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Sample records for aid orthopaedic fe

  1. Stereoscopy in orthopaedics

    Science.gov (United States)

    Tan, S. L. E.

    2005-03-01

    Stereoscopy was used in medicine as long ago as 1898, but has not gained widespread acceptance except for a peak in the 1930's. It retains a use in orthopaedics in the form of Radiostereogrammetrical Analysis (RSA), though this is now done by computer software without using stereopsis. Combining computer assisted stereoscopic displays with both conventional plain films and reconstructed volumetric axial data, we are reassessing the use of stereoscopy in orthopaedics. Applications include use in developing nations or rural settings, erect patients where axial imaging cannot be used, and complex deformity and trauma reconstruction. Extension into orthopaedic endoscopic systems and teaching aids (e.g. operative videos) are further possibilities. The benefits of stereoscopic vision in increased perceived resolution and depth perception can help orthopaedic surgeons achieve more accurate diagnosis and better pre-operative planning. Limitations to currently available stereoscopic displays which need to be addressed prior to widespread acceptance are: availability of hardware and software, loss of resolution, use of glasses, and image "ghosting". Journal publication, the traditional mode of information dissemination in orthopaedics, is also viewed as a hindrance to the acceptance of stereoscopy - it does not deliver the full impact of stereoscopy and "hands-on" demonstrations are needed.

  2. Computer-aided topological analysis of Nd-Fe-B ternary system

    International Nuclear Information System (INIS)

    A three-dimensional partially matrixed topological model of the Nd-Fe-B ternary phase diagram has been established based on experimental results assessed comprehensively with the aid of a computer-aided design and graphic and graphics software, AutoCAD (R10), and application programs developed in this work. Vertical sections at 5.88 at.% B, Nd:B = 1:1, Fe-Nd/sub 2/Fe/sub 14/B-Nd, Nd/sub 2/Fe/sub 17/-Nd/sub 2/Fe/sub 7/B/sub 6/ have been cut out from the model and the corresponding phase relationships have been analyzed. Among them, those on the Nd-rich protons of both the sections at 5.88 at.% B and Nd:B = 2:1 and those on the Nd/sub 2/Fe/sub 14/B-Nd section are given for the first time. (author)

  3. Fabrication mechanism of FeSe superconductors with high-energy ball milling aided sintering process

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Shengnan, E-mail: snzhang@c-nin.com [Northwest Institute for Non-Ferrous Metal Research, 710016, Xi' an (China); Liu, Jixing [Northwest Institute for Non-Ferrous Metal Research, 710016, Xi' an (China); School of Materials and Metallurgical, Northeast University, Shenyang, 110016 (China); Feng, Jianqing; Wang, Yao; Ma, Xiaobo; Li, Chengshan; Zhang, Pingxiang [Northwest Institute for Non-Ferrous Metal Research, 710016, Xi' an (China)

    2015-08-01

    FeSe Superconducting bulks with high content of superconducting PbO-type β-FeSe phase were prepared with high-energy ball milling (HEBM) aided sintering process. During this process, precursor powders with certain Fe/Se ratio were ball milled first then sintered. The influences of HEBM process as well as initial Fe/Se ratio on the phase evolution process were systematically discussed. With HEBM process and proper initial Fe/Se ratio, the formation of non-superconducting hexagonal δ-FeSe phase were effectively avoided. FeSe bulk with the critical temperature of 9.0 K was obtained through a simple one-step sintering process with lower sintering temperature. Meanwhile, the phase evolution mechanism of the HEBM precursor powders during sintering was deduced based on both the thermodynamic analysis and step-by-step sintering results. The key function of the HEBM process was to provide a high uniformity of chemical composition distribution, thus to successfully avoide the formation of intermediate product during sintering, including FeSe{sub 2} and Fe{sub 7}Se{sub 8}. Therefore, the fundamental principal for the synthesis of FeSe superconductors were concluded as: HEBM aided sintering process, with the sintering temperature of >635 °C and a slow cooling process. - Highlights: • A novel synthesis technique was developed for FeSe based superconductors. • FeSe bulks with high Tc and high β-FeSe phase content has been obtained. • Phase evolution process for the HEBM aided sintering process was proposed.

  4. Fabrication mechanism of FeSe superconductors with high-energy ball milling aided sintering process

    International Nuclear Information System (INIS)

    FeSe Superconducting bulks with high content of superconducting PbO-type β-FeSe phase were prepared with high-energy ball milling (HEBM) aided sintering process. During this process, precursor powders with certain Fe/Se ratio were ball milled first then sintered. The influences of HEBM process as well as initial Fe/Se ratio on the phase evolution process were systematically discussed. With HEBM process and proper initial Fe/Se ratio, the formation of non-superconducting hexagonal δ-FeSe phase were effectively avoided. FeSe bulk with the critical temperature of 9.0 K was obtained through a simple one-step sintering process with lower sintering temperature. Meanwhile, the phase evolution mechanism of the HEBM precursor powders during sintering was deduced based on both the thermodynamic analysis and step-by-step sintering results. The key function of the HEBM process was to provide a high uniformity of chemical composition distribution, thus to successfully avoide the formation of intermediate product during sintering, including FeSe2 and Fe7Se8. Therefore, the fundamental principal for the synthesis of FeSe superconductors were concluded as: HEBM aided sintering process, with the sintering temperature of >635 °C and a slow cooling process. - Highlights: • A novel synthesis technique was developed for FeSe based superconductors. • FeSe bulks with high Tc and high β-FeSe phase content has been obtained. • Phase evolution process for the HEBM aided sintering process was proposed

  5. Retractions in orthopaedic research

    Science.gov (United States)

    Yan, J.; MacDonald, A.; Baisi, L-P.; Evaniew, N.; Bhandari, M.

    2016-01-01

    Objectives Despite the fact that research fraud and misconduct are under scrutiny in the field of orthopaedic research, little systematic work has been done to uncover and characterise the underlying reasons for academic retractions in this field. The purpose of this study was to determine the rate of retractions and identify the reasons for retracted publications in the orthopaedic literature. Methods Two reviewers independently searched MEDLINE, EMBASE, and the Cochrane Library (1995 to current) using MeSH keyword headings and the ‘retracted’ filter. We also searched an independent website that reports and archives retracted scientific publications (www.retractionwatch.com). Two reviewers independently extracted data including reason for retraction, study type, journal impact factor, and country of origin. Results One hundred and ten retracted studies were included for data extraction. The retracted studies were published in journals with impact factors ranging from 0.000 (discontinued journals) to 13.262. In the 20-year search window, only 25 papers were retracted in the first ten years, with the remaining 85 papers retracted in the most recent decade. The most common reasons for retraction were fraudulent data (29), plagiarism (25) and duplicate publication (20). Retracted articles have been cited up to 165 times (median 6; interquartile range 2 to 19). Conclusion The rate of retractions in the orthopaedic literature is increasing, with the majority of retractions attributed to academic misconduct and fraud. Orthopaedic retractions originate from numerous journals and countries, indicating that misconduct issues are widespread. The results of this study highlight the need to address academic integrity when training the next generation of orthopaedic investigators. Cite this article: J. Yan, A. MacDonald, L-P. Baisi, N. Evaniew, M. Bhandari, M. Ghert. Retractions in orthopaedic research: A systematic review. Bone Joint Res 2016;5:263–268. DOI: 10

  6. Health economics and orthopaedics.

    Science.gov (United States)

    Maniadakis, N; Gray, A

    2000-01-01

    It is becoming widely accepted that research which considers only the outcome and not the costs associated with new technologies in health care, is of limited value in making decisions about the use of scarce resources. Economic evaluation is becoming a standard feature of clinical research but many published economic evaluations fall short of best practice in their methodology. We have described the essential features of economic evaluation, using published studies in orthopaedics, in order to try to improve the ability of orthopaedic surgeons to read, understand and appraise such studies critically, and to encourage them to consider including economic evaluation in future investigations. PMID:10697306

  7. Successfully reforming orthopaedic outpatients.

    Science.gov (United States)

    Schoch, Peter A; Adair, Lisa

    2012-05-01

    Since 2005, Barwon Health has successfully reformed its orthopaedic outpatient service to address the following issues: increasing number of referrals, inefficient referral management and triage, long waiting times for non-urgent appointments, high 'Did Not Attend' (DNA) rates and poor utilisation of conservative therapies before referral to surgeon. Numerous strategies have been implemented including: waiting list audits, triage guidelines, physiotherapy-led clinics, a DNA policy, an orthopaedic lead nurse role and a patient-focussed booking system. There has been a 66% reduction in the number of patients waiting for their first appointment; an 87% reduction in the waiting time from referral to first appointment; a 10% reduction in new patient DNAs; and more efficient referral management and communication processes. Patients are now seen in clinically appropriate time frames and offered earlier access to a wider range of conservative treatments. PMID:22624648

  8. Orthopaedic Management of Spasticity.

    Science.gov (United States)

    Pidgeon, Tyler S; Ramirez, Jose M; Schiller, Jonathan R

    2015-12-01

    Spasticity is a common manifestation of many neurological conditions including multiple sclerosis, stroke, cerebral palsy, traumatic brain injury, and spinal cord injuries. Management of spasticity seeks to reduce its burden on patients and to limit secondary complications. Non-operative interventions including stretching/splinting, postural management, physical therapy/strengthening, anti-spasticity medications, and botulinum toxin injections may help patients with spasticity. Surgical management of these conditions, however, is often necessary to improve quality of life and prevent complications. Orthopaedic surgeons manage numerous sequelae of spasticity, including joint contractures, hip dislocations, scoliosis, and deformed extremities. When combined with the efforts of rehabilitation specialists, neurologists, and physical/occupational therapists, the orthopaedic management of spasticity can help patients maintain and regain function and independence as well as reduce the risk of long-tem complications. PMID:26623452

  9. Orthopaedic Injuries in Equestrian Sports

    OpenAIRE

    Young, Jason David; Gelbs, Jared Craig; Zhu, David Shiyu; Gallacher, Stacey Elisa; Sutton, Karen Michelle; Blaine, Theodore Alton

    2015-01-01

    Background: Despite the common nature of orthopaedic injuries in equestrian sports, there is no published review to specifically characterize orthopaedic injuries in equestrian athletes. Purpose: To characterize orthopaedic injury patterns in equine sports–related injuries and their treatment. Study Design: Systematic review; Level of evidence, 4. Methods: This review was performed through a PubMed, EMBASE, and Scopus query (from 1978 to June 2014) in the English literature using search terms...

  10. American Academy of Orthopaedic Surgeons

    Science.gov (United States)

    ... Member Groups Distribution of member types. Get Social Facebook Twitter American Academy of Orthopaedic Surgeons Tweets by @AAOSmembers Advertisement Career Opportunities Northwest Permanente, PC Shoulder and Elbow ...

  11. Orthopaedics and the law.

    Science.gov (United States)

    Suk, Michael; Udale, Ann Marie; Helfet, David L

    2005-10-01

    Understanding the relevant legal context is critical to the safe and successful practice of orthopaedic surgery. Specifically, three areas of liability are relevant to most physicians: medical malpractice, products liability, and the liability of health care organizations. Medical malpractice encompasses the professional physician-patient relationship with its implied contract, consent, fiduciary responsibilities, and duty to provide the standard of care, as well as certain common-law duties pertinent in special circumstances. Orthopaedic surgeons who design implants or who have a relationship with a device manufacturer are at risk for liability for a failed product. In general, the hospital entity is responsible for the actions of its physician-employees. Still unclear is the degree to which a physician is obligated to appeal to a third-party payer on behalf of a patient. Physicians should remember that, above all else, common sense with regard to the treatment, informed consent, and advocacy of patients is essential to avoiding many medical-legal pitfalls. PMID:16224112

  12. AIDS

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...

  13. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

    Science.gov (United States)

    2012-01-01

    Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher

  14. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

    Directory of Open Access Journals (Sweden)

    Bouchard Maryse

    2012-05-01

    Full Text Available Abstract Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct

  15. Translating orthopaedic basic science into clinical relevance

    OpenAIRE

    Madry, Henning

    2014-01-01

    In orthopaedic and trauma surgery, the rapid evolution of biomedical research has fundamentally changed the perception of the musculoskeletal system. Here, the rigor of basic science and the art of musculoskeletal surgery have come together to create a new discipline -experimental orthopaedics- that holds great promise for the causative cure of many orthopaedic conditions. The Journal of Experimental Orthopaedics intends to bridge the gap between orthopaedic basic science and clinical relevan...

  16. Corrosion Resistance Analysis of Sintered NdFeB Magnets Using Ultrasonic-Aided EDM Method

    Science.gov (United States)

    Li, L.; Wei, X. T.; Li, Z. Y.; Cheng, X.

    2015-01-01

    Sintered neodymium-iron-boron (NdFeB) permanent magnets are widely used in many fields because of their excellent magnetic property. However, their poor corrosion resistance has been cited as a potential problem that limits their extensive application. This paper presents an experimental investigation into the improvement of surface corrosion resistance with the ultrasonic-aided electrical discharge machining (U-EDM) method. A scanning electron microscope was used to analyze the surface morphology of recast layers formed through the EDM and U-EDM processes. The chemical structure and elements of these recast layers were characterized using x-ray diffraction and energy dispersive spectroscopy. Corrosion resistance was also studied by means of potentiodynamic polarization, electrochemical impedance spectroscopy, and immersion tests in 0.5 mol/L H2SO4 solution. Experimental results show that an amorphous structure was formed in the recast layer during the EDM and U-EDM processes and that this structure could improve the corrosion resistance of sintered NdFeB magnets. Moreover, the corrosion resistance of U-EDM-treated surface was better than that of the EDM-treated surface.

  17. Venous thromboembolism (VTE) risk assessment and prophylaxis in acute orthopaedic admissions: improving compliance with national guidelines

    OpenAIRE

    Watts, Laura; Grant, David

    2013-01-01

    “Each year over 25,000 people die from Venous Thromboembolism (VTE) contracted in hospital. This is more than the combined total of deaths from breast cancer, AIDS and traffic accidents”. (1) Orthopaedic patients are at particular risk of VTE. In 2011, the project team carried out an audit into compliance with national VTE assessment guidelines on all acute trauma and orthopaedic admissions during a two week period at a District General Hospital. The study demonstrated that compliance was ini...

  18. Auditing Orthopaedic Audit

    Science.gov (United States)

    Guryel, E; Acton, K; Patel, S

    2008-01-01

    INTRODUCTION Clinical audit plays an important role in the drive to improve the quality of patient care and thus forms a cornerstone of clinical governance. Assurance that the quality of patient care has improved requires completion of the audit cycle. A considerable sum of money and time has been spent establishing audit activity in the UK. Failure to close the loop undermines the effectiveness of the audit process and wastes resources. PATIENTS AND METHODS We analysed the effectiveness of audit in trauma and orthopaedics at a local hospital by comparing audit projects completed over a 6-year period to criteria set out in the NHS National Audit and Governance report. RESULTS Of the 25 audits performed since 1999, half were presented to the relevant parties and only 20% completed the audit cycle. Only two of these were audits against national standards and 28% were not based on any standards at all. Only a third of the audits led by junior doctors resulted in implementation of their action plan compared to 75% implementation for consultant-led and 67% for nurse-led audits. CONCLUSIONS A remarkably large proportion of audits included in this analysis failed to meet accepted criteria for effective audit. Audits completed by junior doctors were found to be the least likely to complete the cycle. This may relate to the lack of continuity in modern medical training and little incentive to complete the cycle. Supervision by permanent medical staff, principally consultants, and involvement of the audit department may play the biggest role in improving implementation of change. PMID:18828963

  19. American Orthopaedic Foot and Ankle Society

    Science.gov (United States)

    ... education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of ...

  20. Computational radiology for orthopaedic interventions

    CERN Document Server

    Li, Shuo

    2016-01-01

    This book provides a cohesive overview of the current technological advances in computational radiology, and their applications in orthopaedic interventions. Contributed by the leading researchers in the field, this volume covers not only basic computational radiology techniques such as statistical shape modeling, CT/MRI segmentation, augmented reality and micro-CT image processing, but also the applications of these techniques to various orthopaedic interventional tasks. Details about following important state-of-the-art development are featured: 3D preoperative planning and patient-specific instrumentation for surgical treatment of long-bone deformities, computer assisted diagnosis and planning of periacetabular osteotomy and femoroacetabular impingement, 2D-3D reconstruction-based planning of total hip arthroplasty, image fusion for  computer-assisted bone tumor surgery, intra-operative three-dimensional imaging in fracture treatment, augmented reality based orthopaedic interventions and education, medica...

  1. Orthopaedic Injuries in Equestrian Sports

    Science.gov (United States)

    Young, Jason David; Gelbs, Jared Craig; Zhu, David Shiyu; Gallacher, Stacey Elisa; Sutton, Karen Michelle; Blaine, Theodore Alton

    2015-01-01

    Background: Despite the common nature of orthopaedic injuries in equestrian sports, there is no published review to specifically characterize orthopaedic injuries in equestrian athletes. Purpose: To characterize orthopaedic injury patterns in equine sports–related injuries and their treatment. Study Design: Systematic review; Level of evidence, 4. Methods: This review was performed through a PubMed, EMBASE, and Scopus query (from 1978 to June 2014) in the English literature using search terms “(equine-related OR equestrian-related OR horse-related OR equestrian OR equestrians) AND (injury OR injuries).” Only full-text studies reporting on orthopaedic injury patterns pertinent to equestrian sports in the United States (US) and the United Kingdom (UK) were included. Orthopaedic injuries were defined as those resulting in a fracture or dislocation. In all, 182 studies were excluded, leaving a total of 27 studies for evaluation. The studies included were analyzed for demographic and epidemiological data for orthopaedic injuries, including fractures and dislocations. Cranial and facial injuries were excluded from analysis. Results: The majority of those injured in the US were female (64.5%). The leading cause of injury in the US was falling from a horse. The use of protective equipment seemed to vary widely, with helmet use ranging from less than 6% up to 66.7%. In the UK, fractures were found to account for 17.4% of reported injures, compared with 33.6% of injuries in the US. The majority of fractures in US riders occurred in the upper extremities (50.7%). Conclusion: This review helps characterize the epidemiology of equestrian injuries based on currently available data. PMID:26535400

  2. Developmental orthopaedic diseases in foals

    International Nuclear Information System (INIS)

    Developmental Orthopaedic Diseases (DOD) is seen frequently in horses which completed their maturity. Osteochondrosis, physitis, angular limb deformities, flexural deformities, juvenil arthritis, cervical vertebral anomalies, cuboidal bone abnormalities are problems investigated under Developmental Orthopaedic Diseases title. This diseases can develop single or some together in fast growing, heavy animals (especially Arabian and English Thoroughbreds). Multifactorial causes of this diseases etiopathogenesis can be listed as genetic predisposition, trauma, nutrition, vitamins/minerals and endocrine disorders. But the exact causes of these diseases are not known. In this review detailed information are given about the diseases mentioned above

  3. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F

    2012-08-01

    Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

  4. Novel imaging procedure in orthopaedics

    Energy Technology Data Exchange (ETDEWEB)

    Glatt, E.; Wenz, W.; Reinbold, W.D.

    1988-01-07

    CT has been proved as routine method in diagnostic imaging of many orthopaedic diseases, concerning complex spine trauma, spinal disc herniation, bone neoplasmas and chronic inflammatory diseases. MR-Imaging gives further information of the spinal chord and the subarachnoid space and of early diagnostic of inflammatory bone and articular diseases.

  5. Applications of nanotechnology in orthopaedics.

    Science.gov (United States)

    Tasker, L H; Sparey-Taylor, G J; Nokes, L D M

    2007-03-01

    Nanotechnology is the application of science and engineering at the nanoscale. A diverse range of applications are beginning to emerge in all areas of medicine. We performed a survey from November 2005 to March 2006 using the Internet search engines PubMed, ScienceDirect, ISI Web of Knowledge, and Google Scholar. We report on the role of nanotechnology in orthopaedics, exploring current and potential applications. Nanostructured materials have been proposed as the next generation of orthopaedic implant properties by creating a surface environment more conducive for osteoblast function. Bone substitute materials, whose nanoscale composition emulates the hierarchic organization of natural bone, shows initiation of the desirable formation of an apatite layer. Nanotechnology also has been harnessed to improve the cutting performance and quality of surgical blades. Postoperative infection rates may be reduced by using nanofibrous membrane wound dressings containing antibacterial properties. The most notable application of nanotechnology in orthopaedics may be drug delivery, including nanotherapeutics for treating bone cancer and arthritis. Nanotechnology is being used in orthopaedics, and likely will play a valuable role in future developments. PMID:17224843

  6. BaFe{sub 12}O{sub 19} powder with high magnetization prepared by acetone-aided coprecipitation

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Hsuan-Fu, E-mail: hfyu@mail.tku.edu.tw

    2013-09-15

    BaFe{sub 12}O{sub 19} particles with high magnetization were produced using an acetone-aided coprecipitation process. An aqueous solution of iron and barium nitrates, in an Fe{sup 3+}/Ba{sup 2+} molar ratio of 12, was added in a stirred precipitation liquid medium composed of H{sub 2}O, CH{sub 3}(CO)CH{sub 3} and NH{sub 4}OH. After reacting metallic ions with ammonia, the precipitates were formed, centrifugally filtered, freeze dried and calcined. Effects of amount of the acetone in the precipitation liquid medium on the formation of crystalline BaFe{sub 12}O{sub 19} were investigated. The presence of acetone in the precipitation liquid medium can greatly promote formation of the crystalline BaFe{sub 12}O{sub 19} at temperature as low as 650 °C and can enhance magnetization of the derived particles. On the other hand, raising the calcination temperature can effectively accelerate development of crystallite morphology and magnetic characters of the barium hexaferrites. While the barium hexaferrite powder obtained without acetone additions and calcined at 1000 °C had magnetization (measured at 50 kOe; M(50 kOe)) of 63.5 emu/g, remanence magnetization (Mr) of 31.3 emu/g and coercivity (Hc) of 4.7 kOe, the single magnetic domain size BaFe{sub 12}O{sub 19} powder with M(50 kOe) of 70.6 emu/g, Mr of 34.4 emu/g and Hc of 3.7 kOe was produced at 1000 °C, using a precipitation liquid medium of 64 vol% acetone. - Highlights: • BaFe{sub 12}O{sub 19} with high magnetic characters was produced by an acetone-aided coprecipitation. • The effects of acetone addition in the precipitation on the formation of BaFe{sub 12}O{sub 19} were studied. • Acetone presence in the precipitation liquid medium promoted BaFe{sub 12}O{sub 19} formation at ≥650 °C. • BaFe{sub 12}O{sub 19} with M(50 kOe) of 70.6 emu/g, Mr of 34.4 emu/g and Hc of 3.7 kOe was obtained.

  7. [Functional and orthopaedic aspects of dystrophinopathies].

    Science.gov (United States)

    Boulay, C; Finidori, G

    2015-12-01

    Although the clinical picture and the natural progression of Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) differ, borderline forms exist. Classical orthopaedic treatment is based on self-rehabilitation (by the parents and the patient), physical therapy, posture alignment with orthotics, ergotherapy to set up technical aides, notably positioning in an electric wheelchair to provide more satisfactory autonomy. The functional aspect predominates over pure orthopaedics. Although surgical indications have evolved for the lower limbs, pelvic-spinal arthrodesis for treatment of scoliosis remains the reference treatment, but the methods have evolved since the advent of corticotherapy for DMD. Corticotherapy slows the progression of motor deficits, the age at which walking ability is lost is delayed (shifting from 10 years to 13-14 years depending on the studies), scoliosis progresses later, respiratory insufficiency is better controlled, and therefore survival is prolonged (between 20 and 40 years). However, although this functional aspect seems to respond better to the progress in overall treatment, it also results from a multidisciplinary approach to the disease. Nevertheless, assessment is required, not at a time t as reflected by the scales currently in use, but during daily activities as proposed by qualitative and quantitative monitoring seeking to model nyctohemeral functional motor skills. The principle is to characterize the type of activity (sitting, standing, lying down, walking), its duration, its intensity (walking speed), its frequency (number of activity changes, number of walking episodes), and their sequence (temporal sequence, organization of activity variation). The goal is to identify the variety of functional motor skills and their occurrence over time to determine whether treatment contributes a functional benefit and whether this benefit is put into practice daily. PMID:26773586

  8. Synthesis of graphene through direct decomposition of CO$_2$ with the aid of Ni–Ce–Fe trimetallic catalyst

    Indian Academy of Sciences (India)

    Ghazaleh Allaedini; Siti Masrinda Tasirin; Payam Aminayi

    2016-02-01

    In this study, few-layered graphene (FLG) has been synthesized using the chemical vapour deposition (CVD) method with the aid of a novel Ni–Ce–Fe trimetallic catalyst. Carbon dioxide was used as the carbon source in the present work. The obtained graphene was characterized by Raman spectroscopy, and the results proved that high-quality graphene sheets were obtained. Scanning electron microscopy, atomic force microscopy and transmission electron microscopy pictures were used to investigate the morphology of the prepared FLG. The energydispersive X-ray spectroscopy results confirmed a high yield ($\\sim$48%) of the obtained graphene through this method. Ni–Ce–Fe has been shown to be an active catalyst in the production of high-quality graphene via carbon dioxide decomposition. The X-ray photoelectron spectroscopy spectrum was also obtained to confirm the formation of graphene.

  9. International Combined Orthopaedic Research Societies: A model for international collaboration to promote orthopaedic and musculoskeletal research

    Directory of Open Access Journals (Sweden)

    Theodore Miclau

    2014-10-01

    Full Text Available In October 2013, the International Combined Orthopaedic Research Societies (ICORS; http://i-cors.org was founded with inaugural member organisations from the previous Combined Orthopaedic Research Society, which had sponsored combined meetings for more than 2 decades. The ICORS is dedicated to the stimulation of orthopaedic and musculoskeletal research in fields such as biomedical engineering, biology, chemistry, and veterinary and human clinical research. The ICORS seeks to facilitate communication with member organisations to enhance international research collaborations and to promote the development of new international orthopaedic and musculoskeletal research organisations. Through new categories of membership, the ICORS represents the broadest coalition of orthopaedic research organisations globally.

  10. Orthopaedic research and education foundation and industry.

    Science.gov (United States)

    Wurth, Gene R; Sherr, Judy H; Coffman, Thomas M

    2003-07-01

    Members of orthopaedic industry commit a significant amount of funds each year to support research and education programs that are directly related to their product(s). In addition, industry supports organizations such as the Orthopaedic Research and Education Foundation. The relationship between the Orthopaedic Research and Education Foundation and industry began in the early 1980s. The support to the Orthopaedic Research and Education Foundation from industry primarily has come in the form of unrestricted grants. These grants best can be looked at as an investment rather than a contribution. This form of giving, once called corporate philanthropy is more accurately referred to as strategic philanthropy. Members of industry make these investments to enhance their reputations, build brand awareness, market their products and services, improve employee morale, increase customer loyalty, and establish strategic alliances. The specialty of orthopaedics is among the leaders in medicine in the amount of funding raised within the specialty for research and education programs. This is because of the amount of support from members of industry and the surgeons. During the past 15 years, 40% of the annual support to the Orthopaedic Research and Education Foundation has come from industry and the balance has come from surgeons and members of lay public. Future industry support of the Orthopaedic Research and Education Foundation and other organizations within the specialty of orthopaedics will be dependent on the continued demonstration of tangible returns in areas described. PMID:12838052

  11. The Malaysian Orthopaedic Association humanitarian mission to Indonesia and Sri Lanka.

    Science.gov (United States)

    Sharaf, I; Saw, A; Hyzan, Y; Sivananthan, K S

    2005-07-01

    The tsunami which occurred off the west coast of North Sumatra on December 26, 2004 devastated the coastal areas of North Sumatra, South-West Thailand, South-East India and Sri Lanka killing more than a quarter of a million people. The destruction was enormous with many coastal villages destroyed. The other countries affected were Malaysia, Myanmar, Maldives, Bangladesh, Somalia, Kenya, Tanzania and the Seychelles. In January 2005, volunteers went in weekly rotation to Banda Aceh in collaboration with Global Peace Mission. These were Dr Hyzan Yusof, Dr Suryasmi Duski, Dr Sharaf Ibrahim, Dr Saw Aik, Dr Kamariah Nor and Dr Nor Azlin. In Banda Aceh, the surgical procedures that we could do were limited to external fixation of open fractures and debriding infected wounds at the Indonesian Red Crescent field hospital. In February, a team comprising Dato Dr K S Sivananthan, Dr T Kumar and Dr S Vasan spent a week in Sri Lanka. In Sri Lanka, Dato Sivananthan and his team were able to perform elective orthopaedic operations in Dr Poonambalam Memorial Hospital. We appealed for national and international aid and received support from local hospitals and the orthopaedic industry. International aid bound for Banda Aceh arrived in Kuala Lumpur from the Philippine Orthopaedic Association, the Chiba Children's Hospital in Japan and the Chinese Orthopaedic Association. The COA donated 1.5 tons of orthopaedic equipments. A special handing over ceremony from the COA to the Indonesian Orthopaedic Association was held in Putrajaya in March. Malaysia Airlines flew in the donated equipment to Kuala Lumpur while the onward flight to Aceh was provided by the Royal Malaysian Air Force. In April, Dr Saw Aik and Dr Yong Su Mei joined the Tsu-Chi International Medical Association for volunteer services on Batam Island, Indonesia. The MOA acknowledges the many individuals and organizations, both governmental and non-governmental, for their contributions in the humanitarian efforts. PMID

  12. The Role of the Orthopaedic Specialist

    OpenAIRE

    Giannini, S; Donati, D.M.; Frisoni, T.; Cevolani, L.; Chiarello, E.

    2010-01-01

    In recent years, cell therapy for bone regeneration has been found to have different indications in orthopaedic surgery, such as delayed fracture consolidation and the treatment of bone cysts and osteonecrosis.

  13. Orthopaedic Surgeon Burnout: Diagnosis, Treatment, and Prevention.

    Science.gov (United States)

    Daniels, Alan H; DePasse, J Mason; Kamal, Robin N

    2016-04-01

    Burnout is a syndrome marked by emotional exhaustion, depersonalization, and low job satisfaction. Rates of burnout in orthopaedic surgeons are higher than those in the general population and many other medical subspecialties. Half of all orthopaedic surgeons show symptoms of burnout, with the highest rates reported in residents and orthopaedic department chairpersons. This syndrome is associated with poor outcomes for surgeons, institutions, and patients. Validated instruments exist to objectively diagnose burnout, although family members and colleagues should be aware of early warning signs and risk factors, such as irritability, withdrawal, and failing relationships at work and home. Emerging evidence indicates that mindfulness-based interventions or educational programs combined with meditation may be effective treatment options. Orthopaedic residency programs, departments, and practices should focus on identifying the signs of burnout and implementing prevention and treatment programs that have been shown to mitigate symptoms. PMID:26885712

  14. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan

    2015-01-01

    Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

  15. Radiation safety knowledge and practices among Irish orthopaedic trainees.

    LENUS (Irish Health Repository)

    Nugent, M

    2014-04-23

    Fluoroscopy is frequently used in orthopaedic surgery, particularly in a trauma setting. Exposure of patients and staff to ionising radiation has been studied extensively; however, little work has been done to evaluate current knowledge and practices among orthopaedic trainees.

  16. Inpatient consultations to an orthopaedic service: the hidden workload.

    LENUS (Irish Health Repository)

    O'Malley, N T

    2011-12-01

    While the quality and efficiency of out-patient orthopaedic referrals are well documented in the literature, there is little on the standard and appropriateness of inpatient orthopaedic consultations.

  17. Paralytic ileus in the orthopaedic patient.

    Science.gov (United States)

    Daniels, Alan H; Ritterman, Scott A; Rubin, Lee E

    2015-06-01

    Paralytic ileus is marked by the cessation of bowel motility. This condition is a major clinical concern that may lead to severe patient morbidity in orthopaedic surgery and trauma patients. Ileus most commonly occurs following spinal surgery, traumatic injury, or lower extremity joint reconstruction, but it may also occur following minor orthopaedic procedures. Possible consequences of ileus include abdominal pain, malnutrition, prolonged hospital stay, hospital readmission, bowel perforation, and death. Therapies used in the treatment of ileus include minimization of opioids, early patient mobilization, pharmacologic intervention, and multidisciplinary care. Orthopaedic surgeons should be aware of the clinical signs and symptoms of paralytic ileus and should understand treatment principles of this relatively common adverse event. PMID:25917235

  18. Recognizing and Preventing Burnout among Orthopaedic Leaders

    OpenAIRE

    Saleh, Khaled J.; James Campbell QUICK; Sime, Wesley E.; Novicoff, Wendy M.; Einhorn, Thomas A.

    2008-01-01

    Stress, emotional exhaustion, and burnout are widespread in the medical profession in general and in orthopaedic surgery in particular. We attempted to identify variables associated with burnout as assessed by validated instruments. Surveys were sent to 282 leaders from orthopaedic surgery academic departments in the United States by e-mail and mail. Responses were received from 195 leaders for a response rate of 69%. The average surgeon worked 68.3 hours per week and more than ½ of this time...

  19. Imaging from an orthopaedic point of view

    International Nuclear Information System (INIS)

    The paradigm of coping with sometimes gross pathology, while having some small and at first sight insignificant lesions demands for accurate radiological detection and orthopaedic treatment makes it interesting and challenging to be involved in the treatment of professional athletes. In the diagnostic process we differentiate between acute, posttraumatic and overuse injuries. We must realize the importance of reproducible routine X-rays as a first step in the diagnostic process. In case of additional diagnostics, appropriate consultation between the orthopaedic surgeon and the radiologist is essential in order to determine the best strategy

  20. Orthopaedic nurses' perception of research utilization - A cross sectional survey

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

    2015-01-01

    knowledge and practical research competencies among orthopaedic nurses and their interest and motivation to increase these in everyday practice. A newly developed questionnaire was given to a convenience sample of 87 orthopaedic nurses. Forty three orthopaedic nurses (49.4%) completed the questionnaire. The...

  1. Leadership and business education in orthopaedic residency training programs.

    Science.gov (United States)

    Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

    2011-01-01

    Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future. PMID:21838073

  2. Patient compliance and effect of orthopaedic shoes

    DEFF Research Database (Denmark)

    Philipsen, A B; Ellitsgaard, N; Krogsgaard, M R; Sonne-Holm, S

    1999-01-01

    orthopaedic shoes at the authors' department during a 3 year period received a questionnaire concerning relief of symptoms and daily use of the shoes. The answers from 74 patients were correlated to the prescription procedure and the degree of medical follow-up. Only 60 of 74 patients used their shoes. Some...... 51 patients had some benefit while 23 had no effect or even worse symptoms. Some patients even used their shoes despite no symptomatic relief. However, patients who felt they were well informed about the purpose and function of their shoes had more benefit than the rest. Only 12 patients of the 74....... Further investigations of the effect of orthopaedic shoes should be carried out to optimise the use of these expensive devices....

  3. The Impact of Disruptive Innovations in Orthopaedics

    OpenAIRE

    Hansen, Erik; Bozic, Kevin J.

    2009-01-01

    The US healthcare system is currently facing daunting demographic and economic challenges. Because musculoskeletal disorders and disease represent a substantial and growing portion of this healthcare burden, novel approaches will be needed to continue to provide high-quality, affordable, and accessible orthopaedic care to our population. The concept of “disruptive innovations,” which has been studied and popularized by Harvard Business School Professor Clayton Christensen, may offer a potenti...

  4. Lessons learned from benchmark orthopaedic trials.

    Science.gov (United States)

    Swiontkowski, Marc F; Agel, Julie

    2012-07-18

    Benchmark trials in orthopaedics are designed to address a question of substantial interest to clinicians and patients. They are also designed to have prospective data collection, an adequate sample size, an appropriate duration of follow-up based on the injury or treatment under study, blinded adjudication of the outcome variables, appropriate statistical analyses, and widespread and effective dissemination of the information learned in the trial. There are multiple lessons to be gleaned from these trials: (1) Identifying an engaging and relevant clinical question will make it easier to identify centers that are willing to participate. (2) Individual site leadership, both of the overall project and at the individual site, is critical to the success of any trial. (3) Not every trial needs to have a randomized design; observational trials can provide data that will impact clinical care. (4) Patients should understand the long-term goals of the project when they are enrolled so that they have a sense of the importance of their role in the study. (5) Follow-up rates that are >90% are possible for orthopaedic trials, but effort and money are required to achieve this. (6) Patients who do not agree to be randomized should be enrolled as subjects in a parallel observational design if it is available. (7) Blinded adjudication of the outcome variables is recommended whenever feasible. (8) Partnership with the academic community is mandatory for the success of industry-funded, phase-3 United States Food and Drug Administration trials. (9) Intention-to-treat analysis and as-treated analysis should be reported. Benchmark orthopaedic trials can and will change clinical practice, but detailed planning must occur to ensure that the results are believable and relevant to the orthopaedic community. These trials are time-consuming and expensive, but with the use of careful initial planning and continued oversight during the trial, Level-I evidence will be obtained and will be useful

  5. Release of Chromium from Orthopaedic Arthroplasties

    OpenAIRE

    Afolaranmi, G.A.; Tettey, J; Meek, R.M.D; Grant, M.H

    2008-01-01

    Many orthopaedic implants are composed of alloys containing chromium. Of particular relevance is the increasing number of Cobalt Chromium bearing arthroplasies being inserted into young patients with osteoarthritis. Such implants will release chromium ions. These patients will be exposed to the released chromium for over 50 years in some cases. The subsequent chromium ion metabolism and redistribution in fluid and tissue compartments is complex. In addition, the potential biological effects o...

  6. Analysis of kidney dysfunction in orthopaedic patients

    OpenAIRE

    Kateros Konstantinos; Doulgerakis Christos; Galanakos Spyridon P; Sakellariou Vasileios I; Papadakis Stamatios A; Macheras George A

    2012-01-01

    Abstract Backround This retrospective study was undertaken to determine the incidence of kidney dysfunction (KD) and to identify potential risk factors contributing to development of KD in orthopaedic population following an elective or emergency surgery. Methods A total of 1025 patients were admitted in our institution over a period of one year with various indications. Eight hundred and ninety-three patients (87.1%) had a surgical procedure. There were 42 (52.5%) male and 38 (47.5%) female ...

  7. Current status and progress of digital orthopaedics in China

    OpenAIRE

    Guo-Xian Pei; Ya-Bo Yan

    2014-01-01

    Based on the development of digital medicine and digital anatomy, the concept of “digital orthopaedics” was raised by Pei Guo-Xian in China in 2006. The most striking feature of digital orthopaedics is the combination of basic and clinical orthopaedic knowledge with digital technology. In this review, we summarised the development of digital orthopaedics in China in recent years with respect to: the foundation of the Chinese Association of Digital Orthopedics, virtual human project (VHP), thr...

  8. The current situation and future of orthopaedic traumatology

    Institute of Scientific and Technical Information of China (English)

    JIANG Bao-guo

    2010-01-01

    @@ With the development of medical science,orthopaedic traumatology, which derives from orthopaedics, becomes an important sub-discipline.Orthopedic traumatology includes: (1) fracture of limbs and spine; (2) injury to blood vessels, nerves, muscles and tendons; (3) traumatic skin defects of the limbs; (4)the limb injury and spinal cord injury, etc. Since the end of the 20th century, the orthopaedic tranmatology field has been developing rapidly, and is becoming one of the four major sub-groups of orthopaedics along with musculoskeletal and tumor surgery, spinal surgery, and joint surgery. 1-4

  9. 75 FR 32210 - United States v. Idaho Orthopaedic Society, Timothy Doerr, Jeffrey Hessing, Idaho Sports Medicine...

    Science.gov (United States)

    2010-06-07

    ... Antitrust Division United States v. Idaho Orthopaedic Society, Timothy Doerr, Jeffrey Hessing, Idaho Sports.... Idaho Orthopaedic Society, Timothy Doerr, Jeffrey Hessing, Idaho Sports Medicine Institute, John Kloss..., Plaintiffs, vs. Idaho Orthopaedic Society, Timothy Doerr, Jeffrey Hessing, Idaho Sports Medicine...

  10. Sources of information influencing decision-making in orthopaedic surgery - an international online survey of 1147 orthopaedic surgeons

    OpenAIRE

    Schulz, Arndt P; Jönsson, Anders; Kasch, Richard; Jettoo, Prithee; Bhandari, Mohit

    2013-01-01

    Background Manufacturers of implants and materials in the field of orthopaedics use significant amounts of funding to produce informational material to influence the decision-making process of orthopaedic surgeons with regards to choice between novel implants and techniques. It remains unclear how far orthopaedic surgeons are really influenced by the materials supplied by companies or whether other, evidence-based publications have a higher impact on their decision-making. The objective was t...

  11. Orthopaedic thromboprophylaxis: limitations of current guidelines

    DEFF Research Database (Denmark)

    Warwick, D.; Dahl, O.E.; Fisher, W.D.;

    2008-01-01

    research into 'evidence-based' advice. Guidelines should, in theory, benefit patient care by ensuring that every patient routinely receives the best prophylaxis; without guidelines, it is argued, patients may fail to receive treatment or be exposed to protocols which are ineffective, dangerous or expensive....... Guidelines, however, have not been welcomed or applied universally. In the United States, orthopaedic surgeons have published their concerns about the thromboprophylaxis guidelines prepared by the American College of Chest Physicians. In Britain, controversy persists with many surgeons unconvinced of the...

  12. Optimization of Orthopaedic Drilling: A Taguchi Approach

    Directory of Open Access Journals (Sweden)

    Rupesh Kumar Pandey

    2012-06-01

    Full Text Available Bone drilling is a common procedure to prepare an implant site during orthopaedic surgery. An increase in temperature during such a procedure can result in thermal ostenecrosis which may delay healing or reduce the stability of the fixation. Therefore it is important to minimize the thermal invasion of bone during drilling. The Taguchi method has been applied to investigate the optimal combination of drill diameter, feed rate and spindle speed in dry drilling of Polymethylmethacrylate (PMMA for minimizing the temperature produced.

  13. The Affordable Care Act and orthopaedic trauma.

    Science.gov (United States)

    Issar, Neil M; Jahangir, A Alex

    2014-10-01

    The Affordable Care Act has resulted in a dramatic governmental restructuring of the healthcare insurance market and delivery system. Orthopaedic traumatologists must be aware of the law's impact on their clinical practice, finances, and overall business model. This includes the effect of accountable care organizations, the Independent Payment Advisory Board, and the Physician Value-Based Payment Modifier program, as well as the impact of the Affordable Care Act's grace period provision, medical device excise tax, and cuts to funding for the Disproportionate Share Hospital program. PMID:25229683

  14. DIY 3D printing of custom orthopaedic implants: a proof of concept study.

    Science.gov (United States)

    Frame, Mark; Leach, William

    2014-03-01

    3D printing is an emerging technology that is primarily used for aiding the design and prototyping of implants. As this technology has evolved it has now become possible to produce functional and definitive implants manufactured using a 3D printing process. This process, however, previously required a large financial investment in complex machinery and professionals skilled in 3D product design. Our pilot study's aim was to design and create a 3D printed custom orthopaedic implant using only freely available consumer hardware and software. PMID:24574013

  15. Prophylactic antimicrobial practice in the Orthopaedic wards of RIPAS Hospital.

    OpenAIRE

    Lah Kheng CHUA

    2012-01-01

    Introduction: Surgical site infections (SSI) are common healthcare associated infections (HAI) that is associated with increased morbidity and cost. Antimicrobial prophylaxis is effective when used appropriately. This study assesses the prophylactic antimicrobial prescribing and practice in the orthopaedic wards based on the Scottish Intercollegiate Guidelines Network (SIGN) guideline on antibiotic prophylaxis in surgery. Materials and Methods: Patients admitted to the Orthopaedics wards over...

  16. Integrating Surgical Training Video Simulation Into The Virtual Orthopaedic University

    OpenAIRE

    Grange, Simon; Wills, Gary; Humphrey, Nick; Burrill, Josh; Bunker, Tim; De Roure, David

    2003-01-01

    The objective to build integrated bidirectional video support for the digital library systems in orthopaedics, and in particular in the context of the Virtual Universities for computer-supported education and communication has been achieved. This has been set up to concentrate upon the training of image guided orthopaedic surgery, though may be applied generically.

  17. Smartphone apps for orthopaedic sports medicine – a smart move?

    OpenAIRE

    Wong, Seng Juong; Robertson, Greg A.; Connor, Katie L.; Brady, Richard R.; Wood, Alexander M

    2015-01-01

    Background With the advent of smartphones together with their downloadable applications (apps), there is increasing opportunities for doctors, including orthopaedic sports surgeons, to integrate such technology into clinical practice. However, the clinical reliability of these medical apps remains questionable. We reviewed available apps themed specifically towards Orthopaedic Sports Medicine and related conditions and assessed the level of medical professional involvement in their design and...

  18. A Clinico- Epidemiological Study Of Filarial Related Orthopaedic Manifestations

    Directory of Open Access Journals (Sweden)

    Patond K.R

    1992-01-01

    Full Text Available An epidemiological study was undertaken to study the incidence and distribution of orthopaedic manifestations of filariasis in an endemic area. A total of 207 cases were clinically examined and investigated. Patients were divided into three groups , viz., Group A: Orthopaedic manifestations with no history of filariasis . Group B: Orthopaedic manifestations with history of filariasis such as microfilaraemia or filarial fevers etc., Group C: Orthopaedic manifestations with chronic manifestations such as elephantiasis, hydrocele etc. To confirm filarial etiology, all the cases were examined for the presence of filarial antibody by indirect ELISA using wuchereda bancrofti microfilarial excretory- secretary antigen (wd Mf ESAg . A total of 61 of 102 patients of Group A, 14 of 21 patients of group B, and 73 of 84 patients of Group C were positive for filarial antibody. This study showed the prevalence of filarial antibody in about 71.4% of various orthopaedic manifestations.

  19. The functional performance of orthopaedic bone cement

    Energy Technology Data Exchange (ETDEWEB)

    Prendergast, P.J. [Trinity Coll., Dublin (Ireland). Dept. of Mechanical Engineering

    2001-07-01

    This paper presents a summary of our work on the functional behavior of polymethylmethacrylate as a fixation material for load-bearing implants. Experimental tests on models of hip reconstructions have shown that damage accumulation, in the form of growth of numerous microcracks, occurs in cement-fixated orthopaedic implants. To predict failure due to damage accumulation, fatigue tests of hand-mixed and vacuum-mixed cement are used to determine a relationship between the probability-of-failure, stress, and porosity of the cement. This relationship is then applied to the comparative analysis of orthopaedic implants using finite element analysis. Two implant systems are considered: femoral hip prostheses and glenoid replacement prostheses. It is shown how the complex and intricate stress patterns in the polymethylmethacrylate cement 'mantles' can be analyzed in terms of the probability-of-failure. This allows comparison of implants for pre-clinical testing purposes. The results complement those obtained from clinical studies where subsidence of the implant correlates with implant loosening [Karrholm et al. J. Bone Jt. Surg. Vol. 76B (1994) 912-916]. If subsidence is due to creep, then a correlation between damage accumulation and creep should exist. A basis for such a correlation in polymethylmetacrylate is proposed that links clinical findings of subsidence with our results with regard to damage accumulation. (orig.)

  20. Effects of Warm Deformation on Mechanical Properties of TRIP Aided Fe-C-Mn-Si Multiphase Steel

    Institute of Scientific and Technical Information of China (English)

    TIAN Yong; LI Zhuan~

    2012-01-01

    Warm deformation tests were performed using a kind of tubby heater. The microstructures and mechanical properties of an Fe-C-Mn-Si multiphase steel resulting from different warm deformation temperatures were investiga- ted by using LOM (light optical microscopy), SEM and XRD. The results indicated that the microstructure contai- ning polygonal ferrite, granular bainite and a significant amount of the stable retained austenite can be obtained through hot deformation and subsequent austempering. Warm deformation temperature affects the mechanical prop- erties of the hot rolled TRIP steels. Ultimate tensile strength balance reached maximum (881 MPa) when the speci- men was deformed at 250 ~C, and the total elongation and strength-ductility reached maximum (38% and 28 614 MPa ~ ~, respectively) at deforming temperature of 100 ~C. Martensite could nucleate when austenite was deformed above M~, because mechanical driving force compensates the decrease of chemical driving force. The TRIP effect occurs in the Fe-C-Mn-Si multiphase steel at deforming temperature ranging from 15 to 350 ~C. The results of the effects of warm deformation on the mechanical properties of the Fe-C-Mn-Si multiphase steel can provide theoretical basis for the ap- plications and the warm working of the hot rolled TRIP sheet steels in industrial manufacturing.

  1. Biomaterials for orthopaedic implants and bone regeneration

    Science.gov (United States)

    Sargeant, Timothy David

    For bone regeneration, there is need for biodegradable, synthetic scaffolds that direct the formation of de novo mineralized tissue. Orthopaedic implants additionally require mechanical function. The work described herein attempts to address both of these needs. The general strategy involves integrating molecularly designed tissue engineering scaffolds with porous metallic foams to create hybrid materials to direct cellular behavior. Peptide amphiphiles (PAs) that self-assemble into nanofibers were designed to template hydroxyapatite mineral under biological conditions. The molecular design incorporated either serine (S) or phosphoserine S(P) and was mixed with RGDS-bearing PA to evaluate of the key parameters for mineral formation. This led to the discovery of nanoscale hydroxyapatite spheres templated on both S- and S(P)-bearing PA nanofibers. Stem cells were encapsulated in these gels and RT-PCR showed osteoblastic differentiation in all samples. Osteoblast maturation was increased in S-bearing PA compared to S(P)-bearing PA, although the reason is not yet understood. A method to create robust PA nanofiber coatings on NiTi was developed by optimizing the NiTi oxide surface chemistry, optimizing silane vapor deposition, and covalently attaching the PAs to the silanized substrate. The surfaces were characterized by XPS, SIMS, AFM, and fluorimetry. In vitro experiments demonstrated the importance of covalent attachment for cellular adhesion and proved the materials were not cytotoxic. Orthopaedic hybrid materials were created by triggering PA self-assembly within the interconnected pores of Ti foams developed by the Dunand research group. In vitro experiments demonstrate that pre-osteoblasts adhere to, proliferate on, and migrate into PA-Ti hybrids made with S(P)- and RGDS-bearing PA mixtures. The cells differentiate into mature osteoblasts and remain viable up to 28 days. In vivo studies using a rat model demonstrate osteointegration and boney ingrowth into bare

  2. Finite element modelling approaches for well-ordered porous metallic materials for orthopaedic applications: cost effectiveness and geometrical considerations.

    Science.gov (United States)

    Quevedo González, Fernando José; Nuño, Natalia

    2016-06-01

    The mechanical properties of well-ordered porous materials are related to their geometrical parameters at the mesoscale. Finite element (FE) analysis is a powerful tool to design well-ordered porous materials by analysing the mechanical behaviour. However, FE models are often computationally expensive. This article aims to develop a cost-effective FE model to simulate well-ordered porous metallic materials for orthopaedic applications. Solid and beam FE modelling approaches are compared, using finite size and infinite media models considering cubic unit cell geometry. The model is then applied to compare two unit cell geometries: cubic and diamond. Models having finite size provide similar results than the infinite media model approach for large sample sizes. In addition, these finite size models also capture the influence of the boundary conditions on the mechanical response for small sample sizes. The beam FE modelling approach showed little computational cost and similar results to the solid FE modelling approach. Diamond unit cell geometry appeared to be more suitable for orthopaedic applications than the cubic unit cell geometry. PMID:26260268

  3. The orthopaedic trauma literature: an evaluation of statistically significant findings in orthopaedic trauma randomized trials

    OpenAIRE

    Tornetta Paul; Siegel Judith; Sung Jinsil; Bhandari Mohit

    2008-01-01

    Abstract Background Evidence-based medicine posits that health care research is founded upon clinically important differences in patient centered outcomes. Statistically significant differences between two treatments may not necessarily reflect a clinically important difference. We aimed to quantify the sample sizes and magnitude of treatment effects in a review of orthopaedic randomized trials with statistically significant findings. Methods We conducted a comprehensive search (PubMed, Cochr...

  4. Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures.

