bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Classroom Instruction and Independent Study in Body Mechanics
Authors: Scopa Marianne 
Published: April 2021

ABSTRACT
This study was designed to determine which method of instruction in body mechanics results in the higher subsequent use of the techniques taught. Two groups were formed from nursing personnel at a rural general medical-surgical hospital in the southwestern United States, Subjects from the direct care nursing staff were randomly assigned to one of the two groups. One group attended two hours of classroom instruction in body mechanics, while the other completed an independent study module. Subjects were pre- and posttested using the Work-Related Body Mechanics Evaluation (Carlton, 1987) while performing a standardized lifting task in the clinical setting. Using analysis of covariance, no significant differences were found in the posttest scores of the two groups.
The Mock Isolation Room: A Fun Way to Review Infection Control
Authors: Moralejo Donna , Gaese Christina 
Published: April 2021

ABSTRACT
The Infection Control Unit of the Montreal General Hospital implemented a Mock Isolation Room that tested nurses' knowledge with a review of common medical device and isolation infractions and recommendations. Consultants reinforced correct practices and clarified misconceptions. The Mock Isolation Room is recommended as an effective review strategy that encompasses the principles of adult learning. The material was identified by the nurses as clinically relevant and the learning method was considered to be fun and effective. The exercise can also be used as a needs assessment tool.
Comparison of Two Methods for Teaching Advanced Arrhythmias to Nurses
Authors: Lamb Mary J , Henderson Melinda C 
Published: April 2021

ABSTRACT
An experimental study to compare the effectiveness of assisted self-directed learning (ASD) and traditional lecture methods (TLM) in acquiring competency for electrocardiogram interpretation was conducted within a conceptual framework of developmental and adult learning theory (Erickson, Tomlin & Swain, 1983; Knowles, 1980). After two teaching units were designed and an EKG posttest was constructed (r=.75) from actual patient records, registered nurse volunteers (N= 19) were randomly assigned to groups for simultaneous instruction. Because of the small sample size, statistical procedures were used to determine the effectiveness of randomization and to justify statistical procedures. EKG post-test scores for the experimental group (ASD, M= 81) and the control group (TLM, M= 71) were significantly different (one-tailed t = 1.79; p = .045); however, participants' prior knowledge of basic arrhythmias was not independent of method (ANCOVA, f[l, 16] = 21.373, p = .0003, covariate; F[1.16] = 2.312, p =.1479, main effects). EKG post-test scores were not related to critical care experience, cardiac monitoring experience, education level, or course satisfaction. While both methods are effective, ASD had higher mean scores and is more cost- and time-efficient.
Enhancing Clinical Nursing Research: A Vital Role for Staff Development Educators
Authors: Tuohig Gail M , Oleson Kathy J 
Published: April 2021

ABSTRACT
Staff development educators can play a vital role in clinical nursing research. To accomplish this, they must first broaden their role concept to include research facilitation. Second, they must utilize resourceful means to facilitate the research learning process. This article outlines essential steps to guide the staff development educator in enhancing research efforts of staff nurses.
A Rite of Passage to Certification
Authors: Galarowicz LeaRae 
Published: April 2021

ABSTRACT
Becoming certified through examination involves much more than correctly answering test questions. Before some of us are able to take the risk and apply to write the exam, a confrontation with personal issues may be necessary. This article describes one nurse's experience as she seeks the source of her fear, then moves through the examination encounter and finally uncovers serendipitous outcomes.
Searching for Oz: The Canadian Nursing Doctorate
Authors: Kopinak Janice Katherine 
Published: April 2021

ABSTRACT
The pathway leading to a doctorate, for the Canadian nurse, is still a very difficult one to traverse. After completion of a master's degree, many nurses wish to embark on doctoral study. However, for many Canadian, graduate-prepared nurses, finding a doctoral program that will meet the requirement of supplying advanced nursing knowledge is not an easy task. The author describes these difficulties and in drawing on an analogy from the "Wizard of Oz," suggests solutions that can be used to eliminate some of the current roadblocks.
PROLONGED SURVIVAL FOLLOWING REPEATED PULMONARY RESECTIONS FOR METASTATIC OSTEOGENIC SARCOMA
Authors: Light Terry R , May Carl , Fenn John E 
Published: April 2021

