A framework for three-dimensional statistical shape modeling of the proximal femur in Legg-Calvé-Perthes disease.

Purpose: The pathomorphology of Legg-Calvé-Perthes disease (LCPD) is a key contributor to poor long-term outcomes such as hip pain, femoroacetabular impingement, and early-onset osteoarthritis. Plain radiographs, commonly used for research and in the clinic, cannot accurately represent the full extent of LCPD deformity. The purpose of this study was to develop and evaluate a methodological framework for three-dimensional (3D) statistical shape modeling (SSM) of the proximal femur in LCPD.

Acetabular labrum and cartilage contact mechanics during pivoting and walking tasks in individuals with cam femoroacetabular impingement syndrome.

Femoroacetabular impingement syndrome (FAIS) is a motion-related pathology of the hip characterized by pain, morphological abnormalities of the proximal femur, and an elevated risk of joint deterioration and hip osteoarthritis. Activities that require deep flexion are understood to induce impingement in cam FAIS patients, however, less demanding activities such as walking and pivoting may induce pain as well as alterations in kinematics and joint stability. Still, the paucity of quantitative descriptions of cam FAIS has hindered understanding underlying hip joint mechanics during such activities.

Effect of Patient Positioning on Measurement of the Anterior Center-Edge Angle on False-Profile Radiographs and Its 3-Dimensional Mapping to the Acetabular Rim.

Background: The anterior center-edge angle (ACEA) is used to quantify anterior coverage of the femoral head by the acetabulum. However, its measurement has not been evaluated in a manner consistent with routine use, and the precise 3-dimensional (3D) anatomic location where it measures coverage is not known.

Purpose: To determine the effect of patient positioning on ACEA measurement reliability, magnitude, and 3D location.

Prediction of femoral head coverage from articulated statistical shape models of patients with developmental dysplasia of the hip.

Developmental dysplasia of the hip (DDH) is commonly described as reduced femoral head coverage due to anterolateral acetabular deficiency. Although reduced coverage is the defining trait of DDH, more subtle and localized anatomic features of the joint are also thought to contribute to symptom development and degeneration. These features are challenging to identify using conventional approaches.

Combined Estimation of Shape and Pose for Statistical Analysis of Articulating Joints.

Quantifying shape variations in articulated joints is of utmost interest to understand the underlying joint biomechanics and associated clinical symptoms. For joint comparisons and analysis, the relative positions of the bones can confound subsequent analysis. Clinicians design specific image acquisition protocols to neutralize the individual pose variations.

Shoulder mechanical impingement risk associated with manual wheelchair tasks in individuals with spinal cord injury.

Background: Most individuals with spinal cord injury who use manual wheelchairs experience shoulder pain related to wheelchair use, potentially in part from mechanical impingement of soft tissue structures within the subacromial space. There is evidence suggesting that scapula and humerus motion during certain wheelchair tasks occurs in directions that may reduce the subacromial space, but it hasn't been thoroughly characterized in this context.

Methods: Shoulder motion was imaged and quantified during scapular plane elevation with/without handheld load, propulsion with/without added resistance, sideways lean, and weight-relief raise in ten manual wheelchair users with spinal cord injury using biplane fluoroscopy and computed tomography.

An interpolation technique to enable accurate three-dimensional joint kinematic analyses using asynchronous biplane fluoroscopy.

Biplane 2D-3D model-based registration and radiostereometric analysis (RSA) approaches have been commonly used for measuring three-dimensional, in vivo joint kinematics. However, in clinical biplane systems, the x-ray images are acquired asynchronously, which introduces registration errors. The present study introduces an interpolation technique to reduce image registration error by generating synchronous fluoroscopy image estimates.

Transforming Care to Evidence-Based Practice With Scripted Messages: An Improvement Project for Pain Management in Outpatient Surgical Patients.

Background: Outpatient surgeries are common and most patients experience pain postoperatively requiring nursing attention to pain management. Scripting, recommended for consistent, targeted communication to improve patient satisfaction, has limited evidence to support its use.

Aims: To explore the effect of scripted messages on self-reported pain control and patient satisfaction with care in outpatient surgical patients.

Characterizing fluoroscopy based kinematic accuracy as a function of pulse width and velocity.

Fluoroscopic imaging has become increasingly popular to investigate total knee arthroplasty kinematics non-invasively - 3D implant models are aligned with 2D image projections, and optimized via an edge-contour alignment technique. Previous studies have quantified the accuracy of this approach, however they do not always adequately address the impact of image collection parameters. A particularly sensitive parameter is the pulse width, or exposure time per frame.

