Effects of pineapple byproduct and canola oil as fat replacers on physicochemical and sensory qualities of low-fat beef burger.

Science.gov (United States)

Selani, Miriam M; Shirado, Giovanna A N; Margiotta, Gregório B; Saldaña, Erick; Spada, Fernanda P; Piedade, Sonia M S; Contreras-Castillo, Carmen J; Canniatti-Brazaca, Solange G

2016-02-01

Pineapple byproduct and canola oil were evaluated as fat replacers on physicochemical and sensory characteristics of low-fat burgers. Five treatments were performed: conventional (CN, 20% fat) and four low-fat formulations (10% fat): control (CT), pineapple byproduct (PA), canola oil (CO), pineapple byproduct and canola oil (PC). Higher water and fat retention and lower cooking loss and diameter reduction were found in burgers with byproduct addition. In raw burgers, byproduct incorporation reduced L*, a*, and C* values, but these alterations were masked after cooking, leading to products similar to CN. Low-fat treatments were harder, chewier, and more cohesive than full-fat burgers. However, in Warner Bratzler shear measurements, PA and PC were as tender as CN. In QDA, no difference was found between CN and PC. Pineapple byproducts along with canola oil are promising fat replacers in beef burgers. In order to increase the feasibility of use of pineapple byproduct in the meat industry, alternative processes of byproduct preparation should be evaluated in future studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Non-uniform muscle fat replacement along the proximodistal axis in Duchenne muscular dystrophy.

Science.gov (United States)

Hooijmans, M T; Niks, E H; Burakiewicz, J; Anastasopoulos, C; van den Berg, S I; van Zwet, E; Webb, A G; Verschuuren, J J G M; Kan, H E

2017-05-01

The progressive replacement of muscle tissue by fat in Duchenne muscular dystrophy (DMD) has been studied using quantitative MRI between, but not within, individual muscles. We studied fat replacement along the proximodistal muscle axis using the Dixon technique on a 3T MR scanner in 22 DMD patients and 12 healthy controls. Mean fat fractions per muscle per slice for seven lower and upper leg muscles were compared between and within groups assuming a parabolic distribution. Average fat fraction for a small central slice stack and a large coverage slice stack were compared to the value when the stack was shifted one slice (15 mm) up or down. Higher fat fractions were observed in distal and proximal muscle segments compared to the muscle belly in all muscles of the DMD subjects (p muscle end regions are exposed to higher mechanical strain, which points towards mechanical disruption of the sarcolemma as one of the key factors in the pathophysiology. Overall, this non-uniformity in fat replacement needs to be taken into account to prevent sample bias when applying quantitative MRI as biomarker in clinical trials for DMD. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of Persian and almond gums as fat replacers on the physicochemical, rheological, and microstructural attributes of low-fat Iranian White cheese.

Science.gov (United States)

Jooyandeh, Hossein; Goudarzi, Mostafa; Rostamabadi, Hadis; Hojjati, Mohammad

2017-05-01

The effect of Persian and almond gums (0, 0.1 and 0.2% (w/w)) as fat replacers and milk fat (0.4, 0.9, and 1.4% (w/w)) on physicochemical and rheological characteristics and microstructure of low-fat Iranian White cheese was studied. Persian and almond gums both effectively increased moisture-to-protein (M:P) ratio of low-fat cheese samples which in turn led to a significant reduction in the hardness parameters fracture stress and Young's and storage (G') moduli ( p  Persian gum was more pronounced ( p  Persian gum and 0.12% almond gum would result in a low-fat cheese with textural properties similar to its full-fat counterpart. Scanning electron microscopy revealed that the fat replacers produced full-fat-like structure in the low-fat Iranian White cheese, when incorporated at the optimum levels.

Stability Emulsion and Sensory Characteristics Low Fat Mayonnaise Using Kefir as Emulsifier Replacer

Directory of Open Access Journals (Sweden)

Herly Evanuarini

2017-03-01

Full Text Available Mayonnaise is a kind of semi solid oil in water (o/w emulsion which containing pasteurized egg yolk as an emulsifier. The consumers have demanded that the use of egg yolk be reduced. Kefir was used to develop a low fat mayonnaise as emulsifier replacer to egg yolk. The objective of this research was to observe the emulsion stability, sensory characteristics of low fat mayonnaise prepare during kefir as emulsifier replacer. The research method was using experimental design. The result showed that formulation of low fat mayonnaise by using Rice bran oil 40%, kefir 20% produces the optimal low fat mayonnaise in emulsion stability and accepted by the panelist.

Galectin-3 levels relate in children to total body fat, abdominal fat, body fat distribution, and cardiac size.

Science.gov (United States)

Dencker, Magnus; Arvidsson, Daniel; Karlsson, Magnus K; Wollmer, Per; Andersen, Lars B; Thorsson, Ola

2018-03-01

Galectin-3 has recently been proposed as a novel biomarker for cardiovascular disease in adults. The purpose of this investigation was to assess relationships between galectin-3 levels and total body fat, abdominal fat, body fat distribution, aerobic fitness, blood pressure, left ventricular mass, left atrial size, and increase in body fat over a 2-year period in a population-based sample of children. Our study included 170 children aged 8-11 years. Total fat mass and abdominal fat were measured by dual-energy x-ray absorptiometry (DXA). Body fat distribution was expressed as abdominal fat/total fat mass. Maximal oxygen uptake was assessed by indirect calorimetry during a maximal exercise test and scaled to body mass. Systolic and diastolic blood pressure and pulse pressure were measured. Left atrial size, left ventricular mass, and relative wall thickness were measured by echocardiography. Frozen serum samples were analyzed for galectin-3 by the Proximity Extension Assay technique. A follow-up DXA scan was performed in 152 children 2 years after the baseline exam. Partial correlations, with adjustment for sex and age, between galectin-3 versus body fat measurements indicated weak to moderate relationships. Moreover, left atrial size, left ventricular mass, and relative wall thickness and pulse pressure were also correlated with galectin-3. Neither systolic blood pressure nor maximal oxygen uptake was correlated with galectin-3. There was also a correlation between galectin-3 and increase in total body fat over 2 years, while no such correlations were found for the other fat measurements. More body fat and abdominal fat, more abdominal body fat distribution, more left ventricular mass, and increased left atrial size were all associated with higher levels of galectin-3. Increase in total body fat over 2 years was also associated with higher levels of galectin-3. What is Known: • Galectin-3 has been linked to obesity and been proposed to be a novel biomarker

Fat Replacement of Paraspinal Muscles with Aging in Healthy Adults

DEFF Research Database (Denmark)

Dahlqvist, Julia R; Vissing, Christoffer R; Hedermann, Gitte

2017-01-01

also tested for association with sex, body mass index (BMI), physical activity, and lower back pain. RESULTS: Both paraspinal and leg fat fractions correlated directly with age (P ages, fat fraction was higher in paraspinal than leg muscles. The age-related increase in fat fraction...... was associated with lumbar paraspinal fat fraction (P activity or lower back pain. CONCLUSION: The paraspinal muscles were more susceptible to age-related changes than leg muscles. Further, men had......PURPOSE: The aims of this study were to investigate the age-related changes in fatty replacement and cross-sectional area (CSA) of cervical, thoracic, and lumbar paraspinal muscles versus leg muscles in healthy adults and to test for association between muscle fat fraction and lifestyle factors...

Optimization of a sponge cake formulation with inulin as fat replacer: structure, physicochemical, and sensory properties.

Science.gov (United States)

Rodríguez-García, Julia; Puig, Ana; Salvador, Ana; Hernando, Isabel

2012-02-01

The effects of several fat replacement levels (0%, 35%, 50%, 70%, and 100%) by inulin in sponge cake microstructure and physicochemical properties were studied. Oil substitution for inulin decreased significantly (P cake structure development during baking. Cryo-SEM micrographs of cake crumbs showed a continuous matrix with embedded starch granules and coated with oil; when fat replacement levels increased, starch granules appeared as detached structures. Cakes with fat replacement up to 70% had a high crumb air cell values; they were softer and rated as acceptable by an untrained sensory panel (n = 51). So, the reformulation of a standard sponge cake recipe to obtain a new product with additional health benefits and accepted by consumers is achieved. Practical Application:  In this study, fat is replaced by inulin in cakes, which is a fiber mainly obtained from chicory roots. Sponge cake formulations with reductions in fat content up to 70% are achieved. These high-quality products can be labeled as "reduced in fat" according to U.S. FDA (2009) and EU regulations (European-Union 2006). © 2012 Institute of Food Technologists®

Pectin from Citrus Canning Wastewater as Potential Fat Replacer in Ice Cream

Directory of Open Access Journals (Sweden)

Hua Zhang

2018-04-01

Full Text Available Pectin had been recovered from canning wastewater produced by chemical treatment of segment membrane during preparation of canned citrus in our previous research. The purpose of this study was to characterize the extracted pectin from canning wastewater, and to evaluate its application as a fat alternative to replace fat in ice cream. The monosaccharide composition and rheological properties of the pectin were determined. The influences of fat reduction and pectin addition on the physicochemical, rheological and sensory properties of low-fat ice cream were determined. The rheological results showed that pectin solutions were typical pseudoplastic fluids. The addition of pectin in ice cream can cause an increase in viscosity, overrun, and hardness, and a decrease in meltdown of the ice cream. When 0.72% pectin (w/w is incorporated into ice cream, a prototype product of ice cream with 45% lower fat content compared to the control was made. Results indicated that their qualities such as appearance, flavor, and taste were not significantly different. The low-fat ice cream had higher smoothness scores and lower mouth-coating scores. Hence, pectin extracted from citrus canning wastewater can be potentially used as fat replacer in ice cream, which benefits both the environment and the food industry.

