bluuebunny/crossref_metadata_2025_split huggingface dataset:
Falls Documentation in Nursing Homes: Agreement Between the Minimum Data Set and Chart Abstractions of Medical and Nursing Documentation
Authors: Hill‐Westmoreland Elizabeth E. , Gruber‐Baldini Ann L. 
Published: January 2005

Objectives: To assess the agreement between falls as recorded in the Minimum Data Set (MDS) and fall events abstracted from chart documentation of elderly nursing home (NH) residents.Design: Secondary analysis of data from a longitudinal panel study.Setting: Fifty‐six randomly selected NHs in Maryland stratified by facility size and geographic region.Participants: Four hundred sixty‐two NH residents, aged 65 and older, in NHs for 1 year.Measurements: Falls were abstracted from resident charts and compared with MDS fall variables. Fall events data obtained from other sources of chart documentation were matched for the corresponding periods of 30 and 180 days before the 1‐year MDS assessment date.Results: For a 30‐day period, concordance between the MDS and chart abstractions of falls occurred in 65% of cases, with a kappa coefficient of 0.29 (P<.001), indicating fair agreement. Concordance occurred between the sources for 75% of cases for a 180‐day period, with a kappa of 0.50 (P<.001), indicating moderate agreement. During the 180‐day period, chart abstractions showed that 49% of the sample fell, whereas the MDS revealed that only 28% fell. An analysis of residents whose falls the MDS missed indicated that these residents had significantly more activity of daily living impairment and significantly less unsteady gait and cane/walker use.Conclusion: The MDS underreported falls. Nurses completing MDS assessments must carefully review residents' medical records for falls documentation. Future studies should use caution when employing MDS data as the only indicator of falls.
Postoperative Pain Management in Elderly Patients: Correlation Between Adherence to Treatment Guidelines and Patient Satisfaction
Authors: Sauaia Angela , Min Sung‐joon , Leber Chris , Erbacher Kathleen , Abrams Fredrick , Fink Regina 
Published: January 2005

Objectives: To evaluate pain management satisfaction in elderly postoperative patients; to define pain management strategies documented in the medical record (MR) that predict patient satisfaction.Design: Prospective cohort.Setting: Eight urban hospitals.Participants: Three hundred twenty‐two postsurgical patients aged 65 and older.Measurements: Patients were surveyed regarding satisfaction with pain management in the first 24 hours postsurgery and the survey results summarized in a score. Pain management variables (patient education, pharmacological and nonpharmacological interventions, demographic variables, and surgery and anesthesia information) were abstracted from their MR. The correlation between the satisfaction score and MR variables was assessed using linear regression.Results: Sixty‐two percent of patients experienced severe postoperative pain, yet 87% reported being satisfied with the treatment. The mean satisfaction score±standard deviation was 59.3±10.8 (range 10.6–84.3; potential range 0–100, higher score=higher satisfaction). MR variables explained 14% of the satisfaction score variation. The worst pain intensity in the first 24 hours postsurgery as documented in the MR was the most powerful predictor of satisfaction. Other predictors associated with satisfaction were younger age, male sex, preoperative education, surgery type (laparotomy/thoracotomy patients were more satisfied than orthopedic patients), shorter recovery room stay, analgesic given through oral route, and morphine (compared with other opioids).Conclusion: Pain in elderly surgical patients remains undermanaged. Simple strategies such as emphasizing preoperative education may have a large effect in pain management. This study developed a validated patient satisfaction score and a MR instrument to assist in monitoring pain management quality.
A Chart‐Based Method for Identification of Delirium: Validation Compared with Interviewer Ratings Using the Confusion Assessment Method
Authors: Inouye Sharon K. , Leo‐Summers Linda , Zhang Ying , Bogardus Sidney T. , Leslie Douglas L. , Agostini Joseph V. 
Published: January 2005

