Diet or diet plus physical activity versus usual care in patients with newly diagnosed type 2 diabetes: the Early ACTID randomised controlled trial.

Background: Lifestyle changes soon after diagnosis might improve outcomes in patients with type 2 diabetes mellitus, but no large trials have compared interventions. We investigated the effects of diet and physical activity on blood pressure and glucose concentrations.

Methods: We did a randomised, controlled trial in southwest England in adults aged 30-80 years in whom type 2 diabetes had been diagnosed 5-8 months previously.

Pulmonary embolism prophylaxis in more than 30,000 total knee arthroplasty patients: is there a best choice?

Prophylaxis for pulmonary embolism (PE) prevention in total knee arthroplasty remains controversial. A joint registry evaluated venous thromboembolism prophylaxis and anesthesia impact on the incidence of PE, fatal PE, and death. Patients received mechanical prophylaxis alone or chemical with or without mechanical prophylaxis.

Leveraging electronic medical records for surveillance of surgical site infection in a total joint replacement population.

Objective: To evaluate whether a hybrid electronic screening algorithm using a total joint replacement (TJR) registry, electronic surgical site infection (SSI) screening, and electronic health record (EHR) review of SSI is sensitive and specific for SSI detection and reduces chart review volume for SSI surveillance.

Design: Validation study.

Setting: A large health maintenance organization (HMO) with 8.

Large acetabular defects can be managed with cementless revision components.

Background: Optimal techniques for acetabular revision in the setting of major pelvic osteolysis have not been established. Bilobed components, structural grafts, and reinforcement cages have demonstrated 10-24% midterm failure rates. While cementless hemispherical components have been utilized to treat large acetabular defects, most reports have not focused specifically on patients with extensive deficiencies.

Cost-effectiveness of anterior cruciate ligament reconstruction: a preliminary comparison of single-bundle and double-bundle techniques.

Background: There has been growing interest in anatomical reconstruction of the anterior cruciate ligament (ACL), including the use of double-bundle (DB) reconstruction techniques.

Hypothesis: The DB technique will not be cost-effective when compared with single-bundle (SB) reconstruction.

Study Design: Economic and decision analysis; Level of evidence, 1.

Effect of hyperconcavity of the lumbar vertebral endplates on the playing careers of professional american football linemen.

Background: Hyperconcavity of the lumbar spine has been found in a disproportionate percentage of college football lineman evaluated at the National Football League (NFL) Combine compared with age-matched controls.

Hypothesis: College football linemen with hyperconcavity of the lumbar spine are more likely to play in the NFL and to have a longer career in professional football.

Study Design: Cohort study; Level of evidence, 3.

Kaiser Permanente National Total Joint Replacement Registry: aligning operations with information technology.

Background: A Total Joint Replacement Registry was developed in a large community-based practice to track implant utilization, monitor revisions and complications, identify patients during recalls and advisories, and provide feedback on clinical practices.

Questions/purposes: We describe the development, implementation, and integration of this Total Joint Replacement Registry, highlighting critical steps in aligning information technology and operations.

Methods: The primary Total Joint Replacement Registry data source consists of standardized electronic health record forms developed by consensus.

Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome.

Background: Literature regarding the outcomes of revision rotator cuff repair is limited. The purposes of the present study were to report the tendon repair integrity and clinical outcomes for a cohort of patients following revision arthroscopic rotator cuff repair and to examine factors related to tendon healing and the influence of healing on clinical outcomes.

Methods: Twenty-one of twenty-nine consecutive revision arthroscopic rotator cuff repairs with a minimum of two years of postoperative follow-up were retrospectively reviewed.

Expression by Lawsonia intracellularis of type III secretion system components during infection.

Contact-dependent secretion systems, such as the type III secretion system (T3SS), have been shown to play significant roles in the pathogenicity of many gram-negative bacterial pathogens. Lawsonia intracellularis is a novel, obligate intracellular gram-negative bacterium, which has been identified as the etiological agent of proliferative enteropathies in numerous animal species. Analysis of the genome sequence of the L.

Outcomes of routine use of antibiotic-loaded cement in primary total knee arthroplasty.

The routine use of antibiotic-loaded bone cement (ALBC) in primary total knee arthroplasty (TKA) is controversial. Outcomes were recorded in patients who underwent primary TKA from May 2003 to March 2007 using a community-based total joint registry. Infection rates were compared in patients undergoing TKA with ALBC and regular cement.

The protozoan parasite Theileria annulata alters the differentiation state of the infected macrophage and suppresses musculoaponeurotic fibrosarcoma oncogene (MAF) transcription factors.

The tick-borne protozoan parasite Theileria annulata causes a debilitating disease of cattle called Tropical Theileriosis. The parasite predominantly invades bovine macrophages (m phi) and induces host cell transformation by a mechanism that has not been fully elucidated. Infection is associated with loss of characteristic m phi functions and phenotypic markers, indicative of host cell de-differentiation.