ABSTRACT: This case report discusses the clinical course of a gentleman who is alive today without evidence of tumor 14 years following above knee amputation for osteogenic sarcoma of the distal femur. Twice during the two years following his initial ablative surgery, metastatic pulmonary foci were identified and resected. The latter procedure required partial chest wall and pneumonectomy resection.
Survival beyond ten years occasionally occurs following initial ablative surgery for osteogenic sarcoma. Prolonged survival has only rarely been reported following repeated pulmonary resection procedures. The extent of his second resection procedure is noteworthy, in light of the early evidence of recurrent or residual disease a few months after initial thoracotomy.
The potential for long-term survival exists in a substantial fraction of patients with osteosarcoma metastatic to the lung.
Salah Eddin External Fixation System: A Bone Slider and Compressor
Authors: Habboushe Mudhaffar P 
Published: April 2021

ABSTRACT: This study involves 65 patients with severe war injuries to the extremities where all conventional and available lines of treatment have failed or a decision of amputation has been made. Twelve humeri, 45 tibiae and eight femura were studied. The sliding system was used on 39 patients and the compressor system on 26 patients. In the sliding system, gaps ranged from 2 cm to 12 cm. In the compressor system established nonunion, failed bone graft operations, infected pseudarthrosis and gaps less than 2 cm were studied.
Salah Eddin external fixation systems, both sliding and compressor, were found to be efficient, biomechanicaliy adequate, easy to apply and remove and able to replace considerable gaps with no risks of open surgery.
Life-Threatening Clavicular Osteomyelitis in Two Debilitated Patients
Authors: Baratz Mark , Appleby David , Fu Freddie H 
Published: April 2021

ABSTRACT: Two cases are presented of immunologically compromised patients who developed acute pyogenic clavicular osteomyelitis from direct spread of a contiguous focus. Each patient's condition declined despite antibiotic therapy drainage procedures until survival was in doubt. Both showed striking reversal of their conditions and recovery when an aggressive surgical debridement (total claviculectomy) was performed.Acute pyogenic osteomyelitis of the clavicle is uncommon and rarely reported. The special implications in our patients of this disease of the adapted therapy are discussed.
THE EFFECTS OF PRENATAL PROTEIN-ENERGY MALNUTRITION ON OSSIFICATION OF FETAL RAT BONES: A BIOCHEMICAL STUDY
Authors: Miwa Takashi , Shoji Hiromu , Solomonow Moshe , Nakamoto Tetsuo 
Published: April 2021

ABSTRACT
In fetal rats whose dams were fed a low-protein diet, 35S sulfate uptake into the growth plate of the long bone and rib was higher than in the control group. The el ut ion pattern of guanidine-HCI extract in gel chromatography revealed that the malnourished group had more high molecular weight proteoglycans in the dissociative condition and a larger aggregated portion in the associative condition than did the control group; however, the same chondroitinsulfate chain size existed. Calcium content did not differ in both groups. Aggregated proteoglycan or a high molecular *weight proteoglycan that existed in the malnourished group probably played an inhibitory role in calcification. Prenatal protein-energy malnutrition may delay the change of proteoglycan character, which could affect mineralization of fetal bones.
TREATMENT OF KYPHOTIC DEFORMITY IN ANKYLOSING SPONDYLITIS
Authors: Gerscovich Eugenio O , Greenspan Adam , Montesano Pasquale X 
Published: April 2021

ABSTRACT
This article reviews the available literature on the surgical options for the correction of kyphosis in ankylosing spondylitis and presents the radiologie appearance of the postoperative spine. In the postsurgical evaluation of the spine, the focus is on appreciation of the patterns of correction, early and late determination of angular correction, recognition of various complications (infection, nonunion, improper location, or breakage of hardware), and alertness to the possibility of complications at all levels of the spine.
A MISSING LINK IN THE EVOLUTION OF THR: "DISCOVERY" OF THE LATERAL FEMUR
Authors: Fetto Joseph F , Austin Kenneth S 
Published: April 2021