Objectives: To validate a chart‐based method for identification of delirium and compare it with direct interviewer assessment using the Confusion Assessment Method (CAM).Design: Prospective validation study.Setting: Teaching hospital.Participants: Nine hundred nineteen older hospitalized patients.Measurements: A chart‐based instrument for identification of delirium was created and compared with the reference standard interviewer ratings, which used direct cognitive assessment to complete the CAM for delirium. Trained nurse chart abstractors were blinded to all interview data, including cognitive and CAM ratings. Factors influencing the correct identification of delirium in the chart were examined.Results: Delirium was present in 115 (12.5%) patients according to the CAM. Sensitivity of the chart‐based instrument was 74%, specificity was 83%, and likelihood ratio for a positive result was 4.4. Overall agreement between chart and interviewer ratings was 82%, kappa=0.41. By contrast, using International Classification of Diseases, Ninth Revision, Clinical Modification, administrative codes, the sensitivity for delirium was 3%, and specificity was 99%. Independent factors associated with incorrect chart identification of delirium were dementia, severe illness, and high baseline delirium risk. With all three factors present, the chart instrument was three times more likely to identify patients incorrectly than with none of the factors present.Conclusion: A chart‐based instrument for delirium, which should be useful for patient safety and quality‐improvement programs in older persons, was validated. Because of potential misclassification, the chart‐based instrument is not recommended for individual patient care or diagnostic purposes.
A mechanical comparison of veterinary linear external fixation systems
Authors: White David T. , Bronson Dwight G. , Welch Robert D. 
Published: January 2005

Objective—To compare the fixation rigidity of recently developed external fixation systems (EFSs) to that of the traditional Kirschner‐Ehmer (KE) system.Study Design—In vitro biomechanical study.Sample Population—Five different EFSs (KE, Secur‐U, small SK carbon fiber, small SK titanium, large SK carbon fiber) were assembled into 7 frame geometries to stabilize Delrin plastic rods with a 1‐cm gap.Methods—External skeletal fixation (ESF) constructs were tested in axial compression, torsion, medial‐lateral bending, and cranial‐caudal bending. Testing was conducted within the elastic range of each fixator. Mean stiffness in each mode was determined from the slope of the linear portion of the load‐deformation curve. Comparison of stiffness values of each EFS within each loading mode and frame type was performed with 1‐way analysis of variance (P< .05).Results—Mean stiffness values were significantly higher for the large SK EFS in all frame types compared with KE but were equal in torsional stiffness in the double‐bar type 1a frame. The small SK EFS with titanium connecting bar had greater stiffness than the KE in all modes for frame types Ia, Ia‐accessory bar, and II‐modified. No overall difference was detected between the KE EFS and the small SK with carbon fiber rod. The stiffness of the Secur‐U type Ia frame with augmentation plate was significantly greater than the KE type Ia with accessory bar.Conclusions—The newer external fixation systems evaluated in this study provided fixation rigidity equal to or greater than that of the KE system.Clinical Relevance—EFSs with increased frame rigidity should permit the use of less complex frame designs while providing fracture stability.
Thoracoscopic treatment of bullous emphysema in 3 dogs
Authors: Brissot Herve N. , Dupre Gilles P. , Bouvy Bernard M. , Paquet Laurent 
Published: January 2005

Objective—To report thorascopic partial lobectomy for treatment of bullous emphysema in dogs.Study Design—Prospective clinical study.Animals—Three dogs with spontaneous pneumothorax.Methods—Thoracoscopy without pulmonary exclusion was used to identify bulla. The thorascope was introduced into the thorax lateral to the xyphoid process, and instrument portals were made at different levels along the thoracic wall between the third and tenth intercostal spaces. The thorascope was passed through the mediastinum to view the opposite pleural cavity. After identification of bullae, the affected lung was excised using an endoscopic stapler, and the incision line was checked for air leakage. Thoracic drains were used for air aspiration for 2 days after surgery.Results—Bullae were confirmed histologically as emphysematous lesions. Lung inflation did not interfere with identification of bullae or with surgery. All dogs had full recovery without recurrence for 18 to 29 months after surgery.Conclusions—Identification and ablation of bulla can be performed thoracoscopically without pulmonary exclusion in dogs.Clinical Relevance—Thoracoscopy offers several advantages compared with thoracotomy for treatment and diagnosis of idiopathic pneumothorax, including ease of identification of bullae and reduced postoperative pain and morbidity.
Laryngoplasty with ventriculectomy or ventriculocordectomy in 104 draft horses (1992–2000)
Authors: Kraus Beth M. , Parente Eric J. , Tulleners Eric P. 
Published: January 2005

