bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel noninstrumented surgical approach for foramen reconstruction for isthmic spondylolisthesis in patients with radiculopathy: preliminary clinical and radiographic outcomes
Authors: Spoor Jochem K. H. , Dallenga Alof H. G. , Gadjradj Pravesh S. , de Klerk Luuk , van Biezen Frans C. , Bijvoet Henk W. C. , Harhangi Biswadjiet S. 
Published: January 2018

OBJECTIVEThe health care costs for instrumented spine surgery have increased dramatically in the last few decades. The authors present a novel noninstrumented surgical approach for patients with isthmic spondylolisthesis, with clinical and radiographic results.METHODSCharts of patients who underwent this technique were reviewed. The procedure consisted of nerve root decompression by reconstruction of the intervertebral foramen. This was achieved by removal of the pedicle followed by noninstrumented posterolateral fusion in which autologous bone graft from the right iliac crest was used. Outcomes regarding radicular complaints, bony fusion, progression of the slip, and complications were evaluated using patient history and radiographs obtained at follow-up intervals of 3–18 months after surgery.RESULTSA total of 58 patients with a mean age of 47 years were treated with this method. Partial removal of the pedicle was performed in 93.1% of the cases, whereas in 6.9% of the cases the entire pedicle was removed. The mean duration of surgery was 216.5 ± 54.5 minutes (range 91–340 minutes). The mean (± SD) duration of hospitalization was 10.1 ± 2.9 days (range 5–18 days).After 3 months of follow-up, 86% of the patients reported no leg pain, and this dropped to 81% at last follow-up. Radiographic follow-up showed bony fusion in 87.7% of the patients. At 1 year, 5 patients showed progression of the slip, which in 1 patient prompted a second operation within 1 year. No major complications occurred.CONCLUSIONSTreatment of isthmic spondylolisthesis by reconstruction of the intervertebral neuroforamen and posterolateral fusion in situ is a safe procedure and has comparable results with the existing techniques. Cost-effectiveness research comparing this technique to conventional instrumented fusion techniques is necessary to evaluate the merits for both patients and society.
Minimally invasive anterior and lateral transpsoas approaches for closed reduction of grade II spondylolisthesis: initial clinical and radiographic experience
Authors: Xu David S. , Bach Konrad , Uribe Juan S. 
Published: January 2018

OBJECTIVEMinimally invasive anterior and lateral approaches to the lumbar spine are increasingly used to treat and reduce grade I spondylolisthesis, but concerns still exist for their usage in the management of higher-grade lesions. The authors report their experience with this strategy for grade II spondylolisthesis in a single-surgeon case series and provide early clinical and radiographic outcomes.METHODSA retrospective review of a single surgeon’s cases between 2012 and 2016 identified all patients with a Meyerding grade II lumbar spondylolisthesis who underwent minimally invasive lateral lumbar interbody fusion (LLIF) or anterior lumbar interbody fusion (ALIF) targeting the slipped level. Demographic, clinical, and radiographic data were collected and analyzed. Changes in radiographic measurements, Oswestry Disability Index (ODI), and visual analog scale (VAS) scores were compared using the paired t-test and Wilcoxon signed rank test for continuous and ordinal variables, respectively.RESULTSThe average operative time was 199.1 minutes (with 60.6 ml of estimated blood loss) for LLIFs and 282.1 minutes (with 106.3 ml of estimated blood loss), for ALIFs. Three LLIF patients had transient unilateral anterior thigh numbness during the 1st week after surgery, and 1 ALIF patient had transient dorsiflexion weakness, which was resolved at postoperative week 1. The mean follow-up time was 17.6 months (SD 12.5 months) for LLIF patients and 10 months (SD 3.1 months) for ALIF patients. Complete reduction of the spondylolisthesis was achieved in 12 LLIF patients (75.0%) and 7 ALIF patients (87.5%). Across both procedures, there was an increase in both the segmental lordosis (LLIF 5.6°, p = 0.002; ALIF 15.0°, p = 0.002) and overall lumbar lordosis (LLIF 2.9°, p = 0.151; ALIF 5.1°, p = 0.006) after surgery. Statistically significant decreases in the mean VAS and the mean ODI measurements were seen in both treatment groups. The VAS and ODI scores fell by a mean value of 3.9 (p = 0.002) and 19.8 (p = 0.001), respectively, for LLIF patients and 3.8 (p = 0.02) and 21.0 (p = 0.03), respectively, for ALIF patients at last follow-up.CONCLUSIONSEarly clinical and radiographic results from using minimally invasive LLIF and ALIF approaches to treat grade II spondylolisthesis appear to be good, with low operative blood loss and no neurological deficits. Complete reduction of the spondylolisthesis is frequently possible with a statistically significant reduction in pain scores.
A comparison of the techniques of direct pars interarticularis repairs for spondylolysis and low-grade spondylolisthesis: a meta-analysis
Authors: Mohammed Nasser , Patra Devi Prasad , Narayan Vinayak , Savardekar Amey R. , Dossani Rimal Hanif , Bollam Papireddy , Bir Shyamal , Nanda Anil 
Published: January 2018