Pectin from Citrus Canning Wastewater as Potential Fat Replacer in Ice Cream.

Science.gov (United States)

Zhang, Hua; Chen, Jianle; Li, Junhui; Wei, Chaoyang; Ye, Xingqian; Shi, John; Chen, Shiguo

2018-04-17

Pectin had been recovered from canning wastewater produced by chemical treatment of segment membrane during preparation of canned citrus in our previous research. The purpose of this study was to characterize the extracted pectin from canning wastewater, and to evaluate its application as a fat alternative to replace fat in ice cream. The monosaccharide composition and rheological properties of the pectin were determined. The influences of fat reduction and pectin addition on the physicochemical, rheological and sensory properties of low-fat ice cream were determined. The rheological results showed that pectin solutions were typical pseudoplastic fluids. The addition of pectin in ice cream can cause an increase in viscosity, overrun, and hardness, and a decrease in meltdown of the ice cream. When 0.72% pectin ( w / w ) is incorporated into ice cream, a prototype product of ice cream with 45% lower fat content compared to the control was made. Results indicated that their qualities such as appearance, flavor, and taste were not significantly different. The low-fat ice cream had higher smoothness scores and lower mouth-coating scores. Hence, pectin extracted from citrus canning wastewater can be potentially used as fat replacer in ice cream, which benefits both the environment and the food industry.

Associations of Infant Subcutaneous Fat Mass with Total and Abdominal Fat Mass at School-Age: The Generation R Study.

Science.gov (United States)

Santos, Susana; Gaillard, Romy; Oliveira, Andreia; Barros, Henrique; Abrahamse-Berkeveld, Marieke; van der Beek, Eline M; Hofman, Albert; Jaddoe, Vincent W V

2016-09-01

Skinfold thickness enables the measurement of overall and regional subcutaneous fatness in infancy and may be associated with total and abdominal body fat in later childhood. We examined the associations of subcutaneous fat in infancy with total and abdominal fat at school-age. In a population-based prospective cohort study among 821 children, we calculated total subcutaneous fat (sum of biceps, triceps, suprailiacal, and subscapular skinfold thicknesses) and central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat) at 1.5 and 24 months. At 6 years, we measured fat mass index (total fat/height(3) ), central-to-total fat ratio (trunk fat/total fat), and android-to-gynoid fat ratio (android fat/gynoid fat) by dual-energy X-ray absorptiometry and preperitoneal fat mass area by abdominal ultrasound. Central-to-total subcutaneous fat ratio at 1.5 months was positively associated with fat mass index and central-to-total fat ratio at 6 years, whereas both total and central-to-total subcutaneous fat ratio at 24 months were positively associated with all childhood adiposity measures. A 1-standard-deviation scores higher total subcutaneous fat at 24 months was associated with an increased risk of childhood overweight (odds ratio 1.70, 95% confidence interval 1.36, 2.12). These associations were weaker than those for body mass index and stronger among girls than boys. Subcutaneous fat in infancy is positively associated with total and abdominal fat at school-age. Our results also suggest that skinfold thicknesses add little value to estimate later body fat, as compared with body mass index. © 2016 John Wiley & Sons Ltd.

Associations of infant subcutaneous fat mass with total and abdominal fat mass at school-age. The Generation R Study

Science.gov (United States)

Santos, Susana; Gaillard, Romy; Oliveira, Andreia; Barros, Henrique; Abrahamse-Berkeveld, Marieke; van der Beek, Eline M; Hofman, Albert; Jaddoe, Vincent WV

2017-01-01

Background Skinfold thickness enables the measurement of overall and regional subcutaneous fatness in infancy and may be associated with total and abdominal body fat in later childhood. We examined the associations of subcutaneous fat in infancy with total and abdominal fat at school-age. Methods In a population-based prospective cohort study among 821 children, we calculated total subcutaneous fat (sum of biceps, triceps, suprailiacal and subscapular skinfold thicknesses) and central-to-total subcutaneous fat ratio (sum of suprailiacal and subscapular skinfold thicknesses/total subcutaneous fat) at 1.5 and 24 months. At 6 years, we measured fat mass index (total fat/height3), central-to-total fat ratio (trunk fat/total fat) and android-to-gynoid fat ratio (android fat/gynoid fat) by dual-energy X-ray absorptiometry and preperitoneal fat mass area by abdominal ultrasound. Results Central-to-total subcutaneous fat ratio at 1.5 months was positively associated with fat mass index and central-to-total fat ratio at 6 years, whereas both total and central-to-total subcutaneous fat ratio at 24 months were positively associated with all childhood adiposity measures (pfat at 24 months was associated with an increased risk of childhood overweight (Odds Ratio 1.70 [95% Confidence Interval 1.36, 2.12]). These associations were weaker than those for body mass index and stronger among girls than boys. Conclusions Subcutaneous fat in infancy is positively associated with total and abdominal fat at school-age. Our results also suggest that skinfold thicknesses add little value to estimate later body fat, as compared to body mass index. PMID:27225335

Possibilities to develop low-fat products: a review

Directory of Open Access Journals (Sweden)

Tufeanu Roxana

2016-06-01

Full Text Available Research has proved a relationship between high fat consumption and rise in obesity, atherosclerosis, coronary heart diseases and high blood pressure. Therefore is recommended the moderate consumption of fat, such that the total fat does not exceed 30% of total energy intake. Our body needs fats because are providers of calories, essential fatty acids, fat-soluble vitamins and also they are necessary ingredients of the foods. The development of products with low-fat content can be considerate a challenge because the lipids offers aroma, texture, appearance, flavour and mouth feel, qualities that customers want in food products. A fat reduction can be achieved by using different fat replacers to ensure the functionality of the replaced fat. Functional components of fat replacers can have a significant role in promotion of wellbeing, in treating and preventing diseases. Thus, fat replacers should be recognized as safe and healthy, which have sensorial and functional properties. This paper reviews the fat replacers used to obtain foods as meat-based or dairy products. Some ways to obtain healthier meat products by reducing saturated fats content consist in the utilization of unsaturated vegetable oils, vegetable products, fibre. The utilization of fibre in products such bolognas, sausages or hamburgers, can improve the texture profile, binding properties and the characteristics regarding the cooking process. A fat reduction in dairy products can be achieved by replacing it with starches, polysaccharides, gums or fibres from cereal, vegetables and fruits. In acidified milk products, fibres have benefits as: low syneresis, sensory characteristics accepted by consumers, improvement of texture and rheological properties. In cheeses production, the fat reduction can be realised by replacing it with carbohydrate or protein-based replacers in order to obtain a final product with proper characteristics.

Egg white powder-stabilised multiple (water-in-olive oil-in-water) emulsions as beef fat replacers in model system meat emulsions.

Science.gov (United States)

Öztürk, Burcu; Urgu, Müge; Serdaroğlu, Meltem

2017-05-01

Today, multiple emulsions are believed to have a considerable application potential in food industry. We aimed to investigate physical, chemical and textural quality characteristics of model system meat emulsions (MSME) in which beef fat (C) was totally replaced by 10% (E-10), 20% (E-20) or 30% (E-30) multiple emulsions (W 1 /O/W 2 ) prepared with olive oil and egg white powder (EWP). Incorporation of W 1 /O/W 2 emulsion resulted in reduced fat (from 11.54% to 4.01%), increased protein content (from 13.66% to 14.74%), and modified fatty acid composition, significantly increasing mono- and polyunsaturated fatty acid content and decreasing saturated fatty acid content. E-20 and E-30 samples had lower jelly and fat separation (5.77% and 5.25%) compared to C and E-10 (9.67% and 8.55%). W 1 /O/W 2 emulsion treatments had higher water-holding capacity (93.96-94.35%) than C samples (91.84%), and also showed the desired storage stability over time. Emulsion stability results showed that E-20 and E-30 samples had lower total expressible fluid (14.05% and 14.53%) and lower total expressible fat (5.06% and 5.33%) compared to C samples (19.13% and 6.09%). Increased concentrations of W 1 /O/W 2 emulsions led to alterations in colour and texture parameters. TBA values of samples were lower in W 1 /O/W 2 emulsion treatments than control treatment during 60 days of storage. Our results indicated that multiple emulsions prepared with olive oil and EWP had promising impacts on reducing fat, modifying the lipid composition and developing both technologically and oxidatively stable meat systems. These are the first findings concerning beef matrix fat replacement with multiple emulsions stabilised by EWP. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Patients Unicondylar Knee Replacement vs. Total Knee Replacement

OpenAIRE

Hedra Eskander

2017-01-01

The aim of this review article is to analyse the clinical effectiveness of total knee replacement (TKR) compared to unicondylar knee replacement (UKR) on patients. In terms of survival rates, revision rates and postoperative complications. The keywords used were: knee arthroplasty. Nearly three thousand articles were found on 25 August 2016. Of those, only twenty-five were selected and reviewed because they were strictly focused on the topic of this article. Compared with those who have TKR, ...

