Borrelia chilensis, a new member of the Borrelia burgdorferi sensu lato complex that extends the range of this genospecies in the Southern Hemisphere.

Borrelia burgdorferi sensu lato (s.l.), transmitted by Ixodes spp.

Sustained improvement in hand hygiene adherence: utilizing shared accountability and financial incentives.

Objective: To evaluate the impact of an institutional hand hygiene accountability program on healthcare personnel hand hygiene adherence.

Design: Time-series design with correlation analysis.

Setting: Tertiary care academic medical center, including outpatient clinics and procedural areas.

Complexity, temporal stability, and clinical correlates of airway bacterial community composition in primary ciliary dyskinesia.

Primary ciliary dyskinesia (PCD) is a genetic disease characterized by abnormalities in ciliary function, leading to compromised airway clearance and chronic bacterial infection of the upper and lower airways. The compositions of these infections and the relationships between their characteristics and disease presentation are poorly defined. We describe here the first systematic culture-independent evaluation of lower airway bacteriology in PCD.

Establishing the relationship between clinical outcome and extent of osseous bridging between computed tomography assessment in isolated hindfoot and ankle fusions.

Background: Determining the success of joint fusion operations is often a diagnostic dilemma, and many factors may be considered. Most would agree that the broad categories of clinical success and radiographic success are likely most useful to determine the overall success of a joint fusion operation. Very little evidence exists to assist the surgeon in determining what constitutes a successful radiographic fusion.

Survey on the need for bone graft in foot and ankle fusion surgery.

Background: Generally, autologous bone graft is felt to be an important treatment adjunct in the presence of structural deformity, surface irregularities, defects (due to trauma, surgery, or degenerative changes), or underlying comorbidities that predispose the patient to healing challenges. This study assessed the prognostic and predictive factors used in the clinical decision making for bone graft supplementation in foot and ankle fusion surgery.

Methods: Utilizing standard survey research methodology, key-informant interviews, pretesting, and pilot testing; a survey was constructed.

Outcomes of ankle arthroplasty with preoperative coronal-plane varus deformity of 10° or greater.

Background: Preoperative talar varus deformity increases the technical difficulty of total ankle replacement and is associated with an increased failure rate. Deformity of >20° has been reported to be a contraindication to arthroplasty. We determined whether clinical outcomes of total ankle replacement in patients with ankle arthritis and preoperative talar varus deformity of ≥10° were comparable with those of patients with varus deformity of <10°.

An analysis of the use of the Kellgren and Lawrence grading system to evaluate peritalar arthritis following total ankle arthroplasty.

Background: The Kellgren and Lawrence grading system (KLGS) has been used throughout the literature for the radiographic staging of osteoarthritis (OA) of the peritalar joints. Despite its widespread use, the KLGS has never been validated for use in this clinical circumstance. The purpose of this study was to determine the inter- and intrarater reliability of the KLGS in the assessment of radiographic progression of OA in the peritalar joints following total ankle replacement (TAR).

Recombinant human platelet-derived growth factor-BB and beta-tricalcium phosphate (rhPDGF-BB/β-TCP): an alternative to autogenous bone graft.

Background: Joint arthrodesis employing autogenous bone graft (autograft) remains a mainstay in the treatment of many foot and ankle problems. However, graft harvest can lead to perioperative morbidity and increased cost. We tested the hypothesis that purified recombinant human platelet-derived growth factor-BB (rhPDGF-BB) homodimer combined with an osteoconductive matrix (beta-tricalcium phosphate [β-TCP]) would be a safe and effective alternative to autograft.

Type testing of a head band dosemeter for measuring eye lens dose in terms of H(P)(3).

A new head band dosemeter, for the measurement of eye lens dose in terms of Hp(3), has been type tested by Public Health England's Centre for Radiation, Environmental and Chemical Hazards [formerly part of the UK Health Protection Agency (HPA)]. The type tests were based on the International Standard ISO 12794, drawing also upon earlier work at HPA. The results show that, unlike many existing dosemeters, the new head band dosemeter correctly measures Hp(3) for beta radiations as well as photons.

Nebuliser systems for drug delivery in cystic fibrosis.

Background: Nebuliser systems are used to deliver medications to control the symptoms and the progression of lung disease in people with cystic fibrosis. Many types of nebuliser systems are available for use with various medications; however, there has been no previous systematic review which has evaluated these systems.

Objectives: To evaluate effectiveness, safety, burden of treatment and adherence to nebulised therapy using different nebuliser systems for people with cystic fibrosis.

Clinical and radiographic outcomes of the mobility total ankle arthroplasty system: early results from a prospective multicenter study.

Background: The Mobility Total Ankle System is a third-generation design consisting of a 3-component, cementless, unconstrained, mobile-bearing prosthesis. This study reports the early results of a prospective multicenter study of the Mobility prosthesis.

Methods: Eighty-eight Mobility total ankle arthroplasties (TAAs) were implanted in 85 patients.

The ability of outcome questionnaires to capture patient concerns following ankle reconstruction.

Background: The objective of this study was to compare questions from outcome questionnaires with items generated by preoperative and postoperative ankle reconstruction patients (using the open-ended questions of self-reported Patient-Specific Index [PASI]) to determine whether existing questionnaires address patients' concerns.

