bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modification of the Resch procedure
Authors: Roberts V. I. , Komarasamy B. , Pandey R. 
Published: September 2012

Controversy surrounds the management of displaced three- and four-part fractures of the proximal humerus. The percutaneous Resch technique of stabilisation involves minimal soft-tissue dissection and a reduced risk of stiffness and avascular necrosis. However, it requires a second operation to remove Kirschner wires and the humeral block. We describe a modification of this technique that dispenses with the need for this second operation and relies on a sequential pattern of screw placement. We report the outcome of 32 three- or four-part fractures of the proximal humerus treated in this way at a mean follow-up of 3.8 years (2 to 8)). There were 14 men and 18 women with a mean age of 56 years (28 to 83). At final follow-up the mean Oxford shoulder scores were 38 (31 to 44) and 39 (31 to 42), and the mean Constant scores were 79 (65 to 92) and 72 (70 to 80) for three- and four-part fractures, respectively. We further analysed the results in patients aged < 60 years with high-energy fractures and those aged ≥ 60 years with osteoporotic fractures. There were no cases of nonunion or avascular necrosis.The results were good and comparable to those previously reported for the Resch technique and other means of fixation for proximal humeral fractures. We would recommend this modification of the technique for the treatment of displaced three-part and four-part fractures in patients both younger and older than 60 years of age.
Somatosensory evoked potential monitoring of peripheral nerves during external fixation for limb lengthening and correction of deformity in children
Authors: Makarov M. R. , Samchukov M. L. , Birch J. G. , Cherkashin A. M. , Sparagana S. P. , Delgado M. R. 
Published: September 2012

We undertook a retrospective analysis of 306 procedures on 233 patients, with a mean age of 12 years (1 to 21), in order to evaluate the use of somatosensory evoked potential (SSEP) monitoring for the early detection of nerve compromise during external fixation procedures for limb lengthening and correction of deformity. Significant SSEP changes were identified during 58 procedures (19%). In 32 instances (10.5%) the changes were transient, and resolved once the surgical cause had been removed. The remaining 26 (8.5%) were analysed in two groups, depending on whether or not corrective action had been performed in response to critical changes in the SSEP recordings. In 16 cases in which no corrective action was taken, 13 (81.2%, 4.2% overall) developed a post-operative neurological deficit, six of which were permanent and seven temporary, persisting for five to 18 months. In the ten procedures in which corrective action was taken, four patients (40%, 1.3% overall) had a temporary (one to eight months) post-operative neuropathy and six had no deficit.After appropriate intervention in response to SSEP changes, the incidence and severity of neurological deficits were significantly reduced, with no cases of permanent neuropathy. SSEP monitoring showed 100% sensitivity and 91% specificity for the detection of nerve injury during external fixation. It is an excellent diagnostic technique for identifying nerve lesions when they are still highly reversible.
The pathogenesis of degeneration of the intervertebral disc and emerging therapies in the management of back pain
Authors: Hughes S. P. F. , Freemont A. J. , Hukins D. W. L. , McGregor A. H. , Roberts S. 
Published: September 2012

This article reviews the current knowledge of the intervertebral disc (IVD) and its association with low back pain (LBP). The normal IVD is a largely avascular and aneural structure with a high water content, its nutrients mainly diffusing through the end plates. IVD degeneration occurs when its cells die or become dysfunctional, notably in an acidic environment. In the process of degeneration, the IVD becomes dehydrated and vascularised, and there is an ingrowth of nerves. Although not universally the case, the altered physiology of the IVD is believed to precede or be associated with many clinical symptoms or conditions including low back and/or lower limb pain, paraesthesia, spinal stenosis and disc herniation.New treatment options have been developed in recent years. These include biological therapies and novel surgical techniques (such as total disc replacement), although many of these are still in their experimental phase. Central to developing further methods of treatment is the need for effective ways in which to assess patients and measure their outcomes. However, significant difficulties remain and it is therefore an appropriate time to be further investigating the scientific basis of and treatment of LBP.
Management of peri-prosthetic fracture of the humerus with severe bone loss and loosening of the humeral component after total shoulder replacement
Authors: Sewell M. D. , Kang S. N. , Al-Hadithy N. , Higgs D. S. , Bayley I. , Falworth M. , Lambert S. M. 
Published: September 2012