Bovine Blood Constituents as Fat Replacers in Ham Pâté

Directory of Open Access Journals (Sweden)

Fabiana Ribeiro Viana

2004-01-01

Full Text Available Some tests were carried out in this work with the aim of evaluating a partial replacement of fat in the raw batter of ham pâté by using bovine blood constituents, such as globin (GL, plasma (PL or 1:1 globin and plasma (GP. Plasma was separated from red cells by blood centrifugation, and globin was extracted by the carboxymethylcellulose method. The salt-soluble protein content (SSP and the binding properties including water holding capacity (WHC and raw batter stability (RBS were estimated. The results indicated that among the 3 treatments studied, the use of globin showed to be a little more advantageous for the quality of the raw batter of ham pâté, since its incorporation as fat replacer led to an increase in RBS but no change of SSP was observed.

The use of inulin as fat replacer and its effect on texture and sensory properties of emulsion type sausages

Science.gov (United States)

Berizi, E.; Shekarforoush, S. S.; Mohammadinezhad, S.; Hosseinzadeh, S.; Farahnaki, A.

2017-01-01

The present study aimed to investigate the possibility of reducing energy content in emulsion type sausages by replacing fat with inulin. In the manufactured product, the fat content was reduced to 6%-18% and replaced by inulin and water. The quality of the resulting product was determined by chemical and texture profile analyses (TPA), color measurement and sensory evaluation. The results showed that replacing fat with inulin led to a significant energy content reduction of up to 64% (with 6% inulin and 12% water). In addition, color measurement, sensory evaluation and TPA were comparable to the traditional product in the inulin treated samples. The overall acceptability of all experimental groups was adequate; therefore, inulin is suggested as a good replacement for fat in emulsion type sausages. PMID:29387097

Pineapple by-product and canola oil as partial fat replacers in low-fat beef burger: Effects on oxidative stability, cholesterol content and fatty acid profile.

Science.gov (United States)

Selani, Miriam M; Shirado, Giovanna A N; Margiotta, Gregório B; Rasera, Mariana L; Marabesi, Amanda C; Piedade, Sonia M S; Contreras-Castillo, Carmen J; Canniatti-Brazaca, Solange G

2016-05-01

The effect of freeze-dried pineapple by-product and canola oil as fat replacers on the oxidative stability, cholesterol content and fatty acid profile of low-fat beef burgers was evaluated. Five treatments were performed: conventional (CN, 20% fat) and four low-fat formulations (10% fat): control (CT), pineapple by-product (PA), canola oil (CO), and pineapple by-product and canola oil (PC). Low-fat cooked burgers showed a mean cholesterol content reduction of 9.15% compared to the CN. Canola oil addition improved the fatty acid profile of the burgers, with increase in the polyunsaturated/saturated fatty acids ratio and decrease in the n-6/n-3 ratio, in the atherogenic and thrombogenic indexes. The oxidative stability of the burgers was affected by the vegetable oil addition. However, at the end of the storage time (120 days), malonaldehyde values of CO and PC were lower than the threshold for the consumer's acceptance. Canola oil, in combination with pineapple by-product, can be considered promising fat replacers in the development of healthier burgers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Telerehabilitation Feasibility in Total Joint Replacement

Directory of Open Access Journals (Sweden)

Mark J. Nelson

2017-11-01

Full Text Available Despite documented benefits, many Total Joint Replacement (TJR patients find it difficult to access rehabilitation following discharge from hospital. One solution to improve access for TJR patients is telerehabilitation. This study aimed to assess the feasibility of introducing a telerehabilitation program for TJR patients.   TJR patients at QEII Jubilee Hospital were invited to complete a questionnaire regarding their access, feelings towards and preferences in using technology. Seventy-five patients were recruited. Most patients had computer access (72% and internet (69% at home. Sixty-five percent of participants were willing to participate in telerehabilitation. A significant difference was found between older and younger patients. Watching videos on an electronic device was the preferred method for a technology-based home exercise program and phone call the preferred method of communication.  Results indicate telerehabilitation in the TJR population is feasible from the perspective of access to, feelings toward, and preferences for technology. Keywords: Hip replacement, Knee replacement, Telerehabilitation, Telemedicine, Total joint replacement

Total pancreatic lipomatosis with malabsorption syndrome

Directory of Open Access Journals (Sweden)

Rama Anand

2011-01-01

Full Text Available Total fat replacement of the pancreas is rare. Focal fatty replacement is the most common degenerative lesion of pancreas. Focal fatty deposits have no major clinical significance; however, extreme fat replacement is of pathologic significance, as it is associated with marked reduction in exocrine function of pancreas, resulting in malabsorption due to pancreatic enzyme insufficiency.

Functional characterization of steam jet-cooked buckwheat flour as a fat replacer in cake-baking.

Science.gov (United States)

Min, Bockki; Lee, Seung Mi; Yoo, Sang-Ho; Inglett, George E; Lee, Suyong

2010-10-01

With rising consumer awareness of obesity, the food industry has a market-driven impetus to develop low-fat or fat-free foods with acceptable taste and texture. Fancy buckwheat flour was thus subjected to steam jet-cooking and the performance of the resulting product in cake-baking was evaluated as a fat replacer. Steam jet-cooking caused structural breakdown and starch gelatinization of buckwheat flour, thus increasing its water hydration properties. In the pasting measurements, steam jet-cooked buckwheat flour exhibited high initial viscosity, while no peak viscosity was observed. Also, the suspensions of steam jet-cooked buckwheat flour exhibited shear-thinning behaviors, which were well characterized by the power law model. When shortening in cakes was replaced with steam jet-cooked buckwheat gels, the specific gravity of cake batters significantly increased, consequently affecting cake volume after baking. However, shortening replacement with steam jet-cooked buckwheat up to 20% by weight appeared to be effective in producing cakes as soft as the control without volume loss. When buckwheat flour was thermomechanically modified by steam jet-cooking, it was successfully incorporated into cake formulations for shortening up to 20% by weight, producing low-fat cakes with comparable volume and textural properties to the control. Copyright © 2010 Society of Chemical Industry.

Effects of total fat intake on bodyweight in children.

Science.gov (United States)

Naude, Celeste E; Visser, Marianne E; Nguyen, Kim A; Durao, Solange; Schoonees, Anel

2018-02-15

As part of efforts to prevent childhood overweight and obesity, we need to understand the relationship between total fat intake and body fatness in generally healthy children. To assess the effects of total fat intake on measures of weight and body fatness in children and young people not aiming to lose weight. For this update we revised the previous search strategy and ran it over all years in the Cochrane Library, MEDLINE (Ovid), MEDLINE (PubMed), and Embase (Ovid) (current to 23 May 2017). No language and publication status limits were applied. We searched the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov for ongoing and unpublished studies (5 June 2017). We included randomised controlled trials (RCTs) in children aged 24 months to 18 years, with or without risk factors for cardiovascular disease, randomised to a lower fat (30% or less of total energy (TE)) versus usual or moderate-fat diet (greater than 30%TE), without the intention to reduce weight, and assessed a measure of weight or body fatness after at least six months. We included prospective analytical cohort studies in these children if they related baseline total fat intake to weight or body fatness at least 12 months later. We duplicated inclusion decisions and resolved disagreement by discussion with other authors. We extracted data on participants, interventions or exposures, controls and outcomes, and trial or cohort quality characteristics, as well as data on potential effect modifiers, and assessed risk of bias for all included studies. We extracted outcome data using the following time point ranges, when available: RCTs: baseline to six months, six to 12 months, one to two years, two to five years and more than five years; cohort studies: baseline to one year, one to two years, two to five years, five to 10 years and more than 10 years. We planned to perform random-effects meta-analyses with relevant subgrouping, and sensitivity and funnel plot

Severe Heterotopic Ossification following Total Knee Replacement

Directory of Open Access Journals (Sweden)

Alexander L. Dodds

2014-01-01

Full Text Available Although the incidence of minor heterotopic ossification is probably higher than what is usually expected, severe heterotopic ossification (HO is an extremely rare event following total knee replacement surgery. We present the case of a 66-year-old woman who initially had achieved an excellent range of motion following bilateral uncemented rotating platform total knee replacement, before presenting with pain and loss of range of motion at 2 months after surgery. Severe HO was diagnosed on X-rays. Treatment consisted of nonoperative measures only, including physiotherapy with hydrotherapy and anti-inflammatories. She eventually regained her range of motion when seen at 8 months after operation. This case illustrates that nonoperative treatment without the use of radiotherapy or surgery can be used to safely resolve stiffness caused by HO after total knee replacement.

Food-grade double emulsions as effective fat replacers in meat systems

NARCIS (Netherlands)

Eisinaite, Viktorija; Juraite, Dovile; Schroën, Karin; Leskauskaite, Daiva

2017-01-01

Double emulsions were used to not only replace 7 and 11% of animal fat in meat products, but also as a way to enhance the product colour. The coarse emulsion containing native beetroot juice as inner water phase, sunflower oil as oil phase and 0.5% whey protein isolate as outer water phase was

Effect of fat replacement by olive oil on the physico-chemical properties, fatty acids, cholesterol and tocopherol content of pâté

Energy Technology Data Exchange (ETDEWEB)

Dominguez, R.; Agregan, R.; GonCalves, A.; Lorenzo, J.M.

