The assignment of locational attributes to a study subject in epidemiologic analyses is commonly referred to as georeferencing. When georeferencing study subjects to a point location using their residential street address, most researchers rely on the street centerline data model. This study assessed the potential locational bias introduced using street centerline data. It also evaluated georeferencing effects on a location-dependent, exposure assessment process. For comparison purposes, subjects were georeferenced to the center of their residential parcel of land using digitized parcel maps. A total of 10,026 study subjects residing in Jefferson County, Alabama were georeferenced using both street centerline and residential parcel methods. The mean nondirectional, linear distance between points georeferenced using both methods was 246 ft with a range of 11 to 13,260 ft. Correlation coefficients comparing differences in exposure estimates were generated for all 10,026 subjects. Coefficients increased as the geographic areas of analysis around study subjects increased, indicating the influence of nondifferential exposure misclassification.

Bias↗

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Correlation of coagulopathy and pulmonary insufficiency with blood transfusion in spinal fusions.

In a review of 210 spinal fusions, the platelet count and the arterial-alveolar oxygen tension ratio both decreased as the blood transfused increased, but were not correlated with positive fluid balance. In procedures that might require more than 70-80 ml/kg of blood, such as myelodysplastic, paralytic, and congenital spinal surgery, the coagulation system and arterial gases should be monitored frequently intraoperatively and postoperatively.

Adult↗

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Control of postlaminectomy scar formation: an experimental and clinical study.

Scar formation after laminectomy was evaluated in dogs treated with hemostatic agents, antiinflammatory drugs, or mechanical barriers. Microfibrillar collagen was found to be superior to gelatin foam. The antiinflammatory drugs delayed healing and frequently resulted in abscess formation, and eventually scar filled the defect. The fat grafts formed a viable mechanical barrier. Gelatin foam sponge was compared with microfibrillar collagen for hemostasis with free fat grafts in a clinical series of 50 patients. The latter technique was clearly superior.

Adipose Tissue↗

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Bilateral partial aplasia of the atlas definitive treatment by bilateral anterior C1-C2 buttress fusion.

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Cervical Atlas↗

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Risk of iatrogenic septic arthritis in the presence of bacteremia: a rabbit study.

This study of rabbits determined the risk of producing iatrogenic septic arthritis by arthrocentesis in the presence of bacteremia. In bacteremic animals, three of 20 knees became infected following joint aspiration, and six of 20 knees became infected on injection of 0.2 ml of bacteremic blood. Spontaneous joint sepsis did not develop, even in bacteremic animals. Prophylactic cefazolin before joint aspiration prevented the development of iatrogenic septic arthritis but did not prevent the recovery of bacteria from an infected joint. Therefore, there is an increased risk of development of joint sepsis in this animal model following a traumatic aspiration in the presence of bacteremia. This risk can be minimized by intravenous antibiotics without decreasing the likelihood of recovery of an organism if the joint is septic.

Animals↗

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Prophylaxis and management of hamstring muscle injuries in intercollegiate football players.

Hamstring muscle strains were responsible for the loss of playing time of a significant number of football players at the University of Nebraska in the early 1970s. After the acquisition of a Cybex II isokinetic dynamometer, the number of injuries was noted to decrease. A retrospective study was performed over the period 1973 to 1982. Players in Group I, from 1973 to 1977, underwent a training program consisting of a supervised winter running program and self-designed year-long stretching, running, and weight lifting. Hamstring injuries were managed with rest, ice, and elevation initially and, by the third day, mild running was instituted. On the average, by the 14th day the athlete had demonstrated adequate speed and agility and was allowed to return to action. Group II consisted of players from the 1978 to 1982 period. These players received supervised winter running programs and staff-designed year-long stretching, running, and weight lifting programs. In addition, all athletes had baseline testing of hamstrings and quadriceps. Deficits were corrected to a desired ratio of 0.60. Injured players in Group II were treated with rest, ice, and elevation initially. High speed isokinetic workouts were begun on the third day with testing on the fifth day. They were allowed to begin jogging when the peak torque of hamstrings equaled 70% of baseline. Players returned to action when peak-torque reached a level of 95% of the baseline score or a hamstrings:quadriceps ratio of 0.55 or greater. Average time out of action was 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

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Assessment of fracture healing by spectral analysis.

The 'in vivo' impulse response of long bones was investigated with the object of assessing the reliability of data taken under various conditions. The ultimate goal of the research is to develop a non-invasive method of monitoring the healing of long bones. A spectrum analyser was developed specifically for this investigation and is presented here.

Biomedical Engineering↗

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Ganglia of the nerve. Presentation of two unusual cases, a review of the literature, and a discussion of pathogenesis.

Two cases of intraneural ganglia are reported: the first reported involvement of the sciatic nerve and the first reported involvement of the tibial nerve in the tarsal tunnel. Both were successfully treated by excision with sparing the neural elements leading to neurological recovery. A review of the literature fails to reveal any consensus that lesions arise from normal synovial cavities. Incision, evacuation, and complete excision under magnification sparing neural elements gives satisfactory results. Excision of the nerve is not indicated. Pathologic examination suggests that the lesion arises by multicentric metaplasia of connective tissue elements of the nerve rather than by invasion.

Adult↗

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Electrical stimulation of experimental nonunions.

Hypertrophic and oligotrophic nonunions were prepared by resection of a portion of the proximal ulna in dogs. In the hypertrophic nonunions, 20 muamps of direct current for eight weeks produced an increase in bone formation compared to the opposite control limb by radiography, photometry, point counting of new bone, and growth rate by sequential fluorochrome labeling and the dynamic uptake of 99mTc-labeled methylene disphosphonate. Oligotrophic nonunions were treated by plating and aspiration grafting in addition to direct-current stimulation. Ony the point counting of new bone showed a significant increase in bone formation with stimulation. Sequential fluorochrome labeling demonstrated that the new bone was laid down on existing bone and not primarily adjacent to the cathode within the fibrous nonunion. This finding supports the cell-mediated rather than physicochemical effect of electrostimulation.

Animals↗