Forgotten Clause in Malpractice Insurance
Authors: Goodman Richard S , Glass Kenneth S
Published: April 2021

LEGAL LIABILITY AND ORTHOPEDIC SURGERY
Wilson's Disease in a Patient Presenting with Skeletal Abnormalities
Authors: Pan Henry Y M , Ya Huang Chun , Lai Chingx Lung
Published: April 2021

ABSTRACT: We present a case with extensive bone and joint involvement in the form of bone fragmentation and osteochondritis dessecans. The case was subsequently documented to be that of Wilson's disease. Biochemical screening was also carried out on the family members and the results of the findings are presented.
Proximal Tibial Osteotomy for Genu Recurvatum: A Review and Case Report
Authors: Froimson Avrum I , Gorski Jerrold M
Published: April 2021

ABSTRACT: Genu recurvatum may be due to weakness of the muscles that stabilize the knee, with secondary bone changes. The more common etiology is primary bone deformity of the proximal tibia, which may result from multiple causes. An operation is described for the anatomical correction of the latter type. A corrective opening wedge osteotomy is maintained with full thickness bicortical iliac triangular wedges. This technique has been successfully used In one patient who has been followed for 12 years. Key indexing terms: tibia; knee; recurvatum; osteotomy; deformity; graft.