ABSTRACTUsing cadaveric studies and mathematical models that include consideration of the iliotibial band (ITB) as a "tension band/9 the authors have demonstrated that compression loading occurs throughout the entire lateral femoral cortex from the apophyseal line of the greater trochanter to the lateral femoral epicondyle at the knee* This model suggests that the magnitude of this load on the medial and lateral cortices is proportional to the medial displacement of these cortices from the ITB. The authors have further demonstrated that the "tension band" model is more consistent with actual bone morphology and function than existing models and is a strong argument for the incorporation of design concepts such as lateral extensions into total hip arthroplasty femoral components. Such extensions would permit use of lateral femoral cortical bone as an additional base of prosthesis support, distributing loads over a greater area of the proximal femur. This model, therefore, would theoretically reduce the areas of stress concentration in diaphyseal bone and stress shielding of the proximal femur, both of which appear to be deficiencies of present femoral stem designs.
USE OF ANTIBIOTIC-PMMA BEADS IN THE ISCHEMIC FOOT
Authors: Calhoun Jason H , Klemm Klaus , Anger Diane M , Mader Jon T 
Published: April 2021

ABSTRACT
Thirty-six patients with 44 ischemic foot infections were managed with antibiotic-polymethylmethacrylate (PMMA) beads. Most of these patients received gentamicin-impregnated PMMA beads but tobramycin and vancomycin-impregnated PMMA beads were used on three patients. Angiopathy occurred in 35 patients secondary to diabetes and secondary to renal disease in 2; 1 patient had both diabetes and renal disease. The most common bacteria was Staphylococcus aureus (82%), although other organisms and multiple bacteria were present. In spite of the variability of the bacteria, PMMA beads were helpful in managing foot infections in this difficult patient population.
SPINAL EPIDURAL ABSCESSES IN CHILDREN
Authors: Jacobsen F Stig , Sullivan Bradley 
Published: April 2021

ABSTRACT
Spinal epidural abscess (SEA) is rare, especially in children, in which fewer than 90 cases have been reported. We present three case examples illustrating the complex course before diagnosis and treatment. All patients had back pain, but two had pain of the abdomen or extremity dominating the clinical picture. Magnetic resonance imaging (MRI) was found to be the best diagnostic test. All had surgery with full recovery. A literature review of 58 cases since 1945 was done and showed that 76% of children had neurological compromise before surgery, and the overall mortality rate in children was 12%.
REVISION TOTAL JOINT ARTHROPLASTY: DOES MEDICARE REIMBURSEMENT JUSTIFY TIME SPENT?
Authors: Ritter Merrill A , Carr Kimberly D , Keating E Michael , Faris Philip N , Bankoff David L , Ireland Philip M 
Published: April 2021

ABSTRACT
In 1991, five different total joint replacement surgeons performed 337 primary total knee replacements and 250 primary total hip replacements. They revised 25 total knee replacements and 73 total hip replacements. The average length of stay was 6.6 days for the primary total knee arthroplasty and 7.5 days for knee revisions. For total hip replacement, average stay was 5.9 days for primary surgery and 6 days for revisions. The operative time required for each of the five surgeons to complete a total knee replacement increased 55%, 3%, 38%, 72% and 38%; whereas for the total hip replacement, time increased 87%, 77%, 84% and 58%. Overall, there was a 41% increase in operating time for revision total knee replacements and a 77% increase for revision total hip replacement. Allowable charges by Medicare in 1993 for a primary knee and hip replacement were $1,298 and $1,363, respectively. Revision total knee replacement increased 24.3% ($1,613) and revision total hip replacement increased 30.8% ($1,782) in the state of Indiana. These figures do not encourage those surgeons who are capable of doing total joint replacements to revise other surgeons' problems.
MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF HEEL PAIN
Authors: Hall Reginald L , Erickson Scott J , Shereff Michael J , Johnson Jeffrey E , Kneeland J Bruce 
Published: April 2021

