Hydrogel-Based Matrix-Associated Autologous Chondrocyte Implantation Shows Greater Substantial Clinical Benefit at 24 Months Follow-Up than Microfracture: A Propensity Score Matched-Pair Analysis.

Objective: To compare substantial clinical benefit (SCB) of a hydrogel-based, matrix-associated autologous chondrocyte implantation (M-ACI) method versus microfracture (MFx) in the treatment of knee cartilage defects.

Design: Propensity score matched-pair analysis, using the MFx control group of a phase III study as comparator for M-ACI treatment in a single-arm phase III study, resulting in 144 patients in the matched-pair set.

Results: Groups were comparable regarding baseline Knee Injury and Osteoarthritis Outcome Score (KOOS), sex, age, body mass index, symptom duration, smoking status, and previous knee surgeries.

Comparison of Hydrogel-Based Autologous Chondrocyte Implantation Versus Microfracture: A Propensity Score Matched-Pair Analysis.

Background: Few studies exist for large defects comparing matrix-associated autologous chondrocyte implantation (M-ACI) with other cartilage repair methods due to the limited availability of suitable comparator treatments.

Purpose: To compare the clinical efficacy of a novel hydrogel-based M-ACI method (NOVOCART Inject plus) versus microfracture (MFx) in patients with knee cartilage defects.

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

Delayed Cervical Carotid Revascularization After Missile Injury: A Technical Case Report.

Background And Importance: Penetrating missile injury to the carotid arteries may lead to catastrophic hemorrhagic and/or ischemic complications. The incidence of carotid injury in patients with penetrating cervical trauma (PCT) is 11% to 13%, with most cases involving the common carotid artery (73%), followed by the internal carotid artery (ICA) (22%) and external carotid artery (5%). Approximately 50% of PCT cases result in mortality, with specific injury to the carotid arteries carrying nearly a 100% mortality rate.

Effects of Titanium Implant Surface Topology on Bone Cell Attachment and Proliferation in vitro.

Purpose: Titanium is commonly used for implants because of its corrosion resistance and osseointegration capability. It is well known that surface topology affects the response of bone tissue towards implants. In vivo studies have shown that in weeks or months, bone tissue bonds more efficiently to titanium implants with rough surfaces compared to smooth surfaces.

Treatment of Large Cartilage Defects in the Knee by Hydrogel-Based Autologous Chondrocyte Implantation: Two-Year Results of a Prospective, Multicenter, Single-Arm Phase III Trial.

Objective: To evaluate the clinical outcome of a hydrogel-based autologous chondrocyte implantation (ACI) for large articular cartilage defects in the knee joint.

Design: Prospective, multicenter, single-arm, phase III clinical trial. ACI was performed in 100 patients with focal full-thickness cartilage defects ranging from 4 to 12 cm in size.

Chronic epidural hematoma presenting with diplopia.

Background: Epidural hematomas are common intracranial pathologies secondary to traumatic brain injuries and are associated with overlying skull fractures up to 85% of the time. Although many require immediate surgical evacuation, some are observed for stability and followed up conservatively with serial imaging or enlarge slowly overtime, similar to chronic subdural hematomas. Those in the latter category may present with vague symptoms such as diplopia or headache and are often found on routine outpatient evaluation.

Design for now, but with the future in mind: a "cognitive flexibility theory" perspective on online learning through the lens of MOOCs.

This paper is in response to the manuscript entitled "MOOCocracy: the learning culture of massive open online courses" (Loizzo and Ertmer in Educ Tech Res Dev 64:1013-1032, 2016, 10.1007/s11423-016-9444-7) from the perspectives of cognitive flexibility theory (CFT), in the context of pandemic-induced emergency remote teaching. Our response focuses on one of the questions raised in the call for this special issue on the latter topic: what are the implications of current, urgent work being done in digital learning for the future of online learning? We argue that much of what is important for a better future of online learning can also be done well now.

