Search

Competing Interests: Competing interests The authors declare no competing interests.

Total joint arthroplasty frequently is performed in the United States to treat degenerative hip and knee arthritis. Despite the routine nature of this procedure, recommendations about dental prophylaxis in patients with prosthetic joints have varied considerably over the past decade. In 2016, the American Academy of Orthopaedic Surgeons (AAOS) published appropriate use criteria for dental prophylaxis in patients with orthopedic implants. Despite these recommendations, discrepancies in prescribing practices persist, and controversy surrounding this topic remains prevalent in the medical literature. This article reviews the AAOS appropriate use criteria and discusses the ongoing controversy about the use of dental prophylaxis in patients with orthopedic implants.

Geographical scholarship has rightly problematised the act of archival research, showing how the practice of archiving is not only concerned with how a society collectively remembers, but also forgets. As such, the dominant motif for discussing historical methods in geography has been through the lens of absence: the archive is a space of 'traces', 'fragments' and 'ghosts'. In this paper I suggest that the focus on incompleteness and partiality, while true, may also belie what many geographers working in archives find their greatest difficulty: an overwhelming volume of source materials. I reflect on my own research experiences in the pacifist archive to suggest that the growing scale and scope of many collections, along with the taxing research demands of transnational perspectives, pose immediate practical challenges for geographers characterised as much by abundance as by absence. In the second half of the paper, drawing on recent scholarship in history and geography, I argue that the method of biography offers one possible strategy for navigating archival abundance, allowing geographers to tell stories that are wider, deeper and more revealingly complex within the existing time and financial constraints of humanities research.

Purpose: We aimed to determine if state of bladder fullness affects pelvic floor muscle activation in healthy women without urogenital symptoms., Materials and Methods: Twenty-three nulliparous, continent female participants were recruited to participate. Women were randomized to begin the protocol with either an empty (EF) or a full (FE) bladder. Tonic and maximal voluntary pelvic floor muscle electromyographic activity were measured in three states of bladder fullness (empty, full and uncomfortably full). Electromyographic signal amplitudes were compared among bladder states using separate two-way repeated-measures analyses of variance including bladder state and test order as main effects as well as the interaction between bladder state and test order., Results: Tonic activity of the pelvic floor muscles was significantly higher in the full and uncomfortably full bladder states compared to when the bladder was empty (p<0.005). Maximum voluntary electromyographic activation was unaffected by state of bladder fullness (p=0.713)., Conclusions: Consistent with studies in which the bladder was filled through saline infusion, these results suggest that tonic activity of the PFMs is higher when the bladder is full compared to when it is empty. However once the bladder is moderately full, tonic PFM activity does not increase with increases in bladder volume., (Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.)

There are no direct recordings of obturator internus muscle activity in humans because of difficult access for electromyography (EMG) electrodes. Functions attributed to this muscle are based on speculation and include hip external rotation/abduction, and a role in stabilization as an "adjustable ligament" of the hip. Here we present (1) a technique to insert intramuscular EMG electrodes into obturator internus plus (2) the results of an investigation of obturator internus activity relative to that of nearby hip muscles during voluntary hip efforts in two hip positions and a weight-bearing task. Fine-wire electrodes were inserted with ultrasound guidance into obturator internus, gluteus maximus, piriformis and quadratus femoris in ten participants. Participants performed ramped and maximal isometric hip efforts (open kinetic chain) into flexion/extension, abduction/adduction, and internal/external rotation, and hip rotation to end range in standing. Analysis of the relationship between activity of the obturator internus and the other hip muscles provided evidence of limited contamination of the recordings with crosstalk. Obturator internus EMG amplitude was greatest during hip extension, then external rotation then abduction, with minimal to no activation in other directions. Obturator internus EMG was more commonly the first muscle active during abduction and external rotation than other muscles. This study describes a viable and valid technique to record obturator internus EMG and provides the first evidence of its activation during simple functions. The observation of specificity of activation to certain force directions questions the hypothesis of a general role in hip stabilisation regardless of force direction., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Study Design: Validation study., Objectives: To investigate the association between changes in electromyographic (EMG) signal amplitude and sonographic measures of muscle thickness of 4 abdominal muscles, during 2 clinical tests, in adults with and without lumbopelvic pain., Background: There is a trend in rehabilitation to use ultrasound imaging (USI) to determine the extent of abdominal muscle contraction. However, the literature investigating the relationship between abdominal muscle thickness change and level of activation is inconclusive and has not included clinically relevant tasks., Methods: Simultaneous recording from fine-wire EMG and USI was performed for 4 abdominal muscles, in 7 adults with lumbopelvic pain (mean ± SD age, 29.7 ± 12.0 years) and 7 adults without lumbopelvic pain (32.0 ± 10.6 years), during an active straight leg raise (ASLR) test and an abdominal drawing-in maneuver (ADIM). Cross-correlation functions and linear regression analyses were used to describe the relationship between the 2 measures. Analyses of variance were used to compare individuals with and without lumbopelvic pain, with an alpha set at .05., Results: Across all muscles, peak cross-correlation values were low (ASLR, r = 0.28 ± 0.09; ADIM, r = 0.35 ± 0.11), and there was large variability in associated time lags (ASLR, τ = 0.69 ± 2.56 seconds; ADIM, τ = 0.53 ± 3.75 seconds). Regression analyses did not detect a systematic pattern of association between EMG signal amplitude and USI measurements, and analyses of variance revealed no differences between cohorts., Conclusion: These results suggest a weak relationship between EMG amplitude and abdominal muscle thickness change measured with USI during the ADIM and ASLR, and raise questions about thickness change derived from USI as a measure of muscular activity for the abdominal musculature.

Shy Drager Syndrome (SDS) is a movement disorder which is often referred to as a parkinson plus syndrome or Multiple System Atrophy (MSA). For patients afflicted with this condition, rigidity and bradykinesia are the primary extrapyramidal symptoms which are present. The "plus" refers to autonomic nervous system dysfunction which leads to much of the disability seen in this disorder. Syncope, urinary incontinence, impotence, constipation, fecal incontinence, cardiac arrythmias as well as other symptoms occur as a result of widespread pathological changes in multiple areas of the central and autonomic nervous system. The goal of this paper is to provide an overview of the pathophysiology, signs and symptoms of and treatment for SDS. Nursing Care of the patient and family coping with Shy Drager Syndrome and the challenges it presents to the Movement Disorder Nurse are discussed. A coordinate, multidisciplinary team approach is suggested.