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Find video protocols related to scientific articles indexed in Pubmed.
Dynamics of syndesmophyte growth in AS as measured by quantitative CT: heterogeneity within and among vertebral disc spaces.
Rheumatology (Oxford)
PUBLISHED: 11-15-2014
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Syndesmophytes in AS typically grow slowly, but it is not known whether growth is uniform among syndesmophytes in the same intervertebral disc space (IDS) or among different IDSs in the same patient or if growth is heterogeneous. We examined the dynamics of syndesmophyte growth over 24 months using CT, with the main aim of determining if syndesmophytes in the same IDS or the same patient grow at similar rates.
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Supracondylar humeral fractures with isolated anterior interosseous nerve injuries: is urgent treatment necessary?
J Bone Joint Surg Am
PUBLISHED: 11-08-2014
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It is unclear if pediatric patients with a supracondylar humeral fracture and isolated anterior interossous nerve injury require urgent treatment.
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Radiographic Follow-up of DDH in Infants: Are X-rays Necessary After a Normalized Ultrasound?
J Pediatr Orthop
PUBLISHED: 10-22-2014
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Concerns about radiation exposure have created a controversy over long-term radiographic follow-up of developmental dysplasia of the hip (DDH) in infants who achieve normal clinical and ultrasonographic examinations. The purpose of this study was to assess the importance of continued radiographic monitoring by contrasting the incidence of residual radiographic dysplasia to the risks of radiation exposure.
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A Lower Extremity Musculoskeletal and Vascular Trauma Protocol in a Children's Hospital May Improve Treatment Response Times and Appropriate Microvascular Coverage.
J Orthop Trauma
PUBLISHED: 10-02-2014
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Pediatric lower extremity (LE) vascular injuries present many issues: microvascular surgeons are usually unavailable to stand-alone pediatric institutions and the rate of morbidity including limb loss can be high if revascularization is delayed beyond the 8 hour critical period. We assessed if time to revascularization was impacted by institution of a LE vascular trauma protocol (LEVP).
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The efficacy of rib-based distraction with VEPTR in the treatment of early-onset scoliosis in patients with arthrogryposis.
J Pediatr Orthop
PUBLISHED: 09-11-2014
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Although arthrogryposis multiplex congenital (AMC) is a rare condition, rapidly progressive scoliosis is common in children with AMC. Only a limited number of studies characterize the nature of these curves, and even fewer describe surgical outcomes. To determine efficacy or rib-based distraction in these patients, we reviewed the outcomes of the use of the Vertical Expandable Prosthetic Titanium Rib (VEPTR) device in what we believe is the first study to report this.
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Development and initial validation of the Classification of Early-Onset Scoliosis (C-EOS).
J Bone Joint Surg Am
PUBLISHED: 08-22-2014
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Early-onset scoliosis is a heterogeneous condition, with highly variable manifestations and natural history. No standardized classification system exists to describe and group patients, to guide optimal care, or to prognosticate outcomes within this population. A classification system for early-onset scoliosis is thus a necessary prerequisite to the timely evolution of care of these patients.
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Differences in otosclerotic and normal human stapedial osteoblast properties are normalized by alendronate in vitro.
Otolaryngol Head Neck Surg
PUBLISHED: 08-01-2014
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Identify and compare phenotypic properties of osteoblasts from patients with otosclerosis (OSO), normal bones (HOB), and normal stapes (NSO) to determine a possible cause for OSO hypermineralization and assess any effects of the bisphosphonate, alendronate.
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Pediatric Monteggia Fractures: A Multicenter Examination of Treatment Strategy and Early Clinical and Radiographic Results.
J Pediatr Orthop
PUBLISHED: 07-01-2014
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Monteggia fractures remain challenging pediatric injuries because of difficulties in diagnosis, propensity for instability, and complexity of late reconstruction. The objective of this investigation was to assess the efficacy of the following treatment strategy based upon ulnar fracture pattern: closed reduction (CR) for plastic/greenstick fractures, intramedullary (IM) pin fixation for transverse/short oblique fractures, and open reduction and internal fixation for long oblique/comminuted fractures.
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Both bone forearm fractures in children and adolescents, which fixation strategy is superior - plates or nails? A systematic review and meta-analysis of observational studies.
J Orthop Trauma
PUBLISHED: 07-01-2014
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To determine which method of operative fixation, plate and screw, or intramedullary nails (IMN) fixation is superior for pediatric both bone forearm fractures (BBFF).
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The genus Macroteleia Westwood in Middle Miocene amber from Peru (Hymenoptera, Platygastridae s.l., Scelioninae).
Zookeys
PUBLISHED: 06-17-2014
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A new species of the scelionine genus Macroteleia Westwood (Platygastridae s.l., Scelioninae) is described and figured from a female beautifully preserved in Middle Miocene amber from Peru. Macroteleia yaguarum Perrichot & Engel, sp. n., shows a unique combination of characters otherwise seen independently within its congeners. It is most similar to the modern M. surfacei Brues, but differs from it by the non-foveolate notauli, the contiguous punctures of the vertex, and the continuous propodeum. The new species is the first New World fossil of the genus, suggesting a Cretaceous origin for the group and a relatively old age of the South American, tropical African, and Australian faunas, and a younger age of the modern Holarctic faunas.
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Use of the S-hook for Pelvic Fixation in Rib Based Treatment of Early Onset Scoliosis: A Multicenter Study.
