bluuebunny/crossref_metadata_2025_split huggingface dataset:
Segmental Excision versus Intralesional Curettage with Adjuvant Therapy for Giant Cell Tumour of Bone
Authors: Yacob Omar , Umer Masood , Gul Marrium , Qadir Irfan 
Published: October 2016

Purpose. To review the functional outcome and local recurrence rate of 29 patients who underwent segmental excision or intralesional curettage with adjuvant therapy for giant cell tumour (GCT) of bone. Methods. Records of 17 men and 12 women (mean age, 30.17 years) who underwent segmental excision (n=18) or intralesional curettage followed by adjuvant therapy (n=11) for GCT of the femur (n=13), tibia (n=8), radius (n=6), or ulna (n=2) were reviewed. Nine of the patients had recurrent GCT of bone and had undergone segmental excision (n=6) or intralesional curettage (n=3) elsewhere. Functional outcome was evaluated using the Musculoskeletal Tumour Society (MSTS) scoring system. Results. The mean follow-up period was 6.4 (range, 3–13.5) years. 14 patients were followed up for 3 to 5 years, 12 for 5 to 10 years, and 3 for >10 years. Of 20 patients with primary GCT of bone, 12 underwent segmental excision and had no recurrence, and 8 underwent intralesional curettage, 2 of whom developed local recurrence. Of the remaining 9 patients with recurrent GCT of bone, there was one re-recurrence in each surgical option. Local recurrence was not associated with Campanacci grading or type of surgery. One of 18 patients with segmental excision and 3 of 11 patients with intralesional curettage had local recurrence (5.6% vs. 27.3%, p=0.139). The MSTS score was excellent in 7, good in 6, moderate in 2, fair in 2, and poor in one patient after segmental excision, whereas the score was excellent in 9 and good in 2 patients after intralesional curettage (p=0.206). The proportion of yielding an excellent outcome was higher after intralesional curettage (38.9% vs. 81.8%, p=0.0289). Nonetheless, the mean MSTS score of the 2 groups was comparable (74.17% vs. 86.36%, p=0.054). Conclusion. Local recurrence of GCT was not associated with the surgical option. Nonetheless, intralesional curettage resulted in better functional outcome.
Ankle Block versus Popliteal Fossa Block as Primary Anesthesia for Forefoot Surgical Procedures
Authors: Hunter Joshua , Anderson Robert B. , Jones Carroll P. , Cohen Bruce 
Published: October 2016

Category: Midfoot/Forefoot Introduction/Purpose: Postoperative pain is often difficult to control with oral medications, often times requiring large doses of opioid analgesia. The purpose of this study is to compare the analgesic effects of an ankle block (AB) to a single shot popliteal fossa block (PFB) for patients undergoing orthopaedic forefoot procedures. Our hypothesis is that a PFB would have fewer conversions to general anesthesia, less pain medication requirements and better pain control in the immediate postoperative period. Methods: Patients having elective outpatient orthopaedic foot and ankle procedures were invited to participate. Patients with Diabetes, peripheral neuropathy, bilateral procedures, allergy to local anesthetics and procedures proximal to chopart’s joint were excluded. Patients were randomized to either an ultrasound guided AB or PFB by an anesthesiologist pre-operatively. Intraoperative conversion to general anesthesia and PACU opioid requirements were converted to mg of Morphine and then recorded. Postoperative pain was assessed using the visual analog scale (VAS) at regular time intervals until postoperative day (POD) 2. Patients rated their block experience on a 1-5 scale, with 5 being very effective. Results: A total of 167 patients participated in the study with 88 patients (53%) receiving an AB and 79 (47%) receiving a single shot PFB. No difference in the conversion to general anesthesia was seen between the two groups (12 patients in AB v. 10 in PFB, p>0.05), with the most common reason being movement without pain in both groups. PACU morphine requirements were significantly reduced in the PFB group (p=0.004). The VAS was significantly lower for the PFB patients for all time points 24 hrs after surgery (p < 0.01). Individual and combined complication rates were similar between both groups (AB 11.4% v PFB 10.1%, p>0.05). The PFB lasted longer (14.5 hrs v 20.9 hrs, p < 0.001). Both groups felt their block was effective (AB 4.79/5 v PFB 4.82/5, p=0.68) Conclusion: Regional anesthesia can be a safe and reliable adjunct to perioperative pain management with high patient satisfaction in patients undergoing elective forefoot procedures. However, better pain management and decreased opioid requirements in the immediate perioperative period was seen in patients having a popliteal fossa block when compared to an ankle block.
A Longitudinal Analysis of 25 Years of Foot & Ankle Fellowship Training
Authors: Hamid Kamran S. , Nunley James A. 
Published: October 2016

