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  • 1
    Online Resource
    Online Resource
    Traumatic brachial plexus root avulsion and cervical spine epidural hematoma in an 18-year-old man
    Elsevier BV ; 2015
    In:  The Spine Journal Vol. 15, No. 2 ( 2015-02), p. 365-366
    Details
    In: The Spine Journal, Elsevier BV, Vol. 15, No. 2 ( 2015-02), p. 365-366
    Type of Medium: Online Resource
    ISSN: 1529-9430
    URL: Article
    DOI: 10.1016/j.spinee.2014.09.024
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
    detail.hit.zdb_id: 2037072-6
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  • 2
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    New books
    Informa UK Limited ; 1943
    In:  Quarterly Journal of Speech Vol. 29, No. 3 ( 1943-10), p. 365-379
    Details
    In: Quarterly Journal of Speech, Informa UK Limited, Vol. 29, No. 3 ( 1943-10), p. 365-379
    Type of Medium: Online Resource
    ISSN: 0033-5630 , 1479-5779
    URL: Article
    DOI: 10.1080/00335634309380908
    RVK:
    EQ 1000
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 1943
    detail.hit.zdb_id: 219172-6
    detail.hit.zdb_id: 2066946-X
    SSG: 7,11
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  • 3
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    Micropatterning of bioactive self-assembling gels
    Royal Society of Chemistry (RSC) ; 2009
    In:  Soft Matter Vol. 5, No. 6 ( 2009), p. 1228-
    Details
    In: Soft Matter, Royal Society of Chemistry (RSC), Vol. 5, No. 6 ( 2009), p. 1228-
    Type of Medium: Online Resource
    ISSN: 1744-683X , 1744-6848
    URL: Article
    DOI: 10.1039/b819002j
    Language: English
    Publisher: Royal Society of Chemistry (RSC)
    Publication Date: 2009
    detail.hit.zdb_id: 2191476-X
    detail.hit.zdb_id: 2193405-8
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  • 4
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    A Survey of the Practice of Lead Extraction in the United States : LEAD EXTRACTION SURVEY
    Wiley ; 2010
    In:  Pacing and Clinical Electrophysiology Vol. 33, No. 6 ( 2010-02-01), p. 721-726
    Details
    In: Pacing and Clinical Electrophysiology, Wiley, Vol. 33, No. 6 ( 2010-02-01), p. 721-726
    Type of Medium: Online Resource
    ISSN: 0147-8389 , 1540-8159
    URL: Issue
    URL: Article
    DOI: 10.1111/pace.2010.33.issue-6
    DOI: 10.1111/j.1540-8159.2010.02692.x
    Language: English
    Publisher: Wiley
    Publication Date: 2010
    detail.hit.zdb_id: 424437-0
    detail.hit.zdb_id: 2037547-5
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  • 5
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    Intermediate to Long Term Clinical and Radiographic Outcomes of Triple Arthrodesis: A 422 Case Retrospective Review
    SAGE Publications ; 2019
    In:  Foot & Ankle Orthopaedics Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0025-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0025-
    Abstract: Ankle Arthritis, Hindfoot Introduction/Purpose: Triple arthrodesis is a commonly performed surgical treatment for hindfoot arthritis and deformity. No study has clearly delineated correlates of both clinical and radiographic outcomes in a sample size this large. The purpose of this study is to explore predictive and demographic outcome measures with long-term followup after triple arthrodesis. Methods: With IRB approval, an institutional radiology database was queried for patients undergoing triple arthrodesis between 2004 and 2016, by a single surgeon at a single institution. A total of 465 cases were identified. Pre- and post-operative clinical and radiographic data was collected retrospectively. Demographic and predictive data included: age, Body Mass Index (BMI), American Society of Anesthesiologists Score (ASA), Charleston Comorbidity Index (CCI), diabetic status, osteoporosis, hypothyroidism, and neuromuscular disease status. Clinical outcomes including infection rate, reoperation rate and clinical nonunion were recorded. Unintended return to the operating room defined clinical failure. Radiographic data including non-union rate, pre- and post- operative ankle degenerative joint disease was also recorded. Statistical analysis was then performed to evaluate the relationship between predictive measures and various outcomes including reoperation, infection, and non-union rates. 