bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomised controlled trial of kinematically and mechanically aligned total knee replacements
Authors: Dossett H. G. , Estrada N. A. , Swartz G. J. , LeFevre G. W. , Kwasman B. G. 
Published: July 2014

We have previously reported the short-term radiological results of a randomised controlled trial comparing kinematically aligned total knee replacement (TKR) and mechanically aligned TKR, along with early pain and function scores. In this study we report the two-year clinical results from this trial. A total of 88 patients (88 knees) were randomly allocated to undergo either kinematically aligned TKR using patient-specific guides, or mechanically aligned TKR using conventional instruments. They were analysed on an intention-to-treat basis. The patients and the clinical evaluator were blinded to the method of alignment.At a minimum of two years, all outcomes were better for the kinematically aligned group, as determined by the mean Oxford knee score (40 (15 to 48) versus 33 (13 to 48); p = 0.005), the mean Western Ontario McMaster Universities Arthritis index (WOMAC) (15 (0 to 63) versus 26 (0 to 73); p = 0.005), mean combined Knee Society score (160 (93 to 200) versus 137 (64 to 200); p= 0.005) and mean flexion of 121° (100 to 150) versus 113° (80 to 130) (p = 0.002). The odds ratio of having a pain-free knee at two years with the kinematically aligned technique (Oxford and WOMAC pain scores) was 3.2 (p = 0.020) and 4.9 (p = 0.001), respectively, compared with the mechanically aligned technique. Patients in the kinematically aligned group walked a mean of 50 feet further in hospital prior to discharge compared with the mechanically aligned group (p = 0.044).In this study, the use of a kinematic alignment technique performed with patient-specific guides provided better pain relief and restored better function and range of movement than the mechanical alignment technique performed with conventional instruments.Cite this article: Bone Joint J 2014;96-B:907–13.
The outcome following fixation of bicondylar tibial plateau fractures
Authors: Ahearn N. , Oppy A. , Halliday R. , Rowett-Harris J. , Morris S. A. , Chesser T. J. , Livingstone J. A. 
Published: July 2014

Unstable bicondylar tibial plateau fractures are rare and there is little guidance in the literature as to the best form of treatment. We examined the short- to medium-term outcome of this injury in a consecutive series of patients presenting to two trauma centres. Between December 2005 and May 2010, a total of 55 fractures in 54 patients were treated by fixation, 34 with peri-articular locking plates and 21 with limited access direct internal fixation in combination with circular external fixation using a Taylor Spatial Frame (TSF). At a minimum of one year post-operatively, patient-reported outcome measures including the WOMAC index and SF-36 scores showed functional deficits, although there was no significant difference between the two forms of treatment. Despite low outcome scores, patients were generally satisfied with the outcome. We achieved good clinical and radiological outcomes, with low rates of complication. In total, only three patients (5%) had collapse of the joint of > 4 mm, and metaphysis to diaphysis angulation of greater than 5º, and five patients (9%) with displacement of > 4 mm. All patients in our study went on to achieve full union. This study highlights the serious nature of this injury and generally poor patient-reported outcome measures following surgery, despite treatment by experienced surgeons using modern surgical techniques. Our findings suggest that treatment of complex bicondylar tibial plateau fractures with either a locking plate or a TSF gives similar clinical and radiological outcomes. Cite this article: Bone Joint J 2014;96-B:956–62.
The influence of surgical factors on dislocation of the meniscal bearing after Oxford medial unicompartmental knee replacement
Authors: Lee S. Y. , Bae J. H. , Kim J. G. , Jang K. M. , Shon W. Y. , Kim K. W. , Lim H. C. 
Published: July 2014

The aim of this study was to evaluate the risk factors for dislocation of the bearing after a mobile-bearing Oxford medial unicompartmental knee replacement (UKR) and to test the hypothesis that surgical factors, as measured from post-operative radiographs, are associated with its dislocation From a total of 480 UKRs performed between 2001 and 2012, in 391 patients with a mean age of 66.5 years (45 to 82) (316 female, 75 male), we identified 17 UKRs where bearing dislocation occurred. The post-operative radiological measurements of the 17 UKRs and 51 matched controls were analysed using conditional logistic regression analysis. The post-operative radiological measurements included post-operative change in limb alignment, the position of the femoral and tibial components, the resection depth of the proximal tibia, and the femoral component-posterior condyle classification. We concluded that a post-operative decrease in the posterior tibial slope relative to the pre-operative value was the only significant determinant of dislocation of the bearing after medial Oxford UKR (odds ratio 1.881; 95% confidence interval 1.272 to 2.779). A post-operative posterior tibial slope < 8.45° and a difference between the pre-operative and post-operative posterior tibial slope of > 2.19° may increase the risk of dislocation. Cite this article: Bone Joint J 2014; 96-B:914–22.
C5 nerve root palsy following decompression of the cervical spine
Authors: Guzman J. Z. , Baird E. O. , Fields A. C. , McAnany S. J. , Qureshi S. A. , Hecht A. C. , Cho S. K. 
Published: July 2014

