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  1. Toward the development of virtual surgical tools to aid orthopaedic FE analyses. (United States)

    Tadepalli, Srinivas C; Shivanna, Kiran H; Magnotta, Vincent A; Kallemeyn, Nicole A; Grosland, Nicole M


    Computational models of joint anatomy and function provide a means for biomechanists, physicians, and physical therapists to understand the effects of repetitive motion, acute injury, and degenerative diseases. Finite element models, for example, may be used to predict the outcome of a surgical intervention or to improve the design of prosthetic implants. Countless models have been developed over the years to address a myriad of orthopaedic procedures. Unfortunately, few studies have incorporated patient-specific models. Historically, baseline anatomic models have been used due to the demands associated with model development. Moreover, surgical simulations impose additional modeling challenges. Current meshing practices do not readily accommodate the inclusion of implants. Our goal is to develop a suite of tools (virtual instruments and guides) which enable surgical procedures to be readily simulated and to facilitate the development of all-hexahedral finite element mesh definitions.

  2. Toward the Development of Virtual Surgical Tools to Aid Orthopaedic FE Analyses

    Directory of Open Access Journals (Sweden)

    Srinivas C. Tadepalli


    Full Text Available Computational models of joint anatomy and function provide a means for biomechanists, physicians, and physical therapists to understand the effects of repetitive motion, acute injury, and degenerative diseases. Finite element models, for example, may be used to predict the outcome of a surgical intervention or to improve the design of prosthetic implants. Countless models have been developed over the years to address a myriad of orthopaedic procedures. Unfortunately, few studies have incorporated patient-specific models. Historically, baseline anatomic models have been used due to the demands associated with model development. Moreover, surgical simulations impose additional modeling challenges. Current meshing practices do not readily accommodate the inclusion of implants. Our goal is to develop a suite of tools (virtual instruments and guides which enable surgical procedures to be readily simulated and to facilitate the development of all-hexahedral finite element mesh definitions.

  3. Influence of orthopaedic-technical aid on the kinematics and kinetics of the knee joint of patients with neuro-orthopaedic diseases. (United States)

    Lampe, Renée; Mitternacht, Jürgen; Schrödl, Silvia; Gerdesmeyer, Ludger; Natrath, Michaela; Gradinger, Reiner


    In our gait laboratory, the gait pattern of 18 youths with neurogenic foot deformities as a result of spina bifida or cerebral palsy was examined. The influence of technical orthopaedic devices for the foot and ankle on kinematics and kinetics of the gait and especially of the knee joint were analyzed. Kinematic data were derived from 3D-video analysis, kinetic data from force plates and pressure distribution plates. Muscle activities were measured with eight-channel EMG. The data were examined to see if there were differences when using the technical devices. All patients had already been supported externally with the different devices like orthopaedic shoes, insoles, Nancy Hilton orthoses and orthoses for the lower leg extremity. The devices restricted to the foot and the ankle joint improved the feeling of gait stability of the patients. In this investigation, the different supports had various but little effects on the kinematics and kinetics of the knee joint, depending on the type of orthoses used and the kind of handicap of the youths. Because of the great expenditure, the data obtained in this study were taken from a small number of patients. Therefore, they are individual findings and are of restricted general significance.

  4. [Distraction osteogenesis in orthopaedics

    NARCIS (Netherlands)

    Baat, P. de; Baat, C. de; Bessems, J.H.


    For several decades, distraction osteogenesis has been applied in orthopaedics for lengthening limbs. Other indications for distraction osteogenesis in orthopaedics are nonunions, open fractures, oncologic defects, and ankle osteoarthritis. The main principle of distraction osteogenesis is that, wit

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

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Shengnan, E-mail: [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)


    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.

  6. Removal of Microcystis aeruginosa using nano-Fe3O4 particles as a coagulant aid. (United States)

    Zhang, Bo; Jiang, Dan; Guo, Xiaochen; He, Yiliang; Ong, Choon Nam; Xu, Yongpeng; Pal, Amrita


    Blue-green algae bloom is of great concern globally since they adversely affect the water ecosystem and also drinking water treatment processes. This work investigated the removal of Microcystis aeruginosa (M. aeruginosa) by combining the conventional coagulant polyaluminum chloride (PACl) with nano-Fe3O4 particles as a coagulant aid. The results showed that the addition of nano-Fe3O4 significantly improved the removal efficiency of M. aeruginosa by reducing the amount of PACl dosage and simultaneously hastening the sedimentation. At the M. aeruginosa density of an order of magnitude of 10(7), 10(6), and 10(5) pcs/mL, respectively, the corresponding PACl dose of 200, 20, and 2 mg/L and the mass ratio of PACl to nano-Fe3O4 of 4:1, the removal efficiency of M. aeruginosa could be increased by 33.0, 44.7, and 173.1%, respectively. Compared to PACl, PACl combined with the nano-Fe3O4 as a coagulant aid had higher removal efficiency at a wider pH range. SEM images showed that nano-Fe3O4 first combined with PACl to form clusters and further generated the flocs with algae. Results from the laser particle analyzer further suggested that the floc size increased with the addition of nano-Fe3O4. It was noted that the addition of nano-Fe3O4 led to aluminum species change after PACl hydrolyzed in the algae solution, from Ala to Alb and Alc subsequently. As a coagulant aid, the nano-Fe3O4, in conjunction with PACl, apparently provided nucleation sites for larger flocs to integrate with M. aeruginosa. In addition, increased floc density improved the removal of M. aeruginosa.

  7. Orthopaedic Footwear Design (United States)


    Although the need for orthopaedic shoes is increasing, the number of skilled shoemakers has declined. This has led to the development of a CAD/CAM system to design and fabricate, orthopaedic footwear. The NASA-developed RIM database management system is the central repository for CUSTOMLAST's information storage. Several other modules also comprise the system. The project was initiated by Langley Research Center and Research Triangle Institute in cooperation with the Veterans Administration and the National Institute for Disability and Rehabilitation Research. Later development was done by North Carolina State University and the University of Missouri-Columbia. The software is licensed by both universities.

  8. Smartphones in orthopaedics. (United States)

    Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said


    With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to immediately complete work-based assessments, in the absence of computers, hopefully increasing completion rates and reliability. Some journals now provide podcasts and video tutorials which may be accessed on smartphones, which is useful for higher examinations. Smartphones can also be used in the clinical setting to take photographs of wounds. Smartphones are enjoying increased uptake and application in the workplace and we review their use for orthopaedic surgeons and trainees to allow them to make the most out of their training opportunities.

  9. AIDS (United States)

    ... page: // 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 ...

  10. Fe3O4 nano-whiskers by ultrasonic-aided reduction in concentrated NaOH solution

    Institute of Scientific and Technical Information of China (English)

    Chenglong Yu; Xin Hao; Hongtao Jiang; Lili Wang


    Fe3O4 nano-whiskers were synthesized via ultrasonic-aided reduction of FeCl2·4H2O with N2H4·H2O in concentrated NaOH solution. Phase identification and morphology observation were conducted by X-ray diffraction (XRD) analysis,transmission electron microscopy (TEM) and field emission scanning electron microscopy (FE-SEM). Face scanning energy dispersive spectrum (face scanning EDS) and two-dimensional fast Fourier transform (2DFFT) for element distribution were carried out for confirming composition homogeneity. From XRD and TEM,the synthesized Fe3O4 nano-whiskers are of cubic phase with average dimension of 20 nm × 200 nm (average aspect ratio of 10). FE-SEM shows that the nanowhiskers without dispersion are interconnected into a network at a scale of 20μm. 2DFFT of the distribution of Fe and O from face scanning EDS confirms the composition homogeneity of the synthesized Fe3O4. Hydrazine hydrate determines the formation of the nano-whiskers,while the possible mechanism is the preferred growth along certain orientation with the aid of ultrasonic treatment.

  11. 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


    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

  12. Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda (United States)


    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

  13. American Academy of Orthopaedic Surgeons (United States)

    ... Examinations Print Books Video Gallery Orthopaedic Video Theater eBooks Education Focus International Activities Resources for Residents and ... knowledge and prepare for MOC. Available in print, eBook, or USB flash drive for the ultimate in ...

  14. Computational radiology for orthopaedic interventions

    CERN Document Server

    Li, Shuo


    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...

  15. American Orthopaedic Foot and Ankle Society (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 ...

  16. Orthopaedic Injuries in Equestrian Sports (United States)

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


    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

  17. 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:


    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.

  18. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F


    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.

  19. 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


    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.

  20. Prophylactic antibiotics in orthopaedic surgery. (United States)

    Prokuski, Laura; Clyburn, Terry A; Evans, Richard P; Moucha, Calin S


    The use of prophylactic antibiotics in orthopaedic surgery has been proven effective in reducing surgical site infections after hip and knee arthroplasty, spine procedures, and open reduction and internal fixation of fractures. To maximize the beneficial effect of prophylactic antibiotics, while minimizing any adverse effects, the correct antimicrobial agent must be selected, the drug must be administered just before incision, and the duration of administration should not exceed 24 hours.

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

    Directory of Open Access Journals (Sweden)

    Theodore Miclau


    Full Text Available In October 2013, the International Combined Orthopaedic Research Societies (ICORS; 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.

  2. Orthopaedic research and education foundation and industry. (United States)

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


    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.

  3. The Malaysian Orthopaedic Association humanitarian mission to Indonesia and Sri Lanka. (United States)

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


    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.

  4. Patient compliance and effect of orthopaedic shoes

    DEFF Research Database (Denmark)

    Philipsen, A B; Ellitsgaard, N; Krogsgaard, M R


    Orthopaedic shoes are individually handmade after a prescription from an orthopaedic surgeon, hence relatively expensive. Bad compliance is mentioned in the literature but not investigated. In order to evaluate patient compliance and the effect of orthopaedic shoes, 85 patients who were prescribed...... 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...

  5. Physiotherapy following elective orthopaedic procedures. (United States)

    De Kleijn, P; Blamey, G; Zourikian, N; Dalzell, R; Lobet, S


    As haemophilic arthropathy and chronic synovitis are still the most important clinical features in people with haemophilia, different kinds of invasive and orthopaedic procedures have become more common during the last decades. The availability of clotting factor has made arthroplasty of one, or even multiple joints possible. This article highlights the role of physiotherapy before and after such procedures. Synovectomies are sometimes advocated in people with haemophilia to stop repetitive cycles of intra-articular bleeds and/or chronic synovitis. The synovectomy itself, however, does not solve the muscle atrophy, loss of range of motion (ROM), instability and poor propriocepsis, often developed during many years. The key is in taking advantage of the subsequent, relatively safe, bleed-free period to address these important issues. Although the preoperative ROM is the most important variable influencing the postoperative ROM after total knee arthroplasty, there are a few key points that should be considered to improve the outcome. Early mobilization, either manual or by means of a continuous passive mobilization machine, can be an optimal solution during the very first postoperative days. Muscle isometric contractions and light open kinetic chain exercises should also be started in order to restore the quadriceps control. Partial weight bearing can be started shortly after, because of quadriceps inhibition and to avoid excessive swelling. The use of continuous clotting factor replacement permits earlier and intensive rehabilitation during the postoperative period. During the rehabilitation of shoulder arthroplasty restoring the function of the rotator cuff is of utmost importance. Often the rotator cuff muscles are inhibited in the presence of pain and loss of ROM. Physiotherapy also assists in improving pain and maintaining ROM and strength. Functional weight-bearing tasks, such as using the upper limbs to sit and stand, are often discouraged during the first 6

  6. Audit of Orthopaedic Surgical Documentation

    Directory of Open Access Journals (Sweden)

    Fionn Coughlan


    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.

  7. Bioceramic Coatings for Orthopaedic Implants

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, Allison A.


    During the past century, man-made materials and devices have been developed to the point at which they have been used successfully to replace and/or restore function to diseased or damaged tissues. In the field of orthopaedics, the use of metal implants has significantly improved the quality of life for countless individuals. Critical factors for implant success include proper design, material selection, and biocompatibility. While early research focused on the understanding biomechanical properties of the metal device, recent work has turned toward improving the biological properties of these devices. This has lead to the introduction of calcium phosphate (CaP) bioceramics as a bioactive interface between the bulk metal impart and the surrounding tissue. The first calcium phosphate coatings where produced via vapor phase routes but more recently, there has been the emergence of solution based and biomimetic methods. While each approach has its own intrinsic materials and biological properties, in general CaP coatings have the promise to improve implant biocompatibility and ultimately implant longevity.

  8. Damage control orthopaedics in 53 cases of severe polytrauma who have mainly sustained orthopaedic trauma

    Institute of Scientific and Technical Information of China (English)

    WANG Ai-min; YIN Xiang; SUN Hong-zhen; DU Quan-yin; WANG Zi-ming


    Objective: To discuss damage control orthopaedics in 53 cases of severe polytrauma who have mainly sustained orthopaedic trauma.Methods: The data of 53 cases of severe polytrauma who had mainly sustained orthopaedic trauma were retrospectively analyzed.And the methods and timing of damage control orthopaedics were discussed in this study.Results: We succeeded in rescuing the lives of all the 53 patients,and 38 patients returned to their former work.Conclusions: Injury Severity Seore (ISS90) should be 17 in severe polytrauma patients,but in severe polytrauma patients who have mainly sustained orthopaedic trauma,the ISS90 of bone and joint injuries should be 16.We recommend that primary minimally-invasive external fracture stabilization should be made for extremities and pelvis in these patients to avoid additional surgical trauma and that definitive secondary fracture care should be performed after medical stabilization for these patients in intensive care unit (ICU).

  9. Accredited Orthopaedic Sports Medicine Fellowship Websites (United States)

    Yayac, Michael; Javandal, Mitra; Mulcahey, Mary K.


    Background: A substantial number of orthopaedic surgeons apply for sports medicine fellowships after residency completion. The Internet is one of the most important resources applicants use to obtain information about fellowship programs, with the program website serving as one of the most influential sources. The American Orthopaedic Society for Sports Medicine (AOSSM), San Francisco Match (SFM), and Arthroscopy Association of North America (AANA) maintain databases of orthopaedic sports medicine fellowship programs. A 2013 study evaluated the content and accessibility of the websites for accredited orthopaedic sports medicine fellowships. Purpose: To reassess these websites based on the same parameters and compare the results with those of the study published in 2013 to determine whether any improvement has been made in fellowship website content or accessibility. Study Design: Cross-sectional study. Methods: We reviewed all existing websites for the 95 accredited orthopaedic sports medicine fellowships included in the AOSSM, SFM, and AANA databases. Accessibility of the websites was determined by performing a Google search for each program. A total of 89 sports fellowship websites were evaluated for overall content. Websites for the remaining 6 programs could not be identified, so they were not included in content assessment. Results: Of the 95 accredited sports medicine fellowships, 49 (52%) provided links in the AOSSM database, 89 (94%) in the SFM database, and 24 (25%) in the AANA database. Of the 89 websites, 89 (100%) provided a description of the program, 62 (70%) provided selection process information, and 40 (45%) provided a link to the SFM website. Two searches through Google were able to identify links to 88% and 92% of all accredited programs. Conclusion: The majority of accredited orthopaedic sports medicine fellowship programs fail to utilize the Internet to its full potential as a resource to provide applicants with detailed information about the

  10. Nanostructured Fe(III) catalysts for water oxidation assembled with the aid of organic acid salt electrolytes (United States)

    Zhao, Qiang; Li, Dandan; Gao, Guofeng; Yuan, Wen; Hao, Genyan; Li, Jinping


    We describe the preparation of three partially ordered iron-based catalyst films (Fe-OAc, Fe-Pro, Fe-But) with nanoporous structure by electrodeposition from organate electrolytes containing Fe2+. The anions of the organic acids assisted the partial ordering of the nanostructured Fe(III) catalysts for water oxidation. A model involving an electrical double layer is invoked to explain the role of the organate electrolyte system in their formation. Analytical results have revealed the main component of the iron-based films to be a β-FeOOH structure. The Fe-But catalyst catalyzed water oxidation in 0.1 m potassium carbonate solution with an average activity of 1.48 mA cm-2 and an overpotential of 433 mV.

  11. Orthopaedic Rehabilitation Device Actuated with Pneumatic Muscles

    Directory of Open Access Journals (Sweden)

    Ioana Petre


    This paper presents an innovative constructive solution for such orthopaedic rehabilitation equipment, designed to ensure a swift reintegration of patients at as low a cost as possible. The absolute novelty consists in the utilization of the linear pneumatic muscle as actuator of the orthopaedic rehabilitation equipment, thus achieving a light and highly compliant construction that satisfies safety requirements related to man-machine interaction. Pneumatic muscles are bio-inspired actuation systems characterized by a passive variable compliant behaviour. This property, deployed in rehabilitation systems, enables the development of human friendly devices, which are comfortable for the patients, and capable of safe interaction. This paper presents the constructive schematic of the orthopaedic rehabilitation equipment, the structure of the actuation and positioning system, and several of its functional characteristics.

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

    LENUS (Irish Health Repository)

    Nugent, M


    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.

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

    LENUS (Irish Health Repository)

    O'Malley, N T


    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.

  14. Current status and progress of digital orthopaedics in China

    Directory of Open Access Journals (Sweden)

    Guo-Xian Pei


    Full Text Available 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, three-dimensional (3D reconstruction, finite element simulation, navigation in orthopaedic operations, and robot-assisted orthopaedic operations. In addition, we briefly reviewed digital orthopaedics in world leading institutes. We also looked into the future of digital orthopaedics in China and proposed the major challenges in digital technology and application in orthopaedics.

  15. 应用数字骨科技术辅助设计定制桡骨头假体的体外研究%A vitro study on digital orthopaedic technology aided design of custom-made radial head prosthesis

    Institute of Scientific and Technical Information of China (English)

    陆建华; 秦步平; 王志刚; 黄莉; 朱建炜; 黄希


    , to design the custom-made radial head pros-thesis in vitro with the aid of digital orthopaedic technology. Methods:Based on the CT scanned data of the left elbow of a subject, the Mimics 10.0 and Geomagic studio 12 reverse en-gineering software were adopted to generate the entity files of the right radial head. According to the parameters of the right radial neck measured by Mimics 10.0, the UG NX 8.0 software was applied to design the stem and optional collars of the prosthesis with the aid of computer, and assemble the head with the stem. The right radial head prosthesis was custom-de-signed successfully in vitro. CT scanned data of the bilateral elbow joints of 6 subjects were compared to verify the match-ing of the custom-made prosthesis and the injured elbow. The morphological parameters of the bilateral proximal radius of these 6 subjects were measured and compared with the measurement tool of Mimics 10.0 software, which included the maxi-mum height of radial head, the minimum outer diameter on the plane of radial head and neck, the maximum diameter of medullary cavity on the plane of radial head and neck, and the length of marrow cavity in the radial cervical segment. Results:Errors of the morphological parameters were all less than 1 mm. It indicated that the radial head prosthesis custom-designed based on the anatomical parameters of the healthy side can accurately match the injured side. Conclusions: Designing the custom-made radial head prosthesis in vitro with the aid of digital orthopaedic technology is sci-entific and feasible. It has provided a new way to customize the prosthesis for each individual.

  16. The Orthopaedically Handicapped and Computer Usage: The Case of TRNC (United States)

    Dincyurek, Sibel; Arsan, Nihan; Caglar, Mehmet


    Although various studies have been conducted in the field of orthopaedic impairment, research regarding computer education for orthopaedically impaired individuals remains insufficient. This study aimed to evaluate the use of computers by orthopaedically impaired individuals from a wider perspective. The findings of the study emphasise the…

  17. The orthopaedic surgeon and manufacturing industry relationship. Ethical guidelines. (United States)

    Lim, E V; Aquino, N J


    Orthopaedic surgery has progressed over the years because of innovative work of pioneering orthopaedic surgeons; new developments in internal fixation techniques and implants codeveloped with the orthopaedic manufacturing industry have improved treatment greatly. This article analyzes and reviews the relationship of orthopaedic surgeons to the orthopaedic implant industry, analyzing three broad categories of the relationship: (1) physicians receiving gifts from industry; (2) the orthopaedic industry's financial support of educational and research endeavors of academic trauma and other centers; and (3) the relationship of the industry with innovators in the field of orthopaedic surgery by retainer fees, royalties, and stock options from industry. The ethical relationship requires: (1) putting the patient's concerns first above vested interests; (2) an awareness of a potential for abuse; and (3) a level of awareness of the relationship and the ability to explain and inculcate this relationship in the teaching program of young residents to maintain the high standards that have been set.

  18. Deformation-aided segregation of Fe-S liquid from olivine under deep Earth conditions: Implications for core formation in the early solar system (United States)

    Berg, Madeleine T. L.; Bromiley, Geoffrey D.; Butler, Ian B.; Frost, Mungo; Bradley, Robert; Carr, James; Le Godec, Yann; Montési, Laurent G. J.; Zhu, Wenlu; Miller, Kevin; Perrillat, Jean-Philippe; Mariani, Elisabetta; Tatham, Daniel; Redfern, Simon A. T.


    The planets and larger rocky bodies of the inner solar system are differentiated, and consist of metallic, iron-rich cores surrounded by thick shells of silicate. Core formation in these bodies, i.e. the segregation of metal from silicate, was a key process in the early solar system, and one which left a lasting geochemical signature. It is commonly assumed that extensive silicate melting and formation of deep magma oceans was required to initiate core formation, due to the inability of iron-rich melts to segregate from a solid silicate matrix. Here we assess the role of deformation in aiding segregation of core-forming melts from solid silicate under conditions of planetary deep interiors. Low-strain rate, high-pressure/temperature deformation experiments and high-resolution 2-D and 3-D textural analysis demonstrate that deformation fundamentally alters iron-rich melt geometry, promoting wetting of silicate grain boundaries and formation of extensive micron to sub-micron width Fe-rich melt bands. Deformation-aided Fe-S melt networks noted here contrast those observed in higher finite strain experiments conducted at lower pressure, and may reveal either an alternative mechanism for melt segregation at higher pressures, or an early stage process of melt segregation. Results suggest, however, that core-mantle chemical equilibration cannot be assumed in models of planetary formation, and that instead, the chemistry of rocky planets may record a complex, multi-stage process of core formation.

  19. Leadership and business education in orthopaedic residency training programs. (United States)

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


    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.

  20. Evaluation of malnutrition in orthopaedic surgery. (United States)

    Cross, Michael Brian; Yi, Paul Hyunsoo; Thomas, Charlotte F; Garcia, Jane; Della Valle, Craig J


    Malnutrition can increase the risk of surgical site infection in both elective spine surgery and total joint arthroplasty. Obesity and diabetes are common comorbid conditions in patients who are malnourished. Despite the relatively high incidence of nutritional disorders among patients undergoing elective orthopaedic surgery, the evaluation and management of malnutrition is not generally well understood by practicing orthopaedic surgeons. Serologic parameters such as total lymphocyte count, albumin level, prealbumin level, and transferrin level have all been used as markers for nutrition status. In addition, anthropometric measurements, such as calf and arm muscle circumference or triceps skinfold, and standardized scoring systems, such as the Rainey-MacDonald nutritional index, the Mini Nutritional Assessment, and institution-specific nutritional scoring tools, are useful to define malnutrition. Preoperative nutrition assessment and optimization of nutritional parameters, including tight glucose control, normalization of serum albumin, and safe weight loss, may reduce the risk of perioperative complications, including infection.

  1. 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~


    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.

  2. Reno Orthopaedic Trauma Fellowship business curriculum. (United States)

    Althausen, Peter L; Bray, Timothy J; Hill, Austin D


    The Reno Orthopaedic Center (ROC) Trauma Fellowship business curriculum is designed to provide the fellow with a graduate level business practicum and research experience. The time commitments in a typical 12-month trauma fellowship are significant, rendering a traditional didactic master's in business administration difficult to complete during this short time. An organized, structured, practical business education can provide the trauma leaders of tomorrow with the knowledge and experience required to effectively navigate the convoluted and constantly changing healthcare system. The underlying principle throughout the curriculum is to provide the fellow with the practical knowledge to participate in cost-efficient improvements in healthcare delivery. Through the ROC Trauma Fellowship business curriculum, the fellow will learn that delivering healthcare in a manner that provides better outcomes for equal or lower costs is not only possible but a professional and ethical responsibility. However, instilling these values without providing actionable knowledge and programs would be insufficient and ineffective. For this reason, the core of the curriculum is based on individual teaching sessions with a wide array of hospital and private practice administrators. In addition, each section is equipped with a suggested reading list to maximize the learning experience. Upon completion of the curriculum, the fellow should be able to: (1) Participate in strategic planning at both the hospital and practice level based on analysis of financial and clinical data, (2) Understand the function of healthcare systems at both a macro and micro level, (3) Possess the knowledge and skills to be strong leaders and effective communicators in the business lexicon of healthcare, (4) Be a partner and innovator in the improvement of the delivery of orthopaedic services, (5) Combine scientific and strategic viewpoints to provide an evidence-based strategy for improving quality of care in a

  3. Optimization of Orthopaedic Drilling: A Taguchi Approach

    Directory of Open Access Journals (Sweden)

    Rupesh Kumar Pandey


    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.

  4. Nanostructured diamond coatings for orthopaedic applications. (United States)

    Catledge, S A; Thomas, V; Vohra, Y K


    With increasing numbers of orthopaedic devices being implanted, greater emphasis is being placed on ceramic coating technology to reduce friction and wear in mating total joint replacement components, in order to improve implant function and increase device lifespan. In this chapter, we consider ultra-hard carbon coatings, with emphasis on nanostructured diamond, as alternative bearing surfaces for metallic components. Such coatings have great potential for use in biomedical implants as a result of their extreme hardness, wear resistance, low friction and biocompatibility. These ultra-hard carbon coatings can be deposited by several techniques resulting in a wide variety of structures and properties.

  5. DIY 3D printing of custom orthopaedic implants: a proof of concept study. (United States)

    Frame, Mark; Leach, William


    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.

  6. Social Competence and Temperament in Children with Chronic Orthopaedic Disability (United States)

    Yagmurlu, Bilge; Yavuz, H. Melis


    The aim of the study was to investigate social competence in children with orthopaedic disability and its concurrent relations to child's temperament, health condition, and maternal warmth. Participants were 68 Turkish children (mean = 5.94 years) with chronic orthopaedic disability and their mothers coming from disadvantaged backgrounds. Mother…

  7. Do Politics Matter to an Orthopaedic Surgeon? (They Should!). (United States)

    Lee, Adam K; Sethi, Manish K


    Orthopaedic trauma care is intimately tied with health policy, and current changes with health care reform may change how trauma care is delivered. This article offers a brief history of modern health care and the implications of new policies on the practice of orthopaedic trauma.

  8. Social Competence and Temperament in Children with Chronic Orthopaedic Disability (United States)

    Yagmurlu, Bilge; Yavuz, H. Melis


    The aim of the study was to investigate social competence in children with orthopaedic disability and its concurrent relations to child's temperament, health condition, and maternal warmth. Participants were 68 Turkish children (mean = 5.94 years) with chronic orthopaedic disability and their mothers coming from disadvantaged backgrounds.…

  9. Adaptive meshing technique applied to an orthopaedic finite element contact problem. (United States)

    Roarty, Colleen M; Grosland, Nicole M


    Finite element methods have been applied extensively and with much success in the analysis of orthopaedic implants. Recently a growing interest has developed, in the orthopaedic biomechanics community, in how numerical models can be constructed for the optimal solution of problems in contact mechanics. New developments in this area are of paramount importance in the design of improved implants for orthopaedic surgery. Finite element and other computational techniques are widely applied in the analysis and design of hip and knee implants, with additional joints (ankle, shoulder, wrist) attracting increased attention. The objective of this investigation was to develop a simplified adaptive meshing scheme to facilitate the finite element analysis of a dual-curvature total wrist implant. Using currently available software, the analyst has great flexibility in mesh generation, but must prescribe element sizes and refinement schemes throughout the domain of interest. Unfortunately, it is often difficult to predict in advance a mesh spacing that will give acceptable results. Adaptive finite-element mesh capabilities operate to continuously refine the mesh to improve accuracy where it is required, with minimal intervention by the analyst. Such mesh adaptation generally means that in certain areas of the analysis domain, the size of the elements is decreased (or increased) and/or the order of the elements may be increased (or decreased). In concept, mesh adaptation is very appealing. Although there have been several previous applications of adaptive meshing for in-house FE codes, we have coupled an adaptive mesh formulation with the pre-existing commercial programs PATRAN (MacNeal-Schwendler Corp., USA) and ABAQUS (Hibbit Karlson and Sorensen, Pawtucket, RI). In doing so, we have retained several attributes of the commercial software, which are very attractive for orthopaedic implant applications.

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

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi


    The call for evidence-based knowledge in clinical nursing practice has increased during recent decades and research in orthopaedic nursing is needed to improve patients' conditions, care and treatment. A descriptive cross-sectional survey was conducted to determine the self-perceived theoretical...... 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 results indicated that despite the majority of orthopaedic nurses having low self-perceived theoretical knowledge and practical research competencies, their interest and motivation to improve these were high, especially their inner motivation. However, the nurses' inner motivation was inhibited by a lack...

  11. Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures. (United States)

    Romanova, K; Vassileva, J; Alyakov, M


    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.

  12. Thromboembolism prophylaxis practices in orthopaedic arthroplasty patients.

    LENUS (Irish Health Repository)

    Cawley, D


    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.

  13. Atypical Clavicular Involvement of Nonbacterial Osteitis: An Orthopaedic Enigma

    Directory of Open Access Journals (Sweden)

    Salil Umrani


    Full Text Available Nonbacterial osteitis (NBO is an underdiagnosed and poorly understood condition caused by sterile inflammation. It can mimic the presentation of many other orthopaedic conditions, for example, osteomyelitis, septic arthritis, or malignancy, in particular for those patients who have unifocal presentation. Because NBO is a diagnosis by exclusion, it poses much difficulty and confusion to many orthopaedic surgeons in treating such disease. Clavicular involvement is common but it is typically present at the medial aspect of the clavicle. We report a case of NBO with atypical clavicular involvement who presented to our orthopaedic clinic with painful swelling in the left shoulder. Appropriate investigations and management are discussed together with literature review.


    Directory of Open Access Journals (Sweden)

    E. M. Polyakova


    Full Text Available Review brief presents description of polymerase chain reaction method (PCR and its most common variants. Three PCR-based lines of research, carried out in the traumatology and orthopaedics, include identifying a causative agents of the implant-associated infection after orthopaedic surgery; detection of antibiotic resistance genes and biofilm forming genes. It was shown that PCR can be used as additional method for detection of genetic disorders, significant for traumatology and orthopaedics, and for investigation of cartilage and bone regeneration.

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

    DEFF Research Database (Denmark)

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


    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...... Lab, University of Southern Denmark, 4Dept of Geriatrics, Glostrup University Hospital, Denmark   Introduction:  Currently, majority orthopaedic prosthesis and biomaterial researches have been based on investigation in normal animals. In most clinical situations, most...... 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...

  16. Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures. (United States)

    Watters, William; Rethman, Michael P; Hanson, Nicholas Buck; Abt, Elliot; Anderson, Paul A; Carroll, Karen C; Futrell, Harry C; Garvin, Kevin; Glenn, Stephen O; Hellstein, John; Hewlett, Angela; Kolessar, David; Moucha, Calin; O'Donnell, Richard J; O'Toole, John E; Osmon, Douglas R; Evans, Richard Parker; Rinella, Anthony; Steinberg, Mark J; Goldberg, Michael; Ristic, Helen; Boyer, Kevin; Sluka, Patrick; Martin, William Robert; Cummins, Deborah S; Song, Sharon; Woznica, Anne; Gross, Leeaht


    The Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures evidence-based clinical practice guideline was codeveloped by the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association. This guideline replaces the previous AAOS Information Statement, "Antibiotic Prophylaxis in Bacteremia in Patients With Joint Replacement," published in 2009. Based on the best current evidence and a systematic review of published studies, three recommendations have been created to guide clinical practice in the prevention of orthopaedic implant infections in patients undergoing dental procedures. The first recommendation is graded as Limited; this recommendation proposes that the practitioner consider changing the long-standing practice of routinely prescribing prophylactic antibiotic for patients with orthopaedic implants who undergo dental procedures. The second, graded as Inconclusive, addresses the use of oral topical antimicrobials in the prevention of periprosthetic joint infections. The third recommendation, a Consensus statement, addresses the maintenance of good oral hygiene.

  17. Battlefield Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome (United States)


    Award Number: W81XWH-10-2-0138 TITLE: "Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome." PRINCIPAL...Orthopaedic Implant Outcome." 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Nadim James Hallab, PhD 5d. PROJECT NUMBER 5e. TASK NUMBER 5f...battlefield injuries resulting in increased exposure to metal may sensitize individuals and lead to excessive immune responses to orthopedic implants

  18. Nutritional assessment of orthopaedic patients: knowledge test for nurses


    Hristozova, Kalina


    Adequate nutrition during hospitalization is essential for the avoidance of postoperative complications and the overall improved patient outcome. Studies show high prevalence of malnutrition among orthopaedic patients. Nurses play key role in nutritional assessment and are responsible for the provision of good quality nutritional care. The purpose of this final project was to produce a knowledge test for nurses working in orthopaedic wards. The final project answered the study question: Wh...

  19. Bone Adaptation Around Orthopaedic Implants of Varying Materials

    DEFF Research Database (Denmark)

    Bagge, Mette


    The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading......The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading...

  20. The Sheep as an Animal Model in Orthopaedic Research


    J.C. Potes; Reis, J.; Capela e Silva, Fernando; Relvas, C; A.S. Cabrita; Simões, J A


    The use of sheep as model in remodeling process in cancelous and cortical bone for the assessment of new orthopaedic biomaterials and implants, in biomechanical studies and as model for tissue-engineered bone constructs has been described in the literature. Sheep are a well accepted model for in vivo studies in orthopaedic research to address the biomechanical, biochemical and histological processes of bone biology, due to similarities with humans in weight, size, bone and joint structure and...

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

    Directory of Open Access Journals (Sweden)

    Tornetta Paul


    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

  2. The American Orthopaedic Association-Japanese Orthopaedic Association 2010 traveling fellowship. (United States)

    Patel, Alpesh A; Cheng, Ivan; Yao, Jeffrey; Huffman, G Russell


    We started this journey excited by the prospects of visiting Japan, a country with a proud and historic past. We ended the fellowship accomplishing those goals, and we left with a great deal of admiration for our orthopaedic colleagues halfway around the world for their excellence in education, clinical care, and research. Their hospitality and attention to the details of our visit were exemplary and a lesson to us as we host visiting fellows in the future. Japan reflects its past, but it also offers a preview into our own nation's future: an aging population, a shrinking workforce, a stagnant economy, nationalized health care, and a mushrooming national debt. Of all of these factors, it is the aging population that we, as orthopaedic surgeons, will be most acutely aware of and involved with. The degenerative disorders that affect elderly patients dominate the landscape of surgical care in Japan. Osteoporosis and osteopenia permeate many aspects of care across orthopaedic subspecialties. The surgeons in Japan are developing innovative and cost-effective means of treating the large volume of older patients within the fiscal constraints of a nationalized health-care system. We learned, and will continue to learn more, from Japan about the management of this growing patient population with its unique pathologies and challenges. With the recent natural disaster and ongoing safety concerns in Japan, the character and will of the people of Japan have been on display. Their courage and resolve combined with order and compassion are a testament to the nation's cultural identity. The seeds of the Traveling Fellowship were planted shortly after Japan's last wide-scale reconstruction, and the ties that have bound the JOA and the AOA together are strengthened through this trying time. We strongly urge our colleagues in the U.S. to help support the people, the physicians, and the health-care system of Japan through its most recent tribulations and offer them the same care and

  3. Surgical hand scrub practices in orthopaedic surgery. (United States)

    Khan, Adnan; McLaren, Sandra G; Nelson, Carl L


    The purpose of this study was to determine whether the practice of surgical hand scrubbing among orthopaedic surgeons, faculty, residents, and nurses met the institution's recommended 5-minute scrub policy and how often a 2-minute surgical hand scrub was used. Forty-eight subjects' hand scrub times were recorded discreetly for a total of 125 observations. All individuals scrubbed for a mean of 2.54 minutes and all scrubbed less than the 5-minute institutionally recommended policy. We found that 35.2% scrubbed less than 2 minutes and 64.8% scrubbed greater than 2 minutes. The subjects studied were polled to determine whether they knew the scrub policy, the minimum effective scrub time, and their perception of how long they scrub. Three of the 16 respondents correctly answered the question regarding the hospital's recommended policy regarding scrub time of 5 minutes. All stated they thought they scrubbed at least 2 minutes and all agreed that at least a 2-minute scrub should be done.