23 cases were lost to follow-up. Results: A total of 442 feet (397 patients) were analyzed. The average age was 54 years (14 to 85) with the majority of cases being female (60%). Average follow up was 593 days (40 to 4079). Overall failure rate was 13.7% with clinical nonunion rate of 4.5%. Infection rate was 5.9%. Mortality rate was 0% at 2 years post-operatively. Predictors of failure included: increased BMI, elevated ASA, history of diabetes, underlying neuromuscular disorder (Figure 1). We found no significant difference between pre and post-operative degenerative joint disease rates in the midfoot (9.4%, 12.5%) and ankle (11.7%,13.7%), respectively. Conclusion: Triple arthrodesis is a highly effective procedure for treating hindfoot arthritis. Certain predictive measures including BMI, ASA score, diabetic status and underlying neuromuscular disorders significantly correlate with radiographic union. Additionally, diabetic status significantly correlates with infection status postoperatively. An understanding of these predictive measures may help surgeons in their preoperative planning to improve their clinical and radiographic success rates.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419S00250
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2874570-X
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  • 6
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    Ideal Anatomic Location for Saphenous Nerve Block for Foot and Ankle Surgeries: A Prospective Randomized Clinical Evaluation
    SAGE Publications ; 2019
    In:  Foot & Ankle Orthopaedics Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0003-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0003-
    Abstract: Regional anesthesia for foot and ankle surgery Introduction/Purpose: Regional anesthesia has resulted in significant improvements in patient outcomes including reduced postoperative pain, opioid consumption, opioid-related adverse effects, and decreased postoperative length of stay. Saphenous nerve blocks provide distal analgesia while minimizing the reduction in quadriceps strength seen with more proximal femoral nerve blocks. Saphenous nerve blocks may be performed at the mid-thigh with the subsartorial technique or just proximal to the knee with the transsartorial technique. The present study compares these two techniques in terms of analgesia effectiveness and quadriceps motor preservation. Methods: This study was approved by our institutional IRB committee. A power analysis was conducted prior to the study. Patients, aged 18 to 65, were prospectively identified from a list of elective foot and ankle surgeries performed by one of the study investigators. Preoperatively, bilateral isometric knee extension strength was measured, and subjects completed a PROMIS global health survey. The surgeon was blinded to the randomization of patients to proximal or distal blocks. Bilateral isometric knee extension strength was reassessed following the block as well as sensation, post-operative visual analogue pain score (VAS), and subjective satisfaction. Due to non-normality of the sample, the Wilcoxon rank-sum test was employed to analyze continuous variables such as strength measures. For categorical variables such as gender, pain score, and patient satisfaction, the Pearson chi- square test was used. Results: Twenty-four patients (24 lower extremities) were enrolled in the study and 12 randomized to each group. The two groups were not significantly different in age, gender, or pre-operative PROMIS Mental and Physical Summary Scores. The nerve block procedure was successfully performed in a single attempt in all cases. The VAS was not significantly different at 2 in the distal group and 3 in the proximal group. In each group 11 patients were totally satisfied with the block and 1 was moderately satisfied. The knee extension strength decreased in both the operative and non-operative lower extremity following administration of the nerve block. When normalized to the effect in the non-operative extremity, there was no significant difference in strength decrease between the two groups (p=0.89). Conclusion: This randomized, single-blinded trial compared proximal subsartorial saphenous nerve block with distal transsartorial saphenous nerve block outside of the adductor canal. There was no significant difference in the efficacy of the two techniques was observed in terms of VAS pain score or patient satisfaction and no difference in post-operative weakness. This is the first randomized trial on saphenous nerve blocks to normalize strength to the non-operative lower extremity, reducing the confounding effect of peri-operative narcotic and sedative medications. This study offers evidence for equivalence of the subsartorial and transsartorial saphenous nerve block techniques.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419S00030