OBJECTIVESpondylosis with or without spondylolisthesis that does not respond to conservative management has an excellent outcome with direct pars interarticularis repair. Direct repair preserves the segmental spinal motion. A number of operative techniques for direct repair are practiced; however, the procedure of choice is not clearly defined. The present study aims to clarify the advantages and disadvantages of the different operative techniques and their outcomes.METHODSA meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The following databases were searched: PubMed, Cochrane Library, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health Literature). Studies of patients with spondylolysis with or without low-grade spondylolisthesis who underwent direct repair were included. The patients were divided into 4 groups based on the operative technique used: the Buck repair group, Scott repair group, Morscher repair group, and pedicle screw–based repair group. The pooled data were analyzed using the DerSimonian and Laird random-effects model. Tests for bias and heterogeneity were performed. The I2 statistic was calculated, and the results were analyzed. Statistical analysis was performed using StatsDirect version 2.RESULTSForty-six studies consisting of 900 patients were included in the study. The majority of the patients were in their 2nd decade of life. The Buck group included 19 studies with 305 patients; the Scott group had 8 studies with 162 patients. The Morscher method included 5 studies with 193 patients, and the pedicle group included 14 studies with 240 patients. The overall pooled fusion, complication, and outcome rates were calculated. The pooled rates for fusion for the Buck, Scott, Morscher, and pedicle screw groups were 83.53%, 81.57%, 77.72%, and 90.21%, respectively. The pooled complication rates for the Buck, Scott, Morscher, and pedicle screw groups were 13.41%, 22.35%, 27.42%, and 12.8%, respectively, and the pooled positive outcome rates for the Buck, Scott, Morscher, and pedicle screw groups were 84.33%, 82.49%, 80.30%, and 80.1%, respectively. The pedicle group had the best fusion rate and lowest complication rate.CONCLUSIONSThe pedicle screw–based direct pars repair for spondylolysis and low-grade spondylolisthesis is the best choice of procedure, with the highest fusion and lowest complication rates, followed by the Buck repair. The Morscher and Scott repairs were associated with a high rate of complication and lower rates of fusion.
Radial to axillary nerve transfer
Authors: Vanaclocha Vicente , Herrera Juan Manuel , Rivera-Paz Marlon , Martínez-Gómez Deborah , Vanaclocha Leyre 
Published: January 2018

Axillary nerve injury is common after brachial plexus injuries, particularly with shoulder luxation. Nerve grafting is the traditional procedure for postganglionic injuries. Nerve transfer is emerging as a viable option particularly in late referrals. At the proximal arm the radial and axillary nerves lie close by. Sacrificing one of the triceps muscle nerve branches induces little negative consequences. Transferring the long head of the triceps nerve branch is a good option to recover axillary nerve function. The surgical technique is presented in a video, stressing the steps to achieve a successful result.The video can be found here: https://youtu.be/WbVbpMuPxIE.
Neurofibroma of the peroneal nerve
Authors: Haldeman Clayton , Hanna Amgad 
Published: January 2018

Neurofibromas are benign tumors composed of different cell types from the peripheral nervous system. Neurofibromas infiltrate between nerve fascicles and do not have a discrete capsule. On MRI, they are T1 hypointense or isointense, T2 hyperintense, often with a “target sign,” and contrast enhancing. The video shows gross-total resection of a peroneal nerve neurofibroma presenting as a painful mass in the popliteal fossa. Incisions across a skin crease can be either oblique or zigzag, but never perpendicular to it. It is also key to expose normal nerve proximal and distal to the tumor. The patient had a good functional outcome.The video can be found here: https://youtu.be/G74Zoa1Y2JM.
Surgical repair of sciatic nerve traumatic rupture: technical considerations and approaches
Authors: Abou-Al-Shaar Hussam , Yoon Nam , Mahan Mark A. 
Published: January 2018