  4. Justifications and needs for diversity in orthopaedics. (United States)

    White, A A


    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.

  5. Orthopaedic tissue engineering and bone regeneration. (United States)

    Dickson, Glenn; Buchanan, Fraser; Marsh, David; Harkin-Jones, Eileen; Little, Uel; McCaigue, Mervyn


    Orthopaedic tissue engineering combines the application of scaffold materials, cells and the release of growth factors. It has been described as the science of persuading the body to reconstitute or repair tissues that have failed to regenerate or heal spontaneously. In the case of bone regeneration 3-D scaffolds are used as a framework to guide tissue regeneration. Mesenchymal cells obtained from the patient via biopsy are grown on biomaterials in vitro and then implanted at a desired site in the patient's body. Medical implants that encourage natural tissue regeneration are generally considered more desirable than metallic implants that may need to be removed by subsequent intervention. Numerous polymeric materials, from natural and artificial sources, are under investigation as substitutes for skeletal elements such as cartilage and bone. For bone regeneration, cells (obtained mainly from bone marrow aspirate or as primary cell outgrowths from bone biopsies) can be combined with biodegradable polymeric materials and/or ceramics and absorbed growth factors so that osteoinduction is facilitated together with osteoconduction; through the creation of bioactive rather than bioinert scaffold constructs. Relatively rapid biodegradation enables advantageous filling with natural tissue while loss of polymer strength before mass is disadvantageous. Innovative solutions are required to address this and other issues such as the biocompatibility of material surfaces and the use of appropriate scaffold topography and porosity to influence bone cell gene expression.

  6. A systematic review of the methodological quality and extent to which evaluation studies measure the usability of orthopaedic shoes

    NARCIS (Netherlands)

    Jannink, MJA; van Dijk, H; de Vries, J; Groothoff, JW; Lankhorst, GJ


    Objective: To determine the methodological quality of studies evaluating orthopaedic shoes and orthopaedic shoe provisions. To what extent do studies evaluating orthopaedic shoes prescribed for patients with degenerative disorders of the foot, rheumatoid arthritis, diabetes mellitus and neurological

  7. Orthopaedic admissions due to sports and recreation injuries.

    LENUS (Irish Health Repository)

    Delaney, R A


    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.

  8. [The history and development of computer assisted orthopaedic surgery]. (United States)

    Jenny, J-Y


    Computer assisted orthopaedic surgery (CAOS) was developed to improve the accuracy of surgical procedures. It has improved dramatically over the last years, being transformed from an experimental, laboratory procedure into a routine procedure theoretically available to every orthopaedic surgeon. The first field of application of computer assistance was neurosurgery. After the application of computer guided spinal surgery, the navigation of total hip and knee joints became available. Currently, several applications for computer assisted surgery are available. At the beginning of navigation, a preoperative CT-scan or several fluoroscopic images were necessary. The imageless systems allow the surgeon to digitize patient anatomy at the beginning of surgery without any preoperative imaging. The future of CAOS remains unknown, but there is no doubt that its importance will grow in the next 10 years, and that this technology will probably modify the conventional practice of orthopaedic surgery.

  9. Patients’ expectations and actual use of custom-made orthopaedic shoes

    NARCIS (Netherlands)

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


    Objective: To investigate the association between patients’ expectations and the actual use of custom-made orthopaedic shoes. - Design: A prospective cohort study with internal comparison. - Setting: Twelve orthopaedic shoe companies. - Patients: During six months, consecutive patients who were p

  10. Robotic surgery in trauma and orthopaedics: a systematic review. (United States)

    Karthik, K; Colegate-Stone, T; Dasgupta, P; Tavakkolizadeh, A; Sinha, J


    The use of robots in orthopaedic surgery is an emerging field that is gaining momentum. It has the potential for significant improvements in surgical planning, accuracy of component implantation and patient safety. Advocates of robot-assisted systems describe better patient outcomes through improved pre-operative planning and enhanced execution of surgery. However, costs, limited availability, a lack of evidence regarding the efficiency and safety of such systems and an absence of long-term high-impact studies have restricted the widespread implementation of these systems. We have reviewed the literature on the efficacy, safety and current understanding of the use of robotics in orthopaedics.

  11. Closing the gap: bone health education in orthopaedic practice. (United States)

    Rouhe, Mellissa


    Bone health education in an orthopaedic office and hospital setting is uncommon, yet essential. Many benefits are possible for patients by preventing future fractures and improving quality of life in those afflicted with osteoporosis and osteopenia. Ninety percent of hip fractures are due to osteoporosis; only stroke occupies more hospital bed days than hip fracture each year. Clinical time constraints, physician unawareness, cost-effectiveness, and patient noncompliance include some of the obstacles to education. Orthopaedic nurses can be a vital part of the challenging solution to removing barriers and bridging the educational gap for physicians and patients.

  12. Detection of biomaterial-associated infections in orthopaedic joint implants

    NARCIS (Netherlands)

    Neut, D; van Horn, [No Value; van Kooten, TG; van der Mei, HC; Busscher, HJ


    Biomaterial-associated infection of orthopaedic joint replacements is the second most common cause of implant failure. Yet, the microbiologic detection rate of infection is relatively low, probably because routine hospital cultures are made only of swabs or small pieces of excised tissue and not of

  13. Reading the Small Print – Labelling Recommendations for Orthopaedic Implants (United States)

    Haene, Roger A; Sandhu, Ranbir S; Baxandall, Richard


    INTRODUCTION There exist, currently, no clear guidelines regarding standards for surgical implant labelling. Dimensions of the laminar flow canopies in orthopaedic use fixes the distance at which implant labels can be read. Mistakes when reading the label on an implant box can pose health risks for patients, and financial consequences for medical institutions. SUBJECTS AND METHODS Using scientifically validated tools such as the Snellen Chart Formula, a theoretical minimum standard for text on implant labels was reached. This theoretical standard was then tested under real operating conditions. After discovering a minimum practical standard for implant labels, the authors then audited current labels in use on a wide range of orthopaedic implant packages. Furthermore, other non-text-related labelling problems were also noted. RESULTS There is a definite minimum standard which should be observed when implant labels are manufactured. Implants in current use bear labels on the packaging that are of an insufficient standard to ensure patient safety in theatre. CONCLUSIONS The authors have established text parameters that will increase the legibility of implant labels. In the interests of improving risk management in theatre, therefore, the authors propose a standard for orthopaedic implant labelling, and believe this will provide a useful foundation for further discussion between the orthopaedic community and implant manufacturers. PMID:19686615

  14. [Collaboration between geriatricians and orthopaedic surgeons on elderly patients]. (United States)

    Damsgaard, Else Marie; Borris, Lars; Duus, Benn; van der Mark, Susanne


    Close collaboration between geriatricians and orthopaedic surgeons on elderly patients with hip fractures reduces mortality, the number of complications, and the length of hospital stay and increases the functional abilities of the patients. In some Danish hospitals the two groups of doctors work closely together, in others there are few or no geriatricians.

  15. Complex M&E for new orthopaedic centre. (United States)

    Briars, Paul


    Paul Briars, North West regional director for independent engineering, IT, and facilities services business, NG Bailey (pictured), discusses the company's part in a major redevelopment at one of the UK's top orthopaedic hospitals, Wrightington Hospital in Lancashire --famous as the site, in the early 1960s, of first ever hip replacement operations, by pioneering surgeon, Professor Sir John Charnley (HEJ --April 2013).

  16. Infections in orthopaedic surgery : clinical and experimental studies

    NARCIS (Netherlands)

    Vogely, Henri Charles


    The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable d

  17. 99m Tc-labeled heparin test in orthopaedic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bouvier, J.F.; Lafon, J.C.; Colin, M.; Chatelut, J.; Beaubatie, F. (Hopital Universitaire Dupuytren, Limoges (France))


    99m Tc-labeled heparin test was performed for early detection of phlebitis or pulmonary embolism after orthopaedic prothesis. Heparinic treatment and surgery per se were demonstrated to have no effect on the results. If this test demonstrates a statistical difference for pathologic patients, it is of greater value to consider ratio between rates before and after intervention.

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


    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.

  19. 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: [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)


    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.

  20. Computer-assisted Orthopaedic Surgery: Current State and Future Perspective

    Directory of Open Access Journals (Sweden)

    Guoyan eZheng


    Full Text Available Introduced about two decades ago, computer-assisted orthopaedic surgery (CAOS has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopaedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

  1. Using PubMed effectively to access the orthopaedic literature. (United States)

    Clough, J F Myles; Hitchcock, Kristin; Nelson, David L


    PubMed is the free public Internet interface to the US National Library of Medicine's MEDLINE database of citations to medical scientific articles. Many orthopaedic surgeons use PubMed on a regular basis, but most orthopaedic surgeons have received little or no training in how to use PubMed effectively and express frustration with the experience. Typical problems encountered are data overload with very large numbers of returns to look through, failure to find a specific article, and a concern that a search has missed important papers. It is helpful to understand the system used to enter journal articles into the database and the classification of the common types of searches and to review suggestions for the best ways to use the PubMed interface and find sources for search teaching and assistance.

  2. Competency-based education: a new model for teaching orthopaedics. (United States)

    Alman, Benjamin A; Ferguson, Peter; Kraemer, William; Nousiainen, Markku T; Reznick, Richard K


    The current methods used to train residents to become orthopaedic surgeons are based on tradition, not evidence-based models. Educators have only a limited ability to assess trainees for competency using validated tests in various domains. The reduction in resident work hours limits the time available for clinical training, which has resulted in some calls for lengthening the training process. Another approach to address limited training hours is to focus training in a program that allows residents to graduate from a rotation based on demonstrated competency rather than on time on a service. A pilot orthopaedic residency curriculum, which uses a competency-based framework of resident training and maximizes the use of available training hours, has been designed and is being implemented.

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

    DEFF Research Database (Denmark)

    Babiker, Hassan


    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...... 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...

  4. Musculoskeletal ultrasound education: orthopaedic resident ability following a multimedia tutorial. (United States)

    Piposar, Jonathan R; Easley, Mark; Nunley, James A; DeOrio, James K; Talusan, Paul G; Gubler, Kyle E; Reach, John S


    Musculoskeletal ultrasound (MSK-US) is a quick and effective imaging tool that can be utilized by orthopaedic surgeons to identify common musculoskeletal pathology such as ankle tendinopathy. This study evaluated the ability of 15 orthopaedic surgery residents to identify and measure ankle tendons after attending a multimedia tutorial on MSK-US. Afterwards, proficiency of usage was assessed by identification and quantification of three ankle tendons (Achilles, tibialis posterior, and flexor hallucis longus) in a cadaver limb. Resident comfort level and plan for future use were also assessed. After completing the tutorial, accuracy measuring the Achilles, tibialis posterior, and flexor hallucis longus tendons was 94.8%, 90.2%, and 90.1%, respectively. Resident comfort level improved from a level of 2.3 before the tutorial to 6.8 afterwards. Seventy-one percent of residents plan to use ultrasound in clinical practice. These results show that orthopaedic surgery residents can identify and assess tendon size via MSK-US with sufficient accuracy after a multimedia tutorial.

  5. Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis. (United States)

    Hawkey, S; Ghaffar, S


    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.

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

    Directory of Open Access Journals (Sweden)

    S. Hawkey


    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.

  7. Adaptive Meshing Technique Applied to an Orthopaedic Finite Element Contact Problem


    Roarty, Colleen M; Grosland, Nicole M.


    Finite element methods have been applied extensively and with much success in the analysis of orthopaedic implants.6,7,12,13,15 Recently a growing interest has developed, in the orthopaedic biomechanics community, in how numerical models can be constructed for the optimal solution of problems in contact mechanics. New developments in this area are of paramount importance in the design of improved implants for orthopaedic surgery. Finite element and other computational techniques are widely ap...

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

    LENUS (Irish Health Repository)

    O Mir, Marie


    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.

  9. 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


    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.

  10. Emergence of coryneforms in osteomyelitis and orthopaedic surgical site infections

    Directory of Open Access Journals (Sweden)

    Meher Rizvi


    Full Text Available BackgroundCoryneform species other than Corynebacterium diphtheriae are coming up as important pathogens with the potential to cause serious and life-threatening infections not only in immunocompromised but in immunocompetent individuals as well. The exact infectious potential of these bacteria and their rational antimicrobial treatment is a challenging but essential task.Method The study was conducted in the Department of Microbiology and the Department of Orthopaedics, JNMCH, AMU, Aligarh between August 2007 and May 2009. Pus samples were collected from patients of osteomyelitis and other bone infections including orthopaedic surgical site infections. The Corynebacterium species isolated in the study was identified using standard microbiological techniques and antimicrobial sensitivity testing was done by Kirby bauer disc diffusion method.ResultsA total of 312 Corynebacterium species were isolated. The majority of the coryneforms were isolated from the immunocompetent patients 270 (86.54%. C.jeikium was the most common coryneform isolated. Nearly half of the patients 153 (49.04% had acute infection caused by Corynebacterium species after orthopaedic surgery, a quarter 66 (21.15% had chronic infection and 72 (23.08% patients had device-related infection. Coryneforms exhibited maximum resistance to aminoglycosides (58.65% and β-lactams (penicillin group- 57.55%. C.jeikium was found to be the most resistant amongst all the Corynebacterium species.ConclusionThe study highlights the fact that the coryneforms are no longer just opportunistic pathogens but they are also becoming important pathogens among immunocompetent individuals as well. The emergence of drug resistance amongst these isolates is of most concern. More studies should be done on identification and on antimicrobial susceptibility of these organisms for the proper treatment of patients with such infections.

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


    Hawkey, S.; S. Ghaffar


    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 o...

  12. Mechanical properties of cellulose in orthopaedic devices and related environments. (United States)

    Poustis, J; Baquey, C; Chauveaux, D


    The authors have undertaken a series of mechanical tests in order to assess the performance of regenerated cellulose under either static or dynamic conditions, and to evaluate its long-term behaviour under mechanical stress. In this respect, bending stiffness, resistance to compression, creep under compressive stress, in vitro and in vivo ageing and fatigue resistance were studied. It appears that this material demonstrates mechanical properties which depend upon its density, which is itself related to its water content. Moreover, this material is very stable under dynamic stress. This could be an interesting property for use in orthopaedic devices.

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

    LENUS (Irish Health Repository)

    Collins, D


    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.

  14. 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


    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.

  15. Hearing Aids (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 ...

  16. AIDS (image) (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 medicine can suppress symptoms. ...

  17. Patients' expectations and actual use of custom-made orthopaedic shoes

    NARCIS (Netherlands)

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


    Objective: To investigate the association between patients' expectations and the actual use of custom-made orthopaedic shoes. Design: A prospective cohort study with internal comparison. Setting: Twelve orthopaedic shoe companies. Patients: During six months, consecutive patients who were provided w

  18. Burnout and quality of life among orthopaedic trainees in a modern educational programme

    NARCIS (Netherlands)

    van Vendeloo, S. N.; Brand, P. L. P.; Verheyen, C. C. P. M.


    We aimed to determine quality of life and burnout among Dutch orthopaedic trainees following a modern orthopaedic curriculum, with strict compliance to a 48-hour working week. We also evaluated the effect of the clinical climate of learning on their emotional wellbeing. We assessed burnout, quality

  19. Technical evaluation of a CAD system for orthopaedic shoe-upper design. (United States)

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


    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.

  20. 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 th...

  1. Nanobiotechnology Perspectives on Prevention and Treatment of Ortho-paedic Implant Associated Infection. (United States)

    Borse, Vivek; Pawar, Vaishali; Shetty, Gautam; Mullaji, Arun; Srivastava, Rohit


    Implants are an inevitable part of orthopaedic surgery. However, implant associated infection remains a major challenge for orthopaedic surgeons and researchers. This review focuses on current options available for prevention of implant associated infection, their drawbacks and future promising applications of nanotechnology-based approaches. Nanobiotechnology has shown remarkable progress in recent years especially in biomaterials, diagnostics, and drug delivery system. Although several applications of nanobiotechnology in orthopaedics have been described, few have elaborated their role in the prevention of implant related infection in orthopaedics. Novel "smart" drug delivery systems that release antibiotics locally in response to stimuli such as pH, temperature, enzymes or antigens; implant surface modification on a nanoscale to inhibit bacterial adhesion and propagation at the surgical site and biological approaches such as gene therapy to neutralize bacterial virulence and biomolecules to inhibit the quorum sensing adhesion of bacteria and disruption of biofilms can be used effectively to prevent orthopaedic implant related bacterial infection.

  2. Pudendal nerve palsy in trauma and elective orthopaedic surgery. (United States)

    Polyzois, Ioannis; Tsitskaris, Konstantinos; Oussedik, Sam


    The incidence of pudendal nerve palsy following routine trauma and elective orthopaedic surgery procedures ranges from 1.9% to 27.6%. Excessive and/or prolonged traction against the perineal post of a traction table, leading to direct compression and localised ischaemia to the nerve are suggested mechanisms of injury. Misuse of traction and the inappropriate placement of the perineal post, leading to crushing and stretching of the pudendal nerve, are two main contributing factors leading to its postoperative palsy. The sequelae may be sensory, motor or mixed. In most cases, these injuries are transient and tend to resolve within several weeks or months. However, complete neurological recovery may be unpredictable and the effects of ongoing dysfunction potentially disastrous for the individual. In terms of preventative measures, magnitude and duration of traction time should be minimised; traction should be limited to the critical operative steps only. Additionally, the perineal post should be placed between the genitalia and the contralateral leg. A well-padded, large-diameter perineal post should be used (>10cm). Adequate muscle relaxation during anaesthesia is particularly important in young men who have strong muscles and thus require larger traction forces when compared to elderly patients. Orthopaedic surgeons should be aware of the pathophysiology behind the development of this palsy and the measures that can be employed to reduce its occurrence. In procedures where a traction table is employed, consenting for pudendal nerve palsy should be considered by the surgical team.

  3. Palliative care: a challenge for orthopaedic nursing care. (United States)

    Watters, Carol L; Harvey, Carol V; Meehan, Anita J; Schoenly, Lorry


    Patients who face chronic, incurable, or life-ending musculoskeletal conditions often receive inadequate care either due to a lack of caregiver awareness or inattention to maintaining the highest quality at the end of life. Palliative care focuses on the comprehensive physical, psychological, social, spiritual, and existential needs of patients with life-threatening or debilitating illness. Orthopaedic nurses and all nurses in general are challenged to incorporate palliative care principles into care planned with patients and families facing end-of-life issues. This article addresses the leadership role the National Association of Orthopaedic Nurses (NAON) has taken to develop a consensus document which endorses the Last Acts Precepts of Palliative Care and affirms the need for palliative care with patients who experience life-threatening illness. A case study is used to illustrate the opportunity a multidisciplinary team has to center care on the individual, while remaining sensitive to the holistic needs of the patient for self-determination at the end of life.

  4. Orthopaedic applications for PLA-PGA biodegradable polymers. (United States)

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


    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.

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

    LENUS (Irish Health Repository)

    Cashman, J P


    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.

  6. The need for research training in orthopaedic residency education. (United States)

    Anderson, Robert W


    Orthopaedic surgery residents should be exposed during their clinical training to the processes of creativity and innovation that are the basis of research. The definition of a research experience for surgery residents should be broad and include not only traditional bench research in a basic science environment but also translational and clinical research to move innovation from bench to bedside and validate its value in a scientific manner. Additionally, there are enormous opportunities for surgeons to study healthcare delivery and policy and to develop new approaches to educating colleagues, other medical personnel, and patients. The question that must be addressed is how can the knowledge and human resources residing in orthopaedic surgery best be used to meet the challenges future residents will face as healthcare undergoes profound changes? How these issues are managed in a rapidly changing environment is the critical issue and the challenge faced by surgical training programs wishing to remain viable and provide trainees with the opportunity to adapt and be successful in the future. What is state of the art today will not be tomorrow and unless trainees are encouraged and taught to be creative and innovative they risk becoming surgical dinosaurs.

  7. The Impact of the Multicenter Orthopaedic Outcomes Network (MOON) Research on Anterior Cruciate Ligament Reconstruction and Orthopaedic Practice. (United States)

    Lynch, T Sean; Parker, Richard D; Patel, Ronak M; Andrish, Jack T; Spindler, Kurt P; Amendola, Annunziata; Brophy, Robert H; Dunn, Warren R; Flanigan, David C; Huston, Laura J; Jones, Morgan H; Kaeding, Christopher C; Marx, Robert G; Matava, Matthew J; McCarty, Eric C; Pedroza, Angela D; Reinke, Emily K; Wolf, Brian R; Wright, Rick W


    With an estimated 200,000 anterior cruciate ligament reconstructions performed annually in the United States, there is an emphasis on determining patient-specific information to help educate patients on expected clinically relevant outcomes. The Multicenter Orthopaedic Outcomes Network consortium was created in 2002 to enroll and longitudinally follow a large population cohort of anterior cruciate ligament reconstructions. The study group has enrolled >4,400 anterior cruciate ligament reconstructions from seven institutions to establish the large level I prospective anterior cruciate ligament reconstruction outcomes cohort. The group has become more than a database with information regarding anterior cruciate ligament injuries; it has helped to establish a new benchmark for conducting multicenter, multisurgeon orthopaedic research. The changes in anterior cruciate ligament reconstruction practice resulting from the group include the use of autograft for high school, college, and competitive athletes in their primary anterior cruciate ligament reconstructions. Other modifications include treatment options for meniscus and cartilage injuries, as well as lifestyle choices made after anterior cruciate ligament reconstruction.

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

    CERN Document Server

    Schiavone, Patrick; Ohayon, J; Payan, Y


    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....

  9. Overview of Implant Infections in Orthopaedics Department: Retrospective Study

    Directory of Open Access Journals (Sweden)

    Tugrul Bulut


    Full Text Available In this study, our aim was to evaluate the antibiotic susceptibility of bacteria isolated from orthopedic implant infections. Within two years operated 1996 patients in an orthopedics and traumatology clinic were retrospectively investigated. Seventy-six (76/1996, 3.8% orthopedic implant infections were detected. Isolated bacteria and their antibiotic susceptibility patterns were analyzed. The bacteries isolated from implant related infections and antibiotic sensitivity patterns were evaluated retrospectively in our orthopaedics and traumatology clinic. Staphylococcus aureus was the predominant organism (30.3%. Gram negative bacterias were isolated in 65.8% of our patients. No resistance was determined against vancomycin and linezolid in gram positive bacterias. Imipenem, amicasin and cefepim was seen as the most effective antibiotics for gram negative bacterias.

  10. Perioperative Vision Loss in Spine Surgery and Other Orthopaedic Procedures. (United States)

    Su, Alvin W; Lin, Shuai-Chun; Larson, A Noelle


    Perioperative vision loss is a rare complication of orthopaedic surgery and has been documented after spine, knee, hip, and shoulder procedures. It is associated with several ophthalmologic diagnoses, most commonly ischemic optic neuropathy. Although the pathophysiology remains unclear, current evidence suggests that systemic hemodynamic compromise and altered balance of intraocular perfusion contribute to the development of ischemic optic neuropathy. Although vision recovery has been reported, the prognosis of perioperative vision loss is poor, and no proven effective treatment is available. Perioperative vision loss is unpredictable and can occur in healthy patients. Associated risk factors include pediatric or elderly age, male sex, obesity, anemia, hypotension or hypertension, perioperative blood loss, prolonged surgical time, and prone positioning. Preventive strategies include avoiding direct pressure to the eye, elevating the head, optimizing perioperative hemodynamic status, and minimizing surgical time with staged surgical procedures as appropriate.

  11. Nonspinal orthopaedic problems in familial dysautonomia (Riley-Day syndrome). (United States)

    Laplaza, F J; Turajane, T; Axelrod, F B; Burke, S W


    Familial dysautonomia (FD) is a rare autosomal recessive disease occurring in Ashkenazi Jews. It affects the autonomic, central, and peripheral nervous systems. The purpose of this study was to assess the prevalence and characteristics of orthopedic deformities, other than spinal deformities, in this population. A retrospective review of the medical records and radiographs of 182 patients was made. Three main groups of orthopaedic conditions were evaluated: (a) Fractures: 60% of the patients had one or more fractures; the average fracture rate was 1.4/patient. (b) Neuropathic joints: 11% of the cases had one or more neuropathic joints, the knee being the most common. (c) Other musculoskeletal deformities: 26% of the patients had one or more deformities. Lower extremity rotational problems and foot anomalies accounted for most of these deformities. Patients with FD have a higher prevalence of fractures and neuropathic joints than do their peers. The fracture pattern also is different, with a higher incidence of proximal femoral fractures.

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

    LENUS (Irish Health Repository)

    Cawley, D


    \\'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.

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

    Directory of Open Access Journals (Sweden)

    Eszter Kovacs


    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.

  14. Effects of a modified maxillary orthopaedic splint: a cephalometric evaluation. (United States)

    Uner, O; Yücel-Eroğlu, E


    Taking the presence of an interplay between the vertical and sagittal components of craniofacial development into consideration, the beneficial therapeutic potential impacts of controlling vertical development on the correction of Class II discrepancies has been previously investigated. In the present study, a modified maxillary orthopaedic splint combined with an anterior high-pull headgear was used for early correction of the vertical and consequently sagittal dentoskeletal discrepancy as the initial stage of treatment. The aim was to evaluate its effects on the maxillary and mandibular dentoskeletal development, as well as rotational growth pattern. In order to compare with and distinguish from the uninterrupted growth changes, a control group was formed by matching each one of the control subjects to a subject in the treatment group according to certain criteria. The initial and second standardized lateral cephalograms of each subject was evaluated by means of an adopted and biologically more substantial cephalometric analysis. Evaluation of the changes induced by the splint in comparison with the uninterrupted growth changes revealed that the splint had both orthopaedic and orthodontic effects on the growth pattern of the dentoskeletal structures. There seemed to exist a relationship between the direction of total mandibular and maxillary rotations. In addition, it was believed that in order to cause a forward mandibular rotation, i.e. to change the rotational mandibular growth pattern from a backward into a forward direction, the posterior vertical maxillary development should be restrained, but anterior vertical maxillary development should be relatively more restrained or reversed and, thereby, the rotational growth pattern of the maxilla should be changed from a backward into a forward direction. Moreover, the bite block effect of the splint seemed to cause a favourable change in the condylar growth direction from a backward to an upward direction.

  15. Helical rosette nanotubes: a more effective orthopaedic implant material (United States)

    Chun, Ai Lin; Moralez, Jesus G.; Fenniri, Hicham; Webster, Thomas J.


    Due to the nanometric properties of some physiological components of bone, nanomaterials have been proposed as the next generation of improved orthopaedic implant materials. Yet current efforts in the design of orthopaedic materials such as titanium (Ti) are not aimed at tailoring their nanoscale features, which is now believed to be one reason why Ti sometimes fails clinically as a bone implant material. Much effort is thus being dedicated to developing improved bioactive nanometric surfaces and nanomaterials for biospecificity. Helical rosette nanotubes (HRN) are a new class of self-assembled organic nanotubes possessing biologically-inspired nanoscale dimensions. Because of their chemical and structural similarity with naturally-occurring nanostructured constituent components in bone such as collagen and hydroxyapatite, we anticipated that an HRN-coated surface may simulate an environment that bone cells are accustomed to interacting with. The objective of the present in vitro study is therefore to determine the efficacy of HRN as a bone prosthetic material. Results of this study clearly show that both HRN-K1 and HRN-Arg coated Ti displayed enhanced cell adhesion when compared to uncoated Ti. Enhanced cell adhesion was observed even at concentrations as low as 0.005 mg ml-1. These results point towards new possibilities in bone tissue engineering as they serve as a starting point for further mechanistic studies as well as future manipulation of the outer chemistries of HRN to improve the results beyond those presented here. One such effort is the incorporation of peptide sequences on the outer surface of HRN and/or growth factors known to enhance bone functions.

  16. Research on the Influence of Orthopaedic Inserts on Pressure Distribution in the Foot

    Directory of Open Access Journals (Sweden)

    Ignas Rutulys


    Full Text Available The article examines the influence of individual orthopaedic inserts on pressure distribution in the foot. Feet deformations, types of orthopaedic inserts, materials and pressure in the foot testing methods are discussed. Experimental computer measurements of pressure in the foot before and after the use of inserts have been done. During research, the inserts made of different kinds of materials selected according to human weight, pathology, skin sensitivity and many other reasons has been used. It has been determinated that orthopaedic inserts have a more noticeable impact on children whose feet is adjusted easier if compared with those of adults.Article in Lithuanian

  17. 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...

  18. Foreign aid

    DEFF Research Database (Denmark)

    Tarp, Finn


    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...

  19. Do developmental orthopaedic disorders influence future jumping performances in Warmblood stallions?

    DEFF Research Database (Denmark)

    Verwilghen, Denis; Janssens, S; Busoni, V


    REASONS FOR PERFORMING THE STUDY: Few reports are available on the relationship between developmental orthopaedic diseases (DOD) and future performances in Warmblood horses. OBJECTIVES: To investigate the relationship between performance and the presence of DOD lesions. METHODS: Records of Warmbl...

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

    Directory of Open Access Journals (Sweden)

    Bill G. X. Zhang


    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.

  1. Significance of nano- and microtopography for cell-surface interactions in orthopaedic implants. (United States)

    Jäger, M; Zilkens, C; Zanger, K; Krauspe, R


    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.

  2. Housing design and testing of a surgical robot developed for orthopaedic surgery

    Directory of Open Access Journals (Sweden)

    Lai-Yin Qin


    Conclusion: This project demonstrated a good model of multidisciplinary R&D of surgical robotics led by orthopaedic surgeons, in collaboration with mechanical and electronic engineers and industrial designers.

  3. Ethics as an important determinant of success of orthopaedic dental care for debilitated and elderly patients. (United States)

    Schwartzseid, E E


    Ethical aspects of orthopaedic dental care for debilitated and elderly patients--the most complex and the least studied aspects of dentistry--are discussed here. Many articles on dental ethics, as a rule, do not cover the essential ethical aspects of orthopaedic care for the elderly or cover them only partially without reflecting on the problem at large. Understanding of the problem may help to provide more efficient dental care for the elderly population thus improving their quality of life.

  4. Biodegradable Magnesium Alloys for Orthopaedic Applications: A Review on Corrosion, Biocompatibility and Surface Modifications.


    Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna


    Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys an...

  5. Improvement of research quality in the fields of orthopaedics and trauma—a global perspective


    Fayaz, Hangama C.; Haas, Norbert; Kellam, James; Bavonratanavech, Suthorn; Parvizi, Javad; Dyer, George; Pohlemann, Tim; Jerosch, Jörg; Prommersberger, Karl-Josef; Pape, Hans Christoph; Smith, Malcolm; Vrahas, Marc; Perka, Carsten; Siebenrock, Klaus; Elhassan, Bassem


    The international orthopaedic community aims to achieve the best possible outcome for patient care by constantly modifying surgical techniques and expanding the surgeon’s knowledge. These efforts require proper reflection within a setting that necessitates a higher quality standard for global orthopaedic publication. Furthermore, these techniques demand that surgeons acquire information at a rapid rate while enforcing higher standards in research performance. An international consensus exists...

  6. Does a "Level I Evidence" rating imply high quality of reporting in orthopaedic randomised controlled trials?


    Sierevelt Inger N; Krips Rover; Struijs Peter AA; Poolman Rudolf W; Lutz Kristina H; Bhandari Mohit


    Abstract Background The Levels of Evidence Rating System is widely believed to categorize studies by quality, with Level I studies representing the highest quality evidence. We aimed to determine the reporting quality of Randomised Controlled Trials (RCTs) published in the most frequently cited general orthopaedic journals. Methods Two assessors identified orthopaedic journals that reported a level of evidence rating in their abstracts from January 2003 to December 2004 by searching the instr...

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


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


    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...

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


    Neil M. Issar; Kadakia, Rishin J.; James M. Tsahakis; Zachary T. Yoneda; Sethi, Manish K.; Mir, Hassan R.; Kristin Archer; Obremskey, William T.; A. Alex Jahangir


    Abstract: 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 drivin...

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


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


    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...

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


    Zhang, Bill G. X.; Myers, Damian E.; Gordon G. Wallace; Milan Brandt; Choong, Peter F. M.


    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, extracell...

  11. Bone graft materials in fixation of orthopaedic implants in sheep. (United States)

    Babiker, Hassan


    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human 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/Collagen composite alone and in combination with BMA on the early fixation of porous coated titanium implants. In addition, the study compares also the effect of autograft with the gold standard allograft. By using a sheep model, the implants were inserted in the trabecular bone of femoral condyles. The test biomaterials were placed in a well defined peri-implant gap. After the observation period, the bone-implant specimens were harvested and evaluated mechanically by a destructive push

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

    Indira, K.; KamachiMudali, U.; Rajendran, N.


    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. Contribution of biomechanics to clinical practice in orthopaedics. (United States)

    Woo, Savio L-Y


    Biomechanics is a field that has a very long history. It was described in ancient Chinese and Greek literature as early as 400-500 BC. The foundation of biomechanics, however, was laid during a period between the 1500's to 1700's by renowned personalities, da Vinci, Galileo, Borelli, Hooke, Newton, and so (Fung, Y.C., Biomechanics: Mechanical Properties of Living Tissues, 2nd Ed. Springer Verlag, Chapter 1, 1993). Beginning in the 1950's, Muybridge, Steindler, Inman, Lissner, and Hirsch performed the pioneering work on musculoskeletal biomechanics and the foundation of orthopaedic biomechanics was formed. For the following two decades, the field has blossomed and significant contributions in the biomechanics of bone, articular cartilage, soft tissues, upper and lower extremities, spine and so on has been made. More sophisticated equipment, coupled with mathematical modeling and better engineering design, has enabled us to make great strides. Bioengineers, in collaboration with orthopaedic surgeons, have translated many laboratory discoveries into clinical practice, leading to improved patient treatment and outcome. In the past 30 years, my colleagues and I have focused our research on the biomechanics of musculoskeletal soft tissues, ligaments and tendons, in particular. Therefore, in this lecture, the function of knee ligaments, the associated homeostatic responses secondary to immobilization and exercise, and healing of the ligaments will be reviewed. Examples of scientific findings that help to guide the surgical management of injury to ligaments will be given. New ideas on functional tissue engineering to improve the healing of knee ligaments and tendons will be presented. We have learned that tendons and ligaments are indeed complex biological tissues. To fully understand their behavior, healing and remodelling processes, this author advocates major efforts be made to bring molecular biologists, morphologists, biochemists, bioengineers, physical therapists and

  14. Hearing Aid

    Institute of Scientific and Technical Information of China (English)


    A man realized that he needed to purchase ahearing aid, but he was unwilling to spend muchmoney. "How much do they run?"he asked theclerk. "That depends," said. the salesman. "Theyrun from 2 to 2000."

  15. Hearing Aids (United States)

    ... slightly different from the ITC and is nearly hidden in the ear canal. Both canal hearing aids ... Privacy Policy & Terms of Use Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

  16. Renal profile in patients with orthopaedic trauma: a prospective study. (United States)

    Paul, Ashish; John, Bobby; Pawar, Basant; Sadiq, Shalinder


    This prospective study was undertaken to determine the incidence of acute renal failure (ARF) and to identify factors contributing to development of ARF in orthopaedic trauma patients. A total of 55 patients who presented over a period of one year with trauma to upper and lower limbs were studied. Patients with renal injury, chest or abdominal injury, isolated fractures of the hands, feet and axial skeleton involvement were excluded. Out of these, five developed acute renal failure, three recovered and two died. The overall incidence of ARF in this study was 9.1%. Patients with lower limb injuries are at higher risk of developing ARF. Mangled Extremity Severity Score (MESS) > or = 7, higher age, patient presenting with shock, increased myoglobin levels in urine and serum have been correlated with a greater risk of patients developing ARF and a higher mortality. This study attempts to determine the magnitude of crush injury causing renal failure and the incidence of renal failure in patients with injuries affecting the appendicular skeleton exclusively.