Methods: Patients (n = 142) completed the PASI. Questions from 6 standardized questionnaires (American Academy of Orthopaedic Surgeons Foot and Ankle Questionnaire [AAOS], patient-reported portion of the American Orthopaedic Foot and Ankle Society Clinical Rating System Ankle-Hindfoot Scale [AOFAS], Foot Function Index [FFI], Lower Extremity Functional Scale [LEFS], Short Musculoskeletal Function Assessment [SMFA], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) and PASI were matched by 3 reviewers to corresponding categories in the International Classification of Functioning, Disability and Health (ICF).

Effect of implantation of Augment(®) Bone Graft on serum concentrations of platelet-derived growth factors: a pharmacokinetic study.

Background: Augment(®) Bone Graft is a bone graft substitute intended to be used as an alternative to autologous bone graft in the fusion of hindfoot and ankle joints. Augment(®) Bone Graft is a combination device comprised of beta-tricalcium phosphate (β-TCP) and recombinant human platelet-derived growth factor BB homodimer (rhPDGF-BB).

Objective: This human pharmacokinetic study was undertaken to assess the effect of Augment(®) Bone Graft implantation on the serum concentration of platelet-derived growth factors (PDGFs).

Effective detection and management of low-velocity Lisfranc injuries in the emergency setting: principles for a subtle and commonly missed entity.

Objective: To improve the ability of primary care physicians to recognize the mechanisms and common presentations of low-velocity Lisfranc injuries (LFIs) and to impart an improved understanding of the role of imaging and principles of primary care in low-velocity LFIs.

Sources Of Information: A MEDLINE literature review was performed and the results were summarized, reviewing anatomy and mechanisms, clinical and imaging-based diagnoses, and management principles in the primary care setting.

Main Message: Low-velocity LFIs result from various mechanisms and can have very subtle findings on clinical examination and imaging.

Rare diagnosis of IgG4-related systemic disease by lip biopsy in an international Sjögren syndrome registry.

IgG4-related disease has been recently defined as a distinct clinic-pathologic entity, characterized by dense IgG-4 plasmacytic infiltration of diverse organs, fibrosis, and tumefactive lesions. Salivary and lacrimal glands are a target of this disease and, when affected, may clinically resemble Küttner tumor, Mikulicz disease, or orbital inflammatory pseudotumor. In some patients, the disease is systemic, with metachronous involvement of multiple organs, including the pancreas, aorta, kidneys, and biliary tract.

Efficacy of antiepileptic drugs in adults predicts efficacy in children: a systematic review.

Objective: Due to the challenges inherent in performing clinical trials in children, a systematic review of published clinical trials was performed to determine whether the efficacy of antiepileptic drugs (AEDs) in adults can be used to predict the efficacy of AEDs in the pediatric population.

Methods: Medline/PubMed, EMBASE, and Cochrane library searches (1970-January 2010) were conducted for clinical trials of partial-onset seizures (POS) and primary generalized tonic-clonic seizures (PGTCS) in adults and in children <2 and 2-18 years. Independent epidemiologists used standardized search and study evaluation criteria to select eligible trials.

The role of the anterior cingulate cortex in choices based on reward value and reward contingency.

Although several studies have emphasized the role of the anterior cingulate cortex (ACC) in associating actions with reward value, its role in guiding choices on the basis of changes in reward value has not been assessed. Accordingly, we compared rhesus monkeys with ACC lesions and controls on object- and action-based reinforcer devaluation tasks. Monkeys were required to associate an object or an action with one of two reward outcomes, and we assessed the monkey's shift in choices of objects or actions after changes in the value of 1 outcome.

Central line-associated bloodstream infection surveillance outside the intensive care unit: a multicenter survey.

Objective: The success of central line-associated bloodstream infection (CLABSI) prevention programs in intensive care units (ICUs) has led to the expansion of surveillance at many hospitals. We sought to compare non-ICU CLABSI (nCLABSI) rates with national reports and describe methods of surveillance at several participating US institutions.

Design And Setting: An electronic survey of several medical centers about infection surveillance practices and rate data for non-ICU patients.

Search for neutrinoless double-beta decay in 136Xe with EXO-200.

We report on a search for neutrinoless double-beta decay of 136Xe with EXO-200. No signal is observed for an exposure of 32.5 kg yr, with a background of ∼1.

Do we need new diagnostic criteria for Sjögren's syndrome?

Diagnostic and classification criteria for Sjögren's syndrome (SS) continue to evolve as more is learned about SS and about autoimmune diseases in general. Among diagnostic or classification criteria for SS that are in current use, most include various and variable combinations of results from questions about symptoms and objective tests, many of which are not specific to SS. Given the rapid increase of genetic knowledge about other autoimmune diseases and the potential of finding and testing new biological agents to treat SS, selection of patients who have as uniform a disease process as possible becomes an important goal to better understand and treat this prevalent autoimmune disease.

Intermediate outcomes of fresh talar osteochondral allografts for treatment of large osteochondral lesions of the talus.

Background: Large osteochondral defects of the talus present a treatment challenge. Fresh osteochondral allograft transplantation can be used for large lesions without the donor-site morbidity associated with other procedures such as autologous chondrocyte implantation or osteochondral autograft transfer. The goal of this study was to prospectively evaluate the intermediate outcomes of fresh osteochondral allografting for osteochondral lesions of the talus with use of validated outcome measures.

Impact of antibiotic treatment for pulmonary exacerbations on bacterial diversity in cystic fibrosis.

Background: A diverse array of bacterial species is present in the CF airways, in addition to those recognised as clinically important. Here, we investigated the relative impact of antibiotics, used predominantly to target Pseudomonas aeruginosa during acute exacerbations, on other non-pseudomonal species.

Methods: The relative abundance of viable P.