Bucks County Community College

Joshua Clark Davis, From Head Shops to Whole Foods: The Rise and Fall of Activist Entrepreneurs (New York: Columbia University Press, 2017, $35.00). Pp. 245. isbn 978 0 2311 7158 8. - Volume 54 Issue 1

Capsular contracture remains among the most commonly cited reasons for reoperation following implant-based breast augmentation. The introduction of acellular dermal matrix (ADM) in revision surgery has led to a decrease in the recurrence of capsular contracture. However, there remains a relative paucity of literature in secondary aesthetic surgery and its use is associated with increased patient costs. The authors describe a novel technique using segmental interpositional graft placement to treat and prevent contracture recurrence while decreasing additional costs to the patient. This study is a retrospective chart review of patients who presented with recurrent capsular contractures and underwent revision surgery by a single surgeon. Patient demographics, treatment history, and postoperative complications were recorded. Five patients (7 breasts) were identified. Mean age was 36 years old and mean body mass index was 20.6 kg/m 2 (range, 18.1-24.6 kg/m 2 ). All 5 patients had prior surgical treatment for capsular contractures with recurrence. Mean follow-up was 52.8 months (range, 36-60 months). One patient experienced a recurrence in an untreated pole of the breast. The remaining patients did not experience recurrent capsular contracture to date. Multiple studies have shown the benefit of using ADM in the prevention or treatment of capsular contracture. The author’s technique may be an effective strategy to treat recurrent capsular contractures while decreasing the patients’ out-of-pocket costs.

Information regarding the relative risks of developing knee osteoarthritis (OA) as a result of sport participation is critical for shaping public health messages and for informing knee-OA prevention strategies. The purpose of this systematic review was to investigate the association between participation in specific sports and knee OA. We completed a systematic literature search in September 2012 using 6 bibliographic databases (PubMed; Ovid MEDLINE; Journals@Ovid; American College of Physicians Journal Club; Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Review, Database of Abstracts of Reviews of Effects; and Ovid HealthStar), manual searches (4 journals), and reference lists (56 articles). Studies were included if they met the following 4 criteria: (1) an aim was to investigate an association between sport participation and knee OA; (2) the outcome measure was radiographic knee OA, clinical knee OA, total knee replacement, self-reported diagnosis of knee OA, or placement on a waiting list for a total knee replacement; (3) the study design was case control or cohort; and (4) the study was written in English. Articles were excluded if the study population had an underlying condition other than knee OA. One investigator extracted data (eg, group descriptions, knee OA prevalence, source of nonexposed controls). The overall knee-OA prevalence in sport participants (n = 3759) was 7.7%, compared with 7.3% among nonexposed controls (referent group n = 4730, odds ratio [OR] = 1.1). Specific sports with a significantly higher prevalence of knee OA were soccer (OR = 3.5), elite-level long-distance running (OR = 3.3), competitive weight lifting (OR = 6.9), and wrestling (OR = 3.8). Elite-sport (soccer or orienteering) and nonelite-sport (soccer or American football) participants without a history of knee injury had a greater prevalence of knee OA than nonexposed participants. Participants in soccer (elite and nonelite), elite-level long-distance running, competitive weight lifting, and wrestling had an increased prevalence of knee OA and should be targeted for risk-reduction strategies.