Spine
PUBLISHED: 06-13-2014
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Study Design. Retrospective reviewObjective. The purpose of this study was to evaluate how several pre-operative variables affect the outcome using the rib to pelvis s- hook constructs of a rib based distraction implant (VEPTR)Summary of Background Data. Rib to pelvis fixation with s- hooks is one of the options for distal anchoring of rib based distraction growing rod construct to control early onset spinal deformity. Since the initial report, the indications of pelvic fixation with s-hooks have been extended and modified.Methods. This is an Institutional Review Board approved retrospective study of patients who underwent rib based growing rod system surgery - rib to pelvis construct with Dunn McCarthy s-Hook. Data evaluation included: history, physical examination, pre-op and post-op radiographs, surgical variables and complications.Results. Sixty- five patients were evaluated, 38 were male and 27 were female. Mean age at initial procedure was 71 months. The mean follow-up was 46 months. There was a statistically significant improvement of the immediate post-operative Cobb angle and the last follow-up Cobb angle (p<0.0001). Fifty percent of the patients (32/65) had s- hooks related complications. The most common complication was sliding of the s- hook out of the iliac crest, followed by infection, neuropathic pain, distal migration more than 2 centimeters, fracture of the hook and bursitis. The complications were related to the pre-operative ambulatory status, the use of end to end rod connectors, surgical time and not positioning the hook over the central one-third of the iliac crest at the initial implantation.Conclusion. The use of the s-hook as a pelvic attachment of the rib based system is indicated in progressive early onset non ambulatory scoliosis patient curve with a lack of adequate anchor at the lumbar spine. Several technical factors should be considered to reduce the complication rate.
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Body image in patients with adolescent idiopathic scoliosis: validation of the Body Image Disturbance Questionnaire--Scoliosis Version.
J Bone Joint Surg Am
PUBLISHED: 04-18-2014
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Appearance concerns in individuals with adolescent idiopathic scoliosis can result in impairment in daily functioning, or body image disturbance. The Body Image Disturbance Questionnaire (BIDQ) is a self-reported, seven-question instrument that measures body image disturbance in general populations; no studies have specifically examined body image disturbance in those with adolescent idiopathic scoliosis. This study aimed to validate a modified version of the BIDQ in a population with adolescent idiopathic scoliosis and to establish discriminant validity by comparing responses of operatively and nonoperatively treated patients with those of normal controls.
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Evaluation of a Systematic Approach to Pediatric Back Pain: The Utility of Magnetic Resonance Imaging.
J Pediatr Orthop
PUBLISHED: 04-02-2014
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Several studies have suggested that back pain in the majority of pediatric patients does not have an identifiable cause. Many children undergo extensive diagnostic workup that ultimately results in a nonconfirmative diagnosis. The purpose of this study was to (1) describe the prevalence of back pain seen in a pediatric orthopaedic clinic; (2) evaluate the efficacy of a systematic approach dependent on magnetic resonance imaging (MRI) in the diagnosis of pediatric back pain; and (3) analyze sensitivity, specificity, positive predictive value, and negative predictive value of various clinical signs and symptoms.
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Is there a predilection for breech infants to demonstrate spontaneous stabilization of DDH instability?
J Pediatr Orthop
PUBLISHED: 03-05-2014
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Breech position subjects the fetal hip to abnormal mechanical forces. However, unlike genetic or tissue factors linked to developmental dysplasia of the hip (DDH), the causative effect of the breech position ends when the infant is born. The purpose of this study was to evaluate the rate of spontaneous stabilization in mildly unstable hips of breech-presenting infants compared with similarly lax hips in infants with a genetic or tissue-related cause of DDH.
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T-condylar fractures of the distal humerus in children: does early motion affect final range of motion?
J Child Orthop
PUBLISHED: 02-25-2014
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T-condylar fractures of the distal humerus are infrequent injuries in children. There are little data regarding outcomes in this age group. The adult literature demonstrates a high rate of postinjury stiffness. We describe a large series of T-condylar fractures in children and set out to identify factors that influence the postoperative range of motion (ROM) in children. Our hypothesis was that starting motion early (<3 weeks) would favorably influence the postoperative ROM.
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Quantitative syndesmophyte measurement in ankylosing spondylitis using CT: longitudinal validity and sensitivity to change over 2 years.
Ann. Rheum. Dis.
PUBLISHED: 12-04-2013
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Accurate measurement of syndesmophyte development and growth in ankylosing spondylitis (AS) is needed for studies of biomarkers and of treatments to slow spinal fusion. We tested the longitudinal validity and sensitivity to change of quantitative measurement of syndesmophytes using CT.
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Antifibrinolytic Use and Blood Transfusions in Pediatric Scoliosis Surgeries Performed at US Childrens Hospitals.
J Spinal Disord Tech
PUBLISHED: 10-05-2013
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Retrospective cohort study using the Pediatric Health Information Systems (PHIS) database.
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Growing-rod graduates: lessons learned from ninety-nine patients who completed lengthening.
J Bone Joint Surg Am
PUBLISHED: 10-04-2013
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Growing-rod spinal instrumentation systems are a valuable tool for managing severe early-onset scoliosis. There is little information about the end point of treatment.
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Do routine radiographs within the first two years following pediatric posterior spinal fusion prompt revision surgery?
Spine
PUBLISHED: 09-20-2013
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This is a retrospective review of 265 consecutive patients with scoliosis treated by posterior spinal fusion (PSF) and 2990 postoperative radiographs at a single institution.
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Comparative study of notoungulate (Placentalia, Mammalia) bony labyrinths and new phylogenetically informative inner ear characters.
J. Anat.
PUBLISHED: 08-12-2013
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The phylogenetic relationships of notoungulates, an extinct group of predominantly South American herbivores, remain poorly resolved with respect to both other placental mammals and among one another. Most previous phylogenetic analyses of notoungulates have not included characters of the internal cranium, not least because few such features, including the bony labyrinth, have been described for members of the group. Here we describe the inner ears of the notoungulates Altitypotherium chucalensis (Mesotheriidae), Pachyrukhos moyani (Hegetotheriidae) and Cochilius sp. (Interatheriidae) based on reconstructions of bony labyrinths obtained from computed tomography imagery. Comparisons of the bony labyrinths of these taxa with the basally diverging notoungulate Notostylops murinus (Notostylopidae), an isolated petrosal from Itaboraí, Brazil, referred to Notoungulata, and six therian outgroups, yielded an inner ear character matrix of 25 potentially phylogenetically informative characters, 14 of them novel to this study. Two equivocally optimized character states potentially support a pairing of Mesotheriidae and Hegetotheriidae, whereas four others may be diagnostic of Notoungulata. Three additional characters are potentially informative for diagnosing more inclusive clades: one for crown Placentalia; another for a clade containing Kulbeckia, Zalambdalestes, and Placentalia; and a third for Eutheria (crown Placentalia plus stem taxa). Several other characters are apomorphic for at least one notoungulate in our study and are of potential interest for broader taxonomic sampling within Notoungulata to clarify currently enigmatic interrelationships. Measures of the semicircular canals were used to infer agility (e.g. capable of quick movements vs. lethargic movements) of these taxa. Agility scores calculated from these data generally corroborate interpretations based on postcranial remains of these or closely related species. We provide estimates of the low-frequency hearing limits in notoungulates based on the ratio of radii of the apical and basal turns of the cochlea. These limits range from 15?Hz in Notostylops to 149?Hz in Pachyrukhos, values comparable to the Asian elephant (Elephas maximus) and the California sea lion (Zalophus californianus) when hearing in air, respectively.