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

    Energy Technology Data Exchange (ETDEWEB)

    Devanathan, D.; King, R.; Swarts, D.; Lin, S. [Zimmer, Inc., Warsaw, IN (United States); Ramani, K.; Tagle, J. [Purdue Univ., West Lafayette, IN (United States). Dept. of Mechanical Engineering


    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

  18. Thermal cycling can extend tool life in orthopaedic operating rooms. (United States)

    Katchky, Ryan N; McLachlin, Stewart D; Wong, Edwin K Y; Finkelstein, Joel; Kreder, Hans J; Whyne, Cari M


    Thermal cycling is a temperature modulation process developed to improve the performance, durability and longevity of materials. This process has been successfully utilized in the automotive, aeronautic and manufacturing industries. Surgical cutting tools undergo cyclical loading and generally fail by dulling, suggesting that thermal cycling may improve their performance and longevity. Ten 2.5 mm orthopaedic drill bits were randomized, with five undergoing thermal cycling within their sterile packaging and five serving as untreated controls. Using a servohydraulic testing machine, 100 drilling cycles were performed with each drill bit into the diaphyseal region of bovine femurs. After every 25 cycles, data was collected by performing identical drilling cycles into simulated human cortical bone material. Maximum force, maximum normalized torque and drilling work were measured, and a scanning electron microscope was used to measure outer corner wear. After 100 drilling cycles, the maximum drilling force, maximum normalized torque, drilling work and microscopic outer corner wear were all significantly lower for the treated drill bits (p cutting tools. Application of this technology may also be relevant to surgical cutting tools such as saw blades, burrs and reamers.

  19. Orthopaedic Considerations for the Adult With Osteogenesis Imperfecta. (United States)

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


    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.

  20. [Regenerative medicine: orthopaedical applications and medico legal questions]. (United States)

    Ricci, S; Ricci, O; Tucci, C E; Massoni, F; Sarra, M V; Ricci, S


    Over the last decades, the increase in the global population's mean age has implied a corresponding increase in degenerative disease affecting various anatomical areas and tissues, including bones and cartilages, thus provoking a rising number of disabilities and a wider usage of drugs, mostly anti-inflammatory and cortisone. New developments in technologic and biomedical fields gave birth to new subjects, such as tissue engineering, cell therapy, gene therapy that, by and large, create a knowledge network falling under the concept of Regenerative Medicine. This science is essentially based on the usage of stem cells that can replicate and renovate themselves originating, if adequately stimulated, a number of cell types. Inter alia, in orthopaedic field a particular type of adult stem cells is used, the mesenchymal stem cells (MSCs). If combined with synthetic material produced in laboratories, the usage of these cells has provided inspiration for new study interests; today, it can be applied in various degenerative and post-traumatic pathologies, with great therapeutic benefits for the patient. Actually, many studies write about an improvement in patients' life quality. In this sense appear significant reflections on legal medicine, both in accidents and insurance, of this innovative therapeutic alternative and is hopefully an equally valid process of improvement of regulatory and case law.

  1. Computer assisted orthopaedic surgery: present status and future perspectives

    Institute of Scientific and Technical Information of China (English)

    Kwok Sui Leung


    @@ The principle of navigation surgery was first adopted in neurosurgery where a mechanical rigid frame was used in the stereotactic surgery to locate a deep ganglia and tract in the brain by Clark and Horsley1 in 1906. The planning was based on anatomical atlas of the brain and was not patient specific. The navigation procedure was possible with a rigid mechanical frame to define the trajectory with a rigid instrument holder on a rigid fixation of the operating structure, i.e. the skull. With the advancements in 3-D medical imaging, i.e. CT in 1971,MR imaging in 1973, general stereotaxis was possible and became specific to anatomy of each individual patient.Together with the advancement of computer technology:VAX in 1976, Apple in 1977, IBM personal computer in 1981, computer assisted stereotaxis was possible and in 1985, the term computer assisted surgery (CAS) was proposed by Sohn and Robins.2 With further development of 3-D tracking by NDI with Optotrak 1990, computer assisted orthopaedic surgery (CAOS) developed and gradually became widely applicable in clinical practice.

  2. Diversity of patients microflora on orthopaedic and dental implants. (United States)

    Obst, Ursula; Marten, Silke-Mareike; Niessner, Christoph; Hartwig, Erich; Korsch, Michael; Walther, Winfried


    The aim of this study was to compare the diversity of microbial colonization on implant material from different individuals. Eubacterial DNA was extracted, separated and sequenced from orthopaedic metallic implant material, tissues or body fluids, and skin of 4 patients as well as from identical dental cement material from 10 individuals after revision and routine removal. Additionally, the composition of the bacterial population of the dental cement and the oral swab sample from one individual after direct extraction of bacterial DNA was compared to extraction after conventional microbiological enrichment. The latter investigation proved that the commonly used cultivation technique gave different results than direct extraction of DNA, especially as regards the detection of anaerobes. Comparing the bacterial colonization of implant materials from different patients showed significant individual diversity. The common focus on a constricted pathogen spectrum may have to be expanded toward a multispecies population. Moreover, the dependence of the bacterial population on the individual host has to be integrated in discussing implant colonization and infection.

  3. Strategic planning in a highly specialized orthopaedic institution

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran


    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.

  4. Biodegradable injectable polyurethanes: synthesis and evaluation for orthopaedic applications. (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


    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.

  5. 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

  6. Types of Hearing Aids (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 ...

  7. The wear of two orthopaedic biopolymers against each other. (United States)

    Joyce, T J


    The potential for all-polymer prostheses has not been widely investigated. It might be expected that the wear of such biomaterial combinations would be excessive, but an in vivo study of all polymer knee prostheses reported that there were no failures due to wear, even after ten years of clinical use. This design of knee prosthesis used polyacetal and ultra high molecular weight polyethylene (UHMWPE) as the biopolymers. Similarly, an earlier in vitro study of polyacetal and UHMWPE hip prostheses indicated lower wear than for a cobalt chrome and UHMWPE combination. Therefore this study set out to test the poly-acetal and UHMWPE combination in a wear screening rig which had previously been validated against clinical data for artificial hip joints. Two different motion conditions were applied to the test samples and each biopolymer was tested as both pin and plate. Interestingly it was found that, whatever the contribution from pin or plate, the total mean wear factors were 1.5 10 -6 mm 3/Nm under reciprocation-only, and 4.1 10 -6 mm 3 /Nm under multi-directional motion. These wear factors were greater than those found when a conventional metal-on-UHMWPE couple was tested under the same loading, motion and lu-bricant conditions. A comparison was also undertaken with the wear of other orthopaedic biopolymer combinations, namely cross-linked polyethylene (XLPE) against itself, and UHMWPE against itself. The XLPE pairing showed somewhat lower wear than the polyacetal and UHMWPE couple, while the UHMWPE pairing showed the highest wear of all, approximately an or-der of magnitude greater than the polyacetal and UHMWPE combination.

  8. Multiscale Inorganic Hierarchically Materials: Towards an Improved Orthopaedic Regenerative Medicine. (United States)

    Ruso, Juan M; Sartuqui, Javier; Messina, Paula V


    Bone is a biologically and structurally sophisticated multifunctional tissue. It dynamically responds to biochemical, mechanical and electrical clues by remodelling itself and accordingly the maximum strength and toughness are along the lines of the greatest applied stress. The challenge is to develop an orthopaedic biomaterial that imitates the micro- and nano-structural elements and compositions of bone to locally match the properties of the host tissue resulting in a biologically fixed implant. Looking for the ideal implant, the convergence of life and materials sciences occurs. Researchers in many different fields apply their expertise to improve implantable devices and regenerative medicine. Materials of all kinds, but especially hierarchical nano-materials, are being exploited. The application of nano-materials with hierarchical design to calcified tissue reconstructive medicine involve intricate systems including scaffolds with multifaceted shapes that provides temporary mechanical function; materials with nano-topography modifications that guarantee their integration to tissues and that possesses functionalized surfaces to transport biologic factors to stimulate tissue growth in a controlled, safe, and rapid manner. Furthermore materials that should degrade on a timeline coordinated to the time that takes the tissues regrow, are prepared. These implantable devices are multifunctional and for its construction they involve the use of precise strategically techniques together with specific material manufacturing processes that can be integrated to achieve in the design, the required multifunctionality. For such reasons, even though the idea of displacement from synthetic implants and tissue grafts to regenerative-medicine-based tissue reconstruction has been guaranteed for well over a decade, the reality has yet to emerge. In this paper, we examine the recent approaches to create enhanced bioactive materials. Their design and manufacturing procedures as well

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

    Directory of Open Access Journals (Sweden)



    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:

  10. 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


    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

  11. Brand Aid

    DEFF Research Database (Denmark)

    Richey, Lisa Ann; Ponte, Stefano


    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...

  12. Surgical advances during the First World War: the birth of modern orthopaedics. (United States)

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


    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.

  13. The First World War and its influence on the development of orthopaedic surgery. (United States)

    Scotland, T


    By December 1914, overwhelming numbers of soldiers with infected musculoskeletal wounds had filled hospitals in France and Britain. Frequently initial management had been inadequate. In 1915, patients with orthopaedic wounds were segregated for the first time when Robert Jones established an experimental orthopaedic unit in Alder Hey Hospital, Liverpool. In 1916 he opened the first of 17 orthopaedic centres in Britain to surgically treat and rehabilitate patients. Henry Gray from Aberdeen emerged as the leading authority in the management of acute musculoskeletal wounds in casualty clearing stations in France and Flanders. Gray had particular expertise in dealing with compound fractures of the femur for which he documented an 80% mortality rate in 1914-15.

  14. A distributed health data network analysis of survival outcomes: the International Consortium of Orthopaedic Registries perspective. (United States)

    Banerjee, Samprit; Cafri, Guy; Isaacs, Abby J; Graves, Stephen; Paxton, Elizabeth; Marinac-Dabic, Danica; Sedrakyan, Art


    The International Consortium for Orthopaedic Registries is a multinational initiative established by the United States Food and Drug Administration to develop a health data network aimed at providing a robust infrastructure to facilitate evidence-based decision-making on performance of medical devices. Through the International Consortium for Orthopaedic Registries, individual data holders have complete control of their data and can choose to participate in studies of their choice. In this article, we present an overview of the data extraction process and the analytic strategy employed to answer several device performance-related questions in total hip arthroplasty and total knee arthroplasty. In the process, we discuss some nuances pertinent to International Consortium for Orthopaedic Registries data that pose certain statistical challenges, and we briefly suggest strategies to be adopted to address them.

  15. [The Development and Application of the Orthopaedics Implants Failure Database Software Based on WEB]. (United States)

    Huang, Jiahua; Zhou, Hai; Zhang, Binbin; Ding, Biao


    This article develops a new failure database software for orthopaedics implants based on WEB. The software is based on B/S mode, ASP dynamic web technology is used as its main development language to achieve data interactivity, Microsoft Access is used to create a database, these mature technologies make the software extend function or upgrade easily. In this article, the design and development idea of the software, the software working process and functions as well as relative technical features are presented. With this software, we can store many different types of the fault events of orthopaedics implants, the failure data can be statistically analyzed, and in the macroscopic view, it can be used to evaluate the reliability of orthopaedics implants and operations, it also can ultimately guide the doctors to improve the clinical treatment level.


    NARCIS (Netherlands)

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


    Objective:To develop it 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 meetin

  17. Development and reproducibility of a short questionnaire to measure use and usability of custom-made orthopaedic shoes

    NARCIS (Netherlands)

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


    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 meetin

  18. Skeletal metastases - the role of the orthopaedic and spinal surgeon. (United States)

    Eastley, Nicholas; Newey, Martyn; Ashford, Robert U


    Developments in oncological and medical therapies mean that life expectancy of patients with metastatic bone disease (MBD) is often measured in years. Complications of MBD may dramatically and irreversibly affect patient quality of life, making the careful assessment and appropriate management of these patients essential. The roles of orthopaedic and spinal surgeons in MBD generally fall into one of four categories: diagnostic, the prophylactic fixation of metastatic deposits at risk of impending fracture (preventative surgery), the stabilisation or reconstruction of bones affected by pathological fractures (reactive surgery), or the decompression and stabilisation of the vertebral column, spinal cord, and nerve roots. Several key principals should be adhered to whenever operating on skeletal metastases. Discussions should be held early with an appropriate multi-disciplinary team prior to intervention. Detailed pre-assessment is essential to gauge a patient's suitability for surgery - recovery from elective surgery must be shorter than the anticipated survival. Staging and biopsies provide prognostic information. Primary bone tumours must be ruled out in the case of a solitary bone lesion to avoid inappropriate intervention. Prophylactic surgical fixation of a lesion prior to a pathological fracture reduces morbidity and length of hospital stay. Regardless of a lesion or pathological fracture's location, all regions of the affected bone must be addressed, to reduce the risk of subsequent fracture. Surgical implants should allow full weight bearing or return to function immediately. Post-operative radiotherapy should be utilised in all cases to minimise disease progression. Spinal surgery should be considered for those with spinal pain due to potentially reversible spinal instability or neurological compromise. The opinion of a spinal surgeon should be sought early, as delays in referral directly correlate to worse functional recovery following intervention

  19. Tribology considerations for hip joint articulations in relation to the "new orthopaedic patient". (United States)

    Rieker, C B


    The purpose of this review is to examine alternative bearings used in total hip arthroplasty (THA) and discuss the specific tribologic needs of the "New Orthopaedic Patient". As orthopaedic patients today are younger and more active, there is a clear need for hip joint implants and articulations minimising the amount of wear and guarantying better stability. Recent modern developments in tribology with highly cross-linked polyethylenes and hard-on-hard bearings allow the safe and effective use of larger diameter articulations in THA.

  20. Imaging in scoliosis from the orthopaedic surgeon's point of view

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Marc [Stiftung Orthopaedische Universitaetsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg (Germany); Abel, Rainer [Stiftung Orthopaedische Universitaetsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg (Germany)]. E-mail:


    For treating patients with scoliosis orthopaedic surgeons need diagnostic imaging procedures in order to provide answers about a possible underlying disease, choice of treatment, and prognosis. Once treatment is instituted, imaging is also critical for monitoring changes of the deformity so as to optimize therapy. The combined effort of orthopaedic surgeons and radiologists helps detect treatable causes of scoliosis at an early stage, define the need and timing for surgery, and ensure that every precaution is taken to minimize the risks of surgery. Neurosurgical causes, with particular reference to spinal cord tumours and syringomyelia, need to be addressed before scoliosis surgery can be contemplated.

  1. Tactile Aids

    Directory of Open Access Journals (Sweden)

    Mohtaramossadat Homayuni


    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.

  2. Negotiating Aid

    DEFF Research Database (Denmark)

    Whitfield, Lindsay; Fraser, Alastair


    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 actors, the negotiating strategies they fashion, and the success of those strategies. This approach was employed to examine and compare the experiences of eight countries: Botswana, Ethiopia, Ghana, Mali, Mozambique, Rwanda, Tanzania and Zambia. The article presents findings from these country studies...... which investigated the strategies these states have adopted in talks with aid donors, the sources of leverage they have been able to bring to bear in negotiations, and the differing degrees of control that they have been able to exercise over the policies agreed in negotiations and those implemented...

  3. 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)



    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.

  4. The future of orthopaedics in the United States: an analysis of the effects of managed care in the face of an excess supply of orthopaedic surgeons. (United States)

    Clark, R; Thurston, N K


    Recent technological advances in orthopaedic surgery have propelled both the volume of surgical cases and their complexity, resulting in increased costs, which should naturally result in higher incomes for surgeons. However, the transition from a fee-for-service model of physician compensation to a managed care model has resulted in major shifts in economic resource allocation. An economic model of this market based on imperfect competition shows that these changes have shifted market power from surgeons to the managed care organizations. Our model predicts that practicing surgeons will retire earlier, medical students will begin to select other specialties, and innovation will be slowed. Antitrust laws limit surgeons' ability to combat this trend through meaningful collective bargaining, creating the potential for future shortages as the baby boom generation reaches retirement age and the demand for orthopaedic services increases dramatically.

  5. Design of new titanium alloys for orthopaedic applications. (United States)

    Guillemot, F; Prima, F; Bareille, R; Gordin, D; Gloriant, T; Porté-Durrieu, M C; Ansel, D; Baquey, Ch


    Parallel to the biofunctionalisation of existing materials, innovation in biomaterials engineering has led to the specific design of titanium alloys for medical applications. Studies of the biological behaviour of metallic elements have shown that the composition and structure of the material should be carefully tailored to minimise adverse body reactions and to enhance implant longevity, respectively. Consequently, interest has focused on a new family of titanium alloys: Ti-6Mo-3Fe-5Ta, Ti-4Mo-2Fe-5Ta and Ti-6Mo-3Fe-5Zr-5Hf alloys. The non-toxicity of the specially designed titanium alloys compared with osteoblastic cells has been ascertained using MTT and RN tests. In addition, phase transformations upon thermal processing have been investigated, with comparison with a well-defined beta titanium alloy. Optimum thermal processing windows (above 550 degrees C) have been designed to generate a stable and nanostructured alpha phase from the isothermal omega phase that precipitates in a low temperature range (150-350 degrees C). The generation of such nanostructured microstructures should provide a promising opportunity to investigate tissue-biomaterial interactions at the scale of biomolecules such as proteins.

  6. Teaching AIDS. (United States)

    Short, R V


    This article reviews a peer group Acquired Immunodeficiency Syndrome (AIDS) educational program at a university in Australia. Studies in the US have shown that most adolescents, although sexually active, do not believe they are likely to become infected with the Human Immunodeficiency Virus, and therefore do not attempt to modify their sexual behavior. A 1st step in educating students is to introduce them to condoms and impress upon them the fact that condoms should be used at the beginning of all sexual relationships, whether homosexual or heterosexual. In this program 3rd year medical students were targeted, as they are effective communicators and disseminators of information to the rest of the student body. After class members blow up condoms, giving them a chance to handle various brands and observe the varying degrees of strength, statistical evidence about the contraceptive failure rate of condoms (0.6-14.7 per 100 women-years) is discussed. Spermicides, such as nonoxynol-9 used in conjunction with condoms, are also discussed, as are condoms for women, packaging and marketing of condoms, including those made from latex and from the caecum of sheep, the latter condoms being of questionable effectiveness in preventing transmission of the virus. The care of terminal AIDS cases and current global and national statistics on AIDS are presented. The program also includes cash prizes for the best student essays on condom use, the distribution of condoms, condom key rings and T-shirts, and a student-run safe sex stand during orientation week. All of these activities are intended to involve students and attract the interest of the undergraduate community. Questionnaires administered to students at the end of the course revealed that the lectures were received favorably. Questionnaires administered to new medical and English students attending orientation week revealed that 72% of students thought the stand was a good idea and 81% and 83%, respectively found it

  7. Brand Aid

    DEFF Research Database (Denmark)

    Richey, Lisa Ann; Ponte, Stefano


    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......Can Citizen Consumers Make a Difference? DIIS researcher contributes to a Boston Review - New Democracy Forum In the current issue of Boston Review (November/December 2011), contributors to a ‘New Democracy Forum’ debate whether Citizen Consumers can make a difference in stimulating responsible...

  8. 78 FR 20328 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee: Notice of... (United States)


    ... HUMAN SERVICES Food and Drug Administration Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee: Notice of Postponement of Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is postponing the meeting of...

  9. 76 FR 17422 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of... (United States)


    ... 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: Notice. This notice announces a forthcoming meeting of a public advisory committee of the Food and...

  10. Level of Perception of Individualized Care and Satisfaction With Nursing in Orthopaedic Surgery Patients. (United States)

    Tekin, Fatma; Findik, Ummu Yildiz


    Lately, individualized nursing care and patient satisfaction are important and current issues being discussed. But there is not enough information for patients undergoing orthopaedic surgery. The aim of this study was to determine the individualized care perception and satisfaction in nursing care levels in orthopaedic surgery patients. This descriptive cross-sectional study was conducted with 156 patients who underwent orthopaedic surgery. Data were collected using the personal information form, the Individualized Care Scale, and the Newcastle Satisfaction With Nursing Scale. The Spearman correlation analysis and descriptive statistics were performed. The mean individualized care and satisfaction with nursing care scores were found to be close to the preset maximum value, and it was determined that an increase in the level of awareness about nursing interventions and the level of perceived individualized care caused an increase in satisfaction levels regarding nursing care. Nurses should recognize the importance of performing individualized care in order to increase the level of satisfaction with nursing care in orthopaedic surgery patients.

  11. Why veteran orthopaedic trauma surgeons are being fired and what we can do about it? (United States)

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


    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.

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

    NARCIS (Netherlands)

    Meuffels, D.E.; Poldervaart, M.T.; Diercks, R.L.; Fievez, A.W.F.M.; Patt, T.W.; van der 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.


    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 steer

  13. Groningen orthopaedic exit strategy : Validation of a support program after total hip or knee arthroplasty

    NARCIS (Netherlands)

    van den Akker-Scheek, Inge; Zijlstra, Wiebren; Groothoff, Johan W.; van Horn, Jim R.; Bulstra, Sjoerd K.; Stevens, Martin


    Objective: Validation of the program theory of the Groningen orthopaedic exit strategy (GOES), a theory-driven program aiming to improve the rehabilitation of total hip and knee arthroplasty patients after shortened hospital stay. First part of the program theory is the action theory, hypothesising

  14. What influences a patient's decision to use custom-made orthopaedic shoes?

    NARCIS (Netherlands)

    van Netten, Jaap J.; Dijkstra, Pieter U.; Geertzen, Jan H. B.; Postema, Klaas


    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 fac

  15. Inhibition of Orthopaedic Implant Infections by Immunomodulatory Effects of Host Defense Peptides (United States)


    Peptides, Murine model, Staphylococcus aureus, Acinetobacter baumannii 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a...of host defense peptides on macrophages in vitro and on implants infected with Staph. aureus or Acinetobacter baumannii in our murine model of implant...osseointegration. 2. KEYWORDS: Orthopaedic infections Host Defense Peptides Murine model Staphylococcus aureus Acinetobacter baumannii 3. OVERALL

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

    LENUS (Irish Health Repository)

    Egan, C


    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.

  17. The Contributions of Kenelm Hutchinson Digby to Orthopaedics in Hong Kong Part 2

    Directory of Open Access Journals (Sweden)

    Kuo-tai Louis Fu


    Full Text Available As the first professor of surgery in Hong Kong, Kenelm Hutchinson Digby had the tremendous task of building a new clinical department in the infant University of Hong Kong from scratch. Despite his heavy commitments in clinical, administrative, and teaching responsibilities, he pioneered novel orthopaedic treatment principles and techniques, in addition to that of general surgery.

  18. Evaluation of the PROMIS physical function item bank in orthopaedic patients. (United States)

    Hung, Man; Clegg, Daniel O; Greene, Tom; Saltzman, Charles L


    The patient-reported outcomes measurement information system (PROMIS) physical function item bank v1 (PPFIB) contains 124 item response theory (IRT) calibrated items (Rose et al. 2008. J Clin Epidemiol 61:17–33).We report the psychometric properties of these items within an outpatient, orthopaedic patient population. In particular, we investigated whether a single unidimensional IRT scale can adequately define physical function of patients presenting with primarily upper or lower extremity orthopaedic complaints. We conducted a prospective study at an orthopaedic outpatient clinic to collect data from 865 adult patients with all 124 PROMIS physical function items and seven demographic items. Items were evaluated by a Rasch model. Total variance (60.6%) across the 124 items was explained by a single Rasch dimension. The variance explained by the second dimension was 7.7%, reflecting differential item functioning in the upper and lower extremity patients. The upper extremity physical function items had a pronounced ceiling effect. A single physical function dimension accounts for most of the item variance in the PPFIB, suggesting that the items are measuring predominantly one single construct. Separate subscales for lower versus upper extremities, especially with additional items at the upper trait level of the upper extremity subscale, may further enhance evaluation of physical function in orthopaedic patients.

  19. Presurgical Infant Orthopaedics in Unilateral Cleft Lip and Palate Patients (Part 1

    Directory of Open Access Journals (Sweden)

    Törün Özer


    Full Text Available Presurgical infant orthopaedics has been employed for the last fifty years. Traditional approaches failed to address the deformity of the nasal tissues and focus only to correct the alveolar deformities. In this review, our aim is to describe a new technique which is used to mold nasal cartilages with alveolar segments.

  20. Presurgical Infant Orthopaedics in Bilateral Cleft Lip and Palate Patients (Part 2

    Directory of Open Access Journals (Sweden)

    Törün Özer


    Full Text Available The aim of this present study is to present presurgical maxillary orthopaedics method. By means of this method lip, nose and alveolar molding reduces the severity of the deformity. Therefore, the result after the sugery is done more sucessfully.

  1. Analysis of the basic science section of the orthopaedic in-training examination. (United States)

    Sheibani-Rad, Shahin; Arnoczky, Steven Paul; Walter, Norman E


    Since 1963, the Orthopaedic In-Training Examination (OITE) has been administered to orthopedic residents to assess residents' knowledge and measure the quality of teaching within individual programs. The OITE currently consists of 275 questions divided among 12 domains. This study analyzed all OITE basic science questions between 2006 and 2010. The following data were recorded: number of questions, question taxonomy, category of question, type of imaging modality, and recommended journal and book references. Between 2006 and 2010, the basic science section constituted 12.2% of the OITE. The assessment of taxonomy classification showed that recall-type questions were the most common, at 81.4%. Imaging modalities typically involved questions on radiographs and constituted 6.2% of the OITE basic science section. The majority of questions were basic science questions (eg, genetics, cell replication, and bone metabolism), with an average of 26.4 questions per year. The Journal of Bone & Joint Surgery (American Volume) and the American Academy of Orthopaedic Surgeons' Orthopaedic Basic Science were the most commonly and consistently cited journal and review book, respectively. This study provides the first review of the question content and recommended references of the OITE basic science section. This information will provide orthopedic trainees, orthopedic residency programs, and the American Academy of Orthopaedic Surgeons Evaluation Committee valuable information related to improving residents' knowledge and performance and optimizing basic science educational curricula.

  2. Workers' compensation status: does it affect orthopaedic surgery outcomes? A meta-analysis.

    Directory of Open Access Journals (Sweden)

    Vinícius Ynoe de Moraes

    Full Text Available INTRODUCTION: Previous reviews have demonstrated that patient outcomes following orthopaedic surgery are strongly influenced by the presence of Workers' Compensation. However, the variability in the reviews' methodology may have inflated the estimated strength of this association. The main objective of this meta-analysis is to evaluate the influence of Workers' Compensation on the outcomes of orthopaedic surgical procedures. METHODS: We conducted a systematic search of the literature published in this area from 1992-2012, with no language restrictions. The following databases were used MEDLINE (Ovid, Embase (Ovid, CINAHL, Google Scholar, LILACS and Pubmed. We also hand-searched the reference sections of all selected papers. We included all prospective studies evaluating the effect of compensation status on outcomes in adult patients who had undergone surgery due to orthopaedic conditions or diseases. Outcomes of interest included disease specific, region specific and/or overall quality of life scales/questionnaires and surgeons' personal judgment of the results. We used an assessment tool to appraise the quality of all included studies. We used Review Manager to create forest plots to summarize study data and funnel plots for the assessment of publication bias. RESULTS: Twenty studies met our eligibility criteria. The overall risk ratio for experiencing an unsatisfactory result after orthopaedic surgery for patients with compensation compared to non-compensated patients is 2.08 (95% CI 1.54-2.82. A similar association was shown for continuous data extracted from the studies using assessment scales or questionnaires (Standard Mean Difference = -0.70 95% CI -0.97- -0.43. CONCLUSIONS: Among patients who undergo orthopaedic surgical procedures, those receiving Workers' Compensation experience a two-fold greater risk of a negative outcome. Our findings show a considerably lower estimate of risk compared to previous reviews that include retrospective

  3. (United States)

    ... concerns. Search Services Share This Help National HIV/AIDS Strategy Check out NHAS's latest progress in the ... from Read more tweets HIV/AIDS Basics • Federal Resources • Using New ...

  4. Aids for Handicapped Readers. (United States)

    Library of Congress, Washington, DC. Div. for the Blind and Physically Handicapped.

    The reference circular provides information on approximately 50 reading and writing aids intended for physically or visually handicapped individuals. Described are low vision aids, aids for holding a book or turning pages, aids for reading in bed, handwriting aids, typewriters and accessories, braille writing equipment, sound reproducers, and aids…

  5. 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,...

  6. 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


    A triangulation convergence model was applied through a mixed methods design to combine quantitative results and qualitative findings for evaluation. Methods Data were collected from 2013–2014 from 32 orthopaedic nurses in a Danish regional hospital through a newly developed 21-item questionnaire and two focus......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. Design...

  7. Crawling Aid (United States)


    The Institute for the Achievement of Human Potential developed a device known as the Vehicle for Initial Crawling (VIC); the acronym is a tribute to the crawler's inventor, Hubert "Vic" Vykukal; is an effective crawling aid. The VIC is used by brain injured children who are unable to crawl due to the problems of weight-bearing and friction, caused by gravity. It is a rounded plywood frame large enough to support the child's torso, leaving arms and legs free to move. On its underside are three aluminum discs through which air is pumped to create an air-bearing surface that has less friction than a film of oil. Upper side contains the connection to the air supply and a pair of straps which restrain the child and cause the device to move with him. VIC is used with the intent to recreate the normal neurological connection between brain and muscles. Over repetitive use of the device the child develops his arm and leg muscles as well as coordination. Children are given alternating therapy, with and without the VIC until eventually the device is no longer needed.

  8. HIV and AIDS (United States)

    ... Emergency Room? What Happens in the Operating Room? 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 ...

  9. Heart attack first aid (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 ...

  10. Breathing difficulties - first aid (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, ...

  11. 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;


    Objective: To examine the costs per quality-adjusted life year (QALY) gained for surgical interventions in patients with inflammatory arthropathies, and to compare the costs per QALY gained for replacement versus non-replacement surgical interventions. Methods: In total, 248 patients [mean age 57...... 800 for non-replacement surgical procedures measured by EQ-5D (SF-6D: EUR 67 500). Conclusions: Elective orthopaedic surgery in patients with inflammatory arthropathies was cost-effective when measured with EQ-5D, and some procedures were also cost-effective when SF-6D was used in the economic...... (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...

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

    DEFF Research Database (Denmark)

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


    Trøstrup J1, Mikkelsen LR1, Juhl CB2 1 Center for Planlagt Kirurgi, Regionshospitalet Silkeborg 2 Forskningsenheden for Muskuloskeletal Funktion og Fysioterapi (FoF), Institut for idræt og biomekanik, Syddansk Universitet Aim: To evaluate the effectiveness of clinical assessment of patients...... 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......), EMBASE, CINAHL, PEDro and reference lists of included studies and previously published systematic reviews. Studies evaluating 1) adults (18+) with a musculoskeletal complaint referred to orthopaedic outpatient assessment and 2) patient assessment performed by CSP were included. Studies conducted...

  13. Three-dimensional Intraoperative Imaging Modalities in Orthopaedic Surgery: A Narrative Review. (United States)

    Qureshi, Sheeraz; Lu, Young; McAnany, Steven; Baird, Evan


    Intraoperative imaging and navigation systems have revolutionized orthopaedic surgery for the spine, joints, and orthopaedic trauma. Imaging modalities such as the isocentric C-arm, O-arm imaging, and intraoperative MRI or navigation systems allow the visualization of surgical instruments and implants relative to a three-dimensional CT image or MRI. Studies show that these technologies lower the rates of implant misplacement and inadequate fracture reduction, thereby improving surgical outcomes and reducing reoperation rates. An additional benefit is reduced radiation exposure compared with that for conventional fluoroscopy. Concerns surrounding adoption of these technologies include cost and increased operating times, but improvements in design and protocol may improve the integration of these imaging modalities into the operating room.

  14. Estimation of properties of a photoinitiated silorane-based composite with potential for orthopaedic applications. (United States)

    Melander, Jennifer R; Weiler, Rachel A; Miller, Bradley D; Schuman, Thomas P; Kilway, Kathleen V; Day, Delbert E; Velez, Mariano; Eick, J David


    We have synthesized a filler-reinforced silorane composite that has potential applications in orthopaedic surgery, such as for a bone stabilizer. The purpose of the present work was to develop a method for estimating four properties of this material; namely, maximum exotherm temperature, flexural strength, flexural modulus, and fracture toughness. The method involved the use of mixture design-of-experiments and regression analysis of results obtained using 23 formulations of the composite. We validated the estimation method by showing that, for each of four composite formulations that were not included in the method development, the value of each of the aforementioned properties was not significantly different from that obtained experimentally. Our estimation method has the potential for use in the development of a wide range of orthopaedic materials.

  15. The presentation of rickets to orthopaedic clinics: return of the English disease. (United States)

    Naseem, Haris; Wall, Alun P; Sangster, Marshall; Paton, Robin W


    Rickets is a potentially treatable disease of the bone that is most commonly due to deficiency of vitamin D and is increasing in incidence in developed countries. Risk factors include dietary factors, the practice of covering up and darker skin pigmentation. This small retrospective case study set out to examine all cases of rickets presenting to the Paediatric Orthopaedic clinic over a 15-month period. Rickets presented in a bimodal fashion in the 6 cases identified: in males and females aged 3 or less and female adolescents aged 10 and above. This is in keeping with what is known regarding the rapid phases of growth during development. Five cases were from ethnic minority groups. Both female adolescents presented with genu valgum. Rickets can present primarily to Orthopaedic clinics with vague musculoskeletal symptoms. We recommend that biochemical screening be performed on patients from ethnic minorities who may be 'at risk'.

  16. A discharge planning program in orthopaedics: experiences in implementation and evaluation. (United States)

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


    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.

  17. Prediction of Compression of Knitted Orthopaedic Supports by Inlay-Yarn Properties

    Directory of Open Access Journals (Sweden)



    Full Text Available The aim of this study was to find out the possibility to predict the compression properties of orthopaedic knits by inlay-yarn properties. For this purpose, six groups of elastic double covered threads with different raw material were investigated. It was established that in area of low elongation, the covering threads practically don't have significant influence on tensile force values. Also results demonstrate that by increasing the number of tested threads, the elongation value has a higher impact on tensile force. The influence of linear density of elastic PU core on tensile force increases by increasing elongation value of threads. When influence of inlay-yarn linear density and number of threads on tensile force is determined it is possible to predict influence of inlay-yarn properties on compression properties of knitted orthopaedic supports. DOI:

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


    Sahu, S. K.; B Tudu; P K Mall


    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 t...

  19. Extending the role of a healthcare digital library environment to support orthopaedic research. (United States)

    Miles-Board, Timothy; Carr, Leslie; Wills, Gary; Power, Guillermo; Bailey, Christopher; Hall, Wendy; Stenning, Matthew; Grange, Simon


    A digital archive, together with its users and its contents, does not exist in isolation; there is a cycle of activities which provides the context for the archive's existence. In arguing for the broadening of the traditional view of digital libraries as merely collections towards the processes of collecting and deploying, we have developed an extend ed digital library environment for orthopaedic surgeons which bridges the gap between the undertaking of experimental work and the dissemination of its results through electronic publication.

  20. Characterization of wear in composite material orthopaedic implants. Part II: The implant/bone interface. (United States)

    Albert, K; Schledjewski, R; Harbaugh, M; Bleser, S; Jamison, R; Friedrich, K


    Carbon fiber/PEEK polymer (C/PEEK) composite materials are being developed for use as orthopaedic implant materials. Wear is an issue of increasing importance in orthopaedic implants; particulate debris generated by the wearing of biomaterials may be a causal factor leading to osteolysis and implant loosening. Therefore, numerical and experimental studies were completed to characterize the wear of C/PEEK composite materials in comparison to current orthopaedic implant materials. Finite element analyses (FEA) of a composite material hip stem implanted in a femur and loaded at 890 N determined that peak contact stresses will occur at the proximal-medial and distal regions of the implant. These contact stresses were found to be below 1.0 MPa over most of the implant surface; however the peak stress in the proximal-medial region was 1.8 MPa and higher still at the distal portion of the stem. In vivo forces result in contact stress values up to 9.0 MPa. The composite implant exhibited 10-40% lower contact stresses in the distal region compared to a titanium-alloy implant of identical design. Composite material wear samples were slid against porous hydroxylapatite (HA) to simulate the stem/bone interface. An identical series of experiments was run for comparison to a current orthopaedic implant material--Ti6A14V titanium alloy. Two domains of motion were studied; a composite ring-on-HA disc large amplitude sliding wear test; and a composite pin-on-HA disc small amplitude fretting regimen. Nominal contact pressures during testing were 1.4 MPa and 7.6 MPa for sliding and fretting tests, respectively. Fretting and sliding abrasive wear tests resulted in the composite material exhibiting a lower wear rate than the titanium-alloy. The magnitude of the difference was greatly dependent on the contact pressures, sliding amplitudes, and counterface material properties.