Objective—To evaluate efficacy and safety of laryngoplasty with vetriculectomy (VE) or ventriculocordectomy (VCE) for treatment of laryngeal hemiplegia (LH) in draft horses.Study Design—Retrospective study.Sample Population—One hundred four draft horses used for competitive hitch competitions.Methods—Medical records and postoperative endoscopy for competitive hitch draft horses diagnosed with left LH and treated with laryngoplasty and VE or VCE between January 1992 and December 2000 were reviewed. Follow‐up information was obtained from telephone interviews with owners and trainers, and performance scores of 1 to 3 were assigned in which 1 was defined as a horse that was unable to perform (abnormal respiratory noise with or without exercise intolerance), 2 was able to perform but not for its intended use (exercise tolerant but abnormal respiratory noise), and 3 was performing as expected for its intended use (exercise tolerant, no abnormal respiratory noise).Results—One hundred four horses that had 111 laryngoplasty procedures were included. All horses had preoperative performance scores of 1. Follow‐up information was available for 79 horses. Improvement in postoperative performance (exercise tolerant, with or without abnormal respiratory noise) was reported in 92% of horses. Respiratory noise was eliminated in 72% (57 horses) of horses. Postoperative performance scores were the following: 3 in 57 (72%) horses, 2 in 16 (20%) horses, and 1 in 6 (8%) horses. There was no significant difference in postoperative performance based on preoperative grade of LH. There was a trend for horses with ≥70% of possible maximal abduction postoperatively to have a performance score of 3. Postanesthetic complications included prolonged recovery (4 horses, 4%) and myopathy or neuropathy (7 horses, 7%). One of these horses was killed because it did stand; triceps myopathy and encephalopathy were confirmed on necropsy.Conclusions—Laryngoplasty with VE or VCE is an effective and safe procedure for the treatment of LH in the draft horse. Repeat laryngoplasty can be performed successfully, with good performance outcome after laryngoplasty failure. Complications associated with general anesthesia and laryngoplasty in draft horses are higher than reported for light breed horses under similar conditions.Clinical Relevance—For LH, laryngoplasty with VCE or VE under general anesthesia is recommended to eliminate abnormal respiratory noise and improve performance in most competitive hitch draft horses.
Pasteurized tumoral autograft and adjuvant chemotherapy for the treatment of canine distal radial osteosarcoma: 13 cases
Authors: Morello Emanuela , Vasconi Elisabetta , Martano Marina , Peirone Bruno , Buracco Paolo 
Published: January 2005

Objective—To report outcome in 13 dogs with distal radial osteosarcoma, without evidence of metastasis, treated by a combination of adjuvant chemotherapy and a pasteurized autograft limb‐sparing procedure.Study Design—Prospective clinical study.Animals—Thirteen dogs with distal radial osteosarcoma.Methods—Limb‐sparing procedure was performed using an autograft from the excised tumoral segment, pasteurized at 65°C for 40 minutes. Adjuvant chemotherapy (cisplatin or cisplatin and doxorubicin) was administered in all dogs.Results—Mean and median survival times were 531 and 324 days, respectively (range, 180 to 1,868 days). Overall survival was 100% at 6 months, 50% at 12 months, 44% at 18 months, and 22% at 24 months. Lung metastasis occurred in 5 (38%) dogs. Observed complications were local recurrence (2 dogs, 15%), allograft infection (4 dogs, 31%), and implant failure (3 dogs, 23%). Limb function was good in 12 dogs (92%) and fair in 1 dog.Conclusions—Pasteurized bone autograft derived from the tumoral bone segment was an effective alternative to cortical bone allograft for limb sparing in canine distal radial osteosarcoma, in terms of feasibility, pattern of healing, complications, and survival.Clinical Relevance—Use of a pasteurized bone autograft eliminates the need for a canine bone allograft bank and has the added advantage of good fit to the recipient site.
Short‐term outcome after total elbow arthroplasty in dogs with severe, naturally occurring osteoarthritis
Authors: Conzemius Michael G. , Aper Rhonda L. , Corti Lisa B. 
Published: January 2005