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Response to comment on "The placental mammal ancestor and the post-K-Pg radiation of placentals".
Science
PUBLISHED: 08-10-2013
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Tree-building with diverse data maximizes explanatory power. Application of molecular clock models to ancient speciation events risks a bias against detection of fast radiations subsequent to the Cretaceous-Paleogene (K-Pg) event. Contrary to Springer et al., post-K-Pg placental diversification does not require "virus-like" substitution rates. Even constraining clade ages to their model, the explosive model best explains placental evolution.
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Abduction bracing for residual acetabular dysplasia in infantile DDH.
J Pediatr Orthop
PUBLISHED: 07-02-2013
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Abduction bracing is often used to treat residual acetabular dysplasia in infants whose acetabular indices (AI) exceed 30 degrees after 6 months of age. However, little data exist to support this practice. The purpose of this study was to determine the efficacy of part-time abduction bracing in treating residual acetabular dysplasia by comparing a cohort of braced infants with a cohort of unbraced infants.
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VEPTR to treat nonsyndromic congenital scoliosis: a multicenter, mid-term follow-up study.
J Pediatr Orthop
PUBLISHED: 07-02-2013
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Traditional surgical management of multiple congenital vertebral anomalies in young children, including fusion in situ and hemiepiphyseodesis, do not promote spinal growth nor address the associated thoracic insufficiency syndrome. We hypothesize that vertical expandable prosthetic titanium rib (VEPTR) with expansion thoracoplasty may control spinal deformity, allow spinal growth, and address thoracic insufficiency syndrome in children with nonsyndromic complex congenital spinal deformities.
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Surgeon practices regarding infection prevention for pediatric spinal surgery.
J Pediatr Orthop
PUBLISHED: 06-19-2013
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A postoperative spinal infection has significant financial and emotional impact on the patient, family, and health care system. The purpose of this study is to understand approaches used by pediatric spinal surgeons with regard to infection prevention.
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More experienced surgeons less likely to fuse: a focus group review of 315 hypothetical EOS cases.
J Pediatr Orthop
PUBLISHED: 06-19-2013
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Previous work has identified significant variability in decision making and multiple areas of clinical equipoise in the treatment of early-onset scoliosis (EOS). In an attempt to better understand possible determinants of this variability, we examined the relationship between socioclinical attributes of 11 participating surgeons and decision making regarding the treatment of EOS.
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Adjunctive Vancomycin Powder in Pediatric Spine Surgery is Safe.
Spine
PUBLISHED: 06-14-2013
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Study Design: Therapeutic Level II Cohort Study.Objective: To evaluate the safety of adjunctive local application of vancomycin powder (VP) for infection prophylaxis in posterior instrumented thoracic and lumbar spine wounds in pediatric patients >25kg.Summary of Background Data: Spine surgeons have largely turned to vancomycin prophylaxis in an attempt to decrease the incidence of late surgical site infection (SSI) and acute SSI from methicillin resistant Staphylococcus aureus (MRSA). In adult patients the adjunctive local application of VP with an IV cephalosporin has been shown to significantly decrease postsurgical wound infection rates; however, the safety of VP as an adjunct in pediatric spine surgery has not been reported.Methods: We reviewed data collected under a systematic protocol specifically designed to monitor the safety profile of VP. We measured changes in creatinine and systemic vancomycin levels following intrawound application of 500mg of unreconstituted VP during spine deformity correction surgery in patients >25kg (patients also received routine IV cephalosporin prophylaxis). Lab values were measured preoperatively and on postoperative days (POD) 1 and 4. Any adverse reactions and infections through available follow-up (2-8 months) were recorded.Results: 87 consecutive pediatric spinal deformity patients >25kg who received intraoperative VP over a 9 month period were identified. 63% of the patients in this series had adolescent idiopathic scoliosis, 15% congenital scoliosis, 15% neuromuscular scoliosis, and 5% spondylolisthesis. The average change in creatinine levels between the preoperative and POD 1 draw was -0.03 and between the preoperative and POD 4 draw was -0.075. The postoperative systemic vancomycin levels remained undetectable. None of the patients experienced nephrotoxicity or red man syndrome. 3/87 patients developed a SSI.Conclusion: In this cohort there were no clinically significant changes in creatinine level or systemic vancomycin level caused by use of intraoperative VP.
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Whats the evidence? Systematic literature review of risk factors and preventive strategies for surgical site infection following pediatric spine surgery.
J Pediatr Orthop
PUBLISHED: 06-12-2013
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Despite relatively high rates of surgical site infections (SSIs) after pediatric spine surgery, practice guidelines are absent. We performed a systematic review of the literature, determining the level of evidence for risk factors for SSIs and prevention practices to reduce SSIs following pediatric spine surgery.
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Building consensus: development of a Best Practice Guideline (BPG) for surgical site infection (SSI) prevention in high-risk pediatric spine surgery.
J Pediatr Orthop
PUBLISHED: 06-12-2013
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Perioperative surgical site infection (SSI) after pediatric spine fusion is a recognized complication with rates between 0.5% and 1.6% in adolescent idiopathic scoliosis and up to 22% in "high risk" patients. Significant variation in the approach to infection prophylaxis has been well documented. The purpose of this initiative is to develop a consensus-based "Best Practice" Guideline (BPG), informed by both the available evidence in the literature and expert opinion, for high-risk pediatric patients undergoing spine fusion. For the purpose of this effort, high risk was defined as anything other than a primary fusion in a patient with idiopathic scoliosis without significant comorbidities. The ultimate goal of this initiative is to decrease the wide variability in SSI prevention strategies in this area, ultimately leading to improved patient outcomes and reduced health care costs.