    Science.gov (United States)

    Romanova, K; Vassileva, J; Alyakov, M

    2015-07-01

    The aim of the present study was to assess the radiation dose to the eye lens of orthopaedic surgeons during various orthopaedic procedures and to make efforts to ensure that radiation protection is optimised. The study was performed for Fractura femoris and Fractura cruris procedures performed in orthopaedic operating theatres, as well as for fractures of wrist, ankle and hand/shoulder performed in the emergency trauma room. The highest mean value of the eye lens dose of 47.2 μSv and higher mean fluoroscopy time of 3 min, as well as the corresponding highest maximum values of 77.1 μSv and 5.0 min were observed for the Fractura femoris procedure performed with the Biplanar 500e fluoroscopy systems. At a normal workload, the estimated mean annual dose values do not exceed the annual occupational dose limit for the lens of eye, but at a heavy workload in the department, this dose limit could be achieved or exceeded. The use of protective lead glasses is recommended as they could reduce the radiation exposure of the lens of the eye. The phantom measurements demonstrated that the use of half-dose mode could additionally reduce dose to the operator's eye lens. PMID:25944961

  5. Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures

    International Nuclear Information System (INIS)

    The aim of the present study was to assess the radiation dose to the eye lens of orthopaedic surgeons during various orthopaedic procedures and to make efforts to ensure that radiation protection is optimised. The study was performed for Fractura femoris and Fractura cruris procedures performed in orthopaedic operating theatres, as well as for fractures of wrist, ankle and hand/ shoulder performed in the emergency trauma room. The highest mean value of the eye lens dose of 47.2 μSv and higher mean fluoroscopy time of 3 min, as well as the corresponding highest maximum values of 77.1 μSv and 5.0 min were observed for the Fractura femoris procedure performed with the Biplanar 500e fluoroscopy systems. At a normal workload, the estimated mean annual dose values do not exceed the annual occupational dose limit for the lens of eye, but at a heavy workload in the department, this dose limit could be achieved or exceeded. The use of protective lead glasses is recommended as they could reduce the radiation exposure of the lens of the eye. The phantom measurements demonstrated that the use of half-dose mode could additionally reduce dose to the operator's eye lens. (authors)

  6. Thromboembolism prophylaxis practices in orthopaedic arthroplasty patients.

    LENUS (Irish Health Repository)

    Cawley, D

    2010-10-01

    Thromboembolic events are a post-operative complication of arthroplasty surgery for up to 3 months. The incidence however, is not fully known. Some form of prophylaxis should be provided to all arthroplasty patients. Clinicians are wary of side effects, compliance profile and the associated cost. The objective of this study is to investigate practice patterns and their relevance to 3 risk groups. Ninety questionnaires were sent to orthopaedic surgeons with 3 hypothetical clinical scenarios and 10 prophylaxis regimes for thromboembolism across different risk groups. The response rate was 81\\/90 (90%). The most popular options in all 3 cases were early mobilisation, thrombo-embolism deterrant (TED) stockings and low molecular weight heparin (LMWH) (51\\/81, 62% of all cases). An inconsistent relationship exists between preferred practice and relevant guidelines. Preferred practice does not correlate with each level of risk.

  7. HIV and Orthopaedics: Musculoskeletal Manifestations and Outcomes.

    Science.gov (United States)

    Pretell-Mazzini, Juan; Subhawong, Ty; Hernandez, Victor H; Campo, Rafael

    2016-05-01

    ➤Advances in combined antiretroviral therapy (cART) in recent years have transformed HIV infection into a chronic disease when treatment is available, increasing a patient's life expectancy and the chances that orthopaedic surgeons will encounter such patients in their clinical practice.➤Musculoskeletal manifestations in patients with HIV infection are common and sometimes are the initial presentation of the disease. Knowledge about neoplasms and associated conditions affecting muscle, bones, and joints is essential for successful management.➤Since the advent of cART, total joint arthroplasty has been shown to be a safe procedure; however, perioperative infection is still a small risk in patients with uncontrolled viral loads or CD4 counts of nutritional status, cART therapy, viral load count, and other comorbidities (hemophilia, infection among intravenous drug users, etc.) should be considered when treating these patients in order to optimize their clinical outcomes. PMID:27147691

  8. The orthopaedic trauma literature: an evaluation of statistically significant findings in orthopaedic trauma randomized trials

    Directory of Open Access Journals (Sweden)

    Tornetta Paul

    2008-01-01

    Full Text Available Abstract Background Evidence-based medicine posits that health care research is founded upon clinically important differences in patient centered outcomes. Statistically significant differences between two treatments may not necessarily reflect a clinically important difference. We aimed to quantify the sample sizes and magnitude of treatment effects in a review of orthopaedic randomized trials with statistically significant findings. Methods We conducted a comprehensive search (PubMed, Cochrane for all randomized controlled trials between 1/1/95 to 12/31/04. Eligible studies include those that focused upon orthopaedic trauma. Baseline characteristics and treatment effects were abstracted by two reviewers. Briefly, for continuous outcome measures (ie functional scores, we calculated effect sizes (mean difference/standard deviation. Dichotomous variables (ie infection, nonunion were summarized as absolute risk differences and relative risk reductions (RRR. Effect sizes >0.80 and RRRs>50% were defined as large effects. Using regression analysis we examined the association between the total number of outcome events and treatment effect (dichotomous outcomes. Results Our search yielded 433 randomized controlled trials (RCTs, of which 76 RCTs with statistically significant findings on 184 outcomes (122 continuous/62 dichotomous outcomes met study eligibility criteria. The mean effect size across studies with continuous outcome variables was 1.7 (95% confidence interval: 1.43–1.97. For dichotomous outcomes, the mean risk difference was 30% (95%confidence interval:24%–36% and the mean relative risk reduction was 61% (95% confidence interval: 55%–66%; range: 0%–97%. Fewer numbers of total outcome events in studies was strongly correlated with increasing magnitude of the treatment effect (Pearson's R = -0.70, p Conclusion Our review suggests that statistically significant results in orthopaedic trials have the following implications-1 On average

  9. Tissue engineering skeletal muscle for orthopaedic applications

    Science.gov (United States)

    Payumo, Francis C.; Kim, Hyun D.; Sherling, Michael A.; Smith, Lee P.; Powell, Courtney; Wang, Xiao; Keeping, Hugh S.; Valentini, Robert F.; Vandenburgh, Herman H.

    2002-01-01

    With current technology, tissue-engineered skeletal muscle analogues (bioartificial muscles) generate too little active force to be clinically useful in orthopaedic applications. They have been engineered genetically with numerous transgenes (growth hormone, insulinlike growth factor-1, erythropoietin, vascular endothelial growth factor), and have been shown to deliver these therapeutic proteins either locally or systemically for months in vivo. Bone morphogenetic proteins belonging to the transforming growth factor-beta superfamily are osteoinductive molecules that drive the differentiation pathway of mesenchymal cells toward the chondroblastic or osteoblastic lineage, and stimulate bone formation in vivo. To determine whether skeletal muscle cells endogenously expressing bone morphogenetic proteins might serve as a vehicle for systemic bone morphogenetic protein delivery in vivo, proliferating skeletal myoblasts (C2C12) were transduced with a replication defective retrovirus containing the gene for recombinant human bone morphogenetic protein-6 (C2BMP-6). The C2BMP-6 cells constitutively expressed recombinant human bone morphogenetic protein-6 and synthesized bioactive recombinant human bone morphogenetic protein-6, based on increased alkaline phosphatase activity in coincubated mesenchymal cells. C2BMP-6 cells did not secrete soluble, bioactive recombinant human bone morphogenetic protein-6, but retained the bioactivity in the cell layer. Therefore, genetically-engineered skeletal muscle cells might serve as a platform for long-term delivery of osteoinductive bone morphogenetic proteins locally.

  10. Justifications and needs for diversity in orthopaedics.

    Science.gov (United States)

    White, A A

    1999-05-01

    America is founded on high humanitarian, democratic ideals. The historic facts of slavery, discrimination, and segregation challenge and taint these democratic principles. Although progress has been made, serious racial problems remain. In 1997, the United States had 474 active hate groups, up 20% from 1996. African American males who have the same education as white males doing the same work earn approximately 75% of what their white counterparts earn. America, as predicted by the Kerner Commission Report, is two societies: black and white, separate, and unequal. Some astonishing disparities in healthcare exist. Peer reviewed medical literature documents that African Americans have higher infant mortality rates, shorter life expectancies, fewer joint replacements, and more amputations than whites. Communications within a diverse group of students and teachers enriches the educational experience. The late Supreme Court Justice Lewis Powell, LLD, asserted that a medical student from a particular background may enrich classmates' understanding of people whose cultures are different from their own, and improve their ability to serve a heterogeneous patient population. Diversity on clinical teams can enhance rapport between patient and physician, and can diminish unthinking insults to patients, born of physician ethnic insensitivity. Healthcare facilities with diverse staffs are more likely than homogeneous facilities to attract and successfully serve the nation's diverse population. A University of California at Davis School of Medicine study showed that diversity can be achieved without compromising quality of patient care. Clinically and ideologically, diversity in orthopaedics is good for patients and for the country. PMID:10335274

  11. Plaster of Paris: the orthopaedic surgeon heritage.

    Science.gov (United States)

    Hernigou, Philippe

    2016-08-01

    Plastering is one of the most ancient of the building handicrafts. Plaster is the common name for calcium sulphate hemi hydrate made by heating the mineral gypsum, the common name for sulphate of lime. In the tenth century the Arabs used liquid plaster in orthopaedic treatment. At the beginning of the nineteenth century, patients with fractures of the lower extremities-and often of the upper extremities as well-were treated in bed with restriction of all activity for many weeks until the fractures united. It was the practice of surgeons to dress wounds and fractures at frequent intervals. The bandages, pads, and splints were removed, the fractures manipulated, and the dressings reapplied. The search for simpler, less cumbersome methods of treatment led to the development of occlusive dressings, stiffened at first with starch and later with plaster of Paris. The ambulatory treatment of fractures was the direct result of these innovations. Two military surgeons, Antonius Mathijsen of the Netherlands, and Nikolai Ivanovitch Pirogov of Russia, were responsible for the introduction of the new plaster bandage technique. At the beginning of the twentieth century the technique was improved by Jean-François Calot, a French surgeon, who invented the hand manufacture of plaster bandage as a roll. During the twentieth century, walking cast and ambulation for fresh fractures were developed with plaster and pin incorporated in plaster; the open fracture care concept was introduced with plaster of Paris by Trueta before the external fixation. PMID:27055448

  12. Orthopaedic admissions due to sports and recreation injuries.

    LENUS (Irish Health Repository)

    Delaney, R A

    2009-02-01

    The health benefits of exercise may be attenuated by sports and recreation related injury (SRI). Though the majority of SRI are mild and self-limiting, a significant number are serious and require orthopaedic intervention. The aims of this study were to assess the burden of these serious injuries on the orthopaedic inpatient service, and to investigate potential target areas for injury prevention. All 1,590 SRI seen in the ED over a 3-month period were analysed using the Patient Information Management System to determine which patients received inpatient orthopaedic care. The medical records of those 63 patients who required inpatient care under orthopaedics were reviewed and data collected on demographic features, history, operative procedure and theatre resources, and length of hospital stay. Data were analyzed using SPSS. SRI accounted for 12.3% of all ED presentations. The principal activities resulting in injury requiring orthopaedic care were soccer, hurling and informal play e.g. trampoline. Falls made up 37% of the overall mechanism of injury but 68% of the injuries severe enough to require operative management. Most operative procedures were performed as part of a routine day trauma list but 20% were performed out of hours. This group of injuries places a significant burden on a busy trauma service. Injury prevention measures such as public education regarding falls in sport may have a role in reducing this burden.

  13. Analysis of kidney dysfunction in orthopaedic patients

    Directory of Open Access Journals (Sweden)

    Kateros Konstantinos

    2012-09-01

    Full Text Available Abstract Backround This retrospective study was undertaken to determine the incidence of kidney dysfunction (KD and to identify potential risk factors contributing to development of KD in orthopaedic population following an elective or emergency surgery. Methods A total of 1025 patients were admitted in our institution over a period of one year with various indications. Eight hundred and ninety-three patients (87.1% had a surgical procedure. There were 42 (52.5% male and 38 (47.5% female with a mean age of 72 years (range: 47 to 87 years. We evaluated the following potential risk factors: age, comorbidities, shock, hypotension, heart failure, medications (antibiotics, NSAIDs, opiates, rhabdomyolysis, imaging contrast agents and pre-existing KD. Results The overall incidence of KD was 8.9%. Sixty-eight patients developed acute renal injury (AKI and 12 patients developed acute on chronic kidney disease (CKD. In sixty-six (82.5% patients renal function was reversed to initial preoperative status. Perioperative dehydration (p = 0.002, history of diabetes mellitus (p = 0.003, pre-existing KD (p = 0.004, perioperative shock (p = 0.021 and administration of non-steroid anti-inflammatory drugs (NSAIDs (p = 0.028 or nephrotoxic antibiotics (p = 0.037 were statistically significantly correlated with the development of postoperative KD and failure to gain the preoperative renal function. Conclusion We conclude that every patient with risk factor for postoperative KD should be under closed evaluation and monitoring.

  14. Sources of information influencing decision-making in orthopaedic surgery - an international online survey of 1147 orthopaedic surgeons

    Science.gov (United States)

    2013-01-01

    Background Manufacturers of implants and materials in the field of orthopaedics use significant amounts of funding to produce informational material to influence the decision-making process of orthopaedic surgeons with regards to choice between novel implants and techniques. It remains unclear how far orthopaedic surgeons are really influenced by the materials supplied by companies or whether other, evidence-based publications have a higher impact on their decision-making. The objective was to evaluate the subjective usefulness and usage of different sources of information upon which orthopaedic surgeons base their decisions when acquiring new implants or techniques. Methods We undertook an online survey of 1174 orthopaedic surgeons worldwide (of whom n = 305 were head of their department). The questionnaire included 34 items. Sequences were randomized to reduce possible bias. Questions were closed or semi-open with single or multiple answers. The usage and relevance of different sources of information when learning about and selecting orthopaedic treatments were evaluated. Orthopaedic surgeons and trainees were targeted, and were only allowed to respond once over a period of two weeks. Baseline information included country of workplace, level of experience and orthopaedic subspecialisation. The results were statistically evaluated. Results Independent scientific proof had the highest influence on decisions for treatment while OEM (Original Equipment Manufacturer) driven activities like newsletters, white papers or workshops had the least impact. Comparison of answers from the three best-represented countries in this study (Germany, UK and USA) showed some significant differences: Scientific literature and congresses are significantly more important in the US than in the UK or Germany, although they are very important in all countries. Conclusions Independent and peer-reviewed sources of information are preferred by surgeons when choosing between methods and

  15. 77 FR 19293 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Meeting

    Science.gov (United States)

    2012-03-30

    ... the Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee. Submit... INFORMATION: Name of Committee: Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory... with or considering hip replacement (...

  16. Validation of the Osteopenia Sheep Model for Orthopaedic Biomaterial Research

    DEFF Research Database (Denmark)

    Ding, Ming; Danielsen, C.C.; Cheng, L.;

    2009-01-01

    resemble osteoporosis in humans. This study aimed to validate glucocorticoid-induced osteopenia sheep model for orthopaedic implant and biomaterial research. We hypothesized that a 7-month GC treatment together with restricted diet but without OVX would induce osteopenia. Materials and Methods: Eighteen......Validation of the Osteopenia Sheep Model for Orthopaedic Biomaterial Research +1Ding, M; 2Danielsen, CC; 1Cheng, L; 3Bollen, P; 4Schwarz, P; 1Overgaard, S +1Dept of Orthopaedics O, Odense University Hospital, Denmark, 2Dept of Connective Tissue Biology, University of Aarhus, Denmark, 3Biomedicine...... patients do not have a normal bone quality that in many cases are due to osteoporosis (OP) even in osteoarthritic joints. Although a variety of ovariectomized (OVX) animals has been used to study osteoporosis, there is a great need for suitable large animal models with adequate bone size that closely...

  17. Surgical treatment in cases of rare and iatrogenic orthopaedical diseases

    Directory of Open Access Journals (Sweden)

    Batalov O.A.

    2012-12-01

    Full Text Available The aim of the article was to determine symptoms and surgical management for patients in cases of the rare and iatrogenic orthopaedical diseases. Methods. The article concerns Erb-Duchen disease, iatrogenic hallux varus, gout arthropathy of the 1st MTP, spastic supinated foot after astrocytomectomy of the brain, bilateral Haglund disease. Authors describe all symptoms of these rare diseases. Results. There were determined reasons for external apparatuses for lower extremity correction. Accurate preoperative planning allowed to perform effective surgery for patients with rare and hard orthopaedic pathology.

  18. Surgical site infection and clinical microbiology in orthopaedics surgeries in a rural hospital

    Institute of Scientific and Technical Information of China (English)

    Pradeep K. Singh; Sandeep Shrivastva; Rajesh Dulani; Abhishek Yadav

    2011-01-01

    @@ Infection and Clinical Microbiology in Orthopaedics Surgeries in Wound infections resulting from contamination during major orthopaedics surgery continues to be a vital issue.In this study, specimens of pus,draining fluids or suspected pus from the wounds of surgical patients who had been undergone major orthopaedics surgical procedure were cultured.

  19. Bone graft materials in fixation of orthopaedic implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA...

  20. A review of probabilistic analysis in orthopaedic biomechanics

    OpenAIRE

    Laz, P.J.; Browne, M.

    2010-01-01

    Probabilistic analysis methods are being increasingly applied in the orthopaedics and biomechanics literature to account for uncertainty and variability in subject geometries, properties of various structures, kinematics and joint loading, as well as uncertainty in implant alignment. As a complement to experiments, finite element modelling, and statistical analysis, probabilistic analysis provides a method of characterizing the potential impact of variability in parameters on performa...

  1. Improving translation success of cell-based therapies in orthopaedics.

    Science.gov (United States)

    Bara, Jennifer J; Herrmann, Marietta; Evans, Christopher H; Miclau, Theodore; Ratcliffe, Anthony; Richards, R Geoff

    2016-01-01

    There is a clear discrepancy between the growth of cell therapy and tissue engineering research in orthopaedics over the last two decades and the number of approved clinical therapies and products available to patients. At the 2015 annual meeting of the Orthopaedic Research Society, a workshop was held to highlight important considerations from the perspectives of an academic scientist, clinical researcher, and industry representative with the aim of helping researchers to successfully translate their ideas into clinical and commercial reality. Survey data acquired from workshop participants indicated an overall positive opinion on the future potential of cell-based therapies to make a significant contribution to orthopaedic medicine. The survey also indicated an agreement on areas requiring improvement in the development of new therapies, specifically; increased support for fundamental research and education and improved transparency of regulatory processes. This perspectives article summarises the content and conclusions of the workshop and puts forward suggestions on how translational success of cell-based therapies in orthopaedics may be achieved. PMID:26403666

  2. Military Orthopaedic Trauma Registry: Quality Data Now Available.

    Science.gov (United States)

    Rivera, Jessica C; Greer, Renee M; Wenke, Joseph C; Ficke, James R; Johnson, Anthony E

    2016-01-01

    The Military Orthopaedic Trauma Registry (MOTR) orginally began as part of the Department of Defense Trauma Registry (DoDTR) and became a live registry in 2013. As a quality improvement process, this study examined MOTR data for 20 female amputees compared with DoDTR data. The DoDTR provided diagnosis and procedure codes as a list but no details. The MOTR provided additional data, including specific limb, fracture classifications, and associated injuries per limb. The MOTR allowed for construction of a treatment time line for each limb, including number and timing of debridements, antibiotics, and implant types. Orthopaedic-specific complications were also coded more frequently in the MOTR and clearly identified with a specific injury and treatment. During initial quality control checks, the MOTR provides a greater volume and granularity of detail for orthopaedic-specific injury and treatment information, indicating that the MOTR is on track to provide a valuable repository for data-driven orthopaedic management of combat injury. PMID:27518292

  3. Magnesium-containing layered double hydroxides as orthopaedic implant coating materials--An in vitro and in vivo study.

    Science.gov (United States)

    Weizbauer, Andreas; Kieke, Marc; Rahim, Muhammad Imran; Angrisani, Gian Luigi; Willbold, Elmar; Diekmann, Julia; Flörkemeier, Thilo; Windhagen, Henning; Müller, Peter Paul; Behrens, Peter; Budde, Stefan

    2016-04-01

    The total hip arthroplasty is one of the most common artificial joint replacement procedures. Several different surface coatings have been shown to improve implant fixation by facilitating bone ingrowth and consequently enhancing the longevity of uncemented orthopaedic hip prostheses. In the present study, two different layered double hydroxides (LDHs), Mg-Fe- and Mg-Al-LDH, were investigated as potential magnesium (Mg)-containing coating materials for orthopaedic applications in comparison to Mg hydroxide (Mg(OH)2). In vitro direct cell compatibility tests were carried out using the murine fibroblast cell line NIH 3T3 and the mouse osteosarcoma cell line MG 63. The host response of bone tissue was evaluated in in vivo experiments with nine rabbits. Two cylindrical pellets (3 × 3 mm) were implanted into each femoral condyle of the left hind leg. The samples were analyzed histologically and with μ-computed tomography (μ-CT) 6 weeks after surgery. An in vitro cytotoxicity test determined that more cells grew on the LDH pellets than on the Mg(OH)2-pellets. The pH value and the Mg(2+) content of the cell culture media were increased after incubation of the cells on the degradable samples. The in vivo tests demonstrated the formation of fibrous capsules around Mg(OH)2 and Mg-Fe-LDH. In contrast, the host response of the Mg-Al-LDH samples indicated that this Mg-containing biomaterial is a potential candidate for implant coating. PMID:25939995

  4. Composite bone models in orthopaedic surgery research and education.

    Science.gov (United States)

    Elfar, John; Menorca, Ron Martin Garcia; Reed, Jeffrey Douglas; Stanbury, Spencer

    2014-02-01

    Composite bone models are increasingly used in orthopaedic biomechanics research and surgical education-applications that traditionally relied on cadavers. Cadaver bones are suboptimal for many reasons, including issues of cost, availability, preservation, and inconsistency between specimens. Further, cadaver samples disproportionately represent the elderly, whose bone quality may not be representative of the greater orthopaedic population. The current fourth-generation composite bone models provide an accurate reproduction of the biomechanical properties of human bone when placed under bending, axial, and torsional loads. The combination of glass fiber and epoxy resin components into a single phase has enabled manufacturing by injection molding. The high level of anatomic fidelity of the cadaver-based molds and negligible shrinkage properties of the epoxy resin results in a process that allows for excellent definition of anatomic detail in the cortical wall and optimized consistency of features between models. Recent biomechanical studies of composites have validated their use as a suitable substitute for cadaver specimens. PMID:24486757

  5. Orthopaedic patients’ perceptions about their pre-operative information

    Directory of Open Access Journals (Sweden)

    C. Chetty

    2009-09-01

    Full Text Available A non-experimental, descriptive and quantitative survey was conducted to explore orthopaedic patients’ perceptions about the pre-operative information received when undergoing elective surgery in two hospitals in the KwaZulu-Natal Province. The findings indicate that most patients perceived the pre-operative information to be useful in their preparation for surgery. Aspects that were not addressed during preoperative information sessions included post-operative nutrition, pain medication, ambulation, deep breathing and coughing exercises. The recommendations include that all these aspects should be addressed in future pre-operative education sessions. Further research should be conducted for enhancing the pre-operative information provided to patients scheduled to undergo elective orthopaedic surgery.

  6. Myths and Legends in Orthopaedic Practice: Are We All Guilty?

    OpenAIRE

    Tejwani, Nirmal C.; Immerman, Igor

    2008-01-01

    Over years of practice, many beliefs and practices become entrenched as tried and tested, and we subconsciously believe they are based on scientific evidence. We identified nine such beliefs by interviewing orthopaedic surgeons in which studies (or lack thereof) apparently do not support such practices. These are: changing the scalpel blade after the skin incision to limit contamination; bending the patient’s knee when applying a thigh tourniquet; bed rest for treatment of deep vein thrombosi...

  7. Vancouver winters: Environmental influences on inpatient adult orthopaedic trauma demographics

    International Nuclear Information System (INIS)

    Objective: To compare the pattern of adult inpatient orthopaedic injuries admitted at three Vancouver hospitals following one of the worst winter snowstorms in the region with the preceding control winter period. Methods: The surveillance study was conducted at the University of British Columbia, Vancouver, Canada, 2007 to 2010. Inpatient adult admissions for orthopaedic injuries at three hospitals were recorded, including age, gender, anatomic location of injury, type of fracture (open or closed), fixation method (internal versus external fixation), and length of acute care hospital stay. Comparisons between admissions during this weather pattern and admission during a previous winter with minimal snow were made. SPSS 19 was used for statistical analysis. Results: Of the 511 patients admitted under Orthopaedic trauma service during the significant winter snowstorms of December 2008 - January 2009, 100 (19.6%) (CI: 16.2%-23.2%) were due to ice and snow, whereas in the preceding mild winter only 18 of 415 (4.3%) (CI: 2.5%-6.8%) cases were related to snow (p<0.05). Ankle and wrist fractures were the most frequent injuries during the index snow storm period (p<0.05). At all the three institutions, 97 (96.5%) fractures were closed during the snowstorm as opposed to 17 (95%) during the control winter period. Internal fixation in 06 (89%) fractures as opposed to external fixation in 12 (11%) patients was the predominant mode of fixation across the board during both time periods. Conclusion: The study demonstrated a significantly higher inpatient orthopaedic trauma volume during the snowstorm more rigorous prospective studies need to be designed to gain further insight to solving these problems from a public health perspective. (author)

  8. Analysis of scientific articles published in two general orthopaedic journals

    OpenAIRE

    Holzer, Lukas A; Holzer, Gerold

    2013-01-01

    OBJECTIVE: To give an overview of the behaviour and scientific contributions of the Journal of Bone and Joint Surgery American (JBJS-A) and British Volume (JBJS-B). METHODS: 480 original articles published in 2009 were identified through a combined comprehensive computer and manual library search. Articles were assigned to 11 orthopaedic categories and by country, type and specialty of the institution. Possible grants and citations were analysed. USA led all countries in published articles (3...

  9. Biomolecular surface coating to enhance orthopaedic tissue healing and integration

    OpenAIRE

    Reyes, Catherine D.; Petrie, Timothy A.; Burns, Kellie L.; Schwartz, Zvi; Andrés J. García

    2007-01-01

    Implant osseointegration is a prerequisite for clinical success in orthopaedic and dental applications, many of which are restricted by loosening. Biomaterial surface modification approaches, including calcium-phosphate ceramic coatings and macro/microporosity, have had limited success in promoting integration. To improve osseointegration, titanium surfaces were coated with the GFOGER collagen-mimetic peptide, selectively promoting α2β1 integrin binding, a crucial event for osteoblastic diffe...

  10. A missed orthopaedic injury following a seizure: a case report

    Directory of Open Access Journals (Sweden)

    O'Connor-Read Laurence

    2007-05-01

    Full Text Available Abstract Numerous orthopaedic injuries can follow a seizure and are often diagnosed late. This is the first documented case of a missed bilateral anterior shoulder dislocation following a seizure. The possible reasons for the greater incidence of posterior dislocations are examined and why bilateral anterior dislocations following a seizure are so rare. The article discusses the reasons for the delay and highlights potential pitfalls and learning points for junior emergency department doctors.

  11. Aplication of breathable and odorless lining to orthopaedic shoes

    OpenAIRE

    Peixoto, Joaquim Jorge Gomes; Souto, A. Pedro; Flores, Paulo

    2011-01-01

    The main purpose of this work is to apply new materials and new finishing to improve comfort in orthopaedic footwear associated with orthosis. This desideratum will be reached through the selection and application of advanced materials, such, breathables membranes and fabric finished with anti-fungal and anti-bacteria treatments. In this work, water vapor permeability was evaluated to determine the transport property of water vapor produced by transpiration of the skin. A new lining with brea...

  12. Titanium alloys and porous coatings for orthopaedic applications

    OpenAIRE

    Vettorel, Matteo

    2014-01-01

    The project deals with titanium and titanium alloys as biomaterials for implants applications, focusing on their mechanical response under dynamic stresses occurring during common human activities. In the first part, the biomaterials requirements for orthopaedic implants, the properties and the processing of titanium alloys are described. From the combined biomechanics requirements, mechanical behaviour of the materials and the bone is analysed and the additional poroelastic behaviour is adde...

  13. Surgical skills simulation in trauma and orthopaedic training.

    Science.gov (United States)

    Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

    2014-01-01

    Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons. PMID:25523023

  14. Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis.

    Science.gov (United States)

    Hawkey, S; Ghaffar, S

    2015-01-01

    Thioureas, often contained within neoprene to provide water resistance, are an important cause of allergic contact dermatitis (ACD) in those who use neoprene products. We wish to present three cases of thiourea-induced ACD from three different orthopaedic supports containing neoprene. The first case was a 67-year-old woman who developed an itchy rash on her heel three weeks after using a neoprene insole for plantar fasciitis. The second case was a 47-year-old man who developed an itchy rash on his wrist after wearing neoprene wrist splints for psoriatic arthropathy. The third case was a 77-year-old woman who experienced a severe erythematous rash with blistering from a neoprene elbow brace she received following a humeral fracture. All patients were patch tested to the British Society of Cutaneous Allergy Standard and rubber series and a cut piece from all the relevant supports. At 96 hours, all patients had a + reaction to mixed dialkylthiourea, diethylthiourea, and the supports' material. No other positive patch test reactions were identified. As neoprene is fast becoming one of the most popular materials used for orthopaedic supports, awareness of this reaction and close liaison between dermatologists and orthopaedic surgeons are therefore essential to allow for early recognition of this complication. PMID:26236520

  15. Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis

    Directory of Open Access Journals (Sweden)

    S. Hawkey

    2015-01-01

    Full Text Available Thioureas, often contained within neoprene to provide water resistance, are an important cause of allergic contact dermatitis (ACD in those who use neoprene products. We wish to present three cases of thiourea-induced ACD from three different orthopaedic supports containing neoprene. The first case was a 67-year-old woman who developed an itchy rash on her heel three weeks after using a neoprene insole for plantar fasciitis. The second case was a 47-year-old man who developed an itchy rash on his wrist after wearing neoprene wrist splints for psoriatic arthropathy. The third case was a 77-year-old woman who experienced a severe erythematous rash with blistering from a neoprene elbow brace she received following a humeral fracture. All patients were patch tested to the British Society of Cutaneous Allergy Standard and rubber series and a cut piece from all the relevant supports. At 96 hours, all patients had a + reaction to mixed dialkylthiourea, diethylthiourea, and the supports’ material. No other positive patch test reactions were identified. As neoprene is fast becoming one of the most popular materials used for orthopaedic supports, awareness of this reaction and close liaison between dermatologists and orthopaedic surgeons are therefore essential to allow for early recognition of this complication.

  16. Orthopaedic Trauma Care Specialist Program for Developing Countries.

    Science.gov (United States)

    Slobogean, Gerard; Sprague, Sheila; Furey, Andrew; Pollak, Andrew

    2015-10-01

    The dire challenges faced in Haiti, both preearthquake and postearthquake, highlight the need for developing surgical infrastructure to care for traumatic musculoskeletal injuries. The proposed Orthopaedic Trauma Care Specialist (OTCS) residency program aims to close the critical human resource gap that limits the appropriate care of musculoskeletal trauma in Haiti. The OTCS program is a proposal for a 2-year residency program that will focus primarily on the management of orthopaedic trauma. The proposed program will be a comprehensive approach for implementing affordable and sustainable strategies to improve orthopaedic trauma care. Its curriculum will be tailored to the injuries seen in Haiti, and the treatments that can be delivered within their health care system. Its long-term sustainability will be based on a "train-the-trainers" approach for developing local faculty to continue the program. This proposal outlines the OTCS framework specifically for Haiti; however, this concept is likely applicable to other low- and middle-income environments in a similar need for improved trauma and fracture care. PMID:26356211

  17. Investigation of CPD and HMDS Sample Preparation Techniques for Cervical Cells in Developing Computer-Aided Screening System Based on FE-SEM/EDX

    OpenAIRE

    2014-01-01

    This paper investigated the effects of critical-point drying (CPD) and hexamethyldisilazane (HMDS) sample preparation techniques for cervical cells on field emission scanning electron microscopy and energy dispersive X-ray (FE-SEM/EDX). We investigated the visualization of cervical cell image and elemental distribution on the cervical cell for two techniques of sample preparation. Using FE-SEM/EDX, the cervical cell images are captured and the cell element compositions are extracted for both ...

  18. Aligning Incentives in Orthopaedics: Opportunities and Challenges—the Case Medical Center Experience

    OpenAIRE

    Marcus, Randall E.; Zenty, Thomas F.; Adelman Esq., Harlin G.

    2009-01-01

    For 30 years, the orthopaedic faculty at Case Western Reserve University worked as an independent private corporation within University Hospitals Case Medical Center (Hospital). However, by 2002, it became progressively obvious to our orthopaedic practice that we needed to modify our business model to better manage the healthcare regulatory changes and decreased reimbursement if we were to continue to attract and retain the best and brightest orthopaedic surgeons to our practice. In 2002, our...

  19. Extracorporeal Shock Wave Therapy could be a Potential Adjuvant Treatment for Orthopaedic Implant-associated Infections

    OpenAIRE

    Xiao-feng Chen; Xiao-lin Li

    2013-01-01

    Over the past half-century, biomaterials have been used in orthopaedic surgery world widely, but orthopaedic implant-associated infections (OIAIs) are still a puzzle for orthopaedic surgeons, which may result in prolonged hospitalisation, poor functional status and high costs. The presence of implants increases the risk of microbial infection; moreover, the formation of bacterial biofilm leads to a higher resistance to antibiotics and local immune response. In such cases, conventional systemi...

  20. The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics.

    LENUS (Irish Health Repository)

    O Mir, Marie

    2016-04-01

    The demand for paediatric orthopaedic care is growing, and providing the service required is an increasingly challenging task. Physiotherapist-led triage clinics are utilised in adult orthopaedics to enable the provision of care to patients who may not require a surgical consult. The Physiotherapy Orthopaedic Triage Clinic (POTC) was established in Our Lady\\'s Children\\'s Hospital Crumlin in response to increasing demands on the paediatric orthopaedic service. The clinic is run by physiotherapists working in an advanced practice role (APP), and is the first paediatric clinic of its type and scale in the Republic of Ireland.

  1. X-ray photoemission spectroscopy investigation of the early stages of the oxygen aided Cr growth on Fe(0 0 1)

    International Nuclear Information System (INIS)

    We report on an X-ray photoemission spectroscopy investigation of the early stages of growth of ultra-thin Cr films on the oxygen-passivated Fe(0 0 1)–p(1 × 1)O surface. The Cr coverages ranged from sub-monolayer up to a few atomic layers. Cr has been grown either at 380 K or at 570 K. Our investigation reveals that during the Cr film growth oxygen floats toward the free surface. The presence of a metallic Cr signal from the very beginning of film growth is discussed in relation to Cr–Fe intermixing and alloy formation at the interface. Our findings are independent from the growth temperature, indicating that it has a very little influence on the chemical interactions at the interface, at variance with the oxygen-free Cr/Fe interface.

  2. X-ray photoemission spectroscopy investigation of the early stages of the oxygen aided Cr growth on Fe(0 0 1)

    Energy Technology Data Exchange (ETDEWEB)

    Brambilla, A., E-mail: alberto.brambilla@polimi.it [CNISM and Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo Da Vinci 32, 20133 Milano (Italy); Calloni, A.; Picone, A.; Finazzi, M.; Duò, L.; Ciccacci, F. [CNISM and Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo Da Vinci 32, 20133 Milano (Italy)

    2013-02-15

    We report on an X-ray photoemission spectroscopy investigation of the early stages of growth of ultra-thin Cr films on the oxygen-passivated Fe(0 0 1)–p(1 × 1)O surface. The Cr coverages ranged from sub-monolayer up to a few atomic layers. Cr has been grown either at 380 K or at 570 K. Our investigation reveals that during the Cr film growth oxygen floats toward the free surface. The presence of a metallic Cr signal from the very beginning of film growth is discussed in relation to Cr–Fe intermixing and alloy formation at the interface. Our findings are independent from the growth temperature, indicating that it has a very little influence on the chemical interactions at the interface, at variance with the oxygen-free Cr/Fe interface.

  3. 大麻素系统在骨科中的应用进展%Recent progress in the application of cannabinoid system in orthopaedics

    Institute of Scientific and Technical Information of China (English)

    杨豪; 王建儒; 郑召民

    2013-01-01

    Cannabinoids have been implicated in many physiological processes, ranging from appetite regulation and pain perception to motor function development and immune response regulation. And cannabinoids have been approved for clinical use in the treatment of the following symptoms, such as nausea and vomiting caused by cytostatic therapy, loss of appetite in HIV/Aids-related cachexia, refractory spasticity caused by multiple sclerosis, the side effects of chemotherapy in cancer patients, chronic pain and so on. Recent studies found the expressions of cannabinoids and cannabinoid receptors in the bone and synovial tissues, and their important roles in bone metabolism were conifrmed. Preclinical testing in animal models demonstrated that cannabinoids could alleviate the development of arthritis, prevent osteoporosis and improve the neurological function following spinal cord injury. So the recent progress in the application of cannabinoid system in orthopaedics was reviewed in this paper, with the expectation to provide a new direction for orthopaedic research and apply cannabinoid drugs in the clinical treatment of orthopaedic diseases.

  4. Improving patient flow: role of the orthopaedic discharge sister.

    Science.gov (United States)

    Tytler, Beverley

    2016-03-01

    Timely and well-planned discharge improves the patient's experience, contributes to patient safety and reduces the length of hospital stays. The role of orthopaedic discharge sister was developed at James Cook University Hospital in 2007 to provide safe, timely and efficient discharge for patients from the trauma and theatre centre, and to improve patient experience and flow. This article gives an overview of the role and describes how the sister works with colleagues to plan patient discharges from pre-assessment and emergency department admission through their hospital stay until their departure. PMID:26948225

  5. Quantification of facial contamination with blood during orthopaedic procedures.

    LENUS (Irish Health Repository)

    Collins, D

    2012-02-03

    Operative surgery exposes the surgeon to possible blood-borne infections. Risks include pen-etrating injuries and conjunctival contact with infected blood. Visor masks worn during orthopaedic trauma procedures were assessed for blood contamination using computer analysis. This was found to be present on 86% of masks, of which only 15% was recognized by the surgeon intraoperatively. Of the blood splashes 80% were less than 0.6mm in diameter. We conclude that power instrumentation produces a blood particulate mist causing considerable microscopic, facial contamination which is a significant risk to the surgeon.

  6. Demographics, nature and treatment of orthopaedic trauma injuries occurring in an agricultural context in the West of Ireland.

    LENUS (Irish Health Repository)

    Byrne, F J

    2011-03-01

    Farming is a major industry in the West of Ireland. This prospective study examined the age profile, nature and treatment of orthopaedic injuries occurring in agricultural surroundings presenting at the Orthopaedic Unit of Merlin Park Hospital, Galway.

  7. Long Sick Leave after Orthopaedic Inpatient Rehabilitation: Treatment Failure or Relapse?

    Science.gov (United States)

    Mangels, Marija; Schwarz, Susanne; Worringen, Ulrike; Holme, Martin; Rief, Winfried

    2011-01-01

    We investigated whether short-term versus long-term sick leave after orthopaedic inpatient rehabilitation can be predicted by initial assessment information, the clinical status at discharge, or whether the follow-up interval is crucial for later sick leave. We examined 214 patients from an orthopaedic rehabilitation hospital at admission,…

  8. Aid Effectiveness

    DEFF Research Database (Denmark)

    Arndt, Channing; Jones, Edward Samuel; Tarp, Finn

    Controversy over the aggregate impact of foreign aid has focused on reduced form estimates of the aid-growth link. The causal chain, through which aid affects developmental outcomes including growth, has received much less attention. We address this gap by: (i) specifying a structural model of the...... main relationships; (ii) estimating the impact of aid on a range of final and intermediate outcomes; and (iii) quantifying a simplied representation of the full structural form, where aid impacts on growth through key intermediate outcomes. A coherent picture emerges: aid stimulates growth and reduces...

  9. Technical evaluation of a CAD system for orthopaedic shoe-upper design.

    Science.gov (United States)

    Lord, M; Foulston, J; Smith, P J

    1991-01-01

    Computer aided design is now employed routinely in the volume shoe trade. New styles are developed on a three-dimensional image of the last followed by automated pattern generation and engineering. It is suggested that such systems could be useful in the orthopaedic footwear industry although the different requirements for these bespoke products need careful consideration. A clinical trial has been conducted on the Shoemaster (Clarks Shoes) upper design system both to assess its technical capabilities and to consider its role in improvement of service and cosmetic appearance. This particular system works throughout on a three-dimensional representation of the shoe last, which offers particular advantages for integration with shape capture and reproduction. The report concentrates on the technical evaluation to assess (a) its ability to work with unusual last shapes dictated by medical requirements and (b) its potential for integration into a complete computer system for design of both shoe lasts and shoe uppers. The trial indicates that this particular system is promising in both respects. PMID:1840716

  10. Myths and legends in orthopaedic practice: are we all guilty?

    Science.gov (United States)

    Tejwani, Nirmal C; Immerman, Igor

    2008-11-01

    Over years of practice, many beliefs and practices become entrenched as tried and tested, and we subconsciously believe they are based on scientific evidence. We identified nine such beliefs by interviewing orthopaedic surgeons in which studies (or lack thereof) apparently do not support such practices. These are: changing the scalpel blade after the skin incision to limit contamination; bending the patient's knee when applying a thigh tourniquet; bed rest for treatment of deep vein thrombosis; antibiotics in irrigation solution; routine use of hip precautions; routine use of antibiotics for the duration of wound drains; routine removal of hardware in children; correlation between operative time and infection; and not changing dressings on the floor before scrubbing. A survey of 186 practicing orthopaedic surgeons in academic and community settings was performed to assess their routine practice patterns. We present the results of the survey along with an in-depth literature review of these topics. Most surgeon practices are based on a combination of knowledge gained during training, reading the literature, and personal experience. The results of this survey hopefully will raise the awareness of the selected literature for common practices. PMID:18726654

  11. The effect of inclement weather on trauma orthopaedic workload.

    LENUS (Irish Health Repository)

    Cashman, J P

    2012-01-31

    BACKGROUND: Climate change models predict increasing frequency of extreme weather. One of the challenges hospitals face is how to make sure they have adequate staffing at various times of the year. AIMS: The aim of this study was to examine the effect of this severe inclement weather on hospital admissions, operative workload and cost in the Irish setting. We hypothesised that there is a direct relationship between cold weather and workload in a regional orthopaedic trauma unit. METHODS: Trauma orthopaedic workload in a regional trauma unit was examined over 2 months between December 2009 and January 2010. This corresponded with a period of severe inclement weather. RESULTS: We identified a direct correlation between the drop in temperature and increase in workload, with a corresponding increase in demand on resources. CONCLUSIONS: Significant cost savings could be made if these injuries were prevented. While the information contained in this study is important in the context of resource planning and staffing of hospital trauma units, it also highlights the vulnerability of the Irish population to wintery weather.

  12. Orthopaedic applications for PLA-PGA biodegradable polymers.

    Science.gov (United States)

    Athanasiou, K A; Agrawal, C M; Barber, F A; Burkhart, S S

    1998-10-01

    Biodegradable polymers, especially those belonging to the family of polylactic acid (PLA) and polyglycolic acid (PGA), play an increasingly important role in orthopaedics. These polymers degrade by hydrolysis and enzymatic activity and have a range of mechanical and physical properties that can be engineered appropriately to suit a particular application. Their degradation characteristics depend on several parameters including their molecular structure, crystallinity, and copolymer ratio. These biomaterials are also rapidly gaining recognition in the fledging field of tissue engineering because they can be fashioned into porous scaffolds or carriers of cells, extracellular matrix components, and bioactive agents. Although their future appears to be bright, several questions regarding the biocompatibility of these materials linger and should be addressed before their wide-scale use. In the context of musculoskeletal tissue, this report provides a comprehensive review of properties and applications of biodegradable PLA/PGA polymers and their copolymers. Of special interest are orthopaedic applications, biocompatibility studies, and issues of sterilization and storage of these versatile biomaterials. Also discussed is the fact that terms such as PLA, PGA, or PLA-PGA do not denote one material, but rather a large family of materials that have a wide range of differing bioengineering properties and concomitant biological responses. An analysis of some misconceptions, problems, and potential solutions is also provided. PMID:9788368

  13. AIDS (image)

    Science.gov (United States)

    AIDS (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), and is a syndrome that ... life-threatening illnesses. There is no cure for AIDS, but treatment with antiviral medication can suppress symptoms. ...

  14. Hearing Aids

    Science.gov (United States)

    ... more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage ... your doctor. There are different kinds of hearing aids. They differ by size, their placement on or ...

  15. Hearing Aids

    Science.gov (United States)

    ... electrical nerve impulses and send them to the auditory nerve, which connects the inner ear to the ... prefer. Cleaning makes a difference in hearing aid comfort. A perfectly comfortable hearing aid can become pretty ...

  16. Foreign aid

    DEFF Research Database (Denmark)

    Tarp, Finn

    2008-01-01

    Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles and instituti......Foreign aid has evolved significantly since the Second World War in response to a dramatically changing global political and economic context. This article (a) reviews this process and associated trends in the volume and distribution of foreign aid; (b) reviews the goals, principles and...... institutions of the aid system; and (c) discusses whether aid has been effective. While much of the original optimism about the impact of foreign aid needed modification, there is solid evidence that aid has indeed helped further growth and poverty reduction...

  17. Unstated factors in orthopaedic decision-making: a qualitative study

    Directory of Open Access Journals (Sweden)

    Learmonth Ian D

    2010-09-01

    Full Text Available Abstract Background Total joint replacement (TJR of the hip or knee for osteoarthritis is among the most common elective surgical procedures. There is some inequity in provision of TJR. How decisions are made about who will have surgery may contribute to disparities in provision. The model of shared decision-making between patients and clinicians is advocated as an ideal by national bodies and guidelines. However, we do not know what happens within orthopaedic practice and whether this reflects the shared model. Our study examined how decisions are made about TJR in orthopaedic consultations. Methods The study used a qualitative research design comprising semi-structured interviews and observations. Participants were recruited from three hospital sites and provided their time free of charge. Seven clinicians involved in decision-making about TJR were approached to take part in the study, and six agreed to do so. Seventy-seven patients due to see these clinicians about TJR were approached to take part and 26 agreed to do so. The patients' outpatient appointments ('consultations' were observed and audio-recorded. Subsequent interviews with patients and clinicians examined decisions that were made at the appointments. Data were analysed using thematic analysis. Results Clinical and lifestyle factors were central components of the decision-making process. In addition, the roles that patients assigned to clinicians were key, as were communication styles. Patients saw clinicians as occupying expert roles and they deferred to clinicians' expertise. There was evidence that patients modified their behaviour within consultations to complement that of clinicians. Clinicians acknowledged the complexity of decision-making and provided descriptions of their own decision-making and communication styles. Patients and clinicians were aware of the use of clinical and lifestyle factors in decision-making and agreed in their description of clinicians' styles

  18. International Patients on Operation Vacation – Perspectives of Patients Travelling to Hungary for Orthopaedic Treatments

    Directory of Open Access Journals (Sweden)

    Eszter Kovacs

    2014-11-01

    Full Text Available Background The importance of cross-border healthcare, medical and health tourism plays a significant role in the European health policy and health management. After dentistry, orthopaedic treatments are the leading motivation for seeking care in Hungary, as patients with rheumatic and motion diseases are drawn to the thermal spas and well-established orthopaedic centres. This paper aims to gain insight into foreign patients’ perspectives on their experience of having sought medical tourism in orthopaedic care in Hungary. Methods A patient survey was conducted in 2012 on motivations for seeking treatment abroad, orthopaedic care received and overall satisfaction. In addition, health professionals’ interviews, and 17 phone interviews were conducted in 2013 with Romanian patients who had orthopaedic treatment in Hungary. Finally, medical records of foreign patients were analysed. Results The survey was completed by 115 participants – 61.1% females, mean age= 41.9, 87% Romanian origin. Most of the patients came to Hungary for orthopaedic surgeries, e.g. arthroscopy, knee/hip prosthesis or spinal surgery. 72.6% chose Hungary because of related to perceived better quality and longstanding culture of Hungarian orthopaedic care. Over 57% of patients reported being ‘very satisfied’ with care received and 41.6% ‘satisfied’. The follow-up interviews further reflected this level of satisfaction, therefore many respondents stating they have already recommended the Hungarian healthcare to others. Conclusion Based on the findings, patients from neighbouring regions are increasingly seeking orthopaedic care in Hungary. Patients having orthopaedic care are highly satisfied with the quality of care, the whole treatment process from the availability of information to discharge summaries and would consider returning for further treatments.

  19. Novel magnetite-silica nanocomposite (Fe3O4-SBA-15) particles for DNA binding and gene delivery aided by a magnet array.

    Science.gov (United States)

    Yiu, Humphrey H P; McBain, Stuart C; Lethbridge, Zoe A D; Lees, Martin R; Palona, Iryna; Olariu, Cristina I; Dobson, Jon

    2011-04-01

    Novel magnetite-silica nanocomposite particles were prepared using SBA-15 nanoporous silica as template. Magnetite nanoparticles were impregnated into the nanopore array of the silica template through thermal decomposition of iron(III) acetylacetonate, Fe(AcAc)3 at 200 degrees C. These composite particles were characterized using TEM, XRD and SQUID magnetometry. The TEM images showed that the size of composite particles was around 500 nm and the particles retained the nanoporous array of SBA-15. The formation of magnetite nanoparticles was confirmed by the powder XRD study. These composite particles also exhibited ferrimagnetic properties. By coating with short chain polyethyleneimine (PEI), these particles are capable of binding DNA molecules for gene delivery and transfection. With an external magnetic field, the transfection efficiency was shown to have an increase of around 15%. The results indicated that these composite nanoparticles may be further developed as a new tool for nanomagnetic gene transfection. PMID:21776740

  20. [Treatments of Soft Tissue Sarcomas by Orthopaedic Surgeons in Japan].

    Science.gov (United States)

    Tanaka, Kazuhiro

    2016-01-01

    In Japan, the treatment of soft tissue sarcomas (STS) has been performed mainly by orthopaedic surgeons. The standard therapy for all cases of STS is surgical resection of the tumor. The prognosis of patients with unresectable tumors or distant metastases is poor despite treatment with intensive chemotherapy. Adjuvant chemotherapy is indicated for patients with resectable tumors. Round-cell STS, including extraskeletal Ewing sarcoma and rhabdomyosarcoma, have high sensitivity to chemotherapy. The standard treatment for round-cell STS is multimodal therapy with surgery and chemotherapy, with or without radiotherapy. On the other hand, non-round cell STS, including leiomyosarcoma, synovial sarcoma, and liposarcoma, have low sensitivity to chemotherapy. Thus, the standard treatment for non-round cell STS is essentially, surgery. Large and high-grade non-round cell STS are also treated using adjuvant chemotherapy along with surgery. In this review, the standard therapies for STS and the future perspective in Japan are discussed. PMID:26809525

  1. [Recent progress in orthopaedic managements of osteoporosis-related fractures].

    Science.gov (United States)

    Yamamoto, Seizo

    2011-07-01

    Recent progress in orthopaedic treatment of osteoporosis-related fractures was reviewed. In the treatment of femoral neck fractures, impacted or nondisplaced type is treated by three cannulated cancellous pins. Displaced type of femoral neck fracture is treated by bipolar prosthesis. Results of femoral neck fractures are influenced by the complications of each patients. Osteoporotic spine fractures are commonly healed within 2 or 3 months. Spinal compression with paraparesis or paraplegia is unusual complication in burst type of spine fractures. Surgical decompression, bone grafting and stabilization with instrumentation can result in some correction of deformity and neurogenic recovery. Distal radius fractures are common fractures in the eldery. Recently advances includes external fixation and plate fixation for the comminuted fractures in the distal radius. Treatments of osteoporosis-related fractures are still difficult problems to be resolved. PMID:21774371

  2. Direct Observation: Assessing Orthopaedic Trainee Competence in the Ambulatory Setting.

    Science.gov (United States)

    Phillips, Donna P; Zuckerman, Joseph D; Kalet, Adina; Egol, Kenneth A

    2016-09-01

    The Accreditation Council of Graduate Medical Education requires that residency programs teach and assess trainees in six core competencies. Assessments are imperative to determine trainee competence and to ensure that excellent care is provided to all patients. A structured, direct observation program is feasible for assessing nontechnical core competencies and providing trainees with immediate constructive feedback. Direct observation of residents in the outpatient setting by trained faculty allows assessment of each core competency. Checklists are used to document residents' basic communication skills, clinical reasoning, physical examination methods, and medical record keeping. Faculty concerns regarding residents' professionalism, medical knowledge, fatigue, or ability to self-assess are tracked. Serial observations allow for the reinforcement and/or monitoring of skills and attitudes identified as needing improvement. Residents who require additional coaching are identified early in training. Progress in educational milestones is recorded, allowing an individualized educational program that ensures that future orthopaedic surgeons excel across all domains of medical and surgical competence. PMID:27479831

  3. 'Ready-access' CT imaging for an orthopaedic trauma clinic.

