The neglected clubfoot: a salvage procedure

The study included 18 patients (28 feet), between 4 and 14 years of age. Complete homogeneous correction of the neglected clubfoot was achieved by performing a trapezoid resection osteotomy from the cuboid bone after performing an extensive posteromedial soft-tissue release. The procedure did not sacrifice any articular cartilage and allowed realignment of the forefoot. Tibialis anterior tendon transfer to the cuboid was performed in all feet to eliminate its deforming action and to help maintain the desired degree of correction. A Dwyer calcaneal lateral closing wedge osteotomy was needed in 12 feet and was performed concomitantly with the other procedures. After an average follow-up of 26 months (range 8-31 months) 14 (50%) feet had a good result with normal features, 11 (39.3%) feet had a fair result with definite improvement, and three (10.7%) feet had a poor result with limited improvement. Both good and fair results were considered satisfactory. Patients with tight ligaments were significantly more likely to have a poor outcome (p < .0005). However, neither the patient's age at the time of surgery nor the severity of the deformity was significantly associated with unsatisfactory results. The procedure is strongly recommended in supple feet with resilient ligaments, even in teenagers with severe deformity. In severely deformed rigid feet, the procedure serves to minimize bone resection, thus preventing excessive shortening of the foot if a triple arthrodesis should become necessary at a later date.     

The history of psychology: A neglected area.

"I propose to document the extent of the current neglect of the history of our field, to suggest some of the factors which help to bring about this neglect, to answer certain possible criticisms of devoting one's time to advancing knowledge of our history, and to try to show some positive values to be found by research in our history." During a 20-year period (1938-57) only 12 out of 1207 articles published in the American Journal of Psychology, 13 of 937 articles in the Journal of General Psychology, and 13 of 682 articles in the Psychological Bulletin were historical in nature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement of playfulness: A neglected therapist variable.

A 28-item Playfulness Scale for Adults was developed to measure a general predisposition to play. The scale, administered to 104 male and female university students, evidenced high internal consistency (alpha?=?.90). A factor analysis yielded 5 factors: (1) Fun-loving; (2) Sense of Humor; (3) Enjoys Silliness; (4) Informal; and (5) Whimsical. The scale's construct validity was supported by a correlation of .62 with the Multidimensional Sense of Humor Scale. The researchers discuss implications of the playful personality construct for play therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A neglected lesbian health concern: cervical neoplasia

OBJECTIVE: The role of a deficiency of vitamin B1 in the development of alcoholic complaints is confined to the case of the Wernicke-Korsakov syndrome. Findings concerning a deficiency of thiamine in alcoholics in comparison with normal persons are contradictory and there are no differentiated tests in the case of delirium tremens. In this study the vitamin B1 absorption in patients with delirium tremens was of interest in connection with the presence or absence of hallucinations and autonomic symptoms. METHOD: Male patients (N = 70) with delirium tremens were compared with a group of 13 controls. The controls and patients were hospitalized in order to ensure abstinence from alcohol. The examination of the delirium patients was carried out with their consent after termination of the delirium tremens and again on discontinuance of drug therapy. In the case of 33 delirium patients the absorption of thiamine was tested again 4 weeks after the first examination. RESULTS: The absorption of vitamin B1 was in general only minimally lower in the case of the delirium patients in comparison with the nonalcoholics. The results showed, however, a considerably greater range of scattering of vitamin B1 absorption in the delirium patients. The absorption conditions showed marked improvement in the 4 weeks after delirium. The extent of absorption of vitamin B1 showed no influence on the duration of delirium. The patients with visual hallucinations, however, showed lower thiamine absorption than patients without such symptoms, whereas no dependence of autonomic symptoms on vitamin B1 absorption was seen. CONCLUSIONS: The disturbed absorption conditions in the delirium patients were obvious at the time of the examination as demonstrated by the wide range of absorption values. Improvement or near normal conditions were registered 4 weeks after the delirium. The absorption conditions had possibly already improved during the few days of alcohol abstinence in the course of the delirium treatment. The reduced vitamin B1 absorption of patients suffering from visual hallucination corresponds to observations of alcoholic hallucinosis.     

The experimenter: A neglected stimulus object.

In single E experiments it is not possible to generalize to a population of E's. There are 3 cases for multi-E experiments: In Case I different Es do not differentially affect the results; in Case II one E obtains higher scores for all groups than does a second E; and in Case III E characteristics interact with treatment conditions. Results are potentially generalizable for Cases I and II, but not for Case III. Evidence indicates that multi-E experiments are common, but that reports of procedure and results for different Es are almost nonexistent. It is essential that we explicitly attempt to generalize to a population of Es; specify techniques of controlling the E variable; and accumulate knowledge in a variety of experimental situations about the effects of Es on their Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Single-case research designs: A neglected alternative.

