Three-Dimensional Computed Tomography Reconstructions May Detect Pincer Lesions With Higher Sensitivity Than Radiographs in Patients With Femoroacetabular Impingement Syndrome.

Purpose: To assess the diagnostic capability of radiographs (XRs) to detect pincer lesions compared with 3-dimensional (3D) computed tomography scans in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Methods: We performed a retrospective review of all patients who underwent hip arthroscopy for FAIS between September 1, 2020, and October 2, 2022. Preoperative imaging was reviewed.

Preoperative corticosteroid injections are associated with a higher periprosthetic infection rate following primary total shoulder arthroplasty: a systematic review and meta-analysis.

Background: Corticosteroid injections (CSIs) are commonly used for the treatment of shoulder pain in patients with osteoarthritis and rotator cuff arthropathy. These injections may increase the risk of infection following eventual shoulder arthroplasty. The purpose of this study was to perform a systematic review and meta-analysis of existing data to explore the relationship between preoperative CSI's and postoperative periprosthetic joint infection (PJI) following shoulder arthroplasty.

Operating room disinfection: operator-driven ultraviolet 'C' vs. chemical treatment.

Background: In operating room (OR) surfaces, Nosocomial pathogens can persist on inanimate surfaces for long intervals and are highly resistant to traditional surface cleaning.

Aim: This study compares traditional chemical operating room terminal disinfection to a unique operator-driven device that emits germicidal UV light at short distance onto vertical and horizontal surfaces.

Methods: A randomized crossover analogous protocol assigned 40 end-of-day operating rooms into either group A (chemical then UVC treatments) or group B (UVC then chemical treatments).

Conversion Total Hip Arthroplasty in the Era of Bundled Care Payments: Impacts on Costs of Care.

Background: Conversion hip arthroplasty is defined as a patient who has had prior open or arthroscopic hip surgery with or without retained hardware that is removed and replaced with arthroplasty components. Currently, it is classified under the same diagnosis-related group as primary total hip arthroplasty (THA); however, it frequently requires a higher cost of care.

Methods: A retrospective study of 228 conversion THA procedures in an orthopaedic specialty hospital was performed.

Web-based comparison of historical vs contemporary methods of fetal heart rate interpretation.

Background: Contemporary interpretation of fetal heart rate patterns is based largely on the tenets of Drs Quilligan and Hon. This method differs from an older method that was championed by Dr Caldeyro-Barcia in recording speed and classification of decelerations. The latter uses a paper speed of 1 cm/min and classifies decelerations referent to uterine contractions as type I or II dips, compared with conventional classification as early, late, or variable with paper speed of 3 cm/min.

Fellowship training: the ever-changing subspecialty of maternal-fetal medicine.

Objective: To estimate the current scope of practice and evaluate the experience in training of maternal-fetal medicine specialists in the United States.

Methods: We administered an Internet-based, 16-question survey of 1,764 members of the Society for Maternal-Fetal Medicine, inquiring about aspects of fellowship training and scope of practice after completion of training.

Results: Approximately 36% (n=643) of surveys were returned.

Distribution of oxygenated blood flow at three different routes of extracorporeal membrane oxygenation in exteriorized fetal lambs.

Objective: The purpose of this study was to determine which extracorporeal membrane oxygenation (ECMO) route best approximates the normal physiologic pattern of oxygenated blood distribution in fetal lambs submerged in warm saline solution.

Study Design: Six fetal lambs ranging from 113 to 129 days of gestation were delivered by cesarean section and oxygenated with ECMO in a warm saline solution bath. We compared the distribution of oxygenated blood flow during intact placental circulation with 3 routes of ECMO, from the right atrium to the carotid artery (V-A), from the right atrium to umbilical vein (V-UV), and from the right atrium with umbilical artery to umbilical vein [(V + UA)-UV], in exteriorized fetal lambs.

Obstetric emergencies precipitated by malignant brain tumors.

Objective: Our goal was to present a case series of pregnancy-associated malignant brain tumors.

Study Design: A review was conducted from 1978-1998 at 5 hospitals.

Results: Ten women were diagnosed with a malignant brain tumor during pregnancy (n = 8) or post partum (n = 2).

Histologic and biochemical study of the brain, heart, kidney, and liver in asphyxia caused by occlusion of the umbilical cord in near-term fetal lambs.

