Quality improvement in the information age.
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Clinical Laboratory Information Systems↗
Biomedical subjects
D A Kern
Publications and source records attributed to D A Kern.
Use of a modified toggle pin for repair of coxofemoral luxation in dogs with multiple orthopedic injuries: 14 cases (1986-1994).
OBJECTIVE: To develop modifications of the toggle pin procedure for use as a ligament of the head of the femur (LHF) prosthesis and to assess outcomes when used for coxofemoral luxation (CFL) in dogs with multiple orthopedic injuries. DESIGN: Retrospective case series. SAMPLE POPULATION: 14 dogs with CFL as a component of orthopedic polytrauma. PROCEDURE: Modifications to previous descriptions of the technique for use of a toggle pin for LHF prosthesis included deletion of the osteotomy of the greater trochanter in 12 of 16 joints with CFL, drilling of the femoral tunnel from a distal-to-proximal direction, deletion of a second femoral bone tunnel for suture placement, and use of a 2-hole polypropylene button to secure the LHF prosthetic suture. RESULTS: Mean age at time of injury, weight, and duration between injury and definitive surgery was 4.1 +/- 1.1 years, 19.7 +/- 2.8 kg, and 5.8 +/- 2.7 days, respectively. Weightbearing began 3.0 +/- 0.4 days after surgery. Mean postoperative follow-up period for dogs with maintained coxofemoral reduction of longer than 1 month (n = 13) was 19.5 +/- 6.1 months. Owners reported good or excellent clinical results, which were confirmed by semiquantitative assessment methods. Radiographic signs of degenerative joint disease were minimal. There was no significant difference between hind limbs when comparing mid-thigh limb circumference at the time of follow-up examination. CLINICAL IMPLICATIONS: A modified toggle pin procedure for LHF prosthesis can maintain coxofemoral reduction and allow early weightbearing in dogs with coxofemoral luxation as a component of multiple orthopedic injuries.
Accidents, Traffic↗
Informatics applications in blood banking.
The dynamic nature of blood banking presents significant challenges in information acquisition, processing, and management. Blood banks have turned increasingly to computer technology for assistance with information handling. Novel applications of computer-based technology in blood banking and transfusion medicine have been developed and reported in the medical literature. This article reviews computer-based donor interviewing, expert system determination of donor eligibility based on viral marker testing results, inventory management through computer simulation analysis, prospective screening of blood orders by experts systems, and computer-based blood compatibility assessment.
Blood Banks↗
Evaluation of three fixation techniques for repair of mandibular fractures in dogs.
Bilateral midbody hemimandibular osteotomies were performed between premolars 3 and 4 in 18 adult dogs. Hemimandibles were repaired by use of monocortically applied bone plates (n = 6), an interdental fixator composed of an Erich arch bar and acrylic (n = 6), or a type I external skeletal fixator (n = 6). At the immediate postoperative evaluation, hemimandibles stabilized with interdental fixators had an osteotomy gap distance (mean +/- SEM, 1.6 +/- 0.2 mm) that was significantly (P < 0.05) greater than for hemimandibles stabilized with external skeletal fixators (1.2 +/- 0.3 mm). Osteotomy gap distance of hemimandibles stabilized with external skeletal fixators (1.5 +/- 0.2 mm) was significantly (P < 0.05) greater at weeks 4 (1.1 +/- 0.2 mm) and 8 (0.8 +/- 0.3 mm) after surgery than the osteotomy gap distance of hemimandibles stabilized by application of bone plates. By week 16, significant differences in osteotomy gap distance were not detected between groups. Immediately after surgery, mandibular alignment measurements were not significantly different for dogs with bone plates (0.3 +/- 0.1 mm), interdental fixators (0.3 +/- 0.1 mm), and external skeletal fixators (0.9 +/- 0.5 mm). Mandibular alignment scores were not significantly different between treatment groups during the remaining postoperative period. Occlusal measurements were not significantly different between evaluations performed before surgery and 16 weeks after surgery, regardless of treatment group. Radiographic evidence of healing in hemimandibles stabilized with external skeletal fixators was significantly (P < 0.05) less at 4 and 8 weeks, compared with hemimandibles stabilized with bone plates and interdental fixators; however, radiographic evidence of bone healing was not significantly different between fixation groups at 16 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Skull trauma and mandibular fractures.
This article discusses the treatment of skull and mandibular fractures in small animals as well as fixation techniques, including interdental fixation, external skeletal fixation, intraoral splints, wiring, and pinning. Information is provided on the treatment of loose and damaged teeth in the fractured area. Management of temporomandibular joint luxation also is addressed.
Animals↗
Evaluation of bending strength of five interdental fixation apparatuses applied to canine mandibles.
Strength in bending was determined for interdental fixation apparatuses applied to hemimandibles obtained from 24 canine cadavers. Hemimandibles were osteotomized perpendicular to the long axis between the third and fourth premolars, and segments were stabilized with 1 of 5 interdental fixation apparatuses: Erich arch bar (EAB, n = 6); Stout loop (SL, n = 6); acrylic (A, n = 6); Stout loop and acrylic (SLA, n = 24); and Erich arch bar and acrylic (EABA, n = 6). Ultimate strengths (mean +/- SEM) of EAB, SL, A, SLA, and EABA were 395 +/- 48; 523 +/- 57; 1,106 +/- 102; 1,306 +/- 156; and 2,707 +/- 504 N.m, respectively. Stiffness (mean +/- SEM) of EAB, SL, A, SLA, and EABA were 2,944 +/- 357; 6,322 +/- 2,201; 16,010 +/- 5,017; 15,777 +/- 1,026; and 27,079 +/- 5,576 N.m/radian, respectively. Yield strengths (mean +/- SEM) of EAB, SL, A, SLA, and EABA were 66 +/- 6; 264 +/- 19; 911 +/- 126; 1,114 +/- 159; and 1,855 +/- 401 N.m, respectively. There were no significant differences in acrylic weight, cross-sectional area of the acrylic, or area moment of inertia of acrylic at the osteotomy site among A, SLA, and EABA; and there were no significant differences in osteotomy surface area and area moment of inertia at the osteotomy site among all apparatuses (P > 0.05). The EABA apparatus had significantly higher mean ultimate strength, mean stiffness, and mean yield strength compared to other interdental fixation apparatuses. There were no significant differences in the mean ultimate strength, mean stiffness, or mean yield strength between EAB and SL (P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
What is your diagnosis? A large, asymmetric, heterogenous, gas and soft tissue opaque mass compressing the air sac dorsally and to the left.
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Animals↗
Effectiveness of sodium fluoride on tooth hypersensitivity with and without iontophoresis.
The purpose of this study was to assess the short and long term reduction of dentinal hypersensitivity by a single application of sodium fluoride with and without iontophoresis. Two teeth in each of 16 patients were blindly evaluated before and after treatment, and at 1, 3, and 6 months. A blast of air and tactile pressure were used to assess pain. Results indicate that there is significant, immediate reduction in dentinal hypersensitivity with the use of iontophoresis that is lost with time. The use of sodium fluoride alone had no effect. Sodium fluoride with iontophoresis was demonstrated to have an immediate post treatment effect (P less than .001) that lasted through the 3-month observation period. The data suggest that iontophoresis may be a useful adjunct to sensitivity therapy and that an immediate therapeutic effect may be achieved. The efficacy of the use of sodium fluoride alone is obscured by the natural reduction of root sensitivity observed with time.
Dentin Sensitivity↗