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Examples of measurements on an interval scale are time 400mg renagel sale, weight renagel 800mg otc, temperature buy 800 mg renagel amex, age and blood pressure. Bar charts There are different types of bar chart that include vertical, horizontal, mul­ tiple and proportional. Vertical bar charts Each category is represented by a vertical bar, the height of which relates to the numerical value of that category. Horizontal bar charts Each category is represented by a horizontal bar, the length of which rep­ resents the numerical value of the data. This type of bar chart shows com­ parisons between categories at a single point in time. Monthly returns Eye Clinic Chiropody Dental 0 1 2 3 4 5 6 7 Number of failed appointments Figure 13. Multiple bar charts Multiple bar charts show comparisons between related sets of categories. Comparison of side effects 50 40 30 20 10 0 nausea dizziness headache Drug A Drug B Drug C Figure 13. Proportional bar charts These charts are also known as stratified, stacked or component bar charts. It is possible to make comparisons between both the whole and the constituent parts. RESEARCH PROJECTS 215 Design tips: à Limit categories to a maximum of six. For grouped data of at least ordinal level use: ° histograms ° frequency polygons. The x axis is marked off in units that can represent either single scores (1, 2, 3) or scores arranged into groups (1–5, 6–10). The height of the bar on the y axis rep­ resents the frequency of the individual score or group of scores. It is clear that the control scores are higher than the experimental scores. Experimental group 5 4 3 2 1 0 0-5 6- 11- 16- 21- 26- 31- 36- 41- 46- 51- 56- 61- 66- 10 15 20 25 30 35 40 45 50 55 60 65 70 Scores on a verbal reasoning test Figure 13. Control Group 8 7 6 5 4 3 2 1 0 0-5 6-10 11-15 16-20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 Scores on verbal reasoning test Figure 13. Frequency polygons The bars of the histogram are replaced by points plotted at the midpoint of the top of each bar.

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Kita A generic renagel 800mg with visa, Morito N cheap renagel 400 mg on-line, Maeda S discount 400 mg renagel mastercard, et al (1995) Indication and procedure of manual reduction and subcapital osteotomy for slipped capital femoral epiphysis. Peterson MD, Weiner DS, Green NE, et al (1997) Acute slipped capital femoral epiphy- sis: the value and safety of urgent manipulative reduction. Gordon JE, Abrahams MS, Dobbs MB, et al (2002) Early reduction, arthrotomy, and cannulated screw fixation in unstable slipped capital femoral epiphysis treatment. Kumm DA, Lee SH, Hackenbroch MH, et al (2001) Slipped capital femoral epiphysis: a prospective study of dynamic screw fixation. Kamegaya M, Saisu T, Ochiai N, et al (2005) Preoperative assessment for intertrochan- teric femoral osteotomies in severe chronic slipped capital femoral epiphysis using computed tomography. J Pediatr Orthop B 14:71–78 Treatment of Slipped Capital Femoral Epiphysis Motoaki Katano, Naonobu Takahira, Sumitaka Takasaki, Katsufumi Uchiyama, and Moritoshi Itoman Summary. Slipped capital femoral epiphysis (SCFE) is a comparatively rare disorder with various new treatment modalities. Among unilateral SCFE patients, there were 7 acute, 6 acute on chronic, and 16 chronic SCFE. Pinning was performed on 11, osteotomy on 9, and in situ pinning on 9 hips. Postoperative complications of avascular necrosis of the femoral head were noted in 7 hips (24. For acute SCFE, we perform gentle reduction by traction and epiphysiodesis. Opinions remain divided concerning unaffected-side prophylactic fixation; however, we consider observation sufficient. Femoral head avascular necrosis is caused by failure of the remaining capital nutrient vessels. In future reports, we will include many more cases with these procedures, focusing on improved results and patient benefits. Slipped capital femoral epiphysis, Epiphysiodesis, Prophylaxis, In situ pinning, Osteotomy Introduction Slipped capital femoral epiphysis (SCFE) is a comparatively rare disorder; however, various new methods for its treatment have been reported. The various treatments offer methods for gentle reduction by traction, manual reduction, internal fixation, and osteotomy. We have investi- gated clinical and radiographic evaluation of the patients suffering from SCFE who have undergone surgical therapy in our hospital. Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan 9 10 M. Materials and Methods There were 27 patients (23 males, 4 females) in the present study, with 29 hips treated surgically from 1971 to 2004 in the Kitasato University Hospital.

