bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Evaluation of the Three Commercially Available Transdermal Nitroglycerin Delivery Systems
Authors: Cronin Carol M. , Mitrano Erasmo A. , Wilder Rowena S. , Harmon Elizabeth P. , Zusman Randall M. 
Published: February 2017

We comparatively evaluated the patient preference for each of the three commercially available transdermal nitroglycerin delivery systems using a randomized crossover study design. Preference was determined by ease of application, adhesion, occurrence of local irritation at the site of application, and systemic toxicities. In addition, we recorded the number of nitroglycerin tablets taken and angina attacks reported per treatment course. Each treatment course was one month long, with each patient participating for a total of three months. This allowed all patients to be exposed to each of the three products for one treatment course, thereby serving as their own controls. Thirty-eight patients completed the three-phase crossover and expressed a preference. Results showed that Transderm-Nitro was significantly preferred over both Nitro-Dur and Nitrodisc (p < 0.005). Most of the preferences were based on cosmetic appearances or adhesive qualities. Additionally, results showed that there was no difference in efficacy among the three products when number of angina attacks reported and number of nitroglycerin tablets taken were compared.
Surgical Antibiotic Prophylaxis, Patient Morbidity, and Cost Reduction: A Three-Year Study
Authors: Scalley Robert D. , Irwin Alan D. , Poduska Paul J. , Wolff Albert J. , Cochran Robert S. 
Published: February 2017

Twenty-five to 50 percent of all antibiotics prescribed for hospitalized patients are for prevention, not treatment, of infection. Procedures to institute rational, cost-effective utilization of these agents should have a significant impact on drug cost and pharmacy inventory. Several authors have described antibiotic cost reduction programs using pharmacy intervention. Unfortunately, measures that are successful in one institution may not be effective or appropriate in another. A three-year study was undertaken to examine the impact on physician prescribing of an infection control bulletin and formalized recommendations for antibiotic utilization. Patient records also were examined to determine if any change in antibiotic utilization would influence patient morbidity. Over the three examination periods there was a significant reduction in cost of prophylaxis in 7 surgical groups, and a trend toward cost reduction in 21 additional groups. Cost of prophylaxis also increased in other surgical groups. Cost reduction was associated with limited duration of prophylaxis and a shift toward use of first generation cephalosporin products. Patient morbidity did not differ significantly.
Operative Repair of the Fixed Hammertoe Deformity
Authors: Coughlin Michael J. , Dorris John , Polk Eben 
Published: February 2017

Sixty-three patients (118 toes) were evaluated at an average 61 month follow-up following PIP resection arthroplasty for a fixed hammertoe deformity. The deformity involved the second toe in 35%, the third toe in 21%, the fourth toe in 24%, and the fifth toe in 20%. The involved toe averaged 2 mm. greater length than the adjacent toes and was longer in 49/94 (52%). Seventy-eight percent of patients complained of pain preoperatively due to the hammertoe deformity and 49% complained of callus formation. Following a resection arthroplasty technique with intramedullary Kirschner wire fixation, fusion of the PIP joint occurred in 81% of toes. A fibrous union resulted in the remaining 19% of cases. Patients rated subjective alignment as acceptable in 86% of cases and radiographic alignment was rated as good in 79%. Malalignment and numbness were the major factors associated with an unsuccessful result. Pain was relieved in 92%of patients and subjective satisfaction was noted by 84% of patients. Minor complications occurred in 5%. The average postoperative AOFAS score was 83 points. Resection arthroplasty of the proximal interphalangeal joint with intramedullary Kirschner wire fixation as a technique for correction of a fixed hammertoe deformity is a reliable technique that consistently gives a high level of satisfactory results.
Internal Architecture of the Calcaneus: Implications for Calcaneus Fractures
Authors: Sabry Fady F. , Ebraheim Nabil A. , Mehalik John N. , Rezcallah Anthony T. 
Published: February 2017