How Consultant Pharmacists Gained Access to Maryland's Health Information Exchange.

The Chesapeake Regional Information System for our Patients (CRISP) is a health information exchange in Maryland that is designed to improve communication among members of the health care team including physicians, nurses, and other health professionals. Senior care pharmacists gained access to CRISP through successful collaborative efforts at both the state and national levels. This involved efforts to address medication-related problems that continue to be a concern during transitions of care, especially for older, vulnerable adults.

Destabilization of the IFT-B cilia core complex due to mutations in IFT81 causes a Spectrum of Short-Rib Polydactyly Syndrome.

Short-rib polydactyly syndromes (SRPS) and Asphyxiating thoracic dystrophy (ATD) or Jeune Syndrome are recessively inherited skeletal ciliopathies characterized by profound skeletal abnormalities and are frequently associated with polydactyly and multiorgan system involvement. SRPS are produced by mutations in genes that participate in the formation and function of primary cilia and usually result from disruption of retrograde intraflagellar (IFT) transport of the cilium. Herein we describe a new spectrum of SRPS caused by mutations in the gene IFT81, a key component of the IFT-B complex essential for anterograde transport.

Perioperative surgical complications of transforaminal lumbar interbody fusion: a single-center experience.

Object: Since its original description in 1982, transforaminal lumbar interbody fusion (TLIF) has grown in popularity as a means for achieving circumferential fusion. The authors sought to define the perioperative complication rates of the TLIF procedure at a large academic medical center.

Methods: For all eligible patients from a consecutive series of 531 TLIF procedures, the institution's complication database and the medical record were reviewed to identify complications.

Health information technology: A new world for pharmacy.

Objectives: To provide a health information technology (HIT) primer for pharmacists, including the current state of HIT, future expectations, basic information and vocabulary, HIT vendors, communication standards, barriers to implementation, and strategies for pharmacists to ensure success.

Data Sources: By the authors.

Summary: HIT is expected to provide integrated electronic health care with interactive exchange among patients, providers, government agencies, and insurers, resulting in an increase in the overall quality, safety, and efficiency of health care delivery with fewer medical errors, increased administrative efficiency, decreased health care costs, and expanded patient access to affordable health care.

Intraoperative computed tomography image-guided navigation for posterior thoracolumbar spinal instrumentation in spinal deformity surgery.

Object: Placement of thoracolumbar pedicle screws in spinal deformity surgery has a reported inaccuracy rate as high as 30%. At present, image-guided navigation systems designed to improve instrumentation accuracy typically use intraoperative fluoroscopy or preoperative CT scans. The authors report the prospective evaluation of the accuracy of posterior thoracolumbar spinal instrumentation using a new intraoperative CT operative suite with an integrated image guidance system.

Fractures of the clivus: a contemporary series in the computed tomography era.

Objective: We report the morbidity and mortality associated with fractures of the clivus and discuss management approaches specific to this unique diagnostic entity.

Methods: We performed a boolean search of our electronic medical record database to identify patients with fractures of the clivus that were diagnosed using computed tomography of the head. A retrospective imaging and chart analysis was completed to further characterize the fractures and to analyze outcomes.

Occipital condyle fractures: clinical decision rule and surgical management.

Object: Occipital condyle fractures (OCFs) are rare injuries and their treatment remains controversial. Several classification systems have been proposed, first by Anderson and Montesano and more recently by Tuli and colleagues and Hanson and associates, who sought to stratify these fractures in a manner that would guide treatment that has typically ranged from semirigid collar immobilization to halo fixation or occipitocervical fusion. It has been the authors' impression, based on experience with OCFs at their institution, that classification is cumbersome and contributes little to the clinical decision-making process, while the identification of craniocervical misalignment and neural element compromise is paramount, and sufficient, for the planning of treatment.

Coagulation factor VIIa (recombinant) in nonhemophilic patients requiring neurosurgery.

Purpose: The clinical outcomes, safety, and use of resources associated with the administration of factor VIIa (recombinant) to nonhemophilic patients requiring neurosurgery were evaluated.