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The knife used for incising the skin was of whom married members of the staff of Guy’s discarded and a fresh knife employed in the Hospital and the other achieved distinction as an wound renagel 400mg sale. The theater sister held an instru- a leading part in the advance of surgery soon after ment with forceps when handing it to the opera- the antiseptic system was established cheap renagel 800 mg without a prescription. He was one tor and she threaded needles with the aid of two of the first to proceed from the antiseptic method pairs of forceps purchase renagel 400 mg without prescription. And he actually control of the fracture, Lane devised pairs of pow- pioneered the perfection of aseptic surgery by erful bone forceps with long handles, which kept introducing the no-touch technique. No part of of operating and his metallic internal splint have an instrument that entered the wound was allowed had a profound influence upon bone and joint to touch the surgeon’s hand. This scrupulous no-touch technique nary dexterity and imbued them with enthusiasm was a byproduct of Lane’s fracture work, but it for surgery. References Lane retired from the active staff of Guy’s in 1920 but continued to practice from his house at 1. Lane WA (1883) Cases of Empyema in Children maintained that disease was due to defective diet Treated by Removal of a Portion of Rib. In 1926 he founded the New Hospital Reports 41:45 186 Who’s Who in Orthopedics 3. Lane WA (1887) A Remarkable Example of the pathologist Erwin Uehlinger, professor of pathol- Manner in which Pressure-Changes in the Skeleton ogy at the University of Zurich, were significant. His intention was to continue his career in phys- Journal of Anatomy and Physiology 21:385 iology, but work in field hospitals during 4. Lane WA (1890) Two Cases of Subdural Abscess Resulting from Disease of the Antrum and Middle Finland’s war against the Soviet Union from 1941 Ear. Lane WA (1893) On the Advantage of the Steel in surgery and orthopedics at the Helsinki Uni- Screw in the Treatment of Ununited Fractures. Lane WA (1894) A Method of Treating Simple surgeon until 1956, although his interest was in Oblique Fractures of the Tibia and Fibula more Effi- the study and treatment of diseases of the muscu- cient than those in Common Use. Transactions of the Clinical Society of London 27:167 loskeletal system. Lane WA (1908) The Modern Treatment of Cleft Anders Langenskiöld was the medical director Palate. Lane Sir WA (1914) The Operative Treatment of the Invalid Foundation in Helsinki from 1956 to Fractures, 2nd end. London, Bailliere, Tindall and Cox experimental scoliosis, reconstructive surgery in poliomyelitis, coxa plana and coxa vara infantum, He died on July 8, 2000 at the age of 84 years. In 1968, he became professor of orthopedics and traumatology at the University of Helsinki, and was the head of the Department of Orthope- dics and Traumatology, Helsinki University Central Hospital, from 1969 to 1979, and simul- taneously a consulting surgeon at the Orthopedic Hospital of the Invalid Foundation. This was a very busy time in his life because of teaching activities, research work, invited lectureships all over the world, and many national and inter- national activities associated with orthopedic surgery and traumatology.

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Burst fractures cheap renagel 800 mg otc, and fractures affecting the posterior facet joints or Supraspinous Anterior pedicles buy 400 mg renagel with mastercard, are unstable and more easily seen on the lateral ligament column radiograph buy 800mg renagel otc. Instability requires at least two of the three columns of the spine to be disrupted. In simple wedge fractures, only the anterior column is disrupted and the injury remains stable. The demonstration of detail in the thoracic spine can be extremely difficult, particularly in the upper four vertebrae, and computed tomography (CT) is often required Middle Posterior column column Figure 3. Right: CT scan shows the fracture of L4 more clearly, with severe narrowing of the spinal canal. There is a horizontal fracture of the upper part of the vertebral body extending into the posterior elements. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. Radiol Clin also be caused by sternal or bilateral rib fractures, as the North Am 1997;35:507–32 anterior splinting effect of these structures will be lost. A particular type of fracture, the Chance fracture, is London: BMJ Publishing Group, 1995 typically found in the upper lumbar vertebrae. It runs transversely through the vertebral body and usually results from a shearing force exerted by the lap component of a seat belt during severe deceleration injury. These fractures are often associated with intra-abdominal or retroperitoneal injuries. A haematoma in the posterior mediastinum is often seen around the thoracic fracture site, particularly in the anteroposterior view of the spine and sometimes on the chest radiograph requested in the primary survey. If there is any suspicion that these appearances might be due to traumatic aortic dissection, an arch aortogram will be required. Fractures in the thoracic and lumbar spine are often complex and inadequately shown on plain films. If the neurological lesion is complete the patient will have paralysed intercostal muscles and will have to In tetraplegia: rely on diaphragmatic respiration. Partial paralysis of the Intercostal paralysis diaphragm may also be present, either from the outset or after Partial phrenic nerve palsy—immediate 24–48 hours if ascending post-traumatic cord oedema —delayed Impaired ability to expectorate develops. In patients with injuries of the thoracic spine, Ventilation-perfusion mismatch respiratory impairment often results from associated rib fractures, haemopneumothorax, or pulmonary contusion; there In paraplegia: may also be a varying degree of intercostal paralysis depending Variable intercostal paralysis according to level of injury on the neurological level of the lesion. Associated chest injuries Sputum retention occurs readily during the first few days —rib fractures —pulmonary contusion after injury, particularly in patients with high lesions and in —haemopneumothorax those with associated chest injury. The inability to produce an effective cough impairs the clearing of secretions and commonly leads to atelectasis. The loss of lung compliance contributes to difficulty in breathing and leads to a rapid exhaustion of the inspiratory muscles. Abnormal distribution of gases and blood (ventilation-perfusion mismatch) also occurs in the lungs of tetraplegic patients, producing further respiratory impairment.

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