Category: Other Introduction/Purpose: There is a growing demand for orthopaedic surgeons trained in management of foot and ankle conditions, yet there remains wide variation in the process of fellowship training and a dearth of outcomes assessment. The 2016- 2017 American Orthopaedic Foot & Ankle Society (AOFAS) Fellowship Match consisted of 75 available positions—a 44% increase over that a decade prior. Of the 48 programs offering positions, 6 offer standardization and oversight by the Accreditation Council for Graduate Medical Education (ACGME). We aimed to assess the educational curriculum, research production and career paths of 25 years of graduates from the longest running ACGME accredited foot and ankle fellowship program in the United States. Methods: A database of graduates from a single foot and ankle fellowship program was utilized to identify practice types and locations as well as tabulate PubMed indexed articles authored by fellows while in the program. The educational curriculum corresponding to their training is described. Additionally, historical data from the AOFAS Match Program was evaluated for trends. Results: Between 2005-2015, there were 515 graduates of AOFAS sponsored foot & ankle fellowship programs in the U.S. (Figure 1). Successful match rates for fellowship applicants ranged from 80-96% and program fill rates varied between 61-93%. Our fellowship program has graduated 50 fellows in the past 25 years of whom 37 (74%) practice in the U.S. and 13 (26%) practice abroad. When accounting for international, military and academic practitioners, 54% of our graduates entered practice types with a teaching component. Research articles for each fellow were examined and on average 1.9 PubMed indexed articles (range 0-12) were published by fellows during their tenure in the program. Graduates going into military, international and U.S. academic practices published 2.5, 2.8 and 3.7 articles during training, respectively. Conclusion: As technical and cognitive demands of foot and ankle surgeons increase, the need for optimized fellowship training has become paramount. Assessment of educational curriculum, research production and graduate practice type may help fellowships identify areas for improvement in order to meet program and trainee goals.
Is Syndesmotic Screw Removal Needed Before Weight-Bearing Ambulation?
Authors: Kim Jong-Kil , Jeong Seong-Yup , Lee Kwang-Bok 
Published: October 2016

Category: Trauma Introduction/Purpose: In syndesmosis injury, numerous clinical and biomechanical investigations showed some concensus as follows; 1)There are no difference in stainless steel versus titanium screws. 2)A 4.5-mm screw apparently provides greater resistance to shear stress than a 3.5-mm screw. 3)The level of placement probably does not affect outcome. 4)Three-cortical versus four-cortical screw placement does not affect biomechanical stability. But, whether the syndesmosis screw should be removed prior to weight-bearing or not is still debated. The aim of this study is to compare the functional outcome between screw removal and retain group, and between diastasis and no diastasis group. Methods: One hundred twelve patients had undertaken open reduction and internal fixation due to syndesmosis injury, who divided into 4 groups; (A) syndesmotic screw removal before weight-bearing (postoperative 3 months, n=56) and (B) retained group (n=56), (C) recurrence of diastasis (n=16) and (D) no diastasis (n=40) after screw removal. Radiological diastasis, VAS, AOFAS ankle-hindfoot score, SF-12, complications (screw loosening and breakage) were evaluated between groups. Results: AOFAS ankle-hindfoot score shows 75.10±10.40 in group A, 77.07±10.60 in group B, and SF12 shows 45.78±5.68 in group A, 47.33±5.83 in group B, there is no significant difference between group A and B in AOFAS ankle-hindfoot score and SF- 12 (p=0.487, p=0.319). Radiological diastasis significantly develops (p=0.025) in group A (16/56) compare to B (2/56), but screw loosening or breakage significantly develops (p=0.001) in group B (8/56) compare to group A (0/56). AOFAS ankle-hindfoot score shows 70.33±6.22 in group C, 76.50±10.26 in group D, and SF12 shows 49.85±3.83 in group C, 47.40±8.01 in group D, there is no significant difference between group C and D in AOFAS ankle-hindfoot score and SF-12 (p=0.808, p=0.065). There is no significant difference between group C and D B in VAS, AOFAS ankle-hindfoot score and SF-12. Conclusion: Diastasis recurrence is significantly higher in removal group. But, screw retain group shows higher breakage, loosening rate than removal group. Clinical outcome such as VAS, AOFAS ankle-hindfoot score and SF-12 is no significant different in two groups.Also, if diastasis recurred, it did not affect clinical outcome. Therefore, we couldn’t conclude that syndesmotic screw removal is needed before weight-bearing (postoperaive 3 months).
Short versus ‘Standard’ Scarf Osteotomy for Hallux Valgus Correction
Authors: Qasim Sultan N. , Mangwani Jitendra 
Published: October 2016