2016-07-01

The present study investigates the effects of olive oil when used as back fat replacers on the physico-chemical properties, fatty acids, cholesterol and α-tocopherol content of pâté. The replacement of back fat by olive oil at 50 and 100% did not affect the moisture, fat or protein contents, while it increased yellowness. According to texture parameters, reformulated pâté presented lower values for hardness, cohesiveness, gumminess and chewiness. The use of olive oil significantly (P<0.05) affected the fatty acid content. The amount of MUFA increased, while the content of SFA and PUFA decreased as the back fat was replaced by olive oil. The replacement of fat resulted in an improvement in all nutritional indexes. Atherogenic and thrombogenic indexes decreased while the h/H ratio increased with fat replacement. At the same time, the content of α-tocopherol increased and the amount of cholesterol decreased with the addition of olive oil. Therefore, olive oil provides pâté with high levels of C18:1n9c and MUFA, natural antioxidants such as α-tocopherol and reduces cholesterol levels. As a general conclusion, the replacement of back fat by olive oil allows us to obtain a healthier product. (Author)

The effect of replacing lactose by starch on protein and fat digestion in milk-fed veal calves

NARCIS (Netherlands)

Pluschke, A.M.; Gilbert, M.S.; Williams, B.A.; Borne, van den J.J.G.C.; Schols, H.A.; Gerrits, W.J.J.

2016-01-01

Replacing dairy components from milk replacer (MR) with vegetable products has been previously associated with decreased protein and fat digestibility in milk-fed calves resulting in lower live weight gain. In this experiment, the major carbohydrate source in MR, lactose, was partly replaced with

Muffins Elaborated with Optimized Monoglycerides Oleogels: From Solid Fat Replacer Obtention to Product Quality Evaluation.

Science.gov (United States)

Giacomozzi, Anabella S; Carrín, María E; Palla, Camila A

2018-05-22

This study demonstrates the effectiveness of using oleogels from high oleic sunflower oil (HOSO) and monoglycerides as solid fat replacers in a sweet bakery product. Firstly, a methodology to obtain oleogels with desired properties based on mathematical models able to describe relationships between process and product characteristics variables followed by multi-objective optimization was applied. Later, muffins were prepared with the optimized oleogels and their physicochemical and textural properties were compared with those of muffins formulated using a commercial margarine (Control) or only HOSO. Furthermore, the amount of oil released from muffins over time (1, 7, and 10 days) was measured to evaluate their stability. The replacement of commercial margarine with the optimized oleogels in muffin formulation led to the obtention of products with greater spreadability, higher specific volume, similar hardness values, and a more connected and homogeneous crumb structure. Moreover, these products showed a reduction of oil migration of around 50% in contrast to the Control muffins after 10 days of storage, which indicated that the optimized oleogels can be used satisfactorily to decrease oil loss in this sweet baked product. Fat replacement with the optimized monoglycerides oleogels not only had a positive impact on the quality of the muffins, but also allowed to improve their nutritional profile (without trans fat and low in saturated fat). The food industry demands new ways to reduce the use of saturated and trans fats in food formulations. To contribute to this search, oleogels from high oleic sunflower oil and saturated monoglycerides were prepared under optimized conditions in order to obtain a product with similar functionality to margarine, and its potential application as a semisolid fat ingredient in muffins was evaluated. Muffins formulated with oleogels showed an improved quality compare with those obtained using a commercial margarine with the added

Assessment of total polar materials in Frying fats from Czech restaurants

Directory of Open Access Journals (Sweden)

J. Mlcek

2015-06-01

Full Text Available Deep-frying is commonly used as convenient technique for the preparation of foods. The frying oils and fats are absorbed by fried food and become a part of diet. The content of total polar materials was determined in frying oils and fats in 46 restaurants from South Moravia and the Olomouc regions. Twenty-eight samples were found with total polar materials with limit of rejection over 24%. The highest total polar materials values were observed in cooking fat; the lowest one was in vegetable shortening oil. This conclusion corresponds with frying temperatures, which were highest in cooking fat.

The use of adaptive equipment following total knee replacement

OpenAIRE

McNaught, Jamie; Paul, Lorna

2015-01-01

Introduction: This study evaluates the need for adaptive equipment following total knee replacement. There are no recent studies to guide occupational therapists in the optimum time adaptive equipment is required following total knee replacement.\\ud \\ud Method: A non-experimental, concurrent mixed methods approach was used. The study population was patients attending for total knee replacement at a large general hospital. Outcome measures were the Oxford Knee Score, the United Kingdom Functio...

Emulsion characteristics, chemical and textural properties of meat systems produced with double emulsions as beef fat replacers.

Science.gov (United States)

Serdaroğlu, Meltem; Öztürk, Burcu; Urgu, Müge

2016-07-01

In recent years, double emulsions are stated to have a promising potential in low-fat food production, however, there are very few studies on their possible applications in meat matrices. We aimed to investigate the quality of beef emulsion systems in which beef fat was totally replaced by double emulsions (W1/O/W2) prepared with olive oil and sodium caseinate (SC) by two-step emulsification procedure. Incorporation of W1/O/W2 emulsion resulted in reduced lipid, increased protein content, and modified fatty acid composition. W1/O/W2 emulsion treatments had lower jelly and fat separation, higher water-holding capacity and higher emulsion stability than control samples with beef fat. Increased concentrations of W1/O/W2 emulsions resulted in significant changes in texture parameters. TBA values were lower in W1/O/W2 emulsion treatments than control treatment after 60days of storage. In conclusion, our study confirms that double emulsions had promising impacts on modifying fatty acid composition and developing both technologically and oxidatively stable beef emulsion systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Comparative Effect of Carrot and Lemon Fiber as a Fat Replacer on Physico-chemical, Textural, and Organoleptic Quality of Low-fat Beef Hamburger.

Science.gov (United States)

Soncu, Eda Demirok; Kolsarıcı, Nuray; Çiçek, Neslihan; Öztürk, Görsen Salman; Akoğlu, Ilker T; Arıcı, Yeliz Kaşko

2015-01-01

This study was designed to determine the usability of lemon fiber (LF-2%, 4%, 6%) and carrot fiber (CF-2%, 4%, 6%) to produce low-fat beef hamburgers. To that end, a certain amount of fat was replaced with each fiber. The proximate composition, pH value, cholesterol content, cooking characteristics, color, texture profile, and sensory properties of low-fat beef hamburgers were investigated. LF increased moisture content and cooking yield due to its better water binding properties, while CF caused higher fat and cholesterol contents owing to its higher fat absorption capacity (pretention, and fat retention. However it is suggested that CF produces better low-fat hamburgers since up to 2% CF presented sensory and textural properties similar to those of regular hamburgers.

Study on optimal fat content in total parenteral nutrition in partially hepatectomized rats.

Science.gov (United States)

Abe, S; Sakabe, S; Hirata, M; Kamuro, H; Asahara, N; Watanabe, M

1997-04-01

In order to investigate the optimal fat content for total parenteral nutrition (TPN) solutions, male Wistar rats were subjected to 70% hepatectomy and then placed, for five days, on one of five TPN regimens in which fat represented 0%, 10%, 20%, 30% and 40%, respectively, of the total calorie content. As serum triglyceride levels in the fat-treated groups were lower than those in the non-treated normal rats, it was concluded that the administered fat was sufficiently hydrolyzed. The greater the fat content, the higher the regeneration rate of the remnant liver. Significant differences were found between the 0%-fat group and 20%-plus fat groups. Hepatic triglyceride level was significantly lower in the 20%-fat group. Hepatic protein level was significantly elevated in all fat-treated groups. Serum phospholipids and total cholesterol due to the lecithin contained in fat emulsion were significantly elevated in the 30 and 40%-fat groups, indicating that fat content of 30 and 40% was excessive. The results suggest that TPN containing fat is superior to fat-free TPN for liver regeneration after partial hepatectomy, and that optimal fat content is estimated to be about 20% of total calorie content in the case of this fat emulsion.

Rehabilitation after total joint replacement: a scoping study.

Science.gov (United States)

L Snell, Deborah; Hipango, Julia; Sinnott, K Anne; Dunn, Jennifer A; Rothwell, Alastair; Hsieh, C Jean; DeJong, Gerben; Hooper, Gary

2018-07-01

The evidence supporting rehabilitation after joint replacement, while vast, is of variable quality making it difficult for clinicians to apply the best evidence to their practice. We aimed to map key issues for rehabilitation following joint replacement, highlighting potential avenues for new research. We conducted a scoping study including research published between January 2013 and December 2016, evaluating effectiveness of rehabilitation following hip and knee total joint replacement. We reviewed this work in the context of outcomes described from previously published research. Thirty individual studies and seven systematic reviews were included, with most research examining the effectiveness of physiotherapy-based exercise rehabilitation after total knee replacement using randomized control trial methods. Rehabilitation after hip and knee replacement whether carried out at the clinic or monitored at home, appears beneficial but type, intensity and duration of interventions were not consistently associated with outcomes. The burden of comorbidities rather than specific rehabilitation approach may better predict rehabilitation outcome. Monitoring of recovery and therapeutic attention appear important but little is known about optimal levels and methods required to maximize outcomes. More work exploring the role of comorbidities and key components of therapeutic attention and the therapy relationship, using a wider range of study methods may help to advance the field. Implications for Rehabilitation Physiotherapy-based exercise rehabilitation after total hip replacement and total knee replacement, whether carried out at the clinic or monitored at home, appears beneficial. Type, intensity, and duration of interventions do not appear consistently associated with outcomes. Monitoring a patient's recovery appears to be an important component. The available research provides limited guidance regarding optimal levels of monitoring needed to achieve gains following hip

Prevalence of Total Hip and Knee Replacement in the United States.

