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Articles 1 - 20 of 20
Full-Text Articles in Medicine and Health Sciences
A Trial Of Wound Irrigation In The Initial Management Of Open Fracture Wounds, Mohit Bhandari, Kyle J. Jeray, Brad A. Petrisor, P. J. Devereaux, Diane Heels-Ansdell, Emil H. Schemitsch, Jeff Anglen, Gregory J. Della Rocca, Clifford Jones, Hans Kreder, Susan Liew, Paula Mckay, Steven Papp, Parag Sancheti, Sheila Sprague, Trevor B. Stone, Xin Sun, Stephanie L. Tanner, Paul Tornetta, Ted Tufescu, Stephen Walter, Gordon H. Guyatt
A Trial Of Wound Irrigation In The Initial Management Of Open Fracture Wounds, Mohit Bhandari, Kyle J. Jeray, Brad A. Petrisor, P. J. Devereaux, Diane Heels-Ansdell, Emil H. Schemitsch, Jeff Anglen, Gregory J. Della Rocca, Clifford Jones, Hans Kreder, Susan Liew, Paula Mckay, Steven Papp, Parag Sancheti, Sheila Sprague, Trevor B. Stone, Xin Sun, Stephanie L. Tanner, Paul Tornetta, Ted Tufescu, Stephen Walter, Gordon H. Guyatt
Bone and Joint Institute
Copyright © 2015 Massachusetts Medical Society. BACKGROUND The management of open fractures requires wound irrigation and dridement to remove contaminants, but the effectiveness of various pressures and solutions for irrigation remains controversial. We investigated the effects of castile soap versus normal saline irrigation delivered by means of high, low, or very low irrigation pressure. METHODS In this study with a 2-by-3 factorial design, conducted at 41 clinical centers, we randomly assigned patients who had an open fracture of an extremity to undergo irrigation with one of three irrigation pressures (high pressure [>20 psi], low pressure [5 to 10 psi], …
Estimating Osteoporotic Fracture Risk Following A Wrist Fracture: A Tale Of Two Systems, Karen Beattie, Jonathan Adachi, George Ioannidis, Alexandra Papaioannou, William D. Leslie, Ruby Grewal, Joy Macdermid, Anthony B. Hodsman
Estimating Osteoporotic Fracture Risk Following A Wrist Fracture: A Tale Of Two Systems, Karen Beattie, Jonathan Adachi, George Ioannidis, Alexandra Papaioannou, William D. Leslie, Ruby Grewal, Joy Macdermid, Anthony B. Hodsman
Bone and Joint Institute
© 2015, The Author(s). Summary: The WHO fracture risk assessment (FRAX) and Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tools can both be used to determine an individual’s 10-year risk of osteoporotic fracture. However, these tools differ in their risk calculation. For participants fracture, FRAX provides a lower fracture risk estimate than CAROC resulting in fewer decisions to initiate therapy.Purpose: The purpose of the current report is to compare fracture risk prediction rates using the CAROC and the FRAX® tools.Methods: Individuals ≥50 years with a distal radius fracture resulting from a fall from standing height or less were recruited …
Functional Outcomes Of Acutely Infected Knee Arthroplasty: A Comparison Of Different Surgical Treatment Options, Ivan Dzaja, James Howard, Lyndsay Somerville, Brent Lanting
Functional Outcomes Of Acutely Infected Knee Arthroplasty: A Comparison Of Different Surgical Treatment Options, Ivan Dzaja, James Howard, Lyndsay Somerville, Brent Lanting
Bone and Joint Institute
© 2015 8872147 Canada Inc. Background: An infected total knee arthroplasty (TKA) can be treated with irrigation and débridement with polyethylene exchange (IDPE) or a 2-staged revision (2SR). Although research has examined infection eradication rates of both treatments, patient outcomes have not been reported. We examined patient-reported outcomes following treatment compared with matched, noninfected controls. Methods: We retrospectively identified patients with infected TKAs who had undergone the index procedure between May 1991 and November 2011. Patient-reported outcomes included the 12-item Short Form Health Survey, Western Ontario and McMaster Universities Arthritis Index, and Knee Society Scores as well as range of …
Methods And Considerations For The Analysis And Standardization Of Assessing Muscle Sympathetic Nerve Activity In Humans, Daniel W. White, J. Kevin Shoemaker, Peter B. Raven
Methods And Considerations For The Analysis And Standardization Of Assessing Muscle Sympathetic Nerve Activity In Humans, Daniel W. White, J. Kevin Shoemaker, Peter B. Raven
Bone and Joint Institute
© 2015 Elsevier B.V.. The technique of microneurography and the assessment of muscle sympathetic nerve activity (MSNA) are used in laboratories throughout the world. The variables used to describe MSNA, and the criteria by which these variables are quantified from the integrated neurogram, vary among studies and laboratories and, therefore, can become confusing to those starting to learn the technique. Therefore, the purpose of this educational review is to discuss guidelines and standards for the assessment of sympathetic nervous activity through the collection and analysis of MSNA. This review will reiterate common practices in the collection of MSNA, but will …
