bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interpretation of patient-reported outcomes for hip and knee replacement surgery
Authors: Judge A. , Arden N. K. , Kiran A. , Price A. , Javaid M. K. , Beard D. , Murray D. , Field R. E. 
Published: February 2012

We obtained information from the Elective Orthopaedic Centre on 1523 patients with baseline and six-month Oxford hip scores (OHS) after undergoing primary hip replacement (THR) and 1784 patients with Oxford knee scores (OKS) for primary knee replacement (TKR) who completed a six-month satisfaction questionnaire. Receiver operating characteristic curves identified an absolute change in OHS of 14 points or more as the point that discriminates best between patients’ satisfaction levels and an 11-point change for the OKS. Satisfaction is highest (97.6%) in patients with an absolute change in OHS of 14 points or more, compared with lower levels of satisfaction (81.8%) below this threshold. Similarly, an 11-point absolute change in OKS was associated with 95.4% satisfaction compared with 76.5% below this threshold. For the six-month OHS a score of 35 points or more distinguished patients with the highest satisfaction level, and for the six-month OKS 30 points or more identified the highest level of satisfaction. The thresholds varied according to patients’ pre-operative score, where those with severe pre-operative pain/function required a lower six-month score to achieve the highest levels of satisfaction. Our data suggest that the choice of a six-month follow-up to assess patient-reported outcomes of THR/TKR is acceptable. The thresholds help to differentiate between patients with different levels of satisfaction, but external validation will be required prior to general implementation in clinical practice.
The influence of acetabular inclination angle on the penetration of polyethylene and migration of the acetabular component
Authors: Kadar T. , Furnes O. , Aamodt A. , Indrekvam K. , Havelin L. I. , Haugan K. , Espehaug B. , Hallan G. 
Published: February 2012

In this prospective study we studied the effect of the inclination angle of the acetabular component on polyethylene wear and component migration in cemented acetabular sockets using radiostereometric analysis. A total of 120 patients received either a cemented Reflection All-Poly ultra-high-molecular-weight polyethylene or a cemented Reflection All-Poly highly cross-linked polyethylene acetabular component, combined with either cobalt–chrome or Oxinium femoral heads. Femoral head penetration and migration of the acetabular component were assessed with repeated radiostereometric analysis for two years. The inclination angle was measured on a standard post-operative anteroposterior pelvic radiograph. Linear regression analysis was used to determine the relationship between the inclination angle and femoral head penetration and migration of the acetabular component. We found no relationship between the inclination angle and penetration of the femoral head at two years’ follow-up (p = 0.9). Similarly, our data failed to reveal any statistically significant correlation between inclination angle and migration of these cemented acetabular components (p = 0.07 to p = 0.9).
The medium-term results of the Stanmore non-invasive extendible endoprosthesis in the treatment of paediatric bone tumours
Authors: Picardo N. E. , Blunn G. W. , Shekkeris A. S. , Meswania J. , Aston W. J. , Pollock R. C. , Skinner J. A. , Cannon S. R. , Briggs T. W. 
Published: February 2012

In skeletally immature patients, resection of bone tumours and reconstruction of the lower limb often results in leg-length discrepancy. The Stanmore non-invasive extendible endoprosthesis, which uses electromagnetic induction, allows post-operative lengthening without anaesthesia. Between 2002 and 2009, 55 children with a mean age of 11.4 years (5 to 16) underwent reconstruction with this prosthesis; ten patients (18.2%) died of disseminated disease and one child underwent amputation due to infection. We reviewed 44 patients after a mean follow-up of 41.2 months (22 to 104). The mean Musculoskeletal Tumor Society score was 24.7 (8 to 30) and the Toronto Extremity Salvage score was 92.3% (55.2% to 99.0%). There was no local recurrence of tumour. Complications developed in 16 patients (29.1%) and ten (18.2%) underwent revision.The mean length gained per patient was 38.6 mm (3.5 to 161.5), requiring a mean of 11.3 extensions (1 to 40), and ten component exchanges were performed in nine patients (16.4%) after attaining the maximum lengthening capacity of the implant. There were 11 patients (20%) who were skeletally mature at follow-up, ten of whom had equal leg lengths and nine had a full range of movement of the hip and knee.This is the largest reported series using non-invasive extendible endoprostheses after excision of primary bone tumours in skeletally immature patients. The technique produces a good functional outcome, with prevention of limb-length discrepancy at skeletal maturity.
Atypical femoral fractures and bisphosphonate treatment
Authors: Thompson R. N. , Phillips J. R. A. , McCauley S. H. J. , Elliott J. R. M. , Moran C. G. 
Published: February 2012

