Accuracy of ultrasound-guided nerve blocks of the cervical zygapophysial joints

Cervical zygapophysial joint nerve blocks typically are performed with fluoroscopic needle guidance. Descriptions of ultrasound-guided block of these nerves are available, but only one small study compared ultrasound with fluoroscopy, and only for the third occipital nerve. To evaluate the potential usefulness of ultrasound-guidance in clinical practice, studies that determine the accuracy of this technique using a validated control are essential. The aim of this study was to determine the accuracy of ultrasound-guided nerve blocks of the cervical zygapophysial joints using fluoroscopy as control.

Biochemical characterization of detergent-resistant membranes: a systematic approach

Lateral segregation of cholesterol- and sphingomyelin-rich rafts and glycerophospholipid-containing non-raft microdomains has been proposed to play a role in a variety of biological processes. The most compelling evidence for membrane segregation is based on the observation that extraction with non-ionic detergents leads to solubilization of a subset of membrane components only. However, one decade later, a large body of inconsistent detergent-extraction data is threatening the very concept of membrane segregation. We have assessed the validity of the existing paradigms and we show the following. (i) The localization of a membrane component within a particular fraction of a sucrose gradient cannot be taken as a yardstick for its solubility: a variable localization of the DRMs (detergent-resistant membranes) in sucrose gradients is the result of complex associations between the membrane skeleton and the lipid bilayer. (ii) DRMs of variable composition can be generated by using a single detergent, the increasing concentration of which gradually extracts one protein/lipid after another. Therefore any extraction pattern obtained by a single concentration experiment is bound to be 'investigator-specific'. It follows that comparison of DRMs obtained by different detergents in a single concentration experiment is prone to misinterpretations. (iii) Depletion of cholesterol has a graded effect on membrane solubility. (iv) Differences in detergent solubility of the members of the annexin protein family arise from their association with chemically different membrane compartments; however, these cannot be attributed to the 'brick-like' raft-building blocks of fixed size and chemical composition. Our findings demonstrate a need for critical re-evaluation of the accumulated detergent-extraction data.

Ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerve: accuracy of a selective new technique confirmed by anatomical dissection

BACKGROUND: Ilioinguinal and iliohypogastric nerve blocks may be used in the diagnosis of chronic groin pain or for analgesia for hernia repair. This study describes a new ultrasound-guided approach to these nerves and determines its accuracy using anatomical dissection control. METHODS: After having tested the new method in a pilot cadaver, 10 additional embalmed cadavers were used to perform 37 ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerve. After injection of 0.1 ml of dye the cadavers were dissected to evaluate needle position and colouring of the nerves. RESULTS: Thirty-three of the thirty-seven needle tips were located at the exact target point, in or directly at the ilioinguinal or iliohypogastric nerve. In all these cases the targeted nerve was coloured entirely. In two of the remaining four cases parts of the nerves were coloured. This corresponds to a simulated block success rate of 95%. In contrast to the standard 'blind' techniques of inguinal nerve blocks we visualized and targeted the nerves 5 cm cranial and posterior to the anterior superior iliac spine. The median diameters of the nerves measured by ultrasound were: ilioinguinal 3.0x1.6 mm, and iliohypogastric 2.9x1.6 mm. The median distance of the ilioinguinal nerve to the iliac bone was 6.0 mm and the distance between the two nerves was 10.4 mm. CONCLUSIONS: The anatomical dissections confirmed that our new ultrasound-guided approach to the ilioinguinal and iliohypogastric nerve is accurate. Ultrasound could become an attractive alternative to the 'blind' standard techniques of ilioinguinal and iliohypogastric nerve block in pain medicine and anaesthetic practice.

PARTITIONING THE BLOCKS OF A STEINER TRIPLE SYSTEM INTO PARTIAL PARALLEL CLASSES

Does there exist a Steiner Triple System on v points, whose blocks can be partitioned into partial parallel classes of size m, where m ≤ [v⁄3], m | b and b is the number of blocks of the STS(v)? We give the answer for 9 ≤ v ≤ 43. We also show that whenever 2|b, v ≡ 3 (mod 6) we can find an STS(v) whose blocks can be partitioned into partial parallel classes of size 2, and whenever 4|b , v ≡ 3 (mod 6), there exists an STS(v) whose blocks can be partitioned into partial parallel classes of size 4.

