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Kreuzer S.,140 Business Center Drive | Leffers K.,140 Business Center Drive | Leffers K.,Indiana University School of Medicine - Terre Haute | Kumar S.,140 Business Center Drive
Clinical Orthopaedics and Related Research | Year: 2011

Background: The direct anterior approach (DAA) for hip resurfacing arthroplasty is a technically difficult approach but theoretically reduces the soft tissue trauma to the hip because it does not require muscle detachments from the bone. Furthermore, the patient is in the supine position facilitating fluoroscopy to control component placement. However, the complications associated with the learning curve and functional outcome scores are not well defined in the literature. Questions/purposes: We therefore asked how our first 57 operations using the anterior approach and special table extension compared with that in the literature with regard to (1) complication rate; (2) functional outcome scores; (3) component placement; and (4) length of stay. Methods: We retrospectively reviewed 51 patients who underwent 57 hip resurfacing procedures using a DAA. There were 45 men and six women with an average age of 51 years (range, 31-63 years) and a body mass index of 28.7 kg/m2 (range, 19.7-42.0 kg/m2). The minimum followup was 0.3 months (mean, 8.7 months; range, 0.3-24.9 months). Results: There were three atraumatic (5%) and one posttraumatic (1.8%) femoral neck fractures. Average HOOS scores were equal to or better than averages reported for total hip arthroplasty. Average cup inclination was 36.5° (range, 25°-48°). The average length of stay was 2.11 days (range, 1-4 days). Conclusions: The surgical approach for anterior hip resurfacing is technically difficult but may have some clinical benefits. Surgeons interested in using the DAA for hip resurfacing should be very familiar with the DAA for total hip arthroplasty and with hip resurfacing. Level of Evidence: Level IV, retrospective study. See Guidelines for Authors for a complete description of levels of evidence. © 2010 The Association of Bone and Joint Surgeons®. Source


Martin J.M.,Butler University | Warman D.M.,University of Indianapolis | Lysaker P.H.,Roudebush Medical Center | Lysaker P.H.,Indiana University School of Medicine - Terre Haute
Schizophrenia Research | Year: 2010

An increasing number of studies have used the Beck Cognitive Insight Scale (BCIS) to understand the reasoning of individuals with psychotic disorders. Less is known, however, about "normal" levels of insight and how non-psychiatric individuals compare to those with psychosis. The present study examined the structure of the BCIS in a non-psychiatric population and made comparisons between the scores of non-psychiatric individuals and those with psychosis. Participants were 418 students at American universities and 93 outpatients at a VA Medical Center with SCID-confirmed diagnoses of schizophrenia or schizoaffective disorder. Confirmatory factor analysis supports the 2-factor, 15-item structure previously reported for the BCIS, with one factor called self reflectiveness and the other called self certainty. Reliability analyses suggest strong internal consistency and test-retest results. Further, the BCIS subscales and composite index reliably distinguished between non-psychiatric and patient groups, though receiver operating characteristic (ROC) analysis did not suggest a particular cutoff score for predicting patient status. These results suggest that the BCIS is a valid measure to use in a non-psychiatric population, and that it reliably distinguishes between non-psychiatric individuals and those with psychotic disorders. © 2010 Elsevier B.V. Source


Bhimji S.,Stryker Orthopaedics | Meneghini R.M.,Indiana University School of Medicine - Terre Haute
Journal of Arthroplasty | Year: 2014

Initial implant stability is crucial to cementless knee arthroplasty fixation. The objective of this study was to evaluate the stability of two baseplates with different fixation features: a monoblock porous tantalum baseplate featuring two hexagonal pegs alone, and a modular design featuring a keel with four adjuvant cruciform pegs. A physiologically relevant test method previously described was used to evaluate compression and liftoff of the baseplates during stair descent. The porous tantalum baseplate with dual-hex peg fixation experienced greater rocking motions and liftoff compared to the baseplate with a keel and adjuvant pegs. Liftoff and displacement motion is likely deleterious and may inhibit biological fixation due to the physical separation of the baseplate from the bone. © 2014 Elsevier Inc. Source


