bluuebunny/crossref_metadata_2025_split huggingface dataset:
Open Compared with Arthroscopic Treatment of Acute Septic Arthritis of the Native Knee
Authors: Johns Brenton P. , Loewenthal Mark R. , Dewar David C. 
Published: March 2017

Background:
Acute native knee septic arthritis is a joint-threatening emergency. Operative treatments by open or arthroscopic methods are available to surgeons. To our knowledge, the literature to date has primarily consisted of case series and no large study has yet compared these methods. The aim of this study was to compare open and arthroscopic treatment for acute native knee septic arthritis.

Methods:
All adult patients with acute native knee septic arthritis treated at our institution with either open or arthroscopic irrigation from 2000 to 2015 were retrospectively evaluated. The clinical findings, laboratory evidence, arthrocentesis and microbiology results, knee radiographs, and outcomes were compared.

Results:
There were 161 patients (166 knees) with acute native knee septic arthritis treated between 2000 and 2015. Initially, 123 knees were treated by arthroscopic irrigation and 43 knees were treated by open irrigation; however, 71% in the open treatment group required repeat irrigation compared with 50% in the arthroscopic treatment group. The superiority of an arthroscopic procedure persisted after adjustment for potential confounders by multivariable analysis, with an odds ratio of 2.56 (95% confidence interval, 1.1 to 5.9; p = 0.027). After 3 irrigation procedures, the cumulative success rate was 97% in the arthroscopic treatment group and 83% in the open treatment group (p = 0.011). The total number of irrigation procedures required was fewer in the arthroscopic treatment group (p = 0.010). In the arthroscopic treatment group, the mean postoperative range of motion was greater (p = 0.016) and there was a trend toward a shorter median length of stay (p = 0.088).

Conclusions:
Arthroscopic treatment for acute native knee septic arthritis was a more successful index procedure and required fewer total irrigation procedures compared with open treatment. Long-term postoperative range of motion was significantly greater following arthroscopic treatment.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Dynamic Stress Testing Is Unnecessary for Unimalleolar Supination-External Rotation Ankle Fractures with Minimal Fracture Displacement on Lateral Radiographs
Authors: Nortunen Simo , Leskelä Hannu-Ville , Haapasalo Heidi , Flinkkilä Tapio , Ohtonen Pasi , Pakarinen Harri 
Published: March 2017

Background:
This study aimed to identify factors from standard radiographs that contributed to the stability of the ankle mortise in patients with isolated supination-external rotation fractures of the lateral malleolus (OTA/AO 44-B).

Methods:
Non-stress radiographs of the mortise and lateral views, without medial clear space widening or incongruity, were prospectively collected for 286 consecutive patients (mean age, 45 years [range, 16 to 85 years]), including 144 female patients (mean age, 50 years [range, 17 to 85 years]) and 142 male patients (mean age, 40 years [range, 16 to 84 years]) from 2 trauma centers. The radiographs were analyzed for fracture morphology by 2 orthopaedic surgeons, who were blinded to each other’s measurements and to the results of external rotation stress radiographs (the reference for stability). Factors significantly associated with ankle mortise stability were tested in multiple logistic regression. Receiver operating characteristic analyses were performed for continuous variables to determine optimal thresholds. A sensitivity of >90% was used as the criterion for an optimal threshold.

Results:
According to external rotation stress radiographs, 217 patients (75.9%) had a stable injury, defined as that with a medial clear space of <5 mm. Independent factors that predicted stable ankle mortise were female sex (odds ratio [OR], 2.5 [95% confidence interval (CI), 1.4 to 4.6]), a posterior diastasis of <2 mm (corresponding with a sensitivity of 0.94 and specificity of 0.39) on lateral radiographs (OR, 10.8 [95% CI, 3.7 to 31.5]), and only 2 fracture fragments (OR, 7.3 [95% CI, 2.1 to 26.3]). When the posterior diastasis was <2 mm and only 2 fracture fragments were present, the probability of a stable ankle mortise was 0.98 for 48 female patients (16.8%) and 0.94 for 37 male patients (12.9%).

Conclusions:
Patients with noncomminuted lateral malleolar fractures (85 patients [29.7%]) could be diagnosed with a stable ankle mortise without further stress testing, when the fracture line widths were <2 mm on lateral radiographs.

Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Comparison of Single Intra-Articular Injection of Novel Hyaluronan (HYA-JOINT Plus) with Synvisc-One for Knee Osteoarthritis
Authors: Sun Shu-Fen , Hsu Chien-Wei , Lin Huey-Shyan , Liou I-Hsiu , Chen Yin-Han , Hung Chia-Ling 
Published: March 2017

Background:
Viscosupplementation has been widely used for the treatment of knee osteoarthritis. Because we found no well-controlled trial comparing single-injection regimens of hyaluronan for knee osteoarthritis, we compared the efficacy and safety of a single intra-articular injection of a novel cross-linked hyaluronan (HYA-JOINT Plus) with a single injection of Synvisc-One in patients with knee osteoarthritis.

Methods:
In a prospective, randomized, controlled, double-blind trial with a 6-month follow-up, 132 patients with knee osteoarthritis (Kellgren-Lawrence grade 2 or 3) were randomized to receive 1 intra-articular injection of 3 mL of HYA-JOINT Plus (20 mg/mL) (n = 66) or 6 mL of Synvisc-One (8 mg/mL) (n = 66). The primary outcome was the change from baseline in the visual analog scale (VAS) (0 to 100 mm) pain score at 6 months. Secondary outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, Likert scale), Lequesne index, timed “Up & Go” (TUG) test, single-limb stance (SLS) test, use of rescue analgesics, and patient satisfaction.

Results:
A total of 121 patients were available for the intention-to-treat analysis at 6 months. Both groups had a significant improvement in the VAS, WOMAC, and Lequesne index scores at each follow-up visit (p < 0.001). Patients who received HYA-JOINT Plus experienced a significantly greater improvement in the VAS pain score at 1, 3, and 6 months compared with those treated with Synvisc-One (adjusted mean difference: −12.0, −8.5, and −6.6; p = 0.001, 0.033, and 0.045, respectively). There were no significant between-group differences in any of the secondary outcomes except the WOMAC stiffness scores at 6 months, which favored HYA-JOINT Plus treatment (p = 0.043). The TUG time did not change significantly in either group during the study (p > 0.05), but the SLS time improved significantly in both the HYA-JOINT Plus and the Synvisc-One group (p = 0.004 and p = 0.022, respectively). No significant between-group differences were observed with respect to patient satisfaction or consumption of analgesics. No serious adverse events occurred following the injections.

Conclusions:
A single injection of either HYA-JOINT Plus or Synvisc-One is safe and effective for 6 months in patients with knee osteoarthritis. HYA-JOINT Plus is superior to Synvisc-One in terms of reducing the VAS pain score at 1, 3, and 6 months and the WOMAC stiffness score at 6 months, with similar safety.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Efficacy of Patient-Specific Instruments in Total Knee Arthroplasty
Authors: Thienpont Emmanuel , Schwab Pierre-Emmanuel , Fennema Peter 
Published: March 2017

Background:
Patient-specific instrumentation (PSI) was introduced with the aim of making the procedure of total knee arthroplasty more accurate and efficient. The purpose of this study was to compare PSI and standard instrumentation in total knee arthroplasty with regard to radiographic and clinical outcomes as well as operative time and blood loss.

Methods:
A meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. PubMed and Embase were searched from 2011 through 2015. We included randomized controlled trials and cohort studies that reported the effect of PSI on the aforementioned outcomes. The primary end point was deviation from the mechanical axis by >3°. Random and fixed-effect models were used for analysis.

Results:
A total of 44 studies, which included 2,866 knees that underwent surgery with PSI and 2,956 knees that underwent surgery with standard instrumentation, were evaluated. The risk of mechanical axis malalignment was significantly lower for PSI, with a pooled relative risk of 0.79 (p = 0.013). The risk of tibial sagittal-plane malalignment was higher for PSI than for standard instrumentation (relative risk = 1.32, p = 0.001), whereas the risk of femoral coronal-plane malalignment was significantly lower (relative risk = 0.74, p = 0.043). The risk of tibial coronal-plane malalignment was significantly higher for PSI only when employing fixed-effect meta-analysis (relative risk = 1.33, p = 0.042). Minor reductions in total operative time (−4.4 minutes, p = 0.002) and blood loss (−37.9 mL, p = 0.015) were noted for PSI.

Conclusions:
PSI improves the accuracy of femoral component alignment and global mechanical alignment, but at the cost of an increased risk of outliers for the tibial component alignment. The impact of the increased probability of tibial component malalignment on implant longevity remains to be determined. Meta-analyses indicated significant differences with regard to operative time and blood loss in favor of PSI. However, these differences were minimal and, by themselves, not a substantial justification for routine use of the technology.