Thermosensitive Polymer-Grafted Iron Oxide Nanoparticles Studied By In Situ Dynamic Light Backscattering Under Magnetic Hyperthermia, Gauvin Hemery, Elisabeth Garanger, Sébastien Lecommandoux, Andrew D. Wong, Elizabeth R. Gillies, Boris Pedrono, Thomas Bayle, David Jacob, Olivier Sandre
Thermosensitive Polymer-Grafted Iron Oxide Nanoparticles Studied By In Situ Dynamic Light Backscattering Under Magnetic Hyperthermia, Gauvin Hemery, Elisabeth Garanger, Sébastien Lecommandoux, Andrew D. Wong, Elizabeth R. Gillies, Boris Pedrono, Thomas Bayle, David Jacob, Olivier Sandre
Bone and Joint Institute
© 2015 IOP Publishing Ltd. Thermometry at the nanoscale is an emerging area fostered by intensive research on nanoparticles (NPs) that are capable of converting electromagnetic waves into heat. Recent results suggest that stationary gradients can be maintained between the surface of NPs and the bulk solvent, a phenomenon sometimes referred to as 'cold hyperthermia'. However, the measurement of such highly localized temperatures is particularly challenging. We describe here a new approach to probing the temperature at the surface of iron oxide NPs and enhancing the understanding of this phenomenon. This approach involves the grafting of thermosensitive polymer chains to …
Chronic Pain Self-Management Support With Pain Science Education And Exercise (Commence): Study Protocol For A Randomized Controlled Trial, Jordan Miller, Joy C. Macdermid, David M. Walton, Julie Richardson
Chronic Pain Self-Management Support With Pain Science Education And Exercise (Commence): Study Protocol For A Randomized Controlled Trial, Jordan Miller, Joy C. Macdermid, David M. Walton, Julie Richardson
Bone and Joint Institute
© 2015 Miller et al. Background: Previous research suggests that self-management programs for people with chronic pain improve knowledge and self-efficacy but result in negligible effects on function. This study will investigate the effectiveness self-management support with pain science education and exercise on improving function for people with chronic pain in comparison to a wait-list control. A secondary objective is to determine which variables help to predict response to the intervention. Methods/Design: This study will be an unblinded, randomized controlled trial with 110 participants comparing a 6-week program that includes self-management support, pain science education and exercise to a wait-list …
Assessment Of Clinical Practice Guideline Methodology For The Treatment Of Knee Osteoarthritis With Intra-Articular Hyaluronic Acid, Roy D. Altman, Emil Schemitsch, Asheesh Bedi
Assessment Of Clinical Practice Guideline Methodology For The Treatment Of Knee Osteoarthritis With Intra-Articular Hyaluronic Acid, Roy D. Altman, Emil Schemitsch, Asheesh Bedi
Bone and Joint Institute
© 2015 The Authors. Published by Elsevier HS Journals ,Inc. Introduction: Clinical practice guidelines are of increasing importance in the decision making for the treatment of knee osteoarthritis. Inconsistent recommendations regarding the use of intra-articular hyaluronic acid for the treatment of knee osteoarthritis have led to confusion among treating physicians. Methods: Literature search to identify clinical practice guidelines that provide recommendations regarding the use of intra-articular hyaluronic acid treatment for knee osteoarthritis was conducted. Included guidelines were appraised using the AGREE II instrument. Guideline development methodologies, how the results were assessed, the recommendation formation, and work group composition were summarized. …
An In Vitro Study Comparing Limited To Full Cementation Of Polyethylene Glenoid Components, R. Andrew Glennie, Joshua W. Giles, James A. Johnson, George S. Athwal, Kenneth J. Faber
An In Vitro Study Comparing Limited To Full Cementation Of Polyethylene Glenoid Components, R. Andrew Glennie, Joshua W. Giles, James A. Johnson, George S. Athwal, Kenneth J. Faber
Bone and Joint Institute
© 2015 Glennie et al. Background: Glenoid component survival is critical to good long-term outcomes in total shoulder arthroplasty. Optimizing the fixation environment is paramount. The purpose of this study was to compare two glenoid cementing techniques for fixation in total shoulder arthroplasty. Methods: Sixteen cadaveric specimens were randomized to receive peg-only cementation (CPEG) or full back-side cementation (CBACK). Physiological cyclic loading was performed and implant displacement was recorded using an optical tracking system. The cement mantle was examined with micro-computed tomography before and after cyclic loading. Results: Significantly greater implant displacement away from the inferior portion of the glenoid …