Kinney V.C.,Indiana State University | Heemeyer J.L.,Indiana State University | Pessier A.P.,San Diego Zoos Institute for Conservation Research | Lannoo M.J.,Indiana University School of Medicine - Terre Haute
PLoS ONE | Year: 2011

To fully comprehend chytridiomycosis, the amphibian disease caused by the chytrid fungus Batrachochytrium dendrobatidis (Bd), it is essential to understand how Bd affects amphibians throughout their remarkable range of life histories. Crawfish Frogs (Lithobates areolatus) are a typical North American pond-breeding species that forms explosive spring breeding aggregations in seasonal and semipermanent wetlands. But unlike most species, when not breeding Crawfish Frogs usually live singly-in nearly total isolation from conspecifics-and obligately in burrows dug by crayfish. Crayfish burrows penetrate the water table, and therefore offer Crawfish Frogs a second, permanent aquatic habitat when not breeding. Over the course of two years we sampled for the presence of Bd in Crawfish Frog adults. Sampling was conducted seasonally, as animals moved from post-winter emergence through breeding migrations, then back into upland burrow habitats. During our study, 53% of Crawfish Frog breeding adults tested positive for Bd in at least one sample; 27% entered breeding wetlands Bd positive; 46% exited wetlands Bd positive. Five emigrating Crawfish Frogs (12%) developed chytridiomycosis and died. In contrast, all 25 adult frogs sampled while occupying upland crayfish burrows during the summer tested Bd negative. One percent of postmetamorphic juveniles sampled were Bd positive. Zoospore equivalents/swab ranged from 0.8 to 24,436; five out of eight frogs with zoospore equivalents near or >10,000 are known to have died. In summary, Bd infection rates in Crawfish Frog populations ratchet up from near zero during the summer to over 25% following overwintering; rates then nearly double again during and just after breeding-when mortality occurs-before the infection wanes during the summer. Bd-negative postmetamorphic juveniles may not be exposed again to this pathogen until they take up residence in crayfish burrows, or until their first breeding, some years later. © 2011 Kinney et al. Source


King M.W.,Indiana University School of Medicine - Terre Haute | Neff A.W.,Indiana University | Mescher A.L.,Indiana University
Anatomical Record | Year: 2012

The roles of inflammation and immune cell reactivity triggered by amputation have only recently begun to be addressed in investigations of epimorphic regeneration, although studies of tissue repair in mammals clearly show the importance of the immune system in determining the quality of the repair process. Here, we first review inflammation-related work in non-mammalian systems of epimorphic regeneration which suggests that regeneration of an amputated appendage requires continuous modulation of the local immune response, from the first hours after amputation through the period of blastema patterning. We then present data on the effects of anti-inflammatory and proinflammatory agents on regeneration of larval Xenopus hindlimbs. Treatment with the glucocorticoid beclomethasone immediately after amputation inhibits regeneration in regeneration-complete stage 53 limbs. Other anti-inflammatory agents, including the inhibitors of cyclooxygenase-2 (COX-2) activity celecoxib and diclofenac, applied similarly to larvae amputated at stage 55, when the capacity for limb regeneration is normally being lost, restore regenerative capacity. This suggests that although injury-related events sensitive to glucocorticoids are necessary for regeneration, resolution of the inflammatory response may also be required to allow the complete regenerative response and normal blastema patterning. Conversely, if resolution of inflammation is prevented by local treatment of amputated limbs with beryllium, a strong immunoadjuvant, regeneration is inhibited, and gene expression data suggest that this inhibition results from a failure of normal blastema patterning. Both positive and negative effects of immune- or inflammation-related activities occur during anuran limb regeneration and this underscores the importance of considering immune cells in studies of epimorphic regeneration. © 2012 Wiley Periodicals, Inc. Source

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