Objective: We sought to determine the relationship between the degree of histologic changes in the brain, heart, kidney, and liver in fetal lambs after severe asphyxia and to analyze the role of oxidative stress in the pathogenesis of fetal multiple organ failure.

Study Design: Eight chronically instrumented near-term fetal lambs were asphyxiated by partial umbilical cord occlusion for approximately 60 minutes until the fetal arterial pH reached <6.9 and the base excess reached <-20 mEq/L.

Oxidative stress, brain white matter damage and intrauterine asphyxia in fetal lambs.

In order to examine the role of oxidative stress in asphyxia-induced perinatal brain damage, near-term fetal lambs were subjected to umbilical cord occlusion for approximately 60min until fetal arterial pH diminished to less than 6.9 and base excess to less than -20 meq/l. The levels of superoxide, hydrogen peroxide, glutathione (GSH) and thiobarbiturate-reactive substances (TBARS) within brain grey and white matter were determined at 72h to correlate with morphological changes.

Two sinusoidal heart rate patterns in fetal lambs undergoing extracorporeal membrane oxygenation.

Objectives: The study analyzed the phase relationship between fetal heart rate and arterial blood pressure fluctuation during sinusoidal heart rate patterns in fetal lambs.

Study Design: Thirty-two fetal lambs were placed on extracorporeal membrane oxygenation after cesarean delivery at ages ranging between 113 and 133 days' gestation. Sinusoidal heart rate patterns persisting for >10 minutes were analyzed.

Fetal heart rate patterns in postasphyxiated fetal lambs with brain damage.

Objective: We previously showed that in asphyxiated fetal lambs the duration of hypotension correlated well with the severity of histologic damage to the brain, whereas the duration of bradycardia did not. This study compares fetal heart rate patterns with the degree of histologic damage to the brain.

Study Design: Twelve chronically instrumented near-term fetal lambs were subjected to asphyxia by umbilical cord occlusion until fetal arterial pH was <6.

Brain lipid peroxidation and antioxidant levels in fetal lambs 72 hours after asphyxia by partial umbilical cord occlusion.

Objectives: The purpose of this study was to explain the role of oxidative stress in the pathogenesis of brain damage caused by intrauterine fetal asphyxia.

Study Design: Six chronically instrumented near-term fetal lambs were subjected to asphyxia by partial umbilical cord occlusion for approximately 60 minutes until fetal arterial pH diminished to less than 6.9 and base excess to less than -20 mEq.

Physiologic and histologic changes in near-term fetal lambs exposed to asphyxia by partial umbilical cord occlusion.

Objectives: Our purpose was to characterize the histologic changes in the asphyxiated fetal lamb brain and to correlate the severity of these changes with fetal physiologic parameters during and after asphyxia.

Study Design: Seventeen near-term fetuses were used for analysis: control group without manipulation (n = 4, 132 +/- 1.1 days of gestation at autopsy, mean +/- SEM), sham-asphyxia control group (n = 3, 132 +/- 1.

Cardiac oxygenation by extracorporeal membrane oxygenation in exteriorized fetal lambs.

Objective: The purpose of this study was to determine the degree of cardiac oxygenation produced by different routes of extracorporeal membrane oxygenation in fetal lambs submerged in warm saline solution.

Study Design: Seven fetal lambs ranging in age from 113 to 133 days of gestation were delivered by cesarean section and oxygenated with extracorporeal membrane oxygenation. To maintain the patency of the ductus arteriosus, prostaglandin E1 was continuously infused intravenously to the fetus.

Oxygenation in fetal lambs supported by extrauterine right atrium to artery extracorporeal membrane oxygenation.

Objective: Our purpose was to determine the adequacy of oxygenation, particularly cranial and cardiac oxygenation, in exteriorized fetal lambs on right atrium to artery extracorporeal membrane oxygenation.

Study Design: Thirteen fetal lambs were placed on right atrium to artery extracorporeal membrane oxygenation between the gestational ages of 113 and 133 days. Various PO2 and oxygen saturation (SO2) values were obtained by varying the oxygen concentrations at the oxygenator membrane.

Obstetrics and gynecology.

Treating HIV-infected pregnant patients and the newborn with zidovudine reduced the percentage of HIV-infected infants. Uterine myomas are being treated effectively with gonadotropin-releasing hormone analogues. Nonoperative therapy is being used in the patient with an ectopic pregnancy.