Comments on the article by L. Wilkinson & the Task Force on Statistical Inference (see record 1999-03403-008) which was meant to initiate discussion in the field about changes in current practices of data analysis and reporting. The report was concerned with the use of statistical methods only and is not meant as an assessment of research methods in general. The present article criticizes Wilkinson's article, noting that it lacks any recognition that single-case research design might be an alternative to current practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Closed ruptures of the flexor digitorum tendons: MRI evaluation

OBJECTIVE: To assess the MRI findings in cases of closed rupture of the flexor digitorum tendons (FDT). PATIENTS AND DESIGN: Ten patients with a clinical suspicion of rupture of FDT underwent MRI before surgery. None of the patients presented a skin injury. Fingers were imaged using axial T1-weighted SE sequences, three-dimensional GE images, and curved reconstructions. RESULTS: Twelve FDT had surgical confirmation of rupture. Flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) tendons were more frequently ruptured (n=8) than flexor digitorum superficialis (FDS) tendons (n=4). MR images accurately depicted the level of the rupture. The gap between the tendon ends (mean 45 mm, range 21-70 mm) was assessed best with curved reconstructions and was well correlated with the surgical findings. The proximal end mainly retracted into the palm or the carpal tunnel (n=8), and less frequently into the digital canal (n=4). In two cases, the proximal end curled up in the palm, clinically simulating a rupture of a lumbrical muscle in one case. MRI also showed the appearance of the adjacent tendons. CONCLUSION: MRI accurately depicted the level of rupture and the gap between the tendon ends, which assisted the surgical choice between suture, graft or tendon transfer.     

Complications of neglected genital prolapses

Significant advances have been achieved in the exploration of various pathological conditions of the biliary ducts by the introduction of retrograde cholangiography as diagnostic tool in this department. This investigation has proved to be very promising in view of the valuable information gained at little risk to the patient. Furthermore, retrograde pancreaticography has improved diagnostic accuracy in pancreatic diseases. However, these results should only be assessed in conjunction with the complete clinical picture and history.     

The dimensionality of job characteristics: Some neglected issues.

Examined variation in job characteristics across job categories by reanalyzing the original Job Diagnostic Survey database (G. R. Oldham et al, 1979), which includes information on job characteristics for 6,930 employees working on 876 jobs in 56 organizations. Previous research has focused investigation within jobs. A 3-factor solution was found to match best to an a priori structure using principal axis factor anaysis, oblique factor rotations, and a procrustes transformation. This solution retained task identity and job feedback as legitimate job dimensions but detected a 3rd dimension that collapsed skill variety, task significance, and autonomy into a single factor. Additionally, person (age, education) and situational/contextual (position level) variables were found to influence the ability to differentiate among job characteristics. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Replication studies: A neglected aspect of psychological research.

A survey of the literature on replication and cross-validation research has revealed that psychologists have tended to ignore replication research. A review of the functions of and deterrents to replication studies is presented. Consideration of the factors influencing replication research suggests that the experimental method, as adopted from physics and chemistry, is invalid for investigating human behavior. (31 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender-role analysis: A neglected component of psychological assessment.

Discusses the influence of gender membership and gender-role socialization on psychological functioning and psychopathology, and proposes issues for the integration of gender-role analysis into the process of psychological assessment. Illustrations of how awareness or ignorance of gender-role issues can impact the outcome of psychological assessment are presented, and guidelines for the inclusion of gender-role analysis into the psychological assessment process are proposed. It is suggested that the assessment of gender-role issues requires a consideration of the lessons of gender, how they were learned, and what meaning was given to that experience; specific cultural values; how like or different the client's family was from other families who shared the client's cultural background; and the client's adult sexual and physical abuse history. The benefits of including gender-role analysis to both therapist/assessor and client are discussed. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Malnutrition in geriatric patients: a neglected problem?

PURPOSE: The authors report their experience with the translumbar inferior vena cava (IVC) approach for central venous access during a 6-year period at three teaching hospital sites. PATIENTS AND METHODS: Twenty-nine percutaneous IVC central venous access catheters were inserted in 22 patients during a 6-year period in the radiology departments of three teaching hospital sites. All patients had undergone unsuccessful attempts at conventional central venous access. Information was gathered by retrospective radiologic and hospital chart review. RESULTS: All attempted placements were successful. Catheters were in place for a total of 3,510 catheter days. The average length of catheter placement was 121 days (range, 14-536 days). Life-table analysis predicted catheter function rates of 55% and 29% at 6 and 12 months, respectively. Three procedure-related complications occurred. A lower pole branch of the right renal artery was inadvertently entered with a 22-gauge needle during attempted IVC puncture in one patient without clinical sequelae. A second patient developed a small groin hematoma at the femoral venous puncture site, which resolved spontaneously. A third patient developed a moderate retroperitoneal hematoma, which resolved without specific intervention. The sepsis rate was 2.8 infections per 1,000 catheter days with an average time to infection of 127 days (range, 10-536 days). CONCLUSION: In the authors' experience of 29 translumbar central venous catheter insertions, all attempts were successful. Percutaneous central venous access via the IVC is a safe and effective option for patients in whom more conventional access is not possible.     

Fixation of canine tendons to metal

For the purpose of developing a method to attach tendons directly to the prosthesis, canine supraspinatus tendons were attached in vitro to a metallic surface, using 3 different fixation devices: a spiked polyacetal washer (Synthes), a spiked soft tissue fixation plate (Synthes), and a newly designed Enhanced Tendon Anchor (ETA), which straddled the tendon with interlocking spikes oriented at a 20-degree angle. 2 methods were used: 1) the tendon was fixed directly to the metallic surface, or 2) a bone block containing the tendon insertion was fixed to the metallic surface. The specimens were tested for initial fixation strength in tension to failure; intact bone-muscle-tendon-bone units were used as controls. Bone block fixations were stronger than direct tendon fixations when the spiked washer or the ETA was used; this was not true of the fixation plate. The ETA was stronger than the other techniques in ultimate strength in both direct tendon fixation and bone block fixation. The soft tissue fixation plate was found to be weaker than the other techniques in bone block fixation.