  1. Orthopaedic Device Approval Through the Premarket Approval Process: A Financial Feasibility Analysis for a Single Center. (United States)

    Yang, Brian W; Iorio, Matthew L; Day, Charles S


    The 2 main routes of medical device approval through the U.S. Food and Drug Administration are the premarket approval (PMA) process, which requires clinical trials, and the 510(k) premarket notification, which exempts devices from clinical trials if they are substantially equivalent to an existing device. Recently, there has been growing concern regarding the safety of devices approved through the 510(k) premarket notification. The PMA process decreases the potential for device recall; however, it is substantially more costly and time-consuming. Investors and medical device companies are only willing to invest in devices if they can expect to recoup their investment within a timeline of roughly 7 years. Our study utilizes financial modeling to assess the financial feasibility of approving various orthopaedic medical devices through the 510(k) and PMA processes. The expected time to recoup investment through the 510(k) process ranged from 0.585 years to 7.715 years, with an average time of 2.4 years; the expected time to recoup investment through the PMA route ranged from 2.9 years to 24.5 years, with an average time of 8.5 years. Six of the 13 orthopaedic device systems that we analyzed would require longer than our 7-year benchmark to recoup the investment costs of the PMA process. With the 510(k) premarket notification, only 1 device system would take longer than 7 years to recoup its investment costs. Although the 510(k) premarket notification has demonstrated safety concerns, broad requirements for PMA authorization may limit device innovation for less-prevalent orthopaedic conditions. As a result, new approval frameworks may be beneficial. Our report demonstrates how current regulatory policies can potentially influence orthopaedic device innovation.

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


    Tai, Siu-king, Rosetti; 戴筱荊


    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...

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


    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.


    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 modifi...

  4. Efficacy of epidural administration of morphine with bupivacaine for orthopaedic surgery in sheep


    Durej M.; Ledecký V.; Michalák D.; Hluchý M.; Kòazovický D.


    The aim of the study was to test the hypothesis that epidural administration of morphine with bupivacaine provides more intense and sufficient perioperative analgesia compared with parenterally administrated butorphanol during orthopaedic surgery. Sheep were assigned to group C (control group, 6 sheep) and group E (epidural, 5 sheep). Sheep from group C were pre-medicated with midazolam (0.3 mg/kg, i.m.) and butorphanol (0.2 mg/kg, i.m.). Propofol was used ...

  5. Readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons and the American Orthopaedic Society for Sports Medicine. (United States)

    Ganta, Abhishek; Yi, Paul H; Hussein, Khalil; Frank, Rachel M


    Although studies have revealed high readability levels of orthopedic patient education materials, no study has evaluated sports medicine-related patient education materials. We conducted a study to assess the readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Society for Sports Medicine (AOSSM). All sports medicine patient education articles available online in 2012 from the AAOS and the AOSSM, including the Stop Sports Injuries Campaign (STOP), were identified, and their readability was assessed with the Flesch-Kinkaid (FK) readability test. Mean overall FK grade level of the 170 articles reviewed (104 from AAOS, 36 from AOSSM, 30 from STOP) was 10.2. Mean FK levels for the 3 sources were 9.5 (AAOS), 11.0 (AOSSM), and 11.5 (STOP) (P = .16). Fifteen (8.8%) of the 170 articles had a readability level at or below eighth grade (average reading level of US adults); only 2 (1.2%) of the 170 articles were at or below the recommended sixth-grade level. The majority of sports medicine-related patient education materials from AAOS and AOSSM had reading levels higher than recommended, indicating that the majority of the patient population may find it difficult to comprehend these articles.

  6. Rehabilitation and restoration: orthopaedics and disabled soldiers in Germany and Britain in the First World War. (United States)

    Anderson, Julie; Perry, Heather R


    This article offers a comparative analysis of the evolution of orthopaedics and rehabilitation within German and British military medicine during the Great War. In it, we reveal how the field of orthopaedics became integral to military medicine by tracing the evolution of the discipline and its practitioners in each nation during the war. In doing so, however, we document not only when and why both medical specialists and military officials realized that maintaining their respective national fighting forces depended upon the efficient rehabilitation of wounded soldiers, but also how these rehabilitative practices and goals reflected the particularities of the military context, civilian society and social structure of each nation. Thus, while our comparison reveals a number of similarities in the orthopaedic developments within each nation as a response to the Great War, we also reveal significant national differences in war-time medical goals, rehabilitation treatments and soldierly 'medical experiences'. Moreover, as we demonstrate, a social and cultural re-conceptualization of the disabled body accompanied the medical advancements developed for him; however, this re-conceptualization was not the same in each nation. Thus, what our article reveals is that although the guns of August fell silent in 1918, the war's medical experiences lingered long thereafter shaping the future of disability medicine in both nations.

  7. Mechanical compatibility of sol-gel annealing with titanium for orthopaedic prostheses. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    H Madry


    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.

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

    Directory of Open Access Journals (Sweden)

    Xiao-feng Chen


    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.

  10. Recombinant antibodies for specific detection of clostridial [Fe-Fe] hydrogenases (United States)

    Mangayil, Rahul; Karp, Matti; Lamminmäki, Urpo; Santala, Ville


    Biological hydrogen production is based on activity of specific enzymes called hydrogenases. Hydrogenases are oxygen sensitive metalloenzymes containing Ni and/or Fe atoms at the active site, catalyzing reversible reduction of protons. Generally, [Fe-Fe] hydrogenases prefer proton reduction to molecular hydrogen, a potential energy carrier molecule that can be produced by bioprocesses in sustainable manner. Thus, monitoring tools have been developed to study the relationship between [Fe-Fe] hydrogenases and biohydrogen production in bioreactors at DNA and RNA levels. In the present study, novel molecular tools are introduced for quantitative monitoring of clostridial [Fe-Fe] hydrogenases at the protein level. Aerobic and anaerobic biopanning (for inactive and active [Fe-Fe] hydrogenase, respectively) of phage displayed single-chain variable fragment (scFv) antibody libraries aided in isolating nine potential scFvs. The enriched antibodies demonstrated high specificity towards Clostridium spp. [Fe-Fe] hydrogenases allowing detection from pure and mixed cultures. Additionally, the antibodies showed different binding characteristics towards hydrogenase catalytic states, providing a possible means for functional detection of clostridial [Fe-Fe] hydrogenases. From hydrogenase-antibody interaction studies we observed that though antibody binding reduced the enzyme catalytic activity, it facilitated to retain hydrogen evolution from oxygen exposed hydrogenases. PMID:27786270

  11. Recombinant antibodies for specific detection of clostridial [Fe-Fe] hydrogenases. (United States)

    Mangayil, Rahul; Karp, Matti; Lamminmäki, Urpo; Santala, Ville


    Biological hydrogen production is based on activity of specific enzymes called hydrogenases. Hydrogenases are oxygen sensitive metalloenzymes containing Ni and/or Fe atoms at the active site, catalyzing reversible reduction of protons. Generally, [Fe-Fe] hydrogenases prefer proton reduction to molecular hydrogen, a potential energy carrier molecule that can be produced by bioprocesses in sustainable manner. Thus, monitoring tools have been developed to study the relationship between [Fe-Fe] hydrogenases and biohydrogen production in bioreactors at DNA and RNA levels. In the present study, novel molecular tools are introduced for quantitative monitoring of clostridial [Fe-Fe] hydrogenases at the protein level. Aerobic and anaerobic biopanning (for inactive and active [Fe-Fe] hydrogenase, respectively) of phage displayed single-chain variable fragment (scFv) antibody libraries aided in isolating nine potential scFvs. The enriched antibodies demonstrated high specificity towards Clostridium spp. [Fe-Fe] hydrogenases allowing detection from pure and mixed cultures. Additionally, the antibodies showed different binding characteristics towards hydrogenase catalytic states, providing a possible means for functional detection of clostridial [Fe-Fe] hydrogenases. From hydrogenase-antibody interaction studies we observed that though antibody binding reduced the enzyme catalytic activity, it facilitated to retain hydrogen evolution from oxygen exposed hydrogenases.

  12. Home Health Aides (United States)

    ... specifications Help to keep clients engaged in their social networks and communities Home health aides, unlike personal care aides , typically work ... self-care and everyday tasks. They also provide social supports and assistance that enable clients to participate in their ... more information about home health aides, including voluntary credentials for aides, visit ...

  13. 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...... 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 categorize some of the key goals, principles and institutions of the aid system. The evidence on whether aid has...... for aid in the future...

  14. 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....

  15. Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

    Directory of Open Access Journals (Sweden)

    Arianna B Lovati

    Full Text Available BACKGROUND: Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. METHODOLOGY: A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3 colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count, histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy. RESULTS: Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. CONCLUSIONS: Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

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

    Directory of Open Access Journals (Sweden)

    Egenvall Agneta


    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

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

    Directory of Open Access Journals (Sweden)

    Tanner Stephanie


    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.

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

    Directory of Open Access Journals (Sweden)

    Bertin Dibi Kouame


    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.

  19. Aid and growth regressions

    DEFF Research Database (Denmark)

    Hansen, Henrik; Tarp, Finn


    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...

  20. Aid and Development

    DEFF Research Database (Denmark)

    Tarp, Finn

    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 categorize some of the key goals, principles and institutions of the aid system. The evidence on whether aid has......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...

  1. Aid and development

    DEFF Research Database (Denmark)

    Tarp, Finn


    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 categorize some of the key goals, principles and institutions of the aid system. The evidence on whether aid has......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...

  2. Synthesis and characterisation of core-shell structures for orthopaedic surgery. (United States)

    Rusen, Edina; Zaharia, Cătălin; Zecheru, Teodora; Mărculescu, Bogdan; Filmon, Robert; Chappard, Daniel; Bădulescu, Roxana; Cincu, Corneliu


    This paperwork deals with the obtaining and characterisation of new acrylic cements for bone surgery. The final mixture of cement contains derivatives of methacryloyloxyethyl phosphate, methacrylic acid or 2-acrylamido-2-methyl-1-propane sulphonic acid. The idea of using these monomers is sustained by their ability to form ionic bonds with barium, which is responsible for X-ray reflection and by the biocompatibility of these structures. The strategy consists in the obtaining of core-shell structures through heterogeneous polymerisation, which are used for final cement's manufacture. The orthopaedic cements were characterised by SEM, EDX, compression resistance and cytotoxicity assays.

  3. 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


    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.

  4. Adult onset primary focal dystonia of the foot: an orthopaedic intervention. (United States)

    Logan, Loretta; Resseque, Barbara; Dontamsetti, Monica Sakshi


    A 54-year-old woman presented to a foot centre with a chief symptom of cramping in her toes, which, she believed, was of a secondary cause originating from a bunion. She was treated conservatively; however, she returned a month later as the symptoms had progressed to painful cramping of toes, toe-curling and instability while walking, due to involuntary movement of her toes. It was believed that the patient presented with a rare case of primary adult onset focal foot dystonia. This case report explains dystonia further in detail and delves into the different treatment and management options available today, including the unique orthopaedic intervention provided for this patient.

  5. Soft Tissue Structure Modelling for Use in Orthopaedic Applications and Musculoskeletal Biomechanics

    Directory of Open Access Journals (Sweden)

    E. A. Audenaert


    Full Text Available We present our methodology for the three-dimensional anatomical and geometrical description of soft tissues, relevant for orthopaedic surgical applications and musculoskeletal biomechanics. The technique involves the segmentation and geometrical description of muscles and neurovascular structures from high-resolution computer tomography scanning for the reconstruction of generic anatomical models. These models can be used for quantitative interpretation of anatomical and biomechanical aspects of different soft tissue structures. This approach should allow the use of these data in other application fields, such as musculoskeletal modelling, simulations for radiation therapy, and databases for use in minimally invasive, navigated and robotic surgery.

  6. 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


    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.

  7. HIV/AIDS Coinfection (United States)

    ... Laotian Mongolian Spanish Turkish Vietnamese Hindi Subscribe HIV/AIDS Coinfection Approximately 10% of the HIV-infected population ... Control and Prevention website to learn about HIV/AIDS and Viral Hepatitis guidelines and resources. Home About ...

  8. HIV/AIDS Basics (United States)

    ... Partner Spotlight Awareness Days 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 ...

  9. Neurological Complications of AIDS (United States)

    ... in recent years has improved significantly because of new drugs and treatments. AIDS clinicians often fail to recognize ... in recent years has improved significantly because of new drugs and treatments. AIDS clinicians often fail to recognize ...

  10. Variation in use of non-surgical treatments among osteoarthritis patients in orthopaedic practice in the Netherlands (United States)

    Hofstede, Stefanie N; Vliet Vlieland, Thea P M; van den Ende, Cornelia H M; Nelissen, Rob G H H; Marang-van de Mheen, Perla J; van Bodegom-Vos, Leti


    Objectives National and international evidence-based guidelines for hip and knee osteoarthritis (OA) recommend to start with non-surgical treatments, followed by surgical intervention if a patient does not respond sufficiently to non-surgical treatments, but there are indications that these are not optimally used. The aim of this study was to assess the extent to which all recommended non-surgical treatments were used by patients with hip or knee OA who receive(d) a total hip or knee replacement, as reported by patients and orthopaedic surgeons. Setting We performed two cross-sectional internet-based surveys among patients and orthopaedic surgeons throughout the Netherlands. Participants 195 OA patients either have undergone total knee arthroplasty or total hip arthroplasty no longer than 12 months ago or being on the waiting list for surgery with a confirmed date within 3 months and 482 orthopaedic surgeons were invited to participate. Primary and secondary outcome measures The use of recommended non-surgical treatments including education about OA/treatment options, lifestyle advice, dietary therapy, physical therapy, acetaminophen, NSAIDs and glucocorticoid injections. Results 174 OA patients (93%) and 172 orthopaedic surgeons (36%) completed the surveys. Most recommended non-surgical treatments were given to the majority of patients (eg, 80% education about OA, 73% physical therapy, 72% acetaminophen, 80% NSAIDs). However, only 6% of patients and 10% of orthopaedic surgeons reported using a combination of all recommended treatments. Dietary therapy was used least frequently. Only 11% of overweight and 30% of obese participants reported having received dietary therapy and 28% of orthopaedic surgeons reported to prescribe dietary therapy to overweight patients. Conclusions While most recommended non-surgical treatments were used frequently as single therapy, the combination is used in only a small percentage of OA patients. Especially, use of dietary therapy

  11. Review of the current literature as a preparatory tool for the trauma content of the Orthopaedic in-Training Examination. (United States)

    Farjoodi, Payam; Marker, David R; McCallum, Jeremy R; Frassica, Frank J; Mears, Simon C


    Currently, the only standardized evaluation of trauma knowledge throughout orthopedic training is found in the Orthopaedic In-Training Examination, which is administered annually to all residents by the American Academy of Orthopaedic Surgeons. Our goals were to assess the Orthopaedic In-Training Examination to (1) determine the content of the trauma questions, (2) identify the content of the 3 most frequently referenced journals on the answer keys, and (3) evaluate the correlation between those contents.We reviewed the trauma-related Orthopaedic In-Training Examination questions and answer keys for 2002 through 2007. Content for test questions and cited literature was assessed with the same criteria: (1) category type, (2) anatomic location, (3) orthopedic focus, and (4) treatment type. For each of the 3 most frequently referenced journals, we weighted content by dividing the number of times it was referenced by the number of its trauma-related articles. We then compared the journal data individually and collectively to the data from the Orthopaedic In-Training Examination trauma questions. A chi-square analysis with Yates correction was used to determine differences. Questions and literature were similar in the most frequently addressed items in each of the 4 areas: category type (taxonomy 3, treatment), 52.4% and 60.7%, respectively; anatomic location (femur), 23.3% and 27.7%, respectively; orthopedic focus (fracture), 51.0% and 56.5%, respectively; and treatment type (multiple/nonspecific), 39.0% and 35.4%, respectively.The content correlation found between the questions and literature supports the idea that reviewing current literature may help prepare for the trauma content on the Orthopaedic In-Training Examination.

  12. Aid and growth regressions

    DEFF Research Database (Denmark)

    Hansen, Henrik; Tarp, Finn


    . 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...... investment. We conclude by stressing the need for more theoretical work before this kind of cross-country regressions are used for policy purposes....

  13. [The singular story of Doctor Worm -Nicholas Andry de Boisregard- and of his daughters Parasitology and Orthopaedics]. (United States)

    Ledermann, Walter


    Homini verminoso or Dr. Worm were the nicknames that Nicholas Aindry won in life for his consecration to the study of intestinal worms and for his bad temper, which led him to fiercely attack the surgeons. The article reassumes the studies and contributions that gave Andry the title of Father of Parasitology and the candidacy to Father of Orthopaedics, and mentions some other candidates to this honor. Quite a man, he had -besides his biological one- two famous daughters, growing till our days; wrote at least three valuable books; and planted the immortal "tree of Andry", the symbol of Orthopaedics.

  14. Designing State Aid Formulas (United States)

    Zhao, Bo; Bradbury, Katharine


    This paper designs a new equalization-aid formula based on fiscal gaps of local communities. When states are in transition to a new local aid formula, the issue of whether and how to hold existing aid harmless poses a challenge. The authors show that some previous studies and the formulas derived from them give differential weights to existing and…

  15. Determinants of State Aid

    NARCIS (Netherlands)

    Buiren, K.; Brouwer, E.


    From economic theory we derive a set of hypotheses on the determination of state aid. Econometric analysis on EU state aid panel data is carried out to test whether the determinants we expect on the basis of theory, correspond to the occurrence of state aid in practice in the EU. We find that politi

  16. Fever: First Aid (United States)

    First aid Fever: First aid Fever: First aid By Mayo Clinic Staff A fever is a rise in body temperature. It's usually a sign of infection. The ... 2 C) or higher Should I treat a fever? When you or your child is sick, the ...

  17. Stroke: First Aid (United States)

    First aid Stroke: First aid Stroke: First aid By Mayo Clinic Staff A stroke occurs when there's bleeding into your brain or when normal blood flow to ... next several hours. Seek immediate medical assistance. A stroke is a true emergency. The sooner treatment is ...

  18. 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...

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

    LENUS (Irish Health Repository)

    Dillon, J P


    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.

  20. Capturing orthopaedic surgical site infection data and assessing dental recommendations with respect to total joint arthroplasty. (United States)

    Florschutz, Anthony V; Parsley, Brian S; Shapiro, Irving M


    Greater documentation of patient history and clinical course is crucial for identifying factors that can influence surgical outcomes. The Centers for Medicare and Medicaid Services have already begun public reporting of hospital data on readmission, complication, and infection rates and will soon launch a website to make physician-specific outcomes data public. The orthopaedic community has the opportunity to lead the way in ensuring that adequate and accurate data is collected to facilitate appropriate comparisons that are based on patients' true risk of complications and the complexity of treatment. Several studies have reported a link between oral pathogens and periprosthetic infection, although it remains unclear whether organisms unique to dental tissues are also present in osteoarthritic joints and tissues affected by periprosthetic joint infection. The American Academy of Orthopaedic Surgeons and the American Dental Association are aware of these concerns and have created guidelines for antibiotic prophylaxis in patients who have undergone total hip or knee arthroplasty and require high-risk dental procedures. Because these guidelines have received considerable criticism, recommendations that are based on scientific and case-controlled clinical studies and provide effective guidance on this important subject are needed.

  1. Orthopaedic Aspects of Marfan Syndrome: The Experience of a Referral Center for Diagnosis of Rare Diseases

    Directory of Open Access Journals (Sweden)

    Fernando De Maio


    Full Text Available Marfan syndrome is caused by mutations in the fibrillin-1 gene (FBN1. The most important features affect the cardiovascular system, eyes, and skeleton. The aim of this study was to report the most frequent musculoskeletal alterations observed in 146 patients affected by Marfan syndrome. Fifty-four patients (37% underwent cardiac surgery and 11 of them received emergent surgery for acute aortic dissection. Ectopia lentis was found in 68 patients (47% whereas myopia above 3D occurred in 46 patients (32%. Musculoskeletal anomalies were observed in all patients with Marfan syndrome. In 88 patients (60.2%, the associated “wrist and thumb sign” was present; in 58 patients (39.7%, pectus carinatum deformity; in 44 patients (30.1%, pectus excavatum; in 49 patients (33.5%, severe flatfoot; in 31 patients (21.2%, hindfoot deformity; in 54 patients (36.9%, reduced US/LS ratio or increased arm span-height ratio; in 37 patients (25.3%, scoliosis or thoracolumbar kyphosis; in 22 patients (15%, reduced elbow extension (170° or less. Acetabular protrusion was ascertained on radiographs in 27 patients (18.4%. Orthopaedic aspects of the disease are very important for an early diagnosis; however, we have not observed definite correlations between the extent of orthopaedic involvement and aortic complications.

  2. Orthopaedic Aspects of Marfan Syndrome: The Experience of a Referral Center for Diagnosis of Rare Diseases (United States)

    Fichera, Alessandro; De Luna, Vincenzo; Mancini, Federico; Caterini, Roberto


    Marfan syndrome is caused by mutations in the fibrillin-1 gene (FBN1). The most important features affect the cardiovascular system, eyes, and skeleton. The aim of this study was to report the most frequent musculoskeletal alterations observed in 146 patients affected by Marfan syndrome. Fifty-four patients (37%) underwent cardiac surgery and 11 of them received emergent surgery for acute aortic dissection. Ectopia lentis was found in 68 patients (47%) whereas myopia above 3D occurred in 46 patients (32%). Musculoskeletal anomalies were observed in all patients with Marfan syndrome. In 88 patients (60.2%), the associated “wrist and thumb sign” was present; in 58 patients (39.7%), pectus carinatum deformity; in 44 patients (30.1%), pectus excavatum; in 49 patients (33.5%), severe flatfoot; in 31 patients (21.2%), hindfoot deformity; in 54 patients (36.9%), reduced US/LS ratio or increased arm span-height ratio; in 37 patients (25.3%), scoliosis or thoracolumbar kyphosis; in 22 patients (15%), reduced elbow extension (170° or less). Acetabular protrusion was ascertained on radiographs in 27 patients (18.4%). Orthopaedic aspects of the disease are very important for an early diagnosis; however, we have not observed definite correlations between the extent of orthopaedic involvement and aortic complications. PMID:28050285

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

    Directory of Open Access Journals (Sweden)

    Arun Vashisht


    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

  4. 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


    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.

  5. Muscle activation and cutaneous reflex modulation during rhythmic and discrete arm tasks in orthopaedic shoulder instability. (United States)

    Hundza, Sandra R; Zehr, E Paul


    In orthopaedic shoulder instability, muscle activity (EMG) is altered during unconstrained discrete arm movement tasks (e.g. elevation against a load). These findings have been ascribed to deficits in afferent feedback and neural control with glenohumeral instabilities resulting from orthopaedic injury. However, the integrity of neural control during shoulder movements in those with unstable shoulders is unclear. It is not known if there are altered EMG patterns during rhythmic arm movement or during discrete tasks involving no load, as would be experienced in many arm motions performed in daily living. The primary objective of this study was to evaluate neural control of arm movements between those with unstable shoulders and control participants, within a constrained arm movement paradigm involving both rhythmic arm cycling and discrete reaching. To achieve this objective, we determined if the amplitude and timing of EMG related to the movement pattern (background EMG) was significantly different between groups. Cutaneous reflexes were used to simulate a perturbation to the upper limb that would typically evoke a coordinated response. In the elevation phase of the movement path for anterior and posterior deltoid, upper trapezius, infraspinatus and serratus anterior, background EMG during rhythmic arm cycling was significantly (24%, p EMG between the groups during the discrete task. Significant differences (p EMG and the cutaneous reflexes patterns in those with shoulder instabilities suggest that neural control is altered during rhythmic movement.

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

    LENUS (Irish Health Repository)

    Banks, L N


    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.

  7. How to Study Biofilms after Microbial Colonization of Materials Used in Orthopaedic Implants (United States)

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


    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

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

    LENUS (Irish Health Repository)

    Ahmed, M


    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.

  9. Critical review of patient education materials from the American Academy of Orthopaedic Surgeons. (United States)

    Feghhi, Daniel P; Agarwal, Nitin; Hansberry, David R; Berberian, Wayne S; Sabharwal, Sanjeev


    We performed an expanded readability analysis to determine if the American Academy of Orthopaedic Surgeons, AAOS, had sufficiently improved its patient education materials since they were originally studied in 2007. In March 2013, we downloaded patient education materials from the AAOS patient information website, Your Orthopaedic Connection. Using 10 different readability formulas, we found that the mean grade level of patient education materials on the website is 8.84. Flesch-Kincaid analysis showed a mean grade level of 9.98, range, 6.6-12.6. Nine other readability analyses showed a mean reading level of 7.7, range, 6.5-13.7. Although this is an improvement over the 2007 level, it is above the average national reading comprehension level. The readability of patient education materials on the AAOS website still exceeds the average reading ability of a US adult. Revisions made over the 5 years leading up to this latest study resulted in better readability. The Prevention and Safety entries, written near seventh-grade level, should serve as a model for the remaining articles.

  10. 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....

  11. Aid and Development

    DEFF Research Database (Denmark)

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

    This paper considers the relationship between external aid and development in Mozambique from 1980 to 2004. The main objective is to identify the specific mechanisms through which aid has influenced the developmental trajectory of the country and whether one can plausibly link outcomes to aid...... 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...... 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...

  12. China vs. AIDS

    Institute of Scientific and Technical Information of China (English)



    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.

  13. 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...... betweenstudies is real. In particular, the aid-growth association is stronger for Asian countries, and the aid-growth association is shown to have been weaker in the 1970s....

  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


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

    NARCIS (Netherlands)

    Jannink, Michiel J.A.; Vries, de Jaap; Stewart, Roy E.; Groothoff, Johan W.; Lankhorst, Gustaaf J.


    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

  16. Prevalence of answers to orthopaedic in-training examination questions in 3 commonly used orthopedic review sources. (United States)

    Krueger, Chad A; Shakir, Irshad; Fuller, Brian C


    One of the greatest predictors for resident success on the Orthopaedic In-Training Examination (OITE) is reviewing previous OITE questions. However, no studies have examined which review sources contain the most answers to previously asked OITE questions. The goal of this study was to determine which review source contains the most answers to previously asked OITE questions. Each question from the 2006 to 2010 OITEs was examined. The questions were placed into 1 of 13 categories based on their topic. The publication date of the recommended readings associated with each question was recorded. The answer to each question was then searched for in 3 commonly used review sources: Miller's Review of Orthopaedics, 5th edition (MRO), American Academy of Orthopaedic Surgeons Comprehensive Orthopaedic Review (COR), and (OB). Searchable electronic versions of each textbook were used, and each question had a 12-minute time limit. Of 1358 questions, 665 (49%) were found in all 3 sources. Significantly more answers were found on OB (99.4%) compared with MRO (60%) and COR (62%) (P<.0001). Significantly more answers to questions in each question category were found on OB compared with MRO or COR (P<.0001). More than 50% of all recommended readings for OITE questions were published within 5 years of the OITE. Residents using OB to review for the OITE will be exposed to significantly more answers of previously asked OITE questions than residents using MRO or COR (P<.0001).

  17. The effects of infant orthopaedics on speech and language development in children with unilateral cleft lip and palate

    NARCIS (Netherlands)

    Konst, Emmy Maria


    This thesis describes an investigation into the effects of infant orthopaedics (IO) on speech and language development in children with unilateral cleft lip and palate (UCLP). The study was performed within the framework of the three-centre prospective randomised clinical trial 'Dutchcleft'. Two gro

  18. The Impact of Early Infant Jaw-Orthopaedics on Early Speech Production in Toddlers with Unilateral Cleft Lip and Palate (United States)

    Lohmander, Anette; Lillvik, Malin; Friede, Hans


    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…

  19. Does a "Level I Evidence" rating imply high quality of reporting in orthopaedic randomised controlled trials?

    Directory of Open Access Journals (Sweden)

    Sierevelt Inger N


    Full Text Available Abstract Background The Levels of Evidence Rating System is widely believed to categorize studies by quality, with Level I studies representing the highest quality evidence. We aimed to determine the reporting quality of Randomised Controlled Trials (RCTs published in the most frequently cited general orthopaedic journals. Methods Two assessors identified orthopaedic journals that reported a level of evidence rating in their abstracts from January 2003 to December 2004 by searching the instructions for authors of the highest impact general orthopaedic journals. Based upon a priori eligibility criteria, two assessors hand searched all issues of the eligible journal from 2003–2004 for RCTs. The assessors extracted the demographic information and the evidence rating from each included RCT and scored the quality of reporting using the reporting quality assessment tool, which was developed by the Cochrane Bone, Joint and Muscle Trauma Group. Scores were conducted in duplicate, and we reached a consensus for any disagreements. We examined the correlation between the level of evidence rating and the Cochrane reporting quality score. Results We found that only the Journal of Bone and Joint Surgery – American Volume (JBJS-A used a level of evidence rating from 2003 to 2004. We identified 938 publications in the JBJS-A from January 2003 to December 2004. Of these publications, 32 (3.4% were RCTs that fit the inclusion criteria. The 32 RCTs included a total of 3543 patients, with sample sizes ranging from 17 to 514 patients. Despite being labelled as the highest level of evidence (Level 1 and Level II evidence, these studies had low Cochrane reporting quality scores among individual methodological safeguards. The Cochrane reporting quality scores did not differ significantly between Level I and Level II studies. Correlations varied from 0.0 to 0.2 across the 12 items of the Cochrane reporting quality assessment tool (p > 0.05. Among items closely

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

    Directory of Open Access Journals (Sweden)

    Wong Shaun KS


    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. Sutures versus staples for wound closure in orthopaedic surgery: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Shantz Jesse A


    Full Text Available Abstract Background A recently published meta-analysis comparing metallic staples to sutures in orthopaedic procedures revealed three fold increase in risk for infection in stapled wounds. The studies included in the meta-analysis are at risk of bias due to experimental design limitations. A large randomized controlled trial is proposed to direct orthopaedic surgeons in their choice of wound closure material. Methods/Design A parallel group randomized controlled trial with institutional review board approval will be conducted. Patients will be randomized intraoperatively to have skin wounds closed with sutures or staples. Dressings will be used to maintain blinding outcome assessors. The primary outcome measure will be a composite all-cause wound complication outcome measure composed of: infection, wound drainage, wound necrosis, blistering, dehiscence, suture abscess and material sensitivity reaction. An independent review board blinded to treatment assignment will adjudicate suspected complications based on clinical data. All deceased patients will also be reviewed. An interim analysis of complications will take place after half of the patients have been recruited. All data will be analyzed by a blinded statistician. Dichotomous primary and secondary outcome measures will be analyzed using the Chi-squared statistic. Continuous outcome measures will be analyzed using Student's t-test. Subgroup analysis will compare infection rates using sutures versus staples in each anatomic area (upper extremity, pelvis/acetabulum, hip/femur, knee, ankle. A further subgroup analysis will be conducted comparing trauma patients to elective surgery patients. Non-infected revision surgery will also be compared to primary surgery. Discussion Wound closure material is an afterthought for many orthopaedic surgeons. The combined results of several comparative trials suggests that the choice of wound closure materials may have an impact on the rate of surgical site

  2. Daptomycin for the treatment of osteomyelitis and orthopaedic device infections: real-world clinical experience from a European registry. (United States)

    Malizos, K; Sarma, J; Seaton, R A; Militz, M; Menichetti, F; Riccio, G; Gaudias, J; Trostmann, U; Pathan, R; Hamed, K


    Osteomyelitis is a serious infection predominantly caused by Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Orthopaedic device-related infections are complex and require a careful combination of surgical intervention and antimicrobial therapy. Daptomycin, a cyclic lipopeptide, effectively penetrates soft tissue and bone and demonstrates rapid concentration-dependent bactericidal activity against Gram-positive pathogens. This retrospective, non-interventional study evaluated clinical outcomes in patients with osteomyelitis or orthopaedic device infections treated with daptomycin from the European Cubicin® Outcomes Registry and Experience (EU-CORE(SM)) study. Patients were treated between January 2006 and April 2012, with follow-up to 2014. Clinical outcomes were assessed as success (cured or improved), failure or non-evaluable. Of 6,075 patients enrolled, 638 (median age, 63.5 years) had primary infections of osteomyelitis or orthopaedic device infections, 224 had non-prosthetic osteomyelitis, 208 had osteomyelitis related to a permanent or temporary prosthetic device, and 206 had orthopaedic device infections. The most commonly isolated pathogen was S. aureus (214 [49.1 %]; 24.8 % were MRSA). Overall, 455 (71.3 %) patients had received previous antibiotic therapy. Patients underwent surgical interventions, including tissue (225 [35.3 %]) and bone (196 [30.7 %]) debridement, as part of their treatment. Clinical success rates were 82.7 % and 81.7 % in S. aureus and coagulase-negative staphylococcal infections. Adverse events (AEs) and serious AEs assessed as possibly related to daptomycin were observed in 6.7 % and 1.9 % of patients, respectively. Daptomycin was discontinued by 5.5 % of patients due to AEs and 10 (1.6 %) deaths were reported. In conclusion, daptomycin was effective and safe in patients with osteomyelitis or orthopaedic device infections.

  3. Aid and Growth

    DEFF Research Database (Denmark)

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

    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......, 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 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....

  4. Aid and Growth

    DEFF Research Database (Denmark)

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


    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......, 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 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....

  5. AIDS in South Africa. (United States)

    Ijsselmuiden, C; Evian, C; Matjilla, J; Steinberg, M; Schneider, H


    The National AIDS Convention in South Africa (NACOSA) in October 1992 was the first real attempt to address HIV/AIDS. In Soweto, government, the African National Congress, nongovernmental organizations, and organized industry and labor representatives worked for 2 days to develop a national plan of action, but it did not result in a united effort to fight AIDS. The highest HIV infection rates in South Africa are among the KwaZulu in Natal, yet the Inkatha Freedom Party did not attend NACOSA. This episode exemplifies the key obstacles for South Africa to prevent and control AIDS. Inequality of access to health care may explain why health workers did not diagnose the first AIDS case in blacks until 1985. Migrant labor, Bantu education, and uprooted communities affect the epidemiology of HIV infection. Further, political and social polarization between blacks and whites contributes to a mindset that AIDS is limited to the other race which only diminishes the personal and collective sense of susceptibility and the volition and aptitude to act. The Department of National Health and Population Development's voluntary register of anonymously reported cases of AIDS specifies 1517 cumulative AIDS cases (October 1992), but this number is low. Seroprevalence studies show between 400,000-450,000 HIV positive cases. Public hospitals cannot give AIDS patients AZT and DDI. Few communities provided community-based care. Not all hospitals honor confidentiality and patients' need for autonomy. Even though HIV testing is not mandatory, it is required sometimes, e.g., HIV testing of immigrants. AIDS Training, Information and Counselling Centers are in urban areas, but not in poor areas where the need is most acute. The government just recently developed in AIDS education package for schools, but too many people consider it improper, so it is not being used. The poor quality education provided blacks would make it useless anyhow. Lifting of the academic boycott will allow South African

  6. JPRS Report, Epidemiology, Aids (United States)


    at home. For this they can thank the National Federation of Gays and Lesbians (LBL). -To develop an adequate core of specialists in AIDS prevention... Homosexuality [Vusie Ginindza; Mbabane THE TIMES OF SWAZILAND, 15 May 91] ...................................... 4 JPRS-TEP-91-012 5 June 1991 2 AIDS TANZANIA...sensitivity and not to sensa- tionalize the issue. Health Workers ’Alarmed’ at rise in AIDS, Homosexuality SWAZILAND MB1505085891 Mbabane THE TIMES

  7. Radiographic imaging of aids

    CERN Document Server

    Mahmoud, M B


    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.

  8. Patients speak out: development of an evidence-based model for managing orthopaedic postoperative pain. (United States)

    Pulido, Pamela; Hardwick, Mary E; Munro, Michelle; May, Laura; Dupies-Rosa, Denise


    Perioperative pain management after total joint replacement continues to be a concern for orthopaedic nurses. In our institution, the results of routine post-hospital stay surveys had shown below average scores in the area of pain management. This began as a quality management issue, became a pain subcommittee issue, and drew in the research nurses to ask what we can learn from this process. Changing the method of handling pain management is not easy, but it makes a difference in patients' hospital experiences. We learned that cooperation and expertise from multiple departments within the institution and some organizations outside the institution is needed to bring about change. We learned that education of not just staff members but also patients on pain management affected the outcome. This article describes our journey to enhance pain management in our institution.

  9. Microbial colonisation of orthopaedic tourniquets: a potential risk for surgical site infection. (United States)

    Sahu, S K; Tudu, B; Mall, P K


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

    Directory of Open Access Journals (Sweden)

    S K Sahu


    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.

  11. Robotics as a Support Tool for Experimental Optimisation of Surgical Strategies in Orthopaedic Surgery

    Directory of Open Access Journals (Sweden)

    Manel Frigola


    Full Text Available Robotics has shown its potential not only in assisting the surgeon during an intervention but also as a tool for training and for surgical procedure's evaluation. Thus, robotics can constitute an extension of simulators that are based on the high capabilities of computer graphics. In addition, haptics has taken a first step in increasing the performance of current virtual reality systems based uniquely on computer simulation and their corresponding interface devices. As a further step in the field of training and learning in surgery, this work describes a robotic experimental workstation composed of robots and specific measuring devices, together with their corresponding control and monitoring strategies for orthopaedic surgery. Through a case study, humerus arthroplasty, experimental evaluation shows the possibilities of having a test bed available for repetitive and quantifiable trials, which make a reliable scientific comparison between different surgical strategies possible.