Level of Evidence:
Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Efficacy of Surgical-Site, Multimodal Drug Injection Following Operative Management of Femoral Fractures
Authors: Koehler Daniel , Marsh J. Lawrence , Karam Matthew , Fruehling Catherine , Willey Michael 
Published: March 2017

Background:
Multimodal analgesia inclusive of periarticular injection with a local anesthetic agent has been rapidly assimilated, with demonstrated safety and efficacy, into the care of patients undergoing elective lower-extremity arthroplasty. The present study was performed to evaluate the efficacy and safety of a surgical-site, multimodal drug injection for postoperative pain control following operative management of femoral fractures.

Methods:
There were 102 patients undergoing operative intervention (plate fixation, intramedullary device, or arthroplasty) for a broad range of femoral fracture patterns who were prospectively randomized either to receive an intraoperative, surgical-site injection into the superficial and deep tissues containing ropivacaine, epinephrine, and morphine or to receive no injection. Visual analog scale (VAS) scores were recorded at regular intervals as the primary outcome measure. Narcotic consumption and medication-related side effects were also monitored.

Results:
The injection group demonstrated significantly lower VAS scores (p < 0.05) than the control cohort in the recovery room and at the 4, 8, and 12-hour postoperative time points. The median score (and interquartile range) was 1.6 (0 to 4.0) for the injection group and 3.2 (1.3 to 5.7) for the control group immediately postoperatively, 1.0 (0 to 3.0) for the injection group and 5.0 (2.0 to 7.0) for the control group at 4 hours, 2.0 (0 to 4.0) for the injection group and 5.0 (2.0 to 6.8) for the control group at 8 hours, and 3.5 (0 to 5.0) for the injection group and 5.0 (2.0 to 8.0) for the control group at 12 hours. Additionally, narcotic consumption was significantly lower (p = 0.007) in the injection group (5.0 mg [1.3 to 8.0 mg]) compared with the control group (9.7 mg [3.9 to 15.6 mg]) over the first 8 hours following the surgical procedure. No cardiac or central nervous system toxicity was observed secondary to infiltration of the local anesthetic.

Conclusions:
Surgical-site injection with a multimodal analgesic cocktail provides improved pain control and reduces narcotic utilization over the first postoperative day, with no observed adverse effects attributable to the local injection, across a diverse orthopaedic trauma population undergoing operative intervention for femoral fractures.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Absolute Configuration Determination by Quantum Mechanical Calculation of Chiroptical Spectra: Basics and Applications to Fungal Metabolites
Authors: Superchi Stefano , Scafato Patrizia , Gorecki Marcin , Pescitelli Gennaro 
Published: March 2017

Background:
Quantum mechanical simulations of chiroptical properties, such as
electronic circular dichroism (ECD), optical rotation (OR), and vibrational circular dichroism
(VCD), have rapidly become very popular to assign the absolute configuration of novel natural
products.

Objective:
We review the application of the ECD/OR/VCD computational methodology to
chiral metabolites of fungal origin. First, we summarize the fundamentals of the three spectroscopies;
then, we focus on the specific experimental and computational issues allied to the
application of their calculations.

Methods:
We surveyed the entire literature describing the use of ECD/OR/VCD computations
for fungal metabolites, and catalogued all papers according to the method employed and to
the structural family of compounds. Then, we chose several examples to illustrate the use of
the techniques and highlight the practical application of the computational approach.

Results:
Our literature survey demonstrates that the simulation of ECD/OR/VCD spectra is
nowadays widespread and accessible also to non-experts, although a good computational
practice is necessary to avoid wrong assignments. ECD is still the most common technique
used in the context of fungal metabolites. OR and VCD may be profitably employed when the
compound of interest lacks chromophoric groups. Our examples illustrate that the combination
of two or more chiroptical methods is strongly advisable in some cases, especially in the
presence of high conformational flexibility, where a single technique does not lead to a safe
conclusion.

