bluuebunny/crossref_metadata_2025_split huggingface dataset:
Club foot
Authors: Engell V. , Damborg F. , Andersen M. , Kyvik K. O. , Thomsen K. 
Published: February 2006

The aetiology of congenital club foot is unclear. Although studies on populations, families and twins suggest a genetic component, the mode of inheritance does not comply with distinctive patterns. The Odense-based Danish Twin Registry contains data on all 73 000 twin pairs born in Denmark over the last 130 years. In 2002 all 46 418 twins born between 1931 and 1982 received a 17-page questionnaire, one question of which was ‘Were you born with club foot?’ A total of 94 twins answered ‘Yes’, giving an overall self-reported prevalence of congenital club foot of 0.0027 (95% confidence interval (CI) 0.0022 to 0.0034). We identified 55 complete twin pairs, representing 12 monozygotic, 22 dizygotic same sex (DZss), 18 dizygotic other sex (DZos) and three unclassified. Two monozygotic and 2 DZss pairs were concordant. The pairwise concordance was 0.17 (95% CI 0.02 to 0.48) for monozygotic, 0.09 (95% CI 0.01 to 0.32) for DZss and 0.05 (95% CI 0.006 to 0.18) for all dizygotic (DZtot) twins. We have found evidence of a genetic component in congenital club foot, although non-genetic factors must play a predominant role.
Does anterior cruciate ligament reconstruction restore normal knee kinematics?
Authors: Scarvell J. M. , Smith P. N. , Refshauge K. M. , Galloway H. R. , Woods K. R. 
Published: February 2006

This prospective study used magnetic resonance imaging to record sagittal plane tibiofemoral kinematics before and after anterior cruciate ligament reconstruction using autologous hamstring graft. Twenty patients with anterior cruciate ligament injuries, performed a closed-chain leg-press while relaxed and against a 150 N load. The tibiofemoral contact patterns between 0° to 90° of knee flexion were recorded by magnetic resonance scans. All measurements were performed pre-operatively and repeated at 12 weeks and two years. Following reconstruction there was a mean passive anterior laxity of 2.1 mm (sd 2.3), as measured using a KT 1000 arthrometer, and the mean Cincinnati score was 90 (sd 11) of 100. Pre-operatively, the medial and lateral contact patterns of the injured knees were located posteriorly on the tibial plateau compared with the healthy contralateral knees (p = 0.014), but were no longer different at 12 weeks (p = 0.117) or two years postoperatively (p = 0.909). However, both reconstructed and healthy contralateral knees showed altered kinematics over time. At two years, the contact pattern showed less posterior translation of the lateral femoral condyle during flexion (p < 0.01).
Influence of the design of the prosthesis on the outcome after hemiarthroplasty of the shoulder in displaced fractures of the head of the humerus
Authors: Loew M. , Heitkemper S. , Parsch D. , Schneider S. , Rickert M. 
Published: February 2006

We reviewed 39 patients with displaced three- and four-part fractures of the humerus. In 21 patients (group A) we had used an anatomical prosthesis for the humeral head and in 18 (group B) an implant designed for fractures. When followed up at a mean of 29.3 months after surgery the overall Constant score was 51.9 points; in group A it was 51.5 and in group B 52.4 points. The subjective satisfaction of the patients was assessed using a numerical rating scale and was similar in both groups. In group A complete healing of the tuberosities was found in 29% and 50% in group B. Partial integration was seen in 29% of group A and in only one patient in group B, while resorption was noted in 43% of group A and 44% of group B. The functional outcome was significantly better in patients with complete or partial healing of the tuberosities (p = 0.022). The specific trauma prosthesis did not lead to better healing of the tuberosities. The difference in clinical outcome obtained by the two designs did not reach statistical significance.
Compartment syndrome following total knee arthroplasty
Authors: Haggis P. , Yates P. , Blakeway C. , Fick D. , Morgan D. A. F. , Holt M. , Wood D. 
Published: February 2006