Three dimensionality of gleno-humeral deformities in obstetrical brachial plexus palsy.

The primary objective of this study was to test the hypothesis that gleno-humeral deformity in children and adolescent with obstetrical brachial plexus palsy is three-dimensional (3D). The study also compared the metrological properties of typical two-dimensional gleno-humeral measures to the newly developed 3D measures. Thirteen individuals (age = 11.

"I felt violated": women's experience of childbirth-associated anger.

Purpose: To investigate the lived experience of childbirth-associated anger. DESIGN Descriptive phenomenology.

Methods: Open-ended interviews were conducted with 10 women who had experienced the phenomenon of interest and volunteered to participate.

Anger and cancer: an analysis of the linkages.

The purposes of this article are to review literature on anger's link to cancer, to analyze the state of the science in this area, and to propose some directions for future research. Extremely low anger scores have been noted in numerous studies of patients with cancer. Such low scores suggest suppression, repression, or restraint of anger.

"It wasn't working. " Women's experiences with short-term breastfeeding.

Purpose: To investigate the lived experiences of women who initiate breastfeeding but stop within the first 2 weeks after birth.

Design: Phenomenology.

Methods: Interviews were recorded on audio tape, transcribed verbatim, and analyzed for themes by an interdisciplinary group of researchers.

Potentiation of pyridostigmine bromide toxicity in mice by selected adrenergic agents and caffeine.

Pyridostigmine bromide (PB) is a reversible cholinesterase inhibitor used routinely in the treatment of myasthenia gravis and recently by the US Army as a prophylactic agent against potential nerve gas attack in the Persian Gulf War. Pyridostigmine has been implicated as one of several possible causative factors associated with Persian Gulf illnesses. To investigate toxic interactions between PB and other drugs, male ICR mice received contralateral ip injections of either a selected adrenergic drug or caffeine, followed 15 min later by PB.

Factors associated with perceived competency levels of graduating seniors in a baccalaureate nursing program.

Factors hypothesized to affect perceived competency levels of graduating seniors were examined in three classes from a BSN program in a large southeastern university (N = 204). Although externship participation was unrelated to perceived competency, employment in a health care setting during the nursing program was positively related. Trait anxiety and social support were also significantly related to competency.

Antidotal efficacy of alpha-ketoglutaric acid and sodium thiosulfate in cyanide poisoning.

Alpha-ketoglutaric acid and sodium thiosulfate antagonize the toxic effects of cyanide. The present study was performed to test whether a synergistic effect may occur. The alpha-ketoglutaric acid/sodium thiosulfate solutions were injected intraperitoneally into mice prior to exposure to hydrogen cyanide (HCN) in a dynamic inhalation chamber or preceding an intraperitoneal injection of sodium cyanide (NaCN).

Measures of salivary secretory immunoglobulin A and state anxiety after a nursing back rub.

This study examined the effects of a 10-minute nursing back rub on salivary secretory immunoglobulin A (s-IgA) and state anxiety in well older adult subjects. A control group (n = 14) received no intervention, and an experimental group (n = 18) received a slow stroke effleurage back rub. All subjects initially completed the state portion of the Spielberger State/Trait Anxiety Inventory (STAI) and provided a timed, nonstimulated saliva sample.

Pain in labor: a conceptual model for intervention.

A conceptual model, based on the Grantly Dick-Read fear-tension-pain cycle concept, for intervening in pain in labor is presented. The model can serve as a guide to help break the cycle and to establish a new cycle which operates on positive, rather than negative, forces, i.e.

A technique for early Pantopaque myelography in cervical spinal cord injuries.

A simple, reliable method for early Pantopaque myelography in patients with traumatic injuries of the cervical spinal cord is presented. Myelography is accomplished with the patient prone on a Stryker frame after vertebral reduction and alignment have been achieved with axial skeletal traction. A lateral C1-2 spinal puncture and a portable ""C-arm'' image intensifier with televised fluoroscopy are used.

Comparison of blood flow and patency in arterial and vein grafts to basilar artery.

Blood flow and patency rates obtained by lingual to basilar artery anastomosis were compared with those obtained by saphenous vein bypass graft from the carotid to the basilar artey in two groups of ten dogs. Flow was measured by an electromagnetic technique while blood pressure and blood gases were monitored. Graft patency also was determined by angiography and histological examination.

The neurological deficit associated with sudden occlusion of abdominal aorta due to blunt trauma.

A review of the literature revealed five well-documented cases of abdominal aortic injury due to blunt, nonpenetrating trauma. An additional case report is offered. In all cases the level of aortic injury was at or distal to the origin of the inferior mesenteric artery.