bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is adapted measured resection superior to gap-balancing in determining femoral component rotation in total knee replacement?
Authors: Luyckx T. , Peeters T. , Vandenneucker H. , Victor J. , Bellemans J. 
Published: August 2012

Obtaining a balanced flexion gap with correct femoral component rotation is one of the prerequisites for a successful outcome after total knee replacement (TKR). Different techniques for achieving this have been described. In this study we prospectively compared gap-balancing versus measured resection in terms of reliability and accuracy for femoral component rotation in 96 primary TKRs performed in 96 patients using the Journey system. In 48 patients (18 men and 30 women) with a mean age of 65 years (45 to 85) a tensor device was used to determine rotation. In the second group of 48 patients (14 men and 34 women) with a mean age of 64 years (41 to 86), an ‘adapted’ measured resection technique was used, taking into account the native rotational geometry of the femur as measured on a pre-operative CT scan.Both groups systematically reproduced a similar external rotation of the femoral component relative to the surgical transepicondylar axis: 2.4° (sd 2.5) in the gap-balancing group and 1.7° (sd 2.1) in the measured resection group (p = 0.134). Both gap-balancing and adapted measured resection techniques proved equally reliable and accurate in determining femoral component rotation after TKR. There was a tendency towards more external rotation in the gap-balancing group, but this difference was not statistically significant (p = 0.134). The number of outliers for our ‘adapted’ measured resection technique was much lower than reported in the literature.
Comparison of the Genesis II total knee replacement with oxidised zirconium and cobalt-chromium femoral components in the same patients
Authors: Kim Y-H. , Park J-W. , Kim J-S. 
Published: August 2012

Despite many claims of good wear properties following total knee replacement (TKR) with an oxidised zirconium (OxZr) femoral component, there are conflicting clinical results. We hypothesised that there would be no difference in either the mid-term clinical and radiological outcomes or the characteristics of the polyethylene wear particles (weight, size and shape) in patients using an OxZr or cobalt-chrome (CoCr) femoral component. In all 331 patients underwent bilateral TKR, receiving an OxZr femoral component in one knee and a CoCr femoral component in the other. The mean follow-up was 7.5 years (6 to 8). Following aspiration, polyethylene wear particles were analysed using thermogravimetric methods and scanning electron microscopy. At the most recent follow-up, the mean Knee Society score, Western Ontario and McMaster Universities Osteoarthritis Index score, range of movement and satisfaction score were not significantly different in the two groups. The mean weight, size, aspect ratio and roundness of the aspirated wear particles were similar for each femoral component. Survivorship of the femoral, tibial and patellar components was 100% in both groups.In the absence of evidence of an advantage in the medium term we cannot justify the additional expense of an OxZr femoral component.
Outcome of combined unicompartmental knee replacement and combined or sequential anterior cruciate ligament reconstruction
Authors: Weston-Simons J. S. , Pandit H. , Jenkins C. , Jackson W. F. M. , Price A. J. , Gill H. S. , Dodd C. A. F. , Murray D. W. 
Published: August 2012

The Oxford unicompartmental knee replacement (UKR) is an established treatment option in the management of symptomatic end-stage medial compartmental osteoarthritis (MCOA), which works well in the young and active patient. However, previous studies have shown that it is reliable only in the presence of a functionally intact anterior cruciate ligament (ACL). This review reports the outcomes, at a mean of five years and a maximum of ten years, of 52 consecutive patients with a mean age of 51 years (36 to 57) who underwent staged or simultaneous ACL reconstruction and Oxford UKR. At the last follow-up (with one patient lost to follow-up), the mean Oxford knee score was 41 (sd 6.3; 17 to 48). Two patients required conversion to TKR: one for progression of lateral compartment osteoarthritis and one for infection. Implant survival at five years was 93% (95% CI 83 to 100). All but one patient reported being satisfied with the procedure. The outcome was not significantly influenced by age, gender, femoral or tibial tunnel placement, or whether the procedure was undertaken at one- or two-stages.In summary, ACL reconstruction and Oxford UKR gives good results in patients with end-stage MCOA secondary to ACL deficiency.
Neurogenic claudication without spinal stenosis arising as a result of lumbar epidural varices
Authors: Dabasia H. , Rahim N. , Marshall R. 
Published: August 2012