Compartment syndrome is a rare complication of total knee arthroplasty that requires early recognition and prompt decompression in order to prevent long-term disability. We have found only one previous case report in the literature. We present a series of seven cases from four hospitals and five surgeons. Six of the cases resulted in the loss of at least one compartment, and one resulted in amputation. Four of the cases resulted in legal action. We suggest that important risk factors contributing to the development of this condition include complex surgery, soft-tissue compromise, previous surgery, and possibly vascular disease. Delay in the diagnosis and hence delay in decompression was common in our series, and in five cases appeared to be related to the use of a postoperative epidural infusion for pain relief. The presence of associated neurological compromise may have also been a significant factor in the delay to diagnosis in two cases.
Comparison of two types of ulnar component in type-5 Kudo total elbow arthroplasty in patients with rheumatoid arthritis
Authors: Tanaka N. , Sakahashi H. , Ishii S. , Kudo H. 
Published: February 2006

The purpose of this study was to assess the long-term results (more than ten years) of two types of cemented ulnar component with type-5 Kudo total elbow arthroplasty in a consecutive series of 56 patients (60 elbows) with rheumatoid arthritis, and to compare the results in elbows above and below a Larsen grade IV. There was no radiolucency around the humeral component. Patients in whom a metal-backed ulnar component and a porous-coated stem were used had better clinical results and significantly less progression of radiolucent line formation around the ulnar component. They also had a significantly better long-term survival than patients with an all-polyethylene ulnar component. The clinical results of arthroplasty using all-polyethylene ulnar components were inferior, regardless of the degree of joint destruction. We conclude that the type-5 Kudo total elbow arthroplasty with cementless fixation of the porous-coated humeral component and cemented fixation of a metal-backed ulnar component is acceptable and well-tolerated by rheumatoid patients.
Do clinical presentation and pre-operative quality of life predict satisfaction with care after total hip or knee replacement?
Authors: Baumann C. , Rat A. C. , Osnowycz G. , Mainard D. , Delagoutte J. P. , Cuny C. , Guillemin F. 
Published: February 2006

We conducted a multicentre cohort study of 228 patients with osteoarthritis followed up after total hip or knee replacement. Quality of life and patient satisfaction were assessed by self-administered questionnaires. Patient satisfaction was the dependent variable in a multivariate linear regression model. Independent variables included sociodemographic factors, pre- and post-operative clinical characteristics and the pre-operative and post-discharge health-related quality of life. The mean age of the patients was 69 years (sd 9), and 43.8% were male. Pre- and postoperative clinical characteristics were not associated with satisfaction with health care. Only pre-operative bodily pain (p < 0.01) and pre-operative social functioning (p < 0.05) influenced patient satisfaction with care. The pre-operative health-related quality of life and patient characteristics have little effect on inpatient satisfaction with care. This suggests that the impact of the care process on satisfaction may be independent of observed and perceived initial patient-related characteristics.
Should we use a separate knife for the skin?
Authors: Schindler O. S. , Spencer R. F. , Smith M. D. 
Published: February 2006

The aim of this study was to re-assess whether the use of a ‘one-knife technique’ can be considered as safe as the alternative practice of using separate skin and inside knives for elective orthopaedic surgery. A total of 609 knife blades from 203 elective orthopaedic operations, with equal numbers of skin, inside and control blades, were cultured using direct and enrichment media. We found 31 skin blades (15.3%), 22 inside blades (10.8%), and 13 control blades (6.4%) gave bacterial growth. Of the 31 contaminated skin blades only three (9.7%) had growth of the same organism as found on the corresponding inside blade. It is not known whether contamination of deeper layers in the remaining 90% was prevented by changing the knife after the skin incision. The organisms cultured were predominantly coagulase-negative staphylococci and proprionibacterium species; both are known to be the major culprits in peri-prosthetic infection. Our study suggests that the use of separate skin and inside knives should be maintained as good medical practice, since the cost of a single deep infection in human and financial terms can be considerable.
Frequency and timing of clinical venous thromboembolism after major joint surgery
Authors: Bjørnar̊ B. T. , Gudmundsen T. E. , Dahl O. E. 
Published: February 2006