Traumatic proximal sciatic nerve rupture poses surgical repair dilemmas. Disruption often causes a large nerve gap after proximal neuroma and distal scar removal. Also, autologous graft material to bridge the segmental defect may be insufficient, given the sciatic nerve diameter. The authors utilized knee flexion to allow single neurorrhaphy repair of a large sciatic nerve defect, bringing healthy proximal stump to healthy distal segment. To avoid aberrant regeneration, the authors split the sciatic nerve into common peroneal and tibial divisions. After 3 months, the patient can fully extend the knee and has evidence of distal regeneration and nerve continuity without substantial injury.The video can be found here: https://youtu.be/lsezRT5I8MU.
Acute repair of traumatic pan–brachial plexus injury: technical considerations and approaches
Authors: Abou-Al-Shaar Hussam , Karsy Michael , Ravindra Vijay , Joyce Evan , Mahan Mark A. 
Published: January 2018

Particularly challenging after complete brachial plexus avulsion is reestablishing effective hand function, due to limited neurological donors to reanimate the arm. Acute repair of avulsion injuries may enable reinnervation strategies for achieving hand function. This patient presented with pan–brachial plexus injury. Given its irreparable nature, the authors recommended multistage reconstruction, including contralateral C-7 transfer for hand function, multiple intercostal nerves for shoulder/triceps function, shoulder fusion, and spinal accessory nerve–to–musculocutaneous nerve transfer for elbow flexion. The video demonstrates distal contraction from electrical stimulation of the avulsed roots. Single neurorrhaphy of the contralateral C-7 transfer was performed along with a retrosternocleidomastoid approach.The video can be found here: https://youtu.be/GMPfno8sK0U.
Minimally invasive approach to resection of paraspinal schwannoma
Authors: Paullus Patrick , Wilson Taylor A. , Lee Paul , Gunasekaran Arunprasad , Kazemi Noojan 
Published: January 2018

In this video, the authors demonstrate a minimally invasive approach and resection of a paraspinal schwannoma. Using an expandable retractor, the authors were able to identify important adjacent bony landmarks and hence visualize and remove this peripheral nerve sheath tumor. While a tubular retractor is commonly used for interbody fusion procedures, the location of the tumor allowed this minimally invasive approach resulting in excellent access, minimal soft-tissue injury, and a short hospital stay. The authors present this approach as a less invasive and yet effective technique for resection of otherwise difficult-to-access nerve lesions.The video can be found here: https://youtu.be/89OY5wdMB_k.
Peroneal nerve decompression
Authors: Corriveau Mark , Lescher Jacob D. , Hanna Amgad S. 
Published: January 2018

Peroneal neuropathy is a common pathology encountered by neurosurgeons. Symptoms include pain, numbness, and foot drop. When secondary to compression of the nerve at the fibular head, peroneal (fibular) nerve release is a low-risk procedure that can provide excellent results with pain relief and return of function. In this video, the authors highlight key operative techniques to ensure adequate decompression of the nerve while protecting the 3 major branches, including the superficial peroneal nerve, deep peroneal nerve, and recurrent genicular (articular) branches. Key steps include positioning, circumferential nerve dissection, fascial opening, isolation of the major branches, and closure.The video can be found here: https://youtu.be/0y9oE8w1FIU.
Targeted fascicular biopsy in a patient with prostate cancer
Authors: Stone Jonathan J. , Kaszuba Megan C. , Spinner Robert J. 
Published: January 2018

Patients who present with a history of cancer and the new onset of lumbosacral or peripheral neuropathy should be evaluated for the potential of metastasis. Targeted fascicular biopsy can be useful to diagnose atypical lesions within peripheral nerves in patients with major or progressive neurological deficits. In this video, the authors demonstrate the technique of targeted fascicular biopsy of the sciatic nerve in a 63-year-old man with a history of prostate cancer.The video can be found here: https://youtu.be/PTOX9XxNBDU.
Effectiveness in the performance of organ transplants in the State of Paraná, Brazil
Authors: De Oliveira Iria Barbara , De Souza Carla Moretti , Galdino Maria José Quina , Pissinati Paloma S. Cavalcante , Silva Larissa Gutierrez de Carvalho , Vannuchi Marli Terezinha Oliveira , Haddad Maria do Carmo Fernandez Lourenço 
Published: January 2018