Neurogenic claudication is most frequently observed in patients with degenerative lumbar spinal stenosis. We describe a patient with lumbar epidural varices secondary to obstruction of the inferior vena cava by pathological lymph nodes presenting with this syndrome. Following a diagnosis of follicular lymphoma, successful chemotherapy led to the resolution of the varices and the symptoms of neurogenic claudication.The lumbar epidural venous plexus may have an important role in the pathogenesis of spinal stenosis. Although rare, epidural venous engorgement can induce neurogenic claudication without spinal stenosis. Further investigations should be directed at identifying an underlying cause.
Results of the Latarjet procedure for recurrent anterior dislocation of the shoulder in patients with epilepsy
Authors: Raiss P. , Lin A. , Mizuno N. , Melis B. , Walch G. 
Published: August 2012

A total of 12 epileptic patients (14 shoulders) with recurrent seizures and anterior dislocations of the shoulder underwent a Latarjet procedure and were reviewed at a mean of 8.3 years (1 to 20) post-operatively. Mean forward flexion decreased from 165° (100° to 180°) to 160° (90° to 180°) (p = 0.5) and mean external rotation from 54° (10° to 90°) to 43° (5° to 75°) (p = 0.058). The mean Rowe score was 76 (35 to 100) at the final follow-up. Radiologically, all shoulders showed a glenoid-rim defect and Hill-Sachs lesions pre-operatively. Osteo-arthritic changes of the glenohumeral joint were observed in five shoulders (36%) pre-operatively and in eight shoulders (57%) post-operatively. Re-dislocation during a seizure occurred in six shoulders (43%). Five of these patients underwent revision surgery using a bone buttress from the iliac crest and two of these patients re-dislocated due to a new seizure.Due to the unacceptably high rate of re-dislocation after surgery in these patients, the most important means of reducing the incidence of further dislocation is the medical management of the seizures. The Latarjet procedure should be reserved for the well-controlled patient with epilepsy who has recurrent anterior dislocation of the shoulder during activities of daily living.
The outcome of scapulothoracic fusion for painful winging of the scapula in dystrophic and non-dystrophic conditions
Authors: Sewell M. D. , Higgs D. S. , Al-Hadithy N. , Falworth M. , Bayley I. , Lambert S. M. 
Published: August 2012

Scapulothoracic fusion (STF) for painful winging of the scapula in neuromuscular disorders can provide effective pain relief and functional improvement, but there is little information comparing outcomes between patients with dystrophic and non-dystrophic conditions. We performed a retrospective review of 42 STFs in 34 patients with dystrophic and non-dystrophic conditions using a multifilament trans-scapular, subcostal cable technique supported by a dorsal one-third semi-tubular plate. There were 16 males and 18 females with a mean age of 30 years (15 to 75) and a mean follow-up of 5.0 years (2.0 to 10.6). The mean Oxford shoulder score improved from 20 (4 to 39) to 31 (4 to 48). Patients with non-dystrophic conditions had lower overall functional scores but achieved greater improvements following STF. The mean active forward elevation increased from 59° (20° to 90°) to 97° (30° to 150°), and abduction from 51° (10° to 90°) to 83° (30° to 130°) with a greater range of movement achieved in the dystrophic group. Revision fusion for nonunion was undertaken in five patients at a mean time of 17 months (7 to 31) and two required revision for fracture. There were three pneumothoraces, two rib fractures, three pleural effusions and six nonunions. The main risk factors for nonunion were smoking, age and previous shoulder girdle surgery.STF is a salvage procedure that can provide good patient satisfaction in 82% of patients with both dystrophic and non-dystrophic pathologies, but there was a relatively high failure rate (26%) when poor outcomes were analysed. Overall function was better in patients with dystrophic conditions which correlated with better range of movement; however, patients with non-dystrophic conditions achieved greater functional improvement.
The ten-year survival of the Birmingham hip resurfacing
Authors: Murray D. W. , Grammatopoulos G. , Pandit H. , Gundle R. , Gill H. S. , McLardy-Smith P. 
Published: August 2012