Over a 13-year period we studied all patients who underwent major hip and knee surgery and were diagnosed with objectively confirmed symptomatic venous thromboembolism, either deep venous thrombosis or non-fatal pulmonary embolism, within six months after surgery. Low-molecular-weight heparin had been given while the patients were in hospital. There were 5607 patients. The cumulative incidence of symptomatic venous thromboembolism was 2.7% (150 of 5607), of which 1.1% had developed pulmonary embolism, 1.5% had deep venous thrombosis and 0.6% had both. Patients presented with deep venous thrombosis at a median of 24 days and pulmonary embolism at 17 days after surgery for hip fracture. After total hip replacement, deep venous thrombosis and pulmonary embolism occurred at a median of 21 and 34 days respectively. After total knee replacement, the median time to the presentation of deep venous thrombosis and pulmonary embolism was 20 and 12 days respectively. The cumulative risk of venous thromboembolism lasted for up to three months after hip surgery and for one month after total knee replacement. Venous thromboembolism was diagnosed after discharge from hospital in 70% of patients who developed this complication. Despite hospital-based thromboprophylaxis, most cases of clinical venous thromboembolism occur after discharge and at different times according to the operation performed.
Five-year prospective clinical and radiological results of a new cannulated cemented polished Tri-Taper femoral stem
Authors: Field R. E. , Singh P. J. , Latif A. M. H. , Cronin M. D. , Matthews D. J. 
Published: February 2006

We describe the results at five years of a prospective study of a new tri-tapered polished, cannulated, cemented femoral stem implanted in 51 patients (54 hips) with osteoarthritis. The mean age and body mass index of the patients was 74 years and 27.9, respectively. Using the anterolateral approach, half of the stems were implanted by a consultant orthopaedic surgeon and half by six different registrars. There were three withdrawals from the study because of psychiatric illness, a deep infection and a recurrent dislocation. Five deaths occurred prior to five-year follow-up and one patient withdrew from clinical review. In the remaining 51 hips the mean pre-operative Oxford hip score was 47 points which decreased to 19 points at five years (45 hips). Of the stems 49 (98%) were implanted within 1° of neutral in the femoral canal. The mean migration of the stem at five years was 1.9 mm and the survivorship for aseptic loosening was 100%. There was no significant difference in outcome between the consultant and registrar groups. At five years, the results were comparable with those of other polished, tapered, cemented stems. Long-term surveillance continues.
Unexpected Serum Parathyroid Hormone Profiles in Some Patients with Primary Hyperparathyroidism
Authors: Boudou Philippe , Ibrahim Fidaa , Cormier Catherine , Sarfati Emile , Souberbielle Jean-Claude 
Published: February 2006

Abstract
Background: Third-generation parathyroid hormone (PTH) assays have been reported to measure only intact PTH(1–84), in contrast to second-generation assays, which also detect PTH(7–84) fragments. Higher PTH measurements were observed with third- than with second-generation PTH assays in a few patients with either severe primary hyperparathyroidism or parathyroid carcinoma.
Methods: We analyzed biological data [second- and third-generation PTH assays, 25-hydroxyvitamin D (25-OHD), calcium, and phosphate concentrations] obtained before and after surgery for 2 groups of patients selected from a large series of consecutive patients with primary hyperparathyroidism (PHPT): 7 female patients with surgically and histologically confirmed PHPT (group 1) and a matched group (group 2).
Results: For group 1 but not group 2, PTH concentrations measured by third-generation PTH assays before surgery were higher than those measured by the second-generation assays. Circulating 25-OHD, calcium, and phosphate concentrations were similar in both groups. In addition, PTH values measured with the third-generation PTH assays in group 1 decreased after surgery.
Conclusions: Our results confirm that third-generation PTH assays do not measure only PTH(1–84). The frequency of this unexpected finding of markedly lower PTH concentrations than previously reported was ∼5% in patients with PHPT without malignancy. We do not know whether the presence of this unexpected profile is predictive of malignancy.
Analytical Performance and Diagnostic Accuracy of Immunometric Assays for the Measurement of Circulating Oxidized LDL
Authors: Holvoet Paul , Macy Elizabeth , Landeloos Michele , Jones Dan , Nancy Jenny S , Van de Werf Frans , Tracy Russell P 
Published: February 2006