Category: Bunion Introduction/Purpose: Scarf osteotomy is an established procedure for correction of hallux valgus deformity. The technique has evolved and is effectively used for all grades of deformities. Short osteotomy (short scarf/modified chevron) and single screw fixation is an effective option for correction of mild to moderate hallux valgus deformity leading to lesser soft tissue disruption, smaller scar and being cost effective. Aim of this study was to compare radiological parameters of hallux valgus correction by a ‘standard’ scarf osteotomy and 2-screw fixation with a short osteotomy and single screw fixation Methods: We performed a retrospective review of prospectively collected data. The cases were identified from theatre log. 37 consecutive patients, operated between January 2013 and December 2014, were included. All had mild deformity as defined by maximum pre-operative intermetartarsal angle of 13 degrees. 16(43%) had short osteotomy with single screw fixation (Group 1) and the remaining 21 (57%) had ‘standard’ scarf osteotomy with 2 screw fixation (Group 2). Preoperative and final postoperative weight bearing radiographs were independently reviewed by both authors. Radiological parameters assessed were Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), Distal Metatarsal Articular Angle (DMAA) and Medial Sesamoid position.Sesamoid position was determined by dividing metatarsal head into three equal sections and recorded as more than 50% of medial sesamoid in a section. The three grades were 3(lateral), 2(central) and 1(medial).Both groups were comparable for distribution of age and pre-operative radiological measures. Mean duration of X-Ray follow up was 3 months (range 2-12). SPSS version 20 was used to perform statistical analysis. Results: Mean age of patients was 49 years +/- 13 years. Mean improvement in radiological measures in degrees was - HVA from 24.4 to 10.9 (Group 1) and 35.3 to 12.6 (Group 2), IMA 10.0 to 3.3 (Group 1) and 10.5 to 5.4 (Group 2), DMAA 8.5 to 5.4 (Group 1) and 10.9 to 5.8 (Group 2), Medial Sesamoid position changed from 3 to 1 for both groups. Wilcoxon Signed Rank test showed all these improvements to be significant. T-test showed that both groups were comparable, with no statistically significant difference, for improvements in all radiological parameters. Conclusion: Short osteotomy with single screw fixation is equally effective in correction of symptomatic mild hallux valgus deformity as compared to ‘standard’ scarf osteotomy with the advantage of a smaller scar, lesser soft tissue disruption. We believe it is also cost effective because of potential reduction in duration of surgery and the cost of the implant.
The Syndesmotic Insufficiency in Mobile Bearing TAR – A Challenging and Underestimated Problem
Authors: Wagener Joe , Schweizer Christine , Zwicky Lukas , Hintermann Beat 
Published: October 2016