C5 nerve root palsy is a rare and potentially debilitating complication of cervical spine surgery. Currently, however, there are no guidelines to help surgeons to prevent or treat this complication. We carried out a systematic review of the literature to identify the causes of this complication and options for its prevention and treatment. Searches of PubMed, Embase and Medline yielded 60 articles for inclusion, most of which addressed C5 palsy as a complication of surgery. Although many possible causes were given, most authors supported posterior migration of the spinal cord with tethering of the nerve root as being the most likely. Early detection and prevention of a C5 nerve root palsy using neurophysiological monitoring and variations in surgical technique show promise by allowing surgeons to minimise or prevent the incidence of C5 palsy. Conservative treatment is the current treatment of choice; most patients make a full recovery within two years. Cite this article: Bone Joint J 2014;96-B:950–5.
Spilled gallstones during laparoscopic cholecystectomy
Authors: Ahmad J , Mayne AIW , Zen Y , Loughrey MB , Kelly P , Taylor M 
Published: July 2014

Introduction Incidental gallbladder cancer is found in 0.6–2.1% of patients undergoing laparoscopic cholecystectomy for symptomatic gallstones. Patients with Tis or T1a tumours generally undergo no further intervention. However, spilled stones during surgery may have catastrophic consequences. We present a case and suggest aggressive management in patients with incidental gallbladder cancer who had spilled gallstones at surgery. Case History A 37-year-old woman underwent a laparoscopic cholecystectomy for symptomatic gallstones, during which some stones were spilled into the peritoneal cavity. Subsequent histological examination confirmed incidental pT1a gallbladder cancer. Hepatopancreatobiliary multidisciplinary team discussion agreed on regular six-monthly follow-up. The patient developed recurrent pain two years after surgery. Computed tomography revealed a lesion in segment 6 of the liver. At laparotomy, multiple tumour embedded gallstones were found on the diaphragm. Histological examination showed features (akin to the original pathology) consistent with a metastatic gallbladder tumour. Conclusions This case highlights the potential for recurrence of early stage disease resulting from implantation of dysplastic or malignant cells carried through spilled gallstones. It is therefore important to know if stones were spilled during original surgery in patients with incidental gallbladder cancer following a laparoscopic cholecystectomy. Aggressive and early surgical management should be considered for these patients.
A national audit of antibiotic prophylaxis in elective laparoscopic cholecystectomy
Authors: Graham HE , Vasireddy A , Nehra D 
Published: July 2014

Introduction Laparoscopic surgeons in Great Britain and Ireland were surveyed to assess their use of antibiotic prophylaxis in elective laparoscopic cholecystectomy. This followed a Cochrane review that found no evidence to support the use of antibiotic prophylaxis in routine cases. Methods Data were collected on routine use of antibiotics in elective laparoscopic cholecystectomy, and how that was influenced by factors such as bile spillage, patient co-morbidities and surgeons’ experience. An online questionnaire was sent to 450 laparoscopic surgeons in December 2011. Results Data were received from 111 surgeons (87 consultants) representing over 7,000 cases per year. In routine cases without bile spillage, 64% of respondents gave no antibiotics and 36% gave a single dose. In cases with bile spillage, 11% gave no antibiotics. However, 80% gave one dose and 7% gave three doses. Co-amoxiclav was used by 75% of surgeons. Surgeons are more likely to give antibiotics when patients have risk factors for infective endocarditis. Conclusions This study suggests over 20,000 doses of antibiotics and over £100,000 could be saved annually if surgeons modified their practice to follow current guidelines.
Use of the surgical Apgar score to guide postoperative care
Authors: Haddow JB , Adwan H , Clark SE , Tayeh S , Antonowicz SS , Jayia P , Chicken DW , Wiggins T , Davenport R , Kaptanis S , Fakhry M , Knowles CH , Elmetwally AS , Geddoa E , Nair MS , Naeem I , Adegbola S , Muirhead LJ 
Published: July 2014