There is little information about the management of peri-prosthetic fracture of the humerus after total shoulder replacement (TSR). This is a retrospective review of 22 patients who underwent a revision of their original shoulder replacement for peri-prosthetic fracture of the humerus with bone loss and/or loose components. There were 20 women and two men with a mean age of 75 years (61 to 90) and a mean follow-up 42 months (12 to 91): 16 of these had undergone a previous revision TSR. Of the 22 patients, 12 were treated with a long-stemmed humeral component that bypassed the fracture. All their fractures united after a mean of 27 weeks (13 to 94). Eight patients underwent resection of the proximal humerus with endoprosthetic replacement to the level of the fracture. Two patients were managed with a clam-shell prosthesis that retained the original components. The mean Oxford shoulder score (OSS) of the original TSRs before peri-prosthetic fracture was 33 (14 to 48). The mean OSS after revision for fracture was 25 (9 to 31). Kaplan-Meier survival using re-intervention for any reason as the endpoint was 91% (95% confidence interval (CI) 68 to 98) and 60% (95% CI 30 to 80) at one and five years, respectively. There were two revisions for dislocation of the humeral head, one open reduction for modular humeral component dissociation, one internal fixation for nonunion, one trimming of a prominent screw and one re-cementation for aseptic loosening complicated by infection, ultimately requiring excision arthroplasty. Two patients sustained nerve palsies. Revision TSR after a peri-prosthetic humeral fracture associated with bone loss and/or loose components is a salvage procedure that can provide a stable platform for elbow and hand function. Good rates of union can be achieved using a stem that bypasses the fracture. There is a high rate of complications and function is not as good as with the original replacement.
Hybrid versus total pedicle screw instrumentation in patients undergoing surgery for neuromuscular scoliosis
Authors: Mattila M. , Jalanko T. , Puisto V. , Pajulo O. , Helenius I. J. 
Published: September 2012

We compared the clinical, radiological and quality-of-life outcomes between hybrid and total pedicle screw instrumentation in patients undergoing surgery for neuromuscular scoliosis. A matched comparison using prospectively collected data was undertaken. A total of 66 patients underwent posterior or anteroposterior correction and fusion with hybrid (n = 33, mean age at surgery 15.8 years (9.10 to 19.6)) or total pedicle screw instrumentation (n = 33, mean age 14.7 years (7.0 to 20.7)) with a minimum follow-up of two years. The major curve pre-operatively was a mean of 87° (sd 29, 25° to 141°) and 81° (sd 18, 47° to 116°) in the hybrid and total pedicle screw groups, respectively (p = 0.29) and at a minimum of two years it was 33° (sd 20; 2° to 87°) and 20° (sd 12; 1° to 55°), respectively (p = 0.0016). The mean correction of the major curve was 59% (41% to 88%) in the hybrid and 75% (43% to 99%) in the total pedicle screw groups at two-year follow-up (p = 0.0011). The mean operating time was 7.45 hours (sd 2.18) and 6.04 hours (sd 1.71) in the hybrid and total pedicle screw groups, respectively (p = 0.001), and the mean intra-operative blood loss was 3760 ml (sd 2790) and 1785 ml (sd 1110), respectively (p = 0.001). Total pedicle screw instrumentation provided shorter operating times, less blood loss and better correction of the major curve compared with hybrid constructs in patients undergoing surgery for neuromuscular scoliosis.
The radiological assessment of total and unicompartmental knee replacements
Authors: Sarmah S. S. , Patel S. , Hossain F. S. , Haddad F. S. 
Published: September 2012

Radiological assessment of total and unicompartmental knee replacement remains an essential part of routine care and follow-up. Appreciation of the various measurements that can be identified radiologically is important. It is likely that routine plain radiographs will continue to be used, although there has been a trend towards using newer technologies such as CT, especially in a failing knee, where it provides more detailed information, albeit with a higher radiation exposure.The purpose of this paper is to outline the radiological parameters used to evaluate knee replacements, describe how these are measured or classified, and review the current literature to determine their efficacy where possible.
Gastric perforation in an adult male following nasogastric intubation
Authors: Daliya P , White TJ , Makhdoomi KR 
Published: September 2012