    LENUS (Irish Health Repository)

    Cawley, D

    2011-03-01

    \\'Ready-Access\\' to CT imaging facilities in Orthopaedic Trauma Clinics is not a standard facility. This facility has been available at the regional trauma unit, in Merlin Park Hospital, Galway for the past four years. We reviewed the use of this facility over a 2-year period when 100 patients had CT scans as part of their trauma clinic assessment. The rate of CT scan per clinic was 0.6. The mean waiting time for a CT scan was 30 minutes. 20 (20%) new fractures were confirmed, 33 (33%) fractures were out-ruled, 25 (25%) fractures demonstrated additional information and 8 (8%) had additional fractures. 20 (20%) patients were discharged and 12 (12%) patients were admitted as a result of the CT scan. It adds little time and cost to CT scanning lists.

  4. Examples of positive suggestions given to patients undergoing orthopaedic surgeries

    Science.gov (United States)

    Csernátony, Zoltán; Balogh, Ágnes; Varga, Katalin

    2013-01-01

    In the Department of Orthopaedic Surgery in the University of Debrecen, Debrecen, Hungary, we examined the effectiveness of positive suggestions used in the perioperative period in hip and knee arthroplasties performed under spinal anaesthesia. The goal of the suggestions was to reduce the need for red blood cell transfusion and for analgesics, and to increase the patients’ satisfaction. The objective of this article is to present our method with concrete examples of positive suggestions which were given first before the surgery (via personal conversation), then during the operation as well (via audiotaped method). We hope that our article will contribute to the wide-spread awareness of this relatively easy to learn communication method. PMID:24265900

  5. In-vivo measurement of the human soft tissues constitutive laws. Applications to Computer Aided Surgery

    CERN Document Server

    Schiavone, Patrick; Ohayon, J; Payan, Y

    2007-01-01

    In the 80's, biomechanicians were asked to work on Computer Aided Surgery applications since orthopaedic surgeons were looking for numerical tools able to predict risks of fractures. More recently, biomechanicians started to address soft tissues arguing that most of the human body is made of such tissues that can move as well as deform during surgical gestures [1]. An intra-operative use of a continuous Finite Element (FE) Model of a given tissue mainly faces two problems: (1) the numerical simulations have to be "interactive", i.e. sufficiently fast to provide results during surgery (which can be a strong issue in the context of hyperelastic models for example) and (2) during the intervention, the surgeon needs a device that can be used to provide to the model an estimation of the patient-specific constitutive behaviour of the soft tissues. This work proposes an answer to the second point, with the design of a new aspiration device aiming at characterizing the in vivo constitutive laws of human soft tissues....

  6. Education and training opportunities in trauma and orthopaedics in SE Thames Region.

    Science.gov (United States)

    Savage, P E; d'A Fearn, C B; Groom, A F; Heatley, F W

    1997-11-01

    In preparation for the introduction of the specialist registrar grade the specialist advisory committee (SAC) in orthopaedics developed a six-year structured training programme leading to the award of the Certificate of Completion of Specialist Training (CCST). A team comprising the regional adviser in orthopaedics, the two regional programme directors and an associate dean of postgraduate medicine visited all the departments of orthopaedics in the South East Thames Region in order to evaluate the training opportunities they provided. This paper describes the methodology used during these visits, the lessons learned and the conclusions drawn. PMID:9496169

  7. Lean Participative Process Improvement: Outcomes and Obstacles in Trauma Orthopaedics

    Science.gov (United States)

    New, Steve; Hadi, Mohammed; Pickering, Sharon; Robertson, Eleanor; Morgan, Lauren; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

    2016-01-01

    Objectives To examine the effectiveness of a “systems” approach using Lean methodology to improve surgical care, as part of a programme of studies investigating possible synergy between improvement approaches. Setting A controlled before-after study using the orthopaedic trauma theatre of a UK Trust hospital as the active site and an elective orthopaedic theatre in the same Trust as control. Participants All staff involved in surgical procedures in both theatres. Interventions A one-day “lean” training course delivered by an experienced specialist team was followed by support and assistance in developing a 6 month improvement project. Clinical staff selected the subjects for improvement and designed the improvements. Outcome Measures We compared technical and non-technical team performance in theatre using WHO checklist compliance evaluation, “glitch count” and Oxford NOTECHS II in a sample of directly observed operations, and patient outcome (length of stay, complications and readmissions) for all patients. We collected observational data for 3 months and clinical data for 6 months before and after the intervention period. We compared changes in measures using 2-way analysis of variance. Results We studied 576 cases before and 465 after intervention, observing the operation in 38 and 41 cases respectively. We found no significant changes in team performance or patient outcome measures. The intervention theatre staff focused their efforts on improving first patient arrival time, which improved by 20 minutes after intervention. Conclusions This version of “lean” system improvement did not improve measured safety processes or outcomes. The study highlighted an important tension between promoting staff ownership and providing direction, which needs to be managed in “lean” projects. Space and time for staff to conduct improvement activities are important for success. PMID:27124012

  8. Lean Participative Process Improvement: Outcomes and Obstacles in Trauma Orthopaedics.

    Directory of Open Access Journals (Sweden)

    Steve New

    Full Text Available To examine the effectiveness of a "systems" approach using Lean methodology to improve surgical care, as part of a programme of studies investigating possible synergy between improvement approaches.A controlled before-after study using the orthopaedic trauma theatre of a UK Trust hospital as the active site and an elective orthopaedic theatre in the same Trust as control.All staff involved in surgical procedures in both theatres.A one-day "lean" training course delivered by an experienced specialist team was followed by support and assistance in developing a 6 month improvement project. Clinical staff selected the subjects for improvement and designed the improvements.We compared technical and non-technical team performance in theatre using WHO checklist compliance evaluation, "glitch count" and Oxford NOTECHS II in a sample of directly observed operations, and patient outcome (length of stay, complications and readmissions for all patients. We collected observational data for 3 months and clinical data for 6 months before and after the intervention period. We compared changes in measures using 2-way analysis of variance.We studied 576 cases before and 465 after intervention, observing the operation in 38 and 41 cases respectively. We found no significant changes in team performance or patient outcome measures. The intervention theatre staff focused their efforts on improving first patient arrival time, which improved by 20 minutes after intervention.This version of "lean" system improvement did not improve measured safety processes or outcomes. The study highlighted an important tension between promoting staff ownership and providing direction, which needs to be managed in "lean" projects. Space and time for staff to conduct improvement activities are important for success.

  9. Effect of clinical specialist physiotherapists in orthopaedic diagnostic setting - A systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Mikkelsen, Lone Ramer; Juhl, Carsten

    2016-01-01

    with musculoskeletal complaint performed by Clinical Specialist Physiotherapists (CSP) compared to Orthopaedic Surgeons (OS) on diagnostic agreement, economic cost and patient satisfaction. Methods: A systematic review was performed by searching in MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL...

  10. Application of the quality and safety education for nurses competencies in orthopaedic nursing: implications for preceptors.

    Science.gov (United States)

    Altmiller, Gerry

    2013-01-01

    For the last decade, quality and safety have been the ardent focus of healthcare improvement. Many agencies provide resources to healthcare providers to assist their endeavors. The Quality and Safety Education for Nurses (QSEN) Collaboration developed competencies that define the concepts of quality and safety in relation to nursing practice and education. These concepts are not new to orthopaedic nursing; they are better defined through the QSEN competencies so that nurses can develop practice behaviors that ensure quality and safety for the patients they care for. The QSEN competencies guide the processes that support the Orthopaedic Core Competencies: Across the Lifespan. Together, they enhance the orthopaedic specialty by deepening the focus on patient safety and high-quality care. Preceptors are in a unique position to influence new nurses and those transitioning into orthopaedic nursing to adopt these practices as they develop skills to meet the requirements of the specialty. PMID:23518753

  11. Significance of Nano- and Microtopography for Cell-Surface Interactions in Orthopaedic Implants

    Directory of Open Access Journals (Sweden)

    M. Jäger

    2007-09-01

    Full Text Available Cell-surface interactions play a crucial role for biomaterial application in orthopaedics. It is evident that not only the chemical composition of solid substances influence cellular adherence, migration, proliferation and differentiation but also the surface topography of a biomaterial. The progressive application of nanostructured surfaces in medicine has gained increasing interest to improve the cytocompatibility and osteointegration of orthopaedic implants. Therefore, the understanding of cell-surface interactions is of major interest for these substances. In this review, we elucidate the principle mechanisms of nano- and microscale cell-surface interactions in vitro for different cell types onto typical orthopaedic biomaterials such as titanium (Ti, cobalt-chrome-molybdenum (CoCrMo alloys, stainless steel (SS, as well as synthetic polymers (UHMWPE, XLPE, PEEK, PLLA. In addition, effects of nano- and microscaled particles and their significance in orthopaedics were reviewed. The significance for the cytocompatibility of nanobiomaterials is discussed critically.

  12. Nicholas J. Giannestras (1908-1978): a distinguished orthopaedic surgeon, his work, life and times.

    Science.gov (United States)

    Markatos, Konstantinos; Efstathopoulos, Nikolaos; Kaseta, Kiriaki Maria; Nikolaou, Vasileios; Tsoucalas, Gregory; Sgantzos, Markos

    2015-11-01

    The purpose of our study was to summarize all the knowledge concerning the innovative pioneer in the field of orthopaedic surgery, Nicholas J. Giannestras (1908-1978). A thorough study of texts, medical books and reports, in the field of history of medicine, together with a review of the available literature in PubMed, was undertaken. Giannestras left his mark in the history of orthopaedics with his clinical work and his publications, mainly his treatise "Foot Disorders: Medical and Surgical Management" (1973), while his name lingers in Greece with the introduction of spine fusion with the use of metallic implants. He was an eminent university clinical professor of orthopaedics who had harmonically combined academic writing, teaching and clinical research in every field of orthopaedic surgery. PMID:26255057

  13. Bioactive Coatings for Orthopaedic Implants—Recent Trends in Development of Implant Coatings

    Directory of Open Access Journals (Sweden)

    Bill G. X. Zhang

    2014-07-01

    Full Text Available Joint replacement is a major orthopaedic procedure used to treat joint osteoarthritis. Aseptic loosening and infection are the two most significant causes of prosthetic implant failure. The ideal implant should be able to promote osteointegration, deter bacterial adhesion and minimize prosthetic infection. Recent developments in material science and cell biology have seen the development of new orthopaedic implant coatings to address these issues. Coatings consisting of bioceramics, extracellular matrix proteins, biological peptides or growth factors impart bioactivity and biocompatibility to the metallic surface of conventional orthopaedic prosthesis that promote bone ingrowth and differentiation of stem cells into osteoblasts leading to enhanced osteointegration of the implant. Furthermore, coatings such as silver, nitric oxide, antibiotics, antiseptics and antimicrobial peptides with anti-microbial properties have also been developed, which show promise in reducing bacterial adhesion and prosthetic infections. This review summarizes some of the recent developments in coatings for orthopaedic implants.

  14. The surgeon and his tools-the case for a focused orthopaedic theatre induction programme

    OpenAIRE

    Wong Shaun KS; Oakley J; Kumar AJ Shyam; Philips Steve J

    2008-01-01

    Abstract Background Induction programme for trainee doctors in the UK generally do not focus on the surgical aspects of their jobs. In this context we decided to conduct a telephonic survey among the hospitals belonging to three orthopaedic training regions in the UK from the point of view of the diversity of instrumentations and implants used for index procedures. Results We chose four index trauma & orthopaedic procedures (Total hip replacement, total knee replacement, intramedullary nailin...

  15. Users' guide to the orthopaedic literature: What is a cost-effectiveness analysis?

    OpenAIRE

    Tanner, Stephanie; Sprague, Sheila; Jeray, Kyle

    2008-01-01

    As the cost of healthcare continue to rise, orthopaedic surgeons are being pressured to practice cost-effective healthcare. Consequently, economic evaluation of treatment options are being reported more commonly in medical and surgical literature. As new orthopaedic procedures and treatments may improve patient outcome and function over traditional treatment options, the effect of the potentially higher costs of new treatments should be formally evaluated. Unfortunately, the resources availab...

  16. Users′ guide to the orthopaedic literature: What is a cost-effectiveness analysis?

    OpenAIRE

    Tanner Stephanie; Sprague Sheila; Jeray Kyle

    2008-01-01

    As the cost of healthcare continue to rise, orthopaedic surgeons are being pressured to practice cost-effective healthcare. Consequently, economic evaluation of treatment options are being reported more commonly in medical and surgical literature. As new orthopaedic procedures and treatments may improve patient outcome and function over traditional treatment options, the effect of the potentially higher costs of new treatments should be formally evaluated. Unfortunately, the resources availab...

  17. Suction drain tip culture in orthopaedic surgery: a prospective study of 214 clean operations

    OpenAIRE

    Sankar, B.; Ray, P.; Rai, J.

    2004-01-01

    We conducted a prospective cohort study in order to determine whether suction drain specimen cultures from orthopaedic surgery predicted an early wound infection. We included 218 consecutive clean orthopaedic operations requiring drains in one unit over a period of 1 year. The suction drain tip, drain fluid and wound discharge specimens were cultured, and the surgical wound was followed up for 3 months. There were six deep and two superficial wound infections. Wound infection was significantl...

  18. Titanium-Nitride Coating of Orthopaedic Implants: A Review of the Literature

    OpenAIRE

    van Hove, Ruud P.; Sierevelt, Inger N; van Royen, Barend J.; Nolte, Peter A.

    2015-01-01

    Surfaces of medical implants can be enhanced with the favorable properties of titanium-nitride (TiN). In a review of English medical literature, the effects of TiN-coating on orthopaedic implant material in preclinical studies were identified and the influence of these effects on the clinical outcome of TiN-coated orthopaedic implants was explored. The TiN-coating has a positive effect on the biocompatibility and tribological properties of implant surfaces; however, there are several reports ...

  19. Adherent Lipopolysaccharide Inhibits the Osseointegration of Orthopaedic Implants by Impairing Osteoblast Differentiation

    OpenAIRE

    Bonsignore, Lindsay A.; Anderson, J. Robert; Lee, Zhenghong; Goldberg, Victor M.; Greenfield, Edward M.

    2012-01-01

    Osseointegration is the process by which an orthopaedic implant makes direct bone-to-implant contact and is crucial for the long-term function of the implant. Surface contaminants, such as bacterial debris and manufacturing residues, may remain on orthopaedic implants after sterilization and impair osseointegration. For example, specific lots of implants that were associated with impaired osseointegration and high failure rates were discovered to have contaminants including bacterial debris. ...

  20. Mechanical compatibility of sol–gel annealing with titanium for orthopaedic prostheses

    OpenAIRE

    Greer, Andrew I.M.; Lim, Teoh S.; Brydone, Alistair S.; Gadegaard, Nikolaj

    2015-01-01

    Sol–gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol–gel technology to orthopaedics. Primarily, the annealing stage required to tra...

  1. Comparison of published orthopaedic trauma trials following registration in Clinicaltrials.gov

    OpenAIRE

    Gandhi Rajiv; Jan Meryam; Smith Holly N; Mahomed Nizar N; Bhandari Mohit

    2011-01-01

    Abstract Background After the Food and Drug Administration Modernization Act of 1997, the registration of all clinical trials became mandatory prior to publication. Our primary objective was to determine publication rates for orthopaedic trauma trials registered with ClinicalTrials.gov. We further evaluated methodological consistency between registration and publication. Methods We searched Clinical Trials.gov for all trials related to orthopaedic trauma. We excluded active trials and trials ...

  2. Guideline on anterior cruciate ligament injury A multidisciplinary review by the Dutch Orthopaedic Association

    OpenAIRE

    Meuffels, D.E.; Poldervaart, M.T.; Diercks, R.L.; Fievez, A.W.F.M.; Patt, T. W.; Hart, C P; Hammacher, E.R.; van der Meer, F.; Goedhart, E.A.; Lenssen, A.F.; Muller-Ploeger, S.B.; Pols, M.A.; Saris, D.B.F.

    2012-01-01

    The Dutch Orthopaedic Association has a long tradition of development of practical clinical guidelines. Here we present the recommendations from the multidisciplinary clinical guideline working group for anterior cruciate ligament injury. The following 8 clinical questions were formulated by a steering group of the Dutch Orthopaedic Association. center dot What is the role of physical examination and additional diagnostic tools? center dot Which patient-related outcome measures should be used...

  3. Hearing Aids

    Science.gov (United States)

    ... prefer the open-fit hearing aid because their perception of their voice does not sound “plugged up.” ... My voice sounds too loud. The “plugged-up” sensation that causes a hearing aid user’s voice to ...

  4. Brand Aid

    DEFF Research Database (Denmark)

    Richey, Lisa Ann; Ponte, Stefano

    A critical account of the rise of celebrity-driven “compassionate consumption” Cofounded by the rock star Bono in 2006, Product RED exemplifies a new trend in celebrity-driven international aid and development, one explicitly linked to commerce, not philanthropy. Brand Aid offers a deeply informed...

  5. Surgeons' knowledge about the costs of orthopaedic implants.

    Science.gov (United States)

    Rohman, Lebur; Hadi, Saifullah; Whitwell, George

    2014-08-01

    PURPOSE. To investigate consultant surgeons' knowledge about the costs of implants for various joint surgeries. METHODS. Questionnaires were distributed to consultant orthopaedic surgeons at 2 hospitals. Respondents were asked to estimate the implant costs of any brand for low-demand and high-demand total hip replacement (THR), total knee replacement (TKR), uni-compartmental knee replacement, arthroscopy shaver blade, total anterior cruciate ligament (ACL) fixation, and meniscal repair. The actual cost of each implant was obtained from the manufacturer. RESULTS. 16 consultant surgeons completed the questionnaires. The respective mean estimated and actual costs for a low-demand THR implant were £1714 (range, £600-3000) and £1448 (range, £985- 2335), with an overestimation of 18.4%. The respective costs for a high-demand THR implant were £2172 (range, £600-6000) and £1737 (range, £1192-2335), with an overestimation of 25%. The respective costs for a TKR implant were £1550 (range, £600-6000) and £1316 (range, £995-1535), with an overestimation of 17.8%. The respective costs for a uni-compartmental knee replacement implant were £1040 (range, £600-2000) and £1296 (range, £698-1470), with an underestimation of 19.7%. The respective costs for an arthroscopy shaver blade were £110 (range, £75-150) and £94 (range, £80-100), with an overestimation of 16.6%. The respective costs for a total ACL fixation implant were £246 (range, £80-500) and £306 (range, £272-335), with an underestimation of 19.4%. The respective costs for a meniscal repair implant were £153 (range, £50-250) and £242 (range, £170-260), with an underestimation of 37%. CONCLUSION. The knowledge among consultant orthopaedic surgeons about implant costs was poor. To reduce implant costs, cooperation between surgeons and hospital managers and measures to increase surgeons' awareness about cost-reduction programmes are needed. PMID:25163960

  6. Subtalar dislocation: management and prognosis for an uncommon orthopaedic condition.

    Science.gov (United States)

    Prada-Cañizares, Alfonso; Auñón-Martín, Ismael; Vilá Y Rico, Jesús; Pretell-Mazzini, Juan

    2016-05-01

    Subtalar dislocations were first described in 1811 as the simultaneous dislocation of the talo-calcaneal and talo-navicular joints without any tibio-talar or talar neck associated fractures. They were classified in 1853 as: medial, lateral, posterior and anterior based on the displacement of the foot in relationship to the talus. These are uncommon injuries, representing approximately 1 % of all traumatic injuries of the foot and 1-2 % of all dislocations, being associated with high energy trauma.Closed reduction of these dislocations should be performed as early as possible to avoid further damage to the skin and neurovascular structures. If this is not possible, then open reduction without further delay is recommended. Irreducible injuries have been reported in 0 to 47 % of cases. Open dislocations represent between 46 and 83 % of all cases, and have been associated with poor prognosis. Associated fractures have a high incidence, the most frequent ones are the posterior process of the talus, talar head, external malleolus, medial malleolus and the tubercle of the fifth metatarsal.These types of injuries are not faced by orthopaedic surgeons on a daily basis and having a source of information on how to manage and what to expect is important. We present an up-to-date literature review on the epidemiology, clinical presentation, radiologic assessment, treatment options and prognostic factors of these uncommon injuries. PMID:26208589

  7. Orthopaedic Considerations for the Adult With Osteogenesis Imperfecta.

    Science.gov (United States)

    Roberts, Timothy T; Cepela, Daniel J; Uhl, Richard L; Lozman, Jeffery

    2016-05-01

    Osteogenesis imperfecta is a heritable group of collagen-related disorders that affects up to 50,000 people in the United States. Although the disease is most symptomatic in childhood, adults with osteogenesis imperfecta also are affected by the sequelae of the disease. Orthopaedic manifestations include posttraumatic and accelerated degenerative joint disease, kyphoscoliosis, and spondylolisthesis. Other manifestations of abnormal collagen include brittle dentition, hearing loss, cardiac valve abnormalities, and basilar invagination. In general, nonsurgical treatment is preferred for management of acute fractures. High rates of malunion, nonunion, and subsequent deformity have been reported with both closed and open treatment. When surgery is necessary, surgeons should opt for load-sharing intramedullary devices that span the entire length of the bone; locking plates and excessively rigid fixation generally should be avoided. Arthroplasty may be considered for active patients, but the procedure frequently is associated with complications in this patient population. Underlying deformities, such as malunion, bowing, rotational malalignment, coxa vara, and acetabular protrusio, pose specific surgical challenges and underscore the importance of preoperative planning. PMID:27100300

  8. New modalities of pain treatment after outpatient orthopaedic surgery.

    Science.gov (United States)

    Beaussier, M; Sciard, D; Sautet, A

    2016-02-01

    Postoperative pain relief is one of the cornerstones of success of orthopaedic surgery. Development of new minimally-invasive surgical procedures, as well as improvements in pharmacological and local and regional techniques should result in optimal postoperative pain control for all patients. The analgesic strategy has to be efficient, with minimal side effects, and be easy to manage at home. Multimodal analgesia allows for a reduction of opiate use and thereby its side effects. Local and regional analgesia is a major component of this multimodal strategy, associated with optimal pain relief, even upon mobilization, and it has beneficial effects on postoperative recovery. Ultrasound guidance improves the success rate of distal nerve blocks and makes distal selective blockade possible, helping to preserve the limb's motility. Besides peripheral nerve blocks, local infiltration (incisional and/or intra-articular) is also important to consider. Duration of the nerve blockade is limited after a single injection. This must be taken into consideration to avoid the recurrence of pain when the patient returns home. Continuous perineural blocks using catheters are an option that can be easily managed at home with monitoring by home-care nurses. Extended-release liposomal bupivacaine and adjuvants such as dexamethasone could significantly enhance the duration of the sensory block, thereby reducing the indications for pain pumps. Non-pharmacological approaches, such as cryotherapy, hypnosis and acupuncture should not be ignored. PMID:26803223

  9. [Richard von Volkmann, one career of orthopaedic surgeon and poet].

    Science.gov (United States)

    Bumbasirević, M; Lesić, A; Sudjić, V; Zagorac, S

    2010-01-01

    Richard von Volkman was one of the most famous and important surgeons in the 19th century. He pioneered antiseptic procedures and was especially known for his achivements in orthopedic surgery. Von Volkmann was born in Leipzig, Germany and attended medical schools in Giessen, Halle, and Berlin. Starting in 1867, he worked as a professor of surgery at the University of Halle, also leading its surgical clinic. He was active as a surgeon during Seven Weeks' War with Austria in 1866 and the Franco-Prussian war 1870/1871, in the latter as consulting Generalarzt. He was important in the introduction of antiseptic wound treatment in Germany, and through it to the United States of America. Two observations in orthopaedic surgery bear his name to these days: Volkmans contracture and Heuter-Volkmans low. Volkmann also wrote poetry under the name Richard Leander and his book entitled "Dreams by French Firesides" which still has a place in literature. He died of paralysis due to a chronic spinal disease, following a prolonged illness, in the Binswanger institution in Jena in 1889, at the top of his careere. PMID:20954309

  10. PROGRESS OF BIOMATERIALS IN THE FIELD OF ORTHOPAEDICS

    Directory of Open Access Journals (Sweden)

    D. Chandramohan

    2014-01-01

    Full Text Available The aim of this study is to compare the metallic and natural fiber reinforced polymer composite bone plates used in humerus fractures. A 3D finite element model was developed to analyze the performance of both types of plates. This study proposed on fabrication of natural fiber powdered material (like Sisal (Agave sisalana, Banana (Musa sapientum and Roselle (Hibiscus sabdariffa Reinforced Polymer (NFRP composite plate material with bio epoxy resin. Instead of orthopaedics alloys such as titanium, cobalt chrome, stainless steel and zirconium, this plate material can be used for both internal and external fixation on human body for fractured bone. In this study, flexural rigidity of Sisal and banana (hybrid, Roselle and banana (hybrid and Roselle and sisal (hybrid composite at dry and wet conditions was studied. In this study the composition of the microstructure of composites specimens were studied using Electron Dispersive X-Ray Thermo detector and Scanning Electron Microscope.

  11. Biodegradable injectable polyurethanes: synthesis and evaluation for orthopaedic applications.

    Science.gov (United States)

    Adhikari, Raju; Gunatillake, Pathiraja A; Griffiths, Ian; Tatai, Lisa; Wickramaratna, Malsha; Houshyar, Shadi; Moore, Tim; Mayadunne, Roshan T M; Field, John; McGee, Margaret; Carbone, Tania

    2008-10-01

    Biodegradable polyurethanes offer advantages in the design of injectable or preformed scaffolds for tissue engineering and other medical implant applications. We have developed two-part injectable prepolymer systems (prepolymer A and B) consisting of lactic acid and glycolic acid based polyester star polyols, pentaerythritol (PE) and ethyl lysine diisocyanate (ELDI). This study reports on the formulation and properties of a series of cross linked polyurethanes specifically developed for orthopaedic applications. Prepolymer A was based on PE and ELDI. Polyester polyols (prepolymer B) were based on PE and dl-lactic acid (PEDLLA) or PE and glycolic acid (PEGA) with molecular weights 456 and 453, respectively. Several cross linked porous and non-porous polyurethanes were prepared by mixing and curing prepolymers A and B and their mechanical and thermal properties, in vitro (PBS/37 degrees C/pH 7.4) and in vivo (sheep bi-lateral) degradation evaluated. The effect of incorporating beta-tricalcium phosphate (beta-TCP, 5 microns, 10 wt.%) was also investigated. The cured polymers exhibited high compressive strength (100-190 MPa) and modulus (1600-2300 MPa). beta-TCP improved mechanical properties in PEDLLA based polyurethanes and retarded the onset of in vitro and in vivo degradation. Sheep study results demonstrated that the polymers in both injectable and precured forms did not cause any surgical difficulties or any adverse tissue response. Evidence of new bone growth and the gradual degradation of the polymers were observed with increased implant time up to 6 months. PMID:18632149

  12. Nano-Engineered Cubic Zirconia for Orthopaedic Implant Applications

    Science.gov (United States)

    Namavar, F.; Rubinstein, A.; Sabirianov, R.; Thiele, G.; Sharp, J.; Pokharel, U.; Namavar, R.; Garvin, K.

    2012-02-01

    Osseointegration failure of the prosthesis prevents long-term stability, which contributes to pain, implant loosening, and infection that usually necessitates revision surgery. Cell attachment and spreading in vitro is generally mediated by adhesive proteins such as fibronectin and vitronectin. We designed and produced pure cubic zirconia (ZrO2) ceramic coatings by ion beam assisted deposition (IBAD) with nanostructures comparable to the size of proteins. Our ceramic coatings exhibit high hardness and a zero contact angle with serum. In contrast to Hydroxyapatite (HA), nano-engineered zirconia films possess excellent adhesion to all orthopaedic materials. Adhesion and proliferation experiments were performed with a bona fide mesenchymal stromal cells cell line (OMA-AD). Our experimental results indicated that nano-engineered cubic zirconia is superior in supporting growth, adhesion, and proliferation. We performed a comparative analysis of adsorption energies of the FN fragment using quantum mechanical calculations and Monte Carlo simulation on both types of surfaces: smooth and nanostructured. We have found that the initial FN fragment adsorbs significantly stronger on the nanostructured surface than on the smooth surface.

  13. Strategic planning in a highly specialized orthopaedic institution

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2009-01-01

    Full Text Available Introduction. The Institute for Orthopaedic Surgery 'Banjica' in Belgrade provides tertiary healthcare services on national level. After decades of constant development, a recent decline coincided with the decade of great social and governmental disturbance, the transition period after the dissociation of former Yugoslavia. Objective. In order to overcome the crisis, we used modern management methods to define problems in the institution management, and to propose appropriate strategies. Methods. A survey that included 100 employees (17.67% was carried out, followed by descriptive statistical analysis, PEST and SWOT analyses. Results The impact of political fluctuations, ageing of population, financing model, obsolete medical technology was evaluated. Various personal and interpersonal factors were assessed: the quality of medical service (3.59±0.76, mark 1-5; relations among health service participants (3.39±0.78; occupational conditions (not good-91%; human, financial and other resources; professional cooperation, stimulation; rivalry and mobbing (declared in 56%; public informing, institution image (rank 3.70±0.88 and PR activities (new to 78%. 93% declared to give maximum effort at work. Conclusion. Using these results, we defined several strategic objectives. These include strengthening scientific activities, general orientation to specific and exclusive pathological conditions and treatment methods, improvement of management transparency, introduction of quality-based stimulation of workers, support of promotional and PR activities.

  14. Clinical applications of vibration therapy in orthopaedic practice

    Science.gov (United States)

    Cerciello, Simone; Rossi, Silvio; Visonà, Enrico; Corona, Katia; Oliva, Francesco

    2016-01-01

    Summary Background Vibration therapy (VT) has been proposed as an option to improve physical performance and reduce the negative effects of ageing on bone, muscles and tendons. Several discrepancies exist on the type of applications, frequency and magnitude. These differences reflex on the contradictory clinical results in literature. Aim of the present study is to carry on an exhaustive review to focus on technical options on the market, clinical applications in orthopaedic practice and expected outcomes. Methods a literature review using the key words “vibration therapy” and “whole-body vibration” and “orthopaedics” was performed. After checking the available abstracts 71 full text articles were evaluated. Results fifty-one articles focused on the effects of VT on muscles and tendons reporting ways of action and clinical outcomes. In a similar way 20 studies focused on the influence of VT on bone tissue with regard on ways of action and clinical trials. Conclusions VT provides anabolic mechanical signals to bone and musculo-tendinous system. The best effects seem to be achieved with devices that deliver low-intensity stimuli at high frequencies providing linear horizontal displacement. PMID:27331044

  15. Study of the titanium alloys surfaces used in orthopaedic systems

    International Nuclear Information System (INIS)

    Total hip prosthesis (THP) is a highly successful orthopaedic device. However, its durability is generally limited to a few decades due to difficult conditions in the human body and huge demands it is subjected to. A hip prosthesis is deteriorating due to high surface pressures caused by mechanical movements of the body. The aim of this project is to improve the characteristics of hip prostheses, in order to increase their functionality and their life span. This paper presents an analysis regarding the topography and tribological parameters of femoral heads structures and of femoral heads coated with TiN. We studied the tribological properties of the surfaces of some femoral heads made of Ti alloys or coated with TiN. These femoral heads were obtained from some prostheses after revision surgery. Afterwards, we used TiN nanostructured coatings for reducing the wear process. TiN thin films were deposited using physical vapour deposition (PVD) and some scratch tests have been realized on these coatings surfaces. The study of coatings surfaces was made using atomic force microscopy (AFM) that offers the possibility to obtain nanometric 3D control of thin films. Main result of these researches is that used coatings offer the possibility to improve the system properties. (authors)

  16. Thermoplastic polymeric adhesive for structural bonding applications for orthopaedic devices

    International Nuclear Information System (INIS)

    The orthopaedics industry has witnessed tremendous growth in recent years primarily due to the introduction of high performance, porous coated implants. These devices have eliminated the need for the use of bone cement for in vivo implant fixation, replacing it with the ingrowth of bone into the porous surfaces. The metallurgical bonding processes used for attaching the porous to the implant body introduce some undesirable effect i.e., the reduction of the fatigue strength of the implant due to the ''notches'' created and also due to the high temperature exposure during the sintering operations. This paper describes the development of a thermoplastic polymeric adhesive based structural bonding technique. The high performance polymeric adhesive is fully characterized with respect to its intended application. The design of the porous layer is optimized to achieve a reliable bond to the implant. A thermal heating/cooling process was developed to control the final polymer morphology. Static and fatigue tests were conducted to fully characterize the adhesive bond strength. A ring shear test method was developed to determine the shear strength of the bond interface. Besides the characterization of the adhesive bond, the joints will be analyzed using finite element models. The correlation between the analytical models and the

  17. Hearing Aid

    Science.gov (United States)

    ... and Food and Drug Administration Staff FDA permits marketing of new laser-based hearing aid with potential ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  18. Barriers and Facilitators Associated with Non-Surgical Treatment Use for Osteoarthritis Patients in Orthopaedic Practice.

    Directory of Open Access Journals (Sweden)

    Stefanie N Hofstede

    Full Text Available International evidence-based guidelines for the management of patients with hip and knee osteoarthritis (OA recommend to start with (a combination of non-surgical treatments, and using surgical intervention only if a patient does not respond sufficiently to non-surgical treatment options. Despite these recommendations, there are strong indications that non-surgical treatments are not optimally used in orthopaedic practice. To improve the adoption of non-surgical treatments, more insight is needed into barriers and facilitators of these treatments. Therefore, this study assessed which barriers and facilitators are associated with the use and prescription of different non-surgical treatments before hip and knee OA in orthopaedic practice among patients and orthopaedic surgeons in the Netherlands.We performed two internet-based surveys among 172 orthopaedic surgeons and 174 OA patients. Univariate association and multivariable regression techniques are used to identify barriers and facilitators associated with the use of non-surgical treatments.Most barriers and facilitators among patients were associated with the use of physical therapy, lifestyle advice and dietary therapy. Among orthopaedic surgeons, most were associated with prescription of acetaminophen, dietary therapy and physical therapy. Examples of barriers and facilitators among patients included "People in my environment had positive experiences with a surgery" (facilitator for education about OA, and "Advice of people in my environment to keep on moving" (facilitator for lifestyle and dietary advice. For orthopaedic surgeons, examples were "Lack of knowledge about guideline" (barrier for lifestyle advice, "Agreements/ deliberations with primary care" and "Easy communication with a dietician" (facilitators for dietary therapy. Also the belief in the efficacy of these treatments was associated with increased prescription.Strategies to improve non-surgical treatment use in orthopaedic

  19. Orthopaedic surgeries - assessment of ionising radiations exposure in health care workers

    International Nuclear Information System (INIS)

    Full text of publication follows: 1. Objectives: The health care workers are exposed to ionizing radiations during their activities. In the operating rooms, the ionizing radiations are used in orthopaedic surgery and the dose depends on some factors, like the characteristics of the equipment. This study aims to: Estimate the occupational dose of ionizing radiations exposure of the orthopaedic doctors and nurses during the orthopaedic surgeries, in a Portuguese operating room; Sensitize the health care workers to use the individual dosimeter and to adopt radiation preventive measures. 2. Population and methods The study was conducted on nine Orthopaedic doctors and two nurses of an operating room of a hospital in Lisbon neighborhoods. We made a risk evaluating concerning: the radiations dose in different points, corresponding to gonads, hands and crystalline lens levels of all the professionals, during the surgeries; the average period of radiation in the orthopaedic surgeries; the number of annual orthopaedic surgeries, looking for that in the surgeries registers, to estimate the annual ionizing radiations dose of each orthopaedic doctor and nurse. 3. Results The annual doses estimated at different levels for orthopaedic doctors were the following: gonads: between 20,63 and 68,75 mGy; hands: 4,95 16,50 mGy; crystalline lens: 8,25 27,50 mGy). For the orthopaedic nurses: gonads: 130,63 151,25 mGy; hands: 31,35 36,30 mGy; crystalline lens 52,25 60,25 mGy. 4. Conclusions Although the location and positions of health care workers are not the same during the different surgeries and the equipment has an automatic control of the X ray emission, the annual ionizing radiations dose exposure for health care workers is an important one. The risk rating justifies the use of individual dosimeters for better individual dose assessment as part of an ionizing radiations prevention program. As a matter of fact preventive measures begin with a good quantitative risk assessment of

  20. Orthopaedic surgeries - assessment of ionising radiations exposure in health care workers

    Energy Technology Data Exchange (ETDEWEB)

    Leite, E.S.; Uva, A.S. [Lisbon Univ., National School of Public Health/New (Portugal)

    2006-07-01

    Full text of publication follows: 1. Objectives: The health care workers are exposed to ionizing radiations during their activities. In the operating rooms, the ionizing radiations are used in orthopaedic surgery and the dose depends on some factors, like the characteristics of the equipment. This study aims to: Estimate the occupational dose of ionizing radiations exposure of the orthopaedic doctors and nurses during the orthopaedic surgeries, in a Portuguese operating room; Sensitize the health care workers to use the individual dosimeter and to adopt radiation preventive measures. 2. Population and methods The study was conducted on nine Orthopaedic doctors and two nurses of an operating room of a hospital in Lisbon neighborhoods. We made a risk evaluating concerning: the radiations dose in different points, corresponding to gonads, hands and crystalline lens levels of all the professionals, during the surgeries; the average period of radiation in the orthopaedic surgeries; the number of annual orthopaedic surgeries, looking for that in the surgeries registers, to estimate the annual ionizing radiations dose of each orthopaedic doctor and nurse. 3. Results The annual doses estimated at different levels for orthopaedic doctors were the following: gonads: between 20,63 and 68,75 mGy; hands: 4,95 16,50 mGy; crystalline lens: 8,25 27,50 mGy). For the orthopaedic nurses: gonads: 130,63 151,25 mGy; hands: 31,35 36,30 mGy; crystalline lens 52,25 60,25 mGy. 4. Conclusions Although the location and positions of health care workers are not the same during the different surgeries and the equipment has an automatic control of the X ray emission, the annual ionizing radiations dose exposure for health care workers is an important one. The risk rating justifies the use of individual dosimeters for better individual dose assessment as part of an ionizing radiations prevention program. As a matter of fact preventive measures begin with a good quantitative risk assessment of

  1. Investigation on Alteration of Compression of Knitted Orthopaedic Supports during Exploitation

    Directory of Open Access Journals (Sweden)

    Daiva MIKUČIONIENĖ

    2012-12-01

    Full Text Available One of the areas of medical textile is the spacer knitted orthopaedic products. The concept of compression therapy of orthopaedic supports lies on a simple and efficient mechanical principle – it consists of applying elastic garment around the limb. Spacer orthopaedic supports are knitted on flat knitting machines equipped with especial elastomeric thread feeder. Compression made by the support depends on the support area, shape and characteristics of knitting. Because of orthopaedic supports are intended for durable wearing and need to vouchsafe compression of fixed value, it is very important to known how processes acting during exploitation influence alteration of compression values. The aim of this study was to establish the alteration of compression of knitted support during exploitation, i. e. after multifold extension, washing and drying. The samples were knitted on a flat double needle bed knitting machine in combined jacquard-laid-in pattern with elastomeric weft threads. It was established that compressive properties of knits after cyclic tensile load changed slightly, i. e. range between margins of error. It was measured that knitted orthopaedic supports dimensions and density after washing and drying cycles changes significant, i. e. knitted supports shrinks and thickens and their compression decreases.DOI: http://dx.doi.org/10.5755/j01.ms.18.4.3097

  2. Administrative Databases in Orthopaedic Research: Pearls and Pitfalls of Big Data.

    Science.gov (United States)

    Patel, Alpesh A; Singh, Kern; Nunley, Ryan M; Minhas, Shobhit V

    2016-03-01

    The drive for evidence-based decision-making has highlighted the shortcomings of traditional orthopaedic literature. Although high-quality, prospective, randomized studies in surgery are the benchmark in orthopaedic literature, they are often limited by size, scope, cost, time, and ethical concerns and may not be generalizable to larger populations. Given these restrictions, there is a growing trend toward the use of large administrative databases to investigate orthopaedic outcomes. These datasets afford the opportunity to identify a large numbers of patients across a broad spectrum of comorbidities, providing information regarding disparities in care and outcomes, preoperative risk stratification parameters for perioperative morbidity and mortality, and national epidemiologic rates and trends. Although there is power in these databases in terms of their impact, potential problems include administrative data that are at risk of clerical inaccuracies, recording bias secondary to financial incentives, temporal changes in billing codes, a lack of numerous clinically relevant variables and orthopaedic-specific outcomes, and the absolute requirement of an experienced epidemiologist and/or statistician when evaluating results and controlling for confounders. Despite these drawbacks, administrative database studies are fundamental and powerful tools in assessing outcomes on a national scale and will likely be of substantial assistance in the future of orthopaedic research. PMID:26836377

  3. A population-based study of ambulatory and surgical services provided by orthopaedic surgeons for musculoskeletal conditions

    Directory of Open Access Journals (Sweden)

    Davis Aileen M

    2009-03-01

    Full Text Available Abstract Background The ongoing process of population aging is associated with an increase in prevalence of musculoskeletal conditions with a concomitant increase in the demand of orthopaedic services. Shortages of orthopaedic services have been documented in Canada and elsewhere. This population-based study describes the number of patients seen by orthopaedic surgeons in office and hospital settings to set the scene for the development of strategies that could maximize the availability of orthopaedic resources. Methods Administrative data from the Ontario Health Insurance Plan and Canadian Institute for Health Information hospital separation databases for the 2005/06 fiscal year were used to identify individuals accessing orthopaedic services in Ontario, Canada. The number of patients with encounters with orthopaedic surgeons, the number of encounters and the number of surgeries carried out by orthopaedic surgeons were estimated according to condition groups, service location, patient's age and sex. Results In 2005/06, over 520,000 Ontarians (41 per 1,000 population had over 1.3 million encounters with orthopaedic surgeons. Of those 86% were ambulatory encounters and 14% were in hospital encounters. The majority of ambulatory encounters were for an injury or related condition (44% followed by arthritis and related conditions (37%. Osteoarthritis accounted for 16% of all ambulatory encounters. Orthopaedic surgeons carried out over 140,000 surgeries in 2005/06: joint replacement accounted for 25% of all orthopaedic surgeries, whereas closed repair accounted for 16% and reductions accounted for 21%. Half of the orthopaedic surgeries were for arthritis and related conditions. Conclusion The large volume of ambulatory care points to the significant contribution of orthopaedic surgeons to the medical management of chronic musculoskeletal conditions including arthritis and injuries. The findings highlight that surgery is only one component of the work

  4. Types of Hearing Aids

    Science.gov (United States)

    ... Devices Consumer Products Hearing Aids Types of Hearing Aids Share Tweet Linkedin Pin it More sharing options ... some features for hearing aids? What are hearing aids? Hearing aids are sound-amplifying devices designed to ...

  5. Trace metal determination as it relates to metallosis of orthopaedic implants: Evolution and current status.

    Science.gov (United States)

    Ring, Gavin; O'Mullane, John; O'Riordan, Alan; Furey, Ambrose

    2016-05-01

    In utilising metal surfaces that are in constant contact with each other, metal-on-metal (MoM) surgical implants present a unique challenge, in the sense that their necessity is accompanied by the potential risk of wear particle generation, metal ion release and subsequent patient toxicity. This is especially true of orthopaedic devices that are faulty and subject to failure, where the metal surfaces undergo atypical degradation and release even more unwanted byproducts, as was highlighted by the recent recall of orthopaedic surgical implants. The aim of this review is to examine the area of metallosis arising from the wear of MoM articulations in orthopaedic devices, including how the surgical procedures and detection methods have advanced to meet growing performance and analytical needs, respectively. PMID:26794632

  6. Surgical advances during the First World War: the birth of modern orthopaedics.

    Science.gov (United States)

    Ramasamy, Arul; Eardley, W G P; Edwards, D S; Clasper, J C; Stewart, M P M

    2016-02-01

    The First World War (1914-1918) was the first truly industrial conflict in human history. Never before had rifle fire and artillery barrage been employed on a global scale. It was a conflict that over 4 years would leave over 750,000 British troops dead with a further 1.6 million injured, the majority with orthopaedic injuries. Against this backdrop, the skills of the orthopaedic surgeon were brought to the fore. Many of those techniques and systems form the foundation of modern orthopaedic trauma management. On the centenary of 'the War to end all Wars', we review the significant advances in wound management, fracture treatment, nerve injury and rehabilitation that were developed during that conflict. PMID:25512441

  7. Brand Aid

    DEFF Research Database (Denmark)

    Richey, Lisa Ann; Ponte, Stefano

    2011-01-01

    activists, scholars and venture capitalists, discusses the pros and cons of changing the world by ‘voting with your dollars’. Lisa Ann Richey and Stefano Ponte (Professor at Roskilde University and Senior Researcher at DIIS respectively), authors of Brand Aid: Shopping Well to Save the World, highlight how...

  8. Negotiating Aid

    DEFF Research Database (Denmark)

    Whitfield, Lindsay; Fraser, Alastair

    2011-01-01

    This article presents a new analytical approach to the study of aid negotiations. Building on existing approaches but trying to overcome their limitations, it argues that factors outside of individual negotiations (or the `game' in game-theoretic approaches) significantly affect the preferences of...

  9. Multicenter collaborative for orthopaedic research in India: An opportunity for global leadership

    Directory of Open Access Journals (Sweden)

    Mathew George

    2008-01-01

    Full Text Available Road traffic accidents are increasing at an alarming rate and have become a major public health concern in India. In addition, there is a lack of trauma research output and reliable data from India. There are several issues and challenges that have presented an opportunity for researchers and surgeons in India to develop a collaborative aimed at improving the quality and productivity of orthopaedic trauma research. Establishing a network of surgical researchers across India is a necessary first step towards global leadership in orthopaedic surgery trials.

  10. Orthopaedics in China:its past and present%中国骨科的过去与现在

    Institute of Scientific and Technical Information of China (English)

    冯传汉

    2005-01-01

    Orthopaedics in china originated chinese medicine and Western medicine. In the first half of twentieth century , Dr. meng chimao(Beijing),New Way Sung (Shanghai),Fang Hsienchi, and others contributed a great deal to development of modern orthopaedics in china. The orthopaedic group was organized under the auspecies of Chinese Medical Association in 1937. The chinese Medical Association Orthopaedic Society was wstablished in 1980. The main achievements of Orthopaedics in China include replantation of severed limb or fingres,toe teansplantation for thumb and fonger reconstruction, nerve teansfer for brachial plexus avulsion, resrarch and manufacturing of domestic prostheses and the techniques of artifival joint replacement, surgical treatment of severe scoliosis and classification of idiopathic scoliosis, operative tireatment of bone tumor, and basic research on giant cell tumor of bone.

  11. Tactile Aids

    Directory of Open Access Journals (Sweden)

    Mohtaramossadat Homayuni

    1996-04-01

    Full Text Available Tactile aids, which translate sound waves into vibrations that can be felt by the skin, have been used for decades by people with severe/profound hearing loss to enhance speech/language development and improve speechreading.The development of tactile aids dates from the efforts of Goults and his co-workers in the 1920s; Although The power supply was too voluminous and it was difficult to carry specially by children, it was too huge and heavy to be carried outside the laboratories and its application was restricted to the experimental usage. Nowadays great advances have been performed in producing this instrument and its numerous models is available in markets around the world.

  12. In vitro bioactivity and corrosion resistance of Zr incorporated TiO2 nanotube arrays for orthopaedic applications

    International Nuclear Information System (INIS)

    Graphical abstract: - Highlights: • Self-organised TiO2 nanotube arrays (TNT) were developed by anodization. • Zr ions were incorporated onto TNT (Zr-TNT) by dip coating method. • Surface analysis confirmed the presence of ZrTiO4 over the TNT surface. • Zr-TNT was completely covered with HAp after immersion in Hank's solution. • Zr-TNT exhibited higher bioactivity as well as enhanced corrosion resistance. - Abstract: The present investigation deals with the incorporation of zirconium (Zr) ions onto TiO2 nanotube arrays (TNT) by simple dip coating method for biomedical implants. The electrochemical behaviour of the specimens were studied with potentiodynamic polarization (Tafel plots) and electrochemical impedance spectroscopy (EIS), while surface analysis involved field emission scanning electron microscopy (FE-SEM) with energy dispersive X-ray spectroscopy (EDS), atomic force microscopy (AFM), attenuated total reflectance fourier transform infrared (ATR-FTIR) spectroscopy, thin film x-ray diffraction (TF-XRD) and contact angle measurements. The FE-SEM morphology revealed that self-organised TNT was tightly arrayed with an average diameter of 110 ± 4 nm. The wall thickness and length of 15 ± 2 nm and 2.1 ± 0.3 μm respectively were developed by electrochemical anodization of titanium sheet in a mixture of ethylene glycol and NH4F electrolyte. The EDS, ATR-FTIR and TF-XRD studies were revealed the incorporation of Zr onto TNT specimens. Hydroxyapatite (HAp) was grown over Zr ions incorporated TNT (Zr-TNT) via in vitro immersion method. The HAp grown Zr-TNT exhibited higher bioactivity as well as enhanced corrosion resistance when compared to other specimen. Hence, Zr-TNT could be a viable material for the use as orthopaedic implant with good bioactivity and corrosion resistance

  13. The assessment and management of pain in an orthopaedic out-patient setting: A case study.

    Science.gov (United States)

    Hall, Gillian; Gregory, Julie

    2016-08-01

    The management of pain is an important aspect of an orthopaedic nurse's role. The aim of this paper is to use an individual case study to demonstrate the role of an out-patient orthopaedic nurse in the identification, assessment and management of pain. This paper describes how pain was identified and managed for a patient in the orthopaedic outpatient department, highlighting that pain and its management are not isolated to the in-patient setting. The case study illustrates the importance of recognising pain and taking into account the numerous factors that can influence pain perception. The assessment of an individual patient's pain led to obtaining help from the Acute Pain Team which led to improvement in the patient's pain management and quality of life. The nursing team reflected and discussed the issues identified by this case study which led to changes in practice being introduced. This has resulted in an increased knowledge of and confidence in pain management within the nursing team and development and improvement of pain management practice within the orthopaedic out-patient department. PMID:26711709

  14. Biomaterial-associated infection of gentamicin-loaded PMMA beads in orthopaedic revision surgery

    NARCIS (Netherlands)

    Neut, D; van de Belt, H; Stokroos, [No Value; van Horn, [No Value; van der Mei, HC; Busscher, HJ

    2001-01-01

    In two-stage orthopaedic revision surgery, high local levels of antibiotics are achieved after removal of an infected prosthesis through temporary implantation of gentamicin-loaded beads. However, despite their antibiotic release, these beads act as a biomaterial surface to which bacteria preferenti

  15. Cost-effectiveness analyses of elective orthopaedic surgical procedures in patients with inflammatory arthropathies

    DEFF Research Database (Denmark)

    Osnes-Ringen, H.; Kvamme, M. K.; Sønbø Kristiansen, Ivar;

    2011-01-01

    (SD 13) years, 77% female] with inflammatory arthropathies underwent orthopaedic surgical treatment and responded to mail surveys at baseline and during follow-up (3, 6, 9, and 12 months). Questionnaires included the quality-of-life EuroQol-5D (EQ-5D) and Short Form-6D (SF-6D) utility scores. The...