Category: Ankle Arthritis Introduction/Purpose: The consequence of a missed syndesmotic insufficiency during mobile bearing total ankle replacement (TAR) surgery is subsequent valgus deformity leading to dissociation of the distal tibiofibular joint and failure of the TAR. The purpose of this study was to retrospectively review the patients who developed a syndesmotic insufficiency, which lead to a revision surgery, after primary TAR in our centre. The primary goal was to identify red-flags for possible syndesmotic insufficiency in preoperative planning of TAR, in order to reduce this type of complication. Methods: We identified twenty patients (12 females and 8 males) with a missed instability of the distal tibio-fibular joint appearing 3.5 years (range 0.8-9.5 years) after primary TAR. Patient’s records, preoperative and postoperative radiographs and intraoperative fluoroscope images were reviewed especially with regard to previous ankle or lower leg fractures. Functional outcome was assessed with the use of the American Orthopaedic Foot&Ankle (AOFAS) hindfoot score. Results: The mean follow-up after last revision surgery was 3.5 years. The median AOFAS Score at last follow-up was 72.5. We could identify 3 risk factors for possible failure: (a) The nature of trauma: Weber-C-Type fractures or Maisonneuve-Type fractures were found in 13 of 20 cases. (b) A defect in the lateral tibial plafond after for example, a pilon fracture or arising due to cyst formation, was found in 3 cases. Here we concluded that the defect lead to a subsequent valgus tilt of the tibial component, acting as a stress riser in the distal tibio-fibular joint. (c) The remaining 4 cases showed a high tibial resection probably leading to an iatrogenic lesion of the anterior and posterior distal tibio-fibular ligaments. Conclusion: Knowing the etiology of posttraumatic osteoarthritis of the ankle joint is mandatory to identify a syndesmotic insufficiency in the preoperative work-up for mobile bearing three-component TAR. Due to these findings, our surgical protocol for TAR was adapted accordingly. If one or more of the risk factors are present during surgery we suggest performing distal tibio- fibular fusion.
Phase 1 trial of rituximab, lenalidomide, and ibrutinib in previously untreated follicular lymphoma: Alliance A051103
Authors: Ujjani Chaitra S. , Jung Sin-Ho , Pitcher Brandelyn , Martin Peter , Park Steven I. , Blum Kristie A. , Smith Sonali M. , Czuczman Myron , Davids Matthew S. , Levine Ellis , Lewis Lionel D. , Smith Scott E. , Bartlett Nancy L. , Leonard John P. , Cheson Bruce D. 
Published: October 2016

Key Points
The combination of rituximab, lenalidomide, and ibrutinib is associated with a high incidence of rash in follicular lymphoma (all grades 82%). Efficacy of the triplet appears similar to rituximab-lenalidomide in the same patient population.
THE PRIORITY DIRECTIONS OF MODERN FRANCE’S POLICY IN OVERCOMING CRISIS IN THE SOCIAL SPHERE: EXPANSION OF THE STATE SOCIAL GUARANTEES, TARGETING AND DIVERSIFICATION OF THE SOCIAL HELP
Authors: Преображенская Арина , Preobrazhenskaya Arina , Арифуллин Марат , Arifullin Marat 
Published: October 2016

The article analyzes the most pressing social and economic problems of modern France. The crisis phenomena in economy have led to an aggravation of many social problems and deepening of existing social inequality. The young people, especially with low levels of education and professional qualifications, became the most affected part of society and have expanded the increased ranks of the unemployed and recipients of minimum social benefits.
Dramatically increase government spending has led to growth of government deficits. The government has taken a number of measures to reduce costs, including in the social sphere. The article deals with reforms of Socialist Party that is in power. President Hollande’s measures for strengthening the competitiveness and steps to tighten budgetary policy did not lead to a significant improvement of economic indicators in the country.
Particular attention is paid to innovations in the field of social protection. The authors conclude that the French State has kept its position as a guarantor of social development and has pursued a policy of distribution of a set of social standards for emerging categories of recipients. At the same time there is tendency of more &#34;targeting&#34; and diversification of social support.
It is noted that the desire of the French authorities to intensify the implementation of &#34;republican values&#34; in the consciousness of the suburbs inhabitants is based on strong reasons. In recent years researchers are observing a tendency to &#34;re-islamization&#34; of young people, immigrants and their descendants, who mainly live in the suburbs of large cities. Exclusion from the economic life of this category of Muslims, particularly youth, its social marginalization contributed to increased influence of religious ideology, often in its radical forms.
The authors draw the conclusion that the authorities were forced to look for ways to reduce costs, including in the social sphere. It was not a curtailing of social guarantees but granting more flexibility to this system, the transfer of the gravity center from the payment of benefits to unemployed to encouraging labor activity. There is a desire for greater diversification and targeting of social support. At the same time the state social guarantees to provide a decent life for all citizens have been expanded.
Evaluation of psychometric properties and factor structure of the Polish version of Short Health Anxiety Inventory (SHAI)
Authors: Kocjan Janusz 
Published: October 2016