  12. Proactive patient rounding to increase customer service and satisfaction on an orthopaedic unit. (United States)

    Tea, Christine; Ellison, Michael; Feghali, Fadia


    Customer service and patient satisfaction have become increasingly important in the healthcare industry. Given limited resources and a myriad of choices, on which facets of patient satisfaction should healthcare providers focus? An analysis of 40,000 observations across 4 hospitals found 1 important intervention: timely staff responsiveness. Using the Plan-Do-Check-Act (PDCA) quality methodology, the goal was set to improve staff responsiveness to orthopaedic patient needs and requests, thus improving patient satisfaction. A model to improve staff responsiveness was systematically developed and implemented. The I Care Rounding model places the emphasis on proactively meeting patient needs through hourly rounding, rather than caregivers providing care in a reactionary mode. After full implementation, positive improvement was demonstrated.

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

    Directory of Open Access Journals (Sweden)

    Bauer Heike I


    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.

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

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


    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.

  15. Importance of air quality and related factors in the prevention of infection in orthopaedic implant surgery. (United States)

    Gosden, P E; MacGowan, A P; Bannister, G C


    Small numbers of organisms can cause orthopaedic implant infections, which give rise to a considerable degree of morbidity and also mortality. The periprosthetic infection rates have been shown to correlate with the number of airborne bacteria within 30 cm of the wound. This is influenced by factors such as the number of operating theatre personnel, their clothing and the type of ventilation system used. Guidance on routine bacteriological monitoring of ultraclean air theatres, based on the Department of Health document Health Technical Memorandum 2025, is discussed. Factors important in minimizing the number of postoperative implant infections such as the use of ultraclean air, ultraviolet radiation, different types of surgical clothing, prophylactic antibiotics and host-related factors are also discussed. The importance of proper scientific investigation into the effectiveness of practical preventative measures in the operating room is emphasized.

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

    LENUS (Irish Health Repository)

    Dineen, P F


    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.

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

    DEFF Research Database (Denmark)

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


    prescription practice. Prescriptions not following good practice in these intervention areas were defined as "sub-optimal prescriptions," and then discussed between a physician and a clinical pharmacist. The primary parameter was the difference in the number of days with a sub-optimal prescription (Mann...... 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....


    Directory of Open Access Journals (Sweden)

    Claudia eDi Bella


    Full Text Available Chondral and Osteochondral lesions represent one of the most challenging and frustrating scenarios for the orthopaedic surgeon and for the patient. The lack of therapeutic strategies capable to reconstitute the function and structure of hyaline cartilage and to halt the progression towards osteoarthritis has brought clinicians and scientists together, to investigate the potential role of tissue engineering as a viable alternative to current treatment modalities. In particular, the role of bioprinting is emerging as an innovative technology that allows for the creation of organized 3D tissue constructs via a layer-by-layer deposition process. This process also has the capability to combine cells and biomaterials in an ordered and predetermined way. Here we review the recent advances in cartilage bioprinting and we identify the current challenges and the directions for future developments in cartilage regeneration.

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

    Directory of Open Access Journals (Sweden)

    Lawrence E. Murr


    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.

  20. Music and hearing aids. (United States)

    Madsen, Sara M K; Moore, Brian C J


    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.

  1. Internet and social media usage of orthopaedic patients: A questionnaire-based survey (United States)

    Duymus, Tahir Mutlu; Karadeniz, Hilmi; Çaçan, Mehmet Akif; Kömür, Baran; Demirtaş, Abdullah; Zehir, Sinan; Azboy, İbrahim


    AIM To evaluate social media usage of orthopaedic patients to search for solutions to their health problems. METHODS The study data were collected using face-to-face questionnaire with randomly selected 1890 patients aged over 18 years who had been admitted to the orthopaedic clinics in different cities and provinces across Turkey. The questionnaire consists of a total of 16 questions pertaining to internet and social media usage and demographics of patients, patients’ choice of institution for treatment, patient complaints on admission, online hospital and physician ratings, communication between the patient and the physician and its effects. RESULTS It was found that 34.2% (n = 647) of the participants consulted with an orthopaedist using the internet and 48.7% (n = 315) of them preferred websites that allow users to ask questions to a physician. Of all question-askers, 48.5% (n = 314) reported having found the answers helpful. Based on the educational level of the participants, there was a highly significant difference between the rates of asking questions to an orthopaedist using the internet (P = 0.001). The rate of question-asking was significantly lower in patients with an elementary education than that in those with secondary, high school and undergraduate education (P = 0.001) The rate of reporting that the answers given was helpful was significantly higher in participants with an undergraduate degree compared to those who were illiterate, those with primary, elementary or high school education (P = 0.001). It was also found that the usage of the internet for health problems was higher among managers-qualified participants than unemployed-housewives, officers, workers-intermediate staff (P social media to select a specific physician or to seek solution to their health problems in an effective way. Even though the internet and social media offer beneficial effects for physicians or patients, there is still much obscurity regarding their harms and further

  2. Human postmortem device retrieval and analysis--orthopaedic, cardiovascular, and dental systems. (United States)

    Lemons, J; Brott, B; Eberhardt, A


    On the basis of decades of analyzing implant devices, tissues, and clinical records from revision surgical explants (called device failure), studies now include postmortem donors and in situ conditions (called success). A key issue has been information exchange from an interdisciplinary team where basic physical and biological studies complement details of the clinical conditions for each device. Overall, the summary information has shown that most revisions were based on factors associated with the patient health, disease, and compliance, with few outcomes directly correlated with technology and device-specific factors. However, because of the large numbers of devices implanted annually (millions), any sampling that reveals adverse circumstances could result in a high level of importance and the need for additional studies of this type. Experience from prior retrieval and analysis demonstrates significant value where peer reviewed results from investigations have altered the discipline and have improved the quality and longevity of health care associated with implanted devices. This report summarizes completed and ongoing studies of cardiovascular, dental, and orthopaedic systems. Endovascular stents from autopsies showed damage including fretting and corrosion from overlapping and intersecting conditions, plus some corrosion and element transfers to tissues from individual stents. Studies are proposed to increase numbers to evaluate clinical significance. Dental implants from postmortem donors that functioned more than 10 years provided evaluations of cobalt alloy devices and calcium phosphate bone graft substitutes originally investigated in the 1970s. Tissue integration and stability correlated with data from prior laboratory in vitro and in vivo investigations. Studies of articulation and fixation from orthopaedic total joint arthroplasties showed some limitations related to surface changes of YTZ zirconia, specific damage due to implantation procedures, which

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

    Directory of Open Access Journals (Sweden)

    Neil M. Issar


    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

  4. An audit of consent for allograft use in elective orthopaedic surgery. (United States)

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


    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.

  5. A systematic review of contemporary trials of anticoagulants in orthopaedic thromboprophylaxis: suggestions for a radical reappraisal. (United States)

    Chan, Noel C; Siegal, Deborah; Lauw, Mandy N; Ginsberg, Jeffrey S; Eikelboom, John W; Guyatt, Gordon H; Hirsh, Jack


    In the last decade, major advances in venous thromboembolism (VTE) prophylaxis in orthopaedic surgery have included the development of new anticoagulants that are poised to replace low molecular weight heparins (LMWHs) and improvements in operative and perioperative care that have likely led to a decline in the rates of symptomatic VTE and mortality independent of anticoagulant use. A systematic review of the literature was performed to identify phase III randomized controlled trials of VTE prevention that compared new anticoagulants (fondaparinux, rivaroxaban, dabigatran, apixaban) with LMWH (enoxaparin) in major elective orthopaedic surgery. Our aims were to obtain best estimates of the rates of patient important events (symptomatic VTE, mortality, and bleeding) in contemporary trials of VTE prevention, and to consider the implications of these contemporary rates for clinical practice and future research. Fourteen studies, which enrolled 40,285 patients, were included in the analyses. The combined median rates (ranges) for all five anticoagulants for symptomatic VTE and mortality to the end of follow-up were 0.99 % (0.15-2.58 %) and 0.26 % (0-0.92 %) respectively, whereas the median rate (range) of clinically important bleeding was 3.44 % (2.25-7.74 %). In contemporary trials of anticoagulants, the rates of symptomatic VTE and mortality are low, but the rates of clinically important post-operative bleeding remain relatively high. Based on these results, we propose that approaches that minimize bleeding without substantially reducing efficacy merit investigation, particularly if improvement in surgical and perioperative care have also resulted in falling baseline patient important VTE rates independent of anticoagulant use.

  6. [It is not always necessary to establish a "first aid station" at mass gatherings. Cutty Sark Tallships Race 1993]. (United States)

    Larsen, S E; Sørensen, L; Røck, N D


    Previous studies from outdoor music festivals have recommended medical service facilities at first-aid stations. The Cutty Sark Tallships Race was a large outdoor event that took place over four days in Esbjerg harbour with about 500,000 participants and spectators. A total of 68 patients were treated, 28 in the first-aid station at the harbour and 40 at the nearby located hospital. The disease and injuries presented were not severe. The orthopaedic casualties dominated (82%), wounds, contusions and fractures being the most common ones. Only seven casualties were related to alcohol abuse. No casualties were related to drug abuse. The economic expense was estimated to DKK 14,676. Thus, at outdoor mass gatherings of a nature like the Cutty Sark Tallships Race, located near a hospital, first-aid stations are not necessary.

  7. 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)


    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.

  8. Magnetic Implants Aid Hearing

    Institute of Scientific and Technical Information of China (English)



    The next generation of hearing aids may use tiny magnets that fit inside the ear. Researchersat a California company and an engineer at the University of Virginia are both developing systems that rely on magnets to convey sounds. Conventional hearing aids have three components:a microphone, an amplifier, and a speaker. The microphone picks up sounds and sends them to the am-

  9. Genetic Immunity to AIDS

    Institute of Scientific and Technical Information of China (English)


    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.

  10. Aid and sectoral growth

    DEFF Research Database (Denmark)

    Selaya, Pablo; Thiele, Rainer


    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...

  11. International Aid to Education (United States)

    Benavot, Aaron


    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…

  12. AIDS Epidemiological models (United States)

    Rahmani, Fouad Lazhar


    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].

  13. Aid and Income

    DEFF Research Database (Denmark)

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


    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....

  14. First Aid: Burns (United States)

    ... Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild ...

  15. 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 c...

  16. First Aid: Diaper Rash (United States)

    ... Your 1- to 2-Year-Old First Aid: Diaper Rash KidsHealth > For Parents > First Aid: Diaper Rash A A A Diaper rash is a common skin condition in babies. ... rash is due to irritation caused by the diaper, but it can have other causes not related ...

  17. First Aid: Burns (United States)

    ... Old Feeding Your 8- to 12-Month-Old Feeding Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild to life threatening, ...

  18. Aid, Development, and Education (United States)

    Klees, Steven J.


    The world faces pervasive poverty and inequality. Hundreds of billions of dollars in international aid have been given or loaned to developing countries though bilateral and multilateral mechanisms, at least, ostensibly, in order to do something about these problems. Has such aid helped? Debates around this question have been ongoing for decades,…

  19. HIV and AIDS (United States)

    ... one HIV test by the time they are teens. If you are having sex, have had sex in the past, or shared ... reviewed: October 2015 previous 1 • 2 • ... STDs How Do People Get AIDS? Can You Get HIV From Having Sex With Someone Who Has AIDS? Can Someone Get ...

  20. First Aid: Falls (United States)

    ... Your 1- to 2-Year-Old First Aid: Falls KidsHealth > For Parents > First Aid: Falls Print A A A en español Folleto de instructiones: Caídas (Falls) With all the running, climbing, and exploring kids ...

  1. AIDS as Metaphor. (United States)

    McMillen, Liz


    Scholarly interest in Acquired Immune Deficiency Syndrome (AIDS) has spread throughout the humanities, attracting the attention of historians of medicine, political scientists, sociologists, public health scholars, and anthropologists. Most theorists hope their research will aid in policymaking or change understanding of the epidemic. (MSE)

  2. Magnetic Properties and Microstructure of FeOx/Fe/FePt and FeOx/FePt Films

    Directory of Open Access Journals (Sweden)

    Jai-Lin Tsai


    Full Text Available The Fe(6 nm/FePt film with perpendicular magnetization was deposited on the glass substrate. To study the oxygen diffusion effect on the coupling of Fe/FePt bilayer, the plasma oxidation with 0.5~7% oxygen flow ratio was performed during sputtered part of Fe layer and formed the FeOx(3 nm/Fe(3 nm/FePt trilayer. Two-step magnetic hysteresis loops were found in trilayer with oxygen flow ratio above 1%. The magnetization in FeOx and Fe/FePt layers was decoupled. The moments in FeOx layer were first reversed and followed by coupled Fe/FePt bilayer. The trilayer was annealed again at 500°C and 800°C for 3 minutes. When the FeOx(3 nm/Fe(3 nm/FePt trilayer was annealed at 500°C, the layers structure was changed to FeOx(6 nm/FePt bilayer due to oxygen diffusion. The hard-magnetic FeOx(6 nm/FePt film was coupled with single switching field. The FeOx/(disordered FePt layer structure was observed with further annealing at 800°C and presented soft-magnetic loop. In summary, the coupling between soft-magnetic Fe, FeOx layer, and hard-magnetic L10 FePt layer can be controlled by the oxygen diffusion behavior, and the oxidation of Fe layer was tuned by the annealing temperature. The ordered L10 FePt layer was deteriorated by oxygen and became disordered FePt when the annealed temperature was up to 800°C.

  3. A Clinical Practice Update on the Latest AAOS/ADA Guideline (December 2012) on Prevention of Orthopaedic Implant Infection in Dental Patients


    Hamedani Sh. DDS, MSc


    The American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA), along with 10 other academic associations and societies recently (December 2012) published their mutual clinical practice guideline “Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures.” This evidence-based guideline ,detailed in 325 pages, has three recommendations and substitutes the previous AAOS guideline. The new published clinical guideline is a protocol to pre...

  4. HIV/AIDS and Alcohol (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, ...

  5. HIV, AIDS, and the Future (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 ...

  6. Political dimensions of AIDS. (United States)

    Blewett, N


    World political aspects and the example of Australia as a national political response to AIDS are presented. Global policy on AIDS is influenced by the fact that the AIDS epidemic is the 1st to be largely predictable, that long lag times occur between intervention and measurable events, and by the prompt, professional leadership of WHO, lead by Dr. J. Mann. WHO began a Global Programme on AIDS in 1987, modelled on the responses of Canada and Australia. A world summit of Ministers of Health was convened in January 1988. These moves generated a response qualified by openness, cooperation, hope and common sense. The AIDS epidemic calls for unprecedented involvement of politicians: they must coordinate medical knowledge with community action, deal with public fear, exert strong, rational leadership and avoid quick, appealing counterproductive responses. 3 clear directions must be taken to deal with the epidemic: 1) strong research and education campaigns; 2) close contact with political colleagues, interest groups and the community; 3) a national strategy which enjoins diverse interest groups, with courage, rationality and compassion. In Australia, the AIDS response began with the unwitting infection of 3 infants by blood transfusion. A public information campaign emphasizing a penetrating TV ad campaign was instituted in 1987. Policy discussions were held in all parliamentary bodies. The AIDS epidemic demands rapid, creative responses, a break from traditions in health bureaucracy, continual scrutiny of funding procedures and administrative arrangements. In practical terms in Australia, this meant establishing a special AIDS branch within the Health Advancement Division of the Community Health Department. AIDS issues must remain depoliticized to defuse adversary politics and keep leaders in a united front.

  7. [Scoliotic young girls and orthopaedics in Belle Epoque: the urban surge of mecanotherapy in Lausanne and Geneva]. (United States)

    Kaba, Mariama


    In Belle Epoque towns marked by the industrial and medical surge, a new technical therapy, called mechanotherapy, emerged, stemming from Swedish medical gymnastics and auxiliary to orthopaedics. Aiming mostly at treating scoliosis, this therapy by movement attracted a sizeable female clientele to these towns, because of the hygienic and social conceptions feeding collective imagination linked to the bodies of scoliotic young girls. Taking the French-speaking Swiss towns of Lausanne and Geneva as examples, the article first seeks to describe the emergence of mechanotherapy as a medical and urban phenomenon. It then addresses the role played by scoliosis in this orthopaedic practice, and examines the clientele attracted to the towns, among which well-born young girls seem to be predominant.

  8. 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


    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...

  9. Far cortex automatic detection aimed for partial or full bone drilling by a robot system in orthopaedic surgery

    Directory of Open Access Journals (Sweden)

    Tony Boiadjiev


    Full Text Available Far cortex detection during the bone-drilling process is a specific task in orthopaedic surgery. Any errors in its execution could damage the cortex wall from the inside, which often causes additional trauma even with a fatal result. Here we present some functionality enhancements of the drilling orthopaedic robot ODRO concerning the solution of the far cortex detection problem. The solution is based on software control of the thrust force applied to the bone during the drilling process. A new algorithm is created and its software realisation is provided. Experimental results are presented which verify and confirm the new functional characteristics of the robot. The risk of far cortex damage may be avoided by robot application and such precise operations may guarantee better success.

  10. Aid and Growth

    DEFF Research Database (Denmark)

    Tarp, Finn; Mekasha, Tseday Jemaneh


    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....

  11. Aid Supplies Over Time

    DEFF Research Database (Denmark)

    Jones, Edward Samuel


    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....

  12. 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....

  13. 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.


    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.

  14. Managing design excellence tools during the development of new orthopaedic implants. (United States)

    Défossez, Henri J P; Serhan, Hassan


    Design excellence (DEX) tools have been widely used for years in some industries for their potential to facilitate new product development. The medical sector, targeted by cost pressures, has therefore started adopting them. Numerous tools are available; however only appropriate deployment during the new product development stages can optimize the overall process. The primary study objectives were to describe generic tools and illustrate their implementation and management during the development of new orthopaedic implants, and compile a reference package. Secondary objectives were to present the DEX tool investment costs and savings, since the method can require significant resources for which companies must carefully plan. The publicly available DEX method "Define Measure Analyze Design Verify Validate" was adopted and implemented during the development of a new spinal implant. Several tools proved most successful at developing the correct product, addressing clinical needs, and increasing market penetration potential, while reducing design iterations and manufacturing validations. Cost analysis and Pugh Matrix coupled with multi generation planning enabled developing a strong rationale to activate the project, set the vision and goals. improved risk management and product map established a robust technical verification-validation program. Design of experiments and process quantification facilitated design for manufacturing of critical features, as early as the concept phase. Biomechanical testing with analysis of variance provided a validation model with a recognized statistical performance baseline. Within those tools, only certain ones required minimum resources (i.e., business case, multi generational plan, project value proposition, Pugh Matrix, critical To quality process validation techniques), while others required significant investments (i.e., voice of customer, product usage map, improved risk management, design of experiments, biomechanical testing

  15. Orthopaedic Surgery Under National Health Reform: An Analysis of Power, Process, Adaptation, and Leadership: AOA Critical Issues. (United States)

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


    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.

  16. Is There an Association Between Study Materials and Scores on the American Board of Orthopaedic Surgeons Part 1 Examination? (United States)


    Sharkey PF, Hilibrand AS. Passing the boards: can USMLE and orthopaedic in training examination scores predict passage of the ABOS part 1 examination. J... USMLE Step 1 and OITE correlate with the ABOS part I certifying examination?: a multicenter study. Clin Orthop Relat Res. 2010;468(10):2797 2802. 16...examination and scores on USMLE steps 1 and 2. Acad Med. 2009;84:S21 S24. 17. Drystad BW, Pope D, Milbrandt JC, Beck RT, Weinhoeft AL, Idusuyi OB. Predictive


    Institute of Scientific and Technical Information of China (English)


    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.

  18. HIV/AIDS (United States)

    ... equity (covering the populations in need of services). Financing for sustainability (covering the costs of services). Innovation for acceleration (looking towards the future). WHO is a cosponsor of the Joint United Nations Programme on AIDS (UNAIDS). Within UNAIDS, WHO leads ...

  19. First Aid: Croup (United States)

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... with each breath has a pale or bluish color around the mouth drools or has difficulty swallowing ...

  20. Buying a Hearing Aid (United States)

    ... Contact Us Calendar ENTCareers Marketplace ENT Careers Marketplace Log in b Log in Toggle navigation b Join Now Donate Now ... using your hearing aids in quiet surroundings, gradually building up to noisier environments. Then eventually work up ...

  1. HIV/AIDS (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 ...

  2. AidData (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+...

  3. Convulsions - first aid - slideshow (United States)

    ... this page: // Convulsions - first aid - series—Procedure, part 1 To use ... slide 2 out of 2 Overview When a seizure occurs, the main goal is to protect the ...

  4. A synthetic system links FeFe-hydrogenases to essential E. coli sulfur metabolism

    Directory of Open Access Journals (Sweden)

    Grandl Gerald


    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.

  5. Hypophyseal pathology in AIDS


    Mosca, L; Costanzi, G; Antonacci, C.; Boldorini, R; Carboni, N.; Cristina, S; Liberani, C.; Parravicini, C.; Pirolo, A.; Vago, L


    One hundred and eleven pituitary glands of patients (93 males, 18 females; mean age 32 years, 5 months) who died of fully developed AIDS or ARC were examined under light microscopy with the aid of immunohistochemistry. On post mortem (p.m.) examination a wide series of multiorgan alterations was noticed. Microscopically vanous lesions in both adeno- and neurohypophysis were seen. These ranged from vessel damage to secondaries to systemic infections, neoplas...

  6. Plasma-aided manufacturing (United States)

    Shohet, J. L.


    Plasma-aided manufacturing is used for producing new materials with unusual and superior properties, for developing new chemical compounds and processes, for machining, and for altering and refining materials and surfaces. Plasma-aided manufacturing has direct applications to semiconductor fabrication, materials synthesis, welding, lighting, polymers, anti-corrosion coatings, machine tools, metallurgy, electrical and electronics devices, hazardous waste removal, high performance ceramics, and many other items in both the high-technology and the more traditional industries in the United States.


    Directory of Open Access Journals (Sweden)

    Z Khan


    Full Text Available HIV infection and AIDS is increasingly becoming a major public health problem in our country. Currently, the reported cases represent only the 'tip of the iceberg' of the problem. In view of the fact that no cure or vaccine for the disease has yet been found, spreading knowledge and removing misconceptions is about the only way that AIDS can be effectively tackled.This handbook, developed by Prof. Shankar Chowdhury and associates, seeks to address all levels of medical and non-medical AIDS workers, as well as the layman. It deals with topics ranging from biology of the virus, symptoms and transmission of disease, to prevention, counselling for infected persons and action plan for AIDS education.The biology of the virus and the immune system is described in simple terms, as well as methods of testing for HIV, and what these test results mean. The progression of disease in adults and children, development of symptoms, diagnostic criteria for AIDS, treatment and outcome of disease is dealt with. How AIDS spreads between people, and the health risk for health workers and families is examined. The various ways in which transmission of HIV can be prevented is looked at in detail, including public health measures, national and internatonal action, and ethical and human rights issues involved.

  8. [What's new in orthopaedic surgery: hopes and facts in total hip and spine arthroplasty]. (United States)

    Gillet, P


    Progress in implant design and surface properties have improved long-term survival of total hip prosthesis and lowered the incidence of dislocation. New materials, particularly ceramics and metals, decrease the risk for implant loosening because they induce less particle disease than polyethylene debris. These new materials have been submitted to simulator studies before being released for clinical use. They have been used since a sufficient amount of time in clinical practice to consider them as being part of our current armamentarium. They enable the orthopaedic surgeon to tailor the optimal hip prosthesis to each patient's need, depending on his/her bone stock, activity level and life expectancy. Disk prostheses and the general concept of non fusion surgery in spine surgery seems attractive, since intervertebral fusion carries a number of drawbacks, particularly at the level of adjacent segments. However, the documented follow-up of non-fusion spine surgery is at present insufficient to consider a widespread use of these new technologies. Their own possible complications are largely unknown and they do not replace bone fusion in the most clear-cut accepted indications for spine surgery. The use of disk prostheses should therefore be strictly limited according to present knowledge.

  9. Topological design and additive manufacturing of porous metals for bone scaffolds and orthopaedic implants: A review. (United States)

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


    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.

  10. 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)


    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)

  11. Electromagnetic induction heating of an orthopaedic nickel--titanium shape memory device. (United States)

    Müller, Christian W; Pfeifer, Ronny; El-Kashef, Tarek; Hurschler, Christof; Herzog, Dirk; Oszwald, Markus; Haasper, Carl; Krettek, Christian; Gösling, Thomas


    Shape memory orthopaedic implants made from nickel-titanium (NiTi) might allow the modulation of fracture healing, changing their cross-sectional shape by employing the shape memory effect. We aimed to show the feasibility and safety of contact-free electromagnetic induction heating of NiTi implants in a rat model. A water-cooled generator-oscillator combination was used. Induction characteristics were determined by measuring the temperature increase of a test sample in correlation to generator power and time. In 53 rats, NiTi implants were introduced into the right hind leg. The animals were transferred to the inductor, and the implant was electromagnetically heated to temperatures between 40 and 60°C. Blood samples were drawn before and 4 h after the procedure. IL-1, IL-4, IL-10, TNF-α, and IFN-γ were measured. Animals were euthanized at 3 weeks. Histological specimens from the hind leg and liver were retrieved and examined for inflammatory changes, necrosis, and corrosion pits. Cytokine measurements and histological specimens showed no significant differences among the groups. We concluded that electromagnetic induction heating of orthopedic NiTi implants is feasible and safe in a rat model. This is the first step in the development of new orthopedic implants in which stiffness or rigidity can be modified after implantation to optimize bone-healing.

  12. Outlier analysis in orthopaedics: use of CUSUM: the Scottish Arthroplasty Project: shouldering the burden of improvement. (United States)

    Macpherson, Gavin J; Brenkel, Ivan J; Smith, Rik; Howie, Colin R


    National joint registries have become well established across the world. Most registries track implant survival so that poorly performing implants can be removed from the market. The Scottish Arthroplasty Project was established in 1999 with the aim of encouraging continual improvement in the quality of care provided to joint replacement patients in Scotland. This aim has been achieved by using statistics to engage surgeons in the process of audit. We monitor easily identifiable end points of public concern and inform surgeons if they breach our statistical limits and become "outliers." Outlier status is often associated with poor implants, and our methods are therefore applicable for indirect implant surveillance. The present report describes the evolution of our statistical methodology, the processes that we use to promote positive changes in practice, and the improvements in patient outcomes that we have achieved. Failure need not be fatal, but failure to change almost always is. We describe the journey of both the Scottish Arthroplasty Project and the orthopaedic surgeons of Scotland to this realization.

  13. The effect of strain hardening on resistance to electrochemical corrosion of wires for orthopaedics (United States)

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


    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.

  14. Orthopaedic Application Of Spatio Temporal Analysis Of Body Form And Function (United States)

    Tauber, C.; Au, J.; Bernstein, S.; Grant, A.; Pugh, J.


    Spatial and temporal analysis of walking provides the orthopaedist with objective evidence of functional ability and improvement in a patient. Patients with orthopaedic problems experiencing extreme pain and, consequently, irregularities in joint motions on weightbearing are videorecorded before, during and after a course of rehabilitative treatment and/or surgical correction of their disability. A specially-programmed computer analyzes these tapes for the parameters of walking by locating reflective spots which indicate the centers of the lower limb joints. The following parameters of gait are then generated: dynamic hip, knee and foot angles at various intervals during walking; vertical, horizontal and lateral displacements of each joint at various time intervals; linear and angular velocities of each joint; and the relationships between the joints during various phases of the gait cycle. The systematic sampling and analysis of the videorecordings by computer enable such information to be converted into and presented as computer graphics, as well as organized into tables of gait variables. This format of presentation of the skeletal adjustments involved in normal human motion provides the clinician with a visual format of gait information which objectively illuminates the multifaceted and complex factors involved. This system provides the clinician a method by which to evaluate the success of the regimen in terms of patient comfort and function.

  15. Orthopaedic metal devices coated with a novel antiseptic dye for the prevention of bacterial infections. (United States)

    Bahna, Paul; Dvorak, Tanya; Hanna, Hend; Yasko, Alan W; Hachem, Ray; Raad, Issam


    Gendine is a novel antiseptic dye with broad-spectrum antimicrobial activity that may be used to coat plastics and metal devices. Our objective was to determine the efficacy of gendine-coated orthopaedic metal devices in preventing methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Stainless steel and titanium Schanz rods were coated with gendine. The zone of inhibition (ZoI) around the rods with and without gamma-irradiation was determined by a modified Kirby-Bauer method. A previously published bioprosthetic biofilm colonisation model, modified Kuhn's method, was used to determine the adherence of MRSA to coated and uncoated rods, with and without irradiation, after insertion into bovine bone and after 3 months shelf life followed by 2 weeks of immersion in serum. The gendine-coated Schanz metal rods showed a net ZoI of 16 mm against MRSA before and after irradiation. Gendine-coated rods showed no biofilm formation (0 colony-forming units (CFU)), which was a significant reduction (P5000 CFU). Coated rods exposed to high-dose gamma-irradiation and coated rods drilled into bone also showed significant efficacy (P<0.001) in preventing biofilm adherence. After 2 weeks, gendine-coated rods maintained significant durability (P<0.01), resulting in 90% reduction in MRSA biofilm adherence compared with uncoated control rods. Results indicate that gendine-coated metal rods are highly efficacious in the prevention of MRSA biofilm.

  16. In vitro tests of substitute lubricants for wear testing orthopaedic biomaterials. (United States)

    Scholes, Susan C; Joyce, Thomas J


    Bovine serum is the lubricant recommended by several international standards for the wear testing of orthopaedic biomaterials; however, there are issues over its use due to batch variation, degradation, cost and safety. For these reasons, alternative lubricants were investigated. A 50-station Super-CTPOD (circularly translating pin-on-disc) wear test rig was used, which applied multidirectional motion to ultra-high-molecular-weight polyethylene test pins rubbing against cobalt chromium discs. Thirteen possible alternative lubricants were tested. The use of soy protein as a lubricant gave statistically higher wear, while soya oil, olive oil, Channel Island milk, whole milk, whey, wheatgerm oil, 11 mg/mL egg white, albumin/globulin mix and albumin/globulin/chondroitin sulphate mix all gave statistically lower wear than bovine serum. The lubricants giving the closest wear results to bovine serum were 20 and 40 mg/mL egg white solutions. A light absorbance assay found that these egg white solutions suffered from a high degradation rate that increased with increasing protein content. While egg white solutions offer the best alternative lubricant to bovine serum due to the wear volumes produced, cost-effectiveness and safety of handling, protein degradation will still occur, leading to the need for regular lubricant replacement. Of the lubricants tested in this study, none were found to be superior to bovine serum.

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

    Directory of Open Access Journals (Sweden)

    Yoshida Hiroaki


    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.

  18. 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


    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.

  19. Multilateral Aid | L’aide multilatérale

    Directory of Open Access Journals (Sweden)


    Full Text Available Bilateral and Multilateral Aid, DAC Members, 1960–2010 (in million USD constant, 2009Aide bilatérale et multilatérale des pays membres du CAD, 1960-2010 (en millions USD constants de 2009­Bilateral and Multilateral Aid by Recipient Region, DAC Members, 2008 (in percentage of total aid by RegionAide bilatérale et multilatérale des pays membres du CAD par region de destination, 2008 (en pourcentage de l’aide totale par régionSources: OECD (2010 2010 DAC Report on Multilateral Aid (Paris: O...

  20. Fe-Mo-B Enhanced Sintering of P/M 316L Stainless Steel

    Institute of Scientific and Technical Information of China (English)

    YANG Xia; GUO Shi-ju


    Liquid-phase enhanced sintering of powder metallurgy (P/M) 316L stainless steel by addition of sintering aids was studied. 2%-8% of pre-alloyed Fe-Mo-B powder with two different particle sizes was added as sintering aids, and the specimens were sintered in vacuum at 1 200-1 350 ℃. The results show that the fine Fe-Mo-B powder (5-10 μm) has stronger activated effect. The sintered density increases with the increase in sintering aid content or sintering temperature. Warm compaction has a better effect on the control of dimensional precision of compacts. The prealloyed Fe-Mo-B powder deviated from Mo2FeB2 component can also be sintering aid of P/M 316L stainless steel.

  1. Control of crystalline phases in magnetic Fe nanoparticles inserted inside a matrix of porous carbon

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, M.P., E-mail: fernandezpaz.uo@uniovi.e [Dpto. de Fisica, Universidad de Oviedo, Calvo Sotelo, s/n, 33007 Oviedo (Spain); Schmool, D.S. [IN-IFIMUP, Universidade do Porto, Rua do Campo Alegre 687, 4169-007 Porto (Portugal); Dpto. de Fisica, Universidade do Porto, Rua do Campo Alegre 687, 4440-661 Porto (Portugal); Silva, A.S. [Dpto. de Fisica, Universidade do Porto, Rua do Campo Alegre 687, 4440-661 Porto (Portugal); Sevilla, M.; Fuertes, A.B. [Instituto Nacional del Carbon (CSIC), Apartado 73, 33080 Oviedo (Spain); Gorria, P.; Blanco, J.A. [Dpto. de Fisica, Universidad de Oviedo, Calvo Sotelo, s/n, 33007 Oviedo (Spain)


    Two magnetic composites made up of Fe nanoparticles (Fe-NPs) embedded in a porous amorphous carbon matrix are presented. One of the samples, Fe-S-AC, was obtained with the aid of sucrose and the other, Fe-AC, in the absence of this substance. The XRD patterns show Bragg diffraction peaks associated with alpha-Fe and gamma-Fe crystalline phases in the Fe-AC sample, while only peaks corresponding to the alpha-Fe phase are observed for Fe-S-AC powders. The Fe-NPs exhibit broad particle-size distributions for both samples, 5-50 nm for Fe-AC, whereas two populations (2-8 and 10-70 nm) for the Fe-S-AC composite are found. This fact gives rise to poorly defined blocking temperatures, as it can be deduced from the broad maxima observed in M{sub ZFC}(T) variations. In addition, M(H) curves for both Fe-AC and Fe-S-AC samples reveal the existence of exchange-bias effect for T<60 K, probably due to a magnetic coupling within a core/shell structure of the Fe-NPs, although this effect was observed to be less significant for Fe-S-AC.

  2. Women and AIDS: introduction. (United States)

    Krieger, N; Margo, G


    Around the world, more and more women--principally poor women of color--are being diagnosed with and are dying of AIDS, the acquired immune deficiency syndrome. Yet, effective and appropriate prevention programs for women are sorely missing from the global program to control AIDS. To help us understand why this gap exists, and what we must do to close it, the three articles in this issue focus on women and AIDS. Examining the situation in such countries as Zimbabwe and South Africa, as well as in other economically underdeveloped and developed regions, the authors argue that women with the least control over their bodies and their lives are at greatest risk of acquiring AIDS. For example, the high rate of infection among women in Africa cannot be understood apart from the legacy of colonialism (including land expropriation and the forced introduction of a migrant labor system) and the insidious combination of traditional and European patriarchal values. Only by recognizing the socioeconomic and cultural determinants of both disease and sexual behavior, and only by incorporating these insights into our AIDS prevention programs, will we be able to curb the spread of this lethal disease.

  3. AIDS in Africa. (United States)

    Mokhobo, D


    Numerous cultural practices and attitudes in Africa represent formidable obstacles to the prevention of the further spread of acquired immunodeficiency syndrome (AIDS). Polygamy and concubinage are still widely practiced throughout Africa. In fact, sexual promiscuity on the part of males is traditionally viewed as positive--a reflection of male supremacy and male sexual prowess. The disintegration of the rural African family, brought about by urbanization, the migrant labor system, and poverty, has resulted in widespread premarital promiscuity. Contraceptive practices are perceived by many as a white conspiracy aimed at limiting the growth of the black population and thereby diminishing its political power. Condom use is particularly in disfavor. Thus, AIDS prevention campaigns urging Africans to restrict the number of sexual partners and to use condoms are unlikely to be successful. Another problem is that most Africans cannot believe that AIDS is sexually linked in that the disease does not affect the sex organs as is the case with other sexually transmitted diseases. The degree to which African governments are able to allocate resources to AIDS education will determine whether the epidemic can be controlled. Even with a massive outpouring of resources, it may be difficult to arouse public alarm about AIDS since Africans are so acclimated to living with calamities of every kind.