AbstractBackground: Oxidized LDL (ox-LDL) plays an important role in the pathogenesis of coronary heart disease (CHD). Several tests for circulating ox-LDL have been published. We believe it is critical to carefully evaluate these assays because small differences in performance may have profound effects when results are compared; we therefore compared the analytical and clinical performances of 2 assays: one developed in our laboratory and a commercial assay (Mercodia) that uses the same monoclonal antibody (4E6).Methods: We determined the variance of ox-LDL in both tests, including its longitudinal stability (n = 225; 3 time points per person) and its diagnostic accuracy, by ROC analysis of 95 consecutive CHD patients and 20 controls.Results: The between-person variability was 77% for the in-house assay (with the remaining 23% being within-person and analytical variance) and 74% for the commercial assay. For comparison, previously reported values were 66% for high-sensitivity C-reactive protein and 82% for total cholesterol. The areas under the curves for CHD in the 2 assays were identical (0.85). The odds ratios (logistic regression) for CHD among persons with high ox-LDL (≥15 mg/L) compared with persons with low ox-LDL were not different: 4.3 (95% confidence interval, 1.4–12) for the in-house assay and 3.3 (1.1–10) for the commercial assay.Conclusions: The longitudinal stability of ox-LDL, as assessed by multiple measures in people over time, is similar to that of total cholesterol and high-sensitivity C-reactive protein. Both assays tested similarly distinguish between healthy controls and CHD patients.
Fast In Vivo Microextraction: A New Tool for Clinical Analysis
Authors: Musteata Florin Marcel , Musteata Mihaela L , Pawliszyn Janusz 
Published: February 2006

Abstract
Background: We sought to develop a technique with the potential to partly replace current methods of analysis based on blood draws. To achieve this goal, we developed an in vivo microextraction technique that is faster than conventional methods, interferes minimally with the investigated system, minimizes errors associated with sample preparation, and limits exposure to hazardous biological samples.
Methods: Solid-phase microextraction devices based on hydrophilic polypyrrole and polyethylene glycol coatings were used for direct extraction of drugs from the flowing blood of beagle dogs, over a period of 8 h. The drugs extracted on the probes were subsequently quantified by liquid chromatography coupled to tandem mass spectrometry. Two calibration strategies—external and standard on the fiber—were used to correlate the amount extracted with the in vivo concentration.
Results: Diazepam and its metabolites were successfully monitored over the course of a pharmacokinetic study, repeated 3 times on 3 beagles. The fast microextraction technique was validated by comparison with conventional plasma analysis, and a correlation factor of 0.99 was obtained. In addition to total concentrations, the method was useful for determining free drug concentrations.
Conclusions: The proposed technique has several advantages and is suitable for fast clinical analyses. This approach could be used not only for drugs, but for any other endogenous or exogenous compounds.
Testing of Rock Climbing Anchors
Authors: Pircher M 
Published: February 2006

Abstract
The testing procedures for small rock anchors for various recreational activities including rock climbing are regulated in the European Standard EN959. This paper reports on the use of this testing method in a recent study on the strength of rock climbing anchors in sandstone with a relatively low compressive strength. Some limitations of this method were identified and modifications were implemented in order to overcome these limitations. The modified testing procedure and some representative test results are summarized.
Adaptiver Gleitschutz für Schienenfahrzeuge (Adaptive Wheelslide Protection System for Railway Vehicles)
Authors: Stützle Thorsten , Viereck Uwe , Enning Manfred , Stribersky Anton , Rulka Wolfgang 
Published: February 2006