Objective—To evaluate limb function in client‐owned dogs before and after total elbow arthroplasty (TEA) for severe, naturally occurring osteoarthritis (OA).Study Design—Prospective clinical evaluation comparing limb function before and after surgery.Animals—Twenty adult, large breed dogs with elbow OA.Methods—Physical, radiographic, and force platform gait examinations were performed on all dogs before surgery. TEA was performed, and examinations were repeated at 3, 6, and 12 months after surgery. Pre‐ and postoperative findings were compared.Results—TEA led to a satisfactory outcome in 16 dogs. In dogs with a satisfactory outcome, function in the operated limb increased over time, with mean peak vertical force (PVF) and vertical impulse (VI) 1 year after surgery being nearly twice the presurgical value. Serious complications encountered included infection (n = 2), luxation (n = 1), and fracture of the humeral condyle (n = 1).Conclusions—Although TEA, as presented, has significant limitations, it can be successfully performed in dogs with naturally occurring elbow OA. Improvements in technique and implant design should lead to improved prognosis.Clinical Relevance—Based on 1‐year data, TEA can be successfully performed in dogs and should be considered as a treatment alternative for adult dogs with lameness from severe OA of the elbow joint.
Biomechanical investigation of the association between suspensory ligament injury and lateral condylar fracture in thoroughbred racehorses
Authors: Le Jeune Sarah S. , Macdonald Melinda H. , Stover Susan M. , Taylor Ken T. , Gerdes Max 
Published: January 2005

Objective—To determine whether partial transection of the medial branch of the suspensory ligament (MBSL) alters equine third metacarpal bone (MC3) condylar surface strains and forelimb, distal joint angles in a manner consistent with promotion of lateral condylar fracture.Study Design—In vitro biomechanical experiment.Sample Population—Right forelimbs from 7 Thoroughbred horse cadavers.Methods—Lateral and medial MC3 condylar, dorsal and abaxial, bone surface strains and distal joint angles were measured both before and after partial transection of the MBSL during in vitro axial limb compression. Dorsal, principal bone strains and abaxial, uniaxial, and proximodistal strains were compared before and after MBSL partial transection at 1,400‐, 3,000‐, and 5,600‐N loads.Results—Bone strains increased in all locations with increasing axial load. All lateral condylar bone strains were significantly higher, and abaxial surface medial condylar bone strain was significantly lower, after partial transection of the MBSL. Respective distal joints became more flexed or extended as axial load increased but were not significantly different after partial transection of the MBSL.Conclusions—Partial transection of the MBSL increases in vitro MC3 lateral condylar bone surface strains.Clinical Relevance—Loss of integrity of the medial branch of the suspensory ligament could increase the risk for lateral condylar fracture in Thoroughbred horses by amplifying bone strain in the lateral condyle.
Lymphocyte Sub‐populations in Gestational Diabetes
Authors: Mahmoud Fadia , Abul Habib , Omu Alexander , Haines David 
Published: January 2005

Problem:  We hypothesize that the normal immunologic responses by the maternal immune system during pregnancy are not as well‐regulated in gestational diabetes (GD) patients as in healthy pregnant women.Method of study:  Using two‐color flow cytometry we evaluated frequencies of peripheral blood lymphocytes in 20 GD patients being treated with insulin; 43 GD patients treated with dietary therapy but no insulin; 44 women experiencing normal pregnancies; and 48 non‐pregnant women.Results:  When compared with healthy pregnant women, both GD cohorts showed higher percentages CD4+CD25+ (P < 0.05), CD4+CD45RO+ (P < 0.05) and CD4+CD29+ (P < 0.01) but lower percentages of CD4+CD45RA+ (P < 0.05). Higher percentages of the activated phenotypes CD8+CD25+ and CD8+HLA‐DR+ cells in the diet‐treated cohort and CD4+HLA‐DR+ cells in insulin‐treated GB cohort, were observed compared with healthy pregnant subjects (P < 0.05).Conclusions:  Expanded populations of activated peripheral blood T cells are associated with GD, suggesting that normal maternal immunosuppression is less effective in GD‐afflicted women.
Changes in Immune Cell Distribution and IL‐10 Production are Regulated through Endometrial IP‐10 Expression in the Goat Uterus
Authors: Imakawa Kazuhiko , Nagaoka Kentaro , Nojima Hisashi , Hara Yasuhiro , Christenson Ronald K. 
Published: January 2005