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Twenty-year perspective of randomized controlled trials for surgery of chronic nonspecific low back pain: citation bias and tangential knowledge.
Spine J
PUBLISHED: 05-27-2013
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After decades of clinical research, the role of surgery for chronic nonspecific low back pain (CNLBP) remains equivocal. Despite significant intellectual, human, and economic investments into randomized controlled trials (RCTs) in the past two decades, the role of surgery in the treatment for CNLBP has not been clarified.
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Evaluating the extent of clinical uncertainty among treatment options for patients with early-onset scoliosis.
J Bone Joint Surg Am
PUBLISHED: 05-17-2013
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Literature guiding the management of early-onset scoliosis consists primarily of studies with a low level of evidence. Evaluation of clinical equipoise (i.e., when there is no known superiority among treatment modalities) allows for prioritization of research efforts. The objective of this study was to evaluate areas of clinical uncertainty among pediatric spine surgeons regarding the treatment of early-onset scoliosis.
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Do oblique views add value in the diagnosis of spondylolysis in adolescents?
J Bone Joint Surg Am
PUBLISHED: 05-17-2013
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Anteroposterior, lateral, and right and left oblique lumbar spine radiographs are often a standard part of the evaluation of children who are clinically suspected of having spondylolysis. Recent concerns regarding radiation exposure and costs have brought the value of oblique radiographs into question. The purpose of the present study was to determine the diagnostic value of oblique views in the diagnosis of spondylolysis.
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Surgical site infection following spinal instrumentation for scoliosis: a multicenter analysis of rates, risk factors, and pathogens.
J Bone Joint Surg Am
PUBLISHED: 05-03-2013
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Surgical site infection following correction of pediatric scoliosis is well described. However, we are aware of no recent multicenter study describing the rates of surgical site infection, and associated pathogens, among patients with different etiologies for scoliosis.
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Imaging modalities for low back pain in children: a review of spondyloysis and undiagnosed mechanical back pain.
J Pediatr Orthop
PUBLISHED: 03-14-2013
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Mechanical low back pain is common in the pediatric population; recent studies have shown that undiagnosed mechanical low back pain (UMLBP) is the most common cause of low back pain presenting in adolescents, accounting for up to 78% of cases. Spondylolysis/spondylolisthesis is the most common cause with diagnosed pathology observed in this age group. The goals of this study are to: determine the natural history of low back pain, evaluate the value of radiographic studies in establishing a diagnosis of spondylolysis, and determine the cost and radiation effective doses (EDs) associated with those studies with the associated risks radiation exposure.
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The placental mammal ancestor and the post-K-Pg radiation of placentals.
Science
PUBLISHED: 02-09-2013
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To discover interordinal relationships of living and fossil placental mammals and the time of origin of placentals relative to the Cretaceous-Paleogene (K-Pg) boundary, we scored 4541 phenomic characters de novo for 86 fossil and living species. Combining these data with molecular sequences, we obtained a phylogenetic tree that, when calibrated with fossils, shows that crown clade Placentalia and placental orders originated after the K-Pg boundary. Many nodes discovered using molecular data are upheld, but phenomic signals overturn molecular signals to show Sundatheria (Dermoptera + Scandentia) as the sister taxon of Primates, a close link between Proboscidea (elephants) and Sirenia (sea cows), and the monophyly of echolocating Chiroptera (bats). Our tree suggests that Placentalia first split into Xenarthra and Epitheria; extinct New World species are the oldest members of Afrotheria.
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Vancomycin prophylaxis of surgical site infection in clean orthopedic surgery.
Orthopedics
PUBLISHED: 02-06-2013
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Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as a public health concern since the mid-1990s. Because of the increase in reports of this pathogen, it has become increasingly tempting for clinicians to provide prophylaxis against this entity using antibiotics known to be effective against MRSA. The goal of this study was to assess the use of MRSA prophylaxis to determine whether it is safe and effective. A systematic search of the literature was performed to identify articles that examined the use of vancomycin in clean orthopedic surgery. Infection rates and adverse events were extracted, and the data were aggregated and analyzed using a DerSimonian and Laird random effects model. Publication bias and study quality were also assessed. No benefit of parenteral administration of vancomycin was identified. Local, vancomycin-impregnated cement and powder are associated with lower infection rates. Few adverse events occurred, and most of those that occurred involved infusion rate.Cost, resistance, and side effects are concerns in using vancomycin therapy in addition to standard antibiotic prophylaxis. Given the lack of efficacy of intravenous vancomycin, the authors do not recommend its routine use in clean orthopedic surgery. However, local administration appears to be safe and effective. The data are most compelling in orthopedic spine surgery in which a patient without prophylaxis is more than 4 times as likely to have a deep postoperative wound infection compared with a patient who received local vancomycin. The authors recommend the use of local antibiotics when possible in clean orthopedic surgery.
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Perioperative antibiotic use for spinal surgery procedures in US childrens hospitals.
Spine
PUBLISHED: 02-02-2013
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Retrospective cohort study using the Pediatric Health Information System database.
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The oldest known primate skeleton and early haplorhine evolution.
Nature
PUBLISHED: 02-01-2013
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Reconstructing the earliest phases of primate evolution has been impeded by gaps in the fossil record, so that disagreements persist regarding the palaeobiology and phylogenetic relationships of the earliest primates. Here we report the discovery of a nearly complete and partly articulated skeleton of a primitive haplorhine primate from the early Eocene of China, about 55?million years ago, the oldest fossil primate of this quality ever recovered. Coupled with detailed morphological examination using propagation phase contrast X-ray synchrotron microtomography, our phylogenetic analysis based on total available evidence indicates that this fossil is the most basal known member of the tarsiiform clade. In addition to providing further support for an early dichotomy between the strepsirrhine and haplorhine clades, this new primate further constrains the age of divergence between tarsiiforms and anthropoids. It also strengthens the hypothesis that the earliest primates were probably diurnal, arboreal and primarily insectivorous mammals the size of modern pygmy mouse lemurs.
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Quantitative measurement of syndesmophyte volume and height in ankylosing spondylitis using CT.