Study Design Fourteen cadaveri specimens were sectioned to analyze the internal architecture of the human calcaneus. We described the arrangement and orientation of trabecular patterns within the calcaneus and made multiple measurements of its cortical thickness. Objective To characterize the internal architecture of the calcaneus and correlate these findings with well-described patterns of calcaneus fracture in order to better understand the fracture mechanics of this common fracture. Methods Fourteen dry, frozen, human calcanei were sectioned using a saw. In each the coronal, sagittal and axial planes, we sectioned separate specimens into slices of 0.5mm thickness. High-resolution radiographic images were taken of the sectioned specimens. The internal trabecular arrays were described and measurements of cortical thickness were recorded. The correlation between these findings and the known pattern of calcaneal fractures was analyzed. RESULTS A dominant trabecular pattern running anteroposteriorly along the long axis of the calcaneus was observed. In the posterior tuberosity the trabeculae were arranged parallel to the posterior border. There was an area of sparse or absent mineralization in the anterior part of the calcaneus corresponding to the “neutral triangle” described by Wood and Harty 10, 23. The thickest sites of the calcaneal cortex were the lower pole of the posterior tuberosity, the upper surface at the angle of Gissane, and the lateral surface below the anterior portion of the posterior facet. Conclusion The trabecular architecture of the calcaneus is created by applied stress in concordance with Wolff's law. The weakest plane of resistance to stress is parallel to these organized trabeculae or through areas lacking trabeculae. This study demonstrates that the primary and secondary fracture lines commonly encountered in calcaneus fractures correlates with the internal architectural map of the calcaneal trabecular patterns.
The Medial Crosssover Toe: a Cadaveric Dissection
Authors: Deland Jonathan Thorndike , Sung Hoon 
Published: February 2017

The development of a medial crossover second toe (second toe crossing over the first toe) is not a rare clinical condition. It often occurs in the setting of hallux valgus, although not exclusively so. The resulting displacement of the second toe can cause pain in shoes, with surgical correction being problematic. The pathologic anatomy of this condition has not been fully described. In an effort to better understand it, dissection of a cadaveric specimen with a full crossover toe is presented. The dissection revealed findings not previously documented. They include medial displacement of the flexor tendons and plantar plate along with deformity of the plate itself. These changes are in addition to contracture of the medial collateral ligaments and the previously described rupture of the lateral collateral ligaments. Both the plantar plate and the collateral ligaments, the two major static soft tissue stabilizers of the lesser MP joint, were found to be significantly involved. Pull on the flexor tendons only accentuated the malalignment of the toe. Clinical Significance: The extensive soft tissue changes explain the difficulty in achieving a successful long term correction of a full medial crossover toe with a soft tissue procedure. With attenuation of the plantar plate and medial displacement of the flexor tendons, there is an imbalance of muscle forces across the MP joint. This muscle imbalance would not be corrected by release of the medial collateral ligament, dorsal capsular release or extensor tendon lengthening. Reconstruction of the collateral ligament is at risk for incomplete correction since it is unlikely to resolve deformity in the plate if already present.
Current Practice Patterns in the Treatment of Charcot Foot
Authors: Pinzur Michael S. , Shields Naomi , Trepman Elly , Dawson Patrick , Evans Andrew 
Published: February 2017

Treatment of Charcot foot osteoarthropathy has emerged as a major component of the American Orthopaedic Foot and Ankle Society (AOFAS) Diabetes 2000 Initiative. A two-part survey described treatment patterns and current footwear use of patients with Charcot osteoarthropathy of the foot and ankle. In the first part, 94 consecutive patients with a history of Charcot foot and ankle presenting for care were questioned on their foot-specific treatment and current footwear use. A history of diabetic foot ulcer was given by 39 (41%) patients, and an infection had been present in a foot of 20 (21%) patients. The initial treatment of the Charcot foot and ankle had been a total contact cast in 46 (49%) patients, and a pre-fabricated walking boot in 19 (20%). Charcot related surgery had consisted of 76 procedures in 46 (49%) patients. Sixty-three (67%) patients were currently using accommodative footwear (depth-inlay shoes in 46 [49%], custom shoes in 10 [11%], and CROW in 7 [7%] patients), and 72 (77%) were currently using custom accommodative foot orthoses. The second part of this study consisted of a questionnaire completed by 37 orthopaedic surgeons (members of AOFAS) interested in forming a Charcot Study Group. They treated an average of 11.8 patients having Charcot foot or ankle per month. Thirty (81%) used the Semmes-Weinstein 5.07 monofilament as a screening tool for peripheral neuropathy. For treatment of Eichenholtz Stage I, 29 (78%) used a total contact cast and 15 (41%) allowed weightbearing; for Stage II, 30 (81%) physicians used a total contact cast and 18 (49%) allowed weightbearing. Although the literature contains uniform recommendations for immobilization and non-weightbearing as treatment for the initial phases of Charcot arthropathy, the results of this benchmarking study reveal that current treatment is varied.
Collagenous Fibril Texture of the Gliding Zone of the Human Tibialis Posterior Tendon
Authors: Petersen Wolf , Hohmann Gerrit 
Published: February 2017