Problem:  Changes in distribution or redistribution of immune cells are required for the establishment and maintenance of pregnancy, but these changes during early pregnancy have been poorly understood in the ruminant ungulates. Expression of a chemokine, interferon‐γ (IFN‐γ)‐inducible protein 10 kDa (IP‐10, CXCL10), was identified in the endometrium of pregnant goats. Population and/or distribution of endometrial immune cells and their cytokine productions could be regulated by IP‐10 during the period of pregnancy establishment.Method of study:  Using reverse transcriptase‐polymerase chain reaction (RT‐PCR), expression of IP‐10, IFN‐γ, tumor necrosis factor‐α, interleukin‐10 (IL‐10), CXCR3 mRNA and leukocyte cell surface markers, CD4, CD8, CD11b and CD45 mRNA during the caprine early pregnancy was investigated. The ability of IP‐10 to stimulate peripheral blood mononuclear cells (PBMCs) migration was demonstrated using a chemotaxis assay. Changes in migration of PBMCs’ immune cell population and cytokine expressions with IP‐10 stimulation were investigated using flow cytometry and RT‐PCR respectively.Results:  Levels of IP‐10, IL‐10, CD4 and CD11b mRNA, and the number of CD4 and CD11b positive cells in pregnant goat endometrium were higher than those of cyclic goat endometrium. Migration of PBMCs was stimulated by recombinant caprine IP‐10, and the effect was significantly reduced by neutralization with the use of an anti‐IP‐10 antibody. In the flow cytometric and RT‐PCR analyses, migrated cells stimulated by IP‐10 increased the expression of IL‐10 and CD11b mRNA. Furthermore, IP‐10 could stimulate the expression of IL‐10 mRNA from PBMCs.Conclusion:  Endometrial chemokine IP‐10 could regulate IL‐10 production by resident and possibly migrated cells expressing CD11b, probably natural killer cells, and these changes may result in immune environments of the uterus suitable for conceptus implantation in ruminants.
Apoptosis in the regenerate produced by mandibular osteodistraction in the mature rat*
Authors: Liu ZJ , Anderson MW , Gu GM , King GJ 
Published: January 2005

Structured AbstractAuthors – Liu ZJ, Anderson MW, Gu GM, King GJObjective – Little is known about the contribution of apoptosis to the formation of the regenerate in distraction osteogenesis. This study investigated the role of apoptosis in the regulation of osteogenesis in relation to mandibular distraction rate and recovery time.Methods – One hundred and twenty‐nine 3‐month rats received unilateral mandibular ramus osteotomy and distraction device placement. After 3‐day latency, these were distracted for 5 days. The slow group was distracted a total of 1 mm (0.2 mm/day), the moderate 2 mm (0.4 mm/day), the rapid 3 mm (0.6 mm/day), and the sham was not distracted (0.0 mm/day). Eight to nine rats from each group were killed at 6 (mid‐distraction), 10 (early‐consolidation), 24 (mid‐consolidation) and 38 (late‐consolidation) days following device placement. Baseline data were obtained from an additional eight rats killed at day 3 (end of latency). Sagittal sections (7 μm) of the harvested hemi‐mandibles were embedded in paraffin, double‐stained with the DeadEndTM Colorimetric TUNEL system for apoptotic cells and tartrate‐resistant acid phosphatase for osteoclasts. Cell counts of apoptotic cells and osteoclasts (apoptotic or otherwise) were preformed at 40× magnification using a calibrated grid at the middle regions of the caudal, central and rostral parts of the distraction gap. Counting reproducibility was verified as <13%.Results – Counts from all three regions were combined because no significant regional difference was found. The majority of the fibrous matrix regenerate was seen at days 6 and 10 while osseous regenerate occurred mainly at days 24 and 38. Significantly higher levels of apoptotic activity were seen at day 24. Apoptotic osteoclasts also peaked at day 24. Apoptotic cell numbers in the slow and moderate groups most closely followed the pattern of the sham in which the apoptosis activity peaked at days 10 or 24. However, those in the rapid group showed delayed peaks at days 24 or 38.Conclusions – The transition from fibrous to osseous regenerate during mandibular distraction osteogenesis is accompanied by an increase in cell clearance via apoptosis. A slow to moderate distraction rate allows for the most typical pattern of bone healing while a rapid rate prolongs the healing process.