  16. 75 FR 36660 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2010-06-28

    ... Devices Panel of the Medical Devices Advisory Committee. General Function of the Committee: To provide... HUMAN SERVICES Food and Drug Administration Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting AGENCY: Food and Drug Administration, HHS. ACTION:...

  17. 78 FR 20328 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee: Notice of...

    Science.gov (United States)

    2013-04-04

    ... Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee scheduled for April 5, 2013. The meeting was announced in the Federal Register of November 29, 2012 (77 FR 71195). The meeting... Devices Advisory Committee: Notice of Postponement of Meeting AGENCY: Food and Drug Administration,...

  18. Hallmarks in the history of orthopaedic implants for trauma and joint replacement.

    Science.gov (United States)

    Markatos, Konstantinos; Tsoucalas, Gregory; Sgantzos, Markos

    2016-08-01

    This manuscript represents an attempt to review orthopaedic implants and reconstructive orthopaedic surgery for lower limbs lesions or trauma mainly in the 20th century. We emphasized on the type of implants, the biomaterials and their evolution, and we also engaged in a special reference for the pioneers of orthopaedic implant surgery and the innovative designers of those implants, in such a way to understand the ways and the stages through which they evolved to their present forms, as well as the scientific principles that affected their design and progress. A correlation between the evolution of implants and several relevant disciplines (biomaterial chemists and engineers, biomechanics) that developed simultaneously with orthopaedic reconstructive joint surgery is present since the first attempts to reconstruct a damaged joint. In the future, further progress is anticipated in the use of biomaterials, more compatible towards human biology, with minimally invasive applications and a perpetually increased life span. This progress depicts a phenomenon directly related to a multilevel, multifactorial and interdisciplinary scientific and technological field with many expectations. PMID:27598960

  19. 75 FR 33995 - Safety Zone; Michigan Orthopaedic Society 50th Anniversary Fireworks, Lake Huron, Mackinac Island...

    Science.gov (United States)

    2010-06-16

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Michigan Orthopaedic Society 50th... Society 50th Anniversary Fireworks display, June 19, 2010. This temporary safety zone is necessary to... time to publish an NPRM followed by a final rule before the effective date. Under 5 U.S.C....

  20. Addressing the Global Disparities in the Delivery of Pediatric Orthopaedic Services: Opportunities for COUR and POSNA.

    Science.gov (United States)

    Shirley, Eric D; Sabharwal, Sanjeev; Schwend, Richard M; Cabral, Cristina; Spiegel, David

    2016-01-01

    The burden of musculoskeletal conditions, especially injuries, is increasing in low-income and middle-income countries. Road traffic injuries have become epidemic. There are multiple barriers to accessing surgical services at both the individual (utilization) and the health system (availability) levels, and deficiencies in education and training of health providers. Specialty societies such as the Pediatric Orthopaedic Society of North America (POSNA) have an opportunity to play an important role through teaching and training. The POSNA Children's Orthopedics in Underserved Regions (COUR) committee has supported the Visiting Scholars Program, which invites surgeons from the developing world to attend a scientific meeting and facilitates the scholar's visit to North American pediatric orthopaedic centers. POSNA members have held global educational courses that support an educational exchange between lecturers and attendees. The COUR web site allows for submission of trip reports that document successes and obstacles experienced by members performing overseas clinical care and teaching. The web site also provides educational resources relevant to providing care in these environments. POSNA collaborates with other societies, such as the American Academy of Orthopaedic Surgeons and the Society of Military Orthopaedic Surgeons, to provide education in disaster management. In addition to increasing member involvement, specialty societies have the opportunity for continued data collection from overseas care, application of US registry data to disease processes in the developing world, and further collaboration with one another. PMID:26296220

  1. Hydrolytic Decomposition in a Polyamide/PDMS Composite for Orthopaedic Usage

    Czech Academy of Sciences Publication Activity Database

    Sochor, M.; Balík, Karel; Sucharda, Zbyněk; Suchý, Tomáš; Sedláček, R.

    2011-01-01

    Roč. 14, č. 103 (2011), s. 2-3. ISSN 1429-7248 R&D Projects: GA ČR(CZ) GAP108/10/1457 Institutional research plan: CEZ:AV0Z30460519 Keywords : composite * hydrolic decomposition * orthopaedics Subject RIV: BO - Biophysics http://www.biomat.krakow.pl/gazeta/archiwum/103.pdf

  2. Automatic Bone Drilling – More Precise, Reliable and Safe Manipulation in the Orthopaedic Surgery

    Directory of Open Access Journals (Sweden)

    Boiadjiev George

    2016-06-01

    Full Text Available Bone drilling manipulation often occurs in the orthopaedic surgery. By statistics, nowadays, about one million people only in Europe need such an operation every year, where bone implants are inserted. Almost always, the drilling is performed handily, which cannot avoid the subjective factor influence. The question of subjective factor reduction has its answer - automatic bone drilling.

  3. European Working Time Directive and the use of simulators and models in Irish orthopaedics.

    LENUS (Irish Health Repository)

    Egan, C

    2011-09-07

    OBJECTIVE: To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. METHODS: A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. RESULTS: There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. CONCLUSIONS: While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

  4. The Orthopaedic Training Study, Phase II 1968-1972. Final Report Supplement, Psychomotor Skills, Part B.

    Science.gov (United States)

    Olson, Carl J.; And Others

    This document, as a supplement to the final report of the Orthopaedic Training Study, presents a discussion of the rationale behind the implementation of a laboratory course in psychomotor skills development for medical students. Medical educators examined resident training in terms of 3 components of cognitive elements of learning: cognitive,…

  5. Why veteran orthopaedic trauma surgeons are being fired and what we can do about it?

    Science.gov (United States)

    Hill, Austin; Althausen, Peter L; O'Mara, Timothy J; Bray, Timothy J

    2013-06-01

    The financial realities of providing trauma care to injured patients can make it difficult to produce an accurate assessment of the cumulative value orthopaedic trauma surgeons provide to healthcare and university institutions. As with many political battles in the field of medicine, physicians who have been diligently focused on providing patient care were completely unaware of the impending upheaval around them. Whether orthopaedic trauma surgeons are employed or in some type of partnership with hospitals, too often surgeons find the relationship one-sided. In order to effectively negotiate with hospitals, surgeons must demonstrate the comprehensive value they provide to their respective healthcare institutions and universities. Orthopaedic trauma surgeons make direct and indirect financial contributions to the hospital in addition to educational and community services. The sum total of these valued contributions helps fund non-revenue generating programs, provides marketing opportunities, and improves the regional and national reputation of the healthcare institution. This paper provides a comprehensive review of the value contributed to healthcare institutions by orthopaedic trauma surgeons and will serve as a blueprint for all surgeons to accurately account for and demonstrate their value to hospitals while providing efficient and compassionate care to our patients. PMID:23571292

  6. Neurological Complications of AIDS

    Science.gov (United States)

    ... Diversity Find People About NINDS Neurological Complications of AIDS Fact Sheet Feature Federal domestic HIV/AIDS information ... Where can I get more information? What is AIDS? AIDS (acquired immune deficiency syndrome) is a condition ...

  7. AIDS Epidemiyolojisi

    OpenAIRE

    SÜNTER, A.T.; PEKŞEN, Y.

    2010-01-01

    AIDS was first defined in the United States in 1981. It spreads to nearly all the countries of the world with a great speed and can infect everbody without any differantiation. The infection results in death and there is no cure or vaccine for it, yet. To data given to World Health Organization until July-1994, it is estimated that there are about 1 million patients and about 22 millions HIV positive persons In the world. Sixty percent of HIV positive persons are men and 40% are women. The di...

  8. Alignment and articular orientation of lower limbs: manual vs computer-aided measurements on digital radiograms

    International Nuclear Information System (INIS)

    Purpose: To compare the manual measurements of lower limbs on digital images with those obtained with dedicated software. Materials and methods: Forty patients with a clinical suspicion of lower limb deformity were enrolled. Eighty digital radiographs were produced with a remote-controlled radiography system (Philips Omnidia-gnost). The measurements were taken separately by an Orthopaedic Surgeon and by a Radiologist, by hand and with the aid of software, respectively. Five parameters were assessed: femoral length, tibial length, distal-medial femoral angle, proximal-medial tibial angle and tibial-femoral angle. The statistical analysis of the comparison was based on Student's-test. The inter-observer variability of the methods, manual and computer-aided, was evaluated with Fisher's F-test on a sample of measurements (20 lower limbs), taken by 5 different Orthopaedic Surgeons and Radiologists, respectively. Results: There were no statistically significant differences between the measurements taken with the manual and computer-aided methods (p>0.05). The overall reproducibility of both methods was similar; conversely, the separate evaluation of angles and lengths showed that the computer-aided method was less variable in the measurements of lengths than the manual method. Conclusions: The computer-aided evaluation of the alignment and articular orientation parameters of lower limbs is as accurate and reliable as the traditional manual method, but is faster and allows better-quality images

  9. Atomic transfers between implanted bioceramics and tissues in orthopaedics surgery

    CERN Document Server

    Irigaray, J L; Guibert, G; Jallot, E; democrite-00023281, ccsd

    2004-01-01

    We study transfers of ions and debris from bioceramics implanted in bone sites. A contamination of surrounding tissues may play a major role in aseptic loosening of the implant. For these reasons, bioceramics require studies of biocompatibility and biofunctionality . So, in addition to in vitro studies of bioceramics, it is essential to implant them in vivo to know body reactions. We measured the concentration of mineral elements at different time intervals after implantation over a whole cross-section. We found a discontinuity of the mineral elements (Ca, P, Sr, Zn, Fe) at the interface between the implant and the receiver. The osseous attack is not global but, on the contrary, centripetal. Moreover, the fit of the concentration time course indicates that the kinetics of ossification is different for each atomic element and characterizes a distinct biological phenomenon

  10. An evaluation of orthopaedic nurses’ participation in an educational intervention promoting research utilization – A triangulation convergence model

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

    2016-01-01

    by diverse personal and contextual barriers. Relevance to clinical practice The knowledge derived from this study has high clinical and practical relevance and is currently used to facilitate the nurses' research usage in the orthopaedic department setting, by working around the perceived barriers.......Aims and objectives To describe the orthopaedic nurses' experiences regarding the relevance of an educational intervention and their personal and contextual barriers to participation in the intervention. Background One of the largest barriers against nurses' research usage in clinical practice is...... the lack of participation. A previous survey identified 32 orthopaedic nurses as interested in participating in nursing research. An educational intervention was conducted to increase the orthopaedic nurses' research knowledge and competencies. However, only an average of six nurses participated...

  11. Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial

    OpenAIRE

    Samsson, Karin S.; Bernhardsson, Susanne; Larsson, Maria E. H.

    2016-01-01

    Background Physiotherapist-led orthopaedic triage, where physiotherapists diagnose and determine management plans, aims to enhance effectiveness and provide the best care. However, scientific evidence for the effectiveness of this model of care remains limited, and there are few studies reporting on patients’ perceptions of the care provided. The purpose of this study was to evaluate patients’ perceived quality of care in a physiotherapist-led orthopaedic triage in primary care, compared with...

  12. Reflections in a time of transition: orthopaedic faculty and resident understanding of accreditation schemes and opinions on surgical skills feedback

    OpenAIRE

    Gundle, Kenneth R.; Mickelson, Dayne T.; Doug P. Hanel

    2016-01-01

    Introduction: Orthopaedic surgery is one of the first seven specialties that began collecting Milestone data as part of the Accreditation Council for Graduate Medical Education’s Next Accreditation System (NAS) rollout. This transition from process-based advancement to outcome-based education is an opportunity to assess resident and faculty understanding of changing paradigms, and opinions about technical skill evaluation.Methods: In a large academic orthopaedic surgery residency program, res...

  13. DEVELOPMENT AND REPRODUCIBILITY OF A SHORT QUESTIONNAIRE TO MEASURE USE AND USABILITY OF CUSTOM-MADE ORTHOPAEDIC SHOES

    OpenAIRE

    van Netten, Jaap J; Hijmans, Juha M.; Jannink, Michiel J.A.; Geertzen, Jan H. B.; Postema, Klaas

    2009-01-01

    Objective: To develop a short and easy to use questionnaire to measure use and usability of custom-made orthopaedic shoes, and to investigate its reproducibility. Design: Development of the questionnaire (Monitor Orthopaedic Shoes) was based on a literature search, expert interviews, 2 expert meetings, and exploration and testing of reproducibility. The questionnaire comprises 2 parts: a pre part, measuring expectations; and a post part, measuring experiences. Patients: The pre part of the fi...

  14. [Our experience of postoperative saving of drainage blood in orthopaedic surgery].

    Science.gov (United States)

    Sikimić, L B; Blagojević, Z B; Radojević, B B; Mancić, N Z; Djurić, M; Jovanović, Z D

    2006-01-01

    Postoperative saving of drainage blood presents postoperative autologous transfusion and that means group of action of collection patients blood and its late reinfision. The conditions of orthopaedic surgery join with arthroplasty of coxae and knee are connected with signicifant loss of blood (800-1200 ml). With the aim of reducing the need for use of heterologous blood and elimination of potentional risks because of her application, we investigate the possibility of application the system of posteoperative saving of drainage blood in the study group of 48 patients in relation of control group of 25 patients. Postoperative blood saving has been derived after the first 4-8 hours, after the and of surgical operation. In the study group only 4 patients (8%) need additional heterologous transfusions. Postoperative blood saving and its reinfusion have not significant effect at hemostasis and sistem of coagulation. During six months postoperative, no patients in the study group have not any complication after orthopaedic surgery. PMID:17688045

  15. A discharge planning program in orthopaedics: experiences in implementation and evaluation.

    Science.gov (United States)

    Matt-Hensrud, N; Severson, M; Hansen, D C; Holland, D E

    2001-01-01

    The acute care orthopaedic registered nurse plays a key role in assessing and communicating the continuing care needs of patient's and their families, coordinating community resources, and formulating a timely discharge plan to maximize rehabilitation and recovery. Developing and maintaining a staff nurse's discharge planning knowledge and skills can be a challenging endeavor. Discharge Planning Coordinators at a tertiary medical center developed and implemented a Discharge Planning Mentorship Program, an educational pilot program designed to enhance the knowledge and skill level of select nurses in the orthopaedic specialty practice, thus maximizing expert resources at the bedside. Program implementation and evaluation of role preparation, practice changes, and actualization challenges are discussed in this article. Overall, participants demonstrated increased skill in articulating and problem solving a patient's postdischarge needs, devised creative strategies to enhance communication between multiple levels of care, and developed a greater knowledge of community resources and reimbursement mechanisms for continuing care. PMID:12024515

  16. Titanium-Nitride Coating of Orthopaedic Implants: A Review of the Literature

    Science.gov (United States)

    van Hove, Ruud P.; Sierevelt, Inger N.; van Royen, Barend J.; Nolte, Peter A.

    2015-01-01

    Surfaces of medical implants can be enhanced with the favorable properties of titanium-nitride (TiN). In a review of English medical literature, the effects of TiN-coating on orthopaedic implant material in preclinical studies were identified and the influence of these effects on the clinical outcome of TiN-coated orthopaedic implants was explored. The TiN-coating has a positive effect on the biocompatibility and tribological properties of implant surfaces; however, there are several reports of third body wear due to delamination, increased ultrahigh molecular weight polyethylene wear, and cohesive failure of the TiN-coating. This might be due to the coating process. The TiN-coating process should be optimized and standardized for titanium alloy articulating surfaces. The clinical benefit of TiN-coating of CoCrMo knee implant surfaces should be further investigated. PMID:26583113

  17. The effects of introducing a clinical pharmacist on orthopaedic wards in Denmark

    DEFF Research Database (Denmark)

    Buck, Thomas Croft; Brandstrup, Lene; Brandslund, Ivan;

    2007-01-01

    OBJECTIVE: To assess the effects and cost effects of introducing clinical pharmacists on hospital wards. METHODS: Comparative prospective study on four orthopaedic surgical wards in two hospitals. The primary effect variables were 10 target areas widely considered to be indicators of good...... sub-optimal prescriptions were changed, 43% resulted in cost reductions. The reductions achieved could cover 47% of the costs of clinical pharmacy service. CONCLUSION: Clinical pharmacy services offered to four orthopaedic surgical wards resulted in reduction of sub-optimal prescriptions. Every time...... the pharmacist screened seven patients one sub-optimal prescription was found and adjusted. The reduction in medicine costs due to adjusted sub-optimal prescriptions could not cover the whole cost of clinical pharmacy service....

  18. Titanium-Nitride Coating of Orthopaedic Implants: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ruud P. van Hove

    2015-01-01

    Full Text Available Surfaces of medical implants can be enhanced with the favorable properties of titanium-nitride (TiN. In a review of English medical literature, the effects of TiN-coating on orthopaedic implant material in preclinical studies were identified and the influence of these effects on the clinical outcome of TiN-coated orthopaedic implants was explored. The TiN-coating has a positive effect on the biocompatibility and tribological properties of implant surfaces; however, there are several reports of third body wear due to delamination, increased ultrahigh molecular weight polyethylene wear, and cohesive failure of the TiN-coating. This might be due to the coating process. The TiN-coating process should be optimized and standardized for titanium alloy articulating surfaces. The clinical benefit of TiN-coating of CoCrMo knee implant surfaces should be further investigated.

  19. What is the role of the orthopaedic surgeon in management of fragility fractures?

    Science.gov (United States)

    Sharif, Khalid M; Dimitriou, Rozalia; Giannoudis, Peter V

    2011-06-01

    Fragility fractures are the most prevalent trauma condition that orthopaedic surgeons face today. Osteoporosis and susceptibility to falls are the key predisposing factors. Despite evidence supporting the impact of treating osteoporosis on reducing the incidence of fragility fractures, it is often left untreated. Orthopaedic surgeons are often the first physicians to assess and treat the patient after a fragility fracture. Their role therefore does not end in the skillful fixation of the fractures, but they have a unique opportunity to ensure that preventive measures are implemented. This includes falls prevention, investigation of possible causes underlying osteoporosis, attention to diet, exercise, calcium, and vitamin D supplementation as well as prescription of anti-resorptive and anabolic medication. The need for a dedicated multidisciplinary team needs to be emphasized and therefore effective communication between the different parties is of paramount importance. PMID:21566474

  20. Multifunctional coatings to simultaneously promote osseointegration and prevent infection of orthopaedic implants.

    Science.gov (United States)

    Raphel, Jordan; Holodniy, Mark; Goodman, Stuart B; Heilshorn, Sarah C

    2016-04-01

    The two leading causes of failure for joint arthroplasty prostheses are aseptic loosening and periprosthetic joint infection. With the number of primary and revision joint replacement surgeries on the rise, strategies to mitigate these failure modes have become increasingly important. Much of the recent work in this field has focused on the design of coatings either to prevent infection while ignoring bone mineralization or vice versa, to promote osseointegration while ignoring microbial susceptibility. However, both coating functions are required to achieve long-term success of the implant; therefore, these two modalities must be evaluated in parallel during the development of new orthopaedic coating strategies. In this review, we discuss recent progress and future directions for the design of multifunctional orthopaedic coatings that can inhibit microbial cells while still promoting osseointegration. PMID:26851394

  1. Titanium-Nitride Coating of Orthopaedic Implants: A Review of the Literature.

    Science.gov (United States)

    van Hove, Ruud P; Sierevelt, Inger N; van Royen, Barend J; Nolte, Peter A

    2015-01-01

    Surfaces of medical implants can be enhanced with the favorable properties of titanium-nitride (TiN). In a review of English medical literature, the effects of TiN-coating on orthopaedic implant material in preclinical studies were identified and the influence of these effects on the clinical outcome of TiN-coated orthopaedic implants was explored. The TiN-coating has a positive effect on the biocompatibility and tribological properties of implant surfaces; however, there are several reports of third body wear due to delamination, increased ultrahigh molecular weight polyethylene wear, and cohesive failure of the TiN-coating. This might be due to the coating process. The TiN-coating process should be optimized and standardized for titanium alloy articulating surfaces. The clinical benefit of TiN-coating of CoCrMo knee implant surfaces should be further investigated. PMID:26583113

  2. Orthopaedic Disorders in Myotonic Dystrophy Type 1: descriptive clinical study of 21 patients

    OpenAIRE

    Schilling, Lisa; Forst, Raimund; Forst, Jürgen; Fujak, Albert

    2014-01-01

    Background Myotonic Dystrophy Type 1 (DM1) is the most common form of hereditary myopathy presenting in adults. This autosomal-dominant systemic disorder is caused by a CTG repeat, demonstrating various symptoms. A mild, classic and congenital form can be distinguished. Often the quality of life is reduced by orthopaedic problems, such as muscle weakness, contractures, foot or spinal deformities, which limit patients’ mobility. The aim of our study was to gather information about the o...

  3. Prevalence and effect of myths in clinical orthopaedics in Western part of Uttar Pradesh

    OpenAIRE

    Arun Vashisht; Avinash Rastogi

    2016-01-01

    Background: Myths in the field of medicine regarding the treatment of health problems are frequently observed, which may not only retard the recovery but often be harmful for the patients. We were baffled to see lot of patients under the influence of certain myths about treatment of their orthopaedic ailments. The aim of this observational, prospective study was to dispel the misconceptions and to create awareness in the society about the bad effects of these myths. Methods: 1285 patients...

  4. Orthopaedic Interface Tissue Engineering for the Biological Fixation of Soft Tissue Grafts

    OpenAIRE

    Moffat, Kristen L.; Wang, I-Ning Elaine; Rodeo, Scott A.; Lu, Helen H.

    2009-01-01

    Interface tissue engineering is a promising new strategy aimed at the regeneration of tissue interfaces and ultimately enabling the biological fixation of soft tissue grafts utilized in orthopaedic repair and sports medicine. Many ligaments and tendons with direct insertions into subchondral bone exhibit a complex enthesis consisting of several distinct yet continuous regions of soft tissue, noncalcified fibrocartilage, calcified fibrocartilage and bone. Regeneration of this multi-tissue inte...

  5. Tissue Engineering Strategies for the Regeneration of Orthopaedic Interfaces: Interface Tissue Engineering Strategies

    OpenAIRE

    Lu, Helen H.; Subramony, Siddarth D.; Boushell, Margaret K.; Zhang, Xinzhi

    2010-01-01

    A major focus in the field of orthopaedic tissue engineering is the development of tissue engineered bone and soft tissue grafts with biomimetic functionality to allow for their translation to the clinical setting. One of the most significant challenges of this endeavor is promoting the biological fixation of these grafts with each other as well as the implant site. Such fixation requires strategic biomimicry to be incorporated into the scaffold design in order to re-establish the critical st...

  6. The Champions League - Improving the quality of in-patient antibiotic prescription in Trauma and Orthopaedics

    OpenAIRE

    Evans, Jonathan; Saxby, Clair; Armstrong, Alexander

    2014-01-01

    A Trust level audit demonstrated that the trauma and orthopaedic department did not reach its own standards in adhering to Trust antibiotic prescribing guidelines. Junior doctors are the main prescribers of antibiotics during inpatient stays. Local policy states that for all inpatients on antibiotics, the start date, duration, and indication for antibiotics must be documented on the drug card. Each patient drug card was reviewed by the department pharmacist and it was recorded whether the doc...

  7. Early Staphylococcal Biofilm Formation on Solid Orthopaedic Implant Materials: In Vitro Study

    OpenAIRE

    Koseki, Hironobu; Yonekura, Akihiko; Shida, Takayuki; Yoda, Itaru; Horiuchi, Hidehiko; Morinaga, Yoshitomo; Yanagihara, Katsunori; Sakoda, Hideyuki; Osaki, Makoto; Tomita, Masato

    2014-01-01

    Biofilms forming on the surface of biomaterials can cause intractable implant-related infections. Bacterial adherence and early biofilm formation are influenced by the type of biomaterial used and the physical characteristics of implant surface. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis, the main pathogen in implant-related infections, to form biofilms on the surface of the solid orthopaedic biomaterials, oxidized zirconium-niobium alloy, cobalt-chromiu...

  8. An evidence-based dietary fiber enrichment programme for relieving constipation in elderly orthopaedic patients

    OpenAIRE

    Tai, Siu-king, Rosetti; 戴筱荊

    2013-01-01

    Constipation is a multifactorial digestive disorder highly prevailing among the hospitalized elderly Orthopaedic patients. Unlike Western countries, laxative therapy is used to be the first line remedy for constipation in many hospitals of Hong Kong although fiber-rich diet has been proven by numerous studies as the best alternative with low cost and less complications. This dissertation is a translational nursing research which aims at formulating a programme of using fiber-rich food pro...

  9. Emil Theodor Kocher (1841-1917): Orthopaedic surgeon and the first surgeon Nobel Prize winner

    OpenAIRE

    Bumbaširević Marko Ž.; Zagorac Slaviša G.; Lešić Aleksandar R.

    2013-01-01

    Theodor Emil Kocher (1841-1917) was born in Bern and educated in several universities in Europe. Like many surgeons of that time, Kocher performed orthopaedic surgery, general surgery, neurosurgery and endocrine surgery and became famous in many fields. He is remembered for his description of a new approach to the hip joint and elbow joint, as well as a maneuver for reduction of dislocated shoulder joints. He introduced many instruments and some of them, su...

  10. Publication trend in the indian journal of orthopaedics: What is published and why?

    OpenAIRE

    Rishiram Poudel; Venkatesan Sampath Kumar; Ashok Kumar; Shah Alam Khan

    2015-01-01

    Background: Factors influencing publication of manuscripts in reputed journals have never been studied to the best of our knowledge. This study was conducted to evaluate the trend in publication within the Indian Journal of Orthopaedics (IJO). Materials and Methods: A cross-sectional study was conducted by accessing the online database of the IJO. All the issues available online were included. Published articles were classified into one of the following thirteen categories: (i) Basic Scie...

  11. Radiation exposure of eyes, thyroid gland and hands in orthopaedic staff: a systematic review

    Directory of Open Access Journals (Sweden)

    Kesavachandran Chandrasekharan Nair

    2012-10-01

    Full Text Available Abstract Background Various procedures, especially minimal invasive techniques using fluoroscopy, pose a risk of radiation exposure to orthopaedic staff. Anatomical sites such as the eyes, thyroid glands and hands are more vulnerable to radiation considering the limited use of personal protective devices in the workplace. The objective of the study is to assess the annual mean cumulative and per procedure radiation dose received at anatomical locations like eyes, thyroid glands and hands in orthopaedic staff using systematic review. Methods The review of literature was conducted using systematic search of the database sources like PUBMED and EMBASE using appropriate keywords. The eligibility criteria and the data extraction of literature were based on study design (cohort or cross-sectional study, study population (orthopaedic surgeons or their assistants, exposure (doses of workplace radiation exposure at hands/fingers, eye/forehead, neck/thyroid, language (German and English. The literature search was conducted using a PRISMA checklist and flow chart. Results Forty-two articles were found eligible and included for the review. The results show that radiation doses for the anatomical locations of eye, thyroid gland and hands were lower than the dose levels recommended. But there is a considerable variation of radiation dose received at all three anatomical locations mainly due to different situations including procedures (open and minimally invasive, work experience (junior and senior surgeons,distance from the primary and secondary radiation, and use of personal protective equipments (PPEs. The surgeons receive higher radiation dose during minimally invasive procedures compared to open procedures. Junior surgeons are at higher risk of radiation exposure compared to seniors. PPEs play a significant role in reduction of radiation dose. Conclusions Although the current radiation precautions appear to be adequate based on the low dose radiation

  12. Negative pressure wound therapy for management of the surgical incision in orthopaedic surgery

    OpenAIRE

    Karlakki, S.; Brem, M.; Giannini, S.; Khanduja, V.; Stannard, J; R. Martin

    2013-01-01

    Objectives The period of post-operative treatment before surgical wounds are completely closed remains a key window, during which one can apply new technologies that can minimise complications. One such technology is the use of negative pressure wound therapy to manage and accelerate healing of the closed incisional wound (incisional NPWT). Methods We undertook a literature review of this emerging indication to identify evidence within orthopaedic surgery and other surgical disciplines. Liter...

  13. Evaluation of the sterilization efficacy of domestic electric drills used in orthopaedic surgeries

    OpenAIRE

    Goveia, Vania Regina; Pinto, Flavia Morais Gomes; Machoshvili, Irene Alexeevna; Penna, Thereza Christina Vessoni; Graziano, Kazuko Uchikawa

    2009-01-01

    It is estimated that electric drills (ED) have been used in orthopaedic surgeries for bone drilling for more than 50 years in Brazilian hospitals. It is an electric, thermosensitive equipment, not indicated for surgical use, which has not been previously evaluated regarding the sterilization efficacy, being suspect of infection risk. This study evaluated the efficacy of sterilization by ethylene oxide (EtO) of new drills that were intentionally contaminated with Bacillus atrophaeus spores. An...

  14. Interventions to reduce tourniquet-related ischaemic damage in orthopaedic surgery

    DEFF Research Database (Denmark)

    Halladin, N L; Zahle, F V; Rosenberg, J;

    2014-01-01

    showed a significant reduction in biochemical oxidative stress markers. We conclude that propofol and ischaemic pre-conditioning, in particular, appear to show some benefit at reducing oxidative stress following operations under tourniquet; the correlation between a reduction in oxidative stress and......-related oxidative damage in adults undergoing orthopaedic surgery, and the possible relationship between biochemical oxidative stress markers and postoperative clinical outcomes. Seventeen randomised controlled studies were included in the qualitative synthesis. Most trials were of low methodological quality and...

  15. Macroeconomic Issues in Foreign Aid

    DEFF Research Database (Denmark)

    Hjertholm, Peter; Laursen, Jytte; White, Howard

    foreign aid, macroeconomics of aid, gap models, aid fungibility, fiscal response models, foreign debt,......foreign aid, macroeconomics of aid, gap models, aid fungibility, fiscal response models, foreign debt,...

  16. Strengthening of Mg based alloy through grain refinement for orthopaedic application.

    Science.gov (United States)

    Nayak, Soumyaranjan; Bhushan, Bharat; Jayaganthan, R; Gopinath, P; Agarwal, R D; Lahiri, Debrupa

    2016-06-01

    Magnesium is presently attracting a lot of interest as a replacement to clinically used orthopaedic implant materials, due to its ability to solve the stress shielding problems, biodegradability and osteocompatibility. However, the strength of Mg is still lower than the requirement and it becomes worse after it starts degrading fast, while being exposed in living body environment. This research explores the effectiveness of 'grain refinement through deformation', as a tool to modify the strength (while keeping elastic modulus unaffected) of Mg based alloys in orthopaedic application. Hot rolled Mg-3wt% Zn alloy (MZ3) has been investigated for its potential in orthopaedic implant. Microstructure, mechanical properties, bio-corrosion properties and biocompatibility of the rolled samples are probed into. Grain size gets refined significantly with increasing amount of deformation. The alloy experiences a marked improvement in hardness, yield strength, ultimate tensile strength, strain and toughness with finer grain size. An increment in accelerated corrosion rate is noted with decreasing grain size, which is correlated to the increased grain boundary area and mechano-chemical dissolution. However, immersion test in simulated body fluid (SBF) reveals reduction in corrosion rate after third day of immersion. This was possible owing to precipitation of protective hydroxyapatite (HA) layer, formed out of the interaction of SBF and the alloy. More nucleation sites at the grain boundary for fine grained samples help in forming more HA and thus reduce the corrosion rate. Human osteosarcoma cells show less viability and adhesion on grain refined alloy. PMID:26745721

  17. Similarities and differences in coatings for magnesium-based stents and orthopaedic implants

    Directory of Open Access Journals (Sweden)

    Jun Ma

    2014-07-01

    Full Text Available Magnesium (Mg-based biodegradable materials are promising candidates for the new generation of implantable medical devices, particularly cardiovascular stents and orthopaedic implants. Mg-based cardiovascular stents represent the most innovative stent technology to date. However, these products still do not fully meet clinical requirements with regards to fast degradation rates, late restenosis, and thrombosis. Thus various surface coatings have been introduced to protect Mg-based stents from rapid corrosion and to improve biocompatibility. Similarly, different coatings have been used for orthopaedic implants, e.g., plates and pins for bone fracture fixation or as an interference screw for tendon-bone or ligament-bone insertion, to improve biocompatibility and corrosion resistance. Metal coatings, nanoporous inorganic coatings and permanent polymers have been proved to enhance corrosion resistance; however, inflammation and foreign body reactions have also been reported. By contrast, biodegradable polymers are more biocompatible in general and are favoured over permanent materials. Drugs are also loaded with biodegradable polymers to improve their performance. The key similarities and differences in coatings for Mg-based stents and orthopaedic implants are summarized.

  18. Improving the outcome of paediatric orthopaedic trauma: an audit of inpatient management in Southampton.

    Science.gov (United States)

    Cox, P J; Clarke, N M

    1997-11-01

    The patterns, management and outcome of non-fatal orthopaedic injury in childhood was audited over a 1 year period in Southampton. A computer-based audit (1 September 1993 to 31 August 1994) was conducted of all children aged under 15 years who were admitted to the orthopaedic unit after accidental injury. Management was audited by studying the primary conservative and operative treatment methods employed. Treatment outcome was evaluated in terms of need for secondary operative treatment, salvage internal fixation, length of hospital stay and unplanned readmission. In all, 398 children, representing 50/10,000 of the local paediatric population, were admitted with a traumatic injury. There was a significant (P internal fixation procedures were performed as 'salvage' after failure of conservative treatment, entailing either reoperation during the initial admission or a further unplanned readmission. 3 A prolonged inpatient stay for patients with femoral fractures owing to a wide variation in treatment method. The outcome of non-fatal orthopaedic injury can be improved through the selective use of primary internal fixation of distal radial and humeral fractures and the close adherence to a management algorithm in femoral fractures. There may be a role for more specialised supervision of primary treatment of these particular fractures. PMID:9422873

  19. A nurse transition program for orthopaedics: creating a new culture for nurturing graduate nurses.

    Science.gov (United States)

    Orsini, Christine H

    2005-01-01

    Successful training and initiation of new graduate nurses is a critical concern for the entire healthcare industry. Current literature reports that as many as 80-90% of new graduate nurses will leave their job within the first year of employment (Bradley, 2001). In summer 2001, the inpatient orthopaedic department of a large community hospital in the southeastern United States was faced with significant recruitment and retention issues. In response, a new nurse graduate transition program was developed for the orthopaedic specialty. This program uses an adult learning model and a single dedicated preceptor. In addition to clinical experience, the program provides special attention to the development of professional behavior, relationship building, and critical-thinking skills. During the next 2 years, the program produced eight new orthopaedic nurses with a first-year turnover rate of 0%. In addition, this program has positively influenced other areas of importance for RN recruitment and retention, including quality of care, patient satisfaction, and staff satisfaction. PMID:16056167

  20. Barriers and strategies for the clinical translation of advanced orthopaedic tissue engineering protocols

    Directory of Open Access Journals (Sweden)

    H Madry

    2014-05-01

    Full Text Available Research in orthopaedic tissue engineering has intensified over the last decade and new protocols continue to emerge. The clinical translation of these new applications, however, remains associated with a number of obstacles. This report highlights the major issues that impede the clinical translation of advanced tissue engineering concepts, discusses strategies to overcome these barriers, and examines the need to increase incentives for translational strategies. The statements are based on presentations and discussions held at the AO Foundation-sponsored symposium "Where Science meets Clinics 2013" held at the Congress Center in Davos, Switzerland, in September, 2013. The event organisers convened a diverse group of over one hundred stakeholders involved in clinical translation of orthopaedic tissue engineering, including scientists, clinicians, healthcare industry professionals and regulatory agency representatives. A major point that emerged from the discussions was that there continues to be a critical need for early trans-disciplinary communication and collaboration in the development and execution of research approaches. Equally importantly was the need to address the shortage of sustained funding programs for multidisciplinary teams conducting translational research. Such detailed discussions between experts contribute towards the development of a roadmap to more successfully advance the clinical translation of novel tissue engineering concepts and ultimately improve patient care in orthopaedic and trauma surgery.

  1. Extracorporeal Shock Wave Therapy could be a Potential Adjuvant Treatment for Orthopaedic Implant-associated Infections

    Directory of Open Access Journals (Sweden)

    Xiao-feng Chen

    2013-07-01

    Full Text Available Over the past half-century, biomaterials have been used in orthopaedic surgery world widely, but orthopaedic implant-associated infections (OIAIs are still a puzzle for orthopaedic surgeons, which may result in prolonged hospitalisation, poor functional status and high costs. The presence of implants increases the risk of microbial infection; moreover, the formation of bacterial biofilm leads to a higher resistance to antibiotics and local immune response. In such cases, conventional systemic delivery of drugs seems to be fairly inefficient and out-dated. Owing to this, debridement and/or removing the implant always become the only solution. Hence, it needs a simple, minimally invasive and effective therapy to eradicate the problem. There are abundant evidences showing that extracorporeal shock wave therapy (ESWT has favourable effects on stimulating callus formation, inducing angiogenesis, promoting osteogenesis and relieving pain. Studies also indicated that ESWs have a significant bactericidal effect on bacterial strains of bone- and implant-associated infections. Therefore, a hypothesis proposed herein is that ESWT may well be an effective adjuvant treatment for OIAI by controlling infection, inducing bone regeneration and promoting re-osseointegration.

  2. Correlations of radiological assessment of skeletal maturity and orthopaedic injuries in the standardbred

    International Nuclear Information System (INIS)

    The aim of this study was to define a correlation between the incidence of orthopaedic injuries and the skeletal maturity, radiologically assessed, in a group of 23 standardbred horses. Starting at 18 months of age, radiograms of calcaneus and distal radial physis were taken at two months intervals, until X-ray evidence of closure. All the physis were blindly graded as: C: open physis; B-: initial evidence of central closure; B: partially closed physis; B+: full closure of the central portion of the physis; A: closed physis. Based on this classification, the horses were grouped as I (immature subject - C, B- and B), or M (mature subject - B+ and A). Orthopaedic injuries were classified as major lesion, if causing prolonged or definitive interruption of training, or minor, if causing brief or no interruption of training. Estimation of injury incidence in the different groups was calculated using the chi-square test (significance level P0.01). The average ages of physis closure (mean +- SD) were 24.1 +- 2.6 months (range 19-28), for the calcaneal physis, and 28.2 +- 2 months (range 26-33), for the distal radial physis, without significant differences between colts and fillies. In our study, according to a previous report, no correlation between X-ray skeletal maturity and incidence of orthopaedic injuries was demonstrated

  3. Mechanical compatibility of sol-gel annealing with titanium for orthopaedic prostheses.

    Science.gov (United States)

    Greer, Andrew I M; Lim, Teoh S; Brydone, Alistair S; Gadegaard, Nikolaj

    2016-01-01

    Sol-gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol-gel technology to orthopaedics. Primarily, the annealing stage required to transform the sol-gel into a ceramic may compromise the physical integrity of the underlying metal. Secondly, loose particles on medical implants can be carcinogenic and cause inflammation so the coating needs to be strongly bonded to the implant. These concerns are addressed in this paper. Titanium, the dominant material for orthopaedics at present, is examined before and after sol-gel processing for changes in hardness and flexural modulus. Wear resistance, bending and pull tests are also performed to evaluate the ceramic coating. The findings suggest that sol-gel coatings will be compatible with titanium implants for an optimum temperature of 500 °C. PMID:26691162

  4. Database and Registry Research in Orthopaedic Surgery: Part 2: Clinical Registry Data.

    Science.gov (United States)

    Pugely, Andrew J; Martin, Christopher T; Harwood, Jared; Ong, Kevin L; Bozic, Kevin J; Callaghan, John J

    2015-11-01

    The use of large-scale national databases for observational research in orthopaedic surgery has grown substantially in the last decade, and the data sets can be categorized as either administrative claims or clinical registries. Clinical registries contain secondary data on patients with a specific diagnosis or procedure. The data are typically used for patient outcome surveillance to improve patient safety and health-care quality. Registries used in orthopaedic research exist at the regional, national, and international levels, and many were designed to specifically collect outcomes relevant to orthopaedics, such as short-term surgical complications, longer-term outcomes (implant survival or reoperations), and patient-reported outcomes. Although heterogeneous, clinical registries-in contrast to claims data-typically have a more robust list of variables, with relatively precise prospective data input, management infrastructure, and reporting systems. Some weaknesses of clinical registries include a smaller number of patients, inconstant follow-up duration, and use of sampling methods that may limit generalizability. Within the U.S., national joint registry adoption has lagged international joint registries. Given the changing health-care environment, it is likely that clinical registries will provide valuable information that has the potential to influence clinical practice improvement and health-care policy in the future. PMID:26537168

  5. HIV and AIDS

    Science.gov (United States)

    ... Got Homework? Here's Help White House Lunch Recipes HIV and AIDS KidsHealth > For Kids > HIV and AIDS ... actually the virus that causes the disease AIDS. HIV Hurts the Immune System People who are HIV ...

  6. HIV-AIDS Connection

    Science.gov (United States)

    ... Content Marketing Share this: Main Content Area The HIV-AIDS Connection AIDS was first recognized in 1981 ... cancers. Why is there overwhelming scientific consensus that HIV causes AIDS? Before HIV infection became widespread in ...

  7. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle becomes ...

  8. AIDS.gov

    Science.gov (United States)

    ... Hospitalization and Palliative Care Friends & Family Dating and Marriage Family Planning Mixed-Status Couples Discrimination Legal Issues ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latino AIDS ...

  9. Breathing difficulties - first aid

    Science.gov (United States)

    Difficulty breathing - first aid; Dyspnea - first aid; Shortness of breath - first aid ... Breathing difficulty is almost always a medical emergency. An exception is feeling slightly winded from normal activity, ...

  10. Heart attack first aid

    Science.gov (United States)

    First aid - heart attack; First aid - cardiopulmonary arrest; First aid - cardiac arrest ... A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle ...

  11. Nosebleed, First Aid

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Nosebleed, First Aid A A A First Aid for Nosebleed: View ... of the nose, causing bleeding into the throat. First Aid Guide The following self-care measures are recommended: ...

  12. Unconsciousness - first aid

    Science.gov (United States)

    Loss of consciousness - first aid; Coma - first aid; Mental status change; Altered mental status ... has a change in mental status, follow these first aid steps: Call or tell someone to call 911 . ...

  13. Splinter, First Aid

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Splinter, First Aid A A A First Aid for Splinter: View ... wet, it makes the area prone to infection. First Aid Guide Self-care measures to remove a splinter ...

  14. Surgery or consultation: a population-based cohort study of use of orthopaedic surgeon services.

    Directory of Open Access Journals (Sweden)

    Elizabeth M Badley

    Full Text Available BACKGROUND: This population-based cohort study has the objective to understand the sociodemographic characteristics and health conditions of patients who do not receive surgery within 18 months following an ambulatory visit to an orthopaedic surgeon. METHODS: Administrative healthcare databases in Ontario, Canada were linked to identify all patients making an initial ambulatory visit to orthopaedic surgeons between October 1(st, 2004 and September 30(th, 2005. Logistic regression was used to examine predictors of not receiving surgery within 18 months. RESULTS: Of the 477,945 patients in the cohort 49% visited orthopaedic surgeons for injury, and 24% for arthritis. Overall, 79.3% did not receive surgery within 18 months of the initial visit, which varied somewhat by diagnosis at first visit (84.5% for injury and 73.0% for arthritis with highest proportions in the 0-24 and 25-44 age groups. The distribution by income quintile of patients visiting was skewed towards higher incomes. Regression analysis for each diagnostic group showed that younger patients were significantly more likely to be non-surgical than those aged 65+ years (age 0-24: OR 3.45 95%CI 3.33-3.57; age 25-44: OR 1.30 95%CI 1.27-1.33. The odds of not getting surgery were significantly higher for women than men for injury and other conditions; the opposite was true for arthritis and bone conditions. CONCLUSION: A substantial proportion of referrals were for expert diagnosis or advice on management and treatment. The findings also suggest socioeconomic inequalities in access to orthopaedic care. Further research is needed to investigate whether the high caseload of non-surgical cases affects waiting times to see a surgeon. This paper contributes to the development of evidence-based strategies to streamline access to surgery, and to develop models of care for non-surgical patients to optimize the use of scarce orthopaedic surgeon resources and to enhance the management of

  15. Does Admission to Medicine or Orthopaedics Impact a Geriatric Hip Patient’s Hospital Length of Stay?

    Science.gov (United States)

    Greenberg, Sarah E.; VanHouten, Jacob P.; Lakomkin, Nikita; Ehrenfeld, Jesse; Jahangir, Amir Alex; Boyce, Robert H.; Obremksey, William T.; Sethi, Manish K.

    2016-01-01

    Objectives The aim of our study was to determine the association between admitting service, medicine or orthopaedics, and length of stay (LOS) for a geriatric hip fracture patient. Design Retrospective. Setting Urban level 1 trauma center. Patients/Participants Six hundred fourteen geriatric hip fracture patients from 2000 to 2009. Interventions Orthopaedic surgery for geriatric hip fracture. Main Outcome Measurements Patient demographics, medical comorbidities, hospitalization length, and admitting service. Negative binomial regression used to determine association between LOS and admitting service. Results Six hundred fourteen geriatric hip fracture patients were included in the analysis, of whom 49.2% of patients (n = 302) were admitted to the orthopaedic service and 50.8% (3 = 312) to the medicine service. The median LOS for patients admitted to orthopaedics was 4.5 days compared with 7 days for patients admitted to medicine (P medicine (n = 92, 29.8%) than for those admitted to orthopaedics (n = 70, 23.1%). After controlling for important patient factors, it was determined that medicine patients are expected to stay about 1.5 times (incidence rate ratio: 1.48, P medicine service compared with the orthopaedic service increases a geriatric hip fractures patient’s expected LOS. Since LOS is a major driver of cost as well as a measure of quality care, it is important to understand the factors that lead to a longer hospital stay to better allocate hospital resources. Based on the results from our institution, orthopaedic surgeons should be aware that admission to medicine might increase a patient’s expected LOS. PMID:26371621

  16. Osteosarcoma in Adult Patients Living with HIV/AIDS

    Science.gov (United States)

    Marais, Leonard C.; Ferreira, Nando

    2013-01-01

    Background. HIV infection has reached epidemic proportions in South Africa, with an estimated prevalence of 21.5% in adults living in the province of KwaZulu-Natal. Several malignancies have been identified as part of the spectrum of immunosuppression-related manifestations of HIV infection. Very few reports, however, exist regarding the occurrence of non-AIDS-defining sarcomas in the extremities or limb girdles. Methods. A retrospective review was performed on all adult patients, between the ages of 30 and 60 years, with histologically confirmed osteosarcomas of the appendicular skeleton referred to a tertiary-level orthopaedic oncology unit. Results. Five out of the nine patients (62.5%) included in the study were found to be HIV positive. The average CD4 count of these patients was 278 (237–301) cells/mm3, indicating advanced immunological compromise. Three of the malignancies in HIV-positive patients occurred in preexisting benign or low-grade tumours. Conclusion. A heightened index of suspicion is required in HIV patients presenting with unexplained bone and joint pain or swelling. Judicious use of appropriate radiological investigation, including magnetic resonance imaging of suspicious lesions and timely referral to an appropriate specialized orthopaedic oncology unit, is recommended. PMID:23762607

  17. Types of Foreign Aid

    DEFF Research Database (Denmark)

    Bjørnskov, Christian

    Foreign aid is given for many purposes and different intentions, yet most studies treat aid flows as a unitary concept. This paper uses factor analysis to separate aid flows into different types. The main types can be interpreted as aid for economic purposes, social purposes, and reconstruction; a...... residual category captures remaining purposes. Estimating the growth effects of separable types of aid suggests that most aid has no effects while reconstruction aid has direct positive effects. Although this type only applies in special circumstances, it has become more prevalent in more recent years....

  18. The use of damage control orthopaedics to minimize negative sequelae of surgery delay in elderly comorbid patients with hip fracture.

    Science.gov (United States)

    Dong, C-H; Wang, Z-M; Zhao, X-L; Wang, A-M

    2016-06-01

    Hip surgeries count to the most frequent orthopaedic operations in older patients. Nonelective surgeries for hip fractures cause substantial economic burden because of high costs of medical treatment and high associated mortality. Surgery for hip fracture in the elderly comorbid patient still presents a challenge to orthopaedic surgeons. It is recommended that this surgery is performed within 48 hours after sustaining the hip fracture to decrease mortality. Yet the recommended early surgery (i.e. 48 hours after the incident) is not always feasible due to the frequent overall frailty of the patients or conditions of concomitant disease. The care of patients unfit for early surgery has been not adequately addressed in the literature. We have previously introduced an algorithm based on ASA-PS and P-POSSUM scores to stratify elderly comorbid patients for early vs delayed hip surgery, and used principles of Damage Control Orthopaedics to minimized negative sequelae of surgery delay (Dong C et al., PLoS One 2016). In this paper, we elaborate on Damage Control Orthopaedics and the proposed approach in the context of frequent comorbidities in the elderly orthopaedic patients. Further studies on this subject are urgently needed to establish international consensus on hip fracture surgery delayed due to overall patient frailty or extensive comorbidities. PMID:27383299

  19. Thinking about Aid Predictability

    OpenAIRE

    Andrews, Matthew; Wilhelm, Vera

    2008-01-01

    Researchers are giving more attention to aid predictability. In part, this is because of increases in the number of aid agencies and aid dollars and the growing complexity of the aid community. A growing body of research is examining key questions: Is aid unpredictable? What causes unpredictability? What can be done about it? This note draws from a selection of recent literature to bring s...

  20. How to Get Hearing Aids

    Science.gov (United States)

    ... Consumer Products Hearing Aids How to get Hearing Aids Share Tweet Linkedin Pin it More sharing options ... my hearing aids? How do I get hearing aids? To get hearing aids, you should first have ...

  1. Aesthetic, urological, orthopaedic and functional outcomes in complex bladder exstrophy-epispadias′s management

    Directory of Open Access Journals (Sweden)

    Bertin Dibi Kouame

    2015-01-01

    Full Text Available Background: Postoperative complications are related to the surgical procedures, of failures of initial bladder closure and influence the urological, aesthetical and orthopaedic outcomes. Materials and Methods: We reviewed four patients who underwent complex bladder exstrophy-epispadias repair over a period of 14 years. The outcomes of treatment were assessed using, aesthetic, urological and orthopaedic examination data. Orthopaedic complications were explored by a radiography of the pelvis. Results: Out of four patients who underwent bladder exstrophy surgical management, aesthetic, functional outcomes and complications in the short and long follow-up were achieved in three patients. The first patient is a male and had a good penis aspect. He has a normal erection during micturition with a good jet miction. He has a moderate urinary incontinence, which requires diaper. In the erection, his penis-measures 4 cm long and 3 cm as circumference. The second patient was a female. She had an unsightly appearance of the female external genitalia with bipartite clitoris. Urinary continence could not be assessed; she did not have the age of cleanness yet. The third patient had a significant urinary leakage due to the failure of the epispadias repair. He has a limp, a pelvic obliquity, varus and internal rotation of the femoral head. He has an inequality of limbs length. Pelvis radiograph shows the right osteotomy through the ilium bone, the left osteotomy through the hip joint at the acetabular roof. Conclusion: When, the epispadias repair is performed contemporary to initial bladder closure, its success is decisive for urinary continence. In the female, surgical revision is required after the initial bladder closure for an aesthetic appearance to the external genitalia. Innominate osteotomy must be performed with brilliancy amplifier to avoid osteotomy through to the hip joint to prevent inequality in leg length.