We performed a retrospective review of all patients admitted to two large University Hospitals in the United Kingdom over a 24-month period from January 2008 to January 2010 to identify the incidence of atypical subtrochanteric and femoral shaft fractures and their relationship to bisphosphonate treatment. Of the 3515 patients with a fracture of the proximal femur, 156 fractures were in the subtrochanteric region. There were 251 femoral shaft fractures. The atypical fracture pattern was seen in 27 patients (7%) with 29 femoral shaft or subtrochanteric fractures. A total of 22 patients with 24 atypical fractures were receiving bisphosphonate treatment at the time of fracture. Prodromal pain was present in nine patients (11 fractures); 11 (50%) of the patients on bisphosphonates suffered 12 spontaneous fractures, and healing of these fractures was delayed in a number of patients. This large dual-centre review has established the incidence of atypical femoral fractures at 7% of the study population, 81% of whom had been on bisphosphonate treatment for a mean of 4.6 years (0.04 to 12.1). This study does not advocate any change in the use of bisphosphonates to prevent fragility fractures but attempts to raise awareness of this possible problem so symptomatic patients will be appropriately investigated. However, more work is required to identify the true extent of this new and possibly increasing problem.
Preservation of the original femoral cement mantle during the management of infected cemented total hip replacement by two-stage revision
Authors: Morley J. R. , Blake S. M. , Hubble M. J. W. , Timperley A. J. , Gie G. A. , Howell J. R. 
Published: February 2012

The removal of all prosthetic material and a two-stage revision procedure is the established standard management of an infected total hip replacement (THR). However, the removal of well-fixed femoral cement is time-consuming and can result in significant loss of bone stock and femoral shaft perforation or fracture. We report our results of two-stage revision THR for treating infection, with retention of the original well-fixed femoral cement mantle in 15 patients, who were treated between 1989 and 2002. Following partial excision arthroplasty, patients received local and systemic antibiotics and underwent reconstruction and re-implantation at a second-stage procedure, when the infection had resolved. The mean follow-up of these 15 patients was 82 months (60 to 192). Two patients had positive microbiology at the second stage and were treated with six weeks of appropriate antibiotics; one of these developed recurrent infection requiring further revision. Successful eradication of infection was achieved in the remaining 14 patients. We conclude that when two-stage revision is used for the treatment of peri-prosthetic infection involving a THR, a well-fixed femoral cement mantle can be safely left in situ, without compromising the treatment of infection. Advantages of this technique include a shorter operating time, reduced loss of bone stock and a technically more straightforward second-stage procedure.
Sliding hip screw versus the Targon PF nail in the treatment of trochanteric fractures of the hip
Authors: Parker M. J. , Bowers T. R. , Pryor G. A. 
Published: February 2012

In a randomised trial involving 598 patients with 600 trochanteric fractures of the hip, the fractures were treated with either a sliding hip screw (n = 300) or a Targon PF intramedullary nail (n = 300). The mean age of the patients was 82 years (26 to 104). All surviving patients were reviewed at one year with functional outcome assessed by a research nurse blinded to the treatment used. The intramedullary nail was found to have a slightly increased mean operative time (46 minutes (sd 12.3) versus 49 minutes (sd 12.7), p < 0.001) and an increased mean radiological screening time (0.3 minutes (sd 0.2) versus 0.5 minutes (sd 0.3), p < 0.001). Operative difficulties were more common with the intramedullary nail. There was no statistically significant difference between implants for wound healing complications (p = 1), or need for post-operative blood transfusion (p = 1), and medical complications were similarly distributed in both groups. There was a tendency to fewer revisions of fixation or conversion to an arthroplasty in the nail group, although the difference was not statistically significant (nine versus three cases, p = 0.14). The extent of shortening, loss of hip flexion, mortality and degree of residual pain were similar in both groups. The recovery of mobility was superior for those treated with the intramedullary nails (p = 0.01 at one year from injury). In summary, both implants produced comparable results but there was a tendency to better return of mobility for those treated with the intramedullary nail.
Extending AFM Phase Image of Nanocomposite Structures to 3D using FIB
Authors: Bailey Russell J. , Geurts Remco , Stokes Debbie J. , de Jong Frank , Barber Asa H. 
Published: February 2012