ABSTRACT
This study demonstrates magnetic resonance findings in 16 patients (25 heels) with heel pain. Sixteen of 25 (64%) studies demonstrated abnormalities which could be related to the etiology of their heel pain. Eleven of 16 abnormal scans demonstrated thickening of the plantar aponeurosis with associated fibrosis (7 of 11), and a tear of the flexor digitorum brevis (1 of 11). One study demonstrated changes in the heel pad consistent with fluid. The other four abnormal studies demonstrated changes thought to be consistent with bilateral fibrous calcaneonavicular coalitions, subtalar arthrosis and tenosynovitis of the posterior tibial, flexor digitorum longus, and flexor hallucis longus tendons.
THE POTENTIAL USE OF HUMAN RECOMBINANT ERYTHROPOIETIN IN ORTHOPEDIC SURGERY
Authors: Bose William J 
Published: April 2021

ABSTRACT
Human recombinant erythropoietin has been approved by the Food and Drug Administration for treatment of anemia due to chronic renal failure or malignancy and in zidovudine-treated patients with the human immunodeficiency virus. It is highly effective in reducing the anemia commonly seen in these patients, with minimal adverse effects. Approximately 20% of patients undergoing elective orthopedic procedures are not able to donate adequate amounts of autologous blood prior to surgery. Additionally, patients who cannot donate 3 or more units of blood prior to large procedures are at increased risk for receiving a homologous transfusion despite the use of intraoperative and postoperative blood conservation techniques. Investigational use of this drug as an adjuvant to autologous blood donation has been shown to increase the amount of blood donated by patients prior to surgery and, therefore, will decrease homologous blood transfusions after surgery. Perioperative use of this drug, dosage, route of administration, and clinical indications are currently being evaluated in multicenter clinical trials.
ACTIVITY RELATIONSHIPS OF TOTAL HIP ARTHROPLASTY IN PATIENTS WITH OSTEONECROSIS AND OSTEOARTHRITIS
Authors: Letson G D , D'Ambrosia R D , Aguilar E A , Wagespack A 
Published: April 2021

ABSTRACT
We compared the age adjusted results of all primary Osteonics total hip arthroplasties with osteonecrosis and osteoarthritis. The Harris index hip score was used for the analysis. Twenty-eight patients had osteoarthritis and 26 patients had osteonecrosis. The Harris hip score was used to compare the osteoarthritis and osteonecrosis gross. Patients with osteoarthritis gradually increased in Harris hip score, whereas osteonecrosis patients gradually decreased in Harris hip score over 60 months. However, after the patients were adjusted for age above and below 50 years, the trend for each group was similar despite the diagnosis. All patients below 50 years of age, regardless of diagnosis, gradually decreased in hip score over time. On the other hand, all patients over 50 had a gradual increase in hip score with time. The poor results seen in patients with osteonecrosis may be related more to age and activity level than to the primary diagnosis. We do not believe that the diagnosis of osteonecrosis plays as significant a role in the final outcome of a total hip arthroplasty as does the patient's age and, more importantly, activity level following hip arthroplasty.
Blood Management Experience: Relationship Between Autologous Blood Donation and Transfusion in Orthopedic Surgery
Authors: Sculco Thomas P , Gallina Jessica 
Published: April 2021

ABSTRACT
Preoperative autologous donation (PAD) is commonly used for patients undergoing elective total joint arthroplasty; however, PAD is associated with increased overall transfusion rates and may not be cost-effective for all patients. A retrospective analysis was conducted on a series of 1405 patients undergoing unilateral or bilateral total hip or total knee arthroplasty at The Hospital for Special Surgery to determine the effect of PAD on transfusion outcomes. Eighty-three percent of patients predonated blood (1 unit to 3 units). Transfusions occurred in 82% of PAD participants and in only 50% of nondonors. The allogeneic transfusion rates were 8% for PAD participants and 50% for nondonors. Thirty-four percent to 45% of donated autologous units were discarded. Hemoglobin concentrations measured prior to surgery were inversely related to frequency of allogeneic transfusion. These data underscore the importance of hemoglobin levels in blood management planning. This information can be useful for formulating rational, cost-effective blood management guidelines.
In Vitro Comparison of Elongation of the Anterior Cruciate Ligament and Single- and Dual-Tunnel Anterior Cruciate Ligament Reconstructions
Authors: Edwards T Bradley , Guanche Carlos A , Petrie Scott G , Thomas Kevin A 
Published: April 2021