Recent events have highlighted the importance of implant design for survival and wear-related complications following metal-on-metal hip resurfacing arthroplasty. The mid-term survival of the most widely used implant, the Birmingham Hip Resurfacing (BHR), has been described by its designers. The aim of this study was to report the ten-year survival and patient-reported functional outcome of the BHR from an independent centre. In this cohort of 554 patients (646 BHRs) with a mean age of 51.9 years (16.5 to 81.5) followed for a mean of eight years (1 to 12), the survival and patient-reported functional outcome depended on gender and the size of the implant. In female hips (n = 267) the ten-year survival was 74% (95% confidence interval (CI) 83 to 91), the ten-year revision rate for pseudotumour was 7%, the mean Oxford hip score (OHS) was 43 (sd 8) and the mean UCLA activity score was 6.4 (sd 2). In male hips (n = 379) the ten-year survival was 95% (95% CI 92.0 to 97.4), the ten-year revision rate for pseudotumour was 1.7%, the mean OHS was 45 (sd 6) and the mean UCLA score was 7.6 (sd 2). In the most demanding subgroup, comprising male patients aged < 50 years treated for primary osteoarthritis, the survival was 99% (95% CI 97 to 100). This study supports the ongoing use of resurfacing in young active men, who are a subgroup of patients who tend to have problems with conventional THR. In contrast, the results in women have been poor and we do not recommend metal-on-metal resurfacing in women. Continuous follow-up is recommended because of the increasing incidence of pseudotumour with the passage of time.
A Systematic Comparison of Cockcroft-Gault and Modification of Diet in Renal Disease Equations for Classification of Kidney Dysfunction and Dosage Adjustment
Authors: Park Eun Jung , Wu Kunyi , Mi Zenghui , Dong Ting , Lawrence John P , Ko Chia-Wen , Huang Shiew-Mei , Zhang Lei , Crentsil Victor , Zhang Jialu , Xu Nancy N 
Published: August 2012

BACKGROUND: The dosing of drugs in patients with kidney dysfunction is often based on the estimates of kidney function. OBJECTIVE: To systematically compare the performance of the Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault (CG) equations for dosage adjustment. METHODS: We assessed agreement (concordance, kappa statistics [κ,κω]) between CG and MDRD using a Food and Drug Administration database to evaluate the effect of renal function on the pharmacokinetics of 36 approved drugs. Across the approved drugs, we compared the correlation between these 2 equations for renal drug clearance (Clren) and area under the concentration-time curve. For 26 approved drugs that require renal dose adjustment, we also compared dosing regimens and expected exposure using these equations. Sensitivity analyses were performed by adjusting the MDRD estimates for individualized body surface area and/or range of serum creatinine assay calibration errors. RESULTS: In the pharmacokinetic database with 973 subjects (age 18-95 years, weight 35-153 kg, female 33%), we found that the CG and the MDRD classification of renal function generally agreed (64.2%, κ = 0.54, κω = 0.73). Among the subjects studied for drugs requiring renal dose adjustment, dosages in 12% were changed to a higher or lower dosing category by the MDRD compared to the CG equation. In particular, using MDRD in place of CG for dosage modification yielded higher dosing recommendations for subjects with a combination of age >80 years, weight <55 kg, and serum creatinine >0.7 and ≤1.5 mg/dL; the coefficient of determination was also higher by CG than MDRD in trials that enrolled these or similar patients. CONCLUSIONS: For patients with advanced age, low weight, and modestly elevated serum creatinine, further work is needed before the MDRD equations can replace the CG equation for dose adjustment in the labeling.
Drug Interactions with Rivaroxaban following Total Joint Replacement Surgery
Authors: Kwong Louis M , Tong Lisa M 
Published: August 2012