Ann. Rheum. Dis.
PUBLISHED: 01-23-2013
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OBJECTIVE: Syndesmophyte growth in ankylosing spondylitis can be difficult to measure using radiographs because of poor visualisation and semiquantitative scoring methods. We developed and tested the reliability and validity of a new computer-based method that fully quantifies syndesmophyte volumes and heights on CT scans. METHODS: In this developmental study, we performed lumbar spine CT scans on 38 patients and used our algorithm to compute syndesmophyte volume and height in four intervertebral disk spaces. To assess reliability, we compared results between two scans performed on the same day in nine patients. To assess validity, we compared computed measures to visual ratings of syndesmophyte volume and height on both CT scans and radiographs by two physician readers. RESULTS: Coefficients of variation for syndesmophyte volume and height, based on repeat scans, were 2.05% and 2.40%, respectively. Based on Bland-Altman analysis, an increase in syndesmophyte volume of more than 4% or in height of more than 0.20 mm represented a change greater than measurement error. Computed volumes and heights were strongly associated with physician ratings of syndesmophyte volume and height on visual examination of both the CT scans (p<0.0001) and plain radiographs (p<0.002). Syndesmophyte volumes correlated with the Schober test (r=-0.48) and lateral thoracolumbar flexion (r=-0.60). CONCLUSIONS: This new CT-based method that fully quantifies syndesmophytes in three-dimensional space had excellent reliability and face and construct validity. Given its high precision, this method shows promise for longitudinal clinical studies of syndesmophyte development and growth.
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Imputation of microsatellite alleles from dense SNP genotypes for parentage verification across multiple Bos taurus and Bos indicus breeds.
Front Genet
PUBLISHED: 01-01-2013
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To assist cattle producers transition from microsatellite (MS) to single nucleotide polymorphism (SNP) genotyping for parental verification we previously devised an effective and inexpensive method to impute MS alleles from SNP haplotypes. While the reported method was verified with only a limited data set (N = 479) from Brown Swiss, Guernsey, Holstein, and Jersey cattle, some of the MS-SNP haplotype associations were concordant across these phylogenetically diverse breeds. This implied that some haplotypes predate modern breed formation and remain in strong linkage disequilibrium. To expand the utility of MS allele imputation across breeds, MS and SNP data from more than 8000 animals representing 39 breeds (Bos taurus and B. indicus) were used to predict 9410 SNP haplotypes, incorporating an average of 73 SNPs per haplotype, for which alleles from 12 MS markers could be accurately be imputed. Approximately 25% of the MS-SNP haplotypes were present in multiple breeds (N = 2 to 36 breeds). These shared haplotypes allowed for MS imputation in breeds that were not represented in the reference population with only a small increase in Mendelian inheritance inconsistancies. Our reported reference haplotypes can be used for any cattle breed and the reported methods can be applied to any species to aid the transition from MS to SNP genetic markers. While ~91% of the animals with imputed alleles for 12 MS markers had ?1 Mendelian inheritance conflicts with their parents reported MS genotypes, this figure was 96% for our reference animals, indicating potential errors in the reported MS genotypes. The workflow we suggest autocorrects for genotyping errors and rare haplotypes, by MS genotyping animals whose imputed MS alleles fail parentage verification, and then incorporating those animals into the reference dataset.
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The treatment of low-energy femoral shaft fractures: a prospective study comparing the "walking spica" with the traditional spica cast.
J Bone Joint Surg Am
PUBLISHED: 12-14-2011
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A single-leg, walking hip spica cast has been shown to be a safe and effective treatment for a low-energy femoral shaft fracture in young children. We designed a prospective cohort trial comparing walking and traditional hip spica casting to determine whether a walking hip spica cast was superior to a traditional hip spica cast following a low-energy femoral shaft fracture in children one to six years old.
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Impacts of the Cretaceous Terrestrial Revolution and KPg extinction on mammal diversification.
Science
PUBLISHED: 09-22-2011
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Previous analyses of relations, divergence times, and diversification patterns among extant mammalian families have relied on supertree methods and local molecular clocks. We constructed a molecular supermatrix for mammalian families and analyzed these data with likelihood-based methods and relaxed molecular clocks. Phylogenetic analyses resulted in a robust phylogeny with better resolution than phylogenies from supertree methods. Relaxed clock analyses support the long-fuse model of diversification and highlight the importance of including multiple fossil calibrations that are spread across the tree. Molecular time trees and diversification analyses suggest important roles for the Cretaceous Terrestrial Revolution and Cretaceous-Paleogene (KPg) mass extinction in opening up ecospace that promoted interordinal and intraordinal diversification, respectively. By contrast, diversification analyses provide no support for the hypothesis concerning the delayed rise of present-day mammals during the Eocene Period.
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A radiation of arboreal basal eutherian mammals beginning in the Late Cretaceous of India.
Proc. Natl. Acad. Sci. U.S.A.
PUBLISHED: 09-19-2011
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Indias Late Cretaceous fossil mammals include the only undisputed pre-Tertiary Gondwanan eutherians, such as Deccanolestes. Recent studies have suggested a relationship between Deccanolestes and African and European Paleocene adapisoriculids, which have been variably identified as stem euarchontans, stem primates, lipotyphlan insectivores, or afrosoricids. Support for a close relationship between Deccanolestes and any of these placental mammal clades would be unique in representing a confirmed Mesozoic record of a placental mammal. However, some paleogeographic reconstructions place India at its peak isolation from all other continents during the latest Cretaceous, complicating reconstructions of the biogeographic history of the placental radiation. Recent fieldwork in India has recovered dozens of better-preserved specimens of Cretaceous eutherians, including several new species. Here, we incorporate these new specimens into an extensive phylogenetic analysis that includes every clade with a previously hypothesized relationship to Deccanolestes. Our results support a robust relationship between Deccanolestes and Paleocene adapisoriculids, but do not support a close affinity between these taxa and any placental clade, demonstrating that Deccanolestes is not a Cretaceous placental mammal and reinforcing the sizeable gap between molecular and fossil divergence time estimates for the placental mammal radiation. Instead, our expanded data push Adapisoriculidae, including Deccanolestes, into a much more basal position than in earlier analyses, strengthening hypotheses that scansoriality and arboreality were prevalent early in eutherian evolution. This comprehensive phylogeny indicates that faunal exchange occurred between India, Africa, and Europe in the Late Cretaceous-Early Paleocene, and suggests a previously unrecognized ?30 to 45 Myr "ghost lineage" for these Gondwanan eutherians.