An Evaluation of Effective Fiber in Beef Feedlot Finishing Diets

A study was designed to collect a database of Iowa feedlot rations for determination of effective neutral detergent fiber (NDF) in complete diets from fiber analysis and particle size determination of individual feed ingredients and compare this with particle size determination of mixed wet rations. Seventy-one beef finishing total mixed rations were collected by ISU Extension Beef Field Specialists across Iowa. Producers were asked to complete a form assessing the acidosis risk associated with each ration. The average NDF of these diets was 25.9%. Of the total mixed rations 1.33 % remained in the top tray (>.75 in.), 47.27 % remained in the middle tray (>.31 in.), and 50.88 % was smaller than the .31 in screen. The effective NDF (eNDF) calculated from the eNDF of the ingredients averaged 10.56%. Estimated eNDF from total diet NDF and the percentage of the total diet in the top and middle trays averaged 12.47%. The calculated eNDF from non-grain sources alone averaged 3.6%. The percentage of digestive deads was weakly related to the percentage of the ration in the bottom tray (r=.19), the percentage in the top tray (r=- .46) and the effective NDF of the ration (r=-.23). The percentage of bloat was related to the total NDF of the diet (r=.28) and the effective fiber from non-grain sources (r=-.23). The number of off-feed incidences was related to the dry matter of the ration (r=.38), the apparent eNDF (r=-.28) and the percentage of ration in the bottom tray (r=.24). This study confirms that there is some relationship between effective NDF of the diet, effective NDF from non-grain sources or diet particle size; and acidosis indicators. These relationships are weak, however, indicating that other factors such as feedbunk management, feed processing, feed presentation and feed mixing likely also play a role in the incidence of acidosis in feedlot cattle.

The ins and outs of phosphatidylethanolamine synthesis in Trypanosoma brucei.

Phospholipids are not only major building blocks of biological membranes but fulfill a wide range of critical functions that are often widely unrecognized. In this review, we focus on phosphatidylethanolamine, a major glycerophospholipid class in eukaryotes and bacteria, which is involved in many unexpected biological processes. We describe (i) the ins, i.e. the substrate sources and biochemical reactions involved in phosphatidylethanolamine synthesis, and (ii) the outs, i.e. the different roles of phosphatidylethanolamine and its involvement in various cellular events. We discuss how the protozoan parasite, Trypanosoma brucei, has contributed and may contribute in the future as eukaryotic model organism to our understanding of phosphatidylethanolamine homeostasis. This article is part of a Special Issue entitled Phospholipids and Phospholipid Metabolism.

Sexual Health Education from the Perspective of School Staff: Implications for Adoption and Implementation of Effective Programs in Middle School

Introduction: US teens are having sex early; however, the vast majority of schools do not implement evidence-based sexual health education (SHE) programs that could delay sexual behavior and/or reduce risky behavior. This study examines middle school staff’s knowledge, attitudes, barriers, self-efficacy, and perceived support (psychosocial factors known to influence SHE program adoption and implementation). Methods: Professional school staff from 33 southeast Texas middle schools completed an internet or paper-based survey. Prevalence estimates for psychosocial variables were computed for the total sample. Chi-square and t-test analyses examined variation by demographic factors. Results: Almost 70% of participants were female, 37% white, 42% black, 16% Hispanic; 20% administrators, 15% nurses/counselors, 31% non-physical education/non-health teachers, 28% physical education/health teachers; mean age = 42.78 years (SD = 10.9). Over 90% favored middle school SHE, and over 75% reported awareness of available SHE curricula or policies. More than 60% expressed confidence for discussing SHE. Staff perceived varying levels of administrator (28%-56%) support for SHE and varying levels of support for comprehensive sex education from outside stakeholders (e.g., parents, community leaders) (42%-85%). Overall, results were more favorable for physical education/health teachers, nurses/counselors, and administrators (when compared to non-physical education/non-health teachers) and individuals with experience teaching SHE. Few significant differences were observed by other demographic factors. Conclusions: Overall, study results were extremely positive, which may reflect a high level of readiness among school staff for adopting and implementing effective middle school SHE programs. Study results highlight the importance of several key action items for schools.