Introduction Spontaneous gastric perforation is a well known surgical emergency which carries significant mortality and morbidity. Well documented causes in adults include peptic ulcer disease, drugs such as non-steroidal and gastric malignancy. Iatrogenic causes still remain relatively rare. We report an interesting case of an acutely unwell young man who developed gastric perforation secondary to nasogastric intubation. Case Report A 32 year old man initially treated for gastroenteritis underwent laparotomy for acute intra-abdominal bleeding. This was found to be secondary to a ruptured left hepatic artery aneurysm which was subsequently embolised. Patient had multiple laparotomies, a nasogastric tube inserted at the second laparotomy was later found to be the cause of gastric perforation. On further investigation the patient’s multiple aneurysms were histologically confirmed to be secondary to fibromuscular dysplasia (FMD). Conclusion We present here a case of gastric perforation from a nasogastric tube in an adult male and discussed its relevance to the diagnosis of FMD. This case highlights the importance of having a high index of suspicion for this complication when managing patients with severe abdominal sepsis.
An international survey of opinion regarding investigation of possible appendicitis and laparoscopic management of a macroscopically normal appendix
Authors: Jaunoo SS , Hale AL , Masters JPM , Jaunoo SR 
Published: September 2012

INTRODUCTION The use of imaging and laparoscopy in patients with right iliac fossa pain as tools to make or exclude a diagnosis of appendicitis is at the discretion of the clinician. We sought to establish a consensus of opinion on this matter by surveying professional bodies for laparoscopic surgery in France, Italy and the US. METHODS A survey was sent to members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), as well as the French Society for Endoscopic Surgery (SFCE) and the Italian Society for Endoscopic Surgery (SICE). The survey asked about management of both male and female patients presenting with right iliac fossa pain and what operative strategy the respondents would pursue should they find a macroscopically normal appendix at laparoscopy. RESULTS A total of 364 responses were returned from the three groups. The responses from SAGES showed computed tomography to be the preferred modality for investigating patients with right iliac fossa pain, irrespective of sex. Both SFCE and SICE preferred the use of diagnostic laparoscopy, especially in the female patient group. The majority of all respondents stated that they would remove a macroscopically normal appendix at laparoscopy. CONCLUSIONS Laparoscopy remains a potent tool in the management of appendicitis. However, the dilemma of when to remove a macroscopically normal appendix remains. Our study shows that removal of the appendix in this instance would be supported by an international consensus.
Reliability of radiographic measurements of knee motion following knee arthroplasty for use in a virtual knee clinic
Authors: Phillips A , Goubran A , Naim S , Searle D , Mandalia V , Toms A 
Published: September 2012

INTRODUCTION We sought to validate radiographic measurements of range of motion of the knee after arthroplasty as part of a new system of virtual clinics. METHODS The range of motion of 52 knees in 45 patients was obtained by 2 clinicians using standardised techniques and goniometers. Inter-rater reliability and intraclass correlation coefficients (ICCs) were calculated. Radiographs of these patients’ knees in full active flexion and extension were also used to calculate intra and inter-rater reliability compared with clinical measurements using four different methods for plotting angles on the radiographs. RESULTS The ICC for inter-rater reliability using the goniometer was very high. The ICC was 0.91 in extension and 0.85 in flexion while repeatability was 8.49° (-8.03–8.99°) in extension and 5.23° (-4.54–5.74°) in flexion. The best ICC for radiographic measurement in extension was 0.86, indicating ‘near perfect’ agreement, and repeatability was 5.43° (-4.04–6.12°). The best ICC in flexion was 0.95 and repeatability was 5.82° (-3.38–6.55°). The ICC for intrarater reliability was 0.98 for extension and 0.99 for flexion on radiographic measurements. CONCLUSIONS Validating the use of radiographs to reliably measure range of motion following knee arthroplasty has allowed us to set up a ‘virtual knee clinic’. Combining validated questionnaires and radiographic measurement of range of motion, we aim to maintain high quality patient surveillance following knee arthroplasty, reduce our ratio for new to follow-up patients in line with Department of Health guidelines and improve patient satisfaction through reduced travel to hospital outpatients.
Circulating Tumor Cells: Liquid Biopsy of Cancer
Authors: Alix-Panabières Catherine , Pantel Klaus 
Published: September 2012