Objective: To analyze the effectiveness of organ transplants in the state of Paraná, Brazil.
Methods: A cross-sectional quantitative study was conducted with data from 2,036 solid organ transplants performed in the state between 2011 and 2015. Three indicators were calculated, per capita transplants, meeting the demands of the population and the demand for transplants, which demonstrated the effectiveness and the disparities in the process. The association between the variables was verified by Pearson's Chi-Square test and Fisher's exact test.
Results: Most transplants were performed in philanthropic hospitals, male, funded by public funding, and there was an annual increase in the number of transplants per capita and in the productivity of kidney, liver and heart transplantation teams. Although renal transplantation is the most performed in absolute numbers, it served a maximum of 2.2% of its demand.
Conclusion: It is necessary to devise strategies to meet the demand for organ transplants, above all, to consolidate the process of donating organs in the state under study.
Measurement of Physiological Monitor Alarm Accuracy and Clinical Relevance in Intensive Care Units
Authors: Ruppel Halley , Funk Marjorie , Whittemore Robin 
Published: January 2018

Background
Alarm fatigue threatens patient safety by delaying or reducing clinician response to alarms, which can lead to missed critical events. Interventions to reduce alarms without jeopardizing patient safety target either inaccurate or clinically irrelevant alarms, so assessment of alarm accuracy and clinical relevance may enhance the rigor of alarm intervention studies done in clinical units.

Objectives
To (1) examine approaches used to measure accuracy and/or clinical relevance of physiological monitor alarms in intensive care units and (2) compare the proportions of inaccurate and clinically irrelevant alarms.

Methods
An integrative review was used to systematically search the literature and synthesize resulting articles.

Results
Twelve studies explicitly measuring alarm accuracy and/or clinical relevance on a clinical unit were identified. In the most rigorous studies, alarms were annotated retrospectively by obtaining alarm data and parameter waveforms rather than being annotated in real time. More than half of arrhythmia alarms in recent studies were inaccurate. However, contextual data were needed to determine alarms’ clinical relevance. Proportions of clinically irrelevant alarms were high, but definitions of clinically irrelevant alarms often included inaccurate alarms.

Conclusions
Future studies testing interventions on clinical units should include alarm accuracy and/or clinical relevance as outcome measures. Arrhythmia alarm accuracy should improve with advances in technology. Clinical interventions should focus on reducing clinically irrelevant alarms, with careful consideration of how clinical relevance is defined and measured.
Rectal and Bladder Temperatures vs Forehead Core Temperatures Measured With SpotOn Monitoring System
Authors: Schell-Chaple Hildy M. , Liu Kathleen D. , Matthay Michael A. , Puntillo Kathleen A. 
Published: January 2018

BackgroundMethods and frequency of temperature monitoring in intensive care unit patients vary widely. The recently available SpotOn system uses zero-heat-flux technology and offers a noninvasive method for continuous monitoring of core temperature of critical care patients at risk for alterations in body temperature.ObjectiveTo evaluate agreement between and precision of a zero-heat-flux thermometry system (SpotOn) and continuous rectal and urinary bladder thermometry during fever and defervescence in adult patients in intensive care units.MethodsProspective comparison of SpotOn vs rectal and urinary bladder thermometry in eligible patients enrolled in a randomized clinical trial on the effect of acetaminophen on core body temperature and hemodynamic status.ResultsA total of 748 paired temperature measurements from 38 patients who had both SpotOn monitoring and either continuous rectal or continuous bladder thermometry were analyzed. Temperatures during the study were from 36.6°C to 39.9°C. The mean difference for SpotOn compared with bladder thermometry was −0.07°C (SD, 0.24°C; 95% limits of agreement, ± 0.47°C [−0.54°C, 0.40°C]). The mean difference for SpotOn compared with rectal thermometry was −0.24°C (SD, 0.29°C; 95% limits of agreement, ± 0.57°C [−0.81°C, 0.33°C]). Most differences in temperature between methods were within ± 0.5°C in both groups (96% bladder and 85% rectal).ConclusionsThe SpotOn thermometry system has excellent agreement and good precision and is a potential alternative for noninvasive continuous monitoring of core temperature in critical care patients, especially when alternative methods are contraindicated or not available.
Predictors of Moral Distress in a US Sample of Critical Care Nurses
Authors: Hiler Catherine A. , Hickman Ronald L. , Reimer Andrew P. , Wilson Kimberly 
Published: January 2018