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Orthosis noncompliance after the Ponseti method for the treatment of idiopathic clubfeet: a relevant problem that needs reevaluation.
J Pediatr Orthop
PUBLISHED: 08-16-2011
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Idiopathic talipes equinovarus is the most common congenital defect characterized by the presence of a congenital dysplasia of all musculoskeletal tissues distal to the knee. For many years, the treatment has been based on extensive surgery after manipulation and cast trial. Owing to poor surgical results, Ponseti developed a new treatment protocol consisting of manipulation with cast and an Achilles tenotomy. The new technique requires 4 years of orthotic management to guarantee good results. The most recent studies have emphasized how difficult it is to comply with the orthotic posttreatment protocol. Poor compliance has been attributed to parents low educational and low income level. The purpose of the study is to evaluate if poor compliance is due to the complexity of the orthotic use or if it is related to family education, cultural, or income factors.
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Is the vertebral expandable prosthetic titanium rib a surgical alternative in patients with spina bifida?
Clin. Orthop. Relat. Res.
PUBLISHED: 06-08-2011
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Nonambulatory children with myelodysplasia are most likely to develop spinal deformity. As the deformity progresses, the overall health of the patient deteriorates. Traditional management of the deformity with fusion results in a short trunk, crankshaft deformity, and spine and lung growth inhibition. One alternative that potentially minimizes these problems is the vertebral expandable prosthetic titanium rib (VEPTR).
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Acute traumatic compartment syndrome of the leg in children: diagnosis and outcome.
J Bone Joint Surg Am
PUBLISHED: 05-20-2011
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Currently, the most common clinical scenario for compartment syndrome in children is acute traumatic compartment syndrome of the leg. We studied the cause, diagnosis, treatment, and outcome of acute traumatic compartment syndrome of the leg in children.
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Fixation of length-stable femoral shaft fractures in heavier children: flexible nails vs rigid locked nails.
J Pediatr Orthop
PUBLISHED: 04-13-2011
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The treatment of femoral shaft fractures in heavier children has been studied extensively, however, no study has directly compared elastic nail (TEN) and rigid locking nails (RLN) in this population. Our goal was to compare TEN with RLN in length-stable diaphyseal femur fractures in heavier children and adolescents (47 to 85 kg) using weight-matched cohorts.
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Patient global assessment in psoriatic arthritis: a multicenter GRAPPA and OMERACT study.
J. Rheumatol.
PUBLISHED: 02-15-2011
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During OMERACT 8, delegates selected patient global assessment (PGA) of disease as a domain to be evaluated in randomized controlled trials in psoriatic arthritis (PsA). This study assessed the reliability of the PGA, measured by means of 0-100 mm visual analog scale (VAS), and the additional utility of separate VAS scales for joints (PJA) and skin (PSA).
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Aortic insufficiency in a patient with reactive arthritis: case report and review of the literature.
HSS J
PUBLISHED: 01-14-2011
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Reactive arthritis (ReA) consists of the classic clinical triad of arthritis, urethritis, and conjunctivitis generally occurring within 6 weeks of an infection, typically of the gastrointestinal or genitourinary systems. Cardiovascular manifestations of ReA and other members of the spondyloarthritis family have long been recognized.
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Clinical indications for repeat MRI in children with acute hematogenous osteomyelitis.
J Pediatr Orthop
PUBLISHED: 11-25-2010
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At our center and at others, some children with acute hematogenous osteomyelitis (AHO) are evaluated with multiple magnetic resonance imagings (MRIs) during their treatment. Do these serial MRI studies have a role in the management of AHO? We examine several clinical indications for ordering a repeat MRI and whether the imaging study resulted in a change in management.
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Diagnostic performance of a telemedicine system for ophthalmology: advantages in accuracy and speed compared to standard care.
AMIA Annu Symp Proc
PUBLISHED: 11-13-2010
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Telemedicine has potential to improve quality and delivery of medical care, particularly in image-oriented specialties where decisions are based on appearance of morphological features during examination. In the ophthalmology domain, nearly all published telemedicine studies have measured accuracy against a gold standard of ophthalmoscopic examination. The purposes of this study are to examine difficulties in defining an absolute gold standard and to compare diagnostic speed in a representative disease, retinopathy of prematurity. We compare results from ophthalmoscopic and telemedicine examinations by the same physicians. In 180 (86.5%) of 208 eyes, the two examinations produced the same diagnosis. In some discrepancies, there was rationale suggesting that telemedicine may have provided a more accurate diagnosis than ophthalmoscopic examination. The quantity and nature of these disagreements has important implications for evaluation of telemedicine systems in image-based specialties, and for the definition of gold standards in future studies.
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Vertical expandable prosthetic titanium rib as treatment of thoracic insufficiency syndrome in spondylocostal dysplasia.
J Pediatr Orthop
PUBLISHED: 08-25-2010
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Spondylocostal dysplasia (SCD) constitutes a heterogeneous patient group with multiple vertebral formations and segmentation defects of the entire spine, with asymmetric rib malformations. Respiratory failure has been reported in spondylocostal dysplasia secondary to thoracic insufficiency syndrome. The vertical expandable prosthetic titanium rib (VEPTR) reconstructs the chest wall to address the thoracic insufficiency seen in this patient population. The purpose of this study is to evaluate spinal deformity correction and respiratory function outcomes in a spondylocostal dysplasia population treated with VEPTR.
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Inner ear of a notoungulate placental mammal: anatomical description and examination of potentially phylogenetically informative characters.