    Institute of Scientific and Technical Information of China (English)


    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.

  5. AIDS in Colombia. (United States)

    Boshell, J; Gacharná, M G; García, M; Jaramillo, L S; Márquez, G; Fergusson, M M; González, S; Prada, E Y; de Rangel, R; de Cabas, R


    Between January 1984 and December 1987 a total of 178 AIDS cases were reported to the Colombian Ministry of Health. The location of these cases suggests that the human immunodeficiency virus (HIV) is widely distributed in Colombia. Most of those afflicted (97%) have been adult males. HIV seroprevalence studies of selected population groups revealed the highest antibody prevalence (5.65% in females, 22.5% in males) among individuals involved in high-risk behaviors who participated in a free AIDS testing program. High prevalences (from 0.6% to 3.9% in females, and 14.6% to 15.9% in males) were also found in patients (primarily female prostitutes and male homosexuals) attending clinics for sexually transmitted diseases in several urban areas. The number of AIDS cases in Colombia has doubled or tripled annually since reporting began in 1984, a pattern similar to that observed worldwide.

  6. [AIDS mortality in France]. (United States)

    Hatton, F; Maguin, P; Nicaud, V; Renaud, G


    A study about mortality by AIDS had been undertaken since July 1st 1983, in the Service of Information on Medical causes of Death (INSERM SC8), which is in charge of developing mortality statistics in France. From July 1st 1983 to September 30th 1985, 243 deaths due to AIDS were recorded. Only the cases where this diagnosis was clearly mentioned were selected; more than 90% were notified by hospitals and mainly by highly specialized services. The number of deaths, which was low and varied rather irregularly at the beginning, then increased by successive stages. The first year, during which a tenth of deaths was recorded every three months, was followed by a great increase, doubling, then tripling the initial numbers. Lastly, a second and sudden rise occurred during the third trimester of 1985, the trimestrial number of deaths due to AIDS reaching 80.

  7. 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


    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

  8. 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 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...


    Directory of Open Access Journals (Sweden)



    Full Text Available ABSTRACT: INTRODUCTION: Bone infections after implant surgery leading to non union and implant failure is one of the most challenging Ortho paedic complications. This study is done to find out relation of type of pathogens causing postope rative infection with that of fracture nonunion, chronic osteomylities and implant failure. METHODOLOGY: This is a retrograde study of 20 cases, in which post operative wound infe ction occurred after implant surgery from 2009 to 2012. Results: Out of 20 postoperative infect ed cases, 12 were infected by S ’ \\aureus, 2 by pseudomonas and 1 from E-coli. 5 cases had their culture sterile. Out of 12 cases infected by S. aureus 7 developed infected non union in which 4 had serious infection also leading to chronic osteomylities.5 cases of S aureus infection got cured after implant removal following union. CONCLUSION: Most of the postoperative wound infections are cause d by S. aureus. 2-.S. aureus is the commonest organism isolated from infe cted non-union. Majority have early onset of infection. 3-Early culture positive infection (w ithin seven days after surgery have poor out come.4- In our setup S Aurous strain is sensitive t o linezolid, clindamycin and vancomycin. 5- The use of ceftriaxone for preoperative surgical pro phylaxis in orthopaedic implant surgery is questionable.6- The ideal strategy for S. aureus in fected implant is lacking. By surgical debridement, culture sensitivity specific antibiotic for 6 to 8 week and retention of implant, union were not achieved in majority of cases. 7-New approach is required for prevention and management of postoperative S. aureus infected implan t

  10. Does video gaming affect orthopaedic skills acquisition? A prospective cohort-study.

    Directory of Open Access Journals (Sweden)

    Chetan Khatri

    Full Text Available Previous studies have suggested that there is a positive correlation between the extent of video gaming and efficiency of surgical skill acquisition on laparoscopic and endovascular surgical simulators amongst trainees. However, the link between video gaming and orthopaedic trauma simulation remains unexamined, in particular dynamic hip screw (DHS stimulation.To assess effect of prior video gaming experience on virtual-reality (VR haptic-enabled DHS simulator performance.38 medical students, naïve to VR surgical simulation, were recruited and stratified relative to their video gaming exposure. Group 1 (n = 19, video-gamers were defined as those who play more than one hour per day in the last calendar year. Group 2 (n = 19, non-gamers were defined as those who play video games less than one hour per calendar year. Both cohorts performed five attempts on completing a VR DHS procedure and repeated the task after a week. Metrics assessed included time taken for task, simulated flouroscopy time and screw position. Median and Bonett-Price 95% confidence intervals were calculated for seven real-time objective performance metrics. Data was confirmed as non-parametric by the Kolmogorov-Smirnov test. Analysis was performed using the Mann-Whitney U test for independent data whilst the Wilcoxon signed ranked test was used for paired data. A result was deemed significant when a two-tailed p-value was less than 0.05.All 38 subjects completed the study. The groups were not significantly different at baseline. After ten attempts, there was no difference between Group 1 and Group 2 in any of the metrics tested. These included time taken for task, simulated fluoroscopy time, number of retries, tip-apex distance, percentage cut-out and global score.Contrary to previous literature findings, there was no correlation between video gaming experience and gaining competency on a VR DHS simulator.

  11. 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.

  12. Socio-economic outcome after blunt orthopaedic trauma: Implications on injury prevention

    Directory of Open Access Journals (Sweden)

    Zilkens Anna


    Full Text Available Abstract Background Several large studies have identified factors associated with long-term outcome after orthopaedic injuries. However, long-term social and economic implications have not been published so far. The aim of this investigation is to study the long-term socio-economic consequences of patients sustaining severe trauma. Methods Patients treated at a level one trauma center were invited for a follow-up (at least 10 years examination. There were 637 patients who responded and were examined. Inclusion criteria included injury severity score (ISS ≥ 16 points, presence of lower and upper extremity fractures, and age between 3 and 60 years. Exclusion criteria included the presence of amputations and paraplegia. The socio-economic outcome was evaluated in three age groups: group I ( 50 years. The following parameters were analyzed using a standardized questionnaire: financial losses, net income losses, pension precaution losses, need for a bank loan, and the decrease in number of friends. Results 510 patients matched all study criteria, and breakdown of groups were as follows: 140 patients in group I, 341 patients in group II, and 29 patients in group III. Financial losses were reported in all age groups (20%-44%. Younger patients (group I were associated with less income losses when compared with other groups (p Conclusions Economic consequences are reported by polytraumatized patients even ten or more years after injury. Financial losses appear to be common in patients between 19 and 50 years. In contrast, social deprivation appears to be most pronounced in the younger age groups. Early socio-economic support and measures of injury prevention should focus on these specific age groups.

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

    Directory of Open Access Journals (Sweden)

    Vikas Trehan


    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.

  14. Education and Indigenous Knowledge in Africa: Traditional Bonesetting and Orthopaedic Medicine in West Africa (United States)

    Ezeanya, Chika A.

    The underlying philosophy of education in contemporary Africa has been established to be alien, and detached from the indigenous knowledge of the people. Modern day formal education in sub-Saharan Africa came about, for the most part, as a result of missionary activities and colonial efforts of Europe. The education bequeathed to Africa was, therefore, fundamentally European in paradigm and lacking in authenticity. The end of colonialism across sub-Saharan Africa did not herald any tangible transformation in the curriculum of study. Education in Africa is still dependent on foreign input for sustainability, thereby stifling research, creativity and innovation. Sustainable development is founded on indigenous knowledge. When such grassroots knowledge assumes the foundation of learning, home-grown development is easily fostered in all sectors of a national economy. In the field of medicine, indigenous knowledge of healing has been considered unscientific by western biomedical practitioners. Since the days of the missionaries, many Africans have considered indigenous medicine to be fetish; the Christian converts would not be associated with its practice and patronage. However, traditional bonesetting has been proven to be highly efficacious with little supernatural content, it continues to attract huge patronage from Africans, cutting across social and religious boundaries. This study attempts an exploration of the disconnect between indigenous knowledge, practices and learning, on the one hand, and formal education in Africa, on the other. With a focus on traditional bonesetting, the study seeks to determine why that branch of indigenous medicine attracts huge patronage, but is granted very little recognition by modern orthopaedic medical education.

  15. Importance of patient-centred signage and navigation guide in an orthopaedic and plastics clinic. (United States)

    Maqbool, Talha; Raju, Sneha; In, Eunji


    Gulshan & Nanji Orthopaedic and Plastics Center at the North York General Hospital is the second busiest site after the emergency department serving more than 26,000 patients annually. Increase in patient flow, overworked staff, and recent renovations to the hospital have resulted in patients experiencing long wait times, and thusly patient dissatisfaction and stress. Several factors contribute to patient dissatisfaction and stress: i) poor and unfriendly signage; ii) inconsistent utilization of the numbering system; and iii) difficulty navigating to and from the imaging center. A multidisciplinary QI team was assembled to improve the patient experience. We developed a questionnaire to assess patient stress levels at the baseline. Overall, more than half of the patients (54.8%) strongly agreed or agreed to having a stressful waiting experience. Subsequently, based on patient feedback and staff perspectives, we implemented two PDSA cycles. For PDSA 1, we placed a floor graphic (i.e. black tape) to assist patients in navigating from the clinic to the imaging centre and back. For PDSA 2, we involved creating a single 21"×32" patient-friendly sign at the entrance to welcome patients, with clear instructions outlining registration procedures. Surveys were re-administered to assess patient stress levels. A combination of both interventions caused a statistically significant reduction in patient stress levels based on the Kruskal-Wallis and Mann-Whitney U Tests. The present project highlighted the importance of involving stakeholders as well as frontline staff when undertaking quality improvement projects as a way to identify bottlenecks as well as establish sustainable solutions. Additionally, the team recognized the importance of incorporating empirical based solutions and involving experts in the field to optimize results. The present project successfully implemented strategies to improve patient satisfaction and reduce stress in a high flow community clinic. These

  16. Comparison of medetomidine and dexmedetomidine as premedication in isoflurane anaesthesia for orthopaedic surgery in domestic sheep. (United States)

    Kästner, S B; Von Rechenberg, B; Keller, K; Bettschart-Wolfensberger, R


    The objective of the present study was to determine the potency of dexmedetomidine in relation to medetomidine in sheep undergoing orthopaedic surgery by comparing the anaesthetic requirements and cardiovascular changes at a dose relationship that represented equipotency in vitro. Twenty-four non-pregnant, female sheep were used. The study was carried out as a blind, randomized, experimental trial. Group 1 received 5 micrograms/kg bodyweight (BW) dexmedetomidine and group 2 received 10 micrograms/kg BW medetomidine intravenously 5 min prior to induction of anaesthesia. Anaesthesia was induced with ketamine (2.0 mg/kg BW intravenously) and maintained with isoflurane in 100% oxygen. End expired anaesthetic concentration (FEIso), end expired carbon dioxide concentration (FECO2), respiratory frequency (fR), direct arterial blood pressures, heart rates (HR) and arterial blood gases were monitored. Data were averaged over time and tested for differences between groups by independent t-tests, and analysis of variance for repeated measures. Average FEIso concentrations required to maintain a surgical plane of anaesthesia were not different between groups (1: 1.02 +/- 0.04%; 2: 0.99 +/- 0.07%). There was no difference in HR, arterial blood pressures, fR, FECO2 and arterial blood gases between groups. Average mean PaO2 were 279.54 +/- 113.37 mmHg and 220.21 +/- 102.15 mmHg with individual minimum values of 27.2 mmHg and 58.5 mmHg in groups 1 and 2, respectively. In conclusion, intravenous dexmedetomidine at 5 micrograms/kg BW and medetomidine at 10 micrograms/kg BW have the same effects on isoflurane requirements and cardiopulmonary parameters in sheep, indicating an equipotent dose relationship. Both preparations induced moderate to severe hypoxaemia in individual sheep.

  17. Efficacy of epidural administration of morphine with bupivacaine for orthopaedic surgery in sheep

    Directory of Open Access Journals (Sweden)

    Durej M.


    Full Text Available The aim of the study was to test the hypothesis that epidural administration of morphine with bupivacaine provides more intense and sufficient perioperative analgesia compared with parenterally administrated butorphanol during orthopaedic surgery. Sheep were assigned to group C (control group, 6 sheep and group E (epidural, 5 sheep. Sheep from group C were pre-medicated with midazolam (0.3 mg/kg, i.m. and butorphanol (0.2 mg/kg, i.m.. Propofol was used for induction of general anesthesia in both groups. Sheep from group E were pre-medicated with midazolam, but without butorphanol. Sacrococcegeal epidural analgesia with morphine (0.1 mg/kg and bupivacaine (1 mg/kg was performed. We detected a significant increase in heart rate (19%, p=0.021 during surgery in group C. Two hours after surgery, the heart rate was 14.9% lower than prior to surgery in group E (p=0.017. In group E, throughout the surgery, we measured an insignificant increase in respiratory rate of 1.99%. In the same group, 120 minutes post surgery, we measured an increase in respiratory rate of 14.7%, while in group C there was a smaller increase of only 10.9%. The result from both groups was insignificant (p>0.05. The consumption of isoflurane in group C was higher than in group E by 27.3% (p=0.0043. The mean MAC was in group C higher by 27.6% as it was in group E (0.75% ± 0.25, 0.95 ± 0.3 in Group E and C, respectively. This distinction, according to the Mann-Whitney test, was not significant (p=0.329.

  18. 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


    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.

  19. Fe distribution in GaSe and InSe

    Energy Technology Data Exchange (ETDEWEB)

    Kovalyuk, Z.D.; Feichuk, P.I.; Shcherbak, L.P.; Zbykovskaya, N.I.


    In this paper, the authors use tagged atoms to determine the effective coefficients of Fe distribution in GaSe and InSe during crystallization of a doped melt by the Bridgman method. The distribution of Fe in GaSe and InSe was studied with the aid of Fe tagged with the radiosotopes VVFe + VZFe. Doping of the material was combined with the processes of synthesis and crystallization. Equations are presented for the calculation of the real impurity distribution in GaSe and InSe crystals.

  20. Studying Aid: Some Methods

    NARCIS (Netherlands)

    D.R. Gasper (Des)


    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

  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. Parent Hearing Aid Experiences (United States)

    Munoz, Karen; Roberts, Mallory; Mullings, Day; Harward, Richard


    This study addresses parent experiences in obtaining and managing hearing aids for their young child. The purpose was to identify challenges parents encounter to determine what state agencies can do to improve parent access to amplification. Data were collected July through September of 2010; 40 parents of children ages birth to 3 years old…

  3. Hearing Aid Personalization

    DEFF Research Database (Denmark)

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


    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...

  4. Computer Aided Lecturing. (United States)

    Van Meter, Donald E.


    Surveyed students taking a natural resource conservation course to determine the effects of computer software that provides tools for creating and managing visual presentations to students. Results indicated that 94% of the respondents believed computer-aided lectures helped them and recommended their continued use; note taking was more effective,…

  5. AIDS and associated malignancies

    Institute of Scientific and Technical Information of China (English)

    Charles WOOD; William HARRINGTON Jr


    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.

  6. [Post-transfusional AIDS]. (United States)

    Azzini, M; Maccabruni, A; Marcellini, M; Michelone, G; Dei Cas, A


    Two cases of post-transfusional AIDS in two premature babies who received blood of the same seropositive donor, are reported. The risk of the susceptibility to HIV infection of these patients, in relation to the immaturity of immune system and to the transfusional treatment often necessary in premature newborns, is stressed.

  7. The CASPAR finding aids


    Meghini, Carlo; Avancini, Henry; Versienti, Loredana


    One of the CASPAR key components is the FIND Components, which is implementing the Finding Aids of OAIS. According to OAIS, FIND manages Description Information that is associated to Information Packages in order to support the discovery of those Packages. FIND allows defining, creating, persisting, querying, browsing, and accessing both Description Information and the association between Information Packages and Description Information

  8. Coil Welding Aid (United States)

    Wiesenbach, W. T.; Clark, M. C.


    Positioner holds coil inside cylinder during tack welding. Welding aid spaces turns of coil inside cylinder and applies contact pressure while coil is tack-welded to cylinder. Device facilitates fabrication of heat exchangers and other structures by eliminating hand-positioning and clamping of individual coil turns.

  9. Enteric parasites and AIDS

    Directory of Open Access Journals (Sweden)

    Sérgio Cimerman


    Full Text Available OBJECTIVE: To report on the importance of intestinal parasites in patients with AIDS, showing relevant data in the medical literature, with special emphasis on epidemiology, diagnosis and treatment of enteroparasitosis, especially cryptosporidiasis, isosporiasis, microsporidiasis and strongyloidiasis. DESIGN: Narrative review.


    Directory of Open Access Journals (Sweden)

    Amit Kumar


    Full Text Available AIM This study carried out in Department of Orthopaedics, S.S. Medical College and Sanjay Gandhi Memorial Hospital, Rewa, MP to study the orthopaedic injury caused by road traffic accidents and factors responsible for these injuries. BACKGROUND Road traffic accidents are one of the major causes of death in developed as well as developing countries. India accounts for about 10% of road accident fatalities worldwide and more deaths are recorded due to traffic crashes than due to cardiovascular diseases or neoplasms. METHODS The present study was carried out on the patients injured due to road traffic injuries admitted in orthopaedic ward of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP, during the one-year period from 1st October 2014 to 30th September 2015. The collected data was classified and coded as per the guidelines laid down under the WHO/CDC Injury Surveillance System and ICECI. RESULTS This study showed that the majority of crash victims were males in the age group 20-44 years accounting for huge economic losses for their families and the country at large. Motorized two-wheeler accounted for 46.78% of the accidents. Out of total accident victims, 45% were drivers and riders; 49.47% of accidents occurred between 4 pm to 12 pm. Most drivers/riders mentioned had not taken safety measure (Helmet/seat belt during accident. Fractures (87.97% were the most common nature of injuries and lower limb was more commonly involved than the upper limb. CONCLUSION Road traffic accidents are preventable. Strict traffic laws and penalties have to be imposed to curb this ever growing menace.

  11. Screening for AIDS. (United States)


    Tests to detect serum antibody to human T-lymphotropic virus type III (HTLV-III), based on an enzyme-linked immunosorbent assay (ELISA) that uses whole disrupted HTLV-III virus antigens, are now commercially available in the US. Recent surveys of groups at high risk for acquired immunodeficiency syndrome (AIDS) have found that 22-65% of homosexual men, 87% of active intravenous drug users, 56-72% of hemophiliacs, and 35% of women who were sexual partners of men with AIDS have had postitive ELISA tests compared with fewer than 1% of those with no known risk factors. A positive ELISA test could be due to subclinical infection, immunity, or cross-reactivity with other viral antigens. Laboratory error can also produce false positive results. Thus, it is recommended that the ELISA test be repeated at least once on all seropositive specimens before the result is reported to the patient. The western blot test appears to be more specific and less sensitive than the ELISA. Studies of asymptomatic seropositive homosexual men followed for 2-5 years have found that over 50% remain asymptomatic, 5-19% develop full blown AIDS, and 25% develop signs suggestive of the AIDS-related complex. Asymptomatic patients with positive ELISA tests should be made aware of early signs and symptoms of AIDS. Other data suggest that seropositive patients have the HTLV-III virus in their blood, semen, and/or saliva and can transmit the infection. Precautions to prevent transmission, such as the use of condoms, should be taken by such patients. Physicians should be sensitive to the fear and anxiety that a positive ELISA test will create.

  12. Orthopaedic Surgeons as Clinical Leaders in the National Health Service, United Kingdom (NHS UK): Can the World Learn From Us? (United States)

    Javed, Mustafa; Moulder, Elizabeth; Mohsen, Amr


    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.

  13. Henan Surveys Blood Donors to Aid AIDS Prevention

    Institute of Scientific and Technical Information of China (English)


    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.

  14. Perceptions of Aid and Actual Aid in Intergenerational Caregiving. (United States)

    Walker, Alexis J.; And Others


    Compared pairs (n=174) of elderly mothers' and their caregiving daughters' perceptions of aid given to the mothers with actual caregiving activities. Results indicated nearly half of the mothers and daughters were accurate in their perceptions of aid given to the mothers; when mothers' perception of aid was inaccurate, mothers overestimated rather…

  15. What Is HIV/AIDS? (United States)

    ... AIDS? Subscribe Translate Text Size Print What Is HIV/AIDS? Human Immunodeficiency Virus (HIV) HIV stands for human immunodeficiency virus. If left ... need medical treatment to prevent death. Where DId HIV Come From? Scientists identified a type of chimpanzee ...

  16. HIV / AIDS: An Unequal Burden (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- ...

  17. Does Corruption Cause Aid Fatigue?

    DEFF Research Database (Denmark)

    Bauhr, Monika; Charron, Nicholas; Nasiritousi, Naghmeh


    Does perceived corruption in recipient countries reduce support for foreign aid in donor countries? This under-explored yet salient question is examined using the 2009 Eurobarometer survey for the 27 EU countries. We suggest that perceived corruption can cause aid fatigue but that this relationship...... is highly contextualized. The results show that perceptions about corruption in developing countries reduce overall support for aid among respondents in donor countries. However, this effect is mitigated by country and contextual-level effects and different understandings of what we call the “aid-corruption...... paradox,” namely that the need for foreign aid is often the greatest in corrupt environments. Three different dynamics of the aid-corruption paradox influence support for aid: moral, pragmatic, and strategic understandings. In EU-15 countries, the effect of perceived corruption in recipient states on aid...

  18. Computer-assisted orthopaedic surgery and robotic surgery in total hip arthroplasty. (United States)

    Sugano, Nobuhiko


    Various systems of computer-assisted orthopaedic surgery (CAOS) in total hip arthroplasty (THA) were reviewed. The first clinically applied system was an active robotic system (ROBODOC), which performed femoral implant cavity preparation as programmed preoperatively. Several reports on cementless THA with ROBODOC showed better stem alignment and less variance in limb-length inequality on radiographic evaluation, less incidence of pulmonary embolic events on transesophageal cardioechogram, and less stress shielding on the dual energy X-ray absorptiometry analysis than conventional manual methods. On the other hand, some studies raise issues with active systems, including a steep learning curve, muscle and nerve damage, and technical complications, such as a procedure stop due to a bone motion during cutting, requiring re-registration and registration failure. Semi-active robotic systems, such as Acrobot and Rio, were developed for ease of surgeon acceptance. The drill bit at the tip of the robotic arm is moved by a surgeon's hand, but it does not move outside of a milling path boundary, which is defined according to three-dimensional (3D) image-based preoperative planning. However, there are still few reports on THA with these semi-active systems. Thanks to the advancements in 3D sensor technology, navigation systems were developed. Navigation is a passive system, which does not perform any actions on patients. It only provides information and guidance to the surgeon who still uses conventional tools to perform the surgery. There are three types of navigation: computed tomography (CT)-based navigation, imageless navigation, and fluoro-navigation. CT-based navigation is the most accurate, but the preoperative planning on CT images takes time that increases cost and radiation exposure. Imageless navigation does not use CT images, but its accuracy depends on the technique of landmark pointing, and it does not take into account the individual uniqueness of the anatomy

  19. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth

    Directory of Open Access Journals (Sweden)

    Negrini Stefano


    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

  20. Welded-woven fabrics for use as synthetic, minimally invasive orthopaedic implants (United States)

    Rodts, Timothy W.

    The treatment of osteoarthritis in healthcare today focuses on minimizing pain and retaining mobility. Osteoarthritis of the knee is a common disease and known to be associated with traumatic injuries, among other factors. An identified trend is that patients are younger and have expectations of life with the preservation of an active lifestyle. As a result, great strain is placed on the available offerings of healthcare professionals and device manufacturers alike. This results in numerous design challenges for managing pain and disease over an extended period of time. The available treatments are being extended into younger populations, which increasingly suffer traumatic knee injuries. However, these patients are not good candidates for total joint replacement. A common problem for young patients is localized cartilage damage. This can heal, but often results in a painful condition that requires intervention. A welded-woven three-dimensional polymer fabric was developed to mimic the properties of articular cartilage. A process for the laser welding reinforcement of the surface layers of three-dimensional fabrics was investigated. Confined compression creep and pin-on-disc wear studies were conducted to characterize the contribution of the surface welding reinforcement. All materials used in the studies have previously been used in orthopaedic devices or meet the requirements for United States Pharmacopeial Convention (USP) Class VI biocompatibility approval. The compressive behavior of three-dimensional fabrics was tailored by the inclusion of surface welds. The compressive properties of the welded-woven fabrics were shown to better approximate articular cartilage compressive properties than conventional woven materials. The wear performance was benchmarked against identical fabrics without welding reinforcement. The wear rates were significantly reduced and the lifespan of the fabrics was markedly improved due to surface welding. Welding reinforcement offers a

  1. How Do People Get AIDS? (United States)

    ... of Healthy Breakfasts Shyness How Do People Get AIDS? KidsHealth > For Teens > How Do People Get AIDS? A A A en español ¿Cómo contrae alguien el SIDA? AIDS stands for acquired immunodeficiency syndrome , a disease that ...

  2. Cerebral toxoplasmosis in AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Christ, F.; Steudel, H.; Klotz, D.


    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.

  3. Mutual aid fund commission

    CERN Multimedia

    Staff Association


    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.

  4. Mycobacterial Infections in AIDS

    Directory of Open Access Journals (Sweden)

    A Ross Hill


    Full Text Available Tuberculosis (TB remains uniquely important among acquired immune deficiency syndrome (AIDS-associated opportunistic infections: it presents the greatest public health hazard worldwide, is the most readily curable, and is largely preventable with existing means. Given the expanding pool of human immunodeficiency virus (HIV seropositive persons, particularly in developing nations where Mycobacterium tuberculosis remains a leading health problem, one can expect a continued rise in TB cases during the 1990s. Global efforts to eliminate TB are now inextricably entwined with the effectiveness of measures to curtail the HIV epidemic. Mycobacterium avium complex infection, currently an intractable late complication of aids, may increase in clinical importance as success in managing other opportunistic infections and HIV disease itself improves. Understanding of the pathogenesis and management of mycobacterial diseases should increase rapidly given the renewed research spurred on by the advent of HIV.

  5. 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


    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.

  6. Computer aided manipulator control (United States)

    Bejczy, A. K.; Zawacki, R. L.


    This paper describes the hardware and software system of a dedicated mini- and microcomputer network developed at the JPL teleoperator project to aid the operator in real-time control of remote manipulators. The operator can be in series or in parallel with the control computer during operation. The purpose of the project is to develop, demonstrate and evaluate advanced supervisory control concepts and techniques for space applications. The paper concludes with a brief outline of future development plans and issues.

  7. Computer aided product design

    DEFF Research Database (Denmark)

    Constantinou, Leonidas; Bagherpour, Khosrow; Gani, Rafiqul


    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....

  8. Nutritional anemia and AIDS


    Ruíz, Óscar; Instituto de Investigaciones Clínicas, UNMSM; Díaz, David; Instituto de Investigaciones Clínicas, Facultad de Medicina, UNMSM, y Hospital Nacional Dos de Mayo; Castillo, Óscar; Instituto de Investigaciones Clínicas, UNMSM; Reyes, Rafael; Instituto de Investigaciones Clínicas, UNMSM; Marangoni, Manuela; Programa PROCETSS, Hospital Nacional Dos de Mayo; Ronceros, Gerardo; Instituto de Investigaciones Clínicas, Facultad de Medicina, UNMSM


    Objectives: To determine the type of anemia most frequent in patients with AIDS and the various degrees of anemia. Material and methods: One hundred patients 18 to 60 year-old infected with human immune deficiency virus (HIV) with residence in Lima and Callao were studied from January to December 2001 for blood count bone marrow aspiration, serum iron, transferrin, ferritin, folate and vitamin B12 levels. Samples were evaluated at the “Dos de Mayo” Hospital Clinical Pathology Department. Resu...

  9. Transitional justice and aid


    Hellsten, Sirkku K.


    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...

  10. HIV/AIDS eradication


    Marsden, Matthew D.; Zack, Jerome A.


    Antiretroviral therapy can inhibit HIV replication in patients and prevent progression to AIDS. However, it is not curative. Here we provide an overview of what antiretroviral drugs do and how the virus persists during therapy in rare reservoirs, such as latently infected CD4+ T cells. We also outline several innovative methods that are currently under development to eradicate HIV from infected individuals. These strategies include gene therapy approaches intended to create an HIV-resistant i...

  11. Has aid for AIDS raised all health funding boats? (United States)

    Shiffman, Jeremy; Berlan, David; Hafner, Tamara


    Global health analysts have debated whether donor prioritization of HIV/AIDS control has lifted all boats, raising attention and funding levels for health issues aside from HIV/AIDS. We investigate this question, considering donor funding for 4 historically prominent health agendas-HIV/AIDS, health systems strengthening, population and reproductive health, and infectious disease control-over the decade 1998-2007. We employ funding data from the Development Assistance Committee of the Organization for Economic Cooperation and Development, which tracks donor aid. The data indicate that HIV/AIDS may have helped to increase funding for the control of other infectious diseases; however, there is no firm evidence that other health issues beyond the control of infectious diseases have benefited. Between 1998 and 2007, funding for HIV/AIDS control rose from just 5.5% to nearly half of all aid for health. Over the same period, funding for health systems strengthening declined from 62.3% to 23.9% of total health aid and that for population and reproductive health declined from 26.4% to 12.3%. Also, even as total aid for health tripled during this decade, aid for health systems strengthening largely stagnated. Overall, the data indicate little support for the contention that donor funding for HIV/AIDS has lifted all boats.

  12. Comparison of 0.5% Bupivacaine and 0.5% Ropivacaine epidurally in lower limb orthopaedic surgeries

    Directory of Open Access Journals (Sweden)

    Ushma D. Shah


    Full Text Available Background: Ropivacaine in equi-potent concentrations with bupivacaine, the degree of motor blockade is less pronounced with ropivacaine, and there is a greater propensity for blocking pain transmitting A-delta and C fibres rather than A-α motor fibres. It appears to have most of the blocking characteristics of bupivacaine. So we have undertaken the study to compare ropivacaine 0.5% (20ml and bupivacaine 0.5% (20ml for epidural anaesthesia in patients undergoing lower limb orthopaedic surgeries. Methods: This double-blind, randomized study involves 60 patients who were undergone orthopaedic surgery, having ASA-I or ASA-II physical status. Out of 60, 30 patients received 20 ml of 0.5% ropivacaine and 30 patients received 20 ml of 0.5% bupivacaine at the L3, 4 interspace. Parameters measured were the onset time, duration and spread of sensory block, the onset time, peak time, duration and degree of motor block, the quality of anaesthesia and the heart rate and blood pressure profile during block onset. Results: Epidurally, Ropivacaine in comparison to Bupivacaine provides quicker onset, early peak effect and prolonged duration of sensory block and shorter duration of motor block. Ropivacaine provides prolonged effective analgesia. It reduces requirement of rescue analgesics and related side effects. Conclusions: Ropivacaine 0.5% is safer and effective alternative to Bupivacaine in epidural anaesthesia and post operative pain relief.

  13. Single-step electrochemical deposition of antimicrobial orthopaedic coatings based on a bioactive glass/chitosan/nano-silver composite system. (United States)

    Pishbin, F; Mouriño, V; Gilchrist, J B; McComb, D W; Kreppel, S; Salih, V; Ryan, M P; Boccaccini, A R


    Composite orthopaedic coatings with antibacterial capability containing chitosan, Bioglass® particles (9.8μm) and silver nanoparticles (Ag-np) were fabricated using a single-step electrophoretic deposition (EPD) technique, and their structural and preliminary in vitro bactericidal and cellular properties were investigated. Stainless steel 316 was used as a standard metallic orthopaedic substrate. The coatings were compared with EPD coatings of chitosan and chitosan/Bioglass®. The ability of chitosan as both a complexing and stabilizing agent was utilized to form uniformly deposited Ag-np. Due to the presence of Bioglass® particles, the coatings were bioactive in terms of forming carbonated hydroxyapatite in simulated body fluid (SBF). Less than 7wt.% of the incorporated silver was released over the course of 28days in SBF and the possibility of manipulating the release rate by varying the deposition order of coating layers was shown. The low released concentration of Ag ions (effects. This was attributed to the relatively high concentration of Ag-np incorporated in the coatings.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND : Surgical site infections in orthopaedic implant surgery is devasting complication range from 1 - 2% to 22%. It leads to increase case cost , prolongs antibiotic use/abuse , increases morbidity and rehabilitation. METHOD : This prospective cross sectional study was conducted on 624 patients with closed fracture cases undergoing clean and elective orthopaedic implant surgeries admitted at Gandhi Medical College and Hamidia Hospital , Bhopal (Madhya Pradesh , India between ‘1st November 2013 to 31st October 2014’. RESULTS : The surgical site infection was diagnosed in 43 (6.89% pati ents within 30 days after surgery. Klebsiella was most common infective organism islolated in 39.53% cases. On data analysis SSI was significantly associated with increasing age , duration of hospital stay more than 7 days , duration of surgery more than 120 minutes , pre - operative Hb less than 12 gm% , diabetes mellitus , use of intra - operative negative suction and tourniquet. CONCLUSION : Incidence of SSI in implants surgeries are quite high , proper measure are needed to control it. In this study gram negative organism has emerged as major threat in contrast to staphylococcus aureus.

  15. Effect of the systemic inflammatory response, as provoked by elective orthopaedic surgery, on HbA1c. (United States)

    Chadburn, Andrew J; Garman, Elizabeth; Abbas, Raad; Modupe, Anu; Ford, Clare; Thomas, Osmond L; Chugh, Sanjiv; Deshpande, Shreeram; Gama, Rousseau


    Background In acutely ill patients with new onset hyperglycaemia, plasma glucose cannot reliably distinguish between stress hyperglycaemia and undiagnosed diabetes mellitus. We, therefore, investigated the diagnostic reliability of glycated haemoglobin (HbA1c) in acute illness by prospectively evaluating the effect of the systemic inflammatory response, as provoked by elective orthopaedic surgery, on HbA1c. Methods HbA1c and serum C-reactive protein concentrations were compared before and two days after elective knee or hip surgery in 30 patients without diabetes. C-reactive protein was used to assess the systemic inflammatory response. Results The mean (standard deviation) serum C-reactive protein increased following surgery (4.8 [7.5] vs. 179.7 [61.9] mg/L; P<0.0001). HbA1c was similar before and after surgery (39.2 [5.4] vs. 38.1 [5.1] mmol/moL, respectively; P = 0.4363). Conclusions HbA1c is unaffected within two days of a systemic inflammatory response as provoked by elective orthopaedic surgery. This suggests that HbA1c may be able to differentiate newly presenting type 2 diabetes mellitus from stress hyperglycaemia in acutely ill patients with new onset hyperglycaemia.

  16. AIDS and Africa. Introduction. (United States)

    Kopelman, Loretta M; van Niekerk, Anton A


    Sub-Saharan Africa is the epicenter of the HIV/AIDS epidemic, and in this issue of the Journal, seven authors discuss the moral, social and medical implications of having 70% of those stricken living in this area. Anton A. van Niekerk considers complexities of plague in this region (poverty, denial, poor leadership, illiteracy, women's vulnerability, and disenchantment of intimacy) and the importance of finding responses that empower its people. Solomon Benatar reinforces these issues, but also discusses the role of global politics in sub-Saharan Africa, especially discrimination, imperialism and its exploitation by first world countries. Given the public health crisis, Udo Schüklenk and Richard E. Ashcroft defend compulsory licensing of essential HIV/AIDS medications on consequentialist grounds. Keymanthri Moodley discusses the importance of conducting research and the need to understand a moderate form of communitarianism, also referred to as "ubuntu" or "communalism", to help some Africans understand research as an altruistic endeavour. Godfrey B. Tangwa also defends traditional African values of empathy and ubuntu, discussing how they should be enlisted to fight this pandemic. Loretta M. Kopelman criticizes the tendency among those outside Africa to dismiss the HIV/AIDS pandemic, attributing one source to the ubiquitous and misguided punishment theory of disease. The authors conclude that good solutions must be cooperative ventures among countries within and outside of sub-Saharan Africa with far more support from wealthy countries.

  17. 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.......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...... long-run supply trends and short-run dynamics, which motivates use of error correction methods. Panel econometric techniques are employed that are consistent in the presence of parameter heterogeneity and cross-section dependence. Results support the error correction framework, but point to very...