ABSTRACTThe mechanical behavior of nanocomposites is critically dependent on their structural composition. In this paper we use Focused Ion Beam (FIB) microscopy to prepare surfaces from a layered polymer nanocomposite for investigation using phase contrast atomic force microscopy (AFM). Phase contrast AFM provides mechanical information on the surface examined and, by combining with the sequential cross-sectioning of FIB, can extend the phase contract AFM into three dimensions.
Evaluation of infusions of xylazine with ketamine or propofol to modulate recovery following sevoflurane anesthesia in horses
Authors: Wagner Ann E. , Mama Khursheed R. , Steffey Eugene P. , Hellyer Peter W. 
Published: February 2012

Abstract
Objective—To determine whether infusion of xylazine and ketamine or xylazine and propofol after sevoflurane administration in horses would improve the quality of recovery from anesthesia.
Animals—6 healthy adult horses.
Procedures—For each horse, anesthesia was induced by administration of xylazine, diazepam, and ketamine and maintained with sevoflurane for approximately 90 minutes (of which the last 60 minutes were under steady-state conditions) 3 times at 1-week intervals. For 1 anesthetic episode, each horse was allowed to recover from sevoflurane anesthesia; for the other 2 episodes, xylazine and ketamine or xylazine and propofol were infused for 30 or 15 minutes, respectively, after termination of sevoflurane administration. Selected cardiopulmonary variables were measured during anesthesia and recovery. Recovery events were monitored and subjectively scored.
Results—Cardiopulmonary variables differed minimally among treatments, although the xylazine-propofol infusion was associated with greater respiratory depression than was the xylazine-ketamine infusion. Interval from discontinuation of sevoflurane or infusion administration to standing did not differ significantly among treatments, but the number of attempts required to stand successfully was significantly lower after xylazine-propofol infusion, compared with the number of attempts after sevoflurane alone. Scores for recovery from anesthesia were significantly lower (ie, better recovery) after either infusion, compared with scores for sevoflurane administration alone.
Conclusions and Clinical Relevance—Xylazine-ketamine or xylazine-propofol infusion significantly improved quality of recovery from sevoflurane anesthesia in horses. Xylazine-ketamine or xylazine-propofol infusions may be of benefit during recovery from sevoflurane anesthesia in horses for which a smooth recovery is particularly critical. However, oxygenation and ventilation should be monitored carefully.
Prevalence of antimicrobial resistance in relation to virulence genes and phylogenetic origins among urogenital Escherichia coli isolates from dogs and cats in Japan
Authors: Harada Kazuki , Niina Ayaka , Nakai Yuka , Kataoka Yasushi , Takahashi Toshio 
Published: February 2012

Abstract
Objective—To assess the status of antimicrobial resistance (AMR), identify extraintestinal virulence factors (VFs) and phylogenetic origins, and analyze relationships among these traits in extraintestinal pathogenic Escherichia coli (ExPEC) isolates from companion animals.
Sample—104 E coli isolates obtained from urine or genital swab samples collected between 2003 and 2010 from 85 dogs and 19 cats with urogenital infections in Japan.
Procedures—Antimicrobial susceptibility of isolates was determined by use of the agar dilution method; a multiplex PCR assay was used for VF gene detection and phylogenetic group assessment. Genetic diversity was evaluated via randomly amplified polymorphic DNA analysis.
Results—Of the 104 isolates, 45 (43.3%) were resistant to > 2 antimicrobials. Phylogenetically, 64 (61.5%), 22 (21.2%), 13 (12.5%), and 5 (4.8%) isolates belonged to groups B2, D, B1, and A, respectively. Compared with other groups, group B2 isolates were less resistant to all tested antimicrobials and carried the pap, hly, and cnf genes with higher frequency and the aer gene with lower frequency. The aer gene was directly associated and the pap, sfa, hly, and cnf genes were inversely associated with AMR. Randomly amplified polymorphic DNA analysis revealed 3 major clusters, comprised mainly of group B1, B2, and D isolates; 2 subclusters of group B2 isolates had different VF and AMR status.
Conclusions and Clinical Relevance—Prevalences of multidrug resistance and human-like phylogenetic origins among ExPEC isolates from companion animals in Japan were high. It is suggested that VFs, phylogenetic origins, and genetic diversity are significantly associated with AMR in ExPEC.
Sexual Lifestyle and Socioeconomic Profile of the Brothel-based Sex-workers
Authors: Hossain KJ , Kamal MM , Wazed A , Karim MR , Ahmed N , Munjura M , Haque ME 
Published: February 2012