Introduction The surgical Apgar score (SAS) can predict 30-day major complications or death after surgery. Studies have validated the score in different patient populations and suggest it should be used to objectively guide postoperative care. We aimed to see whether using the SAS in a decisive approach in a future randomised controlled trial (RCT) would be likely to demonstrate an effect on postoperative care and clinical outcome. Methods A total of 143 adults undergoing general/vascular surgery in 9 National Health Service hospitals were recruited to a pilot single blinded RCT and the data for 139 of these were analysed. Participants were randomised to a control group with standard postoperative care or to an intervention group with care influenced (but not mandated) by the SAS (decisive approach). The notional primary outcome was 30-day major complications or death. Results Incidence of major complications was similar in both groups (control: 20/69 [29%], intervention: 23/70 [33%], p=0.622). Immediate admissions to the critical care unit was higher in the intervention group, especially in the SAS 0–4 subgroup (4/6 vs 2/7) although this was not statistically significant (p=0.310). Validity was also confirmed in area under the curve (AUC) analysis (AUC: 0.77). Conclusions This pilot study found that a future RCT to investigate the effect of using the SAS in a decisive approach may demonstrate a difference in postoperative care. However, significant changes to the design are needed if differences in clinical outcome are to be achieved reliably. These would include a wider array of postoperative interventions implemented using a quality improvement approach in a stepped wedge cluster design with blinded collection of outcome data.
Syeikh Abdul Qadir Bin Abdur Rahim Al-Fathani Bukit Bayas (1864) Towards Hadith Works and Writings of Fiqh Muamalat al-Maliyyah: An Introduction of The Malay Jawi Manuscript Entitled: Risalah fi Bayani Hukmi Bai’i war Riba
Authors: Nizam Mohd Khairul , Ahmad Mahmud , Jannah Nurul 
Published: July 2014

The Malay work of writings which put Hadith as the Mawdu’ (title) of the writings of Malay Archipelago’s scholars is considered Nadir (small). This view is based on the remnants and the writings of Malay Archipelago’s scholars that are mostly focused on the aspect of tasawuf, fiqh and tauhid. This can be seen from their works or books circulated in the market that are still be read by the Malays. The historical development of knowledge in the Malay archipelago stated that the Malay ulamas have been in command of various fields of knowledge and disciplines such as Astronomy, Mathematics, Medicine and etc.This paperwork is an effort to discover the treasure of those Malay ulamas in producing written works on Fiqh Muamalat al-Maliyyahand putting hadith as a source. This writing is also to introduce Syeikh Abdul Qadir Bin Abdur Rahim Al-Fathani Bukit Bayas Terengganu and his book entitled “Risalah fi Bayani Hukmi Bai’i war Riba (papers describing on the matters of purchasing and interests). This book has been classified as a nadir (small) manuscript. This paper will also observe the method used in narrating hadith, total number of hadith and the source of hadith in the book.
Evaluation of the perioperative analgesic efficacy of buprenorphine, compared with butorphanol, in cats
Authors: Warne Leon N. , Beths Thierry , Holm Merete , Carter Jennifer E. , Bauquier Sébastien H. 
Published: July 2014

Abstract
Objective—To compare the analgesic effects of buprenorphine and butorphanol in domestic cats.
Design—2-phase positive-controlled randomized masked clinical trial.
Animals—39 healthy female cats (10 in phase 1 and 29 in phase 2).
Procedures—Cats admitted for ovariohysterectomy received buprenorphine (4 in phase 1; 14 in phase 2) or butorphanol (6 in phase 1; 15 in phase 2). In phase 1, cats were premedicated with buprenorphine (0.02 mg/kg [0.009 mg/lb], IM) or butorphanol (0.4 mg/kg [0.18 mg/lb], IM), in combination with medetomidine. Anesthesia was induced with propofol (IV) and maintained with isoflurane in oxygen. After extubation, medetomidine was antagonized with atipamezole. A validated multidimensional composite scale was used to assess signs of pain after surgery starting 20 minutes after extubation and continuing for up to 360 minutes, and pain score comparisons were made between the 2 groups. Phase 2 proceeded similar to phase 1 with the following addition: during wound closure, cats from the butorphanol and buprenorphine groups received butorphanol (0.4 mg/kg, IM) or buprenorphine (0.02 mg/kg, IM), respectively.
Results—Phase 1 of the study was stopped after 10 cats were ovariohysterectomized because 9 of 10 cats required rescue analgesia at the first evaluation. In phase 2, at the first pain evaluation, pain scores from the buprenorphine group were lower, and all cats from the butorphanol group required rescue analgesia. None of the cats from the buprenorphine group required rescue analgesia at any time.
Conclusions and Clinical Relevance—Buprenorphine (0.02 mg/kg, IM) given before surgery and during wound closure provided adequate analgesia for 6 hours following ovariohysterectomy in cats, whereas butorphanol did not.
Use of ethylene-vinyl alcohol copolymer as a liquid embolic agent to treat a peripheral arteriovenous malformation in a dog
Authors: Culp William T. N. , Glaiberman Craig B. , Pollard Rachel E. , Wisner Erik R. 
Published: July 2014