Light microscopy and scanning electron microscopy was used to describe the collagenous fibril texture of the wrap around region of the human tibialis posterior tendon in human cadavers. In the region where the tendon wraps around the medial malleolus, the anterior part of the tendon directed towards the pulley had the structure of fibrocartilage. This zone started approximately 25-30 millimeters from the navicular insertion. Scanning electron microscopy of the collagen fibril texture revealed three different layers in the fibrocartilaginous zone. The anterior surface was covered by a meshwork of thin unbanded fibrils with a diameter of app. 30nm. Beneath the superficial network there was an app. 150μm thick layer of banded collagen fibrils, These fibrils formed lamella-like bundles which intersected at various angles. The main portion of the collagen fibrils lie below this layer and run in a longitudinal direction. The longitudinal fibrils were divided into bundles by loose connective tissue. The location of the fibrocartilage corresponds to the region where the tibialis posterior tendon wraps around the medial malleolus which serves as a pulley. Clinical significance: Our study documented the existence of a fibrocartilaginous zone with a specific collagen fibril texture that corresponds to a possible site of rupture, as reported by several authors. Due to special collagen fibril texture the fibrocartilage may be more vulnerable to repetitive tensile micro-trauma.
Outcomes Following Cheilectomy and Interpositional Arthroplasty in Hallux Rigidus
Authors: Lau John T.C. , Daniels Tim R. 
Published: February 2017

Surgical management of hallux rigidus remains controversial. Arthrodesis is considered the gold standard. However, many patients are reluctant to undergo fusion. This paper reviews two commonly used procedures that are reasonable alternatives. A retrospective review of 19 patients (24 feet) with grade 2 osteoarthritis and 11 patients (11 feet) with grade 3 osteoarthritis was performed. The patients with grade 2 osteoarthritis were managed with a cheilectomy and the patients with grade 3 osteoarthritis with an interpositional arthroplasty. All patients were individually assessed with a subjective questionnaire, physical exam, AOFAS hallux scale, SF-36 and pedobarographic analysis. Cheilectomy patients (51.9 years) were younger than interpositional arthroplasty (59 years). Follow up between the interpositional arthroplasties (2.0 years) and cheilectomies (2.1 years) were comparable. Postoperative motion, visual analogue pain scale and SF-36 scores were comparable between groups. Cheilectomies had a higher mean AOFAS score (77.3) than interpositional arthroplasties (71.6). Weakness of the great toe was reported in 72.7% of interpositional arthroplasty patients compared to only 16.7% of patients with a cheilectomy. Patient satisfaction was 87.5% in cheilectomies and 72.7% in interpositional arthroplasties. Pedobarographic analysis demonstrated a decreased load under the great toe with increased weight transfer to the lesser metatarsal heads in all patients. The weight transfer to the lesser metatarsal heads was greatest in patients with interpositional arthroplasty. Management of moderate hallux rigidus with a cheilectomy and phalangeal osteotomy is a reliable method of relieving pain and improving function. Management of severe osteoarthritis of the joint with an interpositional arthroplasty should be considered a salvage procedure with less reliable results.
Postponement of puberty in queens treated with deslorelin
Authors: Cecchetto Marta , Salata Paola , Baldan Anna , Milani Chiara , Mollo Antonio , Fontaine Christelle , Sontas Hasan , Gelli Donatella , De Benedictis Giulia , Stelletta Calogero , Romagnoli Stefano 
Published: February 2017

Objectives The purpose of this study was to assess efficacy of deslorelin, a gonadotropin-releasing hormone (GnRH) agonist marketed in Europe for the control of male dog reproduction, for the postponement of puberty in queens. Methods Nine prepubertal queens aged 3–9 months were selected for this study; their general and reproductive health was checked through clinical, haematological, vaginal cytology and hormonal tests. Following treatment with a 4.7 mg deslorelin implant, each cat received a monthly clinical examination and blood was collected for hormonal assay every third month. Cats were monitored for 14.1 ± 5.2 (range 7–23) months. Results All cats were in good body condition and normal health prior to treatment. Their health status remained unchanged throughout the study and no significant variation was observed with regard to serum progesterone or oestradiol. Seven days post-treatment, 1/9 queens showed signs of heat, and one other queen showed complete vaginal keratinisation. No other signs of heat were subsequently observed in any other queen. Five queens were lost during the study after 7, 7, 16, 17 and 18 months of observation (during which time they did not show signs of heat). By the end of the study, no sign of puberty was observed in the four remaining queens at 21–36 months of age. Conclusions and relevance A 4.7 mg deslorelin implant was able to suppress the feline pituitary–gonadal axis, leading to postponement of puberty for up to 21–36 months in the four queens that completed the study. Deslorelin can be considered as a safe method to postpone puberty in queens.
Blood–brain barrier-on-a-chip: Microphysiological systems that capture the complexity of the blood–central nervous system interface
Authors: Phan Duc TT , Bender R Hugh F , Andrejecsk Jillian W , Sobrino Agua , Hachey Stephanie J , George Steven C , Hughes Christopher CW 
Published: February 2017