The aim of the study was to investigate sexual lifestyle and socioeconomic profile of the brothel based sex workers. The studied population was sex sellers of Dauladia brothel, Rajbari, the largest brothel in Bangladesh. A total of 113 sex sellers were recruited consecutively following the defined selection criteria. The study period was from July 2009 to January 2010. The research instrument was an interviewer questionnaire. Results showed that most of the (92.0%) of the sex workers were illiterate. Their monthly income was Taka 6 thousands to 25 thousands. Majority of them were adolescent or young adult and unmarried. About 51.3% of them had no children and rest had children. The factors induced to adopt sex selling profession were broker's motivation and/or misguide, poverty or financial insolvency, willingly and born in the brothel. Three to fifteen clients visited the sex sellers every day. Nearly 72.0% of them used condom by their clients, 23.9% oral pills and condom, and were 4.4% injections and condom respectively. Knowledge of the sex sellers about STIs including HIV/AIDS was found satisfactory. An alarming finding was that majority of them had poor knowledge about STIs & HIV/AIDS. About 29.2% fathers of them were farmers, 21.3% day labours, 19.4% small businessmen, 10.0% transport driver and 4.4% service holders. Client's occupation was 38.1% business men, 30.9% transport workers, 19.4% service holders, and 11.6% were students. Altering their sexual act and behaviors and substitute rehabilitation may be the applicable way to overcome this social problem. DOI: http://dx.doi.org/10.3329/bmj.v39i3.9946 2010; 39(3)BMJ
Effects of a novel hydrogel on equine bone healing: A pilot study
Authors: Cohen J. M. , Engiles J. , Leitch M. , Nunamaker D. M. , Southwood L. L. 
Published: February 2012

SummaryObjective: To examine the efficacy and biocompatibility of a thiolated gelatin-thiolated carboxymethyl hyaluronan (CMHA-SGX) sponge as an osteoconductive device in an equine second and fourth metacarpal bone defect model.Methods: Seven millimetre segmental ostectomies were created bilaterally in the second and fourth metacarpal bones of four horses. The left and right metacarpal defects were randomly assigned to (1) be filled with a CMHA-SGX sponge (treated) or (2) were left unfilled (control). The duration of the study was nine weeks. Bone healing was evaluated using serial radiology, as well as histologically and histomorphometrically. Data were analyzed using an analysis of variance (ANOVA). The level of significance was p <0.05.Results: Serial radiographic evaluation revealed improved healing in the treated compared to the control defects at weeks eight and nine (p = 0.02). This finding was not corroborated histologically. Histomorphometry did not reveal any significant differences in healing between experimental groups. The CMHA-SGX sponge did not inhibit bone formation, induce local inflammation or lead to surgical site infection.Clinical significance: While further optimization to improve osteoconductive properties should be considered, the CMHA-SGX sponge appears to be a biocompatible orthopaedic implant and its use as a carrier for osteogenic proteins warrants further investigation.
Osteochondrosis dissecans of the tarsus in Labrador Retrievers: Clinical signs, radiological data and force plate gait evaluation after surgical treatment
Authors: Schaeffer I. G. F. , Theyse L. F. H. , Dijkshoorn N. A. , Schwencke M. , Hazewinkel H. A. W. , van der Peijl G. J. W. 
Published: February 2012