J. Anat.
PUBLISHED: 06-08-2010
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We provide the first detailed description of the inner ear of a notoungulate, an extinct group of endemic South American placental mammals, based on a three-dimensional reconstruction extracted from CT imagery of a skull of Notostylops murinus. This description provides new anatomical data that should prove to be phylogenetically informative, an especially significant aspect of this research given that both the interrelationships of notoungulates and the position of Notoungulata within Placentalia are still unresolved. We also assess the locomotor agility of Notostylops based on measurements of the semicircular canals. This is the best available data on the locomotion of a notostylopid because significant postcranial remains for this group have not been described. The cochlea of Notostylops has 2.25 turns, and the stapedial ratio is 1.6. The stapedial ratio is one of the lowest recorded for a eutherian, which typically have ratios greater than 1.8. The fenestra cochleae is located posterior to the fenestra vestibuli, a condition previously only reported for some stem primates. The separation of the saccule and utricule of the vestibule is visible on the digital endocast of the bony labyrinth. The posterior arm of the LSC and the inferior arm of the PSC are confluent, but these do not form a secondary crus commune, and the phylogenetic or functional significance of this confluence is unclear at this time. Locomotor agility scores for Notostylops suggest a medium or average degree of agility of motion compared to extant mammals. In terms of its locomotion, we tentatively predict that Notostylops was a generalized terrestrial mammal, with cursorial tendencies, based on its agility scores and the range of locomotor patterns inferred from postcranial analyses of other notoungulates.
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Eleven years experience in the operative management of pediatric forearm fractures.
J Pediatr Orthop
PUBLISHED: 05-27-2010
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There has been a trend toward operative management of pediatric diaphyseal forearm fractures (DFFx). We studied our experience with surgical management of these injuries to assess indications, frequency, outcome, and complications.
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Plus disease in retinopathy of prematurity: quantitative analysis of vascular change.
Am. J. Ophthalmol.
PUBLISHED: 04-25-2010
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To examine the relationship between rate of vascular change and plus disease diagnosis.
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Steel syndrome: dislocated hips and radial heads, carpal coalition, scoliosis, short stature, and characteristic facial features.
J Pediatr Orthop
PUBLISHED: 04-02-2010
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A syndrome of children with short stature, bilateral hip dislocations, radial head dislocations, carpal coalitions, scoliosis, and cavus feet in Puerto Rican children, was reported by Steel et al in 1993. The syndrome was described as a unique entity with dismal results after conventional treatment of dislocated hips. The purpose of this study is to reevaluate this patient population with a longer follow-up and delineate the clinical and radiologic features, treatment outcomes, and the genetic characteristics.
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The bony labyrinth of the early platyrrhine primate Chilecebus.
J. Hum. Evol.
PUBLISHED: 03-31-2010
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We document the morphology of the bony labyrinth of Chilecebus carrascoensis, one of the best preserved early platyrrhines known, based on high resolution CT scanning and 3D digital reconstruction. The cochlea is low and conical in form, as in other anthropoids, but has only 2.5 spiral turns. When the allometric relationship with body mass is considered, cochlear size is similar to that in extant primates. The relative size of the semicircular canals, which is well within the range of other primates, indicates that Chilecebus carrascoensis was probably not as agile in its locomotion as other small-bodied platyrrhines such as Leontopithecus rosalia, Saguinus oedipus, and Callithrix jacchus, but it probably was not a suspensory acrobat or a slow climber. The proportion, shape, and orientation of the semicircular canals in Chilecebus carrascoensis also mirror that typically seen in extant primates. However, no single variable can be used for predicting the locomotor pattern in Chilecebus carrascoensis. Based on Principle Component Analysis (PCA) scores we calculated rescaled Euclidean distances for various taxa; primates with similar locomotor patterns tend to share shorter distances. Results for Chilecebus carrascoensis underscore its general resemblance to living quadrupedal primate taxa, but it is not positioned especially near any single living taxon.
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Intraobserver and interobserver agreement in the measurement of displaced humeral medial epicondyle fractures in children.
J Bone Joint Surg Am
PUBLISHED: 02-04-2010
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Fractures of the humeral medial epicondyle occur frequently in children. The decision to pursue operative or nonoperative treatment often hinges on the amount of perceived fracture displacement. This study was performed to assess both intraobserver and interobserver agreement in the measurements of displacement of these fractures on radiographs by orthopaedic surgeons with various levels of training.
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New postcrania of Deccanolestes from the Late Cretaceous of India and their bearing on the evolutionary and biogeographic history of euarchontan mammals.
Naturwissenschaften
PUBLISHED: 01-09-2010
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Extant species of the supraordinal mammal clade Euarchonta belong to the orders Primates, Scandentia, or Dermoptera. The fossil record of euarchontans suggests that they underwent their initial radiation during the Paleocene (65-55 million years ago) in North America, Eurasia, and Africa. The time and place of origin is poorly resolved due to lack of definitive fossils of euarchontan stem taxa. We describe a fragmentary humerus and two fragmentary ulnae from the latest Cretaceous of India that bear significantly on this issue. The fossils are tentatively referred to Deccanolestes cf. hislopi due to their small size and the fact that Deccanolestes is the only eutherian dental taxon to have been recovered from the same locality. The new fossils are used to evaluate the existing behavioral hypothesis that Deccanolestes was arboreal, and the competing phylogenetic hypotheses that Deccanolestes is a stem eutherian versus a stem euarchontan. The humerus resembles those of euarchontans in possessing a laterally keeled ulnar trochlea, a distinct zona conoidea, and a spherical capitulum. These features also suggest an arboreal lifestyle. The ulnar morphology is consistent with that of the humerus in reflecting an arboreal/scansorial animal. Detailed quantitative comparisons indicate that, despite morphological correlates to euarchontan-like arboreality, the humerus of Deccanolestes is morphologically intermediate between those of Cretaceous "condylarthran" mammals and definitive Cenozoic euarchontans. Additionally, humeri attributed to adapisoriculids are morphologically intermediate between those of Deccanolestes and definitive euarchontans. If adapisoriculids are euarchontans, as recently proposed, our results suggest that Deccanolestes is more basal. The tentative identification of Deccanolestes as a basal stem euarchontan suggests that (1) Placentalia began to diversify and Euarchonta originated before the Cretaceous-Tertiary boundary and (2) the Indian subcontinent, Eurasia, and Africa are more likely places of origin for Euarchonta than is North America.
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Tobacco as a production platform for biofuel: overexpression of Arabidopsis DGAT and LEC2 genes increases accumulation and shifts the composition of lipids in green biomass.