Influence Of Phase Correction Of Late Gadolinium Enhancement Images On Scar Signal Quantification In Patients With Ischemic And Non-Ischemic Cardiomyopathy, John Stirrat, Sebastien Xavier Joncas, Michael Salerno, Maria Drangova, James White
Influence Of Phase Correction Of Late Gadolinium Enhancement Images On Scar Signal Quantification In Patients With Ischemic And Non-Ischemic Cardiomyopathy, John Stirrat, Sebastien Xavier Joncas, Michael Salerno, Maria Drangova, James White
Bone and Joint Institute
© 2015 Stirrat et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License. Background: Myocardial fibrosis imaging using late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) has been validated as a quantitative predictive marker for response to medical, surgical, and device therapy. To date, all such studies have examined conventional, non-phase corrected magnitude images. However, contemporary practice has rapdily adopted phase-corrected image reconstruction. We sought to investigate the existence of any systematic bias between threshold-based scar quantification performed on conventional magnitude inversion recovery (MIR) and matched phase sensitive inversion recovery (PSIR) images. …
Purchasing And Using Personal Emergency Response Systems (Pers): How Decisions Are Made By Community-Dwelling Seniors In Canada, Alexandra C. Mckenna, Marita Kloseck, Richard Crilly, Jan Polgar
Purchasing And Using Personal Emergency Response Systems (Pers): How Decisions Are Made By Community-Dwelling Seniors In Canada, Alexandra C. Mckenna, Marita Kloseck, Richard Crilly, Jan Polgar
Bone and Joint Institute
© 2015 McKenna et al. Background: As the demographic of older people continues to grow, health services that support independence among community-dwelling seniors have become increasingly important. Personal Emergency Response Systems (PERS) are medical alert systems, designed to serve as a safety net for seniors living alone. Health care professionals often recommend that seniors in danger of falls or other medical emergencies obtain a PERS. The purpose of the study was to investigate the experience of seniors living with and using a PERS in their daily lives, using a qualitative grounded theory approach. Methods: Five focus groups and 10 semi-structured …
Rasch Analysis Of The Patient Rated Elbow Evaluation Questionnaire, Joshua I. Vincent, Joy C. Macdermid, Graham J.W. King, Ruby Grewal
Rasch Analysis Of The Patient Rated Elbow Evaluation Questionnaire, Joshua I. Vincent, Joy C. Macdermid, Graham J.W. King, Ruby Grewal
Bone and Joint Institute
© 2015 Vincent et al. Background: The Patient Rated Elbow Evaluation (PREE) was developed as an elbow joint specific measure of pain and disability and validated with classical psychometric methods. More recently, Rasch analysis has contributed new methods for analyzing the clinical measurement properties of self-report outcome measures. The objective of the study was to determine aspects of validity of the PREE using the Rasch model to assess the overall fit of the PREE data, the response scaling, individual item fit, differential item functioning (DIF), local dependency, unidimensionality and person separation index (PSI). Methods: A convenience sample of 236 patients …
Beyond Silence: Protocol For A Randomized Parallel-Group Trial Comparing Two Approaches To Workplace Mental Health Education For Healthcare Employees, Sandra Moll, Scott Burton Patten, Heather Stuart, Bonnie Kirsh, Joy Christine Macdermid
Beyond Silence: Protocol For A Randomized Parallel-Group Trial Comparing Two Approaches To Workplace Mental Health Education For Healthcare Employees, Sandra Moll, Scott Burton Patten, Heather Stuart, Bonnie Kirsh, Joy Christine Macdermid
Bone and Joint Institute
© 2015 Moll et al.; licensee BioMed Central. Background: Mental illness is a significant and growing problem in Canadian healthcare organizations, leading to tremendous personal, social and financial costs for individuals, their colleagues, their employers and their patients. Early and appropriate intervention is needed, but unfortunately, few workers get the help that they need in a timely way due to barriers related to poor mental health literacy, stigma, and inadequate access to mental health services. Workplace education and training is one promising approach to early identification and support for workers who are struggling. Little is known, however, about what approach …