SummaryObjectives: To report the outcome of unilateral surgery, by a plantaromedial approach, in 15 Labrador Retrievers with osteochondrosis dissecans (OCD) of the medial trochlear ridge of the talus. To evaluate the influence on outcome of age at surgery, bilateral involvement, periarticular soft tissue increase (PSI), osteophyte size (OS), decrease of range of joint motion and follow-up. To assess the extent of tarsal hyperextension in the standing dog.Methods: A retrospective clinical and radiographic study was conducted and the posttreatment gait was analysed using a force plate. Ground reaction force (GRF) data were compared with data derived from 24 healthy Labrador Retrievers (control group).Results: Six dogs had an excellent or good clinical result. Significant differences were found between the patients and the control group for many GRF data. Propulsive and vertical forces significantly decreased in the operated limb and increased in the contralateral pelvic and ipsilateral or both thoracic limbs. The lameness was significantly correlated to the OS postoperatively, the range-of-motion, the PSI, the length of the follow-up period, and the vertical ground force. No hyperextension in stance was recorded.Clinical significance: Although most dogs improved, the prognosis remains guarded. This seems to be independent of age, bilateral involvement, or preoperative OS in these dogs. No relation between medial talar OCD and tarsal hyperextension in stance was found in these dogs.
Morphometric assessment of the hip joint in the Estrela Mountain Dog breed
Authors: Ferreira A. J. , Ginja M. M. , Martins J. 
Published: February 2012

SummaryObjectives: To study the radiographic projected hip parameters of the proximal femur and acetabulum in young and adult Estrela Mountain Dogs with normal and abnormal hip joints. The parameters evaluated were: femoral angles of inclination and anteversion (FAI and FAA), femoral neck length and width (FNL and FNW), acetabular depth (AD) and acetabular angle of retrotorsion (AAR).Methods: Five hundred and twenty-five standard hip-extended ventrodorsal radiographic views and 622 mediolateral views of the right and left femur were used to measure the FAI, FAA, FNL, FNW, AD, AAR and modified AAR (mAAR).Results: The FAI decreased in adult dysplastic dogs, in females and in right femora; FAA decreased with age; FNL was characterized by a greater relative size in normal adult animals; FNW was greater in abnormal hips in young and adult animals; AD was less in adult dysplastic dogs and in right hips; AAR was similar in the studied groups; mAAR was greater in abnormal hips and in left hips.Clinical significance: The data may be used in future studies, which compare this breed to others. Morphological variations in femoral neck and acetabular morphometric parameters were present, and these variables in dogs with different ages and with hips in varying states of health should not be compared.
Strong Antiviral Activity of the New L-Hydroxycytidine Derivative, L-HYD4FC, In HBV-Infected Human Chimeric UPA/SCID Mice
Authors: Volz Tassilo , Lütgehetmann Marc , Allweiss Lena , Warlich Michael , Bierwolf Jeanette , Pollok Joerg M , Petersen Joerg , Matthes Eckart , Dandri Maura 
Published: February 2012

Background Suppression of viral replication with nucleoside/nucleotide inhibitors has been shown to greatly improve the outcome of chronic HBV infection. (β-l-nucleoside analogues, especially β-l-deoxycytidine derivatives represent one of the most efficient groups of antiretroviral compounds. We recently described that hydroxylation of the amino group of these β-l-deoxycytidine derivatives preserved their strong HBV inhibitory activity in vitro, but strongly reduced their cytotoxicity. From this new group of compounds we selected β-l-2′,3′-didehydro-2′,3′-dideoxy-N4-hydroxy-5-fluorocytidine (l-Hyd4FC) for a first in vivo investigation. The aim of this study was to determine the antiviral activity of l-Hyd4FC in HBV-infected human liver chimeric urokinase plasminogen activator (uPA)/SCID mice. Methods Stably infected animals (median 6x107 HBV DNA/ ml) were injected daily with either l-Hyd4FC (50 mg/kg) or saline as controls. Mice treated with lamivudine served to compare the in vivo antiviral potency of l-Hyd4FC. Virological changes were determined by quantitative PCR. Results Treatment with l-Hyd4FC for 4 weeks induced a 2-log reduction of viraemia, while a median 1.5-log decline was achieved with lamivudine. Intrahepatically, l-Hyd4FC induced a median eightfold decline of viral activity (relaxed circular DNA/covalently closed circular DNA), and threefold reduction of pregenomic RNA/GAPDH levels. No significant decline of subgenomic HBV transcripts, as well as of circulating hepatitis B e antigen and hepatitis B surface antigen was detected. Maintenance of human serum albumin concentrations throughout the study, negative TUNEL staining and occurrence of viral rebound after drug withdrawal indicated that l-Hyd4FC was not toxic in human hepatocytes. Conclusions Administration of l-Hyd4FC in uPA/SCID mice harbouring HBV-infected human hepatocytes demonstrated the high antiviral potency of this drug in vivo. Such characteristics make l-Hyd4FC a good candidate for further investigations a as potential HBV therapeutic agent.