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2874570-X
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  • 7
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    Lateral Calcaneal Artery: Pertinent Anatomy for Sinus Tarsi Approach and Calcaneal Osteotomy
    SAGE Publications ; 2019
    In:  Foot & Ankle Orthopaedics Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0020-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0020-
    Abstract: Trauma Introduction/Purpose: The lateral calcaneal artery provides critical arterial supply for healing of the extensile lateral approach to the calcaneus. A recent study has shown that preoperative doppler ultrasound showing non-patency of the lateral calcaneal artery is strongly correlated with wound complications when using this approach. Plate and screw fixation of calcaneus fractures through the sinus tarsi approach has gained popularity, including techniques involving percutaneous screw placement into a plate. Avoidance of lateral calcaneal artery injury may be improved with further quantification of its anatomy and associated variation. Finally, while the lateral approach to the calcaneus for osteotomy is routinely performed with minimal wound complications, the relationship of the lateral calcaneal artery to this approach was studied as well. Methods: This is a cadaveric anatomic study performed using six fresh frozen cadaver specimens. The specimens were treated with intra-arterial injection of latex and dye. The specimens were first utilized in a separate study in which an orthopedic resident, blinded to the present study, performed a standard, oblique osteotomy of the calcaneal body. The cadavers were then examined for the relationship of the lateral calcaneal artery to the previous dissections. Finally, an extended sinus tarsi approach was made, and the relationship of the lateral calcaneal artery was quantified relative to the posterior facet and the posterior most point of the tuberosity, and relative to screw holes in a percutaneous calcaneal plate. Results: Lateral calcaneal artery injury was observed in six out of six cadavers in which calcaneal osteotomy had been performed. The lateral calcaneal artery was encountered when performing the extended sinus tarsi approach at a mean ratio of 0.4 (standard deviation 0.11) of the distance from the posterior facet to the posterior aspect of the tuberosity. It crossed the posterior-most hole in the posterior facet portion of the plate in two cadavers. It also passed within 2 mm of the posterior most hole in the tuberosity portion of the plate in one cadaver. Conclusion: Careful dissection is warranted when extending the sinus tarsi approach beyond the posterior facet to preserve the lateral calcaneal artery. Injury is also possible with percutaneous tuberosity screw placement into a plate, and the consequences for sinus tarsi approach healing are unknown. Lateral calcaneal artery injury is difficult to avoid with the traditional lateral approach for calcaneal osteotomy, and while it has no implications for that approach which heals reliably, it indicates that preoperative doppler would be warranted if extensile lateral approach were considered in a patient who has previously undergone calcaneal osteotomy.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419S00208
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2874570-X
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  • 8
    Online Resource
    Online Resource
    Influence of muscle activity on remodelling of bones in the rat
    Wiley ; 1974
    In:  Journal of Oral Rehabilitation Vol. 1, No. 2 ( 1974-04), p. 171-181
    Details
    In: Journal of Oral Rehabilitation, Wiley, Vol. 1, No. 2 ( 1974-04), p. 171-181
    Abstract: Growth and remodelling of the mandible and the long bones was studied in rats by triple fluorochrome labelling. Diaphyseal remodelling occurred by apposition at certain areas subperiosteally and at the medullary cavity border. Subperiosteal apposition rate was greatly influenced also by muscle attachment in the mandible, while apposition along selected medullary surfaces corresponded to other mechanical and functional demands. Apposition continued at a moderately slower rate after completion of longitudinal growth. The changing locations of the fiuorochromes appear to confirm the concept that bone tissue is in a constant flow from the apposition surface to deep‐seated areas of osteolysis.