Abstract
Case Description—An 11-year-old castrated male Tibetan Mastiff was evaluated because of a visibly enlarged blood vessel and progressively worsening swelling of the right hind limb.
Clinical Findings—On physical examination, the right hind limb was markedly larger than the left hind limb and the dog was minimally weight bearing on the affected limb. A bruit was auscultated over the affected region. Ultrasonography of the tarsal region of the right hind limb revealed an artery with turbulent flow that communicated with venous drainage. A CT scan confirmed the presence of an arteriovenous malformation (AVM).
Treatment and Outcome—Embolization of the AVM with a liquid embolic agent (ethylene-vinyl alcohol copolymer dissolved in dimethyl sulfoxide) was elected. An arteriogram was performed prior to treatment and delineated the vessels that were targeted for embolization. The embolic agent was infused into the AVM, and a postinjection arteriogram confirmed complete occlusion of the AVM nidus and normal arterial flow to the paw with subsequent normal venous drainage. The circumference of the abnormal paw was 51 cm before the procedure and 22.9 cm at 4 weeks after the procedure. Additionally, the gait of the dog dramatically improved. No complications associated with the procedure developed.
Clinical Relevance—Peripheral AVMs in dogs are uncommon, and described treatment options are limited and generally associated with serious morbidity. A liquid embolic agent, ethylene-vinyl alcohol copolymer dissolved in dimethyl sulfoxide, was successfully administered in this case, and no morbidity was observed secondary to the procedure. Clinical success was characterized by substantial improvement in limb swelling and marked improvement in the gait of the dog.
Timing of surgery in thoracolumbar trauma: is early intervention safe?
Authors: O'Boynick Christopher Paul , Kurd Mark F. , Darden Bruce V. , Vaccaro Alexander R. , Fehlings Michael G. 
Published: July 2014

The understanding of the optimal surgical timing for stabilization in thoracolumbar fractures is severely limited. Thoracolumbar spine fractures can be devastating injuries and are often associated with significant morbidity and mortality. The role of early surgical stabilization (within 48–72 hours of injury) as a vehicle to improve outcomes in these patients has generated significant interest. Goals of early stabilization include improved neurological recovery, faster pulmonary recovery, improved pain control, and decreased health care costs. Opponents cite the potential for increased bleeding, hypotension, and the risk of further cord injury as a few factors that weigh against early stabilization. The concept of spinal cord injury and its relationship to surgical timing remains in question. However, when neurological outcomes are eliminated from the equation, certain measures have shown positive influences from prompt surgical fixation.
Early fixation of thoracolumbar spine fractures can significantly decrease the duration of hospital stay and the number of days in the intensive care unit. Additionally, prompt stabilization can reduce rates of pulmonary complications. This includes decreased rates of pneumonia and fewer days on ventilator support. Cost analysis revealed as much as $80,000 in savings per patient with early stabilization. All of these benefits come without an increase in morbidity or evidence of increased mortality. In addition, there is no evidence that early stabilization has any ill effect on the injured or uninjured spinal cord. Based on the existing data, early fixation of thoracolumbar fractures has been linked with positive outcomes without clear evidence of negative impacts on the patient's neurological status, associated morbidities, or mortality. These procedures can be viewed as “damage control” and may consist of simple posterior instrumentation or open reductions with internal fixation as indicated. Based on the current literature it is advisable to proceed with early surgical stabilization of thoracolumbar fractures in a well-resuscitated patient, unless extenuating medical conditions would prevent it.
Venous stenting with concurrent intracranial pressure monitoring for the treatment of pseudotumor cerebri
Authors: Ding Dale , Starke Robert M. , Durst Christopher R. , Crowley R. Webster , Liu Kenneth C. 
Published: July 2014