Implications for Adoption and Implementation of Effective Sexual Health Education Programs

Research on school-based sexual health education programs is at a critical juncture. With the growing number of evidenced-based programs, more focus is needed on how to help schools adopt and implement these programs. The article in this issue titled “Sexual Health Education from the Perspectives of School Staff: Implications for Adoption and Implementation of Effective Programs in Middle School” provides data on individual cognitive factors that may influence adoption and implementation. This commentary explores another framework, Concerns Based Adoption Model, as a tool for examining and supporting change associated with adoption and implementation of sexual health education programs.

Outline of a theory of efficient teams in Sport.

Introduction So far, social psychology in sport has preliminary focused on team cohesion, and many studies and meta-analyses tried to demonstrate a relation between cohesiveness of a team and its performance. How a team really co-operates and how the individual actions are integrated towards a team action is a question that has received relatively little attention in research. This may, at least in part, be due to a lack of a theoretical framework for collective actions, a dearth that has only recently begun to challenge sport psychologists. Objectives In this presentation a framework for a comprehensive theory of teams in sport is outlined and its potential to integrate research in the domain of team performance and, more specifically, the following presentations, is put up for discussion. Method Based on a model developed by von Cranach, Ochsenbein and Valach (1986), teams are considered to be information processing organisms, and team actions need to be investigated on two levels: the individual team member and the group as an entity. Elements to be considered are the task, the social structure, the information processing structure and the execution structure. Obviously, different task require different social structures, communication processes and co-ordination of individual movements. Especially in rapid interactive sports planning and execution of movements based on feedback loops are not possible. Deliberate planning may be a solution mainly for offensive actions, whereas defensive actions have to adjust to the opponent team's actions. Consequently, mental representations must be developed to allow a feed-forward regulation of team member's actions. Results and Conclusions Some preliminary findings based on this conceptual framework as well as further consequences for empirical investigations will be presented. References Cranach, M.v., Ochsenbein, G. & Valach, L. (1986). The group as a self-active system: Outline of a theory of group action. European Journal of Social Psychology, 16, 193-229.

An educational review of cartilage repair: precepts & practice - myths & misconceptions - progress & prospects.

OBJECTIVE The repair of cartilaginous lesions within synovial joints is still an unresolved and weighty clinical problem. Although research activity in this area has been indefatigably sustained, no significant progress has been made during the past decade. The aim of this educational review is to heighten the awareness amongst students and scientists of the basic issues that must be tackled and resolved before we can hope to escape from the whirlpool of stagnation into which we have fallen: cartilage repair redivivus! DESIGN Articular-cartilage lesions may be induced traumatically (e.g., by sports injuries and occupational accidents) or pathologically during the course of a degenerative disease (e.g., osteoarthritis). This review addresses the biological basis of cartilage repair and surveys current trends in treatment strategies, focussing on those that are most widely adopted by orthopaedic surgeons [viz., abrasive chondroplasty, microfracturing/microdrilling, osteochondral grafting and autologous-chondrocyte implantation (ACI)]. Also described are current research activities in the field of cartilage-tissue engineering, which, as a therapeutic principle, holds more promise for success than any other experimental approach. RESULTS AND CONCLUSIONS Tissue engineering aims to reconstitute a tissue both structurally and functionally. This process can be conducted entirely in vitro, initially in vitro and then in vivo (in situ), or entirely in vivo. Three key constituents usually form the building blocks of such an approach: a matrix scaffold, cells, and signalling molecules. Of the proposed approaches, none have yet advanced beyond the phase of experimental development to the level of clinical induction. The hurdles that need to be surmounted for ultimate success are discussed.