    Type of Medium: Online Resource
    ISSN: 0305-182X , 1365-2842
    URL: Issue
    URL: Article
    DOI: 10.1111/jor.1974.1.issue-2
    DOI: 10.1111/j.1365-2842.1974.tb00774.x
    Language: English
    Publisher: Wiley
    Publication Date: 1974
    detail.hit.zdb_id: 187079-8
    detail.hit.zdb_id: 2007587-X
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  • 9
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    Abstract 19419: Algorithm-Based Vendor Selection for Implantable Cardiac Devices Reduces Costs and Avoids Appearance of Conflict of Interest
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Circulation Vol. 126, No. suppl_21 ( 2012-11-20)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 126, No. suppl_21 ( 2012-11-20)
    Abstract: Introduction: In most hospitals, device vendor selection for an individual case is at the discretion of the implanting physician. This exposes the physician to the appearance of conflict of interest and may increase device costs. Methods: At a single academic center, implanting physicians and electrophysiology lab staff constructed and implemented a device selection algorithm based on referring provider request, device features, and equal distribution of cases among the four vendors in our geographic area. Costs for comparable devices were also incorporated into the algorithm, and lower cost devices were selected if all other factors were equal. For each individual case, the algorithm was followed by technical and administrative staff who selected and notified the vendor. Information was solicited from the implanting physicians to inform algorithmic selection. The selection algorithm could be overruled at discretion of implanting physician on clinical grounds. When manufacturer-specific features were selected or non-algorithmic clinical factors incorporated into the decision, the rationale was documented. Results: Over a three-year period of implementation, this algorithm resulted in a distribution of cases among vendors (15.4% Biotronik, 19.0% Boston Scientific, 35.4% Medtronic, and 30.0% St Jude Medical). Imbalances were due to referring provider preferences and the incorporation of cost considerations into the algorithm. In no instance did the implanting physician overrule the algorithm. There were no complaints from referring providers. As compared to prior to the implementation of the algorithm, approximately $750,000 was saved over three years, an 8.3% reduction in device costs. This was largely on the basis of algorithmic selection of less expensive (older generation) devices for appropriate patients. After two years, when vendor contracts were renegotiated, substantial further cost savings were realized. Conclusions: A device selection algorithm removes the daily task of vendor selection from the physician and removes the appearance of conflict of interest. The algorithm also results in a substantial cost savings for the hospital. We hope this model will find broad application in the electrophysiology community.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.126.suppl_21.A19419
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
    detail.hit.zdb_id: 1466401-X
    detail.hit.zdb_id: 80099-5
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  • 10
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    High Mid‐Term Mortality Following Successful Lead Extraction for Infection
    Wiley ; 2011
    In:  Pacing and Clinical Electrophysiology Vol. 34, No. 1 ( 2011-01), p. 32-36
    Details
    In: Pacing and Clinical Electrophysiology, Wiley, Vol. 34, No. 1 ( 2011-01), p. 32-36
    Abstract: Background: Transvenous lead extraction patients tend to have multiple medical problems complicated by prolonged infections that may result in high‐mortality rates following a successful procedure. Methods: All adult patients referred for lead extraction for infection over a 4‐year period were included in this study. Mortality following the procedure was assessed using hospital records and the Social Security Death Index. Results: Indications for extraction were systemic infection (n = 34) and isolated pocket infection (n = 33). Of the 67 patients, 47 (70%) were still alive at follow‐up (6–55 months). No patient died during or within 24 hours of the procedure, and two were sent to emergent surgery and did well. However, five died during prolonged hospitalizations, and two were discharged to hospice care and died shortly thereafter. The remaining 13 deaths occurred after discharge from the hospital at a mean interval of 15 months (range, 24 days to 35 months) following the procedure. Notably, six of seven patients who died in the hospital, and nine of 13 who died after discharge, had bacteremia as their indication for extraction, for an overall mortality risk of 44% in patients with systemic infection. Conclusions: True risk assessment for lead extraction patients is underestimated and may be related to the focus on the procedural risks, while the underlying illness and physiologic state may account for the excess mortality following a successful extraction. In most cases, the infected hardware contributed to the length and severity of the illness, and thus earlier consideration for extraction may be warranted. (PACE 2011; 32–36)
    Type of Medium: Online Resource
    ISSN: 0147-8389 , 1540-8159
    URL: Issue
    URL: Article
    DOI: 10.1111/pace.2011.34.issue-1
    DOI: 10.1111/j.1540-8159.2010.02941.x
    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 424437-0
    detail.hit.zdb_id: 2037547-5
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