  2. Orthopaedic health status of horses from 8 riding schools - a pilot study

    Directory of Open Access Journals (Sweden)

    Egenvall Agneta

    2010-08-01

    Full Text Available Abstract Background Orthopaedic injury is the most common reason for lameness and wastage in sport and leisure horses. Studies on racehorses have shown differences in injury risk between trainers and training strategies. The aim was to study between riding school variation in orthopaedic health status by clinical examination and horses age, and control for change of examiner, in schools with previous high (n = 4 and low (n = 4 insurance utilisation. Methods Horses (n = 99 at 8 riding schools were examined for conformation, movement in all gaits, standing flexion tests and palpation by two veterinary surgeons (in some schools only one. Indexes of findings were created for total health, movements, limbs, conformation and back palpation. Results Logistic regression analyses showed that findings increased with age (walk, trot, canter, conformation left hind limb, palpation fore limbs, hooves and flexion tests or decreased with age (conformation right fore limb. Significant differences in findings were found between riding schools and examiner for seven and eight criteria each (partly overlapping. Increasing indexes were significantly associated with one examiner (total health, movements, back palpation, increasing age (total health, movements or more time at the school (limbs. The back palpation index was highest at 5 Conclusion The age distribution differed markedly between riding schools and age affected several types of findings. This, combined with the two opposite groups of insurance use, shows that schools with low insurance utilisation had previously been able to "avoid" using the insurance, maybe even on similar types of cases if these were more promptly/differently handled indicating differential coverage of disease data in the insurance database. The examiner effect was clearly demonstrated. For some findings, the amount of clinical observations differed by school, even when examiner and age was adjusted for. Most findings were of minor

  3. Users′ guide to the orthopaedic literature: What is a cost-effectiveness analysis?

    Directory of Open Access Journals (Sweden)

    Tanner Stephanie

    2008-01-01

    Full Text Available As the cost of healthcare continue to rise, orthopaedic surgeons are being pressured to practice cost-effective healthcare. Consequently, economic evaluation of treatment options are being reported more commonly in medical and surgical literature. As new orthopaedic procedures and treatments may improve patient outcome and function over traditional treatment options, the effect of the potentially higher costs of new treatments should be formally evaluated. Unfortunately, the resources available for healthcare spending are typically limited. Therefore, cost-effectiveness analyses have become an important and useful tool in informing which procedure or treatment to implement into practice. Cost-effectiveness analysis is a type of economic analysis that compares both the clinical outcomes and the costs of new treatment options to current treatment options or standards of care. For a clinician to be able to apply the results of a cost-effectiveness analysis to their practice, they must be able to critically review the available literature. Conducting an economic analysis is a challenging process, which has resulted in a number of published economic analyses that are of lower quality and may be fraught with bias. It is important that the reader of an economic analysis or cost-effectiveness analysis have the skills required to properly evaluate and critically appraise the methodology used before applying the recommendations to their practice. Using the principles of evidence-based medicine and the questions outlined in the Journal of the American Medical Association′s Users′ Guide to the Medical Literature, this article attempts to illustrate how to critically appraise a cost-effectiveness analysis in the orthopaedic surgery literature.

  4. Prospective assessment of NSAIDs induced ADRs in orthopaedic in-patients

    Directory of Open Access Journals (Sweden)

    Padmanabha TS, Bhaskara K, Nandini T

    2014-04-01

    Full Text Available Background and Objectives: nonsteroidal anti-inflammatory drugs (NSAIDs are one among the most widely used medications to treat pain and inflammation condition. But inadvertent use of NSAIDs have resulted in gastric upset and even death. Hence to minimize such consequences and to identify the incidence of the Adverse drug reaction (ADRs due to NSAIDs in orthopaedic in-patients to promote rational prescribing. Materials and Methods: A prospective study was done in one hundred orthopaedic in-patients of a tertiary care hospital for 3 months from June-Augest 2012. The ADRs pattern were noted with respect to age, gender and drugs involved . The causality of ADRs were assessed by Naranjo’s Algorithm. Results: Among one hundred in- patients 16% developed ADR due to NSAIDs and 1.92% due to Antimicrobial agents (AMAs. The ADRs were more in males (11% than females (5%. Most prescribed NSAID was Diclofenac (76 %, and least was nimesulide (2%. Others were Paracetamol (16%, Ibuprofen (3% and Etoricoxib (3% . Out of 16 ADRs Tablet (Tab Diclofenac accounted for maximum number {87.5%, (n=14} of ADRs, followed by Tab. Paracetamol {12.5 % (n=2}. Conclusion: ADR incidence rate in orthopaedic in-patient due to NSAIDs was 16%. Educating, establishment and encouragement of Pharmacovigilance system among medical and non-health professionals including medical undergraduates improve ADRs identification and to identify the drugs causing it, therefore prolonged hospitalization, treatment cost, morbidity and mortalities can be minimized. Hence, further ADRs due to particular drugs can be reduced in other patients with rational prescription.

  5. A Target-Orientated Marker Image Binarization Method for Orthopaedic Surgical Navigation System

    Institute of Scientific and Technical Information of China (English)

    YAN Shi-ju; CHEN Xiao-jun; WANG Cheng-tao; SU Ying-ying; XIA Qing

    2007-01-01

    Camera calibration is the key technique in a C-arm based orthopaedic surgical navigation system. The extraction of marker location information is a necessary step in the calibration process. Ideal marker images should possess uniform background and contain marker shadow only, but in fact marker images always possess nonuniform background and are contaminated by noise and unwanted anatomic information, making the extraction very difficult. A target-orientated marker shadow extraction method was proposed. With this method a proper threshold for marker image binarization can be determined.

  6. Heat-shock-induced cellular responses to temperature elevations occurring during orthopaedic cutting

    OpenAIRE

    E.B Dolan; Haugh, M. G.; Tallon, D.; Casey, C.; McNamara, L. M.

    2012-01-01

    Severe heat-shock to bone cells caused during orthopaedic procedures can result in thermal damage, leading to cell death and initiating bone resorption. By contrast, mild heat-shock has been proposed to induce bone regeneration. In this study, bone cells are exposed to heat-shock for short durations occurring during surgical cutting. Cellular viability, necrosis and apoptosis are investigated immediately after heat-shock and following recovery of 12, 24 h and 4 days, in osteocyte-like MLO-Y4 ...

  7. The effectiveness of methicillin-resistant Staphylococcus aureus colonisation screening in asymptomatic healthcare workers in an Irish orthopaedic unit.

    LENUS (Irish Health Repository)

    Edmundson, S P

    2012-01-31

    Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with increased mortality, costs and length of stay compared to non-MRSA infections. This observational 4-year study analyses the impact of screening and treating orthopaedic healthcare workers for MRSA colonisation. A total of 1,011 swabs were taken from 566 healthcare workers. Positive healthcare workers were treated with topical mupirocin to both anterior nares. The prevalence of MRSA colonisation on initial testing was 4.77%. The rate of positive MRSA colonisation of those tested on more than one occasion fell from 5.88% to 2.71% (p = 0.055) on subsequent screening. All healthcare workers receiving treatment were successfully cleared of colonisation; however, some required more than one course of treatment. These results show that there could be a role for screening and treating orthopaedic staff for MRSA colonisation as part of a strategy to reduce the prevalence of MRSA infections in orthopaedic units.

  8. Aid and growth regressions

    DEFF Research Database (Denmark)

    Hansen, Henrik; Tarp, Finn

    2001-01-01

    This paper examines the relationship between foreign aid and growth in real GDP per capita as it emerges from simple augmentations of popular cross country growth specifications. It is shown that aid in all likelihood increases the growth rate, and this result is not conditional on ‘good’ policy....... There are, however, decreasing returns to aid, and the estimated effectiveness of aid is highly sensitive to the choice of estimator and the set of control variables. When investment and human capital are controlled for, no positive effect of aid is found. Yet, aid continues to impact on growth via...

  9. The role of biofilm on orthopaedic implants: the "Holy Grail" of post-traumatic infection management?

    Science.gov (United States)

    Mauffrey, C; Herbert, B; Young, H; Wilson, M L; Hake, M; Stahel, P F

    2016-08-01

    The development of post-traumatic infection is potentially a limb threatening condition. The orthopaedic trauma literature lags behind the research performed by our arthroplasty colleagues on the topic of implant-related infections. Surgical site infections in the setting of a recent ORIF are notoriously hard to eradicate due to biofilm formation around the implant. This bacteria-friendly, dynamic, living pluri-organism structure has the ability to morph and adapt to virtually any environment with the aim to maintain the causative organism alive. The challenges are twofold: establishing an accurate diagnosis with speciation/sensitivity and eradicating the infection. Multiple strategies have been researched to improve diagnostic accuracy, to prevent biofilm formation on orthopaedic implants, to mobilize/detach or weaken the biofilm or to target specifically bacteria embedded in the biofilm. The purpose of our paper is to review the patho-physiology of this mysterious pluri-cellular structure and to summarize some of the most pertinent research performed to improve diagnostic and treatment strategies in biofilm-related infections. PMID:27262848

  10. Diamond-like carbon coatings for orthopaedic applications: an evaluation of tribological performance.

    Science.gov (United States)

    Xu, T; Pruitt, L

    1999-02-01

    A detailed investigation of the tribological behaviour of vacuum arc diamond-like carbon coated Ti-6Al-4V against a medical grade ultra-high molecular weight polyethylene is conducted in this work in order to investigate the potential use of diamond-like carbon coatings for orthopaedic appplications. Lubricated and non-lubricated wear experiments are performed using a standard pin-on-disc wear tester. The coefficient of friction is monitored continuously during testing and wear rate calculations are performed using surface profilometry measurements of worn disc surfaces. Sliding wear tests show the existence of two distinct friction and wear regimes distinguished by physically different mechanisms. In the first stages of wear, adhesion and abrasion are the dominant mechanisms of wear while fatigue processes are activated later in the tests. The effects of diamond-like carbon coating structure, surface roughness and lubrication on tribological behaviour are presented. Optimal process-structure-property design for vacuum arc plasma deposition is utilized in order to obtain strong adhesion to the titanium alloy substrate. Diamond-like carbon coatings significantly improve the friction and wear performance of the orthopaedic bearing pair and show exceptional promise for biomedical applications. PMID:15347929

  11. Fracture liaison service in a non-regional orthopaedic clinic--a cost-effective service.

    LENUS (Irish Health Repository)

    Ahmed, M

    2012-01-01

    Fracture liaison services (FLS) aim to provide cost-effective targeting of secondary fracture prevention. It is proposed that a dedicated FLS be available in any hospital to which a patient presents with a fracture. An existing orthopaedic clinic nurse was retrained to deliver a FLS. Proformas were used so that different nurses could assume the fracture liaison nurse (FLN) role, as required. Screening consisted of fracture risk estimation, phlebotomy and DXA scanning. 124 (11%) of all patients attending the orthopaedic fracture clinic were reviewed in the FLS. Upper limb fractures accounted for the majority of fragility fractures screened n=69 (55.6%). Two-thirds of patients (n=69) had reduced bone mineral density (BMD). An evidence based approach to both non-pharmacological and pharmacotherapy was used and most patients (76.6%) receiving pharmacotherapy received an oral bisphosphonate (n=46). The FLS has proven to be an effective way of delivering secondary prevention for osteoporotic fracture in a non-regional fracture clinic, without increasing staff costs.

  12. Prevalence and effect of myths in clinical orthopaedics in Western part of Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Arun Vashisht

    2016-06-01

    Full Text Available Background: Myths in the field of medicine regarding the treatment of health problems are frequently observed, which may not only retard the recovery but often be harmful for the patients. We were baffled to see lot of patients under the influence of certain myths about treatment of their orthopaedic ailments. The aim of this observational, prospective study was to dispel the misconceptions and to create awareness in the society about the bad effects of these myths. Methods: 1285 patients aged 20-55 years, suffering from fractures, neck pain, backache, osteoarthritis knee, myofascial trigger points, episacroiliac lipomas etc. and being under the influence of one or the other myth about the treatment of their ailments, were included in this study. Results: All Patients were counseled and made to realize the harmful effects of their false beliefs regarding treatment of their orthopaedic ailments. Every patient was treated as necessitated for the ailment. All patients were found satisfied at the end of treatment, and were happy after dispelling their myths. Conclusions: Misconceptions do not have any scientific basis rather these are rooted in the society due to high rate of illiteracy and lack of health education. Being a part and parcel of the health care system, it becomes our duty to create awareness among patients about the harmful effects of the prevailing false beliefs by imparting proper health care advice and treatment to relieve the sufferings of our patients. [Int J Res Med Sci 2016; 4(6.000: 2197-2201

  13. The rate of glove perforations in orthopaedic procedures: single versus double gloving. A prospective study.

    Science.gov (United States)

    Chan, K Y; Singh, V A; Oun, B H; To, B H Se

    2006-12-01

    Glove perforation during surgery has always been a matter of concern as it increases the infection rate and the risk of transmission of blood borne diseases. To determine the common causes, the site and the awareness of glove perforations in orthopaedic surgery, a prospective study was conducted to assess the rate of glove perforation during 130 consecutive orthopaedic operations. All gloves worn by the surgical team were assessed after the surgery using the water-loading test. A total of 1452 gloves were tested, and the rate of perforation was 3.58%. Most of these perforations (61.5%) were unnoticed. The main surgeons had the most perforations (76.9%), followed by first assistants (13.5%) and second assistants (9.6%). Most perforations occurred at the non-dominant hand. The commonest site of perforation was the index finger followed by the thumb. Shearing force with instruments accounted for 45% of the noticed perforations. Majority of these occurred during nailing procedures (33%) and internal fixation without the use of wires (19%). Our rate of glove perforation is similar to other series. Most of them went unnoticed and were mainly due to shearing injuries rather than perforation by sharps. Therefore, there is an increased risk of contamination and break in asepsis during surgery. PMID:17605178

  14. How to Study Biofilms after Microbial Colonization of Materials Used in Orthopaedic Implants.

    Science.gov (United States)

    Drago, Lorenzo; Agrappi, Serse; Bortolin, Monica; Toscano, Marco; Romanò, Carlo Luca; De Vecchi, Elena

    2016-01-01

    Over the years, various techniques have been proposed for the quantitative evaluation of microbial biofilms. Spectrophotometry after crystal violet staining is a widespread method for biofilm evaluation, but several data indicate that it does not guarantee a good specificity, although it is rather easy to use and cost saving. Confocal laser microscopy is one of the most sensitive and specific tools to study biofilms, and it is largely used for research. However, in some cases, no quantitative measurement of the matrix thickness or of the amount of embedded microorganisms has been performed, due to limitation in availability of dedicated software. For this reason, we have developed a protocol to evaluate the microbial biofilm formed on sandblasted titanium used for orthopaedic implants, that allows measurement of biomass volume and the amount of included cells. Results indicate good reproducibility in terms of measurement of biomass and microbial cells. Moreover, this protocol has proved to be applicable for evaluation of the efficacy of different anti-biofilm treatments used in the orthopaedic setting. Summing up, the protocol here described is a valid and inexpensive method for the study of microbial biofilm on prosthetic implant materials. PMID:26927075

  15. Relevance of World Health Organization surgical safety checklist to trauma and orthopaedic surgery.

    Science.gov (United States)

    Munigangaiah, Sudarshan; Sayana, Murali K; Lenehan, Brian

    2012-10-01

    Surgery like civil aviation is a risk-prone occupation. Civil Aviation has reported a death rate of less than 1 in a million exposures. On the other hand, surgery has a reported mortality rate of 100 per million surgeries. The National Reporting and Learning System (NRLS) database in England reported 152,017 'incidents' occurred during 4.2 million surgeries in 2008. Trauma and orthopaedic surgery accounted for 32.4 percent of these 'incidents'. Wrong-site surgery occurred in a total of 133 patients, with an incidence of 31.6 per million surgeries. A system to implement and maintain safe surgical practice is mandatory to prevent these 'incidents'. The factors identified in the genesis of these incidents are errors in decision making, lack of communication, leadership and teamwork. These human errors can easily be prevented using a formal structured communication, like the checklists. In 2008, the WHO published a set of guidelines to ensure the safety of surgical patients. In 2009, the checklist was modified with an intention to reduce major surgical complications and was proved to be effective. Wrong level spinal surgery needs special emphasis. There may be an increasing role for checklists in Trauma and Orthopaedic surgical practice to improve its safety profile by being procedure-specific. PMID:23162951

  16. Occupational hazards for pregnant or lactating women in the orthopaedic operating room.

    Science.gov (United States)

    Downes, Jessica; Rauk, Philip N; Vanheest, Ann E

    2014-05-01

    Pregnant or lactating staff working in the orthopaedic operating room may be at risk of occupational exposure to several hazards, including blood-borne pathogens, anesthetic gases, methylmethacrylate, physical stress, and radiation. Because the use of proper personal protective equipment is mandatory, the risk of contamination with blood-borne pathogens such as hepatitis B, hepatitis C, and HIV is low. Moreover, effective postexposure prophylactic regimens are available for hepatitis B and HIV. In the 1960s, concerns were raised about occupational exposure to harmful chemicals in the operating room such as anesthetic gases and methylmethacrylate. Guidelines on safe levels of exposure to these chemicals and the use of personal protective equipment have helped to minimize the risks to pregnant or lactating staff. Short periods of moderate physical activity are beneficial for pregnant women, but prolonged strenuous activity can lead to increased pregnancy complications. The risk of prenatal radiation exposure during orthopaedic procedures is of concern, as well. However, proper lead protection and contamination control can minimize the risk of occupational exposure to radiation. PMID:24788448

  17. The impact of ice-skating injuries on orthopaedic admissions in a regional hospital.

    LENUS (Irish Health Repository)

    Dillon, J P

    2012-02-03

    Since the opening of a temporary ice-rink in our hospital\\'s catchment area, we have observed an increase in patients requiring in-patient treatment for orthopaedic intervention. The authors performed a prospective analysis of all patients admitted to our unit over a one-month period. Epidemiological data, wearing of protective gear and skater experience were collected. Fracture type, treatment required, average length of hospital stay and number of days missed from work was also recorded. Ice-skating injuries accounted for 7.7% of our total admissions over the study period. There was a significant variation noted in the types of fracture sustained ranging from comminuted fractures of the radial head to spiral fractures of the tibia. The average length of hospital stay was 2.6 days and average time missed from work was 6.1 weeks. This paper highlights the potential serious injuries that can occur in ice-skating and their impact on admissions to our orthopaedic unit.

  18. Attitudes towards chiropractic: an analysis of written comments from a survey of north american orthopaedic surgeons

    Directory of Open Access Journals (Sweden)

    Busse Jason W

    2011-10-01

    Full Text Available Abstract Background There is increasing interest by chiropractors in North America regarding integration into mainstream healthcare; however, there is limited information about attitudes towards the profession among conventional healthcare providers, including orthopaedic surgeons. Methods We administered a 43-item cross-sectional survey to 1000 Canadian and American orthopaedic surgeons that inquired about demographic variables and their attitudes towards chiropractic. Our survey included an option for respondants to include written comments, and our present analysis is restricted to these comments. Two reviewers, independantly and in duplicate, coded all written comments using thematic analysis. Results 487 surgeons completed the survey (response rate 49%, and 174 provided written comments. Our analysis revealed 8 themes and 24 sub-themes represented in surgeons' comments. Reported themes were: variability amongst chiropractors (n = 55; concerns with chiropractic treatment (n = 54; areas where chiropractic is perceived as effective (n = 43; unethical behavior (n = 43; patient interaction (n = 36; the scientific basis of chiropractic (n = 26; personal experiences with chiropractic (n = 21; and chiropractic training (n = 18. Common sub-themes endorsed by surgeon's were diversity within the chiropractic profession as a barrier to increased interprofessional collaboration, endorsement for chiropractic treatment of musculoskeletal complaints, criticism for treatment of non-musculoskeletal complaints, and concern over whether chiropractic care was evidence-based. Conclusions Our analysis identified a number of issues that will have to be considered by the chiropractic profession as part of its efforts to further integrate chiropractic into mainstream healthcare.

  19. Irish (Republic) versus British (North West) orthopaedic trainees: what are the differences?

    LENUS (Irish Health Repository)

    Banks, L N

    2012-02-01

    British Trainees have gradually had their working week curtained over the last 8 years. The Republic of Ireland Trainees have not been subjected to the European Working Time Directive prior to 2009 and have therefore worked on average, more hours than their British counterparts. We wanted to see if the differing schemes had an impact on recruiting and training orthopaedic surgeons. We surveyed Republic of Ireland orthopaedic specialist registrars (SpRs) and North West (NW) British SpRs\\/specialist trainees (ST3 and above) to see if there were any discernable differences in working patterns and subsequent training exposure. A standard proforma was given to Irish Trainees and to NW SpRs\\/STs at their National or regional teaching (January\\/February 2009). 62% of Irish and 47% of British NW Trainees responded. Irish trainees were more likely to have obtained a post-graduate degree (p = 0.03). The Irish worked more hours per week (p < 0.001) doing more trauma operative lists (p = 0.003) and more total cases per 6 months than the NW British (p = 0.003). This study suggests that more hours worked, equals more operative exposure, without detriment to the academic side of training. Obviously it is not possible to say whether fewer operations make for a poorer surgeon, but the evidence suggests that it may be true.

  20. Mesenchymal stem cell interaction with ultra-smooth nanostructured diamond for wear-resistant orthopaedic implants.

    Science.gov (United States)

    Clem, William C; Chowdhury, Shafiul; Catledge, Shane A; Weimer, Jeffrey J; Shaikh, Faheem M; Hennessy, Kristin M; Konovalov, Valery V; Hill, Michael R; Waterfeld, Alfred; Bellis, Susan L; Vohra, Yogesh K

    2008-01-01

    Ultra-smooth nanostructured diamond (USND) can be applied to greatly increase the wear resistance of orthopaedic implants over conventional designs. Herein we describe surface modification techniques and cytocompatibility studies performed on this new material. We report that hydrogen (H)-terminated USND surfaces supported robust mesenchymal stem cell (MSC) adhesion and survival, while oxygen- (O) and fluorine (F)-terminated surfaces resisted cell adhesion, indicating that USND can be modified to either promote or prevent cell/biomaterial interactions. Given the favorable cell response to H-terminated USND, this material was further compared with two commonly used biocompatible metals, titanium alloy (Ti-6Al-4V) and cobalt chrome (CoCrMo). MSC adhesion and proliferation were significantly improved on USND compared with CoCrMo, although cell adhesion was greatest on Ti-6Al-4V. Comparable amounts of the pro-adhesive protein, fibronectin, were deposited from serum on the three substrates. Finally, MSCs were induced to undergo osteoblastic differentiation on the three materials, and deposition of a mineralized matrix was quantified. Similar amounts of mineral were deposited onto USND and CoCrMo, whereas mineral deposition was slightly higher on Ti-6Al-4V. When coupled with recently published wear studies, these in vitro results suggest that USND has the potential to reduce debris particle release from orthopaedic implants without compromising osseointegration. PMID:18490051

  1. Quality and Safety in Orthopaedics: Learning and Teaching at the Same Time: AOA Critical Issues.

    Science.gov (United States)

    Black, Kevin P; Armstrong, April D; Hutzler, Lorraine; Egol, Kenneth A

    2015-11-01

    Increasing attention has been placed on providing higher quality and safer patient care. This requires the development of a new set of competencies to better understand and navigate the system and lead the orthopaedic team. While still trying to learn and develop these competencies, the academic orthopaedist is also expected to model and teach them.The orthopaedic surgeon must understand what is being measured and why, both for purposes of providing better care and to eliminate unnecessary expense in the system. Metrics currently include hospital-acquired conditions, "never events," and thirty-day readmission rates. More will undoubtedly follow.Although commitment and excellence at the individual level are essential, the orthopaedist must think at the systems level to provide the highest value of care. A work culture characterized by respect and trust is essential to improved communication, teamwork, and confidential peer review. An increasing number of resources, both in print and electronic format, are available for us to understand what we can do now to improve quality and safety.Resident education in quality and safety is a fundamental component of the systems-based practice competency, the Next Accreditation System, and the Clinical Learning Environment Review. This needs to be longitudinally integrated into the curriculum and applied parallel to the development of resident knowledge and skill, and will be best learned if resident learning is experiential and taught within a genuine culture of quality and safety. PMID:26537169

  2. How HIV Causes AIDS

    Science.gov (United States)

    ... Share this: Main Content Area How HIV Causes AIDS HIV destroys CD4 positive (CD4+) T cells, which ... and disease, ultimately resulting in the development of AIDS. Most people who are infected with HIV can ...

  3. HIV/AIDS Basics

    Science.gov (United States)

    ... Providers Prevention Resources Newsletter Get Tested Find an HIV testing site near you. Enter ZIP code or ... AIDS Get Email Updates on AAA Anonymous Feedback HIV/AIDS Media Infographics Syndicated Content Podcasts Slide Sets ...

  4. Aids for visual impairment.

    OpenAIRE

    Dudley, N. J.

    1990-01-01

    This article provides only a flavour of the type and range of aids available to the visually impaired person. Many other aids for leisure, learning, and daily living are illustrated in the RNIB equipment and games catalogue.

  5. AIDS Myths and Misunderstandings

    Science.gov (United States)

    ... 2014 Select a Language: Fact Sheet 158 AIDS Myths and Misunderstandings WHY ARE THERE SO MANY AIDS ... sweat, saliva or urine of an infected person. Myth: A pregnant woman with HIV infection always infects ...

  6. First Aid: Influenza (Flu)

    Science.gov (United States)

    ... Smoothie Pregnant? Your Baby's Growth First Aid: The Flu KidsHealth > For Parents > First Aid: The Flu Print ... tiredness What to Do If Your Child Has Flu Symptoms: Call your doctor. Encourage rest. Keep your ...

  7. First Aid and Safety

    Science.gov (United States)

    ... Things to Know About Zika & Pregnancy First Aid & Safety Keeping your child safe is your top priority. ... to call for help, and more. First Aid & Safety Center Home Sweet Home A Safe and Spooktacular ...

  8. MICROFICHE AIDS DATA

    Science.gov (United States)

    This data set contains counts of AIDS (Acquired Immune Deficiency Syndrome) cases reported to state and local health departments, by demographics; case-definition; HIV exposure group (risk factors for AIDS); Half-year of diagnosis, report, and death.

  9. Head injury - first aid

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000028.htm Head injury - first aid To use the sharing features on this page, ... a concussion can range from mild to severe. First Aid Learning to recognize a serious head injury and ...

  10. Drug abuse first aid

    Science.gov (United States)

    ... medlineplus.gov/ency/article/000016.htm Drug abuse first aid To use the sharing features on this page, ... Diarrhea Hallucinations Nausea and vomiting Restlessness Shaking Death First Aid 1. Check the patient's airway, breathing, and pulse. ...

  11. Poisoning first aid

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    ... page: //medlineplus.gov/ency/article/007579.htm Poisoning first aid To use the sharing features on this page, ... or burns Stupor Unconsciousness Unusual breath odor Weakness First Aid Seek immediate medical help. For poisoning by swallowing: ...

  12. Frostbite, First Aid

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Frostbite, First Aid A A A Severe frostbite can result in ... became frozen). Frostbite is often associated with hypothermia. First Aid Guide In the case of mild frostbite, the ...

  13. Jellyfish Stings, First Aid

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    ... rashes clinical tools newsletter | contact Share | Jellyfish Stings, First Aid A A A The rash caused by a ... to Portuguese man-of-war stings as well. First Aid Guide The rescuer should take care to avoid ...

  14. Unconsciousness, First Aid

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    ... and rashes clinical tools newsletter | contact Share | Unconsciousness, First Aid A A A Unconsciousness signs and symptoms can ... keep the airway clear while awaiting medical care. First Aid Guide If you find an unconscious person, try ...

  15. Tick Bites, First Aid

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    ... rashes clinical tools newsletter | contact Share | Tick Bites, First Aid A A A It is important to inspect ... temporary paralysis in their host (called tick paralysis). First Aid Guide To remove an embedded tick: Wash your ...

  16. Heat Cramps, First Aid

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    ... rashes clinical tools newsletter | contact Share | Heat Cramps, First Aid A A A Heat cramp signs and symptoms ... if later stages of heat illness are suspected. First Aid Guide Use a combination of the following measures, ...

  17. Blisters, First Aid

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    ... and rashes clinical tools newsletter | contact Share | Blisters, First Aid A A A Blisters on the feet are ... can also be found via the Disease List. First Aid Guide Blisters often go away on their own ...

  18. Heatstroke, First Aid

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    ... and rashes clinical tools newsletter | contact Share | Heatstroke, First Aid A A A Heatstroke signs and symptoms can ... specific to the earlier stages of heat illness. First Aid Guide When heatstroke is suspected, seek emergency medical ...

  19. Heat Exhaustion, First Aid

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    ... rashes clinical tools newsletter | contact Share | Heat Exhaustion, First Aid A A A Heat exhaustion signs and symptoms ... specific to the other stages of heat illness. First Aid Guide Use a combination of the following measures ...

  20. First aid kit

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001958.htm First aid kit To use the sharing features on this ... ahead, you can create a well-stocked home first aid kit. Keep all of your supplies in one ...

  1. Head Trauma, First Aid

    Science.gov (United States)

    ... rashes clinical tools newsletter | contact Share | Head Trauma, First Aid A A A Head trauma signs and symptoms ... to take care for potential neck/spinal injury. First Aid Guide If you suspect either a serious head ...

  2. Bruises, First Aid

    Science.gov (United States)

    ... and rashes clinical tools newsletter | contact Share | Bruises, First Aid A A A Bruises lighten and change color ... Bruises can be a sign of internal bleeding. First Aid Guide If there is external bleeding in addition ...

  3. Fiscal effects of aid

    OpenAIRE

    Timmis, Emilija

    2015-01-01

    This thesis analyses fiscal effects of aid, first of health aid on health spending for a sample of developing countries and then broadly for Ethiopia and Tanzania. Particular attention is paid to data quality and the severe difficulties in achieving a reliable disaggregation of aid into its on-budget and off-budget components. The first essay assesses the sensitivity of estimated health aid fungibility to how the missing data (often considerable) are treated and explores a novel (at least in...

  4. Studying Aid: Some Methods

    OpenAIRE

    Gasper, Des

    2003-01-01

    textabstractINVESTIGATING IDEAS, IDEOLOGIES AND PRACTICES This paper presents some methods for trying to make sense of international aid and of its study.1 Some of the methods may be deemed ethnographic; the others are important partners to them, but rather different. In the course of discussing questions of aid policy and practice—such as: Should international development aid exist at all? How should aid be conducted? Should humanitarian relief be provided in conflict situations when it can ...

  5. Aid and Development

    OpenAIRE

    Tarp, Finn

    2006-01-01

    Foreign aid looms large in the public discourse; and international development assistance remains squarely on most policy agendas concerned with growth, poverty and inequality in Africa and elsewhere in the developing world. The present review takes a retrospective look at how foreign aid has evolved since World War II in response to a dramatically changing global political and economic context. I review the aid process and associated trends in the volume and distribution of aid and categoriz...

  6. First Aid: Falls

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Falls KidsHealth > For Parents > First Aid: Falls Print A A A Text Size en ... Floors, Doors & Windows, Furniture, Stairways: Household Safety Checklist First Aid: Broken Bones Head Injuries Preventing Children's Sports Injuries ...

  7. First Aid: Rashes

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Rashes KidsHealth > For Parents > First Aid: Rashes Print A A A Text Size Rashes ... For Kids For Parents MORE ON THIS TOPIC First Aid: Skin Infections Poison Ivy Erythema Multiforme Hives (Urticaria) ...

  8. First Aid: Dehydration

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Dehydration KidsHealth > For Parents > First Aid: Dehydration Print A A A Text Size Dehydration ... MORE ON THIS TOPIC Summer Safety Heat Illness First Aid: Heat Illness Sun Safety Dehydration Diarrhea Vomiting Word! ...

  9. First Aid: Burns

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Text Size Scald ... THIS TOPIC Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns Household Safety: Preventing ...

  10. First Aid: Choking

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Choking KidsHealth > For Parents > First Aid: Choking Print A A A Text Size Choking ... usually are taught as part of any basic first-aid course. Reviewed by: Steven Dowshen, MD Date reviewed: ...

  11. First Aid: Animal Bites

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Animal Bites KidsHealth > For Parents > First Aid: Animal Bites Print A A A Text Size ... For Kids For Parents MORE ON THIS TOPIC First Aid & Safety Center Infections That Pets Carry Dealing With ...

  12. First Aid: Croup

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Croup KidsHealth > For Parents > First Aid: Croup Print A A A Text Size Croup ... For Kids For Parents MORE ON THIS TOPIC First Aid: Coughing X-Ray Exam: Neck Why Is Hand ...

  13. The Impact of Early Infant Jaw-Orthopaedics on Early Speech Production in Toddlers with Unilateral Cleft Lip and Palate

    Science.gov (United States)

    Lohmander, Anette; Lillvik, Malin; Friede, Hans

    2004-01-01

    The purpose of study was to investigate the impact of pre-surgical Infant Orthopaedics (IO) on consonant production at 18 months of age in children with Unilateral Cleft Lip and Palate (UCLP) and to compare the consonant production to that of age-matched children without clefts. The first ten children in a consecutive series of 20 with UCLP…

  14. Questionnaire for usability evaluation of orthopaedic shoes : Construction and reliability in patients with degenerative disorders of the foot

    NARCIS (Netherlands)

    Jannink, MJA; de Vries, J; Stewart, RE; Groothoff, JW; Lankhorst, GJ

    2004-01-01

    Objective: To develop a self-report questionnaire for patients with degenerative disorders of the foot to evaluate the usability of their orthopaedic shoes, and to assess the reproducibility and responsiveness of the instrument. Design: Development of the Questionnaire for Usability Evaluation of or

  15. The value of nasal mupirocin in containing an outbreak of methicillin- resistant Staphylococcus aureus in an orthopaedic unit

    NARCIS (Netherlands)

    S.P. Barrett

    1990-01-01

    textabstractAn outbreak of methicillin-resistant Staphylococcus aureus (MRSA) occurred in two adjacent orthopaedic wards following the admission of a known carrier. The outbreak was not contained by ward closure or by standard infection control measures. Eventually several nasal carriers were identi

  16. Aid with Multiple Personalities

    OpenAIRE

    Djankov, Simeon; Jose G. Montalvo; Reynal-Querol, Marta

    2009-01-01

    The existing research on foreign aid offers inconclusive evidence on the factors that make aid effective. In this paper, we study the supply of aid money in 112 developing countries over the period 1960-1999 and find that the presence of multiple donors in a given country renders aid less effective. In particular, an aid-receiving country at the median of the donor fractionalization distribution will grow one percentage point faster than a country at the 75th percentile. This is in part becau...

  17. Why foreign aid fails

    Directory of Open Access Journals (Sweden)

    Prokopijević Miroslav

    2007-01-01

    Full Text Available The main point of this paper is that foreign aid fails because the structure of its incentives resembles that of central planning. Aid is not only ineffective, it is arguably counterproductive. Contrary to business firms that are paid by those they are supposed to serve (customers, aid agencies are paid by tax payers of developed countries and not by those they serve. This inverse structure of incentives breaks the stream of pressure that exists on the commercial market. It also creates larger loopholes in the principle-agent relationship on each point along the chain of aid delivery. Both factors enhance corruption, moral hazard and negative selection. Instead of promoting development, aid extends the life of bad institutions and those in power. Proposals to reform foreign aid – like aid privatization and aid conditionality – do not change the existing structure of the incentives in aid delivery, and their implementation may just slightly improve aid efficacy. Larger improvement is not possible. For that reason, foreign aid will continue to be a waste of resources, probably serving some objectives different to those that are usually mentioned, like recipient’s development poverty reduction and pain relief.

  18. Conditional Aid Effectiveness

    DEFF Research Database (Denmark)

    Doucouliagos, Hristos; Paldam, Martin

    The AEL (aid effectiveness literature) studies the effect of development aid using econometrics on macro data. It contains about 100 papers of which a third analyzes conditional models where aid effectiveness depends upon z, so that aid only works for a certain range of the variable. The key term...... in this family of AEL models is thus an interaction term of z times aid. The leading candidates for z are a good policy index and aid itself. In this paper, meta-analysis techniques are used (i) to determine whether the AEL has established the said interaction terms, and (ii) to identify some of the...... determinants of the differences in results between studies. Taking all available studies in consideration, we find no support for conditionality with respect to policy, while conditionality regarding aid itself is dubious. However, the results differ depending on the authors’ institutional affiliation....

  19. China vs. AIDS

    Institute of Scientific and Technical Information of China (English)

    LURUCAI

    2004-01-01

    CHINA's first HIV positive diagnosis was in 1985, the victim an ArgentineAmerican. At that time most Chinese,medical workers included, thought of AIDS as a phenomenon occurring outside of China. Twenty years later, the number of HIV/AIDS patients has risen alarmingly. In 2003, the Chinese Ministry of Health launched an AIDS Epidemiological Investigation across China with the support of the WHO and UN AIDS Program. Its results show that there are currently 840,000 HIV carriers, including 80,000 people with full-blown AIDS, in 31 Chinese provinces, municipalities and autonomous regions. This means China has the second highest number of HIV/AIDS cases in Asia and 14th highest in the world. Statistics from the Chinese Venereal Disease and AIDS Prevention Association indicate that the majority of Chinese HIV carriers are young to middle aged, more than half of them between the ages of 20 and 29.

  20. The surgeon and his tools-the case for a focused orthopaedic theatre induction programme

    Directory of Open Access Journals (Sweden)

    Wong Shaun KS

    2008-10-01

    Full Text Available Abstract Background Induction programme for trainee doctors in the UK generally do not focus on the surgical aspects of their jobs. In this context we decided to conduct a telephonic survey among the hospitals belonging to three orthopaedic training regions in the UK from the point of view of the diversity of instrumentations and implants used for index procedures. Results We chose four index trauma & orthopaedic procedures (Total hip replacement, total knee replacement, intramedullary nailing and external fixator systems for long bone fractures. A telephonic survey was done in six NHS trust hospitals which were part of an orthopaedic training rotation (2 from England, 2 from Wales and 2 from Scotland. In total there were 39 different instrumentation systems for these 4 index procedures in the 6 trusts (see table 1. These comprise 12 Total hip replacement (THR systems, 14 total knee replacement (TKR systems, 9 intra-medullary nailing systems, and 4 external fixator systems. The number of different systems for each trust ranged from 7 to 19. There is a vast array of implants and instrumentation systems in each trust, as highlighted by our survey. The surgical tools are not the same in each hospitals. This situation is more complicated when trainees move to new hospitals as part of training rotations. Table 1 Number of implants/instrumentations used in each of the 6 UK trusts (3 training regions. IMPLANT E1 E2 W1 W2 S1 S2 Total Knee Replacement 4 5 2 4 3 2 Total Hip Replacement 3 4 3 6 3 3 Intramnedullary nailing 2 1 1 6 2 3 External fixators 2 3 2 2 1 1 TOTAL 11 13 8 18 9 9 E = England, W = Wales, S = Scotland Conclusion In view of this we feel that more focused theatre based induction programmes for higher surgical trainees is advocated in each hospital trust so trainees can familiarise themselves with the tools available to them. This could include discussion with the consultants and senior theatre staff along with representatives from the

  1. HIV, AIDS, and the Future

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV, AIDS, and the Future Past Issues / Summer 2009 Table ... and your loved ones from HIV/AIDS. The AIDS Memorial Quilt In 1987, a total of 1, ...

  2. Solid phase extraction of Cd(II) and Pb(II) ions based on a novel functionalized Fe3O4@ SiO2 core-shell nanoparticles with the aid of multivariate optimization methodology.

    Science.gov (United States)

    Tadjarodi, Azadeh; Abbaszadeh, Abolfazl; Taghizadeh, Mohsen; Shekari, Nafiseh; Asgharinezhad, Ali Akbar

    2015-04-01

    This work describes novel Fe3O4@SiO2 core-shell nanoparticles functionalized with phenyl isothiocyanate and its application in the preconcentration of Cd(II) and Pb(II) ions. The parameters affecting the preconcentration procedure were optimized by a Box-Behnken design through response surface methodology. Three variables (extraction time, magnetic sorbent amount, and pH value) were selected as the main factors affecting the sorption step, while four variables (type, volume and concentration of the eluent; and elution time) were selected as effective factors of elution step in the optimization study. Following the sorption and elution, the ions were quantified by FAAS. The limits of detection were 0.05 and 0.9ngmL(-1) for Cd(II) and Pb(II) ions, respectively. The relative standard deviations were less than 6.4%. The sorption capacity (in mg g(-1)) of this new sorbent is 179 for Cd(II) and 156 for Pb(II). Finally, this nanocomposite was successfully applied to the rapid extraction of trace quantities of heavy metal ions from fish, sediment, soil, and water samples and satisfactory results were obtained. PMID:25686967

  3. The sheep as a large osteoporotic model for orthopaedic research in humans

    DEFF Research Database (Denmark)

    Cheng, L.; Ding, Ming; Li, Z.;

    2008-01-01

    Although small animals as rodents are very popular animals for osteoporosis models , large animals models are necessary for research of human osteoporotic diseases. Sheep osteoporosis models are becoming more important because of its unique advantages for osteoporosis reseach. Sheep are docile in...... nature and large in size , which facilitates obtaining blood samples , urine samples and bone tissue samples for different biochemical tests and histological tests , and surgical manipulation and instrument examinations. Their physiology is similar to humans. To induce osteoporosis , OVX and calcium...... fracture. However , to be used as the most ideal animal for osteoporosis model , some researches need to be done for sheep. Here , we review the use of sheep as an animal model for human orthopaedic diseases. Udgivelsesdato: June...

  4. Effect of clinical specialist physiotherapists in orthopaedic diagnostic setting - A systematic review

    DEFF Research Database (Denmark)

    Trøstrup, Jeanette; Juhl, Carsten; Mikkelsen, Lone Ramer

    2016-01-01

    Relevance: Patients with musculoskeletal complaints are commonly referred to orthopaedic surgeons (OS) with 20 % of patients in primary care being referred to OS consultation. A high proportion of these referrals is not relevant for surgery and can potentially be managed entirely by physiotherapist...... with advanced clinical competencies; Clinical Specialist Physiotherapists (CSP). The use of CSPs instead of OSs to perform diagnostic assessment of patients with musculoskeletal complaints has been implemented in several countries (1). Earlier systematic reviews have evaluated CSPs effectiveness in diagnosing...... and patient satisfaction. Results should be managed cautiously as only a few of the included studies had high methodological quality and more high quality studies are needed. Impact and implications: As hospitals continuously are challenged with productivity demands, the physiotherapists’ abilities...

  5. A review of the use of common antiplatelet agents in orthopaedic practice.

    LENUS (Irish Health Repository)

    Dineen, P F

    2010-09-01

    Antiplatelet agents are widely prescribed for the primary and secondary prevention of cardiovascular events. A common clinical problem facing orthopaedic and trauma surgeons is how to manage patients receiving these agents who require surgery, either electively or following trauma. The dilemma is to balance the risk of increased blood loss if the antiplatelet agents are continued peri-operatively against the risk of coronary artery\\/stent thrombosis and\\/or other vascular event if the drugs are stopped. The traditional approach of stopping these medications up to two weeks before surgery appears to pose significant danger to patients and may require review. This paper covers the important aspects regarding the two most commonly prescribed antiplatelet agents, aspirin and clopidogrel.

  6. High-tech and low-tech orthopaedic surgery in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Bauer Heike I

    2002-02-01

    Full Text Available Abstract Background Zambia's governmental health system suffers from shortage of surgical supplies and poor management skills for the sparse resources at hand. The situation has been worsened by the dual epidemics of HIV disease and tuberculosis. On the other hand the private medical sector has benefited greatly from less bureaucracy under the goverment of the Movement for Multi-party Democracy. Discussion The Zambian-Italian Orthopaedic Hospital in Lusaka is a well organized small unit providing free treatment of physically disabled children. The running costs are met from the fees charged for private consultations, supplemented by donations. State of the art surgical techniques are being used for congenital and acquired musculo-skeletal abnormalities. Last year 513 patients were operated upon free of charge and 320 operations were performed on private patients.

  7. Emil Theodor Kocher (1841-1917)--orthopaedic surgeon and the first surgeon Nobel Prize winner.

    Science.gov (United States)

    Bumbasirević, Marko Z; Zagorac, Slavisa G; Lesić, Aleksandar R

    2013-01-01

    Theodor Emil Kocher (1841-1917), born in Bern, educated in many universities in Europe. Kocher as many surgeons of that time performed orthopedic surgery, general surgery, neurosurgery and endocrine surgery, but he become famous in orthopaedic surgery and endocrine surgery. He is remember as a surgeon who described the approach to the hip joint, elbow joint, maneuver for the reduction of dislocated shoulder joint. He introduced many instruments and many of them, such as Kocher clamp is still in use. Most important Kocher work was the thyroid gland surgery, and he received the Nobel Prize for Medicine in 1909, for-in this matter. His nature of meticulous surgeon, scientific and hard working person, dedicated to his patients and students made- found him the place in a history of medicine. PMID:24669574

  8. Next Generation Orthopaedic Implants by Additive Manufacturing Using Electron Beam Melting

    Directory of Open Access Journals (Sweden)

    Lawrence E. Murr

    2012-01-01

    Full Text Available This paper presents some examples of knee and hip implant components containing porous structures and fabricated in monolithic forms utilizing electron beam melting (EBM. In addition, utilizing stiffness or relative stiffness versus relative density design plots for open-cellular structures (mesh and foam components of Ti-6Al-4V and Co-29Cr-6Mo alloy fabricated by EBM, it is demonstrated that stiffness-compatible implants can be fabricated for optimal stress shielding for bone regimes as well as bone cell ingrowth. Implications for the fabrication of patient-specific, monolithic, multifunctional orthopaedic implants using EBM are described along with microstructures and mechanical properties characteristic of both Ti-6Al-4V and Co-29Cr-6Mo alloy prototypes, including both solid and open-cellular prototypes manufactured by additive manufacturing (AM using EBM.

  9. Microbial colonisation of orthopaedic tourniquets: A potential risk for surgical site infection

    Directory of Open Access Journals (Sweden)

    S K Sahu

    2015-01-01

    Full Text Available Pneumatic tourniquets have been used in orthopaedic surgery to get avascular fields. Sixteen such tourniquets were analysed for microbial colonisation. Samples were taken from two inner and two outer areas of each tourniquet and cultured on sheep blood agar. Eight of these were wiped with Savlon and the rest with Sterillium solution. Post-treatment samples from the same sites were again cultured. After incubation, colonies from each site were identified and counted. It was observed that the tourniquets were colonised with coagulase-negative staphylococci, Staphylococcus aureus, Bacillus, diphtheroids, Pseudomonas, Acinetobacter, enterococci, enterobacteria, and Candida. On treating with Savlon and Sterillium, there was 92.18% and 95.70% reduction in the colony count, respectively.

  10. Emil Theodor Kocher (1841-1917: Orthopaedic surgeon and the first surgeon Nobel Prize winner

    Directory of Open Access Journals (Sweden)

    Bumbaširević Marko Ž.

    2013-01-01

    Full Text Available Theodor Emil Kocher (1841-1917 was born in Bern and educated in several universities in Europe. Like many surgeons of that time, Kocher performed orthopaedic surgery, general surgery, neurosurgery and endocrine surgery and became famous in many fields. He is remembered for his description of a new approach to the hip joint and elbow joint, as well as a maneuver for reduction of dislocated shoulder joints. He introduced many instruments and some of them, such as the Kocher clamp are still in use. His most important contribution was thyroid gland surgery, and he received the Nobel Prize for Medicine in 1909, for this advancement. He was a scientific, hard working meticulous surgeon, dedicated to his patients and students, which found him a place in the history of medicine.

  11. Diagnostic classification and orthopaedic physical therapy practice: what we can learn from medicine.

    Science.gov (United States)

    Zimny, Nancy J

    2004-03-01

    Concepts of diagnosis and classification have a long history in medicine, while formal schemes of diagnostic classification in physical therapy are relatively new. Basic differences exist between medicine and physical therapy in the phenomena which are diagnosed and classified. However, similarities in the diagnostic and classification process provide an opportunity to learn from medicine as the process now evolves in physical therapy. This paper provides a brief history of the development of the concept of diagnostic classification in medicine and physical therapy. Difficulties associated with the process are described. Knowledge of these difficulties is used to analyze some of the evolving concepts of diagnostic classification in physical therapy, especially those related to orthopaedic physical therapy practice. PMID:15089023

  12. Intimate partner violence and Musculoskeletal injury: bridging the knowledge gap in Orthopaedic fracture clinics

    Directory of Open Access Journals (Sweden)

    Sprague Sheila

    2013-01-01

    Full Text Available Abstract Intimate partner violence (IPV is a serious health issue. There have been widespread research efforts in the area of IPV over the past several decades, primarily focusing on obstetrics, emergency medicine, and primary care settings. Until recently there has been a paucity of research focusing on IPV in surgery, and thus a resultant knowledge gap. Renewed interest in the underlying risk of IPV among women with musculoskeletal injuries has fueled several important studies to determine the nature and scope of this issue in orthopaedic surgery. Our review summarizes the evidence from surgical research in the field of IPV and provides recommendations for developing and evaluating an IPV identification and support program and opportunities for future research.

  13. Should probenecid be used to reduce the dicloxacillin dosage in orthopaedic infections?

    DEFF Research Database (Denmark)

    Krogsgaard, M R; Hansen, B A; Slotsbjerg, T;

    1994-01-01

    Reduction in the dosage of dicloxacillin from 500 mg to 250 mg 3 times a day would mean lowering of costs and less side-effects in orthopaedic infections. In this cross-over study, the serum concentrations of dicloxacillin were measured in 9 patients after administration of dicloxacillin 500 mg 3...... times a day (dicloxacillin 500 mg) and after co-administration of 250 mg dicloxacillin and 250 mg probenecid 3 times per day (dicloxacillin 250 mg+probenecid 250 mg). Concentrations were measured every hour after the tablet intake. The mean maximum serum concentrations of dicloxacillin were 17.......1 micrograms/ml (dicloxacillin 500 mg) and 12.2 micrograms/ml (dicloxacillin 250 mg+probenecid 250 mg), respectively (P < 0.05). Serum concentrations above 3 micrograms/ml were obtained during 285 min. in both regimes, but the individual variations were biggest during in the dicloxacillin 250 mg+probenecid 250...

  14. Comparison of ropivacaine and bupivacaine as single-shot epidural anaesthesia for orthopaedic surgery

    International Nuclear Information System (INIS)

    To compare the efficacy and side-effects of 0.5% ropivacaine with that of 0.5% bupivacaine when used for single-shot epidural anaesthesia for orthopaedic surgery. Design: Randomized controlled trial. Place and Duration of Study: Department of Anesthesiology, Combined Military Hospital Rawalpindi, over a period of eight months from June 2013 to January 2014. Patients and Methods: The study was carried out in 60 ASA physical status I, II or III patients undergoing elective lower extremity orthopedic surgery. Two groups of 30 patients each received single-shot epidural anaesthesia either with ropivacaine 0.5% (ropivacaine group) or bupivacaine 0.5% (bupivacaine group). Onset, time for maximum height and median height of sensory block was assessed as well as time to two segment recession. Modified Bromage scale was used for motor blockade. Total duration of motor block and common side effects were also recorded. Results: The patients in both groups were similar in age, height, weight, gender and ASA status. There was no significant difference in onset of sensory block and time for maximum height of sensory block. The median heighest level of sensory block was T6 (T5-T8) for ropivacaine group and T5 (T4-T7) for bupivacaine group. Time for two segment regression and duration of sensory block were also comparable for both groups. The total duration of motor block was significantly more in bupivacaine group (159 min vs 134.2 min, p< 0.001). Modified Bromage scale was also significantly higher in bupivacaine group (2.86 vs 1.96 min, p<0.001). Side effects like hypotension, bradycardia, nausea, vomiting and shivering were similar in both groups. Conclusion: Epidural administration of 0.5% ropivacaine provided effective and good quality anaesthesia. Motor blockade was of less duration as compared to equivalent dose of 0.5% bupivacaine, which may offer potential benefit of early patient mobilization after orthopaedic surgery. (author)

  15. The link between texting and motor vehicle collision frequency in the orthopaedic trauma population

    Directory of Open Access Journals (Sweden)

    Neil M. Issar

    2013-07-01

    Full Text Available BACKGROUND: This study will evaluate whether or not texting frequency while driving and/or texting frequency in general are associated with an increased risk of incurring a motor vehicle collision (MVC resulting in orthopaedic trauma injuries. METHODS: All patients who presented to the Vanderbilt University Medical Center Orthopaedic Trauma Clinic were administered a questionnaire to determine background information, mean phone use, texting frequency, texting frequency while driving, and whether or not the injury was the result of an MVC in which the patient was driving. RESULTS: 237 questionnaires were collected. 60 were excluded due to incomplete date, leaving 57 questionnaires in the MVC group and 120 from patients with non-MVC injuries. Patients who sent more than 30 texts per week (“heavy texters” were 2.22 times more likely to be involved in an MVC than those who texted less frequently. 84% of respondents claimed to never text while driving. Dividing the sample into subsets on the basis of age (25 years of age or below considered “young adult,” and above 25 years of age considered “adult”,young, heavy texters were 6.76 times more likely to be involved in an MVC than adult non-heavy texters (p = 0.000. Similarly, young adult, non-heavy texters were 6.65 (p = 0.005 times more likely to be involved in an MVC, and adult, heavy texters were 1.72 (p = 0.186 times more likely to be involved in an MVC. CONCLUSIONS: Patients injured in an MVC sent more text messages per week than non-MVC patients. Additionally, controlling for age demonstrated that young age and heavy general texting frequency combined had the highest increase in MVC risk, with the former being the variable of greatest effect

  16. Nondestructive evaluation of orthopaedic implant stability in THA using highly nonlinear solitary waves

    Science.gov (United States)

    Yang, Jinkyu; Silvestro, Claudio; Sangiorgio, Sophia N.; Borkowski, Sean L.; Ebramzadeh, Edward; De Nardo, Luigi; Daraio, Chiara

    2012-01-01

    We propose a new biomedical sensing technique based on highly nonlinear solitary waves to assess orthopaedic implant stability in a nondestructive and efficient manner. We assemble a granular crystal actuator consisting of a one-dimensional tightly packed array of spherical particles, to generate acoustic solitary waves. Via direct contact with the specimen, we inject acoustic solitary waves into a biomedical prosthesis, and we nondestructively evaluate the mechanical integrity of the bone-prosthesis interface, studying the properties of the waves reflected from the contact zone between the granular crystal and the implant. The granular crystal contains a piezoelectric sensor to measure the travelling solitary waves, which allows it to function also as a sensor. We perform a feasibility study using total hip arthroplasty (THA) samples made of metallic stems implanted in artificial composite femurs using polymethylmethacrylate for fixation. We first evaluate the sensitivity of the proposed granular crystal sensor to various levels of prosthesis insertion into the composite femur. Then, we impose a sequence of harsh mechanical loading on the THA samples to degrade the mechanical integrity at the stem-cement interfaces, using a femoral load simulator that simulates aggressive, accelerated physiological loading. We investigate the implant stability via the granular crystal sensor-actuator during testing. Preliminary results suggest that the reflected waves respond sensitively to the degree of implant fixation. In particular, the granular crystal sensor-actuator successfully detects implant loosening at the stem-cement interface following violent cyclic loading. This study suggests that the granular crystal sensor and actuator has the potential to detect metal-cement defects in a nondestructive manner for orthopaedic applications.