BackgroundMoral distress in registered nurses causes decreased job satisfaction, turnover in staffing, burnout, and heightened states of psychological distress. To date, investigation of modifiable factors, such as perceptions of the practice environment and patient safety, among a diverse sample of critical care nurses has been limited.ObjectiveTo explore the relationships among the severity of moral distress, the practice environment, and patient safety in a national sample of critical care nurses.MethodsCritical care nurses experienced in working with adults (&gt; 1 year of intensive care unit experience) and who were subscribers to the American Association of Critical-Care Nurses’ e-mail listserv and social media sites anonymously participated in this descriptive study. Participants completed a demographic questionnaire, the Moral Distress Scale–Revised, and the Practice Environment Scale of the Nursing Work Index. Descriptive statistics, bivariate correlation coefficients, and a hierarchical regression analysis were used to describe the sample characteristics and to assess relationships among the study variables.ResultsOf a national sample of 328 critical care nurses, 56% had less than 20 years of experience as a registered nurse. Moral distress was modestly associated with negative perceptions of the practice environment and patient safety. Job satisfaction, practice environment, and the participant’s age were statistically significant predictors of moral distress in this sample.ConclusionsModifications of organizational factors such as the development of healthy work environments that promote collegial relationships could reduce moral distress among critical care nurses.
Incidence of Sinusitis Associated With Endotracheal and Nasogastric Tubes: NIS Database
Authors: Metheny Norma A. , Hinyard Leslie J. , Mohammed Kahee A. 
Published: January 2018

Background
Endotracheal and nasogastric tubes are recognized risk factors for nosocomial sinusitis. The extent to which these tubes affect the overall incidence of nosocomial sinusitis in acute care hospitals is unknown.

Objective
To use data for 2008 through 2013 from the Nationwide Inpatient Sample database to compare the incidence of sinusitis in patients with nasogastric tubes with that in patients with an endotracheal tube alone or with both an endotracheal tube and a nasogastric tube.

Methods
Patients’ data with any of the following International Classification of Disease, Ninth Revision, Clinical Modification codes were abstracted from the database: (1) 96.6, enteral infusion of concentrated nutritional substances; (2) 96.07, insertion of other (naso-)gastric tube; or (3) 96.04, insertion of an endotracheal tube. Sinusitis was defined by the appropriate codes. Weighted and unweighted frequencies and weighted percentages were calculated, categorical comparisons were made by χ2 test, and logistic regression was used to examine odds of sinusitis development by tube type.

Results
Of 1 141 632 included cases, most (68.57%) had an endotracheal tube only, 23.02% had a nasogastric tube only, and 8.41% had both types of tubes. Sinusitis was present in 0.15% of the sample. Compared with patients with only a nasogastric tube, the risk for sinusitis was 41% greater in patients with an endotracheal tube and 200% greater in patients with both tubes.

Conclusion
Despite the low incidence of sinusitis, a significant association exists between sinusitis and the presence of an endotracheal tube, especially when a nasogastric tube is also present.
Insecticidal and synergistic activity of two monoterpenes against diamondback moth (Lepidoptera: Plutellidae)
Authors: Webster A.E. , Manning P. , Sproule J.M. , Faraone N. , Cutler G.C. 
Published: January 2018

AbstractWe examined the insecticidal activity of linalool and thymol, against diamondback moth,Plutella xylostella(Linnaeus) (Lepidoptera: Plutellidae), and whether they would synergise the activity of spinosad against this pest. Both linalool and thymol were toxic to diamondback moth larvae by topical and oral exposure, but orders of magnitude less so than spinosad. We found that low concentrations of linalool weakly synergised spinosad, increasing its toxicity more than twofold. An interaction between spinosad, and acetone meant it was not possible to identify any potential synergisms between thymol and spinosad. Our results demonstrate limited potential for thymol and linalool to act as biopesticides or synergists for managing diamondback moth.