Increasing evidence supports dural venous sinus stenosis as the patho-etiology of pseudotumor cerebri (PTC) in a subset of affected patients. In this video, we demonstrate our technique for 1) diagnostic venous manometry to identify a flow-limiting stenosis of the transverse sinus in a PTC patient; and 2) successful treatment of the patient with venous stenting across the structural and physiological stricture in the dural sinus. The pressure gradient decreased from 20 mmHg pre-stent to 3 mmHg post-stent. In order to further quantify the effect of our intervention, concurrent intracranial pressure monitoring was performed.The video can be found here: http://youtu.be/auxRg17F8yI.
Balloon-assisted transarterial embolization of type 1 spinal dural arteriovenous fistula
Authors: Lee Brian , Mehta Vivek A. , Mack William J. , Tenser Matthew S. , Amar Arun P. 
Published: July 2014

Type 1 spinal dural arteriovenous fistula (dAVF) constitute the vast majority of all spinal vascular malformations. Here we present the case of a 71-year-old male with progressive myelopathy, lower-extremity weakness and numbness, and urinary incontinence. MRI imaging of the thoracic spine demonstrated cord edema, and catheter spinal angiography confirmed a type 1 spinal dAVF. The fistula was supplied by small dural branches of the left L-2 segmental artery. Angiographic cure was achieved with a one-stage procedure in which coils were used to occlude the distal segmental vessels, followed by balloon-assisted embolization with Onyx.The video can be found here: http://youtu.be/8aehJbueH0U.
Y-stent-assisted coil embolization of cerebral aneurysms
Authors: Tan Lee A. , Johnson Andrew K. , Keigher Kiffon M. , Moftakhar Roham , Lopes Demetrius K. 
Published: July 2014

Y-stent–assisted coiling is a technique used by neuroendovascular surgeons to treat complex, wide-necked, bifurcation aneurysms in locations such as basilar tip and middle cerebral artery bifurcation. Several recent studies have demonstrated low complication rate and favorable clinical and angiographic outcomes. The Y-stent technique is illustrated here in detail and the intraoperative nuances are also discussed to minimize potential complications associated with technique.The video can be found here: http://youtu.be/77pEmqx_fyQ.
Endovascular treatment of complex dural arteriovenous fistula using the dual-microcatheter technique
Authors: Levitt Michael R. , Osbun Joshua W. , Nerva John D. , Kim Louis J. 
Published: July 2014

A 71-year-old woman presented with headache and dilated vessels on CTA. Angiography demonstrated a complex dural arteriovenous fistula with retrograde cortical venous hypertension, supplied by branches of internal and external carotids bilaterally into a fistulous pouch paralleling the left transverse and sigmoid sinuses, which was occluded at the jugular bulb. The patient refused treatment and was lost to follow-up, returning with sudden confusion and hemianopsia from left temporo-occipital hemorrhage. Transvenous endovascular embolization was performed using the dual-microcatheter technique with a combination of coiling and Onyx copolymer, completely occluding the sinus and fistula while preserving normal venous drainage.The video can be found here: http://youtu.be/u_4Oc7tSmDM.
Endovascular treatment of a spinal dural arteriovenous malformation (DAVF)
Authors: Agarwal Vijay , Zomorodi Ali , Jabbour Pascal , Chalouhi Nohra , Tjoumakaris Stavropoula , Babu Ranjith , Back Adam , Gonzalez L. Fernando 
Published: July 2014

We present a case of a patient with rapid loss of motor strength in his lower extremities. He became bedridden with bowel and bladder incontinence, and developed saddle anesthesia. MRI of the lumbar spine showed edema in the conus medullaris and multiple flow voids within the spinal canal. A spinal angiogram showed a dorsal Type I spinal AVF. This was treated successfully with Onyx 18 (eV3, Irvine, CA). The patient showed rapid post-procedure improvement, and at discharge from the hospital to a rehabilitation center he was fully ambulatory. At 3-year follow-up, the patient was found to ambulate without difficulty. He also had improved saddle anesthesia, and he was voiding spontaneously. There was no evidence of flow voids on repeat MRI of the lumbar spine.The video can be found here: http://youtu.be/SDYNIGNQIW8.