  17. Rapid prototyping for patient-specific surgical orthopaedics guides: A systematic literature review.

    Science.gov (United States)

    Popescu, Diana; Laptoiu, Dan

    2016-06-01

    There has been a lot of hype surrounding the advantages to be gained from rapid prototyping processes in a number of fields, including medicine. Our literature review aims objectively to assess how effective patient-specific surgical guides manufactured using rapid prototyping are in a number of orthopaedic surgical applications. To this end, we carried out a systematic review to identify and analyse clinical and experimental literature studies in which rapid prototyping patient-specific surgical guides are used, focusing especially on those that entail quantifiable outcomes and, at the same time, providing details on the guides' design and type of manufacturing process. Here, it should be mentioned that in this field there are not yet medium- or long-term data, and no information on revisions. In the reviewed studies, the reported positive opinions on the use of rapid prototyping patient-specific surgical guides relate to the following main advantages: reduction in operating times, low costs and improvements in the accuracy of surgical interventions thanks to guides' personalisation. However, disadvantages and sources of errors which can cause patient-specific surgical guide failures are as well discussed by authors. Stereolithography is the main rapid prototyping process employed in these applications although fused deposition modelling or selective laser sintering processes can also satisfy the requirements of these applications in terms of material properties, manufacturing accuracy and construction time. Another of our findings was that individualised drill guides for spinal surgery are currently the favourite candidates for manufacture using rapid prototyping. Other emerging applications relate to complex orthopaedic surgery of the extremities: the forearm and foot. Several procedures such as osteotomies for radius malunions or tarsal coalition could become standard, thanks to the significant assistance provided by rapid prototyping patient-specific surgical

  18. A mutual-information-based registration algorithm for ultrasound-guided computer-assisted orthopaedic surgery

    Science.gov (United States)

    Chen, Thomas K.; Abolmaesumi, Purang

    2005-04-01

    This paper presents a novel approach and its preliminary laboratory results for the employment of ultrasound (US) imaging in intraoperative guidance of computer-assisted orthopaedic surgeries (CAOS). The goal is to register live intraoperative US images with preoperative surgical planning data using minimal number of images. Preoperatively, a set of 2D US images are acquired with the corresponding positional information of the US probe provided by an optical tracking system. Using calibration parameters, the position of every pixel in the acquired images is transformed into the world coordinate frame to construct a 3D volumetric representation of the targeted anatomy for surgical planning. Intraoperatively, the surgeon takes live US images from the patient with the position of the US probe tracked in real time. A mutual-information-based registration algorithm is then used to find the closest match to the live image in the preoperative US image database. Because the position of the preoperative image inside the US volume is known, we are able to register the preoperative US volume to the live image, thus to the patient. Experiments have shown the registration algorithm has sub-millimeter accuracy in localizing the best match between the intraoperative and pre-operative images, demonstrating great potential for orthopaedic surgery applications. This method has some significant advantages over the previously reported US-guided CAOS techniques: it requires no segmentation, and employs only a few intraoperative images to accurately and robustly localize the patient. Preliminary laboratory results on both a Sawbones model of a radius bone and human subjects are presented.

  19. An audit of consent for allograft use in elective orthopaedic surgery.

    Science.gov (United States)

    Mullan, C J; Pagoti, R; Davison, H; McAlinden, M G

    2016-04-01

    Introduction Patients receiving musculoskeletal allografts may be at risk of postoperative infection. The General Medical Council guidelines on consent highlight the importance of providing patients with the information they want or need on any proposed investigation or treatment, including any potential adverse outcomes. With the increased cost of defending medicolegal claims, it is paramount that adequate, clear informed patient consent be documented. Methods We retrospectively examined the patterns of informed consent for allograft bone use during elective orthopaedic procedures in a large unit with an onsite bone bank. The initial audit included patients operated over the course of 1 year. Following a feedback session, a re-audit was performed to identify improvements in practice. Results The case mix of both studies was very similar. Revision hip arthroplasty surgery constituted the major subgroup requiring allograft (48%), followed by foot and ankle surgery (16.3%) and revision knee arthroplasty surgery (11.4%) .On the initial audit, 17/45 cases (38%) had either adequate preoperative documentation of the outpatient discussion or an appropriately completed consent form on the planned use of allograft. On the re-audit, 44/78 cases (56%) had adequate pre-operative documentation. There was little correlation between how frequently a surgeon used allograft and the adequacy of consent (Correlation coefficient -0.12). Conclusions Although the risk of disease transmission with allograft may be variable, informed consent for allograft should be a routine part of preoperative discussions in elective orthopaedic surgery. Regular audit and feedback sessions may further improve consent documentation, alongside the targeting of high volume/low compliance surgeons. PMID:26924483

  20. To Assess Prerequisites Before an Implementation Strategy in an Orthopaedic Department in Sweden.

    Science.gov (United States)

    Bahtsevani, Christel; Idvall, Ewa

    2016-01-01

    Promoting Action on Research Implementation in Health Services (PARiHS) asserts that the success of knowledge implementation relates to multiple factors in a complex and dynamic way, and therefore the effects of implementation strategies vary by method and context. An instrument based on the PARiHS framework was developed to help assess critical factors influencing implementation strategies so that strategies can be tailored to promote implementation.The purpose of this study was to use the Evaluation Before Implementation Questionnaire (EBIQ), to describe staff perceptions in one orthopaedic department, and to investigate differences between wards.Staff members in four different wards at one orthopaedic department at a university hospital in Sweden were invited to complete a questionnaire related to planning for the implementation of a clinical practice guideline. The 23 items in the EBIQ were expected to capture staff perceptions about the evidence, context, and facilitation factors that influence the implementation process. Descriptive statistics and differences between wards were analyzed. Although the overall response rate was low (n = 49), two of the four wards accounted for most of the completed questionnaires (n = 25 and n = 12, respectively), enabling a comparison of these wards. We found significant differences between respondents' perceptions at the two wards in six items regarding context and facilitation in terms of receptiveness to change, forms of leadership, and evaluation and presence of feedback and facilitators.The EBIQ instrument requires further testing, but there appears to be initial support for pre-implementation use of the EBIQ as a means to enhance planning for implementation. PMID:27028686

  1. Aid Effectiveness on Growth

    DEFF Research Database (Denmark)

    Doucouliagos, Hristos; Paldam, Martin

    The AEL (aid effectiveness literature) is econo¬metric studies of the macroeconomic effects of development aid. It contains about 100 papers of which 68 are reduced form estimates of theeffect of aid on growth in the recipient country. The raw data show that growth is unconnected to aid, but the...... AEL has put so much structure on the data that all results possible have emerged. The present meta study considers both the best-set of the 68 papers and the all-set of 543 regressions published. Both sets have a positive average aid-growth elasticity, but it is small and insignificant: The AEL has...... not established that aid works. Using meta-regression analysis it is shown that about 20 factors influence the results. Much of the variation between studies is an artifact and can be attributed to publication outlet, institu¬tional affiliation, and specification differences. However, some of the...

  2. Aid and Growth

    DEFF Research Database (Denmark)

    Arndt, Channing; Jones, Edward Samuel; Tarp, Finn

    , are being drawn on the basis of fragile evidence. This paper first assesses the aid-growth literature with a focus on recent contributions. The aid-growth literature is then framed, for the first time, in terms of the Rubin Causal Model, applied at the macroeconomic level. Our results show that aid......The micro-macro paradox has been revived. Despite broadly positive evaluations at the micro and meso-levels, recent literature has turned decidedly pessimistic with respect to the ability of foreign aid to foster economic growth. Policy implications, such as the complete cessation of aid to Africa...... has a positive and statistically significant causal effect on growth over the long run with point estimates at levels suggested by growth theory. We conclude that aid remains an important tool for enhancing the development prospects of poor nations....

  3. Hearing Aids and Music

    OpenAIRE

    Chasin, Marshall; Russo, Frank A.

    2004-01-01

    Historically, the primary concern for hearing aid design and fitting is optimization for speech inputs. However, increasingly other types of inputs are being investigated and this is certainly the case for music. Whether the hearing aid wearer is a musician or merely someone who likes to listen to music, the electronic and electro-acoustic parameters described can be optimized for music as well as for speech. That is, a hearing aid optimally set for music can be optimally set for speech, even...

  4. Radiographic imaging of aids

    International Nuclear Information System (INIS)

    The acquired immunodeficiency syndrome (AIDS) has impacted the civilized world like no other disease. This research aimed to discuss some of the main aids-related complications and their detection by radiology tests, specifically central nervous system and musculoskeletal system disorders. The objectives are: to show specific characteristics of various diseases of HIV patient, to analyze the effect of pathology in patients by radiology, to enhance the knowledge of technologists in aids imaging and to improve communication skills between patient and radiology technologists

  5. Radiographic imaging of aids

    CERN Document Server

    Mahmoud, M B

    2002-01-01

    The acquired immunodeficiency syndrome (AIDS) has impacted the civilized world like no other disease. This research aimed to discuss some of the main aids-related complications and their detection by radiology tests, specifically central nervous system and musculoskeletal system disorders. The objectives are: to show specific characteristics of various diseases of HIV patient, to analyze the effect of pathology in patients by radiology, to enhance the knowledge of technologists in aids imaging and to improve communication skills between patient and radiology technologists.

  6. AIDS: acquired immunodeficiency syndrome

    OpenAIRE

    Gilmore, N. J.; Beaulieu, R.; Steben, M.; Laverdière, M.

    2002-01-01

    Acquired immunodeficiency syndrome, or AIDS, is a new illness that occurs in previously healthy individuals. It is characterized by immunodeficiency, opportunistic infections and unusual malignant diseases. Life-threatening single or multiple infections with viruses, mycobacteria, fungi or protozoa are common. A rare neoplasm, Kaposi's sarcoma, has developed in approximately one third of patients with AIDS. More than 800 cases of AIDS have been reported in North America, over 24 of them in Ca...

  7. Aid, growth, and development

    DEFF Research Database (Denmark)

    Arndt, Channing; Jones, Edward Samuel; Tarp, Finn

    2010-01-01

    The micro-macro paradox has been revived. Despite broadly positive evaluations at the micro- and meso-levels, recent literature doubts the ability of foreign aid to foster economic growth and development. This paper assesses the aid-growth literature and, taking inspiration from the program...... evaluation literature, we re-examine key hypotheses. In our findings, aid has a positive and statistically significant causal effect on growth over the long run, with confidence intervals conforming to levels suggested by growth theory. Aid remains a key tool for enhancing the development prospects of poor...

  8. Music and hearing aids.

    Science.gov (United States)

    Madsen, Sara M K; Moore, Brian C J

    2014-01-01

    The signal processing and fitting methods used for hearing aids have mainly been designed to optimize the intelligibility of speech. Little attention has been paid to the effectiveness of hearing aids for listening to music. Perhaps as a consequence, many hearing-aid users complain that they are not satisfied with their hearing aids when listening to music. This issue inspired the Internet-based survey presented here. The survey was designed to identify the nature and prevalence of problems associated with listening to live and reproduced music with hearing aids. Responses from 523 hearing-aid users to 21 multiple-choice questions are presented and analyzed, and the relationships between responses to questions regarding music and questions concerned with information about the respondents, their hearing aids, and their hearing loss are described. Large proportions of the respondents reported that they found their hearing aids to be helpful for listening to both live and reproduced music, although less so for the former. The survey also identified problems such as distortion, acoustic feedback, insufficient or excessive gain, unbalanced frequency response, and reduced tone quality. The results indicate that the enjoyment of listening to music with hearing aids could be improved by an increase of the input and output dynamic range, extension of the low-frequency response, and improvement of feedback cancellation and automatic gain control systems. PMID:25361601

  9. HIV / AIDS Network.

    Science.gov (United States)

    1995-01-01

    The HIV/AIDS Network and the Philippines Department of Health (DOH) collaborated to produce the AIDS Candlelight Memorial at the Philippine International Convention Center (PICC), May 1995, and World AIDS Day activities on December 1, 1995. After the memorial, a fashion show, "Body Shots," provided a channel for information on acquired immunodeficiency syndrome (AIDS). On World AIDS Day, at the request of DOH, the Network provided speakers who lectured on human immunodeficiency virus (HIV) and AIDS in different government offices. Prior to World AIDS Day, the Network focused on strengthening its cohesiveness and building the capabilities of its member organizations through lectures and symposia during November. Network activities were coordinated by the Remedios AIDS Foundation with support from the other members of the Coordinating Council: Health Action Information Network (HAIN); Caritas; Kabalikat, Stop Trafficking of Pilopinos Foundation, Inc. (STOP);and the Library Foundation (TLF). The Coordinating Council elected for 1996 includes the Remedios AIDS Foundation, HAIN, Caritas, TLF, STOP, the Foundation for Adolescent Development (FAD), and the Salvation Army. PMID:12291699

  10. AIDS is your business.

    Science.gov (United States)

    Rosen, Sydney; Simon, Jonathon; Vincent, Jeffrey R; MacLeod, William; Fox, Matthew; Thea, Donald M

    2003-02-01

    If your company operates in a developing country, AIDS is your business. While Africa has received the most attention, AIDS is also spreading swiftly in other parts of the world. Russia and Ukraine had the fastest-growing epidemics last year, and many experts believe China and India will suffer the next tidal wave of infection. Why should executives be concerned about AIDS? Because it is destroying the twin rationales of globalization strategy-cheap labor and fast-growing markets--in countries where people are heavily affected by the epidemic. Fortunately, investments in programs that prevent infection and provide treatment for employees who have HIV/AIDS are profitable for many businesses--that is, they lead to savings that outweigh the programs' costs. Due to the long latency period between HIV infection and the onset of AIDS symptoms, a company is not likely to see any of the costs of HIV/AIDS until five to ten years after an employee is infected. But executives can calculate the present value of epidemic-related costs by using the discount rate to weigh each cost according to its expected timing. That allows companies to think about expenses on HIV/AIDS prevention and treatment programs as investments rather than merely as costs. The authors found that the annual cost of AIDS to six corporations in South Africa and Botswana ranged from 0.4% to 5.9% of the wage bill. All six companies would have earned positive returns on their investments if they had provided employees with free treatment for HIV/AIDS in the form of highly active antiretroviral therapy (HAART), according to the mathematical model the authors used. The annual reduction in the AIDS "tax" would have been as much as 40.4%. The authors' conclusion? Fighting AIDS not only helps those infected; it also makes good business sense. PMID:12577655

  11. A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings

    OpenAIRE

    Norris, R.; Chapman, AWP; Krikler, S; Krkovic, M

    2013-01-01

    Introduction There has been recent interest in the use of negative pressure wound therapy (NWPT) as an adjunct to parenteral antibiotics in the treatment of infection in orthopaedic patients with metalwork in situ. To address some of the limitations of standard NPWT in this situation, the senior author has developed a modified method of treatment for infected metalwork (excluding arthroplasty) in orthopaedic patients that includes irrigation and skin closure over the standard NPWT dressing. M...

  12. International Aid to Education

    Science.gov (United States)

    Benavot, Aaron

    2010-01-01

    Recent evidence highlights several worrisome trends regarding aid pledges and disbursements, which have been exacerbated by the global financial crisis. First, while overall development assistance rose in 2008, after 2 years of decline, the share of all sector aid going to the education sector has remained virtually unchanged at about 12 percent…

  13. AIDS Epidemiological models

    Science.gov (United States)

    Rahmani, Fouad Lazhar

    2010-11-01

    The aim of this paper is to present mathematical modelling of the spread of infection in the context of the transmission of the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS). These models are based in part on the models suggested in the field of th AIDS mathematical modelling as reported by ISHAM [6].

  14. Genetic Immunity to AIDS

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    In an article on genetic immunity to AIDS published in Science magazine, American and Chinese scientists claim to have discovered why certain HIV carriers do not develop full-blown AIDS. They say that the key to this conundrum lies in a particular protein in the endocrine system that inhibits development of HIV.

  15. Aid and Income

    DEFF Research Database (Denmark)

    Lof, Matthijs; Mekasha, Tseday Jemaneh; Tarp, Finn

    2015-01-01

    to nonrandom omission of a large proportion of observations. Furthermore, we show that NDHKM’s use of co-integrated regressions is not a suitable empirical strategy for estimating the causal effect of aid on income. Evidence from a Panel VAR model estimated on the dataset of NDHKM, suggests a...... positive and statistically significant long-run effect of aid on income....

  16. AIDS and Chemical Dependency.

    Science.gov (United States)

    Pohl, Melvin I.

    After defining HIV and the AIDS disease and outlining symptoms and means of infection, this fact sheet lists the ways alcohol and drugs are involved with the AIDS epidemic, noting that needle-sharing transmits the virus; that alcohol or mood-altering drugs like crack cocaine cause disinhibition, increase sex drive, encourage sex for drugs, and…

  17. [Oral hygiene aids].

    Science.gov (United States)

    Hovius, M; Leemans, G J

    1994-05-01

    Different dental hygiene aids are discussed, such as floss, tape, superfloss, gauze, flat shoelace, toothpick, interproximal brush, single-tufted brush, electric toothbrush, manual toothbrush and oral irrigation. Research shows that not one specific aid is superior to another if effectiveness is taken into consideration. Other factors which can influence oral hygiene efficacy are discussed as well. PMID:11830968

  18. Changing epidemiology of AIDS.

    OpenAIRE

    Donovan, C. A.; Stratton, E.

    1994-01-01

    It has been 15 years since AIDS made its first appearance in North America, probably longer worldwide. In that time, our knowledge of the epidemiology of AIDS has grown and changed. This review highlights significant aspects of the epidemic with particular emphasis on the evolution of this disease in North America.

  19. Hearing aid and Noise

    OpenAIRE

    Ahmad Reza Nazeri

    1999-01-01

    Prescription of hearing aid is an extensive special category of knowledge in the field of audiology. This article is aimed at discussing the function of hearing aid and also management of patients in the noisy environments and presenting solutions to overcome problems regarding to this issue along with taking a look to the equipments prepared nowadays to cope with noisy situations.

  20. Aid and sectoral growth

    DEFF Research Database (Denmark)

    Selaya, Pablo; Thiele, Rainer

    2010-01-01

    This article examines empirically the proposition that aid to poor countries is detrimental for external competitiveness, giving rise to Dutch disease type effects. At the aggregate level, aid is found to have a positive effect on growth. A sectoral decomposition shows that the effect is (i) sign...... labour capacity that prevents the real exchange rate from appreciating....

  1. Implementing AIDS Education

    Directory of Open Access Journals (Sweden)

    Grace C. Huerta

    1996-08-01

    Full Text Available The world has been challenged by the AIDS epidemic for 15 years. In 1985, the U.S. Department of Health and Human Services, Centers for Disease Control, allocated funds to all state departments of education to assist schools in the development of AIDS education policies and programs. Yet, these policies do not ensure that all students receive effective AIDS education. On September 21, 1991, the Arizona Legislature passed Senate Bill 1396, which requires public schools to annually provide AIDS education in grades K-12. The bill was rescinded in 1995. With prohibitive curriculum guidelines, limited teacher training opportunities and tremendous instructional demands, this educational policy was implemented in disparate forms. By examining the perspectives of the Arizona educators (representing three school districts, this qualitative study reveals how teachers ultimately controlled the delivery and nature of AIDS instruction based upon personal values, views of teacher roles, and their interpretation of the mandate itself.

  2. Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte; Kofoed, Poul-Erik; Ohm Kyvik, Kirsten;

    2012-01-01

    Scand J Caring Sci; 2012; Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care Rationale:  Despite the fact that communication has become a core topic in health care, patients still experience the information provided as...... insufficient or incorrect and a lack of involvement. Objective:  To investigate whether adult orthopaedic patients' evaluation of the quality of care had improved after a communication skills training course for healthcare professionals. Design and methods:  The study was designed as an intervention study...... limitation. Response rates were comparable to those of other studies. Conclusion:  Patients show increased satisfaction with the quality of health care after professionals have attended a communication skills training course, even when implemented in an entire department. Practice implications:  We recommend...

  3. Orthopaedic Surgery Under National Health Reform: An Analysis of Power, Process, Adaptation, and Leadership: AOA Critical Issues.

    Science.gov (United States)

    Callahan, Charles D; Adair, Daniel; Bozic, Kevin J; Manning, Blaine T; Saleh, Jamal K; Saleh, Khaled J

    2014-07-01

    Morrison argued that demography, economy, and technology drive the evolution of industries from a formative first-generation state ("First Curve") to a radically different way of doing things ("Second Curve") that is marked by new skills, strategies, and partners. The current health-reform movement in the United States reflects these three key evolutionary trends: surging medical needs of an aging population, dramatic expansion of Medicare spending, and care delivery systems optimized through powerful information technology. Successful transition from a formative first-generation state (First Curve) to a radically different way of doing things (Second Curve) will require new skills, strategies, and partners. In a new world that is value-driven, community-centric (versus hospital-centric), and prevention-focused, orthopaedic surgeons and health-care administrators must form new alliances to reduce the cost of care and improve durable outcomes for musculoskeletal problems. The greatest barrier to success in the Second Curve stems not from lack of empirical support for integrated models of care, but rather from resistance by those who would execute them. Porter's five forces of competitive strategy and the behavioral analysis of change provide insights into the predictable forms of resistance that undermine clinical and economic success in the new environment of care. This paper analyzes the components that will differentiate orthopaedic care provision for the Second Curve. It also provides recommendations for future-focused orthopaedic surgery and health-care administrative leaders to consider as they design newly adaptive, mutually reinforcing, and economically viable musculoskeletal care processes that drive the level of orthopaedic care that our nation deserves-at a cost that it can afford. PMID:24990985

  4. Predicting Non Return to Work after Orthopaedic Trauma: The Wallis Occupational Rehabilitation RisK (WORRK) Model

    OpenAIRE

    Luthi F.; Deriaz O.; Vuistiner P.; Burrus C.; Hilfiker R.

    2014-01-01

    BACKGROUND: Workers with persistent disabilities after orthopaedic trauma may need occupational rehabilitation. Despite various risk profiles for non-return-to-work (non-RTW), there is no available predictive model. Moreover, injured workers may have various origins (immigrant workers), which may either affect their return to work or their eligibility for research purposes. The aim of this study was to develop and validate a predictive model that estimates the likelihood of non-RTW after occu...

  5. Reduction Mammoplasty in a Developing Country: A 10-year Review (2001-2010) at the National Orthopaedic Hospital, Enugu

    OpenAIRE

    Chimaobi Isiguzo; Sunday Iheuko Ogbonnaya; Anthonia O Uduezue

    2015-01-01

    Context: Large breast is a major problem because of associated symptomatology and aesthetic concerns. Reduction mammoplasty (RM) resolves the symptom and at the same time improves the aesthetic appearance of the breast, hence improving self-esteem and social integration. Aims: To describe the pattern of RM in a hospital in the developing world and its impact on postgraduate surgical training. Settings and Design: A retrospective review of all the RMs done in the National Orthopaedic Hospital,...

  6. Arthroscopic verification of objectivity of the orthopaedic examination and magnetic resonance imaging in intra-articular knee injury. Retrospective study

    OpenAIRE

    Dutka, Julian; Skowronek, Michał; Skowronek, Paweł; Dutka, Łukasz

    2011-01-01

    Introduction Arthroscopy of the knee joint is regarded as the most objective diagnostic method in intra-articular knee joint lesions. Aim The purpose of this study was to assess the objectivity and diagnostic value of orthopaedic examination (OE) and magnetic resonance imaging (MRI) in reference to the arthroscopic result. Material and methods In a group of 113 patients treated by arthroscopic surgery for post-traumatic knee pathology between 2008 and 2010 in our department, accuracy of clini...

  7. General practice based physiotherapy: its use and effect on referrals to hospital orthopaedics and rheumatology outpatient departments.

    OpenAIRE

    O Cathain, A.; Froggett, M; Taylor, M. P.

    1995-01-01

    BACKGROUND. In November 1992, a pilot scheme was established in Doncaster to provide an on-site physiotherapy service in six non-fundholding general practices covering a population of approximately 44,000 people. AIM. The aim of the pilot scheme was to transfer a hospital-based physiotherapy service, to which general practitioners had direct access, to a primary care setting and to reduce referrals to an orthopaedics outpatient department. METHOD. Use of physiotherapy services and referrals t...

  8. A cross-sectional study of aggression levels in physicians and orthopaedic surgeons: impact on specialty selection and training?

    OpenAIRE

    Barlow, T.; Wight, A.; Barlow, D

    2012-01-01

    Objectives To determine if current validated psychometric evaluations could determine a difference in basic behavioural characteristics between surgical and medical specialties. Design Cross-sectional study. Setting Two district general hospitals and one University teaching hospital in England, UK. Participants Internal medicine (16) and trauma and orthopaedic (20) consultants. Main outcome measures Aggression levels as assessed by the Buss and Warren questionnaire. The self-administered ques...

  9. Drug-resistant coagulase-negative skin staphylococci. Evaluation of four marker systems and epidemiology in an orthopaedic ward.

    OpenAIRE

    Thore, M.; Kühn, I; Löfdahl, S; Burman, L G

    1990-01-01

    Drug-resistant coagulase-negative staphylococci (DRCNS) in orthopaedic patients and ward staff were studied. A significant increase in the DRCNS carriage rate was observed among the 16 patients studied after 14 days of hospitalization with levels approaching that of the staff. Patients receiving dicloxacillin prophylaxis (n = 9) were more likely to be colonized with methicillin-resistant CNS, while patients receiving no antibiotics (n = 7) became to a larger extent colonized with multiple DRC...

  10. Cobalt-based orthopaedic alloys: Relationship between forming route, microstructure and tribological performance

    International Nuclear Information System (INIS)

    The average longevity of hip replacement devices is approximately 10–15 years, which generally depends on many factors. But for younger generation patients this would mean that revisions may be required at some stage in order to maintain functional activity. Therefore, research is required to increase the longevity to around 25–30 years; a target that was initially set by John Charnley. The main issues related to metal-on-metal (MoM) hip replacement devices are the high wear rates when malpositioned and the release of metallic ions into the blood stream and surrounding tissues. Work is required to reduce the wear rates and limit the amount of metallic ions being leached out of the current MoM materials, to be able to produce an ideal hip replacement material. The most commonly used MoM material is the cobalt-based alloys, more specifically ASTM F75, due to their excellent wear and corrosion resistance. They are either fabricated using the cast or wrought method, however powder processing of these alloys has been shown to improve the properties. One powder processing technique used is spark plasma sintering, which utilises electric current Joule heating to produce high heating rates to sinter powders to form an alloy. Two conventionally manufactured alloys (ASTM F75 and ASTM F1537) and a spark plasma sintered (SPS) alloy were evaluated for their microstructure, hardness, tribological performance and the release of metallic content. The SPS alloy with oxides and not carbides in its microstructure had the higher hardness, which resulted in the lowest wear and friction coefficient, with lower amounts of chromium and molybdenum detected from the wear debris compared to the ASTM F75 and ASTM F1537. In addition the wear debris size and size distribution of the SPS alloy generated were considerably small, indicating a material that exhibits excellent performance and more favourable compared to the current conventional cobalt based alloys used in orthopaedics

  11. Cobalt-based orthopaedic alloys: Relationship between forming route, microstructure and tribological performance

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Bhairav [Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Favaro, Gregory [CSM Instruments SA, Rue de la Gare 4, Galileo Center, CH-2034 Peseux (Switzerland); Inam, Fawad [Advanced Composite Training and Development Centre and School of Mechanical and Aeronautical Engineering, Glyndwr University, Mold Road, Wrexham LL11 2AW (United Kingdom); School of Engineering and Materials Science and Nanoforce Technology Ltd, Queen Mary University of London, London E1 4NS (United Kingdom); Reece, Michael J. [School of Engineering and Materials Science and Nanoforce Technology Ltd, Queen Mary University of London, London E1 4NS (United Kingdom); Angadji, Arash [Orthopaedic Research UK, Furlong House, 10a Chandos Street, London W1G 9DQ (United Kingdom); Bonfield, William [Department of Materials Science and Metallurgy, University of Cambridge, Pembroke Street, Cambridge CB2 3QZ (United Kingdom); Huang, Jie [Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Edirisinghe, Mohan, E-mail: m.edirisinghe@ucl.ac.uk [Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom)

    2012-07-01

    The average longevity of hip replacement devices is approximately 10-15 years, which generally depends on many factors. But for younger generation patients this would mean that revisions may be required at some stage in order to maintain functional activity. Therefore, research is required to increase the longevity to around 25-30 years; a target that was initially set by John Charnley. The main issues related to metal-on-metal (MoM) hip replacement devices are the high wear rates when malpositioned and the release of metallic ions into the blood stream and surrounding tissues. Work is required to reduce the wear rates and limit the amount of metallic ions being leached out of the current MoM materials, to be able to produce an ideal hip replacement material. The most commonly used MoM material is the cobalt-based alloys, more specifically ASTM F75, due to their excellent wear and corrosion resistance. They are either fabricated using the cast or wrought method, however powder processing of these alloys has been shown to improve the properties. One powder processing technique used is spark plasma sintering, which utilises electric current Joule heating to produce high heating rates to sinter powders to form an alloy. Two conventionally manufactured alloys (ASTM F75 and ASTM F1537) and a spark plasma sintered (SPS) alloy were evaluated for their microstructure, hardness, tribological performance and the release of metallic content. The SPS alloy with oxides and not carbides in its microstructure had the higher hardness, which resulted in the lowest wear and friction coefficient, with lower amounts of chromium and molybdenum detected from the wear debris compared to the ASTM F75 and ASTM F1537. In addition the wear debris size and size distribution of the SPS alloy generated were considerably small, indicating a material that exhibits excellent performance and more favourable compared to the current conventional cobalt based alloys used in orthopaedics. - Highlights

  12. CHANGES OF INTERLEUKIN-6 AND RELATED FACTORS AS WELL AS GASTRIC INTRAMUCOSAL Ph DURING COLORECTAL AND ORTHOPAEDIC SURGICAL PROCEDURES

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To investigate the changes of perioperative serum levels of interleukin-6 ( IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures. Methods Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation. Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol, pHi and plasma lactate were also measured at the same time points. Results Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation. CRP was not detectable until the first day after operation. Peak concentration of IL-6 had positive relationship with CRP. These variables changed more significantly in colorectal group than that in orthopaedic group (P < 0. 05). pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group ( P < 0. 05 ).Conclusion IL-6 may reflect tissue damage more sensitively than CRP. Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi.

  13. Computational thermodynamics aided design of novel ferritic alloys

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ying [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Chen, Tianyi [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Tan, Lizhen [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-06-30

    With the aid of computational thermodynamics, Ni was identified to suppress the liquidus temperature of Fe2Zr and four Fe-Cr-Ni-Zr alloys were designed to study the Ni effect on the phase stability of Fe2Zr laves_phase. These alloys were fabricated through traditional arc-metling, followed by annealing at 1000 C for 336 hours and 700 C for 1275 hours. The microstructure were examined and characterized by SEM BSE image, EDS compositional mapping and point scan, XRD and TEM analysis. The major results were summarized below: 1)For investigated alloys with 12wt% Cr, 3~6wt% Zr and 3~9 wt%Ni, the phases in equilibrium with the BCC phase are C15_Laves phase, Fe23Zr6 phase. The volume fraction of intermetallic phases increases with Ni and Zr contents. 2)Instead of (Fe,Cr)2Zr C14_Laves phase, Ni stabilizes the C15_Laves structure in Fe-Cr-Ni-Zr alloys by substituting Fe and Cr atoms with Ni atoms in the first sublattice. 3)Fe23Zr6, that is metastable in the Fe-Cr-Zr ternary, is also stabilized by Ni addition. 4)Ni7Zr2 phase was observed in samples with high Ni/Zr ratio. Extensive solubility of Fe was identified in the phase. The microstructural and composition results obtained from this study will be incorportated into the the Fe-Cr-Ni-Zr database. The current samples will be subjected to ion irradiaition to be compared with those results for Fe-Cr-Zr alloys. Additional alloys will be designed to form (Fe,Cr,Ni)2Zr nanoprecipitates for further studies.

  14. Research Report: HIV/AIDS

    Science.gov (United States)

    ... Reports » HIV/AIDS » Letter from the Director HIV/AIDS Email Facebook Twitter Letter from the Director Human ... the virus that causes acquired immune deficiency syndrome (AIDS) — has been with us for three decades now. ...

  15. HIV/AIDS and Alcohol

    Science.gov (United States)

    ... Psychiatric Disorders Other Substance Abuse HIV/AIDS HIV/AIDS Human immunodeficiency virus (HIV) targets the body’s immune ... and often leads to acquired immune deficiency syndrome (AIDS). Each year in the United States, between 55, ...

  16. HIV, AIDS, and the Future

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV, AIDS, and the Future Past Issues / Summer 2009 ... turn Javascript on. Photo: The NAMES Project Foundation HIV and AIDS are a global catastrophe. While advances ...

  17. HIV/AIDS: Women's Health

    Science.gov (United States)

    ... Hospitalization and Palliative Care Friends & Family Dating and Marriage Family Planning Mixed-Status Couples Discrimination Legal Issues ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latino AIDS ...

  18. What Is HIV/AIDS?

    Science.gov (United States)

    ... Hospitalization and Palliative Care Friends & Family Dating and Marriage Family Planning Mixed-Status Couples Discrimination Legal Issues ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latino AIDS ...

  19. HIV/AIDS and Vaccines

    Science.gov (United States)

    ... Hospitalization and Palliative Care Friends & Family Dating and Marriage Family Planning Mixed-Status Couples Discrimination Legal Issues ... National HIV/AIDS and Aging Awareness Day National Gay Men's HIV/AIDS Awareness Day National Latino AIDS ...

  20. HIV / AIDS: An Unequal Burden

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: An Unequal Burden Past Issues / Summer 2009 Table ... Victoria Cargill talks to students about HIV and AIDS at the opening of a National Library of ...

  1. Aid Supplies Over Time

    DEFF Research Database (Denmark)

    Jones, Edward Samuel

    2015-01-01

    What determines how much foreign aid donors provide? Existing answers to this question point to a complex range of influences. However, the tasks of distinguishing between long- and short-run factors, as well as differences between donors, have not been adequately addressed. Taking advantage of...... data spanning nearly 50 years, this paper uses panel cointegration techniques to consider these issues. The analysis provides clear evidence for heterogeneity both between donors and over time, bandwagon effects, and a growing influence of security considerations in aid provision. Domestic...... macroeconomic shocks have a moderate but delayed effect on aid disbursements....

  2. Aid and Growth

    DEFF Research Database (Denmark)

    Tarp, Finn; Mekasha, Tseday Jemaneh

    2013-01-01

    Recent litterature in the meta-analysis category where results from a range of studies are brought together throws doubt on the ability of foreign aid to foster economic growth and development. This article assesses what meta-analysis has to contribute to the litterature on the effectiveness of...... foreign aid in terms of growth impact. We re-examine key hypotheses, and find that the effect of aid on growth is positive and statistically significant. This significant effect is genuine, and not an artefact of publication selection. We also show why our results differ from those published elsewhere....

  3. Aid and development

    DEFF Research Database (Denmark)

    Tarp, Finn

    2006-01-01

    Foreign aid looms large in the public discourse; and international development assistance remains squarely on most policy agendas concerned with growth, poverty and inequality in Africa and elsewhere in the developing world. The present review takes a retrospective look at how foreign aid has...... been effective in furthering economic growth and development is discussed in some detail. I add perspective and identify some critical unresolved issues. I finally turn to the current development debate and discuss some key concerns, I believe should be kept in mind in formulating any agenda for aid in...

  4. Aid and Growth

    DEFF Research Database (Denmark)

    Mekasha, Tseday Jemaneh; Tarp, Finn

    Some recent literature in the meta-analysis category where results from a range of studies are brought together throws doubt on the ability of foreign aid to foster economic growth and development. This paper assesses what meta-analysis has to say about the effectiveness of foreign aid in terms of...... the growth impact. We re-examine key hypotheses, and find that the effect of aid on growth is positive and statistically significant. This significant effect is genuine, and not an artefact of publication selection. We also show why our results differ from those published elsewhere....

  5. Pulmonary complications of AIDS: radiologic features. [AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, B.A.; Pomeranz, S.; Rabinowitz, J.G.; Rosen, M.J.; Train, J.S.; Norton, K.I.; Mendelson, D.S.

    1984-07-01

    Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Of the 52 patients, 41 had died by the time this report was completed.

  6. Current status of presurgical infant orthopaedic treatment for cleft lip and palate patients: A critical review

    Directory of Open Access Journals (Sweden)

    P Priyanka Niranjane

    2014-01-01

    Full Text Available Rehabilitation of cleft lip and palate (CLP patients is a challenge for all the concerned members of the cleft team, and various treatment modalities have been attempted to obtain aesthetic results. Presurgical infant orthopaedics (PSIO was introduced to reshape alveolar and nasal segments prior to surgical repair of cleft lip. However, literature reports lot of controversy regarding the use of PSIO in patients with CLP. Evaluation of long-term results of PSIO can provide scientific evidence on the efficacy and usefulness of PSIO in CLP patients. The aim was to assess the scientific evidence on the efficiency of PSIO appliances in patients with CLP and to critically analyse the current status of PSIO. A PubMed search was performed using the terms PSIO, presurgical nasoalveolar moulding and its long-term results and related articles were selected for the review. The documented studies report no beneficial effect of PSIO on maxillary arch dimensions, facial aesthetics and in the subsequent development of dentition and occlusion in CLP patients. Nasal moulding seems to be more beneficial and effective in unilateral cleft lip and palate patients with better long-term results.

  7. Perspectives on the policy 'black box': a comparative case study of orthopaedics services in England.

    Science.gov (United States)

    McLeod, Hugh; Millar, Ross; Goodwin, Nick; Powell, Martin

    2014-10-01

    There has been much recent debate on the impact of competition on the English National Health Service (NHS). However, studies have tended to view competition in isolation and are controversial. This study examines the impact of programme theories associated with the health system reforms, which sought to move from a dominant target-led 'central control' programme theory, to one based on 'market forces', on orthopaedics across six case-study local health economies. It draws on a realistic evaluation approach to open up the policy 'black box' across different contexts using a mixed methods approach: analysis of 152 interviews with key informants and analysis of waiting times and admissions. We find that the urban health economies were more successful in reaching the access targets than the rural health economies, although the gap in performance closed over time. Most interviewees were aware of the policies to increase choice and competition, but their role appeared comparatively weak. Local commissioners' ability to influence demand appeared limited with providers' incentives dominating service delivery. Looking forward, it is clear that the role of competition in the NHS has to be considered alongside, rather than in isolation from, other policy mechanisms. PMID:24556091

  8. Hemodynamic performance of NMES in the early post operative period following orthopaedic surgery.

    Science.gov (United States)

    Broderick, Barry J; Breathnach, Oisín; Masterson, Eric; Breen, Paul P; ÓLaighin, Gearóid

    2011-01-01

    Patients post total hip arthroplasty (THA) remain at high risk of developing Deep Vein Thrombosis (DVT) during the recovery period following surgery. The use of calf muscle neuromuscular electrical stimulation (NMES) during the hospitalized recovery period on this patient group may be effective at preventing DVT. However, the haemodynamic effectiveness and comfort characteristics of NMES in post-THA patients immediately following surgery has yet to be demonstrated. The popliteal veins of 5 patients, who had undergone unilateral total hip replacement surgery on the day previous to the study, were measured using Doppler ultrasound during a 4 hour calf-muscle NMES session. The effect of calf muscle NMES on peak venous velocity and volume flow were compared to resting values. Comfort was assessed using a 100 mm non-hatched visual analogue scale taken before application of NMES, once NMES was initiated and before NMES was withdrawn. Results of the study showed that NMES produces a beneficial hemodynamic response in patients in the early postoperative period following orthopaedic surgery. This patient group found extended periods of calf-muscle NMES tolerable. PMID:22256105

  9. Influence of bone morphological properties on a new expandable orthopaedic fastener

    Science.gov (United States)

    Oldakowski, M.; Oldakowska, I.; Kirk, T. B.; Ford, C. T.; Sercombe, T. B.; Hardcastle, P.; Day, R. E.

    2016-03-01

    Previous studies have demonstrated that bone morphological properties are a significant determinant of orthopaedic fastener fixation strength. The authors previously tested a new design of unthreaded expandable fastener (UEF) prototype against screws and demonstrated a significant increase in pull-out strength. However the effect of bone morphology on the pull-out strength of the UEF and expandable fasteners in general is unknown. This study assessed the correlation between failure force and maximum force against five microstructural parameters. The failure force of the UEF was correlated to the trabecular bone volume fraction, as with screws. Unlike screws, however, the maximum force of the UEF has an inverse relationship with cortical volume. No correlation was found between failure force and the Structural Model Index (SMI). Additionally the critical volume of interest (VOI) for the UEF is around the bottom of the fastener where the expansion occurs, whereas for the screw a full height VOI is critical. Furthermore, we observed that screw mechanical performance may be affected more by bone morphological parameters that are associated with poorer quality bone. Therefore the UEF may perform better than screws in low quality osteoporotic bone.

  10. Application of micro beam PIXE to detection of titanium ion release from dental and orthopaedic implants

    International Nuclear Information System (INIS)

    In the past two decades the utilization of dental and orthopaedic implants in reconstructive surgery has been spread widely. Most of these implants are inserted in the corrosive environment of the human body for long periods of time. The level of dissolution, release, and transport of metal ions as a result of corrosion of these materials are not fully known at present. We report the results of application of micro ion beam PIXE spectroscopy to detect release of titanium from titanium and titanium alloy implants inserted in the tibiae of rabbits for three months. It was found that titanium ions could be detected in the surrounding tissues, with high precision, as a gradient from the implant surface and in higher amounts in the bone tissue as compared with the soft tissues. It is concluded that application of micro ion beam PIXE spectroscopy for detection of metal ion release, and distribution of the released material around the implants with high special resolution and accuracy may be used to further investigate the mechanism of metal release, and the relation between surface micromorphology and corrosion resistance of the implant materials. (author)

  11. Estimation of radiation doses to patients and surgeons from various fluoroscopically guided orthopaedic surgeries

    International Nuclear Information System (INIS)

    In this study, a mathematical method was used to estimate the entrance surface dose (ESD) to the patient and the scattered dose (Ds) to the operating surgeon during various fluoroscopically guided surgical orthopaedic procedures. For 204 patients, the procedure type, the fluoroscopy time and the highest tube potential and current values observed during fluoroscopy were recorded. For the most often performed procedures (intramedullary nailing of peritrochanteric fractures, open reduction and internal fixation of malleolar fractures and intramedullary nailing of diaphyseal fractures of the femur), the respective mean fluoroscopy times were 3.2, 1.5 and 6.3 min while the estimated mean ESDs were 183, 21 and 331 mGy, respectively. The estimated Ds rates for the hands, chest, thyroid, eyes, gonads and legs of the operating surgeon were on average to 0.103, 0.023, 0.013, 0.012, 0.066 and 0.045 mGy min-1, respectively, and compare well with the literature. The mathematical estimation of doses cannot replace actual measurements; however, it can be used for a preliminary assessment of the radiation dose levels during various surgical procedures, so that the operator, the surgeon and the rest of the medical staff involved could be aware of the associated radiation risk and the radiation protection measures required. (authors)

  12. Orthochina.org: case-based orthopaedic Wiki project in China.

    Science.gov (United States)

    Ma, Zhen-Sheng; Zhang, Hong-Ju; Yu, Tao; Ren, Gang; Du, Guo-Sheng; Wang, Yong-Hua

    2008-10-01

    Traditional continuing medical education (CME) depended primarily on periodic courses and conferences. The cost-effectiveness of these courses has not been established, and often the content is not tailored to best meet the needs of the students. Internet training has the potential to accomplish these goals. Over the last 10 years, we have developed a Web site entitled "Orthochina.org," based upon the wiki concept, which uses an interactive, case-based format. We describe the development of online case discussions, and various technical and administrative requirements. As of December 31, 2007, there were 33,984 registered users, 9,759 of which passed the confirmation procedures. In 2007, an average of 211 registrants visited daily. The average number of first page clicks was 4,248 per day, and the average number of posts was 70 per day. All cases submitted for discussion include the patient's complaint, physical examination findings, and relevant images based on specific criteria for case discussion. The case discussions develop well professionally. No spam posting or unauthorized personal advertisement is permitted. In conclusion, online academic discussions proceed well when the orthopaedic surgeons who participate have established their identities. PMID:18685911

  13. Stem Cell-Derived Exosomes: A Potential Alternative Therapeutic Agent in Orthopaedics.

    Science.gov (United States)

    Burke, John; Kolhe, Ravindra; Hunter, Monte; Isales, Carlos; Hamrick, Mark; Fulzele, Sadanand

    2016-01-01

    Within the field of regenerative medicine, many have sought to use stem cells as a promising way to heal human tissue; however, in the past few years, exosomes (packaged vesicles released from cells) have shown more exciting promise. Specifically, stem cell-derived exosomes have demonstrated great ability to provide therapeutical benefits. Exosomal products can include miRNA, other genetic products, proteins, and various factors. They are released from cells in a paracrine fashion in order to combat local cellular stress. Because of this, there are vast benefits that medicine can obtain from stem cell-derived exosomes. If exosomes could be extracted from stem cells in an efficient manner and packaged with particular regenerative products, then diseases such as rheumatoid arthritis, osteoarthritis, bone fractures, and other maladies could be treated with cell-free regenerative medicine via exosomes. Many advances must be made to get to this point, and the following review highlights the current advances of stem cell-derived exosomes with particular attention to regenerative medicine in orthopaedics. PMID:26904130

  14. Stem Cell-Derived Exosomes: A Potential Alternative Therapeutic Agent in Orthopaedics

    Directory of Open Access Journals (Sweden)

    John Burke

    2016-01-01

    Full Text Available Within the field of regenerative medicine, many have sought to use stem cells as a promising way to heal human tissue; however, in the past few years, exosomes (packaged vesicles released from cells have shown more exciting promise. Specifically, stem cell-derived exosomes have demonstrated great ability to provide therapeutical benefits. Exosomal products can include miRNA, other genetic products, proteins, and various factors. They are released from cells in a paracrine fashion in order to combat local cellular stress. Because of this, there are vast benefits that medicine can obtain from stem cell-derived exosomes. If exosomes could be extracted from stem cells in an efficient manner and packaged with particular regenerative products, then diseases such as rheumatoid arthritis, osteoarthritis, bone fractures, and other maladies could be treated with cell-free regenerative medicine via exosomes. Many advances must be made to get to this point, and the following review highlights the current advances of stem cell-derived exosomes with particular attention to regenerative medicine in orthopaedics.

  15. Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review.

    Science.gov (United States)

    Wang, Xiaojian; Xu, Shanqing; Zhou, Shiwei; Xu, Wei; Leary, Martin; Choong, Peter; Qian, M; Brandt, Milan; Xie, Yi Min

    2016-03-01

    One of the critical issues in orthopaedic regenerative medicine is the design of bone scaffolds and implants that replicate the biomechanical properties of the host bones. Porous metals have found themselves to be suitable candidates for repairing or replacing the damaged bones since their stiffness and porosity can be adjusted on demands. Another advantage of porous metals lies in their open space for the in-growth of bone tissue, hence accelerating the osseointegration process. The fabrication of porous metals has been extensively explored over decades, however only limited controls over the internal architecture can be achieved by the conventional processes. Recent advances in additive manufacturing have provided unprecedented opportunities for producing complex structures to meet the increasing demands for implants with customized mechanical performance. At the same time, topology optimization techniques have been developed to enable the internal architecture of porous metals to be designed to achieve specified mechanical properties at will. Thus implants designed via the topology optimization approach and produced by additive manufacturing are of great interest. This paper reviews the state-of-the-art of topological design and manufacturing processes of various types of porous metals, in particular for titanium alloys, biodegradable metals and shape memory alloys. This review also identifies the limitations of current techniques and addresses the directions for future investigations. PMID:26773669

  16. COMPARATIVE STUDY OF DIFFERENT DOSES OF DEXMEDETOMIDINE IN SPINAL ANAESTHESIA IN LOWER LIMB ORTHOPAEDIC PROCEDURES

    Directory of Open Access Journals (Sweden)

    Kashif M.

    2014-11-01

    Full Text Available BACKGROUND AND OBJECTIVE: Spinal Anaesthesia is the most commonly used as it is very economical, easy to administer and safe. Dexmedetomidine, an alpha-adrenoreceptor agonist, is being used as a neuraxial adjuvant as it provides stable hemodynamic conditions, good quality of intra-operative and prolongs post-operative analgesia with minimal side effects. This study is aimed to assess the effect of intrathecal administration of different doses of dexmedetomidine with hyperbaric bupivacaine on the duration of sensory and motor block, side effects produced by spinal anaesthesia in lower limb orthopaedic surgeries. METHODS AND MATERIALS: A randomized double blind study is planned in 90 patients divided in 3 groups. Group A, B and C patients received inj. Bupivacaine (12.5mg with normal saline, with dexmedetomidine (5µg and with dexmedetomidine (10 µg respectively. Hemodynamic data were recorded after every 5 min for 30 minutes than after every 15 min. Degree of motor block (Bromage 1, sensory block, time of regression of sensory block, side effects were assessed. RESULT: Dexmedetomidine (10 µg prolonged time for two segment regression. Effect was greater in group C (Dex 10 µg than group B (Dex 5 µg as well as higher sedation scores achieved intraoperatively. Hemodynamic stability was maintained in all the three groups. CONCLUSION: Dexmedetomidine in different doses prolongs the anaesthetic effect of intrathecal hyperbaric bupivacaine. A 10 µg dose may be of benefit for prolonged duration of surgery.