Science.gov (United States)

Maradit Kremers, Hilal; Larson, Dirk R; Crowson, Cynthia S; Kremers, Walter K; Washington, Raynard E; Steiner, Claudia A; Jiranek, William A; Berry, Daniel J

2015-09-02

Descriptive epidemiology of total joint replacement procedures is limited to annual procedure volumes (incidence). The prevalence of the growing number of individuals living with a total hip or total knee replacement is currently unknown. Our objective was to estimate the prevalence of total hip and total knee replacement in the United States. Prevalence was estimated using the counting method by combining historical incidence data from the National Hospital Discharge Survey and the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases from 1969 to 2010 with general population census and mortality counts. We accounted for relative differences in mortality rates between those who have had total hip or knee replacement and the general population. The 2010 prevalence of total hip and total knee replacement in the total U.S. population was 0.83% and 1.52%, respectively. Prevalence was higher among women than among men and increased with age, reaching 5.26% for total hip replacement and 10.38% for total knee replacement at eighty years. These estimates corresponded to 2.5 million individuals (1.4 million women and 1.1 million men) with total hip replacement and 4.7 million individuals (3.0 million women and 1.7 million men) with total knee replacement in 2010. Secular trends indicated a substantial rise in prevalence over time and a shift to younger ages. Around 7 million Americans are living with a hip or knee replacement, and consequently, in most cases, are mobile, despite advanced arthritis. These numbers underscore the substantial public health impact of total hip and knee arthroplasties. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Intake at a single, palatable buffet test meal is associated with total body fat and regional fat distribution in children.

Science.gov (United States)

Fearnbach, S Nicole; Thivel, David; Meyermann, Karol; Keller, Kathleen L

2015-09-01

Previous studies testing the relationship between short-term, ad libitum test-meal intake and body composition in children have shown inconsistent relationships. The objective of this study was to determine whether children's intake at a palatable, buffet meal was associated with body composition, assessed by dual-energy X-ray absorptiometry (DXA). A sample of 71 children (4-6 years) participated in 4 sessions where ad libitum food intake was measured. Children's intake at two of the test-meals was retained for the present analysis: a baseline meal consisting of moderately palatable foods and a highly palatable buffet including sweets, sweet-fats, and savory-fats. On the last visit, anthropometrics and DXA were assessed to determine child body composition. Children consumed significantly more calories at the palatable buffet compared to the baseline test-meal. Children's total fat-free mass was positively associated with intake at both the baseline meal and the palatable buffet meal. Total energy intake at both meals and intake of savory-fats at the palatable buffet were positively associated with children's total fat mass, total percent body fat, and percent android fat. Intake of sweet-fats was associated with child fat-free mass index. Intake of sweets was not correlated with body composition. Children's intake at a palatable test-meal, particularly of savory-fat foods, was associated with measures of total and regional body fat. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pancreatic Enzyme Therapy and Coefficient of Fat Absorption in Children and AdolReplacement escents With Cystic Fibrosis

NARCIS (Netherlands)

Woestenenk, Janna W; van der Ent, Cornelis K.; Houwen, Roderick H J; van der Ent, CK

Objectives: Pancreatic enzyme replacement therapy (PERT) is the proven therapy to substantially reduce fat malabsorption in patients with cystic fibrosis (CF). Few details of the daily practice regarding PERT and the resulting coefficient of fat absorption (CFA) are known. We therefore recorded the

Optimize fat Replacers in food

Directory of Open Access Journals (Sweden)

M HassaniMoosaAbadi

2018-03-01

CONCLUSION: In order to solve some problems related to the elimination or reduction of fat , cardiovascular diseases prevention and health improvement, it is possible to use fat alternatives in communities’ food, furthermore, the obtained results indicated that the production of low-calorie foods is similar to the texture of high fat products.

Effect of extruded wheat flour as a fat replacer on batter characteristics and cake quality.

Science.gov (United States)

Román, Laura; Santos, Isabel; Martínez, Mario M; Gómez, Manuel

2015-12-01

The effects of three levels of fat replacement (1/3, 2/3, and 3/3) by extruded flour paste and the effects of the presence of emulsifier on layer cake batter characteristics and final cake quality were studied. Replacement of oil by extruded flour paste modified the batter density and microscopy, reducing the number of air bubbles and increasing their size, while emulsifier incorporation facilitated air entrapment in batter. Emulsifier addition also increased the elastic and viscous moduli of the batter, while oil reduction resulted in a less structured batter. Emulsifier incorporation leads to good quality cakes, minimizing the negative effect of oil reduction, maintaining the volume and reducing the hardness of cakes. Furthermore, consumer acceptability of the reduced fat cakes was improved by the addition of emulsifier. Thus, the results confirmed the positive effect of partial oil substitution (up to 2/3) by extruded flour paste on the quality of reduced fat cakes when emulsifier was incorporated.

Radiological evaluation of failed total hip replacement

International Nuclear Information System (INIS)

Raspa, V.; Aldrovandi, S.; Pompei, G.

1988-01-01

The retrospective study of 50 operated cases of cemented total hip replacement and a review of the literature enabled the authors to define the radiological features of the above-mentioned condition. These features include one or more of the following signs: calcar reabsorption, lacunar erosions, modified relatioships between the prosthesis components, sepsis and loosening, periarticular calcifications dislocation and fracture of prosthesis components. Careful evaluation of these radiological features is extremely important for both an early diagnosis of failed total hip replacement and the choice of an adequate surgical treatment

Use of iDXA spine scans to evaluate total and visceral abdominal fat.

Science.gov (United States)

Bea, J W; Hsu, C-H; Blew, R M; Irving, A P; Caan, B J; Kwan, M L; Abraham, I; Going, S B

2018-01-01

Abdominal fat may be a better predictor than body mass index (BMI) for risk of metabolically-related diseases, such as diabetes, cardiovascular disease, and some cancers. We sought to validate the percent fat reported on dual energy X-ray absorptiometry (DXA) regional spine scans (spine fat fraction, SFF) against abdominal fat obtained from total body scans using the iDXA machine (General Electric, Madison, WI), as previously done on the Prodigy model. Total body scans and regional spine scans were completed on the same day (N = 50). In alignment with the Prodigy-based study, the following regions of interest (ROI) were assessed from total body scans and compared to the SFF from regional spine scans: total abdominal fat at (1) lumbar vertebrae L2-L4 and (2) L2-Iliac Crest (L2-IC); (3) total trunk fat; and (4) visceral fat in the android region. Separate linear regression models were used to predict each total body scan ROI from SFF; models were validated by bootstrapping. The sample was 84% female, a mean age of 38.5 ± 17.4 years, and mean BMI of 23.0 ± 3.8 kg/m 2 . The SFF, adjusted for BMI, predicted L2-L4 and L2-IC total abdominal fat (%; Adj. R 2 : 0.90) and total trunk fat (%; Adj. R 2 : 0.88) well; visceral fat (%) adjusted R 2 was 0.83. Linear regression models adjusted for additional participant characteristics resulted in similar adjusted R 2 values. This replication of the strong correlation between SFF and abdominal fat measures on the iDXA in a new population confirms the previous Prodigy model findings and improves generalizability. © 2017 Wiley Periodicals, Inc.

Estimation of Total Body Fat from Potassium-40 Content

International Nuclear Information System (INIS)

Taha Mohamed Taha Ahmed, T.M.T.

2010-01-01

This paper concerns on estimation of total body fat from potassium 40 content using total body counting technique. The work performed using fast scan whole body counter. Calibration of that system for K-40 was carried out under assumption that uniformity distribution of radioactivity of potassium was distributed in 10 polyethylene bottles phantom. Different body sizes were represented by 2, 4, 6, 8 and 10 polyethylene bottles; each bottle has a volume of 0.04 m3. The counting efficiency for each body size was determined. Lean body weight (LBW) was calculated for ten males and ten females using appropriate mathematical equation. Total Body Potassium, TBK for the same selected group was measured using whole body counter. A mathematical relationship between lean body weight and potassium content was deduced .Fat contents for some individuals were calculated and weight/height ratio was indicated for fatness.

Allometric relationship between changes of visceral fat and total fat mass

DEFF Research Database (Denmark)

Hallgreen, C. E.; Hall, K. D.

2008-01-01

Objective: To elucidate the mathematical relationship between changes of visceral adipose tissue (VAT) and total body fat mass (FM) during weight loss. Design: We hypothesized that changes of VAT mass are allometrically related to changes of FM, regardless of the type of weight-loss intervention...

Total body fat as a possible indicator of metabolic syndrome in adults

Directory of Open Access Journals (Sweden)

Edgar Navarro Lechuga

2016-09-01

Full Text Available Introduction: The metabolic syndrome is a set of factors related to insulin resistance, which increases the likelihood of coronary events. It is important timely onset identifying to reduce its prevalence. Objective: To explore the percentage of total body fat as indicator of metabolic syndrome in adults from Soledad, Colombia. Material and Methods: Cross-sectional study. n=99 adults (non-pregnant, nor subjects with psychomotor disturbances. Blood samples were taken: total cholesterol, HDL; triglycerides and glucose. Waist circumference, Body Mass Index and body fat by bioimpedance and skinfold thickness were measured. Diagnosis of metabolic syndrome was made according to NHLBI/AHA, ATP III and IDF criteria. Subjects with and without metabolic syndrome according to total body fat averages were compared. Results: The average percentage of body fat was higher (p0.05 in the classification according to ATP III in women, where the average fat percentage was 39.31 % in those with metabolic syndrome and 37.7% in those not suffering. Conclusions: Subjects with metabolic syndrome have higher mean total body fat, significantly, compared with those who did not, so it could be considered the values of total body fat obtained by bioimpedance as future indicators of metabolic syndrome, both as screening and control.