Conclusion:
The ECD/OR/VCD computational approach is a reliable and versatile method to
assign the absolute configuration of fungal metabolites and related natural products.
PROCESSING OF HIGH-RESOLUTION, SHALLOW SEISMIC PROFILES, GUANABARA BAY – RIO DE JANEIRO STATE, BRAZIL
Authors: Marino Igor Kestemberg , Santos Marco Antonio Cetale , Silva Cleverson Guizan 
Published: March 2017

ABSTRACT. This paper presents a proposal for implementing a processing flowchart for high-resolution single-channel seismic data acquired in Guanabara Bay, followed by its interpretation. Geologically, it consists of mapping the Guanabara Bay Quaternary deposits relative to the drowning of a fluvial paleochannel that resulted from recent sea level changes. So far, high-resolution seismic data have been interpreted without any signal improvement, while the development of a processing flowchart for this is hardly addressed in the literature. The parameters were selected based on the processing applied to conventional seismic prospecting for oil and gas in order to compose a less extensive and more applicable flowchart. The results confirmed the efficacy of the processing applied to shallow seismic data, with noise and multiples attenuation and better lateral continuity of reflectors in subsurface, thus increasing the quality of the final seismic record.Keywords: Processing, shallow seismic, Guanabara Bay, high-resolution seismic. RESUMO. O presente trabalho apresenta uma proposta de aplicação de um fluxo de processamento para dados de sísmica monocanal de alta resolução adquiridos na Baía de Guanabara e, posteriormente, sua interpretação. O objetivo geológico consiste no mapeamento dos depósitos Quaternários da Baía de Guanabara relativos ao afogamento de um paleocanal fluvial como consequência das variações recentes do nível do mar. Até o momento os dados de sísmica de alta resolução vêm sendo interpretados sem a aplicação de nenhuma melhoria e a elaboração de um fluxo de processamento para tal é raramente abordada na literatura. Os parâmetros foram selecionados para a elaboração do fluxo com base no processamento aplicado à sísmica convencional na prospecção de hidrocarbonetos de forma a compor um fluxo mais sucinto e aplicável. Os resultados obtidos nos perfis analisados comprovaram a eficácia do processamento de dados de sísmica rasa, com a atenuação de ruídos, das múltiplas de fundo e maior continuidade lateral dos refletores em subsuperfície, aumentando assim a qualidade do registro sísmico.Palavras-chave: Processamento, sísmica rasa, baía da Guanabara, alta resolução sísmica.
UNION SEA LAND PROPERTY AND THE RELATIVE 1831 SEA LEVEL AT BARRA DO UNA BEACH
Authors: Mesquita Afrânio Rubens de , França Carlos Augusto De Sampaio , Blitzkow Denizard , Corrêa Marco Antonio , Trabanco Jorge Luiz Alves , Monteiro Mauro Quandt 
Published: March 2017

ABSTRACT. Measurements of relative sea level have been performed at Barra do Una (BU) located on the Southern Brazilian coast near the Island of São Sebastião, in São Paulo State, Brazil, relative to the sea level in 1831, as established by law n. 9760, 1946. The estimate took into account three plausible hypotheses about the change in global relative sea level from 1831 to the present and allowed to establish the “Terrenos de Marinha” on BU. The motivation behind this work, the hypothesesand the methods used are described, along a brief history of the “Terrenos de Marinha”. The discussion of the results reveals the need to reactivate the national network of sea level gauges, bearing in mind the clear evidence of relative sea level increase nowadays, on the Brazilian coast and the consequentneed of deﬁning legal standards for its use according to the law.Keywords: sea land property, Barra do Una, Southern Brazilian coast, relative sea level, global warming. RESUMO. Foi feita a medição do nível relativo do mar (Barra do Una, BU) situada na região Sudeste do Brasil, próximo à Ilha de São Sebastião no Estado de São Paulo, referido ao nível médio relativo do mar do ano de 1831, conforme estabelece a lei n. 9.760 de 1946. A estimativa se fez através de hipóteses plausíveis sobre a variação do nível global do mar desde 1831 até o presente e permitiu estabelecer a materialização do “Terreno de Marinha” em BU, ao longo dos termos da lei. A motivação deste trabalho, as hipóteses e os métodos utilizados são descritos juntamente com um breve histórico sobre os “Terrenos de Marinha”. A discussão dos resultados revela a necessidade de ser reativada a rede nacional de medidores de Nível do Mar, tendo em vista as claras evidências de aumento, nos dias atuais, do nível relativo do mar nas Costas Brasileiras e a consequente necessidade de deﬁnição de normas legais adequadas para a sua utilização.Palavras-chave: terrenos de marinha, Barra do Una, costa brasileira sudeste, nível relativo do mar, aquecimento global.
LONG-TERM VARIABILITY OF TIDAL AND MEAN SEA LEVEL COMPONENTS ON THE BRAZILIAN COAST
Authors: Harari Joseph , França Carlos Augusto De Sampaio , De Camargo Ricardo 
Published: March 2017