ABSTRACT
This study evaluated strain in the normal anterior cruciate ligament (ACL) and compared it to four different doubte-strand hamstring tendon reconstructive techniques. Seventeen fresh-frozen knees from 11 cadavers were tested. The strain in the anteromedial and posterolateral bands of the native ACL and their equivalents in four autograft techniques were measured using differential variable reluctance transducers.
The anteromedial band of the intact ACL shortened from 0°-30° of flexion, then lengthened to 120°; the posterolateral band of the intact ACL shortened from 0°-120° of flexion. Following ACL excision, these knees underwent reconstruction with double-strand hamstring tendons with either single tibial and femoral tunnels, single tibial and dual femoral tunnels, dual tibial and single femoral tunnels, or dual tibial and dual femoral tunnels. With the exception of the dual-band, dual-tunnel technique, all of the procedures placed greater strain on the reconstructive tissues than was observed on the native ACL, after approximately 30° of flexion.
These results indicate that dual-band hamstring tendon reconstructions placed with single tibial and femoral tunnels do not address the complexity of the entire ACL. Rather, these procedures appear to only duplicate the effect of the anteromedial band, while perhaps overconstraining the joint as a result of its inability to reproduce the function of the posterolateral band. During rehabilitation following ACL reconstruction, therefore, only from 0°-30° of the graft tissues are not significantly strained. Dual tibial and femoral tunnel techniques should be evaluated further to more closely recreate knee kinematics following ACL reconstruction.
Elbow Ligament Strain Under Valgus Load: A Biomechanical Study
Authors: Pribyl Charles R , Wascher Daniel C , Firoozbakhsh Keikhosrow , Hurley Davis K , McNally Thomas P , Weiser Martin W 
Published: April 2021

ABSTRACT
This study assessed the importance of the anterior and posterior bundles of the medial collateral ligament in the elbow by measuring in situ strain in response to valgus loads at three positions of forearm rotation throughout a full arc of motion. Strain in the anterior bundle was significantly greater than in the posterior bundle and increased with more flexion. The anterior bundle developed strain at a lower flexion angle (30°) than the posterior bundle (60°). Strain ratio increased with load increase for all flexion angles. Forearm position minimally affected strain. These results indicate that the anterior bundle is important in resisting a valgus load, particularly in mid-flexion, while the importance of the posterior bundle increases as the elbow approaches full flexion.
Treatment of Large Skeletal Defects in the Lower Extremities Using Double-Strut, Free Vascularized Fibular Bone Grafting
Authors: Chang Ming-Chau , Lo Wai-Hee , Chen Chuan-Mu , Chen Tain-Hsiung 
Published: April 2021

ABSTRACT
This article reports on the use of double-strut, free vascularized fibular grafts to treat six patients with infected nonunion or traumatic bone loss in the femur or tibia after prolonged treatment and multiple operations. The defects were 6-13 cm long. Five patients achieved solid union within 6 months, and one patient required additional cancellous grafting to achieve union at the distal end of the fibula. One patient experienced a stress fracture due to strenuous exercise, and union was achieved 3 months after reapplying an external fixator. Although three patients had some restricted knee motion, all patients had a satisfactory outcome in regard to walking, and no limb-length discrepancies were noted in any patient.
In Vitro Analysis of Periprosthetic Strains Following Total Knee Arthroplasty
Authors: Parry Bryan R , Ganley Theodore J , Bortel David T , Englund Richard , Cooney Timothy E 
Published: April 2021

ABSTRACT
Clinical case studies have disclosed certain risk factors associated with periprosthetic fracture in elderly patients. How the mechanical strength of the distal femur is changed by total knee arthroplasty (TKA) has not been elucidated. Using elderly cadaveric femora, this study evaluated both periprosthetic strains and associated fracture patterns arising from an in vitro simulation of a fall onto the distal femur. The data showed a significant Increase in anterior and posterior mechanical strain following TKA. Neither stemless nor stemmed versions of two cemented Howmedica prostheses (Rutherford, NJ) reduced distal femur strains to baseline values. However, neither produced a disproportionate frequency of periprosthetic fractures. Although not formally evaluated herein, bone geometry/density may contribute more profoundly to the occurrence of periprosthetic fracture than the implants tested.