Plant Biotechnol. J.
PUBLISHED: 12-23-2009
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When grown for energy production instead for smoking, tobacco can generate a large amount of inexpensive biomass more efficiently than almost any other agricultural crop. Tobacco possesses potent oil biosynthesis machinery and can accumulate up to 40% of seed weight in oil. In this work, we explored two metabolic engineering approaches to enhance the oil content in tobacco green tissues for potential biofuel production. First, an Arabidopsis thaliana gene diacylglycerol acyltransferase (DGAT) coding for a key enzyme in triacylglycerol (TAG) biosynthesis, was expressed in tobacco under the control of a strong ribulose-biphosphate carboxylase small subunit promoter. This modification led to up to a 20-fold increase in TAG accumulation in tobacco leaves and translated into an overall of about a twofold increase in extracted fatty acids (FA) up to 5.8% of dry biomass in Nicotiana tabacum cv Wisconsin, and up to 6% in high-sugar tobacco variety NC-55. Modified tobacco plants also contained elevated amounts of phospholipids. This increase in lipids was accompanied by a shift in the FA composition favourable for their utilization as biodiesel. Second, we expressed in tobacco Arabidopsis gene LEAFY COTYLEDON 2 (LEC2), a master regulator of seed maturation and seed oil storage under the control of an inducible Alc promoter. Stimulation of LEC2 expression in mature tobacco plants by acetaldehyde led to the accumulation of up to 6.8% per dry weight of total extracted FA. The obtained data reveal the potential of metabolically modified plant biomass for the production of biofuel.
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Telemedical diagnosis of retinopathy of prematurity: accuracy of expert versus non-expert graders.
Br J Ophthalmol
PUBLISHED: 12-02-2009
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To assess accuracy of telemedical retinopathy of prematurity (ROP) diagnosis by trained non-expert graders compared with expert graders.
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The correction of pelvic obliquity in patients with cerebral palsy and neuromuscular scoliosis: is there a benefit of anterior release prior to posterior spinal arthrodesis?
Spine
PUBLISHED: 11-26-2009
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A retrospective study of 61 patients with cerebral palsy (CP) and neuromuscular scoliosis treated by either a combined anterior-posterior spinal arthrodesis or a posterior-only arthrodesis with the unit rod.
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Increased hemoglobin levels in patients with early onset scoliosis: prevalence and effect of a treatment with Vertical Expandable Prosthetic Titanium Rib (VEPTR).
Spine
PUBLISHED: 11-21-2009
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The medical records of 138 subjects with Early Onset Scoliosis (EOS) from 5 US institutions were reviewed to analyze their hemoglobin levels before and after surgery. Eighty-five subjects were operated with the Vertical Expandable Prosthetic Titanium Rib (VEPTR) and 53 with growing rods.
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CR/PACS for scoliosis: a turn for the better?
Radiol Manage
PUBLISHED: 09-01-2009
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As radiology departments convert to digital imaging, the acquisition, reading,and management of scoliosis studies pose unique challenges. This case study assesses the actual impact on efficiency,file management, cost, and clinical acceptability after a conversion to see whether goals were accomplished. As digital imaging for scoliosis studies became the new standard of care in the Childrens Hospital of Philadelphia radiology department, it renewed interest and attention to these disorders and facilitated improved patient care.
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The use of an immunization information system to establish baseline childhood immunization rates and measure contract objectives.
J Public Health Manag Pract
PUBLISHED: 08-26-2009
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Measuring progress toward national immunization objectives at the local level, although difficult, is becoming more feasible owing to statewide immunization information systems. This article describes how a state immunization program expanded the scope of immunization service contracts with local health departments (LHDs) to address the immunization rates among children living within their jurisdictions using the Wisconsin Immunization Registry (WIR) to measure achievement of population-based objectives. By contract year (CY) 2008, 99 percent of Wisconsin LHDs selected population-based contract objectives. In late 2008, the Wisconsin Immunization Program assessed all children at 24 months of age for completeness of the 4:3:1:3:3:1 (diphtheria, tetanus, pertussis/poliovirus/measles-containing vaccine/Haemophilus influenzae type b/hepatitis B/varicella) series by county for each of four CYs, using the WIR. From CY 2005 to CY 2008, LHDs in 61 (86%) of the 71 counties demonstrated increased series completeness rates for the series, and the overall statewide series completeness increased from 58 percent to 64 percent. However, the increases we observed cannot be attributed solely to LHDs acceptance of population-based objectives because controlling for other factors known to influence immunization coverage levels was outside the scope of this case study. We found the WIR to be a powerful tool that can measure immunization coverage among local populations independent of the immunization provider, assess improvement toward contract objectives, and target resources toward pockets of need.
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Radiographic classification of complications of instrumentation in adolescent idiopathic scoliosis.
Clin. Orthop. Relat. Res.
PUBLISHED: 07-24-2009
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In spinal deformity surgery, techniques and implants must be assessed for their safety and efficacy. Regulatory bodies, third-party payors, and patients will increasingly scrutinize treatment methods based on the frequency of adverse events. We therefore developed a classification of adverse hardware-related events using plain radiographic criteria. We analyzed the adverse events in 466 patients surgically treated for adolescent idiopathic scoliosis for a Type 1 (Lenke et al.) curve. We used plain radiographic films to define complications as either serious radiographic adverse events or radiographic adverse events in four technique groups: posterior spinal fusion with hooks and/or hybrid systems, posterior spinal fusion using mostly pedicle screws, open anterior spinal fusion, and thoracoscopic anterior spinal fusion. We defined serious radiographic adverse events as those requiring subsequent surgery. The minimum followup was 2 years. We found a reoperation rate ranging from 4.5% (open anterior spinal fusion) to 8.8% (posterior spinal fusion with hooks); we found no difference in the incidence of serious radiographic adverse events between surgical techniques. Among serious radiographic adverse events, the most common problems were revision for lumbar progression, rod breakage, and proximal screw pullout in the anterior spinal fusions and instrumentation removal for pain and infection in the posterior spinal fusions. We propose a new radiographic system of adverse hardware-related events for patients with Type 1 adolescent idiopathic scoliosis.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.