BACKGROUND
The detection and molecular characterization of circulating tumor cells (CTCs) are one of the most active areas of translational cancer research, with &gt;400 clinical studies having included CTCs as a biomarker. The aims of research on CTCs include (a) estimation of the risk for metastatic relapse or metastatic progression (prognostic information), (b) stratification and real-time monitoring of therapies, (c) identification of therapeutic targets and resistance mechanisms, and (d) understanding metastasis development in cancer patients.

CONTENT
This review focuses on the technologies used for the enrichment and detection of CTCs. We outline and discuss the current technologies that are based on exploiting the physical and biological properties of CTCs. A number of innovative technologies to improve methods for CTC detection have recently been developed, including CTC microchips, filtration devices, quantitative reverse-transcription PCR assays, and automated microscopy systems. Molecular-characterization studies have indicated, however, that CTCs are very heterogeneous, a finding that underscores the need for multiplex approaches to capture all of the relevant CTC subsets. We therefore emphasize the current challenges of increasing the yield and detection of CTCs that have undergone an epithelial–mesenchymal transition. Increasing assay analytical sensitivity may lead, however, to a decrease in analytical specificity (e.g., through the detection of circulating normal epithelial cells).

SUMMARY
A considerable number of promising CTC-detection techniques have been developed in recent years. The analytical specificity and clinical utility of these methods must be demonstrated in large prospective multicenter studies to reach the high level of evidence required for their introduction into clinical practice.
Metal release from hip prostheses: cobalt and chromium toxicity and the role of the clinical laboratory
Authors: Campbell Jonathon R. , Estey Mathew P. 
Published: September 2012

Abstract
Individuals with advanced hip disease suffer from pain, impaired hip function, and decreased quality of life. Roughly one million metal-on-metal (MoM) hip prostheses have been implanted worldwide in order to ameliorate these issues. While most MoM hip replacements are successful, some patients suffer from serious adverse effects secondary to the release of metal debris due to implant wear and corrosion. MoM hip prostheses are comprised predominantly of cobalt and chromium, and the serum concentration of these metal ions has been shown to correlate with both implant wear and the accumulation of metal debris in the periprosthetic tissue. Consequently, measurement of cobalt and chromium concentrations may be useful in the assessment of implant function and the potential for adverse effects in the follow-up of patients with MoM hip prostheses. The purpose of this Mini Review is to describe the adverse biological consequences of metal release from hip prostheses, provide an overview of the clinical utility of cobalt and chromium measurement and the current recommendations for testing, and alert laboratorians and physicians to the many challenges associated with measuring these metal ions.
Updating Impressions of the Military-Industry Complex
Authors: Lieberman A. E. 
Published: September 2012

To connote a somewhat sinister relationship, or worse, between the Department of Defense and its industrial suppliers, the phrase “military-industry complex” may he invoked. However, all of industry has a role in supplying defense requirements, whether as an active participant or on call. Rather than conspiratorial gain, the element of indenture in industry's responsibility suggests that major companies engaged in defense contracting may soon alter their business emphasis in favor of civilian markets and that the industry stake in DOD as a market may become relatively smaller.
The Twilight of the Mechanical Technology
Authors: Fried Louis 
Published: September 2012

Jacques Ellul, Norbert Weiner, and Marshall McLuhan have pointed out the revolutionary impact of the electronic technology on man and his society. This article explores the validity of their observations and extends their ideas for an examination of the impact of the new technology on the organization and the individual. The author predicts that the electronic technology's reorientation of individual motivation, as seen in the current college group's move toward social involvement, will result in an “anti-specialist” with major implications to present organization structures and goals.
Production Planning in a Multiplant System
Authors: Schrier Elliot 
Published: September 2012