  17. Publication trend in the indian journal of orthopaedics: What is published and why?

    Directory of Open Access Journals (Sweden)

    Rishiram Poudel

    2015-01-01

    Full Text Available Background: Factors influencing publication of manuscripts in reputed journals have never been studied to the best of our knowledge. This study was conducted to evaluate the trend in publication within the Indian Journal of Orthopaedics (IJO. Materials and Methods: A cross-sectional study was conducted by accessing the online database of the IJO. All the issues available online were included. Published articles were classified into one of the following thirteen categories: (i Basic Sciences (ii trauma (upper limb and lower limb (iii infections (iv pediatric orthopedics (v arthroplasty (vi arthroscopy (vii spine surgery (viii musculoskeletal oncology (ix hand and microvascular surgery (x adult reconstruction (including the Ilizarov technique (xi general orthopedics and miscellaneous (xii letter to editor (xiii book review. A scatter diagram was plotted to study the individual trends. Results: A total of 2213 articles from 110 issues published between 1967 and 2014 were studied. Total number of articles per issue have increased over the years. Publications in the fields of trauma, adult reconstruction, arthroscopy and hand and microvascular surgery have increased steadily. Arthroplasty and spine surgery have recorded dramatic increase in publication. On the other hand, publications in the rest of the fields have declined of which the greatest fall is noted in the field of musculoskeletal oncology. Conclusions: Trend in publication with the IJO has changed over years with more articles being published in arthroplasty and Spine surgery. Despite advances, publication in the field of musculoskeletal oncology has fallen.

  18. The effect of strain hardening on resistance to electrochemical corrosion of wires for orthopaedics

    Science.gov (United States)

    Przondziono, J.; Walke, W.; Hadasik, E.; Szymszal, J.

    2012-05-01

    The purpose of this research is to evaluate electrochemical corrosion resistance of wire with modified surface, made of stainless steel of Cr-Ni-Mo type, widely used in implants for orthopaedics, depending on hardening created in the process of drawing. Tests have been carried out in the environment imitating human osseous tissue. Pitting corrosion was determined on the ground of registered anodic polarisation curves by means of potentiodynamic method with application of electrochemical testing system VoltaLab® PGP 201. Wire corrosion tests were carried out in Tyrode solution on samples that were electrochemically polished as well as electrochemically polished and finally chemically passivated. Initial material for tests was wire rod made of X2CrNiMo17-12-2 steel with diameter of 5.5 mm in supersaturated condition. Wire rod was drawn up to diameter of 1.35 mm. This work shows the course of flow curve of wire made of this grade of steel and mathematical form of yield stress function. The study also presents exemplary curves showing the dependence of polarisation resistance in strain function in the drawing process of electrochemically passivated and electrochemically polished and then chemically passivated wire.

  19. Scanning electron microscopical observation of an osteoblast/osteoclast co-culture on micropatterned orthopaedic ceramics.

    Science.gov (United States)

    Halai, Mansur; Ker, Andrew; Meek, Rm Dominic; Nadeem, Danish; Sjostrom, Terje; Su, Bo; McNamara, Laura E; Dalby, Matthew J; Young, Peter S

    2014-01-01

    In biomaterial engineering, the surface of an implant can influence cell differentiation, adhesion and affinity towards the implant. On contact with an implant, bone marrow-derived mesenchymal stromal cells demonstrate differentiation towards bone forming osteoblasts, which can improve osteointegration. The process of micropatterning has been shown to improve osteointegration in polymers, but there are few reports surrounding ceramics. The purpose of this study was to establish a co-culture of bone marrow-derived mesenchymal stromal cells with osteoclast progenitor cells and to observe the response to micropatterned zirconia toughened alumina ceramics with 30 µm diameter pits. The aim was to establish whether the pits were specifically bioactive towards osteogenesis or were generally bioactive and would also stimulate osteoclastogenesis that could potentially lead to osteolysis. We demonstrate specific bioactivity of micropatterns towards osteogenesis, with more nodule formation and less osteoclastogenesis compared to planar controls. In addition, we found that that macrophage and osteoclast-like cells did not interact with the pits and formed fewer full-size osteoclast-like cells on the pitted surfaces. This may have a role when designing ceramic orthopaedic implants. PMID:25383174

  20. Orthopaedic complications of osteogenesis imperfecta; Les complications orthopediques de l'osteogenese imparfaite

    Energy Technology Data Exchange (ETDEWEB)

    Azrak, S.; Ksyar, R.; Ben Rais, N. [hOpital Ibn Sina, CHU de Rabat-Sale, Service de Medecine Nucleaire, Rabat-Sale (Morocco)

    2009-12-15

    Osteogenesis imperfecta is a genetic disease characterized by bone frailty. It is generally caused by an abnormal production of collagen, which is the main fibrous protein of the bone. Collagen is also present in the skin, tendons, the sclera of the eye and dentin. The most frequent manifestation of osteogenesis imperfecta is the occurrence of multiple fractures without major trauma. Severity and timing of the attack varies widely: some patients sustain a significant number of fractures during early childhood which may have a serious impact on growth, while others will have some fractures separated by a few years. In all cases, the bone strength improves in adulthood. The bone fractures cause pain and bone deformities sometimes result in a smaller size. Scoliosis is frequent and associated with painful vertebral collapses. We present a case of osteogenesis imperfecta in a 40-year-old adult and we describe the various orthopaedic complications of the disease, stressing the role of bone scintigraphy in the diagnosis and monitoring of these complications. (authors)

  1. Virtual interactive musculoskeletal system (VIMS in orthopaedic research, education and clinical patient care

    Directory of Open Access Journals (Sweden)

    Yoshida Hiroaki

    2007-03-01

    Full Text Available Abstract The ability to combine physiology and engineering analyses with computer sciences has opened the door to the possibility of creating the "Virtual Human" reality. This paper presents a broad foundation for a full-featured biomechanical simulator for the human musculoskeletal system physiology. This simulation technology unites the expertise in biomechanical analysis and graphic modeling to investigate joint and connective tissue mechanics at the structural level and to visualize the results in both static and animated forms together with the model. Adaptable anatomical models including prosthetic implants and fracture fixation devices and a robust computational infrastructure for static, kinematic, kinetic, and stress analyses under varying boundary and loading conditions are incorporated on a common platform, the VIMS (Virtual Interactive Musculoskeletal System. Within this software system, a manageable database containing long bone dimensions, connective tissue material properties and a library of skeletal joint system functional activities and loading conditions are also available and they can easily be modified, updated and expanded. Application software is also available to allow end-users to perform biomechanical analyses interactively. Examples using these models and the computational algorithms in a virtual laboratory environment are used to demonstrate the utility of these unique database and simulation technology. This integrated system, model library and database will impact on orthopaedic education, basic research, device development and application, and clinical patient care related to musculoskeletal joint system reconstruction, trauma management, and rehabilitation.

  2. Buying a Hearing Aid

    Science.gov (United States)

    ... Treatments & Cures Buying a Hearing Aid Cancer Treatment Scams Cancer Treatment Scams CURE-ious Bookmark Direct-to-Consumer Genetic Tests ... Money Privacy, Identity & Online Security Blog Video & Media Scam Alerts Get health and fitness updates by email ...

  3. The Aid Effectiveness Literature

    DEFF Research Database (Denmark)

    Doucouliagos, Hristos; Paldam, Martin

    The AEL consists of empirical macro studies of the effects of development aid. At the end of 2004 it had reached 97 studies of three families, which we have summarized in one study each using meta-analysis. Studies of the effect on investments show that they rise by 1/3 of the aid – the rest is...... crowded out by a fall in savings. Studies of the effect on growth show an insignificant positive effect. Studies of the effect on growth, conditional on something else, have till now shown weak results. The Dutch Disease effect of aid has been ignored. The best aggregate estimate is that since its start...... in the early 1960s aid has increased the standard of living in the poor countries by 20%....

  4. Performance Aided Design

    DEFF Research Database (Denmark)

    Parigi, Dario

    2014-01-01

    The paper present the methodologies and tools developed in the framework of Performance Aided Design (PAD), a term that indicates the shift in the use of Computer Aided Design (CAD) tools from a mere translation in a digital environment of the operations once carried on paper, to an evolving...... paradigm where the increasing integration of parametric tools and performative analysis is changing the way we learn and design. The term Performance Aided Architectural Design (PAD) is proposed at the Master of Science of Architecture and Design at Aalborg University, with the aim of extending a tectonic...... tradition of architecture with computational tools, preparing the basis for the creation of the figure of a modern master builder, sitting at the boundary of the disciplines of architecture and engineering. Performance Aided Design focuses on the role of performative analysis, embedded tectonics, and...

  5. HIV/AIDS

    Science.gov (United States)

    HIV stands for human immunodeficiency virus. It harms your immune system by destroying the white blood cells ... It is the final stage of infection with HIV. Not everyone with HIV develops AIDS. HIV most ...

  6. Aid and Development

    DEFF Research Database (Denmark)

    Tarp, Finn; Arndt, Channing; Jones, Edward Samuel

    inputs. We take as our point of departure a growth accounting analysis and review both intended and unintended effects of aid. Mozambique has benefited from sustained aid inflows in conflict, post-conflict and reconstruction periods. In each of these phases aid has made an unambiguous, positive...... sustained future growth, Mozambique will have to develop its capacity to maximise the benefits from its natural resources while ensuring at the same time the necessary framework is put in place to promote constructive integration in international markets...... contribution both enabling and supporting rapid growth since 1992. At the same time, the proliferation of donors and aid-supported interventions has burdened local administration and there is a distinct need to develop government accountability to its own citizens rather than donor agencies. In ensuring...

  7. World AIDS Day 1998.

    Science.gov (United States)

    1999-01-01

    Excerpts of speeches given at a public rally on World AIDS Day 1998 underscore the need to energize support for those living with HIV/AIDS, emphasize the importance of increasing public education efforts, and memorialize those lost to the disease. Reverend Pat Bumgardner stressed the need to educate children about practicing safe sex and the dangers of drug use. He also focused attention on AIDS as a worldwide crisis, with the 30 million people who have HIV or AIDS. Councilwoman Margarita Lopez spoke about achieving objectives and securing resources through activism. She also condemned New York City's Mayor for trying to hinder the rally. Anne Chelimsky, who did not speak at the rally but attended it, reflected on her new role as an activist, and on how the rally affected her. PMID:11367196

  8. AidData

    Data.gov (United States)

    US Agency for International Development — AidData is a research and innovation lab making information on development finance more accessible and actionable. Tracking more than $6 trillion dollars from 90+...

  9. HIV/AIDS

    Science.gov (United States)

    ... Casual contact, such as hugging Mosquitoes Participating in sports Touching items that were touched by a person ... 20 years. People with AIDS have had their immune system damaged by HIV. They are at very high ...

  10. House OK's Russian aid

    International Nuclear Information System (INIS)

    This article discusses the 2.5 Billion dollar aid package to Russia which House Appropriations Foreign Operations Subcommittee Chairman David Obey successfully defended on the House floor last June. Arizona Republican Jon Kyl offered an admendment that would cut 700 million from the package and was defeated with a 118 to 140 vote. The bill is currently in the hands of the Senate. The controversy over the bill and details concerning the aid package are discussed. The aid deal includes 250 million dollars for nuclear reactor safety and energy as well as environmental technical assistance, 655 million dollars to aid private sector development, and 704 million dollars for additional technical and economic assistance

  11. AIDS: A National Dilemma.

    Science.gov (United States)

    Issues in Science and Technology, 1987

    1987-01-01

    Contains excerpts from a special study on the AIDS epidemic by the Institute of Medicine and National Academy of Sciences. Presents an overview of the problem, outlines educational needs and public health measures, and identifies future research needs. (ML)

  12. HIV/AIDS

    Science.gov (United States)

    HIV stands for human immunodeficiency virus. It kills or damages the body's immune system cells. AIDS stands ... is the most advanced stage of infection with HIV. HIV most often spreads through unprotected sex with ...

  13. AIDS: the hidden enemy.

    Science.gov (United States)

    Tinker, J; Sabatier, R

    1987-01-01

    This article discusses the acquired immunodeficiency syndrome (AIDS) epidemic an its effect on developing countries, with emphasis on Africa. The AIDS death toll will be high in the US: 180,000 by 1991, but it will be in the millions in developing countries. In Africa, AIDS is mainly transmitted heterosexually, is as prevalent among women as among men, and is taking a serious toll among professional classes and young wage earners. The social costs of funerals has increased, and company clinics and sick pay funds have been overwhelmed. In Uganda, the epidemic adds to the state of psychological shock people have sufferred because of the civil war. Medical professionals have been hard-pressed to acquire equipment for testing blood for the virus, although there have been efforts to protect blood supplies through exhaustive testing. Endemic tuberculosis becomes an even more serious problem in developing countries, since AIDS lowers resistance to it. AIDS also effects many developing country children, usually through infected mothers, who can transmit AIDS through breast milk or during pregnancy of birth. This poses a dilemma for promoters of breastfeeding. It is also feared that innoculation of immunosuppressed children may be dangerous. The global picture suggests that Africa is hardest hit: seropositivity prevalence ranges from 0.7% of Congo blood donors to 33% of male donors in Lusaka Zambia. Brazil's cases are mainly homosexual, and in Asia the prevalence is mostly low, although there is a great potential danger in countries where prostitution and heroin addiction are prevalent. The only effective weapon against AIDS is education and blood testing to prevent spread. Despite good education programs in some countries, e.g. Rwanda, there is still widespread ignorance of how AIDS is spread. PMID:12314457

  14. Aid and Vulnerability

    OpenAIRE

    Andrea Filippo Presbitero

    2013-01-01

    Managing and identifying risks are a key challenge for Low Income Countries (LICs), which are extremely vulnerable to exogenous shocks. However, the use of risk management tools by developing countries is quite limited. The paper discusses in which ways aid could strengthen the capacity of LICs to deal with vulnerability to external shocks and to manage capital flows. We provide some novel empirical evidence on the potential role of aid as output stabilizer and shock absorber in recipient cou...

  15. Chagas' disease and AIDS

    OpenAIRE

    Vaidian, Anil K; Louis M Weiss; Tanowitz, Herbert B.

    2004-01-01

    Chagas' disease caused by Trypanosoma cruzi is an opportunistic infection in the setting of HIV/AIDS. Some individuals with HIV and chronic T. cruzi infection may experience a reactivation, which is most commonly manifested by meningoencephalitis. A reactivation myocarditis is the second most common manifestation. These presentations may be difficult to distinguish from toxoplasmosis in individuals with HIV/AIDS. The overlap of HIV and Trypanosoma cruzi infection occurs not only in endemic ar...

  16. [The liver and AIDS].

    Science.gov (United States)

    Rull, S; Sanchís, M J; Palacios, A; Anguiz, A; Colomina, J

    1992-02-01

    Hepatic disorders in AIDS are very common, although the injuries observed are usually non-specific. This is the reason why the real usefulness of hepatic biopsy in this patients is being currently discussed. In this work, such aspect and the hepatic injuries observed in patients with AIDS are discussed. Current indications for hepatic biopsy are summarized, as well as its later manipulation in order to obtain maximum profitability of it. PMID:1576316

  17. World AIDS Day 2004

    Institute of Scientific and Technical Information of China (English)

    CynthiaKirk; 刘保行

    2005-01-01

    December first was World AIDS Day. Last year, the campaign (运动;活动) centered on women and girls. They made up almost half of all people infected with the virus HIV that causes AIDS. And H1V was spreading faster among women than men in most areas of the world. These findings (发现) werefrom the yearly report by the United Nations and the World Health Organization, a UN agency

  18. Hearing aid adjustment

    DEFF Research Database (Denmark)

    Heinemann, Trine; Matthews, Ben; Raudaskoski, Pirkko Liisa

    2012-01-01

    to the interaction during hearing aid fitting. This report of a Danish pilot study describes two such problems. The first problem arises from the requirement that the audiologist needs to ‘translate’ the patient’s subjective hearing description for making technological decisions. The second problem...... is the way in which the hearing aid user’s implicit and often unrealistic expectations are handled. This kind of research has potential application for developing a model of best practices....

  19. Early staphylococcal biofilm formation on solid orthopaedic implant materials: in vitro study.

    Directory of Open Access Journals (Sweden)

    Hironobu Koseki

    Full Text Available Biofilms forming on the surface of biomaterials can cause intractable implant-related infections. Bacterial adherence and early biofilm formation are influenced by the type of biomaterial used and the physical characteristics of implant surface. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis, the main pathogen in implant-related infections, to form biofilms on the surface of the solid orthopaedic biomaterials, oxidized zirconium-niobium alloy, cobalt-chromium-molybdenum alloy (Co-Cr-Mo, titanium alloy (Ti-6Al-4V, commercially pure titanium (cp-Ti and stainless steel. A bacterial suspension of Staphylococcus epidermidis strain RP62A (ATCC35984 was added to the surface of specimens and incubated. The stained biofilms were imaged with a digital optical microscope and the biofilm coverage rate (BCR was calculated. The total amount of biofilm was determined with the crystal violet assay and the number of viable cells in the biofilm was counted using the plate count method. The BCR of all the biomaterials rose in proportion to culture duration. After culturing for 2-4 hours, the BCR was similar for all materials. However, after culturing for 6 hours, the BCR for Co-Cr-Mo alloy was significantly lower than for Ti-6Al-4V, cp-Ti and stainless steel (P0.05. These results suggest that surface properties, such as hydrophobicity or the low surface free energy of Co-Cr-Mo, may have some influence in inhibiting or delaying the two-dimensional expansion of biofilm on surfaces with a similar degree of smoothness.

  20. A mixed model study evaluating lean in the transformation of an Orthopaedic Radiology service

    International Nuclear Information System (INIS)

    Objective: The purpose of the study was to explore the proposition that lean is an effective methodology for service improvement within healthcare by using it to evaluate and implement change in a poor service. Design: A mixed model approach was used with data being collected before and after change. Setting: The orthopaedic radiology out-patient pathway in a large district general hospital was receiving increasing numbers of complaints with long waiting times and poor levels of satisfaction amongst patients and staff. Participants: Data were collected in the form of qualitative and quantitative data taken from questionnaires completed by staff and patients, and quantitative data extracted from the Radiology Information System. A proportionate stratified random sampling method was used to collect data from the patients and a theoretical sample was used for the staff. Intervention: The pre-implementation data was collected during a lean event in which a value stream map of the pathway was created. From this information, changes were planned and implemented, before collecting the post-implementation data using the same methods. Main outcome measures: The aims of the study were to compare pre-implementation and post-implementation data related to patient journey time, patient experience and staff and patient satisfaction. The quantitative data were analysed using Levene's test for equality of variance and a 2-sample t-test to test for comparison of the means. Descriptive statistics were used to analyse data collected from the polar and the selected response questions from the questionnaires, whilst thematic analysis was used to analyse the qualitative data. Results: Results demonstrated that the new service offered a better quality of patient experience with higher levels of staff satisfaction whilst enabling an improvement in productivity. Conclusions: The author proposes that these findings support the proposition that lean is an effective methodology for service

  1. Comparison of two approaches of infraclavicular brachial plexus block for orthopaedic surgery below mid-humerus

    Directory of Open Access Journals (Sweden)

    Vikas Trehan

    2010-01-01

    Full Text Available The brachial plexus in infraclavicular region can be blocked by various approaches. Aim of this study was to compare two approaches (coracoid and clavicular regarding success rate, discomfort during performance of block, tourniquet tolerance and complications. The study was randomised, prospective and observer blinded. Sixty adult patients of both sexes of ASA status 1 and 2 requiring orthopaedic surgery below mid-humerus were randomly assigned to receive nerve stimulator guided infraclavicular brachial plexus block either by lateral coracoid approach (group L, n = 30 or medial clavicular approach (group M, n = 30 with 25-30 ml of 0.5% bupivacaine. Sensory block in the distribution of five main nerves distal to elbow, motor block (Grade 1-4, discomfort during performance of block and tourniquet pain were recorded by a blinded observer. Clinical success of block was defined as the block sufficient to perform the surgery without any supplementation. All the five nerves distal to elbow were blocked in 77 and 67% patients in groups L and M respectively. Successful block was observed in 87 and 73% patients in groups L and M, respectively (P > 0.05. More patients had moderate to severe discomfort during performance of block due to positioning of limb in group M (14 vs. 8 in groups M and L. Tourniquet was well tolerated in most patients with successful block in both groups. No serious complication was observed. Both the approaches were equivalent regarding success rate, tourniquet tolerance and safety. Coracoid approach seemed better as positioning of operative limb was less painful, coracoids process was easy to locate and the technique was easy to learn and master.

  2. The past, present and near future of materials for use in biodegradable orthopaedic implants

    Directory of Open Access Journals (Sweden)

    Clara Eugenia Plazas Bonilla

    2011-05-01

    Full Text Available  The aim of bone replacement or fracture treatment methodologies is to induce tissue regeneration respecting anatomy and try to recover functionality. This goal was initially achieved in the 17th century by using animal or human grafts and several medical devices made of natural and synthetic materials are currently used having a whole range of chemical and physical properties. Research in this field continues to seek a solution to the disadvantages usually found when using grafts: immunological reactions, the risk of microbiological contamination, the absence of donors, the need for several surgical interventions and the risk of disease transmission. Basic and applied research must thus be carried out not only in the development of biology and studies about embryonic stem cells but also in the field of new material development. This tendency may be clearly detected by looking at the vast numbers of studies related to using metallic, polymer and ceramic materials and, at present, compound or hybrid materials having potential use in orthopaedic implants. Most of them fulfil conditions regarding biocompatibility and non-toxicity and could be considered when designing biodegradable materials thereby making it feasible to identify a range of research subjects on biomaterials. This paper starts by identifying material development periods and then establishes the advantages and disadvantages of groups which have been considered for bone regeneration and identifies some guidelines which should be taken into account in the field of biodegradable materials in the near future. There is still a long way to go in this subject, especially regarding the field of materials science and technology. 

  3. Heat-shock-induced cellular responses to temperature elevations occurring during orthopaedic cutting.

    Science.gov (United States)

    Dolan, E B; Haugh, M G; Tallon, D; Casey, C; McNamara, L M

    2012-12-01

    Severe heat-shock to bone cells caused during orthopaedic procedures can result in thermal damage, leading to cell death and initiating bone resorption. By contrast, mild heat-shock has been proposed to induce bone regeneration. In this study, bone cells are exposed to heat-shock for short durations occurring during surgical cutting. Cellular viability, necrosis and apoptosis are investigated immediately after heat-shock and following recovery of 12, 24 h and 4 days, in osteocyte-like MLO-Y4 and osteoblast-like MC3T3-E1 cells, using flow cytometry. The regeneration capacity of heat-shocked Balb/c mesenchymal stem cells (MSCs) and MC3T3-E1s has been investigated following 7 and 14 day's recovery, by quantifying proliferation, differentiation and mineralization. An immediate necrotic response to heat-shock was shown in cells exposed to elevated temperatures (45°C, 47°C and most severe at 60°C). A longer-term apoptotic response is induced in MLO-Y4s and, to a lesser extent, in MC3T3-E1s. Heat-shock-induced differentiation and mineralization by MSCs. These findings indicate that heat-shock is more likely to induce apoptosis in osteocytes than osteoblasts, which might reflect their role as sensors detecting and communicating damage within bone. Furthermore, it is shown for the first time that mild heat-shock (less than equal to 47°C) for durations occurring during surgical cutting can positively enhance osseointegration by osteoprogenitors. PMID:22915633

  4. Alignment and articular orientation of lower limbs: manual vs computer-aided measurements on digital radiograms; Allineamento ed orientamento articolare degli arti inferiori: confronto tra misure manuali e computerizzate su radiogrammi digitali

    Energy Technology Data Exchange (ETDEWEB)

    Rozzanigo, Umberto; Caudana, Roberto [Azienda Ospedaliera Carlo Poma, Mantova (Italy). Dipartimento di Diagnostica per Immagini; Pizzoli, Andrea [Azienda Ospedaliera Carlo Poma, Mantova (Italy). Divisione di Ortopedia e Traumatologia; Minari, Chiara [Azienda Ospedaliera Carlo Poma, Mantova (Italy). Servizio di Fisica Sanitaria

    2005-03-01

    Purpose: To compare the manual measurements of lower limbs on digital images with those obtained with dedicated software. Materials and methods: Forty patients with a clinical suspicion of lower limb deformity were enrolled. Eighty digital radiographs were produced with a remote-controlled radiography system (Philips Omnidia-gnost). The measurements were taken separately by an Orthopaedic Surgeon and by a Radiologist, by hand and with the aid of software, respectively. Five parameters were assessed: femoral length, tibial length, distal-medial femoral angle, proximal-medial tibial angle and tibial-femoral angle. The statistical analysis of the comparison was based on Student's-test. The inter-observer variability of the methods, manual and computer-aided, was evaluated with Fisher's F-test on a sample of measurements (20 lower limbs), taken by 5 different Orthopaedic Surgeons and Radiologists, respectively. Results: There were no statistically significant differences between the measurements taken with the manual and computer-aided methods (p>0.05). The overall reproducibility of both methods was similar; conversely, the separate evaluation of angles and lengths showed that the computer-aided method was less variable in the measurements of lengths than the manual method. Conclusions: The computer-aided evaluation of the alignment and articular orientation parameters of lower limbs is as accurate and reliable as the traditional manual method, but is faster and allows better-quality images.

  5. AIDS ORPHANS GET SPECIAL VISITOR

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Chinese Premier Wen Jiabao visits AIDS orphans in Shangcai County,central China’s Henan Province,on November 30,a day before the 20th World AIDS Day. The region of Shangcai has the highest concentration of people living with HIV/AIDS in China. The Chinese Government has released a package of policies that offer people living with HIV/AIDS free medicine,health checks and consultations,as well as free schooling to AIDS orphans.

  6. Early AIDS dementia complex

    International Nuclear Information System (INIS)

    A frequent complication of the acquired immunodeficiency syndrome (AIDS) is AIDS dementia complex (ADC). The authors evaluated seven patients with AIDS (aged 28-55 years, all male) for ADC by psychiatric evaluation, neuropsychological testing, CT scanning, and IMP-SPECT. Six of seven patients exhibited cognitive or behavioral abnormalities. Neuropsychological testing showed general deficits but no cases of explicit dementia. SPECT showed marked abnormalities in two cases: posterior temporal-parietal diminution of tracer uptake in one case (posterior/anterior=0.81) and marked right/left subcortical asymmetry (1.17) in the other. In three additional cases there was asymmetric tracer uptake in the subcortical and parietal regions. CT findings were normal in all seven cases. The authors conclude that functional imaging with the use of IMP-SPECT may be a useful method to follow ADC progression and response to therapy

  7. A constitution for AIDS.

    Science.gov (United States)

    Koshy, L M

    1996-01-15

    The Indian Health Organization projected the number of deaths per day due to AIDS by the year 2000 at 10,000. An interdisciplinary international conference was held in New Delhi to draft an international law governing the issues related to AIDS. Human freedom and public health policies are the most affected by this disease. In the absence of an international AIDS law, judicial verdicts set precedents and could have serious ramifications. A participant from the John Marshall Law School, Chicago, suggested that instead of making new laws, the existing ones from the colonial past should be repealed. This includes Section 377 of the Indian Penal Code, which provides criminal sanctions against those who indulge in unnatural relations with man, woman, or animal. Penalizing homosexuality will only perpetuate clandestine relations and spread the virus into their families. Another participant seconded this motion stating that even a sex worker must be protected from abuse and indignity. The National AIDS Control Organization responded to the criticism that the government had not utilized all the World Bank funds allocated for anti-AIDS projects. The trends of the epidemic were the most important indicators not just the numbers. In Manipur and Mizoram, infection was almost entirely due to injecting drug use. The Saheli project undertaken in the red-light areas of Bombay encompassed brothel owners and prostitutes, which could be replicated in other areas. Because existing government policies were focusing on prevention, there was no protection of an HIV-infected individual's privacy, one participant from Madras stated. The confidentiality issue was also echoed by a US participant. The New Delhi Declaration and Action Plan on HIV/AIDS was also discussed. It forbids discrimination in employment, education, housing, health care, social security, travel, and marital and reproductive rights. Providing sterile needles and ensuring the safety of the blood supply were other concerns

  8. Titanium coated with functionalized carbon nanotubes — A promising novel material for biomedical application as an implantable orthopaedic electronic device

    Energy Technology Data Exchange (ETDEWEB)

    Przekora, Agata, E-mail: agata.przekora@umlub.pl [Department of Biochemistry and Biotechnology, Medical University of Lublin, Faculty of Pharmacy with Medical Analytics Division, Chodzki 1, 20-093 Lublin (Poland); Benko, Aleksandra; Nocun, Marek; Wyrwa, Jan; Blazewicz, Marta [Faculty of Materials Science and Ceramics, AGH-Univ. of Science and Technology, A. Mickiewicz 30 Ave., 30-059 Cracow (Poland); Ginalska, Grazyna [Department of Biochemistry and Biotechnology, Medical University of Lublin, Faculty of Pharmacy with Medical Analytics Division, Chodzki 1, 20-093 Lublin (Poland)

    2014-12-01

    The aim of the study was to fabricate titanium (Ti) material coated with functionalized carbon nanotubes (f-CNTs) that would have potential medical application in orthopaedics as an implantable electronic device. The novel biomedical material (Ti-CNTs-H{sub 2}O) would possess specific set of properties, such as: electrical conductivity, non-toxicity, and ability to inhibit connective tissue cell growth and proliferation protecting the Ti-CNTs-H{sub 2}O surface against covering by cells. The novel material was obtained via an electrophoretic deposition of CNTs-H{sub 2}O on the Ti surface. Then, physicochemical, electrical, and biological properties were evaluated. Electrical property evaluation revealed that a Ti-CNTs-H{sub 2}O material is highly conductive and X-ray photoelectron spectroscopy analysis demonstrated that there are mainly COOH groups on the Ti-CNTs-H{sub 2}O surface that are found to inhibit cell growth. Biological properties were assessed using normal human foetal osteoblast cell line (hFOB 1.19). Conducted cytotoxicity tests and live/dead fluorescent staining demonstrated that Ti-CNTs-H{sub 2}O does not exert toxic effect on hFOB cells. Moreover, fluorescence laser scanning microscope observation demonstrated that Ti-CNTs-H{sub 2}O surface retards to a great extent cell proliferation. The study resulted in successful fabrication of highly conductive, non-toxic Ti-CNTs-H{sub 2}O material that possesses ability to inhibit osteoblast proliferation and thus has a great potential as an orthopaedic implantable electronic device. - Highlights: • Functionalized carbon nanotubes were electrophoretically deposited on Ti surface. • Physicochemical, electrical, and biological properties were evaluated. • Ti-CNTs-H{sub 2}O is highly conductive and there are mainly COOH groups on its surface. • Novel material is non-toxic and retards to a great extent osteoblast proliferation. • Ti-CNTs-H{sub 2}O has a promising potential as implantable orthopaedic

  9. The role of social support in the relationship between mental health and posttraumatic stress disorder amongst orthopaedic patients

    Directory of Open Access Journals (Sweden)

    Vhuhwavho M. Maselesele

    2013-01-01

    Full Text Available Background: Some life-event experiences such as injuries in car accidents, gun shots and the like, can be life changing and traumatic. Objectives: The article investigated the relationship between mental health and posttraumatic stress disorder (PTSD symptoms after orthopaedic trauma, and attempted to understand whether social support moderates the relationship between mental health and PTSD.Method: A cross-sectional research model was used. Two hundred participants were selected using simple randomisation within a hospital complex in Gauteng, South Africa. The sample consisted of 110 men and 90 women (x̄ = 37.8 years, s.d. = 12.9 years. Data were collected using the Revised Civilian Mississippi Scale for PTSD, the Multidimensional Scale of Perceived Social Support (MSPSS, and the General Health Questionnaire version 28.Results: The findings of the study indicated that there is a statistically significant relationship between mental health and PTSD after orthopaedic trauma, and a positive correlation between poor mental health and PTSD (r = 0.52, n = 200, p < 0.05. However, perceived social support did not moderate mental health or PTSD, indicating that perceived social support did not significantly influence mental health or PTSD, (MSPSS B = 0.07, p = 0.66. Those with high scores on social support had a lower regression coefficient (B = 0.19 for mental health and PTSD than those who reported low social support (B = 0.26.Conclusion: There is a significant relationship between mental health and PTSD of orthopaedic patients, and social support did not moderate the relationship between mental health and PTSD. 

  10. Towards a National Pediatric Musculoskeletal Trauma Outcomes Registry: the Pediatric Orthopaedic Trauma Outcomes Research Group (POTORG) experience.

    Science.gov (United States)

    Vitale, Michael G; Vitale, Mark A; Lehmann, Charles L; Hyman, Joshua E; Roye, David P; Skaggs, David L; Schmitz, Michael L; Sponseller, Paul D; Flynn, John M

    2006-01-01

    This study is a pilot effort towards the broader implementation of a national pediatric musculoskeletal trauma outcomes registry. The primary goal of this project is to explore the feasibility of a web-based data acquisition and management platform and to identify catalysts and obstacles to multi-center collaboration. A prospective cohort of children presenting to the Pediatric Emergency Departments with ankle, femur, supracondylar humerus, tibial spine, or open fractures at five clinical centers between October 2001 and March 2003 comprised the study population. Patients were enrolled via the treating orthopaedic resident, using a web-based data acquisition and management system. Orthopaedic attendees were sent an automated reminder to complete a follow-up form one week after treatment, and parents of enrolled children were sent child and parent health questionnaires by e-mail and mail in order to capture health-related quality of life and post-traumatic stress symptoms. A total of 299 patients were enrolled in the study with an average age of 7.3 years. Post-treatment follow-up questionnaires were completed by 39% of the attending orthopaedic surgeons, and by 43% of the enrolled patients or patient's parents. Children old enough to complete health questionnaires scored lower in 5 of 12 functional domains including Physical Function, Role/Social Emotional/Behavioral, Parental Impact-Emotional, Family Activities, and Family Cohesion. Within the subset of patients sustaining femur fractures whose parents completed health questionnaires, 9.5% reported significant post-traumatic stress symptoms. This study demonstrates the potential of a multi-center web-based registry to facilitate the collection of a rich array of pediatric trauma, treatment and patient-based outcomes data, although new regulatory issues regarding patient privacy pose challenges to such an approach. PMID:16557126

  11. Aid Supplies Over Time

    DEFF Research Database (Denmark)

    Jones, Edward Samuel

    The recent financial crisis has rekindled interest in the foreign aid supply behaviour of bilateral donors. Using the latest data covering the period 1960-2009, this paper examines how such behaviour is related to domestic factors. Based on a simple empirical model, a distinction is made between...... substantial heterogeneity between countries. There is also good evidence that donor behaviour continues to evolve over time. As such, past trends in aid supplies are unlikely to provide a good guide to those of the future....

  12. Hearing Aid Personalization

    DEFF Research Database (Denmark)

    Nielsen, Jens Brehm; Nielsen, Jakob; Jensen, Bjørn Sand;

    2013-01-01

    Modern digital hearing aids require and offer a great level of personalization. Today, this personalization is not performed based directly on what the user actually perceives, but on a hearing-care professional’s interpretation of what the user explains about what is perceived. In this paper, an...... interactive personalization system based on Gaussian process regression and active learning is proposed, which personalize the hearing aids based directly on what the user perceives. Preliminary results demonstrate a significant difference between a truly personalized setting obtained with the proposed system...

  13. Computer aided control engineering

    DEFF Research Database (Denmark)

    Szymkat, Maciej; Ravn, Ole

    1997-01-01

    Current developments in the field of Computer Aided Control Engineering (CACE) have a visible impact on the design methodologies and the structure of the software tools supporting them. Today control engineers has at their disposal libraries, packages or programming environments that may be speci......Current developments in the field of Computer Aided Control Engineering (CACE) have a visible impact on the design methodologies and the structure of the software tools supporting them. Today control engineers has at their disposal libraries, packages or programming environments that may...

  14. Aid and Development

    DEFF Research Database (Denmark)

    Tarp, Finn

    Foreign aid looms large in the public discourse; and international development assistance remains squarely on most policy agendas concerned with growth, poverty and inequality in Africa and elsewhere in the developing world. The present review takes a retrospective look at how foreign aid has...... been effective in furthering economic growth and development is discussed in some detail. I add perspective and identify some critical unresolved issues. I finally turn to the current development debate and discuss some key concerns, which I believe should be kept in mind in formulating any agenda for...

  15. Orthopaedic Surgeons as Clinical Leaders in the National Health Service, United Kingdom (NHS UK): Can the World Learn From Us?

    Science.gov (United States)

    Javed, Mustafa; Moulder, Elizabeth; Mohsen, Amr

    2015-07-01

    This article outlines some of the key concepts in leadership (both styles and theories) to provide a platform for further learning and to help the modern day orthopaedic surgeons to apply these concepts to their current practice. It is focused on two major aspects: management of medical organizations and effective twenty-first century care by surgeons through proper leadership guide and aimed in improving patient care outcomes. Practicing proper leadership skills based on evidence resulted in effective management of organization. Thus achieving patient's satisfaction. PMID:26208560

  16. A synthetic system links FeFe-hydrogenases to essential E. coli sulfur metabolism

    Directory of Open Access Journals (Sweden)

    Grandl Gerald

    2011-05-01

    Full Text Available Abstract Background FeFe-hydrogenases are the most active class of H2-producing enzymes known in nature and may have important applications in clean H2 energy production. Many potential uses are currently complicated by a crucial weakness: the active sites of all known FeFe-hydrogenases are irreversibly inactivated by O2. Results We have developed a synthetic metabolic pathway in E. coli that links FeFe-hydrogenase activity to the production of the essential amino acid cysteine. Our design includes a complementary host strain whose endogenous redox pool is insulated from the synthetic metabolic pathway. Host viability on a selective medium requires hydrogenase expression, and moderate O2 levels eliminate growth. This pathway forms the basis for a genetic selection for O2 tolerance. Genetically selected hydrogenases did not show improved stability in O2 and in many cases had lost H2 production activity. The isolated mutations cluster significantly on charged surface residues, suggesting the evolution of binding surfaces that may accelerate hydrogenase electron transfer. Conclusions Rational design can optimize a fully heterologous three-component pathway to provide an essential metabolic flux while remaining insulated from the endogenous redox pool. We have developed a number of convenient in vivo assays to aid in the engineering of synthetic H2 metabolism. Our results also indicate a H2-independent redox activity in three different FeFe-hydrogenases, with implications for the future directed evolution of H2-activating catalysts.

  17. Computer aided control engineering

    DEFF Research Database (Denmark)

    Szymkat, Maciej; Ravn, Ole

    Current developments in the field of Computer Aided Control Engineering (CACE) have a visible impact on the design methodologies and the structure of the software tools supporting them. Today control engineers has at their disposal libraries, packages or programming environments that may be...

  18. HIV/AIDS

    Science.gov (United States)

    ... health days Meetings and consultations 2014 Fact sheets Features Commentaries 2014 Multimedia Contacts HIV/AIDS Fact sheet Updated July 2016 Key facts HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2015, 1.1 (940 000– ...

  19. Computer aided magnet design

    International Nuclear Information System (INIS)

    In this paper the elements of a computer aided magnet design system is outlined. The methods of solving the field equations are briefly reviewed, followed by a survey of available codes. Particular examples of the use of RAL codes in solving 3D magnetic design problems are given. Future developments are discussed. (author)

  20. Computer aided safety analysis

    International Nuclear Information System (INIS)

    The document reproduces 20 selected papers from the 38 papers presented at the Technical Committee/Workshop on Computer Aided Safety Analysis organized by the IAEA in co-operation with the Institute of Atomic Energy in Otwock-Swierk, Poland on 25-29 May 1987. A separate abstract was prepared for each of these 20 technical papers. Refs, figs and tabs

  1. Hearing Aids Communication

    DEFF Research Database (Denmark)

    Globally, hearing loss is the second most frequent disability. About 80% of the persons affected by hearing loss do not use hearing aids. The goal of this edited volume is to present a theoretically founded, interdisciplinary approach geared at understanding and improving social interaction impac...

  2. AIDS, a development challenge.

    Science.gov (United States)

    1999-01-01

    During the Joint Conference of African Ministers of Planning and Finance, hosted by the UN Economic Commission for Africa in Addis Ababa on May 6-8, 1999, HIV/AIDS was highlighted as one of the major agendas for development planning. AIDS was considered to have a major impact on the household economy, the private sector, and at the macroeconomic level. Aside from the emotional impact of losing a loved one, the families of deceased HIV-infected individuals suffer an almost 50% reduction of income. This would consequently lead to cutting down on educational expenditures. On the other hand, national economies and private sectors suffer from a decreased purchasing power and loss of competitiveness in the global economy due to illiteracy. Furthermore, 50% of the national budget would be allocated for AIDS treatment, while private companies would experience a 7-20% decrease in profits as a result of high cost of medical treatment. In addition, the reduced pool of skilled labor and high expense of training would eventually bring about a decrease in high quality foreign investment. At the macroeconomic level, AIDS would result in a 1% reduction of gross domestic product growth per capita annually. It was suggested that strong political support, broad institutional participation and carefully selected program intervention, as well as openness about the disease and information dissemination on its cause and spread are deemed effective in the plan of eliminating the spread of the disease. PMID:12349447

  3. Leishmaniasis and AIDS coinfection*

    OpenAIRE

    Hozannah, Adriana; Santos, Monica; Chrusciak-Talhari, Anette; Talhari, Carolina

    2013-01-01

    Cutaneous leishmaniasis and HIV coinfection has been reported in Brazil since the initial description of AIDS in the country. We report an HIV-positive patient under antiretroviral treatment who presented with cutaneous leishmaniasis which was successfully treated with meglumine antimoniate.

  4. Range Scheduling Aid (RSA)

    Science.gov (United States)

    Logan, J. R.; Pulvermacher, M. K.

    1991-01-01

    Range Scheduling Aid (RSA) is presented in the form of the viewgraphs. The following subject areas are covered: satellite control network; current and new approaches to range scheduling; MITRE tasking; RSA features; RSA display; constraint based analytic capability; RSA architecture; and RSA benefits.

  5. Studying Aid: Some Methods

    NARCIS (Netherlands)

    D.R. Gasper (Des)

    2003-01-01

    textabstractINVESTIGATING IDEAS, IDEOLOGIES AND PRACTICES This paper presents some methods for trying to make sense of international aid and of its study.1 Some of the methods may be deemed ethnographic; the others are important partners to them, but rather different. In the course of discussing q

  6. AIDS Overspill to Everyman

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Xu Wenqing, national project officer of the UN International Children's Emergency Fund (UNICEF), recently issued a warning that the men/women ratio of HIV infection in China now stands at 5:5. This indicates that AiDS now threatens other than intravenous drug users, sex workers and hemophiliacs.

  7. Apartheid and AIDS.

    Science.gov (United States)

    Viljoen, A T

    1989-11-25

    To persuade South Africa to abolish its apartheid policy several measures have been taken by the international community, including economic sanctions. The harm done by sanctions to the South African economy is obvious. As economic activity has slowed down, unemployment, especially in the black community, has risen. For the unemployed poverty and hunger are harsh realities while for those lucky enough to have jobs income remains quite high. Prostitution has become a way of redistributing income and for many families it is the only way to avoid starvation. With prostitution, however, has come AIDS: it is estimated that HIV infection is doubling every 5-8 months. On 1 calculation 85% of sexually active blacks could be infected with HIV by 1996; most would proceed to AIDS and die, leaving millions of children without parents. Although economic sanctions have speeded up some measure of reform in South Africa they are now harming the very people they were intended to help. Furthermore insidious voices are already being heard saying the government should stop all reform processes and anti-AIDS campaigns and just "sit it out" for the next few years. A further consequence of an ailing economy is the unavailability of funding for those who wish to curb the spread of AIDS via educational and other programs. [Full text] PMID:2573792

  8. DIAPASON, supervision aid system

    International Nuclear Information System (INIS)

    Diapason, a supervision aid system, gives to the operator a synthetic representation of the process. It permits to predict the evolution of the process in order to realize an anticipated control; in incidental conditions, it permits a precocious detection and gives a default diagnostic. It comprises 3 modules used in a spent fuel reprocessing simulator. 9 refs

  9. Oesophageal candiasis in AIDS

    OpenAIRE

    Yadav, S. P. S.; Ranga, Rupender K.; Singh, Jagat; Yadav, Rohtas

    2003-01-01

    With the explosion in the number of AIDS patients, many of these are likely to consult to otolaryngologists the head & neck is a rather common site to be affected. Sometimes only oesophageal candidiasis is the presenting feature as in the present case which is being reported show typical radiological appearance. the differential diagnosis and treatment of nesophageal candidiasis is briefly discussed

  10. Aid Projects Benefit Xigaze

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Motivated by the thirdnational conference onwork in Tibet held by theCPC Central Committeeand the State Council meeting in July1994, Shanghai and Shandong provincedecided to provide aid to the Xigazearea from May 1995 onwards. Thefourth conference on work in Tibet heldin May 2001 again established that the

  11. More than First Aid

    Science.gov (United States)

    Schoessler, Sally

    2011-01-01

    The school nurse is an important member of the school team since school health services keep students in school, in the classroom, and ready to learn. Although school nurses are often seen as the people who deliver first aid at school, their role is much deeper and has such breadth that only a registered, professional nurse has the skill set to…

  12. Agglomeration and aid

    NARCIS (Netherlands)

    S. Brakman (Steven); J.H. Garretsen (Harry); J.G.M. van Marrewijk (Charles)

    2007-01-01

    textabstractA key issue in development economics is the explanation of core-periphery patterns around the world. Combining this issue with that of analyzing unilateral transfers (e.g. foreign aid) points in the direction of the use of New Economic Geography (NEG) models which, so far, has not been d

  13. First Aid Challenge

    Science.gov (United States)

    Roman, Harry T.

    2011-01-01

    This article describes a challenge wherein students will be asked to design a portable first aid kit that is normally carried in a recreational vehicle (RV), but can also be hand-carried or backpacked off road for distances of approximately 1-2 miles. This can be a very practical challenge for the students because it touches everyone. Everybody…

  14. First aid advisor

    Energy Technology Data Exchange (ETDEWEB)

    Saffer, S.I.; Weng, Wen-Chang [Texas A & M Univ., Commerce, TX (United States)

    1996-12-31

    A knowledge-based system (KBS), First Aid Advisor (FAA), is developed to provide a guidance for either a trained or untrained person to take some emergent actions to rescue the victim from life-threatening hazard or to prevent from causing serious problem before the Emergency Medical Service System (EMS) personnels arrive the scene. The First Aid Advisor will collect victim`s information by interacting with the user through a sequence of questions, analyze the victim`s problem, and give instructions step by step before offering a final advice. Since all the possible conditions are taken into consideration, it will guide the user to perform first aid from the most to the least urgent step for the victim. Furthermore, it will offer a suitable first aid advice for victim and eliminate the possibility of wrong actions done by trained person due to carelessness or nervousness. Offering advice to handle problems involving life-threatening conditions is the main objective of this system. In this paper, we will describe six major components of FAA and their respective tasks. Decision tables and dependency diagrams used in FAA implementation will also be described. System performance issues will conclude the paper.

  15. AIDS and associated malignancies

    Institute of Scientific and Technical Information of China (English)

    Charles; WOOD; William; HARRINGTON; Jr

    2005-01-01

    AIDS associated malignancies (ARL) is a major complication associated with AIDS patients upon immunosuppression.Chronically immunocompromised patients have a markedly increased risk of developing lymphoproliferative disease. In the era of potent antiretrovirals therapy (ARV), the malignant complications due to HIV- 1 infection have decreased in developed nations where ARV is administered, but still poses a major problem in developing countries where HIV- 1incidence is high and ARV is still not yet widely available. Even in ARV treated individuals there is a concern that the prolonged survival of many HIV- 1 carriers is likely to eventually result in an increased number of malignancies diagnosed.Malignancies that were found to have high incidence in HIV-infected individuals are Kaposi's sarcoma (KS), Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). The incidence of NHL has increased nearly 200 fold in HIV-positive patients, and accounts for a greater percentage of AIDS defining illness in the US and Europe since the advent of HAART therapy. These AIDS related lymphomas are distinct from their counterparts seen in HIV- 1 seronegative patients.For example nearly half of all cases of ARL are associated with the presence of a gamma herpesvirus, Epstein Barr virus (EBV) or human herpesvirus-8 (HHV-8)/Kaposi's sarcoma associated herpesvirus (KSHV). The pathogenesis of ARLs is complex. B-cell proliferation driven by chronic antigenemia resulting in the induction of polyclonal and ultimately monoclonal lymphoproliferation may occur in the setting of severe immunosuppression.

  16. AIDS: there's hope.

    Science.gov (United States)

    1993-06-01

    In 1993, 10 years after realizing that AIDS posed a threat to the future of mankind, social mobilization will improve the odds against AIDS. The objective is to create awareness about the virus, and to affect positive behavioral change through advocacy, communication, and grass-roots actions. The first goal is to change the societal attitude about the status of youth and women in order to understand that gender inequality fuels the pandemic. They are the most vulnerable groups, therefore their economic and social power must be improved. The Convention on the Rights of the Child and the Convention on the Elimination of All Forms of Discrimination against Women constitute a platform for broader action by governmental, nongovernmental, and religious institutions. In addition, these organizations need strong allies in society: 1) the media, which can communicate the importance of youth, women, and attitudes in the epidemic; 2) religious leaders, who can be powerful sources of advocacy for change in attitudes as well as support and care for AIDS-affected individuals and families; 3) policy makers, who can be crucial in changing existing policies and altering the allocation of government resources to youth and women; 4) human rights organizations, which play an important role in promoting the concept of health as a human right and for enhancing the understanding of AIDS in the context of discrimination and poverty; 5) the private sector, including commerce and industry, which can promote changes in attitude within the work force and AIDS prevention initiatives; and 6) parent-teacher groups and models for youth, who can educate them about socially acceptable and unacceptable behavior and can empower them to make responsible behavior choices. PMID:12179231

  17. [AIDS in Tanzania].

    Science.gov (United States)

    Barstad, S

    1993-04-20

    The World Health Organization has announced that within 3 years 10% of Tanzania's population of 26 million will be infected with the human immunodeficiency virus (HIV). But there is some faint hope in the research of Tanzanian traditional medicine. An almost 90-year-man, Waziri Mrisho, is credited with having treated AIDS patients successfully with herbs that strengthen the immune system. Margaret Nakamya was stricken by the symptoms of AIDs in March 1990. She was referred to Waziri and started using his herbs. 3 years later she weighs 49 kg compared to 40 kg before. The old man's son set up a little factory where he pulverizes herbs and sells them at the price he can command The 3 types of trees that the herbal medicine is taken from grow in the wild, but some have also been planted around the factory. Even if these herbs are effective, it will take years before the AIDS epidemic is over, when people have changed their lifestyles. The means of communication (TV, cinema, radio, telephone) are missing or inadequate. In the Kagera region, with 1.2 million inhabitants, 25% of pregnant women are HIV-infected and 65,000 children lost their parents to AIDS. There are 2000 children in Dar Es Salaam living in the streets. The Anglican St. Albans Church runs a center for street kids where they get meals 3 times a week. The nurse Ruth Nesje enlisted a Norwegian physician and homeopath in a research project involving 30 AIDS patients in Norway. The University in Bergen will do in vitro testing. One group of patients will receive both AZT and the herbs, another group will get only AZT, and the 3rd group will obtain only the herbs. The Norwegian Nursing Association, NORAD, and DANIDA also plan various projects in the Tanga region. PMID:8499187

  18. The Prevalence of Accidental Needle Stick Injury and their Reporting among Healthcare Workers in Orthopaedic Wards in General Hospital Melaka, Malaysia

    OpenAIRE

    Bhardwaj, A.; Sivapathasundaram, N; Yusof, MF; Minghat, AH; Swe, KMM; Sinha, NK

    2014-01-01

    Abstract Background :Accidental needle-stick injuries (NSIs) are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9%) and majority of it occurred during assisting ...