OBJECTIVE: To evaluate potential drug-drug interactions with rivaroxaban in patients undergoing total hip replacement (THR) and total knee replacement (TKR) surgeries. DATA SOURCES: PubMed; January 2009-April 2012 abstract databases of major congresses for hematology and cardiovascular medicine. STUDY SELECTION AND DATA EXTRACTION: Searches were performed using the key words rivaroxaban and drug interaction. Studies were included if they evaluated interactions with drugs that are commonly used in patients undergoing THR or TKR, based on our clinical experience. DATA SYNTHESIS: A Phase 1 study found that coadministration of rivaroxaban and the nonsteroidal antiinflammatory drug (NSAID) naproxen significantly increased bleeding time. However, in a retrospective analysis of 4 large trials evaluating rivaroxaban in patients undergoing THR or TKR, the difference between major and clinically relevant nonmajor bleeding was not significantly different between NSAID users and nonusers. In addition, proton pump inhibitors, which are frequently coadministered with NSAIDs to prevent gastrointestinal toxicity, have not been demonstrated to cause any appreciable changes in rivaroxaban pharmacokinetics or pharmacodynamics. A Phase 2 study that evaluated several doses and administration intervals of rivaroxaban in combination with aspirin or both aspirin and clopidogrel in patients with acute coronary syndrome found that clinically significant bleeding events occurred in patients receiving rivaroxaban 10 mg daily (the dose approved for the orthopedic indication). However, this risk was not great enough to end the trial early. CONCLUSIONS: Phase 1 drug-drug interaction studies in healthy humans provided little insight into the pharmacodynamic drug interactions between rivaroxaban and NSAIDs or antiplatelet agents. A pooled analysis of the RECORD (Regulation of Coagulation in Orthopedic Surgery to Prevent Deep Vein Thrombosis and Pulmonary Embolism) trials and data from other large trials provides clinical evidence that these agents can be coadministered with rivaroxaban, as long as proper monitoring is instituted.
Improving Pharmacist Knowledge of Oral Chemotherapy in the Community
Authors: Charpentier Margaret M , Orr Katherine Kelly , Taveira Tracey H 
Published: August 2012

BACKGROUND: Approximately 10% of chemotherapy agents are administered orally, with anticipated annual growth of this practice. In the future, community pharmacy practitioners will potentially serve a larger role in the management of patients with cancer. OBJECTIVE: To improve pharmacist confidence, knowledge of oral chemotherapy agents, and dispensing behaviors through live continuing pharmacy education (CPE) programs. METHODS: A prospective cohort study of pharmacists attending live CPE programs in Rhode Island and Maine was conducted between March and May 2010. A survey was administered before and after the educational program; primary outcome measures included change in level of pharmacist confidence in oral chemotherapy knowledge, overall knowledge, and willingness to adjust behavior when dispensing oral chemotherapy agents in community pharmacy. RESULTS: Two hundred fifty-seven of the 410 pharmacists in attendance participated in the survey. Pharmacists significantly improved in confidence level, from no confidence to some confidence (p < 0.001). Counseling the family on the safe handling of oral chemotherapy increased from 37.1% pre-CPE program to 100% post-CPE program. Following the CPE program, behaviors such as (1) using a separate counting tray, (2) wearing gloves, and (3) requiring a double-check improved from 22.5%, 31.5%, and 29.4% baseline to 92.0%, 81.3%, and 81.8%, respectively. All responses to knowledge-based questions improved significantly. CONCLUSIONS: A live CPE program on oral chemotherapy designed to improve pharmacist confidence and knowledge, as well as inform about behaviors, is an effective method. Additional education to improve the knowledge of community-based practitioners to safely dispense and properly counsel patients receiving oral chemotherapy is required.
The Impact of Antiplatelet and Anticoagulant Therapies on Gastrointestinal Symptoms in Patients with Atrial Fibrillation: A Systematic Review
Authors: Sobieraj Diana M , White C Michael , Alikhanov Sabina , Winkler Sara , Mediouni Malek , Kluger Jeffrey , Coleman Craig I 
Published: August 2012

