Marcaine applied to irritated nerve roots during extradural spinal surgery may attenuate sympathetically mediated and somatosensory (pain)-related hypertensive and tachycardic crises.

Anesthesia, Epidural↗

PubMedDate not supplied

The importance of statistics in documentation on hip prostheses.

The authors illustrate the possibilities and the limits of instruments that statistics currently make available in the analysis of a medical series involving hip prosthesis surgery. An analysis of the survival rate constitutes one of the most important tools with regard to data in the study of the effectiveness of implants, but its correct application is influenced by the assumption that so-called censored cases have no differences in survival in relation to those that remain under observation even in periods that follow. Simulation reveals the need to process series with a high number of cases, in order to obtain reliable estimates. Finally, only multivaried techniques allow for a correct evaluation of the incidence that single factors have in causing failure of implants.

Arthroplasty, Replacement, Hip↗

PubMedDate not supplied

Development and use of a clinical evaluation tool.

Literature in nursing education reveals that there are few standardized clinical evaluation methods or tools used by nurse educators. Faculty at a Midwest school developed a clinical evaluation tool and have used it for one year. A questionnaire, developed and pilot tested, measured student and faculty satisfaction with the tool. Both students and faculty agreed that the tool was an accurate measure of clinical performance. This tool is adaptable to the hospital setting, where it may be used to evaluate the performance of staff nurses. The tool was cited for excellence by NLN visitors during a recent accreditation visit.

Education, Nursing, Associate↗

PubMedDate not supplied

Intraoperative fractures of the femur in prosthetic hip reimplantations.

A total of 19 cases of intraoperative fractures of the femoral diaphysis occurring during prosthetic hip reimplantation are described. Incidence, predisposing factors, treatment, and influence on long-term results are discussed. The pre-existence of osteolysis or narrowing of the femoral cortex, often associated with primary cemented implantation with a metal-polyethylene combination, constitutes a factor that predisposes the patient to fracture. Fracture consolidation occurs in most cases with minimum treatment, at times without instrumentation; fracture, however, always means a delay in weight-bearing and a slowing down in recovery times. Long-term clinical evaluation shows functional results that are worse for reimplantations complicated by fracture as compared to those where there are no complications. The differences in the radiographic results instead do not reveal statistical significance.

Aged↗

PubMedDate not supplied

Metal-UHWMPE (Ultra High Molecular Weight Polyethylene) wear: experimental testing.

Testing conducted on a hip joint simulator verified the Charnley hypothesis that the diameter of the prosthetic head is proportional to wear. The study was conducted by pairing heads in Ortinox TM with acetabular cups in polyethylene at high molecular weight (UHMWPE). A comparison between the different sizes of the heads (26 and 30 mm in diameter) showed a different trend in the wear rate; in particular, the head with a smaller diameter behaves better tribologically than the head with a larger diameter.

Acetabulum↗