Effects of replacing beef fat with pre-emulsified pumpkin seed oil on some quality characteristics of model system chicken meat emulsions

Science.gov (United States)

Serdaroğlu, M.; Nacak, B.; Karabıyıkoğlu, M.; Tepe, M.; Baykara, I.; Kökmen, Y.

2017-09-01

In this study, the effects of adding pumpkin seed oil (PSO) in water emulsion to model system chicken meat emulsions (MSME) on product quality and oxidative stability were investigated. MSME were produced by replacing 25% (P25) and 50% (P50) of beef fat with PSO-in-water emulsion (PSO/W) while control treatment was prepared with only beef fat. Addition of PSO/W to the formulation resulted in significant differences in chemical composition and pH values of both raw and cooked MSME treatments. The use of PSO/W produced significant improvements to emulsion stability, oxidative stability and cooking yield of MSME. It was determined that the use of PSO/W formulation results in decreased total expressible fluid values and increased cooking yields of the emulsions. It was observed that the highest cooking yield and the lowest total expressible fluid were found in the sample containing 50% PSO/W. It should be a feasible strategy to produce fat-reduced meat products with healthier lipid profiles by using PSO/W.

Formulation of reduced-calorie biscuits using artificial sweeteners and fat replacer with dairy–multigrain approach

Directory of Open Access Journals (Sweden)

Dipesh Aggarwal

2016-03-01

Conclusion: The study demonstrated that highly acceptable reduced-calorie biscuits can be produced by using dairy–multigrain composite flour with maltitol and FOS-sucralose (as sweetener and PD (as fat replacer.

Gait analysis after successful mobile bearing total ankle replacement.

NARCIS (Netherlands)

Doets, H.C.; van Middelkoop, M.; Houdijk, J.H.P.; Nelissen, R.G.; Veeger, H.E.J.

2007-01-01

Background: The effect of total ankle replacement on gait is not fully known in terms of joint kinematics, ground reaction force, and activity of the muscles of the lower leg. Methods: A comparative gait study was done in 10 patients after uneventful unilateral mobile-bearing total ankle replacement

TOTAL KNEE REPLACEMENT IN PATIENTS WITH BELOW-KNEE AMPUTATION

Science.gov (United States)

Karam, Matthew D; Willey, Michael; Shurr, Donald G

2010-01-01

Total knee replacement (TKR) is reserved for patients with severe and disabling arthritis that is non-responsive to conservative measures. Based on existing data, total knee replacement is a safe and cost-effective treatment for alleviating pain and improving physical function in patients who do not respond to conservative therapy. Despite the large variation in health status of patients and types of prosthesis implanted, total knee replacement has proven to be a relatively low risk and successful operation. Each year in the United States surgeons perform approximately 300,000 TKR.1 Likewise, lower extremity amputation is commonly performed in the United States with an annual incidence of 110,000 per year.2 Nearly 70% of all lower extremity amputations are performed as the result of chronic vascular disease, followed by trauma (22%), congenital etiology and tumor (4% each).3 Approximately 50% of all lower extremity amputations are performed secondary to complications from Diabetes Mellitus. Norvell et al. demonstrated that patients who have previously undergone transtibial amputation and ambulate with a prosthesis are more likely to develop degenerative joint disease in the con-tralateral extremity than the ipsilateral extremity.4 Further, radiographic changes consistent with osteoporosis have been demonstrated in up to 88% of limbs that have undergone transtibial amputation.8 To our knowledge, there have been only three reported cases of total knee replacement in patients with ipsilateral transtibial amputation.5,7 The purpose of the present study is to review the existing data on total knee replacement in patients who have undergone transtibial amputation. Further we present a patient with a transtibial amputation who underwent contralateral total knee replacement. PMID:21045987

Physicochemical and functional properties of micronized jincheng orange by-products (Citrus sinensis Osbeck) dietary fiber and its application as a fat replacer in yogurt.

Science.gov (United States)

Yi, Tian; Huang, Xingjian; Pan, Siyi; Wang, Lufeng

2014-08-01

Orange by-products from juice extraction are generally discarded or used in animal feed due to their low market value. However, orange by-products show potential as dietary fiber (DF) and fat replacers in products such as yogurt. This study assessed the benefits of using orange by-products in DF-enriched materials such as DF powders (OP) and micronized DF with ball-milling (MDF). The study also investigated the effects of adding different levels of OP and MDF on the quality of low-fat yogurt. Results show that MDF showed better physicochemical and functional properties than OP, and that 2% MDF as a fat replacer in yogurt retained most of the textural and sensory properties of full-fat yogurt. Therefore, this study showed that MDF is a promising alternative as a fat replacer in low-fat yogurt, without sacrificing good taste and other qualities of full-fat yogurt.

Effect of Replacing Pork Fat with Vegetable Oils on Quality Properties of Emulsion-type Pork Sausages

OpenAIRE

Lee, Hyun-Jin; Jung, Eun-Hee; Lee, Sang-Hwa; Kim, Jong-Hee; Lee, Jae-Joon; Choi, Yang-II

2015-01-01

This study was conducted to evaluate the quality properties of emulsion-type pork sausages when pork fat is replaced with vegetable oil mixtures during processing. Pork sausages were processed under six treatment conditions: T1 (20% pork fat), T2 (10% pork fat + 2% grape seed oil + 4% olive oil + 4% canola oil), T3 (4% grape seed oil + 16% canola oil), T4 (4% grape seed oil + 4% olive oil + 12% canola oil), T5 (4% grape seed oil + 8% olive oil + 8% canola oil), and T6 (4% grape seed oil + 12%...

Primary extra-cranial meningioma following total hip replacement

Energy Technology Data Exchange (ETDEWEB)

Campbell, T.J.; Beggs, I. [Royal Infirmary, Department of Radiology, Edinburgh (United Kingdom); Patton, J.T.; Porter, D. [Royal Infirmary, Department of Orthopaedics, Edinburgh (United Kingdom); Salter, D.M.; Al-Nafussi, A. [Royal Infirmary, Department of Pathology, Edinburgh (United Kingdom)

2009-01-15

A 61-year-old man presented with pain at the left hip and decreased mobility 10 years after total hip replacement. Imaging demonstrated a large destructive expansile mass adjacent to the prosthesis. Histological analysis confirmed the presence of an extra-cranial meningioma. Primary tumours after total hip replacement are rare and include soft tissue sarcomas, bone sarcomas and lymphomas. To our knowledge, no previous cases of primary extracranial meningioma have been identified. The imaging features, histology, pathogenesis and differential diagnosis are discussed. (orig.)

Phytosterol-based edible oleogels: A novel way of replacing saturated fat in food.

Science.gov (United States)

Matheson, A; Dalkas, G; Clegg, P S; Euston, S R

2018-06-01

This article presents a summary of recent results relating to phytosterol oleogels. Oleogels represent a novel way of replacing saturated fat in food, whilst phytosterols have been shown to actively lower low-density lipoprotein (LDL)- cholesterol levels. There are a number of technical challenges to exploiting phytosterol oleogels, including a high sensitivity to water. To facilitate their incorporation into food, the fundamental physiochemical processes which mediate the formation of these gels and two different approaches to produce phytosterol oleogels that are stable in the presence of water were explored as part of the recent Biotechnology and Biological Sciences Research Council (BBSRC)-Diet and Health Research Industry Club (DRINC)-funded Edible Oleogels for Reduction of Saturated Fat project. This report summarises the findings, which will support the development of healthier food products that are lower in saturated fat and acceptable to consumers.

Expandable Total Humeral Replacement in a Child with Osteosarcoma

Directory of Open Access Journals (Sweden)

Eric R. Henderson

2015-01-01

Full Text Available Case. A right-handed 8-year-old female patient presented with a conventional, high-grade osteosarcoma involving her right humerus; through-shoulder amputation was recommended. After consultation, total humerus resection with expandable, total humeral endoprosthesis reconstruction was performed with a sleeve to encourage soft-tissue ingrowth. At three-year follow-up she has received one lengthening procedure and her functional scores are excellent. Conclusion. Total humeral resection and replacement in the pediatric population are rare and although early reports of expandable total humeral endoprosthesis outcomes demonstrate high failure rates, this patient’s success indicates that expandable total humeral replacement is a viable option.

Special features of total knee replacement in hemophilia.

Science.gov (United States)

Rodriguez-Merchan, Emerito Carlos

2013-12-01

Total knee replacement is an operation frequently needed by hemophilia patients, which greatly improves their quality of life. This operation, however, carries a higher risk of bleeding and infection for hemophiliacs than it does for osteoarthritis sufferers. It is advisable to implant prosthetic components using antibiotic-loaded cement. It is essential to maintain a level of 100% of the replacement clotting factor for 2 weeks. Hematological treatment must be established, depending on the patient's factor levels and other pharmacokinetic parameters such as recovery and half-life, optimal doses and treatment time. It is preferable to use general anesthesia due to the risk of spinal bleeding. The lifespan of total knee replacement in hemophilic patients is shorter than in patients with osteoarthritis because of the increased risk of infection.

Properties of bologna-type sausages with pork back-fat replaced with pork skin and amorphous cellulose.