BACKGROUND: Patients with atrial fibrillation (AF) may be susceptible to gastrointestinal (GI) effects of medications used for thromboprophylaxis. OBJECTIVE: To determine the incidence of thromboprophylaxis discontinuation due to GI symptoms and GI events. METHODS: A systematic search of MEDLINE (1950-November 2011) and Cochrane Central (through third quarter of 2011) databases was conducted for randomized trials of adults with AF published in English full-text and reporting on discontinuation due to GI symptoms or the incidence of various GI symptoms. RESULTS: Of studies comparing oral direct thrombin inhibitors (DTIs) to vitamin K antagonists (VKAs), 67%, 100%, and 100% found significantly higher incidences of discontinuation due to GI symptoms, upper GI symptoms, and nondistinct GI symptoms with DTIs, respectively. When comparing aspirin to control therapy, 50% and 33% of trials found significantly higher incidences of discontinuation due to GI symptoms and nondistinct GI symptoms with aspirin, respectively. Aspirin significantly increased the incidence of upper GI symptoms compared to VKAs in 1 trial, but VKAs did not increase the incidence of discontinuation due to GI symptoms and nondistinct GI symptoms versus control. In the only trial comparing a factor Xa inhibitor to VKAs, no significant difference in diarrhea was seen, and when a factor Xa inhibitor was compared to aspirin, there was no significant difference in nondistinct GI symptoms. The incidence of discontinuation due to GI symptoms (4 trials) ranged from 0.0% to 0.4% for control, 0.0% to 2.4% for aspirin, 0.0% to 0.63% for VKA, and 1.2% to 4.7% for oral DTI recipients. The incidence of upper GI symptoms (2 trials) was 1.2% for aspirin, 0.0-5.8% for VKA, 4.2% for VKA plus aspirin, and 11.3-11.8% for DTI recipients. The incidence of nondistinct GI symptoms (7 trials) was 0.0-12.4% for control, 0.2-17.9% for aspirin, 0.0-14.1% for VKA, 23% for DTI, and 2.42% for factor Xa inhibitor recipients. Five trials evaluated diarrhea incidence, which ranged from 0.0% to 12.4% for VKA and 3.2% to 12.2% for oral DTI, and was 5.31% for factor Xa inhibitor recipients. One trial evaluated nausea, with incidences of 1.5% and 2.7% for VKA and DTI recipients, respectively. CONCLUSIONS: GI adverse events are common in AF trial populations. DTIs were associated with more discontinuations due to GI symptoms and aspirin appeared to increase the incidence of GI symptoms compared to control.
Deterring or Mobilizing? The Influence of Government Partisanship and Force on the Frequency, Lethality and Suicide Attacks of Terror Events
Authors: Koch Michael , Tkach Benjamin 
Published: August 2012

AbstractThe ability of a government to prevent violence and threats against the state and its citizens depends on the government’s ability to deter enemies from engaging in such tactics. Because deterrence relies on both capabilities and credibility it is not clear that governments that emerge within the same state are similarly effective at deterring attacks. We examine whether partisan politics and the decision to use force against an enemy or those thought to be associated with an enemy—in our case terrorists—affects successful deterrence. We test our expectations using data from the Israeli-Palestine conflict between the years 1979 and 2003. The results suggest that governments of the right are more effective at using force to deter future terrorist attacks.
The Impact of Employment in Israel on the Palestinian Labor Force
Authors: Etkes Haggay 
Published: August 2012

AbstractThis study provides circumstantial evidence for the impact of permits for employment in Israel on the Palestinian labor force in the West Bank during the late Intifada period and its aftermath (2005–2008). The study utilizes a unique dataset that merges data from the Palestinian Labor Force Survey with Israeli administrative data on permits for employment in Israel. The study quantifies the increase in Palestinian employment in the Israeli and Palestinian economies and the decrease in Palestinian unemployment, as well as the drop in the return to schooling in a West Bank governorate, which coincided with an increase in the number of permits issued for residents of that governorate. These results reflect the short-run benefits for the un-skilled Palestinian labor force as well as the adverse long-run effects of Palestinian employment in Israel on human capital accumulation.
The diversity and importance of fungi associated with marine sponges
Authors: Suryanarayanan Trichur S. 
Published: August 2012

Abstract
A few recent investigations have established that marine-derived fungi associated with sponges are an excellent source of novel bioactive metabolites with the potential to function as drugs or drug leads. Given the high species diversity and wide distribution of sponges, it is reasonable to expect that they harbour marine-derived fungi with the ability to produce diverse secondary metabolites. For a more complete realisation of their technological potential, a thorough knowledge of the different taxa of marine-derived fungi associated with sponges is essential. There is scarce information on the interplay between sponges and associated marine-derived fungi and between the marine-derived fungi and other sponge endosymbionts. Unravelling such interactions could be useful in recreating the sponge microcosm conditions in vitro for harvesting novel fungal metabolites. This is essential as many genes of fungal secondary metabolism are inactive in axenic cultures. This review addresses these issues by focusing on the isolation, identification, nature of association, secondary metabolites and potential interactions of marine-derived fungi of sponges and presents some future prospects regarding the bioprospecting of these fungi.