  19. The comprehensive cohort model in a pilot trial in orthopaedic trauma

    Directory of Open Access Journals (Sweden)

    Parsons Nick R

    2011-04-01

    Full Text Available Abstract Background The primary aim of this study was to provide an estimate of effect size for the functional outcome of operative versus non-operative treatment for patients with an acute rupture of the Achilles tendon using accelerated rehabilitation for both groups of patients. The secondary aim was to assess the use of a comprehensive cohort research design (i.e. a parallel patient-preference group alongside a randomised group in improving the accuracy of this estimate within an orthopaedic trauma setting. Methods Pragmatic randomised controlled trial and comprehensive cohort study within a level 1 trauma centre. Twenty randomised participants (10 operative and 10 non-operative and 29 preference participants (3 operative and 26 non-operative. The ge range was 22-72 years and 37 of the 52 patients were men. All participants had an acute rupture of their Achilles tendon and no other injuries. All of the patients in the operative group had a simple end-to-end repair of the tendon with no augmentation. Both groups then followed the same eight-week immediate weight-bearing rehabilitation programme using an off-the-shelf orthotic. The disability rating index (DRI; primary outcome, EQ-5D, Achilles Total Rupture Score and complications were assessed ed at two weeks, six weeks, three months, six months and nine months after initial injury. Results At nine months, there was no significant difference in DRI between patients randomised to operative or non-operative management. There was no difference in DRI between the randomised group and the parallel patient preference group. The use of a comprehensive cohort of patients did not provide useful additional information as to the treatment effect size because the majority of patients chose non-operative management. Conclusions Recruitment to clinical trials that compare operative and non-operative interventions is notoriously difficult; especially within the trauma setting. Including a parallel patient

  20. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

    Directory of Open Access Journals (Sweden)

    Negrini Stefano

    2012-01-01

    Full Text Available Abstract Background The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT, that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS. Methods All types of professionals (specialty physicians, and allied health professionals engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting. Results The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations, PSE to prevent scoliosis progression during growth (8, PSE during brace treatment and surgical therapy (5, Other conservative treatments (3, Respiratory function and exercises (3, Sports activities (6, Assessment (20. No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D. Conclusion These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas

  1. What influences a patient’s decision to use custom-made orthopaedic shoes?

    Directory of Open Access Journals (Sweden)

    van Netten Jaap J

    2012-06-01

    Full Text Available Abstract Background Despite potential benefits, some patients decide not to use their custom-made orthopaedic shoes (OS. Factors are known in the domains ‘usability’, ‘communication and service’, and ‘opinion of others’ that influence a patient’s decision to use OS. However, the interplay between these factors has never been investigated. The aim of this study was to explore the interplay between factors concerning OS, and the influences thereof on a patient’s decision to use OS. Methods A mixed-methods design was used, combining qualitative and quantitative data by means of sequential data analysis and triangulation. Priority was given to the qualitative part. Qualitative data was gathered with a semi-structured interview covering the three domains. Data was analysed using the framework approach. Quantitative data concerned the interplay between factors and determining a rank-order for the importance of factors of ‘usability’. Results A patient’s decision to use OS was influenced by various factors indicated as being important and by acceptance of their OS. Factors of ‘usability’ were more important than factors of ‘communication’; the ‘opinion of others’ was of limited importance. An improvement of walking was indicated as the most important factor of ‘usability’. The importance of other factors (cosmetic appearance and ease of use was determined by reaching a compromise between these factors and an improvement of walking. Conclusions A patient’s decision to use OS is influenced by various factors indicated as being important and by acceptance of their OS. An improvement of walking is the most important factor of ‘usability’, the importance of other factors (cosmetic appearance and ease of use is determined by reaching compromises between these factors and an improvement of walking. Communication is essential to gain insight in a patient’s acceptance and in the compromises they are willing to reach

  2. Foreign Aid and Consumption Smoothing; Evidence From Global Food Aid

    OpenAIRE

    Erwin Tiongson; Benedict J. Clements; Sanjeev Gupta

    2003-01-01

    Global food aid is considered a critical consumption smoothing mechanism in many countries. However, its record of stabilizing consumption has been mixed. This paper examines the cyclical properties of food aid with respect to food availability in recipient countries, with a view to assessing its impact on consumption in some 150 developing countries and transition economies, covering 1970 to 2000. The results show that global food aid has been allocated to countries most in need. Food aid ha...

  3. A study on the radiation dose of the orthopaedic surgeon and staff from a mini c-arm fluoroscopy unit

    International Nuclear Information System (INIS)

    In this study, radiation exposure to the surgeon and supporting staff from a mini C-arm unit during fluoroscopically guided orthopaedic surgeries was studied. A Diadose dosemeter and Gamma-Scout meter were used for air-kerma measurements for primary and scattered radiations. The entrance dose of hands, eyes and thyroid of the surgeon was measured during direct observation. Scattered air-kerma rate was measured to quantify the received entrance dose of the supporting staff. During direct observation, the skin-entrance exposure rates of the surgeon's hand, eye and thyroid gland were 8036, 0.85 and 0.9 μGy min-1, respectively. The scattered exposure rate was precipitously dropped beyond the path of the primary radiation beam, and reached 0.51 μGy min-1 at a distance of 40 cm from the beam's central axis. This study showed that the surgeon's hand was the most dose-limiting organ for fluoroscopically guided orthopaedic surgery procedures when it was exposed to primary radiation. The exposure of supporting staff at a working distance of >20 cm from the beam was minimal during fluoroscopy by mini C-arm unit. (authors)

  4. Fabrication of poly(propylene fumarate)-based orthopaedic implants by photo-crosslinking through transparent silicone molds.

    Science.gov (United States)

    Timmer, Mark D; Carter, Cory; Ambrose, Catherine G; Mikos, Antonios G

    2003-11-01

    This work presents a new molding process for photo-crosslinked, degradable polymeric networks of poly(propylene fumarate) (PPF) and the crosslinking agent poly(propylene fumarate)-diacrylate (PPF-DA). Transparent room temperature vulcanizing silicone molds were fabricated for parts ranging from simple test coupons to orthopaedic implants. The PPF/PPF-DA resin blend was injected into the cavity and photo-crosslinked as light was transmitted through the mold wall. The volumetric shrinkage, mechanical properties, and the effects of gamma sterilization were reported for molded PPF/PPF-DA networks prepared with varying compositions of the two polymer components. The shrinkage decreased while the mechanical properties displayed a general increasing trend when more of the crosslinking agent was incorporated into the network. Gamma irradiation resulted in an improvement of the mechanical properties. In addition, PPF/PPF-DA replicates of a 70:30 poly(L/DL-lactide) biodegradable fixation plate and a bone allograft interbody fusion spacer were produced to evaluate the performance of PPF/PPF-DA as an orthopaedic implant and allow for a comparison to be made with materials that have been established for clinical use. PMID:12951014

  5. Henan Surveys Blood Donors to Aid AIDS Prevention

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    Central China's Henan Province, one of the worst AIDS-hit provinces in the country, launched a sweeping survey in September of past blood donors to ascertain tile number of HIV-infected individuals to aid AIDS prevention and control work.

  6. Women and HIV/AIDS

    Science.gov (United States)

    ... About Us Contact Us Text size | Print | HIV/AIDS This information in Spanish ( en español ) The human ... HIV, is a sexually transmitted infection and causes acquired immunodeficiency syndrome, or AIDS. Today, about one in four Americans ...

  7. HIV / AIDS: An Unequal Burden

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues HIV / AIDS HIV / AIDS: An Unequal Burden Past Issues / Summer 2009 ... high-risk category, emphasizes Dr. Cargill. Photo: iStock HIV and Pregnancy Are there ways to help HIV- ...

  8. Different Styles of Hearing Aids

    Science.gov (United States)

    ... aids available and offer some cosmetic and listening advantages. Photo courtesy of Phonak Click for larger image ... in place. These aids offer cosmetic and listening advantages and are used typically for adults. Photo courtesy ...

  9. Ten Common First Aid Mistakes

    Science.gov (United States)

    ... for the Latest in Workplace Safety Ten Common First Aid Mistakes These days, there are countless resources to ... We’ve listed some of the most common first aid mistakes below, along with the correct response methods. ...

  10. Global NeuroAIDS roundtable

    OpenAIRE

    Joseph, J.; Achim, CL; Boivin, MJ; Brew, BJ; Clifford, DB; Colosi, DA; Ellis, RJ; Heaton, RK; Gallo-Diop, A; Grant, I; Kanmogne, GD; Kumar, M; Letendre, S; Marcotte, TD; Nath, A

    2013-01-01

    In May 2012, the Division of AIDS Research at the National Institute of Mental Health (NIMH) organized the "Global NeuroAIDS Roundtable" in conjunction with the 11th International Symposium on Neurovirology and the 2012 Conference on HIV in the Nervous System. The meeting was held in New York, NY, USA and brought together NIMH-funded investigators who are currently working on projects related to the neurological complications of AIDS (NeuroAIDS) in Africa, Asia, Eastern Europe, and Latin Amer...

  11. Aid allocation and fragile states

    OpenAIRE

    McGillivray, Mark

    2006-01-01

    This paper summarises research on aid allocation and effectiveness, highlighting the current findings of recent research on aid allocation to fragile states. Fragile states are defined by the donor community as those with either critically poor policies or poorly performing institutions, or both. The paper examines the research findings in the broader context of research and analysis on how aid should and is being allocated across all developing countries. Various aid allocation models and th...

  12. Cerebral toxoplasmosis in AIDS

    International Nuclear Information System (INIS)

    Since 1982 (Hauser and co-workers), literature has reported focal cerebral tissue charges in AIDS patients whose diagnosis was unclear at first but which could be identified finally as florid toxoplasmosis encephalitis by biopsy and autopsy. It was found that the value of otherwise reliable serological tests (KBR, Sabin-Feldmann tests, etc.) is questionable in patients with severely impaired or incompetent immune systems, and, in particular, that a negative or uncharacteristic test result may not preclude any opportunistic infection process. Furthermore, isolation of Toxoplasma gondii or specific antibodies from the cerebrospinal fluid will be successful in exceptional cases only. In patients with AIDS or lymphadenopathy syndrome, the differential diagnosis will have to include - first and foremost - reactivated toxoplasma infection (not newly acquired, as a rule) if central neurological symptoms occur. (orig.)

  13. Mutual aid fund commission

    CERN Multimedia

    Staff Association

    2011-01-01

    The composition of the Board of the Mutual Aid Fund for 2011 is as follows: President: Pascal Droux Vice-president: Connie Potter Treasurer: Louis Pereira Deputy treasurer: Barbara Brugger Secretary: Sonia Casenove Deputy secretary: Isabelle Mardirossian Members: Christopher David Thomas   Jean-Claude Vialis (GAC member)   Marie-Luce Falipou   Gunilla Santiard (Jean-Claude Vialis’s alternate) The role of the Fund is to provide financial help to members of personnel and beneficiaries of the Pension Fund who are in need of exceptional financial assistance. All requests are treated in the strictest confidence. Should you wish to apply for aid from the Fund, kindly contact any member of the Board as given above or Social Services, tel.74479 – 73867.

  14. How Do People Get AIDS?

    Science.gov (United States)

    ... a Friend Who Cuts? How Do People Get AIDS? KidsHealth > For Teens > How Do People Get AIDS? Print A A A Text Size en español ¿Cómo contrae alguien el SIDA? AIDS stands for acquired immunodeficiency syndrome , a disease that ...

  15. HIV/AIDS and Alcohol

    Science.gov (United States)

    ... Other Psychiatric Disorders Other Substance Abuse HIV/AIDS HIV/AIDS Human immunodeficiency virus (HIV) targets the body’s immune ... and abuse can contribute to the spread of HIV/AIDS and affect treatment for infected patients. Abusing alcohol ...

  16. AIDS: Dynamics and Rehabilitation Concerns.

    Science.gov (United States)

    Wong, Henry; And Others

    1988-01-01

    The epidemic of Acquired Immune Deficiency Syndrome (AIDS) confronts the rehabilitation professional with a number of concerns. This paper reviews literature on the diagnosis, epidemiological factors, psychosocial elements, medical intervention of AIDS, and rehabilitation issues involved in serving AIDS patients. (JDD)

  17. Computer aided product design

    DEFF Research Database (Denmark)

    Constantinou, Leonidas; Bagherpour, Khosrow; Gani, Rafiqul; Klein, J.A.; Wu, D.T.

    A general methodology for Computer Aided Product Design (CAPD) with specified property constraints which is capable of solving a large range of problems is presented. The methodology employs the group contribution approach, generates acyclic, cyclic and aromatic compounds of various degrees of......-liquid equilibria (LLE), solid-liquid equilibria (SLE) and gas solubility. Finally, a computer program based on the extended methodology has been developed and the results from five case studies highlighting various features of the methodology are presented....

  18. Transitional justice and aid

    OpenAIRE

    Hellsten, Sirkku K.

    2012-01-01

    This paper examines the current security-governance-development nexus, something that is often also discussed under the concept of transitional justice (TJ). The paper analyses how the ambiguous, evolving and expanding nature of the concept of TJ affects the planning, coordination, evaluation and assessment of aid given to conflict ridden, post-conflict or (post) authoritarian societies in order to strengthen their democracy. Special attention is paid to gender justice. Illustrations are draw...

  19. Pulmonary mycosis in AIDS

    International Nuclear Information System (INIS)

    We retrospectively reviewed our series of 35 pulmonary mycosis in patients with AIDS, observed from 1987 to 1999, to correlate the imaging and pathologic findings. We further evaluated the frequency of fungal pneumonia before and after the use of a highly active antiretroviral therapy (HAART). Early recognition of pulmonary mycosis is imperative in these patients and improved survival can be achieved with early CT detection and prompt institution of high-dose antifungal therapy

  20. Pulmonary mycosis in AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Busi Rizzi, Elisa; Schinina, Vincenzo; Bellussi, Angelo; De Santis, Andrea; Mazzuoli, Giovanna; Giosue, Sandro; Bibbolino, Corrado

    2001-01-01

    We retrospectively reviewed our series of 35 pulmonary mycosis in patients with AIDS, observed from 1987 to 1999, to correlate the imaging and pathologic findings. We further evaluated the frequency of fungal pneumonia before and after the use of a highly active antiretroviral therapy (HAART). Early recognition of pulmonary mycosis is imperative in these patients and improved survival can be achieved with early CT detection and prompt institution of high-dose antifungal therapy.

  1. Computer aided product design

    DEFF Research Database (Denmark)

    Constantinou, Leonidas; Bagherpour, Khosrow; Gani, Rafiqul;

    1996-01-01

    A general methodology for Computer Aided Product Design (CAPD) with specified property constraints which is capable of solving a large range of problems is presented. The methodology employs the group contribution approach, generates acyclic, cyclic and aromatic compounds of various degrees......-liquid equilibria (LLE), solid-liquid equilibria (SLE) and gas solubility. Finally, a computer program based on the extended methodology has been developed and the results from five case studies highlighting various features of the methodology are presented....

  2. [AIDS in Africa].

    Science.gov (United States)

    Bolin, H

    1987-12-01

    Acquired immunodeficiency syndrome (AIDS) is believed to have begun in Rwanda with the transmission of green monkey virus to humans; the virus spread among prostitutes and truck drivers along the highways and then to the cities. In the most threatened areas, for example, Kinshasa in Zaire, 20% of the inhabitants are infected. 8% of pregnant women are human immunodeficiency virus (HIV)-positive. Social conditions are important. In Kenya prostitutes who work along the highways are carriers of socially transmitted diseases and genital sores. They are 60-80% HIV-positive. The better-off prostitutes at bars and hotels enjoy better health and fewer contacts and are 30% HIV-positive. It should be possible to develop a vaccine against the AIDS virus, but only a few virologists believe that this can be done within 10 years. Because HIV virus mutates rapidly, many different vaccines would have to be prepared. About 80 countries are cooperating with the World Health Organization to combat HIV and AIDS in Africa. Traveling and working abroad is beginning to be a problem. 15 countries have introduced restrictions on foreign visitors. Swedish midwives have an important role to play in fighting HIV. Their youth counseling activities can spread information about HIV and AIDS. Children who are in early stages of sexuality are probably the most important group to be influenced. It is already too late to begin informing 15-17 year olds about the disease. Midwives should probably be starting much sooner, perhaps even with 10-year olds. PMID:3692943

  3. Theoretical simulations of emission spectra of Fe7+ and Fe8+

    Institute of Scientific and Technical Information of China (English)

    Zeng Jiao-Long; Wang Yan-Gui; Zhao Gang; Yuan Jian-Min

    2006-01-01

    The energy levels, oscillator strengths, spontaneous radiative decay rates, and electron impact collision strengths are calculated for Fe Ⅷ and Fe Ⅸ using the recently developed flexible atomic code (FA3. These atomic data are used to analyse the emission spectra of both laboratory and astrophysical plasmas. The nf-3d emission lines have been simulated for Fe Ⅷ and Fe Ⅸ in a wavelength range of 6-14 nm. For Fe Ⅷ, the predicted relative intensities of lines are insensitive to temperature. For Fe Ⅸ, however, the intensity ratios are very sensitive to temperature, implying that the information of temperature in the experiment can be inferred. Detailed line analyses have also been carried out in a wavelength range of 60-80 nm for Fe Ⅷ, where the solar ultraviolet measurements of emitted radiation spectrometer records a large number of spectra. More lines can be identified with the aid of present atomic data. A complete dataset is available electronically from http://www.astrnomy.csdb.cn/EIE/.

  4. iPadagogy 101: Using Clinical ORthopedic Exam (C.O.R.E.) to Facilitate Evidence-Based Practice in the Orthopaedic Evaluation Classroom

    Science.gov (United States)

    Hamson-Utley, J. Jordan; Stiller-Ostrowski, Jennifer L.

    2013-01-01

    Evidence-based practice (EBP) and educational technology have become fundamental skills within athletic training programs. The objective of this article is to share experiences implementing clinical orthopaedic evaluation applications ("apps") that can be integrated into classroom and clinical education to enhance students' proficiency…

  5. Effectiveness of custom-made orthopaedic shoes in the reduction of foot pain and pressure in patients with degenerative disorders of the foot

    NARCIS (Netherlands)

    Jannink, M.; van Dijk, H.; Ijzerman, M.; Groothuis-Oudshoorn, K.; Groothoff, J.; Lankhurst, G.

    2006-01-01

    Background. Degenerative disorders of the foot often are painful during standing and walking. It is assumed that, because of bone deformity, callus, and deformity of the plantar pads, the plantar pressure distribution changes. Prescription of orthopaedic shoes for patients with degenerative disorder

  6. Effectiveness of custom-made orthopaedic shoes in the reduction of foot pain and pressure in patients with degenerative disorders of the foot

    NARCIS (Netherlands)

    Jannink, M.J.A.; Dijk, van H.; IJzerman, M.J.; Groothuis, C.G.M.; Groothoff, J.W.; Lankhorst, G.J.

    2006-01-01

    Background: Degenerative disorders of the foot often are painful during standing and walking. It is assumed that, because of bone deformity, callus, and deformity of the plantar pads, the plantar pressure distribution changes. Prescription of orthopaedic shoes for patients with degenerative disorder

  7. 时间矫形外科学一门应运而生的新学科(英文)〖%Chrono-orthopaedics: A new discipline in need

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Orthopaedics: as an ancient discipline concerning bones, joints, muscles, tendons and nerves-the skeletal system, has been developing rapidly since more and more progresses in theory and improvements in technology have been employed in orthopaedic practices. A variety of subdisciplines, such as hand surgery, spinal surgery and hip joint surgery, have emerged to meet the demands by the development of special services in the field of orthopaedics. However, the basic conception remains consistent in the principle of diagnosis and treatment of orthopaedic disorders. Taking the clubfoot treatment for an example, the prevailing protocol of surgical treatment is to achieve one-stage correction of all the components of the deformity relying on three-dimensional analysis within the time frame of an operation[1]. The diagnosis aims mainly to identify the pathologic morphology and the related factors, even in terms of three-dimensional architecture, signal transduction at the molecular level and the biologic activity[2-7]. Nevertheless, little is known about the adjustable means and predictable situation for the process of disorder and treatment planning.

  8. Reflections in a time of transition: orthopaedic faculty and resident understanding of accreditation schemes and opinions on surgical skills feedback

    Science.gov (United States)

    Gundle, Kenneth R.; Mickelson, Dayne T.; Hanel, Doug P.

    2016-01-01

    Introduction Orthopaedic surgery is one of the first seven specialties that began collecting Milestone data as part of the Accreditation Council for Graduate Medical Education's Next Accreditation System (NAS) rollout. This transition from process-based advancement to outcome-based education is an opportunity to assess resident and faculty understanding of changing paradigms, and opinions about technical skill evaluation. Methods In a large academic orthopaedic surgery residency program, residents and faculty were anonymously surveyed. A total of 31/32 (97%) residents and 29/53 (55%) faculty responded to Likert scale assessments and provided open-ended responses. An internal end-of-rotation audit was conducted to assess timeliness of evaluations. A mixed-method analysis was utilized, with nonparametric statistical testing and a constant-comparative qualitative method. Results There was greater familiarity with the six core competencies than with Milestones or the NAS (p<0.05). A majority of faculty and residents felt that end-of-rotation evaluations were not adequate for surgical skills feedback. Fifty-eight per cent of residents reported that end-of-rotation evaluations were rarely or never filled out in a timely fashion. An internal audit demonstrated that more than 30% of evaluations were completed over a month after rotation end. Qualitative analysis included themes of resident desire for more face-to-face feedback on technical skills after operative cases, and several barriers to more frequent feedback. Discussion The NAS and outcome-based education have arrived. Residents and faculty need to be educated on this changing paradigm. This transition period is also a window of opportunity to address methods of evaluation and feedback. In our orthopaedic residency, trainees were significantly less satisfied than faculty with the amount of technical and surgical skills feedback being provided to trainees. The quantitative and qualitative analyses converge on one

  9. Reflections in a time of transition: orthopaedic faculty and resident understanding of accreditation schemes and opinions on surgical skills feedback

    Directory of Open Access Journals (Sweden)

    Kenneth R. Gundle

    2016-04-01

    Full Text Available Introduction: Orthopaedic surgery is one of the first seven specialties that began collecting Milestone data as part of the Accreditation Council for Graduate Medical Education's Next Accreditation System (NAS rollout. This transition from process-based advancement to outcome-based education is an opportunity to assess resident and faculty understanding of changing paradigms, and opinions about technical skill evaluation. Methods: In a large academic orthopaedic surgery residency program, residents and faculty were anonymously surveyed. A total of 31/32 (97% residents and 29/53 (55% faculty responded to Likert scale assessments and provided open-ended responses. An internal end-of-rotation audit was conducted to assess timeliness of evaluations. A mixed-method analysis was utilized, with nonparametric statistical testing and a constant-comparative qualitative method. Results: There was greater familiarity with the six core competencies than with Milestones or the NAS (p<0.05. A majority of faculty and residents felt that end-of-rotation evaluations were not adequate for surgical skills feedback. Fifty-eight per cent of residents reported that end-of-rotation evaluations were rarely or never filled out in a timely fashion. An internal audit demonstrated that more than 30% of evaluations were completed over a month after rotation end. Qualitative analysis included themes of resident desire for more face-to-face feedback on technical skills after operative cases, and several barriers to more frequent feedback. Discussion: The NAS and outcome-based education have arrived. Residents and faculty need to be educated on this changing paradigm. This transition period is also a window of opportunity to address methods of evaluation and feedback. In our orthopaedic residency, trainees were significantly less satisfied than faculty with the amount of technical and surgical skills feedback being provided to trainees. The quantitative and qualitative analyses

  10. Pregnancy and AIDS.

    Science.gov (United States)

    Henrion, R

    1988-02-01

    Since the first cases of a new acquired immunodeficiency syndrome (AIDS) described by Oleske et al. and Rubinstein et al. in children in 1983, we have witnessed an ever-increasing number of such observations. As serology is not being performed on all pregnant women in many European countries, obstetricians must try to identify those belonging to risk groups: intravenous drug abusers, natives of affected regions or women having travelled to these areas, women having numerous sexual partners, presenting with other sexually transmitted diseases or living with infected individuals, prostitutes, transfused women. If the woman belongs to risk groups, HIV antibody testing is to be done at the beginning of pregnancy. The risks for the mother remain ill-defined, due in part to the difficulties inherent in keeping track of heroin abusers. Aggravation is certain if the mother is affected with AIDS or an associated syndrome called ARC (AIDS-related complex). It is debatable and at least rarer if the mother presents no clinical symptoms. Infant risks are becoming better known. The existence of materno-fetal contamination by transplacental route is undebatable. However, contamination during delivery or during the passage through the maternal genital tract cannot be excluded. The proportion of contaminated infants is approximately 40%. The disease in the infant is highly dangerous. According to these data, the procedure adopted by most obstetricians is the following: abortion is recommended at the first trimester of the pregnancy, a free choice is left open for the woman at the second trimester and at the third trimester delivery is carried out naturally. Caesarean sections are only done when there are obstetrical indications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3281969

  11. Computer aided engineering drawing

    CERN Document Server

    Dubey, N H

    2006-01-01

    This book caters to the need of First Year Engineering Students desiring to achieve a firm footage in the Subject Computer Aided Engineering Drawing. The formulation and methodology of the contents in this book is that one can easily understand the finer details of the subject and can master them with regular practice. It is essential that every on involved in engineering field must understand CAD for Drawing. This book contains well-illustrated figures along with theory for explaining procedures wherever necessary. A large number of solved and unsolved problems are provided so that one can ge

  12. Refocusing disaster aid.

    Science.gov (United States)

    Linnerooth-Bayer, Joanne; Mechler, Reinhard; Pflug, Georg

    2005-08-12

    With new modeling techniques for estimating and pricing the risks of natural disasters, the donor community is now in a position to help the poor cope with the economic repercussions of disasters by assisting before they happen. Such assistance is possible with the advent of novel insurance instruments for transferring catastrophe risks to the global financial markets. Donor-supported risk-transfer programs not only would leverage limited disaster-aid budgets but also would free recipient countries from depending on the vagaries of postdisaster assistance. Both donors and recipients stand to gain, especially because the instruments can be closely coupled with preventive measures. PMID:16099976

  13. First aid in mathematics

    CERN Document Server

    Sulley, Robert

    2014-01-01

    Achieve the best possible standard with this bestselling book of traditional practice and guidance - now in colour!. First Aid in Mathematics provides all the help and support needed for learning and practising Mathematics. It offers comprehensive coverage of core mathematical topics in clear and accessible language. It is suitable for both native English speakers and students of English as a second language and can be used in class, or as a reference and revision book. - Develops a strong basis of understanding with core topics covered in clear and accessible language. - Improves student's ab

  14. First aid at mines

    Energy Technology Data Exchange (ETDEWEB)

    1993-01-01

    This Code of Practice has been approved by the Health and Safety Commission with the consent of the Secretary of State under section 16 of the Health and Safety at Work etc. Act 1974. It gives practical guidance on the requirements placed on employers and self-employed persons by the Health and Safety (First-Aid) Regulations 1981 as they now apply to mines and comes into effect on 1 October 1993 which is the date on which the Management and Administration of Safety and Health at Mines Regulations 1993 come into force.

  15. Biocompatibility testing of novel starch-based materials with potential application in orthopaedic surgery: a preliminary study.

    Science.gov (United States)

    Mendes, S C; Reis, R L; Bovell, Y P; Cunha, A M; van Blitterswijk, C A; de Bruijn, J D

    2001-07-01

    This paper describes an extensive biocompatibility evaluation of biodegradable starch-based materials aimed at orthopaedic applications as temporary bone replacement/fixation implants. For that purpose, a polymer (starch/ethylene vinyl alcohol blend, SEVA-C) and a composite of SEVA-C reinforced with hydroxyapatite (HA) particles, were evaluated in both in vitro and in vivo assays. For the in vitro analysis cell culture methods were used. The in vivo tissue reactions were evaluated in an intramuscular and intracortical bone implantation model on goats, using light and scanning electron microscopy. A computerized image analysis system was used to obtain histomorphometric data regarding bone contact and remodelling after 6 and 12 weeks of implantation. In both in vitro and in vivo models, the SEVA-C-based materials did not induce adverse reactions, which in addition to their bone-matching mechanical properties makes them promising materials for bone replacement fixation. PMID:11426886

  16. State of the art of direct magnifying X-ray technique in orthopaedics. Bestandsaufnahme der direktvergroessernden Roentgentechnik in der Orthopaedie

    Energy Technology Data Exchange (ETDEWEB)

    Wuelker, N. (Orthopaedische Klinik, Medizinische Hochschule Hannover (Germany)); Siebert, W.E. (Orthopaedische Klinik, Medizinische Hochschule Hannover (Germany))

    1993-03-01

    22 patients suffering from different orthopaedic disease patterns were X-rayed with direct X-ray magnification with focus diameters between 0.012 and 0.100 mm. This yielded improved resolution of detail structures, especially in tumours and aseptic bone necroses. Due to the relatively low efficiency of the X-ray tube (conditioned by the physics of the X-ray equipment), however, exposure times of several seconds were required, and the voltage had to be higher than in conventional X-ray procedure. This resulted in lack of sharpness due to movement and to a loss in contrast. Hence, the clinical use of focus diameters below 0.1 mm does not seem to be meaningful. (orig.)

  17. The efficacy of using search engines in procuring information about orthopaedic foot and ankle problems from the World Wide Web.

    Science.gov (United States)

    Nogler, M; Wimmer, C; Mayr, E; Ofner, D

    1999-05-01

    This study has attempted to demonstrate the feasibility of obtaining information specific to foot and ankle orthopaedics from the World Wide Web (WWW). Six search engines (Lycos, AltaVista, Infoseek, Excite, Webcrawler, and HotBot) were used in scanning the Web for the following key words: "cavus foot," "diabetic foot," "hallux valgus,"and "pes equinovarus." Matches were classified by language, provider, type, and relevance to medical professionals or to patients. Sixty percent (407 sites) of the visited websites contained information intended for use by physicians and other medical professionals; 30% (206 sites) were related to patient information; 10% of the sites were not easily classifiable. Forty-one percent (169 sites) of the websites were commercially oriented homepages that included advertisements. PMID:10353772

  18. Heat-washout measurements compared to distal blood pressure and perfusion in orthopaedic patients with foot ulcers

    DEFF Research Database (Denmark)

    Midttun, Mette; Azad, B.B.S.; Broholm, R;

    2015-01-01

    Distal blood pressure and local skin perfusion pressure were compared to measurement of blood flow rate (BFR) measured by the heat-washout method in orthopaedic patients with and without diabetes, all with a foot ulcer in one foot, compared to healthy controls. The correlation was good between heat......-washout and distal blood pressure in patients with diabetes with and without an ulcer (P = 0·024 and 0·059, respectively). The correlation was weak in patients without diabetes with and without an ulcer, most probably due to power problems (P = 0·118 and 0·116, respectively). The correlation in the healthy...... oxygen from the surrounding tissue, and therefore, measurements are easier made in these subjects. BFR in the first toe increased significantly in all patients when the foot was moved from heart level to 50 cm below heart level (P = between 0·03 and 0·05) as previously seen in patients with claudication...

  19. On the Feasibility of Steering Swallowable Microsystem Capsules Using Computer-Aided Magnetic Levitation

    OpenAIRE

    Wu, Billy; Mintchev, Martin

    2008-01-01

    Swallowable capsule endoscopy is used for non-invasive diagnosis of some gastrointestinal (GI) organs. However, control over the position of the capsule is a major unresolved issue. This study presents a design for steering the capsule based on magnetic levitation. The levitation is stabilized with the aid of a computer-aided feedback control system and diamagnetism. Peristaltic and gravitational forces to be overcome were calculated. A levitation setup was built to analyze the fe...

  20. SURVEY OF SHORT-TERM ORAL CORTICOSTEROID ADMINISTRATION BY ORTHOPAEDIC PHYSICIANS IN COLLEGE AND HIGH SCHOOL ATHLETES

    Directory of Open Access Journals (Sweden)

    Albert W. Pearsall IV

    2009-03-01

    Full Text Available The use of oral corticosteroid (OCS drugs is advocated because of their potent anti-inflammatory effects. They also possess many potential adverse effects. No study has assessed physician prescribing practices of OCS therapy in high school (HS or college (COL athletes. This paper reports the prescribing patterns of sports medicine physicians who used short-term OCS therapy and to describe associated complications in HS and COL athletes within a 24- month period. An internet link to a descriptive epidemiology survey was included in an e-mail to all members of the Arthroscopy Association of North America and the American Orthopaedic Society for Sports Medicine. Descriptive statistics and correlation analysis were used to examine responses. Total response rate was 32% (615/1,928. Sixty-six percent of the physicians indicated prescribing OCS to both groups of athletes, while 29% reported prescribing OCS to COL athletes and 5% to HS athletes for musculoskeletal injuries. Physicians who prescribed multiple OCS regimens to the same athlete within the same season (P = 0.01 and physicians who prescribed OCS to the skeletally immature athlete (P = 0.009 reported more complications than other physicians. Among the 412 physicians who did not prescribe OCS in the treatment of athletic induced musculoskeletal injury, 251 (61% cited a risk of developing medical complications as the primary reason for avoiding use. The reported number of medical complications was low with no cases of avascular necrosis reported for the 2-year recall period. Orthopaedic surgeons who treated athletic induced musculoskeletal injuries with a short-term course of oral corticosteroids reported that high school and college athletes benefited with few medical complications

  1. In vivo degradation in modern orthopaedic UHMWPE bearings and structural characterization of a novel alternative UHMWPE material

    Science.gov (United States)

    Reinitz, Steven D.

    Ultra-high molecular weight polyethylene (UHMWPE) remains the most common bearing material for total joint arthroplasty. Advances in radiation cross-linking and other post-consolidation treatments have led to a rapid differentiation of polyethylene products on the market, with more than twenty unique materials currently being sold by the five largest orthopaedic manufacturers alone. Through oxidation, cross-link density, and free radical measurements, this work demonstrates for the first time that in vivo material degradation is occurring in cross-linked UHMWPE materials. Based on the rate of the reaction in certain materials, it is concluded that oxidative degradation may compromise the mechanical properties of the bearings in as few as ten years, potentially leading to early clinical failure of the devices. Using the knowledge gained from this work as well as previously published observations about UHMWPE oxidation, a two-mechanism model of oxidation is proposed that offers an explanation for the observed in vivo changes. From this model it is concluded that oxidative degradation is in part the result of in vivo chemical species. The two-mechanism model of oxidation suggests that different processing techniques for UHMWPE may reduce the risk of oxidative degradation. It is concluded that by avoiding any radiation cross-linking step, Equal Channel Angular Processing (ECAP) can produce UHMWPE materials with a reduced risk for in vivo oxidation while at the same time offering superior mechanical properties compared to commercially available UHMWPE materials, as well as similar wear behavior. Using dynamic mechanical analysis, the entanglement density in ECAP materials is quantified, and is related back to the ECAP processing parameters. The relationship between entanglement density and resultant material properties is established. The results will allow informed processing parameter selection for producing optimized materials for orthopaedics and other applications.

  2. Sol-gel derived HA/TiO2 double coatings on Ti scaffolds for orthopaedic applications

    Institute of Scientific and Technical Information of China (English)

    XU W; HU W Y; LI M H; MA Q Q; P. D. HODGSON; WEN C E

    2006-01-01

    Hydroxyapatite/titania (HA/TiO2) double layers were coated onto Ti scaffolds throughout for orthopaedic applications by sol-gel method. Differential scanning calorimetry (DSC),thermogravimetric analysis (TG) and X-ray diffractometry (XRD) were used for the characterisation of the phase transformations of the dried gels and coated surface structures. Scanning electron microscope (SEM) equipped with energy dispersive spectrometry (EDS) was used for the observation and evaluation of the morphology and phases of the surface layers and for the assessment of the in vitro tests. The in vitro assessments were performed by soaking the HA/TiO2 double coated samples into the simulated body fluid (SBF) for various periods. The TiO2 layer was coated by a dipping-coating method at a speed of 12 cm/min,followed by a heat treatment at 600 ℃ for 20 min. The HA layer was subsequently dipping-coated on the outer surface at the same speed and then heat-treated at difference temperatures. The results indicat that the HA phase begins to crystallize after a heat treatment at 560 ℃. The crystallinity increases obviously at 760 ℃. SEM observations find no delamination or crack at the interfaces of HA/TiO2 and TiO2/Ti. The HA/TiO2 coated Ti scaffolds displays excellent bone-like apatite forming ability when it is soaked into SBF. Ti scaffolds after HA/TiO2 double coatings can be anticipated as promising implant materials for orthopaedic applications

  3. Dermatitis de contacto por prótesis ortopédicas Contact dermatitis for orthopaedic prostheses

    Directory of Open Access Journals (Sweden)

    C.A. Danielo

    2007-09-01

    Full Text Available Diversas aleaciones son utilizadas en la fabricación de prótesis ortopédicas (ej: titanio, vitalio, etc, dentro de las cuales la más utilizada es la de acero inoxidable. El níquel, parte importante de esta aleación, es capaz de liberarse y provocar sensibilización, desencadenando reacciones cutáneas locales y sistémicas. De los materiales que componen la aleación para formar acero inoxidable, el níquel es el que más frecuentemente se ve implicado en reacciones cutáneas por sensibilidad, en tanto que otros como el cromo y cobalto, la posibilidad de pérdida de material a partir de la prótesis es discutida. Presentamos el caso de una paciente con dermatitis alérgica al níquel con lesiones generalizadas, que aparecieron luego del implante de prótesis ortopédicas de acero inoxidable, dando positivo para níquel sulfato en las pruebas epicutáneas.Several alloys are used in the manufacture of orthopaedics prostheses (ie: titanium, vitalium. Stainless steel is the most frequently used among them. Nickel is an important component of this alloy and may release and provoke sensitivity. Arising local and systemic cutaneous reactions. Nickel is the material composing stainless steel that ordinary is implicated in cutaneous reactions of sensitivity; the role of chrome or cobalt is still uncertain. Our patient is a woman affected of nickel contact dermatitis, with generalized reactions that appear after an implant of a stainless steel orthopaedic prosthesis. Epicutaneous tests were performed, confirming a strong sensitivity to nickel sulphate.

  4. THE ORTHOPAEDIC REHABILITATION OF BALANCE: AN EXPERIMENTAL STUDY ON THE ROLE OF MENTAL IMAGERY AND EMOTIONAL VARIABLES.

    Directory of Open Access Journals (Sweden)

    Santo F. Di Nuovo

    2015-05-01

    Full Text Available Mental Imagery (i.e., processing of objects’ properties and spatial relations, including the ability of mentally rotating and manipulating objects in the space, is relevant for movement and its development, and particularly for rehabilitation of motor skills. Few studies aimed at assessing  the efficacy of imagery training used objective scores of Mental Imagery skills, preferring self-evaluations of these abilities reported by the subjects themselves. The aim of the paper was to explore the relevance of Mental Imagery, assessed by objective tests, in predicting the improvement of balance skills, after a standard rehabilitative training in orthopaedic settings; taking into account also emotional variables as anxiety and depression. A controlled study was conducted assessing the changes in balance skills after rehabilitative training. The sample was composed of 30 orthopaedic inpatients (females 66.7%, age range 47-91 years. To measure the dependent variable for pre-post assessment, B-scale from Performance-oriented mobility assessment test (POMA was used. Independent variables were measured using Mental Imagery Test, Mini-Mental State Examination, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scales. The best predictor of improvement in balance after rehabilitation is the Mental Imagery test, followed by age and mental efficiency. Anxiety predicts negatively the improvement, while education and depression appear to influence less the rehabilitation process. In conclusion, the study demonstrates that mental imagery is relevant in helping balance rehabilitation. A training of this function could be essential for clinical practice; the trainers should assess preliminarily the subject's attitude and ability to use mental imagery, with the aim of optimizing the rehabilitative process.

  5. Strontium- and calcium-containing, titanium-stabilised phosphate-based glasses with prolonged degradation for orthopaedic tissue engineering.

    Science.gov (United States)

    Al Qaysi, Mustafa; Walters, Nick J; Foroutan, Farzad; Owens, Gareth J; Kim, Hae-Won; Shah, Rishma; Knowles, Jonathan C

    2015-09-01

    Strontium- and calcium-releasing, titanium-stabilised phosphate-based glasses with a controlled degradation rate are currently under development for orthopaedic tissue engineering applications. Ca and/or Sr were incorporated at varying concentrations in quaternary phosphate-based glasses, in order to promote osteoinduction. Ti was incorporated at a fixed concentration in order to prolong degradation. Glasses of the general formula (P2O5)-(Na2O)-(TiO2)-(CaO)-(SrO) were prepared via the melt-quench technique. The materials were characterised by energy-dispersive X-ray spectroscopy, X-ray diffraction, (31)P magic angle spinning nuclear magnetic resonance, Fourier transform infrared spectroscopy, differential thermal analysis and density determination. The dissolution rate in distilled water was determined by measuring mass loss, ion release and pH change over a two-week period. In addition, the cytocompatibility and alkaline phosphatase activity of an osteoblast-like cell line cultured on the surface of glass discs was assessed. The glasses were shown to be amorphous and contained Q(1), Q(2) and Q(3) species. Fourier transform infrared spectroscopy revealed small changes in the glass structure as Ca was substituted with Sr and differential thermal analysis confirmed a decrease in crystallisation temperature with increasing Sr content. Degradation and ion release studies also showed that mass loss was positively correlated with Sr content. These results were attributed to the lower electronegativity of Sr in comparison to Ca favouring the formation of phosphate-based mineral phases. All compositions supported cell proliferation and survival and induced at least 2.3-fold alkaline phosphatase activity relative to the control. Glass containing 17.5 mol% Sr had 3.6-fold greater alkaline phosphatase activity than the control. The gradual release of Ca and Sr supported osteoinduction, indicating their potential suitability in orthopaedic tissue engineering applications

  6. AIDS-related myopathy.

    Science.gov (United States)

    Sheikh, Rafiq A.; Yasmeen, Shagufta; Munn, Robert; Ruebner, Boris H.; Ellis, William G.

    1999-09-01

    Infection with the human immunodeficiency virus (HIV) is often associated with the acquired immunodeficiency syndrome (AIDS), and wasting is one of the defining clinical features of AIDS. Muscular weakness due to myopathy may develop at any stage of HIV infection. We report two illustrative cases of HIV-associated myopathies. One was due to inflammatory myosits most likely directly related to the HIV infection, and the other was most likely the result of mitochondrial damage due to zidovudine, a nucleoside analogue commonly used in treating HIV infection. Biopsies from both patients showed alterations of myofiber structures, of varying severity, culminating in necrosis, lipid droplets, and lymphoplasmocytic inflammatory response. The zidovudine-treated patient also showed distinctive mitochondrial changes, predominantly enlargement, variation in shape and size, and disorganization of the cristae. These two types of HIV-associated inflammatory myopathies are reviewed, along with other HIV-associated myopathies, including HIV wasting syndrome, nemaline rod myopathy, pyomyositis, rhabdomyolysis, cardiomyopathy, and other miscellaneous myopathies associated with HIV infection. PMID:11810429

  7. Talking about AIDS

    Directory of Open Access Journals (Sweden)

    2003-09-01

    Full Text Available This paper explores the significance of social relationships to two important stages in the process of sexual behavioral change in response to increased HIV/AIDS risk in rural Africa: the perceived risk of becoming HIV-infected through unprotected sexual intercourse and the preferred methods of protection either through sexual fidelity, or through condom use. The empirical analyses are based on cross-sectional data from the 'Kenyan Diffusion and Ideational Change Project' (KDICP which provides information about AIDS-related, ego-centered communication networks of Kenyan men and women. The results show that perceived risks, as well as preferred methods of protection against HIV-infection, depend in general on the prevailing perceptions and favored protective methods within personal communication networks. However, different influential network properties can be found. The risk-perceptions of women are shaped by strong relationships and cohesive network structures. Male's risk perception depends more on the number of risk-perceivers in their communication networks. Heterogeneous relationships of various kinds are influential on women's and men's probability of favoring sexual faithfulness as a method of protection against HIV-infection.

  8. HIV/AIDS epidemiology.

    Science.gov (United States)

    Todd, C

    2000-10-14

    In this paper, Charles Todd comments that the report of Evan Wood and colleagues illustrates the dangers of taking a narrow medical view of the HIV/AIDS epidemic in Africa. It runs the risk of reversing the growing realization that the HIV/AIDS epidemic in southern Africa is a broad, social, cultural, political, and economic issue rather than a purely medical one. Todd raises the point that Wood and colleagues did not model the costs associated with the voluntary testing and counseling that should accompany a prophylaxis program. To this effect, a more helpful approach on meeting basic health needs and eradicating poverty would be to compare the impact of such levels of expenditure. It is also emphasized that the title of the paper of Wood and colleagues is misleading, implying that the focus of the modeling was sub-Saharan Africa as a whole, when it was in fact South Africa alone. Accordingly, the gross domestic product of South Africa per person is higher than that of nearly all other sub-Saharan African countries, and health expenditure is 10-20 times greater. PMID:11073053

  9. Aid Policy and the Macroeconomic Management of Aid

    DEFF Research Database (Denmark)

    Addison, Tony; Tarp, Finn

    2015-01-01

    This is an introduction to the UNU-WIDER special issue of World Development on aid policy and the macroeconomic management of aid. We provide an overview of the 10 studies, grouping them under three sub-themes: the aid–growth relationship; the supply-side of aid (including its level, volatility......, and coordination of donors); and the macroeconomic framework around aid. The studies in the special issue demonstrate the centrality of research methodology, the importance of disaggregation, and the need to account for country-specific situations and problems. This introduction concludes that the sometimes “over...

  10. 57Fe Mössbauer spectroscopy and magnetic study of Al13Fe4

    International Nuclear Information System (INIS)

    Highlights: • We show that Mössbauer spectra of Al13Fe4 can be fitted well with three quadrupole doublets. • The shape of the in-field Mössbauer spectrum is well accounted for with five component subspectra. • The electronic density of states has a pseudogap around the Fermi energy. • We find that the Debye temperature of the compound studied is 383(3) K. - Abstract: The results of ab initio electronic structure and electric field gradient (EFG) calculations, and of X-ray diffraction, 57Fe Mössbauer spectroscopy, and magnetic studies of Al13Fe4 are reported. It is shown that Al13Fe4 crystallizes in the monoclinic space group C2/m, in which Fe atoms are located at five inequivalent crystallographic sites, with the lattice parameters a=15.503(2) Å, b=8.063(2) Å, c=12.464(2) Å, and β=107.71(2)°. We demonstrate that zero-field Mössbauer spectra can be decomposed into three quadrupole doublets. With the aid of the calculated EFG parameters we show that the first doublet results from one Fe site, the second doublet is due to two other Fe sites, and the third doublet originates from the last two Fe sites. We find that the shape of the Mössbauer spectrum of Al13Fe4 measured in an external magnetic field of 90 kOe can be accounted for with five component subspectra generated using the calculated EFG parameters at five inequivalent Fe sites. The quadrupole splittings corresponding to three component doublets are shown to increase with decreasing temperature and are well described by a T3/2 power-law relation. The Debye temperature of Al13Fe4 is found to be 383(3) K. We find a pseudogap in the density of states (DOS), with a width of ∼0.2 eV, that is centered 0.1 eV above the Fermi energy. The finite DOS at the Fermi energy confirms good metallicity of Al13Fe4. The 1/T-like dependence of the magnetic susceptibility shows that Al13Fe4 is a paramagnet

  11. Aid, social policy, and development

    DEFF Research Database (Denmark)

    Addison, Tony; Niño-Zarazúa, Miguel; Tarp, Finn

    This paper discusses past and current social policy strategies in the international aid architecture. From the 1990s, aid strategy and policy shifted to put a stronger emphasis on human development. This accelerated with the Millennium Development Goals and will continue under the Sustainable...... Development Goals, which have even more ambitious targets. The paper also assesses some of the concerns associated with the ‘Paris-style’ aid modalities, and discusses major challenges for the future global development agenda....

  12. Aid, social policy, and development

    OpenAIRE

    Addison, Tony; Niño-Zarazúa, Miguel; Tarp, Finn

    2015-01-01

    This paper discusses past and current social policy strategies in the international aid architecture. From the 1990s, aid strategy and policy shifted to put a stronger emphasis on human development. This accelerated with the Millennium Development Goals and will continue under the Sustainable Development Goals, which have even more ambitious targets. The paper also assesses some of the concerns associated with the 'Paris-style' aid modalities, and discusses major challenges for the future glo...

  13. The Consequences of Merit Aid

    OpenAIRE

    2002-01-01

    Since the early Nineties, a dozen states have established broad-based merit aid programs. The typical program waives tuition and fees at public colleges and universities in one's home state. Unlike traditional merit programs, such as the National Merit Scholarship, this aid requires relatively modest academic performance and provide scholarships to hundreds of thousands of students. This paper examines how merit aid programs in seven states have affected an array of schooling decisions, payin...

  14. Aid and sectoral labour productivity

    OpenAIRE

    Selaya, Pablo; Thiele, Rainer

    2008-01-01

    The paper examines empirically the proposition that aid to poor countries is detrimental for external competitiveness, giving rise to Dutch disease type effects. At the aggregate level, aid is found to have a positive effect on growth of labour productivity. A sectoral decomposition shows that the effect is significant and positive both in the tradables and the nontradables sectors. The paper thus finds no empirical support for the hypothesis that aid reduces external competitiveness in devel...

  15. National HIV/AIDS Strategy

    Centers for Disease Control (CDC) Podcasts

    2012-02-01

    Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, talks about the importance of the National HIV/AIDS Strategy and the work of CDC.  Created: 2/1/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/1/2012.

  16. National Latino AIDS Awareness Day

    Centers for Disease Control (CDC) Podcasts

    2014-10-08

    This podcast highlights National Latino AIDS Awareness Day, to increase awareness of the disproportionate impact of HIV on the Hispanic or Latino population in the United States and dependent territories. The podcast reminds Hispanics or Latinos that they have the power to take control of their health and protect themselves against HIV.  Created: 10/8/2014 by Office of Health Equity, Office of the Director, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention.   Date Released: 10/14/2014.

  17. Ergogenic Aids and Supplements.

    Science.gov (United States)

    Porrini, Marisa; Del Boʼ, Cristian

    2016-01-01

    Great interest is currently shown for the contribution of nutrition to optimize training and athletic performance, and a considerable debate exists about the potential ergogenic value of several dietary supplements. However, most of the products used by athletes do not provide sufficient scientific evidence regarding their efficacy in enhancing physical performance as well as their specificity of action and safety. For this reason, sport nutrition professionals need skills in evaluating the scientific value of papers and advertisements on ergogenic aids and supplements in order to support athletes in their choice. In the present chapter, the efficacy of some of the most popular supplements used by athletes and sport practitioners will be discussed. Particular attention will be devoted to amino acids and derivatives, caffeine and caffeinated energy drinks, and some antioxidants. PMID:27348226

  18. Learning to aid learning.

    Science.gov (United States)

    Richards, Jacqui

    2016-01-01

    The National Health Service (NHS) is one of the largest employers in the world and, with 1.3 million staff, the biggest employer in Europe. With over three hundred different careers on offer (NHS 2015), the acquisition of skills and qualifications, through academic and clinical training, is an integral part of day-to-day life in the health service. As such, mentoring has become a significant feature in the preparation of healthcare professionals, to support students and ensure learning needs and experiences are appropriate to competency. This article examines the mentor's role, in relation to a teaching innovation designed to address students' identified learning needs to meet the requirements of the multi-professional learning and assessment in practice course NM6156. The effectiveness of the aids to learning will be assessed through an online quiz, and its usefulness will be analysed with reference to educational theories of learning and development. PMID:26975128

  19. AIDS Care Ignores Children

    Institute of Scientific and Technical Information of China (English)

    Apoorva; Mandavilli; 张祖明

    2005-01-01

    艾滋病的全称为"获得性免疫缺陷综合症(AIDS)",通过性、血液和母婴三种接触方式传播,是一种严重危害健康的传染性疾病。它通过破坏人的免疫系统和机体抵抗能力给人以致命的打击,被称为"超级绝症"。儿童感染艾滋病通常是由于母体传播的,但是他们却成为艾滋病防治过程中的一个"盲点"。究竟为什么呢?请看下文。

  20. Aids and Infectious Diseases (aid) Pmp 2013 Report

    Science.gov (United States)

    Buonaguro, Franco M.

    2014-07-01

    The AIDS and Infectious Diseases (AID) PMP of the WFS contributed this year with a session on August 22nd to the Plenary Sessions of the International Seminars on Planetary Emergencies and Associated Meetings--46th Session: The Role of Science in the Third Millennium (Erice, 19-24 August 2013). Furthermore a workshop on August 24th was organized...