Science.gov (United States)

de Oliveira Faria, Miriam; Cipriano, Tayssa Martins; da Cruz, Adriano Gomes; Santos, Bibiana Alves Dos; Pollonio, Marise Aparecida Rodrigues; Campagnol, Paulo Cezar Bastianello

2015-06-01

Bologna-type sausages were produced with 50% of their pork back-fat content replaced with gels elaborated with different ratios of pork skin, water, and amorphous cellulose (1:1:0, 1:1:0.1, 1:1:0.2, 1:1:0.3, and 1:1:0.4). The impact of such replacement on the physico-chemical characteristics and the consumer sensory profiling was evaluated. The modified treatments had 42% less fat, 18% more protein, and 8% more moisture than the control group. Treatments with amorphous cellulose had a lower cooking loss and higher emulsion stability. High amorphous cellulose content (1:1:0.3 and 1:1:0.4) increased hardness, gumminess, and chewiness. The gel formulated with the ratio of 1:1:0.2 (pork skin: water: amorphous cellulose gel) provided a sensory sensation similar to that provided by fat and allowed products of good acceptance to be obtained. Therefore, a combination of pork skin and amorphous cellulose is useful in improving technological quality and producing healthier and sensory acceptable bologna-type sausages. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prospective study of ascending venogram following total hip replacement or total knee replacement

Energy Technology Data Exchange (ETDEWEB)

Youm, Chang Seon; Suh, Jin Seok; Lee, Jong Doo; Park, Chang Yun; Kim, Young Hoo [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

1987-04-15

The ascending leg venogram was performed in one hundred forty six lower extremities on the 7th day following total hip replacement (THR) or total knee replacement (TKR). The results were as follows; 1.Overall incidence of deep vein thrombosis (DVT) in 146 limbs who underwent THR or TKR was 10%: DVT was detected in 8 limbs among 110 limbs following THR (7%) and 6 limbs among 36 limbs following TKR (17%). 2.The anatomic distribution of DVT was as follows: In THR, 12.5% in FV, 25% in FV and PV, 25% in FV and PV and CV, 12.5% in FV and CV, and 25% in CV. In TKR, 100% in CV. 3.There were many anatomic variations in deep veins of lower extremities: Accessory SFV (41 limbs), double PV(24), accessory SFV and double PV(7), duplication of SFV and PV(3), accessory SFV and multiple PV(2), and accessory SFV and double PV(1). 4.There were multiple SFV in 37%, and 19% of these limbs had DVT. It represented statistically higher than 4% in limbs with a single SFV (P-value < 0.05). 5.The incidence of DVT was 8% in cases of multiple PV, and there was no statistically significant difference between these groups and single PV groups. 6.We could assess number of values from popliteal vein to common femoral vein in 72 limbs. Mean number of value was 5.45 and there was no statistically significant difference between groups having valve over 5 and under 5.

Ethamsylate and blood loss in total hip replacement.

Science.gov (United States)

Keith, I

1979-01-01

Nineteen consecutive patients undergoing total hip replacement under epidural anaesthesia were randomly divided into two groups. The treatment group received 1000 mg of ethamsylate intravenously before induction of anaesthesia. Blood lost during surgery was measured by a colorimetric technique. Closed suction drains were used and all blood lost after operation collected for measurement. Ethamsylate did not decrease the average volumes of blood lost during or after the operation. Neither did it reduce the requirements for blood transfusion. Although there were no side-effects attributable to ethamyslate, there seems to be no indication for its use in total hip replacement under epidural anaesthesia.

Failure rate of cemented and uncemented total hip replacements

DEFF Research Database (Denmark)

Makela, K. T.; Matilainen, M.; Pulkkinen, P.

2014-01-01

). Participants 347 899 total hip replacements performed during 1995-2011. Main outcome measures Probability of implant survival (Kaplan-Meier analysis) along with implant survival with revision for any reason as endpoint (Cox multiple regression) adjusted for age, sex, and diagnosis in age groups 55-64, 65......Objective To assess the failure rate of cemented, uncemented, hybrid, and reverse hybrid total hip replacements in patients aged 55 years or older. Design Register study. Setting Nordic Arthroplasty Register Association database (combined data from Sweden, Norway, Denmark, and Finland......-74, and 75 years or older. Results The proportion of total hip replacements using uncemented implants increased rapidly towards the end of the study period. The 10 year survival of cemented implants in patients aged 65 to 74 and 75 or older (93.8%, 95% confidence interval 93.6% to 94.0% and 95.9%, 95...

Autologous blood transfusion in total knee replacement surgery.

Science.gov (United States)

Sarkanović, Mirka Lukić; Gvozdenović, Ljiljana; Savić, Dragan; Ilić, Miroslav P; Jovanović, Gordana

2013-03-01

Total knee replacement (TKR) surgery is one of the most frequent and the most extensive procedures in orthopedic surgery, accompanied with some serious complications. Perioperative blood loss is one of the most serious losses, so it is vital to recognize and treat such losses properly. Autologous blood transfusion is the only true alternative for the allogeneic blood. The aim of this study was to to examine if autologous blood transfusion reduces usage of allogenic blood in total knee replacement surgery, as well as to examine possible effect of autologous blood transfusion on postoperative complications, recovery and hospital stay of patients after total knee replacement surgery. During the controlled, prospective, randomised study we compared two groups of patients (n = 112) with total prosthesis implanted in their knee. The group I consisted of the patients who received the transfusion of other people's (allogeneic) blood (n = 57) and the group II of the patients whose blood was collected postoperatively and then given them [their own (autologous) blood] (n = 55). The transfusion trigger for both groups was hemoglobin level of 85 g/L. In the group of patients whose blood was collected perioperatively only 9 (0.9%) of the patients received transfusion of allogeneic blood, as opposed to the control group in which 98.24% of the patients received the transfusion of allogeneic blood (p blood was collected stayed in hospital for 6.18 days, while the patients of the control group stayed 7.67 days (p blood transfusion is a very effective method for reducing consumption of allogenic blood and thus, indirectly for reducing all complications related to allogenic blood transfusion. There is also a positive influence on postoperative recovery after total knee replacement surgery due to the reduction of hospital stay, and indirectly on the reduction of hospital costs.

An analysis of sodium, total fat and saturated fat contents of packaged food products advertised in Bronx-based supermarket circulars.

Science.gov (United States)

Samuel, L; Basch, C H; Ethan, D; Hammond, R; Chiazzese, K

2014-08-01

Americans' consumption of sodium, fat, and saturated fat exceed federally recommended limits for these nutrients and has been identified as a preventable leading cause of hypertension and cardiovascular disease. More than 40% of the Bronx population comprises African-Americans, who have increased risk and earlier onset of hypertension and are also genetically predisposed to salt-sensitive hypertension. This study analyzed nutrition information for packaged foods advertised in Bronx-based supermarket circulars. Federally recommended limits for sodium, saturated fat and total fat contents were used to identify foods that were high in these nutrients. The proportion of these products with respect to the total number of packaged foods was calculated. More than a third (35%) and almost a quarter (24%) of the 898 advertised packaged foods were high in saturated fat and sodium respectively. Such foods predominantly included processed meat and fish products, fast foods, meals, entrees and side dishes. Dairy and egg products were the greatest contributors of high saturated fat. Pork and beef products, fast foods, meals, entrees and side dishes had the highest median values for sodium, total fat and saturated fat content. The high proportion of packaged foods that are high in sodium and/or saturated fat promoted through supermarket circulars highlights the need for nutrition education among consumers as well as collaborative public health measures by the food industry, community and government agencies to reduce the amounts of sodium and saturated fat in these products and limit the promotion of foods that are high in these nutrients.

Apparent and true ileal and total tract digestibility of fat in canola press-cake or canola oil and effects of increasing dietary fat on amino acid and energy digestibility in growing pigs.

Science.gov (United States)

Zhou, X; Beltranena, E; Zijlstra, R T

2017-06-01

Digestibility of remaining oil in canola press-cake (CPC) may be lower than that of extracted, liquid canola oil (CO) because oil may be partly entrapped in the CPC matrix. To determine true digestibility of fat in ingredients, endogenous fat losses should be estimated. Dietary fat may interact with digestion of other dietary components. To test these hypotheses, 10 ileal-cannulated pigs (initial BW, 25.4 kg) were fed 10 diets for 8 periods in a 10 × 8 Youden square. A basal diet was formulated based on wheat, barley, and canola meal. The 4 CPC and 4 CO test diets were prepared by replacing identical portion of basal diet with 10%, 20%, 30%, or 40% CPC, or 1.5%, 3.0%, 4.5%, or 6.0% CO, respectively, to match the fat content of CPC diet with CO diet at each fat level. An N-free diet based on corn starch was prepared to measure basal endogenous losses of AA. Apparent total tract digestibility (ATTD) and apparent ileal digestibility (AID) of acid-hydrolyzed ether extract (AEE) were calculated for each diet. True ileal digestibility (TID) and true total tract (TTTD) digestibility of AEE in CPC and CO, and total endogenous losses of AEE were estimated by regressing apparent digestible AEE (g/kg of DMI) against dietary AEE intake (g/kg of DM) at the total tract and distal ileum, respectively. The mean AID and ATTD of AEE in CPC diets were 78.9% and 61.5%, which were lower ( digestible AEE content in CPC and CO diets increased linearly ( 0.05) total tract or ileal endogenous losses of AEE. The TID and TTTD of AEE in CPC were 92.3% and 94.5%, respectively, lower ( digestibility (SID) of CP, Lys, Met, Thr, and Trp, and quadratically increased ( digestibility of AEE in CPC than in CO indicates that fat digestibility of CPC should be considered to predict its nutritional value accurately. Dietary inclusion of CO may increase digestibility of CP and energy originating from the balance of the diet.