The blood–brain barrier is a dynamic and highly organized structure that strictly regulates the molecules allowed to cross the brain vasculature into the central nervous system. The blood–brain barrier pathology has been associated with a number of central nervous system diseases, including vascular malformations, stroke/vascular dementia, Alzheimer’s disease, multiple sclerosis, and various neurological tumors including glioblastoma multiforme. There is a compelling need for representative models of this critical interface. Current research relies heavily on animal models (mostly mice) or on two-dimensional (2D) in vitro models, neither of which fully capture the complexities of the human blood–brain barrier. Physiological differences between humans and mice make translation to the clinic problematic, while monolayer cultures cannot capture the inherently three-dimensional (3D) nature of the blood–brain barrier, which includes close association of the abluminal side of the endothelium with astrocyte foot-processes and pericytes. Here we discuss the central nervous system diseases associated with blood–brain barrier pathology, recent advances in the development of novel 3D blood–brain barrier -on-a-chip systems that better mimic the physiological complexity and structure of human blood–brain barrier, and provide an outlook on how these blood–brain barrier-on-a-chip systems can be used for central nervous system disease modeling. Impact statement The field of microphysiological systems is rapidly evolving as new technologies are introduced and our understanding of organ physiology develops. In this review, we focus on Blood–Brain Barrier (BBB) models, with a particular emphasis on how they relate to neurological disorders such as Alzheimer’s disease, multiple sclerosis, stroke, cancer, and vascular malformations. We emphasize the importance of capturing the three-dimensional nature of the brain and the unique architecture of the BBB – something that until recently had not been well modeled by in vitro systems. Our hope is that this review will provide a launch pad for new ideas and methodologies that can provide us with truly physiological BBB models capable of yielding new insights into the function of this critical interface.
Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services
Authors: Solis Guillermina R. , Champion Jane Dimmitt 
Published: February 2017

Introduction: Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person’s quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. Method: A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. Results: A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Conclusion: Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.
Outcomes of grafting intrasynovial tendons of the toes to the hands in 10 patients: a preliminary report
Authors: Ohi H. , Uchiyama S. , Kanda T. , Mukoda M. , Hayashi M. , Kato H. 
Published: February 2017

Ten patients had intrasynovial tendon grafting harvested from the toes for secondary flexor tendon reconstruction in nine fingers and one thumb in our institutes from 2009 to 2014. These patients were followed for a mean of 15 (range: 8–36) months. The ranges of total active motion of the proximal and distal interphalangeal joints of these nine fingers were 143° (range: 108–175°) and of the metacarpophalangeal and interphalangeal joints of one thumb were 110°. In conclusion, this technique is feasible and gives a good result when successful but with a high complication rate. Level of Evidence IV
Conscious performance and arthroscopic findings in athletes with anterior cruciate ligament injuries treated via conservative therapy during the competitive season
Authors: Takata Yasushi , Nakase Junsuke , Toratani Tatsuhiro , Numata Hitoaki , Oshima Takeshi , Kitaoka Katsuhiko , Tsuchiya Hiroyuki 
Published: February 2017

Purpose: Athletes often receive conservative treatment for injured anterior cruciate ligaments (ACLs) so that they can continue to play to the end of their season. The purpose of this study was to examine the conscious performance and arthroscopic findings of athletes who received conservative therapy for ACL injuries. Methods: Forty-two patients with ACL injuries underwent conservative treatment. After the season ended, ACL reconstruction was performed. We examined the following parameters: (1) time required for return to competition after injury, (2) conscious performance after return to competition, (3) whether the injured knee gave way during conservative therapy or after return to competition, and (4) cause of performance deterioration if applicable. To determine conscious performance, patients were asked to rate their performance after therapy relative to their performance before injury. Results: Thirty-eight of the 42 patients (90.5%) returned to competition after conservative treatment. The mean time to return was 13.8 ± 7.6 weeks, and the mean conscious performance score was 58.4 ± 16.5%. Thirty-eight patients (90.5%) experienced their knee giving way, of whom 36 (94.9%) stated that fear of their knee giving way hampered their performance. At the time of ACL reconstruction, 9 patients had chondral injuries and 22 patients had meniscus injuries. Conclusion: Most athletes with damaged ACLs returned to the field within the same season after conservative treatment. However, conscious performance was only about 60%. It is possible that knees giving way caused secondary meniscus and joint cartilage damage. Therefore, conservative treatment of individuals with ACL injuries should be considered carefully.