Methods: An interdisciplinary group created guidelines for the pharmacy and therapeutics committee for the unlabeled use of factor VIIa (recombinant). Nonhemophilic patients were eligible to receive the agent without approval from the hematology-coagulation service if they had an intracranial hemorrhage (ICH), were undergoing an emergency neurosurgical procedure, and had coagulopathy.

Detailed characterization of, and clinical correlations in, 10 patients with distal deletions of chromosome 9p.

Purpose: Deletions of distal 9p are associated with trigonocephaly, mental retardation, dysmorphic facial features, cardiac anomalies, and abnormal genitalia. Previous studies identified a proposed critical region for the consensus phenotype in band 9p23, between 11.8 Mb and 16 Mb from the 9p telomere.

MRI is unnecessary to clear the cervical spine in obtunded/comatose trauma patients: the four-year experience of a level I trauma center.

Background: Cervical (C)-spine clearance protocols exist both to identify traumatic injury and to expedite rigid collar removal. Computed tomography (CT) of the C-spine in trauma patients facilitates the removal of immobilization collars in patients who are neurologically intact, and magnetic resonance imaging (MRI) has become an indispensable adjunct for evaluating trauma patients with neurologic deficits. Yet, the management of patients with impaired mental status who lack neurologic deficits attributable to the spinal cord remains controversial.

Electronic prescribing in long-term care: an overview of five pilot projects.

In January 2006 the federal Agency for Healthcare Research and Quality (AHRQ) awarded five pilot grants to study the use of electronic prescribing (ePrescribing) standards-one in a long-term care setting and four in ambulatory care settings. Although forms of ePrescribing have been used in the long-term care environment for many years, this was the first pilot to test the National Council of Prescription Drug Programs (NCPDP) SCRIPT ePrescribing standards. This article describes a summary of the results of that study.

Corridor surgery: the current paradigm for skull base surgery.

Introduction: Clival chordomas are rare tumors, especially in the pediatric population. In this report, we present the case of a 3-year-old boy who was found to have a large posterior pharyngeal, clival, and posterior fossa tumor detected on a CT scan after a closed head injury.

Discussion: Further questioning revealed a history of ataxia and dysphagia.

Electronic-prescribing: will long-term care be ready?

Passage of the Medicare Modernization Act has thrust electronic prescribing (e-prescribing) into the forefront of health care technology. Health care providers, payers, and the government are hoping that e-prescribing will improve patient safety, quality of care, and efficiency. However, for long-term care facilities, pharmacies, and prescribers to embrace these changes and incorporate e-prescribing into their every day practices, communication standards will have to be created to facilitate transfer of prescription/order information among all three parties.

The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report.

The transoral approach to the odontoid process is considered the "gold standard" for resection of extradural lesions at this location. A completely transnasal endoscopic approach is feasible based on anatomic studies and our experience with the expanded endonasal approach for neoplasms of the cranial base. An illustrative case is presented to demonstrate the technical details of a fully transnasal completely endoscopic approach for the resection of the odontoid process.

Role of N-linked polymannose oligosaccharides in targeting glycoproteins for endoplasmic reticulum-associated degradation.

Misfolded or incompletely assembled multisubunit glycoproteins undergo endoplasmic reticulum-associated degradation (ERAD) regulated in large measure by their N-linked polymannose oligosaccharides. In this quality control system lectin interaction with Glc(3)Man(9)GlcNAc(2) glycans after trimming with endoplasmic reticulum (ER) alpha-glucosidases and alpha-mannosidases sorts out persistently unfolded glycoproteins for N-deglycosylation and proteolytic degradation. Monoglucosylated (Glc(1)Man(9)GlcNAc(2)) glycoproteins take part in the calnexin/calreticulin glucosylation-deglucosylation cycle, while the Man(8)GlcNAc(2) isomer B product of ER mannosidase I interacts with EDEM.