Abstract
Dieser Beitrag beschäftigt sich mit der Auslegung und dem Test einer Gleitschutzregelung für Schienenfahrzeuge. Als Grundlage für die Reglerentwicklung werden zunächst einfache Modelle des Schienenfahrzeugs, der Kraftschlussbeanspruchung und des Bremssystems vorgestellt. An Hand einer Analyse des Gesamtmodells kann der Wertebereich eines bestimmten Modellparameters berechnet werden, der bei der Auslegung des linearen, robusten Schlupfreglers berücksichtigt werden muss. Daneben wird die Adaption der Reglerverstärkung an einen leicht zu identifizierenden Fahrzeugparameter (Bremszustandsfaktor) beschrieben. Schließlich werden Versuchsergebnisse von Testfahrten mit einer Regelung im Mikroschlupfbereich vorgestellt und diskutiert.
Outcome of bilateral adrenalectomy in congenital adrenal hyperplasia: one unit’s experience
Authors: Ogilvie Cara Megan , Rumsby Gill , Kurzawinski Tom , Conway Gerard S 
Published: February 2006

Objective: The use of bilateral adrenalectomy in the management of congenital adrenal hyperplasia (CAH) is controversial. We set out to review the outcome of 5 cases of CAH who have undergone adrenalectomy in our unit.
Design: A retrospective case note review and subject interview of the experience of adrenalectomy in the setting of a tertiary adult CAH clinic.
Methods: Subjects who had undergone adrenalectomy were reviewed at a routine clinic visit with particular reference to clinical and biochemical outcomes after adrenalectomy.
Results: Two subjects underwent surgery for the sole indication of desire for fertility with successful outcome and without subsequent adrenal crises. Three women suffered from the common clinical management problem of unsuppressible hyperandrogenism and worsening obesity. Whilst the outcome of improved appearance and weight loss was achieved in these subjects, all three experienced significant complications including pigmentation and acute episodes of adrenal insufficiency.
Conclusion: We present a mean follow-up of 4.2 patient years and conclude that this procedure may be suitable for selected women with CAH. Outcomes for those pursuing fertility were positive; however, complications were noted in those women for whom the procedure was performed for symptom control. Accepting that the number of subjects is small, it is clear that more data are required before widely recommending this procedure.
Increased serum osteoprotegerin values in long-lived subjects: different effects of inflammation and bone metabolism
Authors: Mazziotti Gherardo , Amato Giovanni , Sorvillo Francesca , Piscopo Marco , Rizzo Maria Rosaria , Lalli Eleonora , Iride Lorenza , Cioffi Michele , Molinari Anna Maria , Paolisso Giuseppe , Carella Carlo 
Published: February 2006

Aim: To evaluate serum osteoprotegerin (OPG) concentrations in relation to age-dependent changes in serum markers of bone metabolism and systemic inflammation.
Methods: Two-hundred and eighty-three healthy subjects were evaluated for plasma estimated crea-tinine clearance (Cr-clearance), C-reactive protein (CRP), bone alkaline phosphatase, C-telopeptides of type-1 collagen (CrossLaps), nuclear factor-kappaB ligand (RANKL) and OPG concentrations.
Results: In adult subjects (82 cases aged between 27 and 64 years) serum OPG concentrations were significantly and independently correlated with RANKL and Cr-clearance (R2: 0.29), but not with CRP and biochemical markers of bone metabolism. In old subjects who were between 65 and 84 years of age (52 cases) serum OPG concentrations were significantly higher as compared with the adult subjects and correlated independently and significantly with serum RANKL, Cr-clearance and CrossLaps values (R2: 0.63). The highest OPG values were found in the long-lived subjects (149 cases with ages between 85 and 110 years) who also showed increased serum CrossLaps and CRP concentrations as compared with the younger subjects. However, in the long-lived subjects serum OPG concentrations were significantly and independently correlated with Cr-clearance and CRP (R2: 0.45) but not with CrossLaps values.
Conclusions: These data would suggest that different factors might be responsible for the age-dependent enhancement of OPG production. Bone metabolism would seem to be the most important factor influencing serum OPG concentrations in old subjects under 85 years of age, whereas in long-lived subjects the circulating values of this cytokine seem to be mainly correlated with serum CRP which could be a marker of inflammation and cardiovascular risk.