ABSTRACT. Recovery and analysis of sea level data from the ports of Belém, Recife, Santos and Cananeia, Brazil, in a decadal time scale, allow determining the seasonal, annual and decadal variability of mean sea level and tidal components, such as M2 and S 2, which are associated to a probably local phenomena not yet clearly understood and established. On the other hand, trending values of (relative) mean sea level of these ports agree with the variability observed up to now in several ports around the world; the mean sea level trend in Cananeia, about 40 cm/century, may be occurring along the entire Brazilian Coast. Keywords: Brazilian coast, relative mean sea level, tidal components, decadal trends, Belém, Recife, Santos, Cananeia. RESUMO. A recuperação e análise de dados de niveldo mar dos portos de Belém, Recife, Santos e Cananeia, Brasil, em escala de tempo decadal, permitem determinar variabilidades sazonais, anuais e decadais do nível médio do mar e das componentes de maré, como M 2 e S 2, as quais são associadas a fenômenos, provavelmente locais, ainda não claramente entendidos e estabelecidos. Por outro lado, os valores das tendências de variações do nível médio (relativo) do mar de longo termo desses portos estão em consonância com as variabilidades até agora registradas em vários portos em todo o mundo; a tendência do nível médio do mar no porto de Cananeia, com cerca de 40 cm/século, pode estar ocorrendo em toda costa brasileira. Palavras-chave: costa brasileira, nível médio relativo do mar, componentes de maré, tendências decadais, Belém, Recife, Santos, Cananeia.
SALINITY INTRUSION IN THE GUAPIMIRIM ESTUARY, RIO DE JANEIRO STATE, BRAZIL
Authors: Melo Gustavo Vaz de , Neto José Antonio Baptista , Vinzón Susana Beatriz , Oliveira Allan Sandez de , Vicente Michel Arthur Faria , Malm Olaf , Silva Cleverson Guizan 
Published: March 2017

ABSTRACT. This work was conducted in the Guapimirim estuary, the main tributary of the Guanabara Bay. This system is located in a preserved area in the catchmentbasin of the bay, inside the Guapimirim Environmental Protection Area. The estuary presents a meandering channel with 3 meters mean depth. The aim of thiswork is to evaluate the salinity intrusion dynamics in response to the tide and freshwater discharge, as well as its effects on the water column structure and residencetime. Surveys were performed to assess the salinity structure along the estuary main channel under different freshwater discharges (dry and rainy period) and tide (neapand spring). The results showed significant differences in the water column structure, presenting high stratification in neap tide and conditions homogeneous in springtide. The salinity front (SF) showed a bigger displacement in the spring tide. Under highly stratified conditions, in neap tide, its displacement was bigger with smallertidal amplitude. The location of SF inside of the estuary, in the high water, was influenced manly by freshwater discharge. The residence time in the Guapimirim estuarywas longer in neap tide and dry period, presenting a good relationship with freshwater discharge.Keywords: Guapimirim estuary, salinity intrusion, residence time. RESUMO. Este trabalho foi desenvolvido no estuário de Guapimirim, principal tributário da Baía de Guanabara. Este sistema se localiza em uma área ainda preservadana bacia de drenagemda baía, dentro da Área de Proteção Ambiental de Guapimirim. O estuário apresenta um canal meandrante com uma profundidade média de 3 metros. O objetivo deste trabalho consiste em avaliar a dinâmica da intrusão salina em resposta a atuação dos processos físicos como a vazão fluvial e a maré, assimcomo, sua consequência na estrutura da coluna d’água e tempo de residência. Foram realizados levantamentos sobre a estrutura salina ao longo do canal principal doestuário em diferentes condições de vazão fluvial (período seco e chuvoso) e maré (quadratura e sizígia). Os resultados mostraram diferenças marcantes na estrutura dacoluna d’´agua sendo estratificado em maré de quadratura e mais homogêneo em maré de sizígia. A frente salina apresentou um maior deslocamento em maré de sizígia.Em condições de alta estratificação, em maré de quadratura, o maior deslocamento da frente salina esteve associado a uma menor amplitude da maré. A vazão fluvial foio principal processo físico que atuou no alcance máximo da frente salina. O tempo de residência de uma parcela de água dentro do estuário de Guapimirim foi maiorem condição de maré de quadratura e em período seco, apresentando boa relação com a vazão fluvial.Palavras-chave: estuário de Guapimirim, intrusão salina, tempo de residência.