Surgical Approach In Primary Total Hip Arthroplasty: Anatomy, Technique And Clinical Outcomes, Stephen Petis, James L. Howard, Brent L. Lanting, Edward M. Vasarhelyi
Surgical Approach In Primary Total Hip Arthroplasty: Anatomy, Technique And Clinical Outcomes, Stephen Petis, James L. Howard, Brent L. Lanting, Edward M. Vasarhelyi
Bone and Joint Institute
©2015 8872147 Canada Inc. Total hip arthroplasty (THA) has revolutionized the treatment of hip arthritis. A number of surgical approaches to the hip joint exist, each with unique advantages and disadvantages. The most commonly used approaches include the direct anterior, direct lateral and posterior approaches. A number of technical intricacies allow safe and efficient femoral and acetabular reconstruction when using each approach. Hip dislocation, abductor insufficiency, fracture and nerve injury are complications of THA, although their relative risk varies by approach. Numerous clinical trials have sought to elicit differences in patient-reported outcomes, complication rates and return to function among the …
Proteomic Signature Of The Murine Intervertebral Disc, Matthew R. Mccann, Priya Patel, Agya Frimpong, Yizhi Xiao, Walter L. Siqueira, Cheryle A. Séguin
Proteomic Signature Of The Murine Intervertebral Disc, Matthew R. Mccann, Priya Patel, Agya Frimpong, Yizhi Xiao, Walter L. Siqueira, Cheryle A. Séguin
Bone and Joint Institute
© 2015 McCann et al. Low back pain is the most common musculoskeletal problem and the single most common cause of disability, often attributed to degeneration of the intervertebral disc. Lack of effective treatment is directly related to our limited understanding of the pathways responsible for maintaining disc health. While transcriptional analysis has permitted initial insights into the biology of the intervertebral disc, complete proteomic characterization is required. We therefore employed liquid chromatography electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS) protein/peptide separation and mass spectrometric analyses to characterize the protein content of intervertebral discs from skeletally mature wild-type mice. A total …
Diagnostic Accuracy Of Ultrasonography, Mri And Mr Arthrography In The Characterisation Of Rotator Cuff Disorders: A Systematic Review And Meta-Analysis, Jean Sébastien Roy, Caroline Braãn, Jean Leblond, François Desmeules, Clermont E. Dionne, Joy C. Macdermid, Nathalie J. Bureau, Pierre Frémont
Diagnostic Accuracy Of Ultrasonography, Mri And Mr Arthrography In The Characterisation Of Rotator Cuff Disorders: A Systematic Review And Meta-Analysis, Jean Sébastien Roy, Caroline Braãn, Jean Leblond, François Desmeules, Clermont E. Dionne, Joy C. Macdermid, Nathalie J. Bureau, Pierre Frémont
Bone and Joint Institute
Background Different diagnostic imaging modalities, such as ultrasonography (US), MRI, MR arthrography (MRA) are commonly used for the characterisation of rotator cuff (RC) disorders. Since the most recent systematic reviews on medical imaging, multiple diagnostic studies have been published, most using more advanced technological characteristics. The first objective was to perform a meta-analysis on the diagnostic accuracy of medical imaging for characterisation of RC disorders. Since US is used at the point of care in environments such as sports medicine, a secondary analysis assessed accuracy by radiologists and nonradiologists. Methods A systematic search in three databases was conducted. Two raters …
A Comparison Of Registration Errors With Imageless Computer Navigation During Mis Total Knee Arthroplasty Versus Standard Incision Total Knee Arthroplasty: A Cadaveric Study, Edward T. Davis, Joseph Pagkalos, Price A. Price, Kelly Macgroarty, James P. Waddell, Emil H. Schemitsch
A Comparison Of Registration Errors With Imageless Computer Navigation During Mis Total Knee Arthroplasty Versus Standard Incision Total Knee Arthroplasty: A Cadaveric Study, Edward T. Davis, Joseph Pagkalos, Price A. Price, Kelly Macgroarty, James P. Waddell, Emil H. Schemitsch
Bone and Joint Institute
© 2015 The Authors. Optimal component alignment in total knee arthroplasty has been associated with better functional outcome as well as improved implant longevity. The ability to align components optimally during minimally invasive (MIS) total knee replacement (TKR) has been a cause of concern. Computer navigation is a useful aid in achieving the desired alignment although it is limited by the error during the manual registration of landmarks. Our study aims to compare the registration process error between a standard and a MIS surgical approach. We hypothesized that performing the registration error via an MIS approach would increase the registration …