Does the use of fluoroscopy and isometry during anterior cruciate ligament reconstruction affect surgical decision making?

Objective: Poor results after anterior cruciate ligament (ACL) reconstruction are often due to inaccurate graft placement. Numerous strategies have been advocated to improve accuracy and consistency of tunnel positioning, including computer-assisted navigation. Less expensive alternatives, such as intraoperative fluoroscopy and isometry, have also been advocated for confirming guide pin placement before reaming the femoral tunnel.

Knee replacement: epidemiology, outcomes, and trends in Southern California: 17,080 replacements from 1995 through 2004.

Background And Purpose: There are limited population-based data on utilization, outcomes, and trends in total knee arthroplasty (TKA). The purpose of this study was to examine TKA utilization and short-term outcomes in a pre-paid health maintenance organization (HMO), and to determine whether rates and revision burden changed over time. We also studied whether this population is representative of the general population in California and in the United States.

The effect of ketorolac on anteroposterior knee laxity after anterior cruciate ligament reconstruction.

Unlabelled: This study investigated the effect of ketorolac on anteroposterior laxity after anterior cruciate ligament (ACL) reconstruction. A total of 168 ACL reconstructions performed between July 2003 and November 2004 were reviewed. The 6-week KT-1000 manual maximum differences between the ACL-reconstructed knee and nonoperative knee were compared for patients who received ketorolac and those who did not.

The kaiser permanente national total joint replacement registry.

The Kaiser Permanente National Total Joint Replacement Registry (TJRR) is a national level database designed as a postmarket surveillance system for elective total hip and knee replacement. As of March 31, 2007, the TJRR recorded 16,945 primary total hip arthroplasties (THA), 2144 revisions (11.2%); and 30,815 total knee arthroplasties (TKA), 1794 revisions (5.

Differences in the transcriptional responses induced by Theileria annulata infection in bovine monocytes derived from resistant and susceptible cattle breeds.

Tropical theileriosis is a cattle disease of global economic importance, caused by the tick-borne protozoan parasite Theileria annulata. Conventional control strategies are failing to contain the disease and an attractive alternative is the use of pre-existing genetic resistance or tolerance. However, tropical theileriosis tolerant cattle are less productive than some susceptible breeds.

Can the need for future surgery for acute traumatic anterior shoulder dislocation be predicted?

Background: Some surgeons believe that they can identify patients who are at high risk for shoulder redislocation and that these patients are best served by immediate surgical stabilization. This natural history study was performed to examine the validity of this concept and to determine whether it is possible to predict the need for future surgery at the time of the index injury and examination.

Methods: One hundred and thirty-one patients were followed for an average of four years after their first shoulder dislocation.

Influence of ethanol water-content on gatifloxacin recrystallisations.

Gatifloxacin is a flouroquinolone anti-bacterial agent. This study proved that even the presence of small amounts of water in the recrystallisation medium influenced the product obtained. Different crystal forms were produced from various binary mixtures of ethanol and water.

Development and validation of a bovine macrophage specific cDNA microarray.

Background: The response of macrophages to danger signals is an important early stage in the immune response. Our understanding of this complex event has been furthered by microarray analysis, which allows the simultaneous investigation of the expression of large numbers of genes. However, the microarray resources available to study these events in livestock animals are limited.

An analysis of the risk of hip dislocation with a contemporary total joint registry.

Dislocation rates after total hip arthroplasty in a community setting have not been well documented. We used a community based joint registry to evaluate hip dislocations that occurred within 1 year after total hip arthroplasty. We evaluated patient, implant, and technical factors associated with dislocation, including primary versus revision surgery, femoral head size (28 mm versus > or = 32 mm), operative time, surgeon volume, surgical approach, age, gender, diagnosis, American Society of Anesthesiologists (ASA) classification, and body mass index (BMI).

Impact of isolated clinical performance feedback on clinical productivity of an academic surgical faculty.

Background: There is increasing financial pressure to maximize clinical productivity for academic physicians. We examined whether clinical performance feedback alone could contribute to improving the clinical productivity of surgeons in an academic department of surgery.

Study Design: We implemented a clinical performance feedback program in January 2003.

Outcome instruments for patellofemoral arthroplasty.

Although there are numerous patient outcome instruments available, the most reliable and valid instruments for evaluating patient outcomes after patellofemoral arthroplasty have not been identified. In this article, we review and evaluate the psychometric properties and practical considerations of administering general health instruments (Medical Outcomes Study (MOS) Short Form-36 and Short Form-12), knee scales (Knee Society Clinical Rating System, Knee Outcome Survey, International Knee Documentation Committee form, Knee Injury and Osteoarthritis Outcome Score) and a disease specific scale (Western Ontario and McMaster Universities Osteoarthritis Index) for patellofemoral arthroplasty outcome assessment. Based on our review of the literature, we recommend the Short Form-36 and Knee Injury and Osteoarthritis Outcome Score for evaluation of patellofemoral arthroplasty outcomes and provide recommendations for implementation of these instruments in a clinical setting.