Aim of the studyThe aim of the study was to adapt english language version of Short Health Anxiety Inventory (SHAI) developed by Salkovskis et all., to Polish conditions and to investigate its psychometric properties and factor structure in clinical and non-clinical samples.Subject or material and methodsA total of 296 subjects participated in this study: 172 clinical samples (46% females and 54% males; mean age: 57,29 ± 13,01 years) and 124 non-clinical samples (51% females and 49% males; mean age: 54,45 ± 13,63). They completed the polish language version of an 18-item SHAI and Hamilton Anxiety Rating Scale (HAM-A). To assess psychometric proporties, internal consistency, test-retest reliability, item-total statistics, construct and convergent validity, and analysis of ROC curves were performed.ResultsThe internal consistency (Cronbach's α of 0,91 and 0,92) and the test-retest reliability (r=0,91 and r=0,94) was excellent for both samples. Correlational analysis revealed a significant relationship of anxiety to SHAI total score and to each of two SHAI subscales. Using the factor analysis, two-factors solution were found, which accounted 48% and 49% of the variance, respectively. A cut-off score of 20 was optimal for detecting severe form of health anxiety in clinical and non-clinical samples, considering the best balance between specificity and sensitivity.DiscussionDespite the widespread application of SHAI, polish language version was not created to this time. The results of the psychometric properties of the scale, confirmed a high reliability and accuracy of the proposed solutions.ConclusionsThis findings provide that polish language version of the SHAI is reliable and valid instrument to detect health anxiety.
A questionnaire based study to assess compassion fatigue in UK practising veterinary nurses
Authors: Smith Nicola 
Published: October 2016

Background:Veterinary staff have been identified as a profession at high risk of suffering from the effects of compassion fatigue (CF), although no specific studies have been carried out to date to assess the risk to UK registered veterinary nurses (RVNs), of this important area of mental health.Aims and objectives:To establish whether CF was a risk factor to RVNs, with the aim of improving mental wellbeing across the veterinary profession as a whole.Methods:An internet-based survey was produced, open to all RVNs who had worked in practice within the last 30 days, using a version of the Professional Quality of Life Scale V (ProQOL). The survey was promoted through various means including social media, an email campaign of veterinary practices and an internet link promoted through veterinary nurse (VN) training colleges.Results:A total of 992 eligible responses were received; 92.8% of respondents were identified as being at moderate/high risk of burnout, with 68.1% of respondents being at moderate/high risk of secondary traumatic stress (STS). Levels of burnout and STS were statistically lower in those experiencing high levels of compassion satisfaction (CS).Conclusion:The statistical analysis performed showed that RVNs are at risk of suffering from CF. The study revealed that working as an RVN posed a risk to mental health in the form of CF. The preventative effect of CS was statistically significant therefore employers should strive to ensure their workers achieve satisfaction in their work to help maintain a mentally healthy workforce.
Association of chlorhexidine and high fluoride dentifrice on Streptococcus mutans viability using an in vitro biofilm model
Authors: Santana Guilherme Bandeira , Silva Debora Lima , Ferreira Josie Haydée Lima , Rolim Fabiana Gouveia , Vale Glauber Campos 
Published: October 2016

Objective. This in vitro study investigated the effect of Fluoride (F), Chlorhexidine (CHX), and their association on the viability of Streptococcus mutans using a biofilm model. Materials and Methods. Biofilms were anaerobically grown on glass slides that were vertically suspended in 24-well plates for 5 days. After 48 h of initial growth, biofilms were treated for the next 72 h, 2x/day with CHX at 0.12% and 2%, F as NaF at 0.08% and 0.4% and their association. Results. CHX treatment decreased the bacteria counts either alone or in association with both F concentrations, when compared with control group and the F treatments alone (p<0.05). Conclusion. No addition effect was observed when CHX and F were used in combination, when compared with CHX used alone.