Hip Fracture Evaluation With Alternatives Of Total Hip Arthroplasty Versus Hemiarthroplasty (Health): Protocol For A Multicentre Randomised Trial, Mohit Bhandari, P. J. Devereaux, Thomas A. Einhorn, Lehana Thabane, Emil H. Schemitsch, Kenneth J. Koval, Frede Frihagen, Rudolf W. Poolman, Kevin Tetsworth, Ernesto Guerra-Farfán, Kim Madden, Sheila Sprague, Gordon Guyatt
Hip Fracture Evaluation With Alternatives Of Total Hip Arthroplasty Versus Hemiarthroplasty (Health): Protocol For A Multicentre Randomised Trial, Mohit Bhandari, P. J. Devereaux, Thomas A. Einhorn, Lehana Thabane, Emil H. Schemitsch, Kenneth J. Koval, Frede Frihagen, Rudolf W. Poolman, Kevin Tetsworth, Ernesto Guerra-Farfán, Kim Madden, Sheila Sprague, Gordon Guyatt
Bone and Joint Institute
Introduction: Hip fractures are a leading cause of mortality and disability worldwide, and the number of hip fractures is expected to rise to over 6 million per year by 2050. The optimal approach for the surgical management of displaced femoral neck fractures remains unknown. Current evidence suggests the use of arthroplasty; however, there is lack of evidence regarding whether patients with displaced femoral neck fractures experience better outcomes with total hip arthroplasty (THA) or hemiarthroplasty (HA). The HEALTH trial compares outcomes following THA versus HA in patients 50 years of age or older with displaced femoral neck fractures. Methods and …
The Impact Of Socioeconomic Status On Implant Selection For Patients Undergoing Hip Arthroplasty, Michael Olsen, Michael Neufeld, Michael Sellan, Zachary Morison, Emil H. Schemitsch
The Impact Of Socioeconomic Status On Implant Selection For Patients Undergoing Hip Arthroplasty, Michael Olsen, Michael Neufeld, Michael Sellan, Zachary Morison, Emil H. Schemitsch
Bone and Joint Institute
© 2015, UTMJ. All rights reserved. Hip resurfacing arthroplasty (HRA) is an alternative to total hip arthroplasty (THA) that preserves proximal femoral bone stock. Patient socioeconomic status (SES) has been demonstrated to impact access to care for numerous healthcare interventions but little is known about its impact on HRA when compared to THA. The aim of this study was to investigate whether there are disparities in SES for patients receiving HRA or THA. A retrospective database review was conducted comprising 617 hip arthroplasty patients (310 HRA, 307 THA). Patient postal code was used as a surrogate marker for patients’ SES …
Forebrain Neurocircuitry Associated With Human Reflex Cardiovascular Control, J. Kevin Shoemaker, Ruma Goswami
Forebrain Neurocircuitry Associated With Human Reflex Cardiovascular Control, J. Kevin Shoemaker, Ruma Goswami
Bone and Joint Institute
© 2015 Shoemaker and Goswami. Physiological homeostasis depends upon adequate integration and responsiveness of sensory information with the autonomic nervous system to affect rapid and effective adjustments in end organ control. Dysregulation of the autonomic nervous system leads to cardiovascular disability with consequences as severe as sudden death. The neural pathways involved in reflexive autonomic control are dependent upon brainstem nuclei but these receive modulatory inputs from higher centers in the midbrain and cortex. Neuroimaging technologies have allowed closer study of the cortical circuitry related to autonomic cardiovascular adjustments to many stressors in awake humans and have exposed many forebrain …
A Technique Of Superficial Medial Collateral Ligament Reconstruction Using An Adjustable-Loop Suspensory Fixation Device, Shaneel Deo, Alan Getgood
A Technique Of Superficial Medial Collateral Ligament Reconstruction Using An Adjustable-Loop Suspensory Fixation Device, Shaneel Deo, Alan Getgood
Bone and Joint Institute
© 2015 Arthroscopy Association of North America. This report describes superficial medial collateral ligament reconstruction of the knee using a novel method of graft fixation with the ACL Tightrope RT (Arthrex, Naples, FL). After tibial fixation with either a standard interference screw or staple, femoral fixation of the semitendinosus tendon is performed with the adjustable-loop suspensory fixation device, which allows for both initial graft tensioning and re-tensioning after cyclical knee range of motion. This provides the ability for the graft to accommodate for resultant soft-tissue creep and stress relaxation, thereby allowing for optimal soft-tissue tension and reduction in laxity at …