  18. Redirecting British foreign aid. (United States)

    Dean, M


    Britain has longed followed a disease-control strategy for providing aid in the health sector to developing, low-income countries. Given, however, the high level of waste upon tertiary care and specialized medicine in current health programs of low-income countries as documented by the World Bank; the poor performance of existing general government hospitals and clinics; and the poor image of Third World health systems in the eyes of Western officials and government ministers, the chief health advisor of the Overseas Development Administration has called for a drastic redirection of policy toward development aid. Specifically, a shift away from a specific-disease control approach toward an overall, sweeping reform of the health sector in developing countries is urged. The level of waste needs to be reduced and more attention given to the poor. Unless such changes result, government ministers will grow increasingly reluctant to provide tangible aid to the health sectors of countries in need. The availability of such funds invested in effective, well-managed health programs will grow more critical to health in the Third World as populations shift away from communicable disease morbidity and mortality toward illnesses which are of a more noncommunicable nature such as stroke and cancer.

  19. [Adolescence and AIDS]. (United States)


    The myths and prejudices that distort the reality and hide the true causes and effects of natural and social phenomena related to sexuality have a fertile ground in AIDS, given its obvious link to sex. The alarming spread of AIDS has been 1 result of these myths and prejudices. Human beings are sexual by nature; genital organs determine sex and also induce sexual behavior. It is by not fairly well accepted that an individual's sexuality exists from birth. Puberty usually begins at 12-16 years for both sexes. The physical changes of puberty terminate in the ability of the female to conceive and the male to procreate. The sexual excitation of adolescents resulting from production of various hormones can only be eliminated by some type of sexual satisfaction or sublimation. Sexuality, according to Freud, is an organizing principle of the personality. The sexual organs exist not merely for reproduction but to provide pleasure. Puberty signifies entry into active sex life. But the ideological structure of society, perpetuated by the family, schools, religion, the mass media, and other social institutions, sends confused signals to adolescents, requiring abstinence and virginity until marriage for women while encouraging sexual adventures for men. Adolescents are confronted by their new sexual feelings in the midst of a virtual bombardment of visual sexual stimuli from the mass media. It becomes impossible for adolescents to satisfy the requirements of appearances while also resolving the problems and pressures of their newly gained sexual maturity. Many adolescents become sexually active, and the problem is not to prevent sexual activity but to improve the conditions under which it occurs. Adolescents, lacking education and information about sex, begin their sex lives without protection. AIDS has now been added to the list of dire consequences that can result. A true sex education beginning in the home is needed to enable young people to develop healthy and full sex

  20. Hearing aid adjustment

    DEFF Research Database (Denmark)

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


    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......Conversation analytic research on clinical encounters shows that interactional conduct can be consequential for diagnosis, treatment and compliance. Problems reported for doctor-patient interaction can also be identified in Danish audiological encounters. There are, however, also specific aspects...

  1. First aid in mathematics

    CERN Document Server

    Sulley, Robert


    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

  2. 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.


    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

  3. 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)


    @@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.

  4. Random effect modelling of patient-related risk factors in orthopaedic procedures: results from the Dutch nosocomial infection surveillance network 'PREZIES'.

    NARCIS (Netherlands)

    Muilwijk, J.; Walenkamp, G.H.; Voss, A.; Wille, J.C.; Hof, S. van den


    In the Dutch surveillance for surgical site infections (SSIs), data from 70277 orthopaedic procedures with 1895 SSIs were collected between 1996 and 2003. The aims of this study were: (1) to analyse the trends in SSIs associated with Gram-positive and Gram-negative bacteria; (2) to estimate patient-

  5. iPadagogy 101: Using Clinical ORthopedic Exam (C.O.R.E.) to Facilitate Evidence-Based Practice in the Orthopaedic Evaluation Classroom (United States)

    Hamson-Utley, J. Jordan; Stiller-Ostrowski, Jennifer L.


    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…

  6. Identifying and exploring physical and psychological morbidity and patient and family caregiver resilience following acute wound development and/or wound blistering post orthopaedic surgery: a systematic review. (United States)

    Ousey, Karen; Edward, Karen-Leigh; Lui, Steve


    The aim of this article was to identify the literature that examined and explored physical and psychological morbidity and patient and family caregiver resilience following acute wound development and/or wound blistering post orthopaedic surgery. A systematic review of the literature using the databases MEDLINE, CINAHL and EMBASE was undertaken. The papers were examined using title and abstract for relevance to the primary and secondary outcomes. The primary outcome of interest was family caregiver resilience following acute wound development and/or wound blistering post orthopaedic surgery. The search yielded 275 records after removing any duplicates; eight studies were considered eligible and were reviewed as full text. Following full review, none of the studies was included in this article. To conclude, there were no papers that investigated or examined the concept of resilience in relation to the management of acute post-surgical orthopaedic wounds. Four of the papers identified, following the review process, did discuss quality of life outcomes and how these may be improved following wound development; most papers focused on the management of chronic wounds. It is apparent from the review that there is no evidence currently available that explores patient and family caregiver resilience following acute wound development and/or wound blistering post orthopaedic surgery.

  7. Erosions in the foot at baseline are predictive of orthopaedic shoe use after 10 years of treat to target therapy in patients with recent onset rheumatoid arthritis

    NARCIS (Netherlands)

    S.A. Bergstra (Sytske Anne); I.M. Markusse (Iris M.); G. Akdemir (Gülşah); H.K. Ronday; K.H. Han (K. Huub); W.F. Lems (Willem); P.J.S.M. Kerstens; R. van Den Berg (Rosaline); R. Landewé (Robert); C.F. Allaart (Cornelia)


    textabstractThe objective of this study is to investigate if foot joint damage due to rheumatoid arthritis (RA) can predict whether patients will start wearing orthopaedic shoes (OS) within 10 years after treatment start. Data from recent onset RA patients with 10 years follow-up from the BeSt (Dutc

  8. 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


    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

  9. Aid Policy and the Macroeconomic Management of Aid

    DEFF Research Database (Denmark)

    Addison, Tony; Tarp, Finn


    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. Talking about AIDS

    Directory of Open Access Journals (Sweden)


    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.

  11. Newly developed Ti-Nb-Zr-Ta-Si-Fe biomedical beta titanium alloys with increased strength and enhanced biocompatibility. (United States)

    Kopova, Ivana; Stráský, Josef; Harcuba, Petr; Landa, Michal; Janeček, Miloš; Bačákova, Lucie


    Beta titanium alloys are promising materials for load-bearing orthopaedic implants due to their excellent corrosion resistance and biocompatibility, low elastic modulus and moderate strength. Metastable beta-Ti alloys can be hardened via precipitation of the alpha phase; however, this has an adverse effect on the elastic modulus. Small amounts of Fe (0-2 wt.%) and Si (0-1 wt.%) were added to Ti-35Nb-7Zr-6Ta (TNZT) biocompatible alloy to increase its strength in beta solution treated condition. Fe and Si additions were shown to cause a significant increase in tensile strength and also in the elastic modulus (from 65 GPa to 85 GPa). However, the elastic modulus of TNZT alloy with Fe and Si additions is still much lower than that of widely used Ti-6Al-4V alloy (115 GPa), and thus closer to that of the bone (10-30 GPa). Si decreases the elongation to failure, whereas Fe increases the uniform elongation thanks to increased work hardening. Primary human osteoblasts cultivated for 21 days on TNZT with 0.5Si+2Fe (wt.%) reached a significantly higher cell population density and significantly higher collagen I production than cells cultured on the standard Ti-6Al-4V alloy. In conclusion, the Ti-35Nb-7Zr-6Ta-2Fe-0.5Si alloy proves to be the best combination of elastic modulus, strength and also biological properties, which makes it a viable candidate for use in load-bearing implants.

  12. The efficacy of using search engines in procuring information about orthopaedic foot and ankle problems from the World Wide Web. (United States)

    Nogler, M; Wimmer, C; Mayr, E; Ofner, D


    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.

  13. An Osteoconductive, Osteoinductive, and Osteogenic Tissue-Engineered Product for Trauma and Orthopaedic Surgery: How Far Are We?

    Directory of Open Access Journals (Sweden)

    Wasim S. Khan


    Full Text Available The management of large bone defects due to trauma, degenerative disease, congenital deformities, and tumor resection remains a complex issue for the orthopaedic reconstructive surgeons. The requirement is for an ideal bone replacement which is osteoconductive, osteoinductive, and osteogenic. Autologous bone grafts are still considered the gold standard for reconstruction of bone defects, but donor site morbidity and size limitations are major concern. The use of bioartificial bone tissues may help to overcome these problems. The reconstruction of large volume defects remains a challenge despite the success of reconstruction of small-to-moderate-sized bone defects using engineered bone tissues. The aim of this paper is to understand the principles of tissue engineering of bone and its clinical applications in reconstructive surgery.

  14. Heat-washout measurements compared to distal blood pressure and perfusion in orthopaedic patients with foot ulcers

    DEFF Research Database (Denmark)

    Midttun, M; Azad, B B S; Broholm, R


    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 controls...... 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...

  15. The Role of 3D Modelling and Printing in Orthopaedic Tissue Engineering: A Review of the Current Literature. (United States)

    Shaunak, Shalin; Dhinsa, Baljinder S; Khan, Wasim S


    Orthopaedic surgery lends itself well to advances in technology. An area of interest and ongoing research is that of the production of scaffolds for use in trauma and elective surgery. 3D printing provides unprecedented accuracy in terms of micro- and macro-structure and geometry for scaffold production. It can also be utilised to construct scaffolds of a variety of different materials and more recently has allowed for the construction of bio-implants which recapitulate bone and cartilage tissue. This review seeks to look at the various methods of 3DP, the materials used, elements of functionality and design, as well as modifications to increase the biomechanics and bioactivity of 3DP scaffolds.

  16. National HIV/AIDS Strategy

    Centers for Disease Control (CDC) Podcasts


    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.

  17. 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....

  18. Dermatitis de contacto por prótesis ortopédicas Contact dermatitis for orthopaedic prostheses

    Directory of Open Access Journals (Sweden)

    C.A. Danielo


    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.

  19. Preclinical investigation of an innovative magnesium-based bone graft substitute for potential orthopaedic applications

    Directory of Open Access Journals (Sweden)

    Chen Liu


    Full Text Available Degradable or corrosive biometal is an attractive research and development (R&D area in clinical orthopaedics. This study was designed to investigate biomechanical and biological properties of magnesium (Mg and strontium (Sr with a focus on Mg-based metals, including pure Mg and Mg–xwt% Sr (x = 0.25, x = 1.0, x = 1.5, x = 2.5 alloys, as potential bone graft substitutes in respect to their mechanical strength, corrosion resistance, and cytocompatibility for further optimization and establishing indications for relevant in vivo applications. Our data showed that the tensile and compressive strength increased with addition of Sr because of the Mg17Sr2 precipitation strengthen. Compared with commercially used bone graft substitutes, the mechanical properties of Mg–Sr alloys were close to those of cortical bone, and the compressive strength could reach 300 MPa, suggesting its potential application for load-bearing bone as bone defect filler. The corrosion rates of Mg–xwt% Sr alloys were controlled in the range of 0.05–0.07 mm/y, indicating feasibility of bone grafting and the in situ bone repair process. Moreover, Mg–Sr alloys also exhibit good cytocompatibility and antibacterial properties. Our innovation presented in this work supported in vivo clinical indication-based assessment of biodegradable Mg-based metals that could be potential candidates for bone graft substitutes for future orthopaedic applications.

  20. Sol-gel derived HA/TiO2 double coatings on Ti scaffolds for orthopaedic applications

    Institute of Scientific and Technical Information of China (English)



    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


    Directory of Open Access Journals (Sweden)

    Santo F. Di Nuovo


    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.


    Directory of Open Access Journals (Sweden)

    Albert W. Pearsall IV


    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

  3. National Latino AIDS Awareness Day

    Centers for Disease Control (CDC) Podcasts


    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.

  4. Public knowledge about AIDS increasing. (United States)

    Campbell, M J; Waters, W E


    In response to concern over the perceived limited effectiveness of Department of Health and Social Security (UK) advertising campaigns to inform the public of the basic facts of Acquired Immunodeficiency Syndrome (AIDS), a prospective questionnaire study was undertaken in Southampton, England to test the effectiveness of government education prior to a January, 1987 government television/leaflet advertising campaign. 300 questionnaires about AIDS were mailed in December of 1986 to a sample drawn from electoral rolls. The response rate was 61%. Most of the questions were drawn from material covered in the campaign. The results seemed to indicate a small overall increase in knowledge about AIDS. Some changes from a June survey were noted, e.g.: more people were aware that AIDS is a virus for which there is no cure and that it is not readily transmitted by sharing washing, eating or drinking utensils; more people believed that the statement that women are at greater risk for catching AIDS is false. Respondents were generally favorable to the government's continued use of television, even with explicit language, and to its use of the schools, for AIDS education. Many were not aware of the dangers to intravenous drug users or of the symptoms of AIDS. Other surveys have shown an increasing knowledge of AIDS dangers. It is possible that television coverage of the problem will continue to be necessary, in order that less literate populations be reached. Further AIDS health education in general is needed.

  5. Aids and Infectious Diseases (aid) Pmp 2013 Report (United States)

    Buonaguro, Franco M.


    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...

  6. Removal of Uranium (VI from aqueous solution by Uranium Benzamide Complex using AC_Fe3O4 Nanocomposite

    Directory of Open Access Journals (Sweden)

    Z Akbari Jonoush


    Conclusion: The removal of U(VI on AC_Fe3O4 nanocomposite with the aid of benzamide is a rapid and highly pH depended process. The maximum sorption capacity (15/87 mg/g of AC_Fe3O4 nanocomposite shows that this method is a suitable method for Uranium removal.

  7. Ergogenic Aids and Supplements. (United States)

    Porrini, Marisa; Del Boʼ, Cristian


    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.

  8. Learning to aid learning. (United States)

    Richards, Jacqui


    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.

  9. AIDS and sex tourism. (United States)

    Herold, E S; Van Kerkwijk, C


    Tourists traveling internationally lower their inhibitions and take greater risks than they would typically in their home cultures. Loneliness, boredom, and a sense of freedom contribute to this behavioral change. Some tourists travel internationally in search of sexual gratification. This motivation may be actively conscious or subconscious to the traveler. Billed as romantic with great natural beauty, Thailand, the Philippines, Brazil, the Dominican Republic, and Kenya are popular destinations of tourists seeking sex. The Netherlands and countries in eastern Europe are also popular. With most initial cases of HIV infection in Europe having histories of international travel, mass tourism is a major factor in the international transmission of AIDS. While abroad, tourists have sex with casual partners, sex workers, and/or other tourists. Far from all tourists, however, carry and consistently use condoms with these partners. One study found female and non white travelers to be less likely than Whites and males to carry condoms. The risk of HIV infection increases in circumstances where condoms are not readily available in the host country and/or are of poor quality. Regarding actual condom use, a study found only 34% of sex tourists from Switzerland to consistently use condoms while abroad. 28% of men in an STD clinic in Melbourne, Australia, reported consistent condom use in sexual relations while traveling in Asia; STDs were identified in 73% of men examined. The few studies of tourists suggest that a significant proportion engage in risky behavior while traveling. HIV prevalence is rapidly increasing in countries known as destinations for sex tourism. High infection rates are especially evident among teenage sex workers in Thailand. Simply documenting the prevalence of risky behavior among sex tourists will not suffice. More research is needed on travelers and AIDS with particular attention upon the motivating factors supporting persistent high-risk behavior.

  10. AIDS Resource Manual for Educators. (United States)

    Edwards, Sara A., Ed.; And Others

    This manual presents, for educators, known facts about Acquired Immune Deficiency Syndrome (AIDS), how it is transmitted, and how it can be prevented. Answers to common questions about AIDS are listed and a summary sheet is provided. A resource list is included that contains names, addresses, and phone numbers of organizations that produce or…

  11. Combating Homophobia in AIDS Education. (United States)

    Croteau, James M.; Morgan, Suzanne


    Reviews literature explicating connection between homophobia and Acquired Immune Deficiency Syndrome (AIDS) and then calls for integration of antihomophobia elements into AIDS education. Discusses negative messages in portrayals of homosexual and bisexual men and in discussions of safer sexual practices. Suggests guidelines for countering…

  12. Moral Character and Student Aid (United States)

    Flint, Thomas A.


    Thirty years after the creation of federal student financial aid programs through the Higher Education Act of 1965, the link between moral character and student financial aid programs is once again influencing the public policy debate. A careful look at the debate, though, shows that the nature of concerns has shifted. In the past, the question…

  13. HIV/AIDS and Pregnancy (United States)

    If you have HIV/AIDS and find out you are pregnant or think you may be pregnant, you should let your health care provider know as soon as possible. Some HIV/AIDS medicines may harm your baby. Your health ...

  14. Basic HIV/AIDS Statistics (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Statistics Center . How many people are diagnosed with HIV each year in the United States? In 2015, ...

  15. World AIDS Day PSA (:30)

    Centers for Disease Control (CDC) Podcasts


    December 1 is World AIDS Day. In this PSA, communities are encouraged to get tested for HIV.  Created: 11/16/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 11/16/2011.

  16. Information Handbook for Teacher Aides. (United States)

    Pucciarelli, Catherine S., Ed.

    This handbook provides an introduction for teacher aides recently hired by the Nassau Board of Cooperative Education Services (BOCES) to work with handicapped students. Topics covered include mental, learning, physical and emotional disabilities, the role of the teacher aide, crisis intervention, building students' self-esteem, managing student…

  17. Translation: Aids, Robots, and Automation. (United States)

    Andreyewsky, Alexander


    Examines electronic aids to translation both as ways to automate it and as an approach to solve problems resulting from shortage of qualified translators. Describes the limitations of robotic MT (Machine Translation) systems, viewing MAT (Machine-Aided Translation) as the only practical solution and the best vehicle for further automation. (MES)

  18. Aid and Sectoral Labour Productivity

    DEFF Research Database (Denmark)

    Selaya, Pablo; Thiele, Rainer


    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 th...... of dollarization in financial liabilities at the firm level....

  19. Attitudes towards and Knowledge of AIDS. (United States)

    Edwards, Andrew; Hiday, Virginia Aldige'

    Most research on Acquired Immune Deficiency Syndrome (AIDS) has been medical and most social science research on AIDS has been concerned with social factors in its spread and with social-psychological effects of contracting AIDS. This study was conducted to examine public attitudes toward, and public knowledge about AIDS. Knowledge about AIDS was…

  20. Transformation impacts of dissolved and solid phase Fe(II) on trichloroethylene (TCE) reduction in an iron-reducing bacteria (IRB) mixed column system: a mathematical model. (United States)

    Bae, Yeunook; Kim, Dooil; Cho, Hyun-Hee; Singhal, Naresh; Park, Jae-Woo


    In this research, we conducted trichloroethylene (TCE) reduction in a column filled with iron and iron-reducing bacteria (IRB) and developed a mathematical model to investigate the critical reactions between active species in iron/IRB/contaminant systems. The formation of ferrous iron (Fe(II)) in this system with IRB and zero-valent iron (ZVI, Fe(0)) coated with a ferric iron (Fe(III)) crust significantly affected TCE reduction and IRB respiration in various ways. This study presents a new framework for transformation property and reducing ability of both dissolved (Fe(II)(dissolved)) and solid form ferrous iron (Fe(II)(solid)). Results showed that TCE reduction was strongly depressed by Fe(II)(solid) rather than by other inhibitors (e.g., Fe(III) and lactate), suggesting that Fe(II)(solid) might reduce IRB activation due to attachment to IRB cells. Newly exposed Fe(0) from the released Fe(II)(dissolved) was a strong contributor to TCE reduction compared to Fe(II)(solid). In addition, our research confirmed that less Fe(II)(solid) production strongly supported long-term TCE reduction because it may create an easier TCE approach to Fe(0) or increase IRB growth. Our findings will aid the understanding of the contributions of iron media (e.g., Fe(II)(solid), Fe(II)(dissolved), Fe(III), and Fe(0)) to IRB for decontamination in natural groundwater systems.

  1. Fe atom exchange between aqueous Fe2+ and magnetite. (United States)

    Gorski, Christopher A; Handler, Robert M; Beard, Brian L; Pasakarnis, Timothy; Johnson, Clark M; Scherer, Michelle M


    The reaction between magnetite and aqueous Fe(2+) has been extensively studied due to its role in contaminant reduction, trace-metal sequestration, and microbial respiration. Previous work has demonstrated that the reaction of Fe(2+) with magnetite (Fe(3)O(4)) results in the structural incorporation of Fe(2+) and an increase in the bulk Fe(2+) content of magnetite. It is unclear, however, whether significant Fe atom exchange occurs between magnetite and aqueous Fe(2+), as has been observed for other Fe oxides. Here, we measured the extent of Fe atom exchange between aqueous Fe(2+) and magnetite by reacting isotopically "normal" magnetite with (57)Fe-enriched aqueous Fe(2+). The extent of Fe atom exchange between magnetite and aqueous Fe(2+) was significant (54-71%), and went well beyond the amount of Fe atoms found at the near surface. Mössbauer spectroscopy of magnetite reacted with (56)Fe(2+) indicate that no preferential exchange of octahedral or tetrahedral sites occurred. Exchange experiments conducted with Co-ferrite (Co(2+)Fe(2)(3+)O(4)) showed little impact of Co substitution on the rate or extent of atom exchange. Bulk electron conduction, as previously invoked to explain Fe atom exchange in goethite, is a possible mechanism, but if it is occurring, conduction does not appear to be the rate-limiting step. The lack of significant impact of Co substitution on the kinetics of Fe atom exchange, and the relatively high diffusion coefficients reported for magnetite suggest that for magnetite, unlike goethite, Fe atom diffusion is a plausible mechanism to explain the rapid rates of Fe atom exchange in magnetite.

  2. Electronic structure and characteristics of Fe 3d valence states of Fe(1.01)Se superconductors under pressure probed by x-ray absorption spectroscopy and resonant x-ray emission spectroscopy. (United States)

    Chen, J M; Haw, S C; Lee, J M; Chen, S A; Lu, K T; Deng, M J; Chen, S W; Ishii, H; Hiraoka, N; Tsuei, K D


    The electronic structure and characteristics of Fe 3d valence states of iron-chalcogenide Fe(1.01)Se superconductors under pressure were probed with x-ray absorption spectroscopy and resonant x-ray emission spectroscopy (RXES). The intensity of the pre-edge peak at ~7112.7 eV of the Fe K-edge x-ray absorption spectrum of Fe(1.01)Se decreases for pressure from 0.5 GPa increased to 6.9 GPa. The satellite line Kβ' was reduced in intensity upon applying pressure and became absent for pressure 52 GPa. Fe(1.01)Se shows a small net magnetic moment of Fe(2+), likely arising from strong Fe-Fe spin fluctuations. The 1s3p-RXES spectra of Fe(1.01)Se at pressures 0.5, 6.9, and 52 GPa recorded at the Fe K-edge reveal that unoccupied Fe 3d states exhibit a delocalized character, stemming from hybridization of Fe 3d and 4p orbitals arising from a local distortion around the Fe atom in a tetrahedral site. Application of pressure causes suppression of this on-site Fe 3d-Fe 4p hybridization, and thereby decreases the intensity of the pre-edge feature in the Fe K-edge absorption spectrum of Fe(1.01)Se. Compression enhances spin fluctuations at Fe sites in Fe(1.01)Se and increases the corresponding T(c), through a competition between nearest-neighbor ferromagnetic and next-nearest-neighbor antiferromagnetic superexchange interactions. This result aids our understanding of the physics underlying iron-based superconductors.

  3. Fe-doped 8YSZ at different composition for solid electrolyte in solid oxide fuel cell

    Directory of Open Access Journals (Sweden)

    Johar B.


    Full Text Available Pure 8 mol% yttria stabilized zirconia (YSZ and Fe-doped (1 mol%, 2 mol% and 3 mol% YSZ electrolyte were prepared and sintered at 1550°C. Transition metal oxide is added into YSZ as sintering aided has a function to reduce the sintering temperature. The microstructure, crystal structure and ionic conductivity of pure YSZ and Fe-doped YSZ at different composition were investigated. The amount of cubic phase decreased as the amount of Fe increased. Fe-doped 8YSZ had higher conductivity than pure 8YSZ. The ionic conductivity of 3FeYSZ is 9.35×10−8 S/cm higher than 1FeYSZ which is 4.72×10−9 S/cm when operated at 300°C.

  4. Educating Brazilian workers about AIDS. (United States)


    This article contains a the script for a slide-tape presentation entitled Working Against AIDS, a presentation developed by the Brazil Family Planning Association (BEMFAM) which is designed to debunk common misconceptions about the disease. This audio-visual, which targets Brazilian workers, can be used during talks, seminars, and meetings. A discussion of the issues involved usually follows the presentation of Working Against AIDS. The presentation contains 30 illustrated slides (these are included in the article). The presentation begins by explaining that much of the information concerning AIDS is prejudicial and misleading. The next few slides point out some of the common misconceptions about AIDS, such as claims denying the existence of the disease, or suggestions that only homosexuals and prostitutes are at risk. The presentation then goes on to explain the ways in which the virus can and cannot be transmitted. Then it discusses how the virus destroys the body's natural defenses and explains the ensuing symptoms. Slides 14 and 15 point out that no cure yet exists for AIDS, making prevention essential. Slides 16-23 explain what actions are considered to be high risk and which ones do not entail risk. Noting that AIDS can be prevented, slide 24 says that the disease should not present an obstacle to spontaneous manifestations of human relations. The next slide explains that condoms should always be used when having sex with someone who could be infected with AIDS. Finally slides 26-30 demonstrate the proper way to use and dispose of a condom.

  5. Alaska Dental Health Aide Program

    Directory of Open Access Journals (Sweden)

    Sarah Shoffstall-Cone


    Full Text Available Background. In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska’s Tribal Health Organizations (THO developed a new and diverse dental workforce model to address AI/AN oral health disparities. Objectives. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. Results. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Conclusions. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

  6. HIV/AIDS Clinical Trials Fact Sheet (United States)

    ... and effective in people. What is an HIV/AIDS clinical trial? HIV/AIDS clinical trials help researchers ... to HIV Can anyone participate in an HIV/AIDS clinical trial? It depends on the study. Some ...

  7. HIV/AIDS and the Flu (United States)

    ... this? Submit What's this? Submit Button Past Newsletters HIV/AIDS and the Flu Questions & Answers Language: English ... people with HIV and AIDS. Should people with HIV/AIDS receive the inactivated influenza vaccine? People with ...

  8. Reprieve for Thailand's AIDS campaign. (United States)

    Clements, A


    A promilitary coalition began to govern Thailand in March 1992. It reduced the budget for the original proposed national AIDS awareness campaign from 30 million British pounds to almost 15 million British pounds. The Ministry of Health professed that the campaign had exaggerated the problem of AIDS in Thailand and had damaged tourism. Yet prodemocracy demonstrations in Bangkok in which troops killed many protesters restored the politicians who started the AIDS campaign to power in May 1992. There were to remain in power until new elections in September 1992. In July, the Minister of Health, Mechai Viravaidya, said he would step down if the government did not completely restore the 30 million British pounds for the AIDS campaign. It then increased the budget to almost that amount. Mr. Viravaidya initiated Thailand's open policy on the AIDS crisis and was known as Mr. Condom. He claimed that at the present HIV prevalence rate, Thailand may have between 2-4 million HIV infected people by 2000. If the country would take on anti-AIDS efforts now, however, they could cut the spread of HIV by 75%. As of mid-1992, about 400,000 people living in Thailand were HIV positive. The AIDS campaign planned to sue the mass media to inform people about AIDS especially those in universities and schools and high risk occupational groups. The increasing number of construction workers in Bangkok and existing sex workers were a high risk occupational group. At the 2nd national seminar of AIDS, the Minister of Health reproached tourists who come to Thailand for its sex industry. He said that Thailand does not need the 1 billion British pounds they bring to Thailand annually, and Thais do not want their homeland to be referred to as the sex capital.

  9. AIDS. Grim news for Asia. (United States)


    While Asia was the last region to be exposed to the global spread of HIV and AIDS, the incidence of HIV infection there is increasing fastest. The Asian Development Bank predicts mortality from AIDS will cause some town and village populations to begin declining by the year 2000. With an estimated 1 million people infected in India, and 400,000 in Thailand, these 2 countries are particularly exposed to the risk of epidemic HIV spread. In 5 years, more people may be affected by AIDS in India than anywhere else in the world. Concern over a growing presence of HIV is also merited for the Philippines, Indonesia, China, and the drug trade's Golden Triangle. The Second International Conference on AIDS in Asia and the Pacific in November 1992 stressed that AIDS no longer affects only homosexual and IV drug using populations. 50% of new infections worldwide in the first half of 1992 were among women, 65% of Thailand's AIDS cases are among heterosexuals, and 3-5% of Thailand's long-haul truck drivers have tested positive for HIV infection. HIV and AIDS robs economies and societies of their best workers. The immediate costs of caring for AIDS patients will pale next to the far greater losses to be realized in private sector economic productivity. Asia's more developed economies will probably be able to survive the epidemic, but small, poor countries like Laos will wilt. Prompt action must be taken to overcome public and religious ignorance and objections to promoting and using condoms throughout the region. For the first time, Beijing has organized an AIDS awareness conference for male homosexuals. Further, Singapore has implemented compulsory testing for lower-income foreign workers. Pakistan has even solicited educational assistance and support from Islamic religious leaders; similar action is being considered in Bangladesh.

  10. Psychological first-aid: a practical aide-memoire. (United States)

    Leach, J


    Despite advances made in recent years in medical first aid, psychiatric intervention, survival training and equipment design, many people still perish quickly during and immediately following a disastrous event. In this study, individuals and groups of survivors of life-threatening events were debriefed and the behavior of those who coped well during such a threat to life were compared with those who did not. The behaviors of those who coped well were distilled into a set of principles for psychological first aid; that is, a series of simple actions for use within a disaster which serves to recover victims to functional behavior as quickly as possible, thus increasing their chance for survival. These principles of psychological first aid have recently been introduced into basic first aid and survival training courses for both military and civilian units.

  11. Aid Efficacy: An Institutional Approach

    Directory of Open Access Journals (Sweden)

    José Antonio Alonso Rodríguez


    Full Text Available This work aims to explore some of the weaknesses that the international aid system presents for efficaciously operating in promoting development. For this, it adopts an institutionalapproach, attempting to investigate the problems of asymmetry in information that occur both in relationships between donor and receiver and within aid organisations. The analysis of these aspects leads the author to underscore the importance that learning processes have in enriching interventions in development; he also underscores the importance of the attitudes and aptitudes of the agents in fostering these processes of improvement in aid quality.

  12. Positioning the image of AIDS. (United States)

    Cooter, Roger; Stein, Claudia


    AIDS posters can be treated as material objects whose production, distribution and consumption varied across time and place. It is also possible to reconstruct and analyse the public health discourse at the time these powerful images appeared. More recently, however, these conventional historical approaches have been challenged by projects in literary and art criticism. Here, images of AIDS are considered in terms of their function in and for a new discursive regime of power centred on the human body and its visualization. How images of AIDS came to be understood in Western culture in relation to wider political and economic conditions redefines the historical task.

  13. 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 as an introduction to the UNU-WIDER Special Issue. Beginning in the 1990s, aid strategy and policy shifted to put a stronger emphasis on human development. This accelerated with the Millennium...... Development Goals (MDGs) and will continue under the Sustainable Development Goals (SDGs), 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....

  14. Aid and Authoritarianism in Africa

    DEFF Research Database (Denmark)

    In 2013 almost half of Africa’s top aid recipients were ruled by authoritarian regimes. While the West may claim to promote democracy and human rights, in practice major bilateral and international donors, such as USAID , DFID , the World Bank and the European Commission, have seen their aid...... and Authoritarianism in Africa sheds light on the political intricacies and moral dilemmas raised by the relationship between foreign aid and autocratic rule in Africa. Through contributions by leading experts exploring the revival of authoritarian development politics in Ethiopia, Uganda, Rwanda, Cameroon, Mozambique...

  15. Aid and Sectoral Labour Productivity

    DEFF Research Database (Denmark)

    Selaya, Pablo; Thiele, Rainer


    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 developing countries. Possible reasons are the existence of large idle labour capacity and high levels......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...

  16. Use of autologous bone marrow mononuclear cells and cultured bone marrow stromal cells in dogs with orthopaedic lesions. (United States)

    Crovace, A; Favia, A; Lacitignola, L; Di Comite, M S; Staffieri, F; Francioso, E


    The aim of the study is to evaluate the clinical application in veterinary orthopedics of bone marrow mononuclear cells (BMMNCs) and cultured bone marrow stromal cells (cBMSCs) for the treatment of some orthopaedic lesions in the dog. The authors carried out a clinical study on 14 dogs of different breed, age and size with the following lesions: 1 bone cyst of the glenoid rime; 2 nonunion of the tibia; 3 nonunion of the femur; 2 lengthening of the radius; 1 large bone defect of the distal radius;1 nonunion with carpus valgus; 4 Legg-Calvé-Perthés disease. In 9 cases the BMMCNs were used in combination with a three dimensional resorbable osteogenic scaffold the chemical composition and size of which facilitates the ingrowth of bone. In these cases the BMMNCs were suspended in an adequate amount of fibrin glue and then distribuited uniformly on a Tricalcium-Phosphate (TCP) scaffold onto which were also added some drops of thrombin. In 1 case of nonunion of the tibia and in 3 cases of Legg-Calvè-Perthés (LCP) disease the cultured BMSCs were used instead because of the small size of the dogs and of the little amount of aspirated bone marrow. X-ray examinations were performed immediately after the surgery. Clinical, ultrasounds and X-ray examinations were performed after 20 days and then every month. Until now the treated dogs have shown very good clinical and X-ray results. One of the objectives of the study was to use the BMMNCs in clinical application in orthopaedic lesions in the dog. The advantages of using the cells immediately after the bone marrow is collected, are that the surgery can be performed the same day, the cells do not need to be expanded in vitro, they preserve their osteogenic potential to form bone and promote the proper integration of the implant with the bone and lastly, the technique is easier and the costs are lower.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND: There are always efforts to find a better and safer local anaesthetic along with adjuvants in epidural anaesthesia. Bupivacaine is a long acting , effective local anaesthetic that is commonly administered in anaesthesia practice. Despite its undoubted efficacy, bupivacaine is associated with cardiotoxicity and neurotoxicity. Central nervous system (CNS and cardiovascular adverse reactions reported after inadvertent intravascular or intravenous regional anesthesia have been linked to R (+ isomer of bupivacaine. So Levobupivacaine, the pure S ( - – enantiomer of racemic bupivacaine, was developed as an alternative to bupivacaine. Levobupivacaine is increasingly used in the clinical practice because of its safer pharmacological profile and faster protein binding rate AIM: This study was conducted to evaluate the onset and duration of analgesia, extent and duration of sensory and motor block, sedation and side effects of Dexmedetomidine and Clonidine when used as adjuvants to Levobupivacaine in epidural anaesthesia for lower limb orthopaedic surgeries. MATERIALS AND METHODS: A prospective randomized study was carried out in the department of Anaesthesia at Rajarajeswari Medical College and Hospital which included 50 adult patients between the ages of 21 and 60 years (o f ASA I/II grade who underwent lower limb orthopaedic surgeries. The patients were randomly allocated into two groups; levobupivacaine + dexmedetomidine (LD and levobupivacaine + clonidine (LC, comprising of 25 patients each. Group LD was administered 18 ml of 0.5% epidural levobupivacaine and 1.5 μg/kg of dexmedetomidine, while group LC received admixture of 18 ml of 0.5% levobupivacaine and 2 μg/kg of Clonidine . Onset of analgesia, sensory and motor block levels, sedation, duration of analgesia and side effects were observed. STATISTICAL ANALYSIS: The data obtained was subjected to statistical analysis using analysis of variance, student t test, chi - square test

  18. Computer aided surface representation

    Energy Technology Data Exchange (ETDEWEB)

    Barnhill, R.E.


    The central research problem of this project is the effective representation and display of surfaces, interpolating to given information, in three or more dimensions. In a typical problem, we wish to create a surface from some discrete information. If this information is itself on another surface, the problem is to determine a surface defined on a surface,'' which is discussed below. Often, properties of an already constructed surface are desired: such geometry processing'' is described below. The Summary of Proposed Research from our original proposal describes the aims of this research project. This Summary and the Table of Contents from the original proposal are enclosed as an Appendix to this Progress Report. The broad sweep from constructive mathematics through algorithms and computer graphics displays is utilized in the research. The wide range of activity, directed in both theory and applications, makes this project unique. Last month in the first Ardent Titan delivered in the State of Arizona came to our group, funded by the DOE and Arizona State University. Although the Titan is a commercial product, its newness requires our close collaboration with Ardent to maximize results. During the past year, four faculty members and several graduate research assistants have worked on this DOE project. The gaining of new professionals is an important aspect of this project. A listing of the students and their topics is given in the Appendix. The most significant publication during the past year is the book, Curves and Surfaces for Computer Aided Geometric Design, by Dr. Gerald Farin. This 300 page volume helps fill a considerable gap in the subject and includes many new results on Bernstein-Bezier curves and surfaces.