Frobell RB, Roos HP, Roos EM, Roemer FW, Ranstam J, Lohmander LS. Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ. 2013;346:F232. Does early anterior cruciate ligament (ACL) reconstruction with rehabilitation lead to better patient-reported outcomes and a lower incidence of osteoarthritis at 5 years postinjury compared with delayed ACL reconstruction with rehabilitation? This randomized controlled trial with extended follow-up at 5 years postrandomization was conducted in 2 Swedish orthopaedic departments. The authors studied a total of 121 moderately active adults (age = 18-35 years) with an acute ACL rupture in a knee with no other history of trauma. Excluded were patients with a collateral ligament rupture, full-thickness cartilage defect, or extensive meniscal fixation. One patient assigned to the early ACL-reconstruction group did not attend the 5-year follow-up visit. Patients were randomly assigned to (1) an early ACL reconstruction plus structured rehabilitation group (n = 62, surgery within 10 weeks of injury) or (2) optional-delayed ACL reconstruction plus structured rehabilitation group (n = 59). The primary outcome measure was change in the average of 4 out of 5 subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS). The authors also assessed crude KOOS (combined 4 subscales), KOOS subscale scores, general physical and mental health (Short-Form 36), activity level (Tegner Activity Scale), mechanical knee stability (Lachman and pivot shift tests), meniscal surgery status, and presence of knee osteoarthritis on radiographs. Among patients randomized to the optional-delayed ACL-reconstruction group, 30 (51%) opted for an ACL reconstruction. The treatment groups had comparable 5-year patient-reported outcomes and changes in patient-reported outcomes (eg, knee pain, knee symptoms, activities of daily living, sport and recreational levels, knee-related quality of life, general physical health, and general mental health). Patients in the optional-delayed ACL-reconstruction group had greater mechanical knee instability than patients who received early ACL reconstruction; however, this was primarily among the patients opting for conservative management alone. In the overall sample, 61 knees (51%) required meniscal surgery over 5 years, regardless of treatment group. At 5 years, radiographs were available for 113 patients (93%). Overall, 29 patients (26%) had knee osteoarthritis at 5 years. Specifically, 13 patients (12%) developed tibiofemoral radiographic osteoarthritis (9 patients [16%] in the early ACL-reconstruction group, 4 [7%] in the optional-delayed ACL-reconstruction group) and 22 (19%) developed patellofemoral osteoarthritis (14 patients [24%] in the early ACL-reconstruction group, 8 [15%] in the optional-delayed ACL-reconstruction group). Patients with patellar tendon grafts (n = 40) had a greater incidence of ipsilateral patellofemoral osteoarthritis than patients with hamstrings tendon grafts (n = 51), but the 2 groups had similar incidences of ipsilateral tibiofemoral osteoarthritis. Six knees (5%) had both tibiofemoral and patellofemoral osteoarthritis. Early ACL reconstruction plus rehabilitation did not provide better results at 5 years compared with optional-delayed ACL reconstruction plus rehabilitation. Furthermore, the authors found no radiographic differences among patients with early ACL reconstruction, delayed ACL reconstruction, or no ACL reconstruction (rehabilitation alone).

This article critiques two studies conducted by Jacobson and colleagues whose findings indicated that hypnosis hinders encoding and might not be useful in education. While their findings provide important information about hypnosis and its possible uses in teaching and learning, there are several important methodological and interpretive shortcomings that limit the applicability of the study. It is argued that the authors conflated some components of hypnotic phenomenology, as measured by the Phenomenology of Consciousness Inventory, and consequently failed to assess the hypnotic experience properly. This article argues that the encoding deficits produced by hypnosis may have resulted from the way hypnosis was used and other contextual factors, and highlights some additional concerns with the statistical analyses. This article suggests some more effective uses of hypnosis and suggestion in improving the learning process in light of prior research, and offers some ideas for future research.

Distance learning via the World Wide Web offers convenience and flexibility. Online education connects nurses geographically in a manner that the traditional face-to-face learning environment lacks. Delivered in both a synchronous (real time interaction) or asynchronous (delayed interaction) format, distance programs continue to provide nurses with choice, especially in the pursuit of advanced degrees. This article explores the pros and cons of distance education, in addition to the most popular platform used in distance learning today, the Blackboard Academic Suite. Characteristics of the potential enrollee to ensure a successful distance education experience are also discussed. Distance nursing programs are here to stay. Although rigorous, the ease of accessibility makes distance learning a viable alternative for busy nurses.

Science and the National Science Foundation announce the winners and honorable mentions in the categories of photography, illustration, informational graphics, noninteractive multimedia, and interactive multimedia in this year's Science and Engineering Visualization Challenge.