The author describes a centralized production planning system for multiplant operations, based on a research project conducted by Matson Research Corporation for a large food-processing firm. The system assigns clear responsibilities to the departments of sales, distribution, material, and production and provides organizational and functional buffers (including production inventories) to soften conflicts. All of the procedures are within the normal reach of any manufacturing company.
Understanding Contract Audits: An Experimental Approach
Authors: Bertrand Robert M. M. , Schram Arthur J. H. C. , Vaassen Eddy H. J. 
Published: September 2012

SUMMARY
A contract audit is a buyer-initiated audit of prices and other conditions, which aims to decrease the information asymmetry between a buyer and a seller. Contract audits are frequently used in monopolistic or oligopolistic markets, as in government procurement. We draw upon three distinct literatures to develop hypotheses (transaction cost theory, the theory of planned behavior, and social preference theory) and test these hypotheses using data obtained in a laboratory experiment. Our results show that contract audits are widely used, a phenomenon that cannot be explained by traditional economic reasoning. Their demand is well explained by the theory of planned behavior, however. Our data show that contract audits decrease transaction costs by increasing the probability of successful negotiations. Audits lead to an increased share of the trade surplus for the buyer, but this increased welfare may be offset by the audit costs. They also yield lower transaction prices.
Remogliflozin Etabonate, a Selective Inhibitor of the Sodium-Glucose Transporter 2, Improves Serum Glucose Profiles in Type 1 Diabetes
Authors: Mudaliar Sunder , Armstrong Debra A. , Mavian Annie A. , O’Connor-Semmes Robin , Mydlow Patricia K. , Ye June , Hussey Elizabeth K. , Nunez Derek J. , Henry Robert R. , Dobbins Robert L. 
Published: September 2012

OBJECTIVE
Remogliflozin etabonate (RE), an inhibitor of the sodium-glucose transporter 2, improves glucose profiles in type 2 diabetes. This study assessed safety, tolerability, pharmacokinetics, and pharmacodynamics of RE in subjects with type 1 diabetes.

RESEARCH DESIGN AND METHODS
Ten subjects managed with continuous subcutaneous insulin infusion were enrolled. In addition to basal insulin, subjects received five randomized treatments: placebo, prandial insulin, 50 mg RE, 150 mg RE, and mg RE 500.

RESULTS
Adverse events and incidence of hypoglycemia with RE did not differ from placebo and prandial insulin groups. RE significantly increased urine glucose excretion and reduced the rise in plasma glucose concentration after oral glucose. RE reduced incremental adjusted weighted mean glucose (0–4 h) values by 42–49 mg/dL and mean glucose (0–10 h) by 52–69 mg/dL.

CONCLUSIONS
RE can be safely administered with insulin in type 1 diabetes and reduces plasma glucose concentrations compared with placebo.
Reduced Incidence of Lower-Extremity Amputations in People With Diabetes in Scotland
Authors: Kennon Brian , Leese Graham P. , Cochrane Lynda , Colhoun Helen , Wild Sarah , Stang Duncan , Sattar Naveed , Pearson Donald , Lindsay Robert S. , Morris Andrew D. , Livingstone Shona , Young Matthew , McKnight John , Cunningham Scott 
Published: September 2012

OBJECTIVE
To establish the incidence of nontraumatic lower-extremity amputation (LEA) in people with diabetes in Scotland.

RESEARCH DESIGN AND METHODS
This cohort study linked national morbidity records and diabetes datasets to establish the number of people with diabetes who underwent nontraumatic major and minor LEA in Scotland from 2004 to 2008.

RESULTS
Two thousand three hundred eighty-two individuals with diabetes underwent a nontraumatic LEA between 2004 and 2008; 57.1% (n = 1,359) underwent major LEAs. The incidence of any LEA among persons with diabetes fell over the 5-year study period by 29.8% (3.04 per 1,000 in 2004 to 2.13 per 1,000 in 2008, P &lt; 0.001). Major LEA rates decreased by 40.7% from 1.87 per 1,000 in 2004 to 1.11 per 1,000 in 2008 (P &lt; 0.001).

CONCLUSIONS
There has been a significant reduction in the incidence of LEA in persons with diabetes in Scotland between 2004 and 2008, principally explained by a reduction in major amputation.