  19. An Evaluation of the Significance of Work-Related Influence Factors on Fitness and the Development of Medical and Orthopaedic Conditions in Military Executives

    Directory of Open Access Journals (Sweden)

    Christoph Schulze


    Full Text Available Occupational health promotion is an effective tool to improve the state of health of employees. As part of occupational health promotion in the German Bundeswehr, top-ranking military executives are offered a medical examination and training programme. Health-related data is collected as a basis for training and lifestyle counselling. This data was subjected to a retrospective evaluation in order to identify occupational risk factors and their correlation with cardiovascular resilience, trunk strength, and the development of orthopaedic and internal disorders. A total of 122 military executives (all male, age 54.6±4.2 years answered a questionnaire aimed at evaluating private and occupational stress factors. The medical history was followed by a medical and orthopaedic examination involving a lactate performance test (treadmill or bicycle ergometry and an isometric trunk strength measurement. The data obtained was then statistically evaluated. For military executives, work-related travelling and commuting involve a high risk of medical and orthopaedic conditions. Regular exercise leads to improved fitness levels. In order to prevent medical problems, military executives working long hours should regularly take part in fitness and weight training under professional instructions.

  20. An Evaluation of the Significance of Work-Related Influence Factors on Fitness and the Development of Medical and Orthopaedic Conditions in Military Executives (United States)

    Becker, Michael; Finze, Susanne; Holtherm, Christoph; Hinder, Jens; Lison, Andreas


    Occupational health promotion is an effective tool to improve the state of health of employees. As part of occupational health promotion in the German Bundeswehr, top-ranking military executives are offered a medical examination and training programme. Health-related data is collected as a basis for training and lifestyle counselling. This data was subjected to a retrospective evaluation in order to identify occupational risk factors and their correlation with cardiovascular resilience, trunk strength, and the development of orthopaedic and internal disorders. A total of 122 military executives (all male, age 54.6 ± 4.2 years) answered a questionnaire aimed at evaluating private and occupational stress factors. The medical history was followed by a medical and orthopaedic examination involving a lactate performance test (treadmill or bicycle ergometry) and an isometric trunk strength measurement. The data obtained was then statistically evaluated. For military executives, work-related travelling and commuting involve a high risk of medical and orthopaedic conditions. Regular exercise leads to improved fitness levels. In order to prevent medical problems, military executives working long hours should regularly take part in fitness and weight training under professional instructions.

  1. The Prevalence of Accidental Needle Stick Injury and their Reporting among Healthcare Workers in Orthopaedic Wards in General Hospital Melaka, Malaysia

    Directory of Open Access Journals (Sweden)

    Bhardwaj A


    Full Text Available 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 in operation theatre 13(37.4%. Among them six (18.8% were specialist, 12(37.5% medical officer, 10 (31.2% house officer and four staff nurses (12.5%. Among the respondents 142 (92.8% had been immunized against Hepatitis B and 148 (96.7% participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant.

  2. Local environment analysis of Fe ions in BaMgSiO4 (United States)

    Kase, Junya; Shingaki, Yoshihiro; Inaba, Yuta; Meguro, Kazune; Murata, Hidenobu; Okajima, Toshihiro; Yamamoto, Tomoyuki


    Polycrystalline Fe-doped BaMgSiO4 is synthesized by the conventional solid state reaction method, which shows strong photochromism. Photochromic property of the synthesized specimens is investigated by measuring the diffuse reflectance spectrum. Local environment of doped Fe ions in BaMgSiO4 has been studied by the analysis of the X-ray absorption near-edge structure (XANES) spectrum with the aid of the first-principles calculations.

  3. How to Get Hearing Aids (United States)

    ... records from your hearing healthcare professional, and may purchase your hearing aid elsewhere (ex: by mail order, ... feeds Follow FDA on Twitter Follow FDA on Facebook View FDA videos on YouTube View FDA photos ...

  4. HIV/AIDS in Women (United States)

    HIV, the human immunodeficiency virus, kills or damages cells of the body's immune system. The most advanced stage of infection with HIV is AIDS, which stands for acquired immunodeficiency syndrome. ...

  5. Hearing Aid Fitting & Electrophysiologic Procedure

    Directory of Open Access Journals (Sweden)

    Bahram Jalaei


    Full Text Available Rehabilitation of deaf individual is one of the important subjects that has attracted attention of many researchers during past centuries. Different opinions have been established in this direction. Electrophysiologic tests were established and developed parallel to developments in rehabilitation. Therefore, opinion of using electrophysiologic test for evaluation and fitting of hearing aid became gradually popular. Ultimately, the electrophysiologic tests are used in evaluation and fitting of hearing aid in two ways: 1-Direct way 2- Indirect way "nIn direct way aided ABR is obtained and special attention is paid to wave V. This technique has many difficulties. Inindirect way, electrophysiologic tests such, ECochG, OAE and ABR, AMLR, ALR and P300 and other objective tests are used, especially in infants and neonates for evaluating the state of hearing. Researches are continuing in this field. It is probable to have aided electrophysiologic responses with speech stimuli in near future.

  6. HIV/AIDS Clinical Trials (United States)

    ... Home Apps APIs Widgets Order Publications Skip Nav HIV/AIDS Clinical Trials Home > Clinical Trials Español small ... Renal (Kidney) Complications/Damage Skin Diseases FDA-Approved HIV Drugs Abacavir Atazanavir Atripla Cobicistat Combivir Complera Darunavir ...

  7. Different Styles of Hearing Aids (United States)

    ... Careers Certification Publications Events Advocacy Continuing Education Practice Management Research Home / Information for the Public / Hearing and Balance Different Styles of Hearing Aids In-the-Canal (ITC) and ...

  8. The return to foreign aid

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Hansen, Henrik

    We investigate the marginal productivity of investment across countries. The aim is to estimate the return on investments financed by foreign aid and by domestic resource mobilization, using aggregate data. Both returns are expected to vary across countries and time. Consequently we develop a cor...... cent. This is in accord with micro estimates of the economic rate of return.......We investigate the marginal productivity of investment across countries. The aim is to estimate the return on investments financed by foreign aid and by domestic resource mobilization, using aggregate data. Both returns are expected to vary across countries and time. Consequently we develop...... a correlated random coefficients model, to estimate the average aggregate return on ‘aid investments’ and ‘domestic investments’. Across different estimators and two different sources for GDP and investment data our findings are remarkably robust; the average gross return on ‘aid investments’ is about 20 per...

  9. Global HIV/AIDS Epidemic (United States)

    ... to text United Nations. Transforming our world: the 2030 Agenda for Sustainable Development ; 2015. ← Return to text UNAIDS. 2011 Political Declaration on HIV/AIDS; 2011, available at: ... 2030 ; 2014. ← Return to text Global Fund. Grants Portfolio; ...

  10. Electronic aids to conceptual design (United States)

    Bouchard, Eugene E.


    Presented in viewgraph form are techniques to improve the conceptual design of complex systems. The paper discusses theory of design, flexible software tools for computer aided design, and methods for enhancing communication among design teams.

  11. Visual Landing Aids (VLA) Laboratory (United States)

    Federal Laboratory Consortium — Purpose:The Visual Landing Aids (VLA) Laboratory serves to support fleet VLA systems by maintaining the latest service change configuration of currently deployed VLA...

  12. AIDS and the management prerogative. (United States)

    Gildea, J


    As with affirmative action in the '70s, it is the big companies that have, in just the last 10 or 12 months, begun to address AIDS in the workplace. Their top executives have come to add such action to the list of management responsibilities. More employers of all sizes may join them, especially those that grasp the true role--and the non-role--of geography in the AIDS epidemic.

  13. The history of AIDS exceptionalism

    Directory of Open Access Journals (Sweden)

    Smith Julia H


    Full Text Available Abstract In the history of public health, HIV/AIDS is unique; it has widespread and long-lasting demographic, social, economic and political impacts. The global response has been unprecedented. AIDS exceptionalism - the idea that the disease requires a response above and beyond "normal" health interventions - began as a Western response to the originally terrifying and lethal nature of the virus. More recently, AIDS exceptionalism came to refer to the disease-specific global response and the resources dedicated to addressing the epidemic. There has been a backlash against this exceptionalism, with critics claiming that HIV/AIDS receives a disproportionate amount of international aid and health funding. This paper situations this debate in historical perspective. By reviewing histories of the disease, policy developments and funding patterns, it charts how the meaning of AIDS exceptionalism has shifted over three decades. It argues that while the connotation of the term has changed, the epidemic has maintained its course, and therefore some of the justifications for exceptionalism remain.

  14. Survey of HIV/AIDS-related Knowledge, Attitude and Determinants in Urban Residents

    Institute of Scientific and Technical Information of China (English)

    何群; 杨放; 林鹏; 王晔; 刘勇鹰; 付笑冰; 赵茜茜


    Objectives: To provide references for HIV/AIDS-re-lated health education strategies through survey on HIV/AIDS-related knowledge, attitude and determi-nants of HIV/AIDS awareness.Methods: The study subjects were selected by ran-dom interception in a downtown street of Guangzhou city on World AIDS Day-December 1,2002. The uni-form questionnaires were finished by means of self-administration.Results: Two hundred questionnaires were distrib-uted and 147 qualified questionnaires were collected.The results showed, the awareness rate of HIV/AIDS-related knowledge was 63.3%, and awareness rate of transmission routes was 76.2 %, whilst non-transmis-sion route was 60.5 %; the awareness rate of trans-mission was 59.2%; the awareness rate of prevention was 47.0%; the positive attitude to people living with HIV/AIDS was 65.6%. Multiple variable Logistic re-gression analysis showed the determinants of HIV/AIDS-related knowledge were education level, age,marital status and gender, of which people with high level of education, young age and the group of male and married had better awareness of HIV/AIDS.Conclusion: Current HIV/AIDS-related knowledge of urban residents is relativly low, especially for the non-transmission route, hence further HIV/AIDS-re-lated education should be strengthened, especially fo-cusing on non-transmission route to eliminate dis-crimination over people living with HIV/AIDS.Further, education efforts also should be put on fe-male population, unmarried population and poorly edu-cated population.


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    Full Text Available In view of the reported emergence of vancomycin resistance in MRSA from the state and the country as a whole we evaluated the pattern of culture and sensitivity on 160 samples from Orthopaedic Department over a period of one year between Nov 2014 and Nov 2015. These belonged to 111 males and 49 females with different aetiologies. Using standard protocols for the culture, 84 (52% samples grew no organisms while Staph aureus was grown in 43 samples (26.8% and gram negative organism in 28 and 5 samples grew mixed organism. Out of these 43 isolates of Staph aureus, MRSA was grown in 32 (74.4% and MSSA in 11 (25.6%. These belonged to 23 (71.8% males and 9 (28.1% females. Majority of MRSA were grown from the patients of acute osteomyelitis and operated fractures (63.3%. Linezolid showed highest sensitivity (100% followed by Vancomycin (96.8%, Clindamycin (37.5%, erythromycin (21%, Amikacin (21%, Levofloxacin (9.3%, cotrimoxazole (9.3% and ciprofloxacin (3.1%. By diffusion method 6 positive cultures depicted doubtful sensitivity pattern for vancomycin (18.75%. However, on further analysis using MIC only one isolate (3.3% showed intermediate resistance to vancomycin; 12 cultures (37.5% were sensitive to vancomycin and linezolid only. The presence of vancomycin resistance calls for a watchful approach towards these infections and an extensive study to better define the problem.

  16. Comparison of operator radiation exposure between C-arm and O-arm fluoroscopy for orthopaedic surgery. (United States)

    Park, Moon Seok; Lee, Kyoung Min; Lee, Boram; Min, Eunki; Kim, Youhyun; Jeon, Sungchae; Huh, Young; Lee, Kisung


    The O-arm system has recently been introduced and has the capability of combined two-dimensional (2-D) fluoroscopy imaging and three-dimensional computed tomography imaging. In this study, an orthopaedic surgical procedure using C-arm and O-arm systems in their 2-D fluoroscopy modes was simulated and the radiation doses to susceptible organs to which operators can be exposed were investigated. The experiments were performed in four configurations of the location of the X-ray source and detector. Shielding effects on the thyroid surface and the direct exposure delivered to the surgeon's hands were also compared. The results obtained show that the O-arm delivered higher doses to the sensitive organs of the operator in all configurations. The thyroid shield cut-off 89 % of the dose in the posteroanterior configuration of both imaging systems. Thus, the operators need to pay more attention to managing radiation exposure, especially when using the O-arm system.

  17. A comparative study of clonidine versus a combination of diazepam and atropine for premedication in orthopaedic patients.

    Directory of Open Access Journals (Sweden)

    Chaurasia S


    Full Text Available Sixty patients in the age group of 18-60 years of A.S.A. Grade I/II risk, scheduled for elective orthopaedic surgeries under general anaesthesia were studied for pre-medication with either oral clonidine or with combination of effects of diazepam & atropine. Patients in Group A (clonidine group received tablet clonidine 100 mcg (1 tablet if less than 50 kg in weight and 200 mcg if weighing more than 50 kg two hours before surgery. Patients in Group B (Diazepam-atropine group received one tablet of Diazepam (10 mg orally two hours before surgery and injection atropine-sulphate 0.01 mg/kg half an hour preoperatively by intramuscular route. In our study, the sedative and anti-sialogogue effects of clonidine were comparable to those of diazepam-atropine combination, which are commonly used premedicants. The anti-anxiety effect of clonidine was found to be better than that of diazepam-atropine combination. Clonidine also proved to be a better agent for the attenuation of pressor response to laryngoscopy and intubation. Thus, oral clonidine is a better premedicant compared to atropine-diazepam combination. Also, it is a more acceptable agent because of its oral route of administration.

  18. Surface treatment by electric discharge machining of Ti-6Al-4V alloy for potential application in orthopaedics. (United States)

    Harcuba, Petr; Bačáková, Lucie; Stráský, Josef; Bačáková, Markéta; Novotná, Katarína; Janeček, Miloš


    This study investigated the properties of Ti-6Al-4V alloy after surface treatment by the electric discharge machining (EDM) process. The EDM process with high peak currents proved to induce surface macro-roughness and to cause chemical changes to the surface. Evaluations were made of the mechanical properties by means of tensile tests, and of surface roughness for different peak currents of the EDM process. The EDM process with peak current of 29 A was found to induce sufficient surface roughness, and to have a low adverse effect on tensile properties. The chemical changes were studied by scanning electron microscopy equipped with an energy dispersive X-ray analyser (EDX). The surface of the benchmark samples was obtained by plasma-spraying a titanium dioxide coating. An investigation of the biocompatibility of the surface-treated Ti-6Al-4V samples in cultures of human osteoblast-like MG 63 cells revealed that the samples modified by EDM provided better substrates for the adhesion, growth and viability of MG 63 cells than the TiO2 coated surface. Thus, EDM treatment can be considered as a promising surface modification to orthopaedic implants, in which good integration with the surrounding bone tissue is required.

  19. Characterization of wear in composite material orthopaedic implants. Part I: The composite trunnion/ceramic head interface. (United States)

    Maharaj, G; Bleser, S; Albert, K; Lambert, R; Jani, S; Jamison, R


    Carbon fiber reinforced polyetheretherketone (C/PEEK) composite materials are being investigated as an alternative to metal in the femoral component of a total hip arthroplasty. Wear is among the issues that must be addressed before introducing a new orthopaedic implant material. This study examines the generation of wear debris when zirconia femoral heads are mechanically attached to C/PEEK trunnions and loaded under simulated physiological conditions. Mechanical testing was performed on a trunnion/head assembly loaded from 445 to 4450N at an angle of 39 degrees to the long axis of the trunnion. The trunnions were tested at a frequency of 20 Hz for 10 million cycles. After completion of the fatigue test, solution from the test assembly was characterized by laser scattering and by SEM image analysis to determine the size, shape, total number, and identify of the particles. In addition, the peak load to pull the head from the trunnion was measured. The total number of particles generated during the test was in the range of 10(5) as indicated by both laser scattering and (SEM) image analysis. Both carbon fiber and PEEK particles were found in an average proportion of about 1:13, respectively. The carbon fiber particle size average was 153 microns and the PEEK particle size average was 2.2 microns. The zirconia heads remained well attached to the C/PEEK trunnions as indicated by a mean peak distraction force of 1942 +/- 116N.

  20. Reduction mammoplasty in a developing country: A 10-year review (2001-2010 at the national orthopaedic hospital, Enugu

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    Chimaobi Isiguzo


    Full Text Available 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, Enugu (a major plastic surgery training center in Nigeria over a ten-year period (2001-2010, in the developing country of Nigeria. Subjects and Methods: All RMs done in the hospital were reviewed after retrieving their records from operation register and medical records department. Fifteen (15 cases were retrieved and analyzed. Data Analysis: Data was analyzed with Microsoft excel 2007. Results: Average age of female patients who had RM was 26.5 years and 83.3% were single. The most common complaint was abnormally large breast (macromastia. Inferior pedicle technique was commonly used. Conclusions: The results of RM are remarkable as it impact positively on the quality of life of the patients. However, the level of awareness about the availability of this service is still low in the region as shown by few cases done over the period of review and this impacts negatively on the training. The need for public awareness cannot be overemphasized.

  1. Singapore General Hospital Experience on Ethnicity and the Incidence of Postoperative Nausea and Vomiting after Elective Orthopaedic Surgeries

    Directory of Open Access Journals (Sweden)

    Xin Yu Adeline Leong


    Full Text Available Introduction. We explored how ethnicity affects the risk of postoperative nausea and vomiting (PONV and established the correlation of suggested risk factors of PONV in the multiethnic population of Singapore. Methods. 785 patients who underwent orthopaedic surgery were recruited. These comprised 619 Chinese (78.9%, 76 Malay (9.7%, 68 Indian (8.7%, and 22 other (2.8% cases. The presence of possible risk factors of PONV and nausea and/or vomiting within 24 h after surgery was studied. Univariate and multivariate logistic regression analyses were performed. Results. The incidence of PONV was 33.2% (261 patients. There was no statistically significant difference of PONV incidence between Chinese, Malay, and Indian cases (34.6% versus 34.2% versus 29.4%, p=0.695. Indian females younger than 50 years were found to have a higher incidence of vomiting (p=0.02. The significant risk factors for this population include females, use of nitrous oxide, and a history of PONV. Conclusion. In the groups studied, ethnicity is not a significant risk factor for PONV except for young Indian females who have a higher risk of postoperative vomiting. We suggest the selective usage of antiemetic for young Indian females as prophylaxis and avoiding nitrous oxide use in high-risk patients.

  2. 数字化技术在骨科的临床应用%Digital technologu used in orthopaedic surery

    Institute of Scientific and Technical Information of China (English)

    张元智; 陆声; 赵建民; 王跃文; 刘瑞; 裴国献


    Objective To discuss digital technology used in orthopaedic surgcry. Methods Digital orthopadic anatomy: 3D models of anterolateral femral flap were teconsructed based on the 2D CT data of 6 adult volunteers using Amira 4.1 software.Next.8 adult volunteers underwent continuous thin-layer chromatography sanning on the hip,knee and ankle joinnts.On the 3D reconstruction models of the joints,centers of th femoral head,the knee,tibia and the ankle wrer defined using Imageware 12.1 software,and the mechanical axes of lower limb were deternined.Digital orthopaedic operative procedure: The preoperative CT scans of 12 patients with hip arthodysplasia were used to reconstruct 3D models of the hip,on the basis of which rapid prototyping was applied to produce the navigation template used in the total hip arthroplasty.Virtual simulation: CT scan images of lumbar vcrtebrae were obtained from 8 adult male volunteers.3D models of L4-5 and their dises and liganents were reconstructed.The models of Wallis system were established and re-meshed to be transformed into Ansys 10.0 software for pre-processing.Next Pemberton osteotomy was simulated for an infant with congenital dislocation of the hip. Results The 3D reconstrution models could perfectly display the anatomic relationships of the strueturcs.The tecmplatc designs facilitated accurate placement of acetabular components in managemen of dysplasia of acetabulum.Virtual simulation could reproduc the process of the orthopaedic proedures. Conclusion All these studies and applications of digital technology in orthopaedic surger3 provide a convineing illustration of an important role of digital orthopaecdics.%目的 探讨数字骨科学理论及数字化技术在骨科中的应用. 方法 数字骨科解剖学:获取健康成人下肢连续薄层CT扫描数据,三维重建股前外侧皮瓣结构并立体显示;获取健康成人髋髓膝、踝关节连续薄层CT扫描数据,三维重建各关节后均建股骨

  3. Understanding involvement in surgical orthopaedic randomized controlled trials: A qualitative study of patient and health professional views and experiences (United States)

    Horwood, Jeremy; Johnson, Emma; Gooberman-Hill, Rachael


    Background Factors influencing patients' motivations for enrolling in, and their experiences of, orthopaedic randomized controlled trials (RCTs) are not fully understood. Less is known about healthcare professionals' (HCP) experiences of RCT involvement. Aim This study investigates patients' and HCPs' views and experiences of RCT participation and delivery to inform the planning of future RCTs. Methods Total hip or knee replacement patients (n = 24) participating in the single-center double-blind APEX RCTs of an intra-operative anesthetic intervention and HCPs (n = 15) involved in trial delivery were interviewed. Data were audio-recorded, transcribed, anonymized and thematically analyzed. Results Although altruistic reasons for RCT participation were common, patients also weighed up demands of the RCT with the potential benefits of taking part, demonstrating the complex and conditional nature of trial participation. HCPs were interested in RCT involvement as a means of contributing towards advances in medical knowledge and also considered the costs and benefits of RCT involvement. Conclusion Patients and HCPs value involvement in RCTs that they see as relevant and of value, while imposing minimum burden. These findings have important implications for the design of methods to recruit patients to RCTs and for planning how an RCT might best interface with HCP clinical commitments. PMID:26772763

  4. Staff perception of interprofessional working relationships after a work redesign intervention in a Danish orthopaedic hand unit outpatient clinic. (United States)

    de Beijer, Anke Elisabeth; Hansen, Torben Bæk; Stilling, Maiken; Jakobsen, Flemming


    There is evidence that clinical pathways improve quality of care; however, knowledge is limited concerning the influence on and the benefits experienced by the interprofessional teams working with these pathways. Our working methods in a hand unit in an orthopaedic outpatient clinic in Denmark were redesigned to include, among other changes, the introduction of clinical pathways. Changes included standardising treatment and communication methods, delegating tasks from medical specialists to nurses, and providing nurses with their own consultation room. Using focus group interviews before and after the implementation of the new working methods, we investigated staff-perceived experiences of the effects on working relationships and the utilisation of professional skills and attitudes, resulting from the mentioned change in working methods. The results were changes in daily communication methods among healthcare staff and improvements in the actual communication and collaborative problem solving skills concerning standard patients with simple hand pathology; however, there are still challenges for patients with more complex hand pathology. Though this new interprofessional arrangement improves the use of nurse and medical specialist professional competencies, it also requires a high degree of trust among the team members.

  5. American Academy of Orthopaedic Surgeons Disclosure Policy Fails to Accurately Inform Its Members of Potential Conflicts of Interest. (United States)

    Tanzer, Dylan; Smith, Karen; Tanzer, Michael


    The American Academy of Orthopaedic Surgeons (AAOS) disclosure policy is designed to ensure that members involved in education or policy development remain free of outside influence. Although mandatory for these members, it is voluntary for the rest of the AAOS membership. To determine surgeon compliance with disclosure policy, we conducted a study in which we compared surgeon-consultants' disclosures as posted on 6 major orthopedic companies' websites in 2011 with those surgeons' disclosures as listed in AAOS disclosure program records. We found that 549 AAOS members were identified by at least 1 company as having received consulting payments. Overall, 44% of AAOS members did not comply with disclosure policy, or their information was not available on the AAOS website (range, 37%-61%). This study demonstrated that AAOS's policy of mandatory disclosure for select members and voluntary disclosure for all other members is ineffective. The AAOS disclosure program and the potential consequences of noncompliance need to be reevaluated by the organization if it wants its program to succeed.

  6. Generating 3D tissue constructs with mesenchymal stem cells and a cancellous bone graft for orthopaedic applications

    Energy Technology Data Exchange (ETDEWEB)

    Arca, Turkan; Genever, Paul [Department of Biology, University of York, York, YO10 5DD (United Kingdom); Proffitt, Joanne, E-mail: [TSL Centre of Biologics, Covidien, Allerton Bywater, Castleford, WF10 2DB (United Kingdom)


    Bone matrix (BM) is an acellular crosslinked porcine-derived cancellous bone graft, and therefore may provide advantages over other synthetic and naturally derived materials for use in orthopaedic surgery. Here, we analysed the potential of BM to support the growth and differentiation of primary human multipotent stromal cells/mesenchymal stem cells (MSCs) in order to predict in vivo bone regeneration events. Imaging with laser scanning confocal microscopy and scanning electron microscopy showed that 1 day after static seeding, a dense population of viable MSCs could be achieved on scaffolds suggesting they could be used for in vivo delivery of cells to the implant site. Long-term growth analysis by confocal imaging and histology demonstrated that BM was permissive to the growth and the 3D population of primary MSCs and an enhanced green fluorescent protein expressing osteosarcoma cell line, eGFP.MG63s, over several days in culture. Measurement of alkaline phosphatase (ALP) activities and mRNA expression levels of osteogenic markers (Runx-2, ALP, collagen type I, osteonectin, osteocalcin and osteopontin) indicated that BM supported osteogenesis of MSCs when supplemented with osteogenic stimulants. Upregulation of some of these osteogenic markers on BM, but not on tissue culture plastic, under non-osteogenic conditions suggested that BM also had osteoinductive capacities.

  7. Orthopaedic rehabilitation--the new marketing concept of value chain%骨科康复--价值链的市场新概念

    Institute of Scientific and Technical Information of China (English)

    陈启明; 罗尚尉; 林蜜蜜


    人员和医院都将得益。%With patients increasing demand on quality of life, the development in orthopaedic rehabilitation is inevitable. As an important part of overall treatment process, rehabilitation is essential for orthopaedic value chain. The integrity of the value chain can lead to high standards of health care and will keep the advantage of orthopaedic in today's competitive market. The Sich⁃uan earthquake in 2008 shows that the patients need long term and comprehensive orthopaedics rehab services apart from ortho⁃paedic surgeries, so that they can resume their living ability and return to society. Moreover, the ageing trend, GDP growth and im⁃provement on healthcare system in China show a great potential in rehabilitation industry. And the market of orthopaedics is uge. It is worth thinking that how we can seize the opportunity to let orthopaedic take the lead in the competitive medical market. In the rapid development, the orthopaedic field has to review its own development model. Apart from a comprehensive value chain with 4A supply chain concepts, the ability to heal the patients, patients' accessibility to service information, consideration of patients' affordability are needed. By improving the flow of orthopaedic rehab, the orthopaedic value chain can be enhanced, including re⁃ducing the time patients have to stay in hospital, improving the treatment effect, making the management more systematic, doing more promotion, enlarging the network, following the country’s healthcare insurance scheme. As patients have higher demand for life quality, they have greater expectation on orthopaedic doctors, surgeries and medicines alone cannot provide the best rehabilita⁃tion. After leaving hospital, patients need to be referred to community healthcare institutions to have rehab treatment. Orthopae⁃dics rehab is an important part in orthopaedic treatments. The ideal value chain is to gather experts, resources, services and equip⁃ment, to make

  8. Human Subjects Issues in AIDS Research. (United States)

    Bayer, Ronald, Ed.


    Six articles are presented on the use of human subjects in research on acquired immune deficiency syndrome (AIDS). Topics include the ethics of human experimentation, female and pediatric AIDS patients, Human Immunodeficiency Virus (HIV) infection and AIDS among correctional inmates, community-based AIDS research, and clinical trials of HIV…

  9. 30 CFR 57.18010 - First aid. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false First aid. 57.18010 Section 57.18010 Mineral... Underground § 57.18010 First aid. An individual capable of providing first aid shall be available on all... aid training shall be made available to all interested miners....

  10. 29 CFR 1915.98 - First aid. (United States)


    ... 29 Labor 7 2010-07-01 2010-07-01 false First aid. 1915.98 Section 1915.98 Labor Regulations...) OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD EMPLOYMENT General Working Conditions § 1915.98 First aid...) Unless a first aid room and a qualified attendant are close at hand and prepared to render first aid...

  11. 7 CFR 15b.37 - Auxiliary aids. (United States)


    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Auxiliary aids. 15b.37 Section 15b.37 Agriculture... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Other Aid, Benefits, or Services § 15b.37 Auxiliary aids... appropriate auxiliary aids to persons with impaired sensory, manual, or speaking skills, where necessary...

  12. Training Aids for Online Instruction: An Analysis. (United States)

    Guy, Robin Frederick

    This paper describes a number of different types of training aids currently employed in online training: non-interactive audiovisual presentations; interactive computer-based aids; partially interactive aids based on recorded searches; print-based materials; and kits. The advantages and disadvantages of each type of aid are noted, and a table…

  13. Spin transition in [Fe (United States)

    Garcia, Y.; Ksenofontov, V.; Campbell, S. J.; Lord, J. S.; Boland, Y.; Gütlich, P.


    The reversible thermal spin transition which occurs in [Fe(phen)2(NCS)2] around T1/2 177 K has been investigated by muon spin relaxation (μSR) (10-280 K). The depolarisation curves are well described by two Lorentzian lines represent fast and slow components in the decay curves, with the initial asymmetry parameter of the fast component found to track the spin transition in [Fe(phen)2(NCS)2]. Comparison of zero-field and transverse field (20 Oe) μSR measurements shows that diamagnetic muonic species occur over the entire temperature range.

  14. How to perform first aid. (United States)

    Gloster, Annabella Satu; Johnson, Phillip John


    RATIONALE AND KEY POINTS: This article aims to help nurses to perform first aid in a safe, effective and patient-centred manner. First aid comprises a series of simple, potentially life-saving steps that an individual can perform with minimal equipment. Although it is not a legal requirement to respond to an emergency situation outside of work, nurses have a professional duty to respond and provide care within the limits of their competency. First aid is the provision of immediate medical assistance to an ill or injured person until definitive medical treatment can be accessed. First aid can save lives and it is essential that nurses understand the basic principles. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. Your skill in performing first aid and any areas where you may need to extend your knowledge. 2. How reading this article will change your practice. Subscribers can upload their reflective accounts at: .

  15. First-aid boxes - Reminder

    CERN Multimedia

    GS Department


    With a view to ensuring optimum use of the first-aid boxes on the CERN site, we should like to remind you of various changes introduced in March 2009: The TSO of the buildings concerned is responsible for the first-aid boxes, including checking their contents.   First-aid boxes may be restocked ONLY at the CERN stores (SCEM No. 54.99.80). This is no longer possible at the Infirmary. The associated cost is charged to the Departments.   First-aid boxes should be used only for mild injuries. All other cases should be referred to the Medical Service Infirmary (Bldg. 57 – ground-floor, tel. 73802) between 8.00 a.m. and 5.30 p.m. or to the Fire and Rescue Service (tel. 74444). N.B.: This information does not apply to the red emergency first-aid boxes in the underground areas or to the emergency kits for use in the event of being splashed with hydrofluoric acid.

  16. Why foreign aid does (not) improve democracy?


    Audrey Menard


    Foreign aid has become closely connected to the development of democracy since the nineties. This paper analyses the democracy effects of aid accounting for this change in donors’ criteria. This approach contributes to the literature by analysing how the kind of donor allocating aid flows influences the effect of aid on democ- racy. I estimate a dynamic panel data model using data from 52 African countries between 1997 and 2008. I find that aid favours democracy. However when consider- ing th...

  17. Changing the Course of AIDS

    DEFF Research Database (Denmark)

    Richey, Lisa Ann


    of social change in southern Africa. This sociological study of HIV/AIDS peer education in diverse South African businesses tries to understand "the web of social relationships that influence behavior" (5), particularly with reference to Erving Goffman's classic framing of social space as "front stage......" and "back stage" and Victor Turner's notion of "liminality." So-called front-stage behavior includes that of workplace peer educators who give training sessions to coworkers within vertically structured communication programs run by HIV/AIDS managers; back-stage interventions include educators...

  18. Governance and Foreign Aid Allocation (United States)


    Aid the Rest Have Done So Much Ill and So Little Good,” Penguin Press, 2005 25. Easterly, William; Levine, Ross and Roodman , David . “New Data, New...Subramanian, “What Undermines Aid’s Impact on Growth?” IMF Working Paper 05/126, Washington, D.C., 2005b 156 85. Roodman , David “An Index of Donor...2000) measure of good policy. Roodman (2004) weights aid from individual donors depending on whether it goes to poor countries and whether it goes to

  19. Italian translation, cultural adaptation and validation of the "American Orthopaedic Foot and Ankle Society's (AOFAS) ankle-hindfoot scale". (United States)

    Leigheb, Massimiliano; Janicka, Paulina; Andorno, Silvano; Marcuzzi, Augusto; Magnani, Corrado; Grassi, Federico


    Background and Aim of the workAnkle and hindfoot injuries are common and may lead to functional impairment, disability, exclusion from occupational and daily activities. It's necessary a standardized method for assessing treatment outcomes in people with same condition and disease.American-Orthopaedics-Foot-and-Ankle-Society's-Ankle-Hindfoot-Evaluation-Scale (AOFAS-AHES) is specific to estimate clinical problems of the ankle-hindfoot.Outcome evaluation scales should be translated and culturally adapted into the language of the investigated patient.Our purpose was to translate and culturally adapt into Italian AOFAS-AHES, and to check its reproducibility and validity.MethodsAn Italian translation of the AOFAS-scale was retranslated into English by a native English and compared to the original to define a second correct Italian-version, that was submitted to 50 randomized patients operated at their ankle or hindfoot with a minimum follow-up of 6 months for cultural adaptation, and to 10 healthcare professionals to check comprehension of the medical part.To check intra and inter-observer reproducibility each patient underwent 2 interviews by interviewer-A and 1 by B. ShortForm(SF)-36-questionnaire for quality of life and Visual-Analogue-Scale (VAS) for pain were also compared for validation. The Pearson's-Correlation-Coefficient and the Intra-Class-Correlation coefficient were calculated to check inter and intra-observer reproducibility for validation.ResultsCultural adaptation revealed to be good. We obtained a good correlation of the inter and intra-observer reproducibility. Further validation of the Italian-AOFAS-AHES was obtained comparing AOFAS results to SF-36.ConclusionsItalian translation, cultural adaptation and validation of the AOFAS-AHES has been performed successfully and could be useful to improve assistance quality in care practice.

  20. Spark Plasma Sintering of Load-Bearing Iron-Carbon Nanotube-Tricalcium Phosphate CerMets for Orthopaedic Applications (United States)

    Montufar, Edgar B.; Horynová, Miroslava; Casas-Luna, Mariano; Diaz-de-la-Torre, Sebastián; Celko, Ladislav; Klakurková, Lenka; Spotz, Zdenek; Diéguez-Trejo, Guillermo; Fohlerová, Zdenka; Dvorak, Karel; Zikmund, Tomáš; Kaiser, Jozef


    Recently, ceramic-metallic composite materials (CerMets) have been investigated for orthopaedic applications with promising results. This first generation of bio-CerMets combine the bioactivity of hydroxyapatite with the mechanical stability of titanium to fabricate bioactive, tough and biomechanically more biocompatible osteosynthetic devices. Nonetheless, these first CerMets are not biodegradable materials and a second surgery is required to remove the implant after bone healing. The present work aims to develop the next generation bio-CerMets, which are potential biodegradable materials. The process to produce the new biodegradable CerMet consisted of mixing powder of soluble and osteoconductive alpha tricalcium phosphate with biocompatible and biodegradable iron with consolidation through spark plasma sintering (SPS). The microstructure, composition and mechanical strength of the new CerMet were studied by metallography, x-ray diffraction and diametral tensile strength tests, respectively. The results show that SPS produces CerMet with higher mechanical performance (120 MPa) than the ceramic component alone (29 MPa) and similar mechanical strength to the pure metallic component (129 MPa). Nonetheless, although a short sintering time (10 min) was used, partial transformation of the alpha tricalcium phosphate into its allotropic and slightly less soluble beta phase was observed. Cell adhesion tests show that osteoblasts are able to attach to the CerMet surface, presenting spread morphology regardless of the component of the material with which they are in contact. However, the degradation process restricted to the small volume of the cell culture well quickly reduces the osteoblast viability.