A general approach to total repair cost limit replacement policies

Directory of Open Access Journals (Sweden)

F. Beichelt

2014-01-01

Full Text Available A common replacement policy for technical systems consists in replacing a system by a new one after its economic lifetime, i.e. at that moment when its long-run maintenance cost rate is minimal. However, the strict application of the economic lifetime does not take into account the individual deviations of maintenance cost rates of single systems from the average cost development. Hence, Beichet proposed the total repair cost limit replacement policy: the system is replaced by a new one as soon as its total repair cost reaches or exceeds a given level. He modelled the repair cost development by functions of the Wiener process with drift. Here the same policy is considered under the assumption that the one-dimensional probability distribution of the process describing the repair cost development is given. In the examples analysed, applying the total repair cost limit replacement policy instead of the economic life-time leads to cost savings of between 4% and 30%. Finally, it is illustrated how to include the reliability aspect into the policy.

Orange fiber as a novel fat replacer in lemon ice cream

Directory of Open Access Journals (Sweden)

Tainara de Moraes Crizel

2014-06-01

Full Text Available Orange fiber was used as a novel fat replacer in light lemon ice cream. Nine ice cream formulations were compared: standard control ice cream (IC; ice cream with fiber (F1 from the peel, bagasse, and orange seed (ICA and ICB; ice cream with fiber (F2 from the orange peel alone (ICC and ICD; ice cream with fiber (F3 from the peel, bagasse, and orange seed pretreated with hydro-distillation (ICE and ICF; and ice cream with fiber (F4 from the orange peel pretreated with hydro-distillation (ICG and ICH.The orange fiber reduced the ice cream fat content (50 % and the overrun ratio and increased the fiber content and the hardness, gumminess, and springiness values, but it did not affect the adhesiveness and odor of the samples. The samples with 1.0 % of orange fiber showed low melting rate values than those of the control ice cream. The overall acceptance of the ice cream with 1.0 % of pre-treated orange peel fiber did not differ from that of the control ice cream (80 %. The orange fiber proved a promising food ingredient since it can be used to decrease the fat content and increase bioactive compounds content, such as fiber and carotenoids.

Variability in the reported energy, total fat and saturated fat contents in fast-food products across ten countries.

Science.gov (United States)

Ziauddeen, Nida; Fitt, Emily; Edney, Louise; Dunford, Elizabeth; Neal, Bruce; Jebb, Susan A

2015-11-01

Fast foods are often energy dense and offered in large serving sizes. Observational data have linked the consumption of fast foods to an increased risk of obesity and related diseases. We surveyed the reported energy, total fat and saturated fat contents, and serving sizes, of fast-food items from five major chains across ten countries, comparing product categories as well as specific food items available in most countries. MRC Human Nutrition Research, Cambridge, UK. Data for 2961 food and drink products were collected, with most from Canada (n 550) and fewest from the United Arab Emirates (n 106). There was considerable variability in energy and fat contents of fast foods across countries, reflecting both the portfolio of products and serving size variability. Differences in total energy between countries were particularly noted for chicken dishes (649-1197 kJ/100 g) and sandwiches (552-1050 kJ/100g). When comparing the same product between countries variations were consistently observed in total energy and fat contents (g/100 g); for example, extreme variation in McDonald's Chicken McNuggets with 12 g total fat/100 g in Germany compared with 21·1 g/100 g in New Zealand. These cross-country variations highlight the possibility for further product reformulation in many countries to reduce nutrients of concern and improve the nutritional profiles of fast-food products around the world. Standardisation of serving sizes towards the lower end of the range would also help to reduce the risk of overconsumption.

Variability in the reported energy, total fat and saturated fat content in fast food products across ten countries

Science.gov (United States)

Ziauddeen, Nida; Fitt, Emily; Edney, Louise; Dunford, Elizabeth; Neal, Bruce; Jebb, Susan A.

2016-01-01

Objective Fast foods are often energy dense and offered in large serving sizes. Observational data has linked the consumption of fast food to an increased risk of obesity and related diseases. Design We surveyed the reported energy, total fat and saturated fat contents, and serving sizes, of fast food items from five major chains across 10 countries, comparing product categories as well as specific food items available in most countries. Setting MRC Human Nutrition Research (HNR), Cambridge Subjects Data for 2961 food and drink products were collected, with most from Canada (n=550) and fewest from United Arab Emirates (n=106). Results There was considerable variability in energy and fat content of fast food across countries, reflecting both the portfolio of products, and serving size variability. Differences in total energy between countries were particularly noted for chicken dishes (649-1197kJ/100g) and sandwiches (552-1050kJ/100g). When comparing the same product between countries variations were consistently observed in total energy and fat content (g/100g) with extreme variation in McDonald’s Chicken McNuggets with 12g total fat (g/100g) in Germany compared to 21.1g in New Zealand. Conclusions These cross-country variations highlight the possibility for further product reformulation in many countries to reduce nutrients of concern and improve the nutritional profiles of fast food products around the world. Standardisation of serving sizes towards the lower end of the range would also help to reduce the risk of overconsumption. PMID:25702788

The potential application of rice bran wax oleogel to replace solid fat and enhance unsaturated fat content in ice cream.

Science.gov (United States)

Zulim Botega, Daniele C; Marangoni, Alejandro G; Smith, Alexandra K; Goff, H Douglas

2013-09-01

The development of structure in ice cream, characterized by its smooth texture and resistance to collapse during melting, depends, in part, on the presence of solid fat during the whipping and freezing steps. The objective of this study was to investigate the potential application of 10% rice bran wax (RBW) oleogel, comprised 90% high-oleic sunflower oil and 10% RBW, to replace solid fat in ice cream. A commercial blend of 80% saturated mono- and diglycerides and 20% polysorbate 80 was used as the emulsifier. Standard ice cream measurements, cryo-scanning electron microscopy (cryo-SEM), differential scanning calorimetry (DSC), and transmission electron microscopy (TEM) were used to evaluate the formation of structure in ice cream. RBW oleogel produced higher levels of overrun when compared to a liquid oil ice cream sample, creating a lighter sample with good texture and appearance. However, those results were not associated with higher meltdown resistance. Microscopy revealed larger aggregation of RBW oleogel fat droplets at the air cell interface and distortion of the shape of air cells and fat droplets. Although the RBW oleogel did not develop sufficient structure in ice cream to maintain shape during meltdown when a mono- and diglycerides and polysorbate 80 blend was used as the emulsifier, micro- and ultrastructure investigations suggested that RBW oleogel did induce formation of a fat globule network in ice cream, suggesting that further optimization could lead to an alternative to saturated fat sources for ice cream applications. © 2013 Institute of Food Technologists®

Total body fat, abdominal fat, body fat distribution and surrogate markers for health related to adipocyte fatty acid-binding protein (FABP4) in children.

Science.gov (United States)

Dencker, Magnus; Danielson, Anton; Karlsson, Magnus K; Wollmer, Per; Andersen, Lars B; Thorsson, Ola

2017-04-01

The aim of the study was to assess possible relationships between adipocyte fatty acid-binding protein (FABP4) and total body fat (TBF), abdominal fat, body fat distribution, aerobic fitness, blood pressure, cardiac dimensions and the increase in body fat over 2 years in a community sample of children. A cross-sectional study was used in a community sample of 170 (92 boys and 78 girls) children aged 8-11 years. TBF and abdominal fat (AFM) were measured by dual-energy X-ray absorptiometry (DXA). TBF was also expressed as percentage of total body mass (BF%), and body fat distribution was calculated as AFM/TBF. Maximal oxygen uptake (VO2PEAK) was assessed by indirect calorimetry during a maximal exercise test and scaled to body mass. Systolic and diastolic blood pressure (SBP and DBP) and pulse pressure (PP) were measured. Echocardiography was performed. Left atrial (LA) size was measured, and left ventricular mass (LVM) was calculated. A follow-up DXA scan was available in 152 children (84 boys and 68 girls). Frozen serum samples were analyzed for FABP4. Partial correlations, with adjustment for sex, between FABP4 vs. ln TBF, ln BF%, ln AFM, AFM/TBF and VO2PEAK were (r=0.69, 0.68, 0.69, 0.49 and -0.39, pfat or change in fat distribution were not correlated.) Conclusions: Findings from this community-based cohort of young children show that increased body fat and abdominal fat, more abdominal body fat distribution, low fitness, more LVM and increased LA, increased SBP and PP were all associated with increased levels of FABP4. Increase in TBF and abdominal fat over 2 years were also associated with increased levels of FABP4.

Testosterone replacement alters the cell size in visceral fat but not in subcutaneous fat in hypogonadal aged male rats as a late-onset hypogonadism animal model

Directory of Open Access Journals (Sweden)

Abdelhamed A

2015-03-01

Full Text Available Amr Abdelhamed,1,2 Shin-ichi Hisasue,1 Masato Shirai,3 Kazuhito Matsushita,1 Yoshiaki Wakumoto,1 Akira Tsujimura,1 Taiji Tsukamoto,4 Shigeo Horie1 1Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan; 2Department of Dermatology, Venereology and Andrology, Sohag University, Graduate School of Medicine, Sohag, Egypt; 3Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Japan; 4Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan Background: Patients with late-onset hypogonadism (LOH benefit from testosterone replacement by improvement in the parameters of the metabolic syndrome, but fat cell morphology in these patients is still unclear. This study aims to determine the effect of testosterone replacement on the morphology of fat cells in subcutaneous and visceral adipose tissue and on erectile function in hypogonadal aged male rats as a model of LOH. Methods: Ten male Sprague-Dawley rats aged 20–22 months were randomly allocated to two groups, ie, aged male controls (control group, n=5 and aged males treated with testosterone replacement therapy (TRT group, n=5. Testosterone enanthate 25 mg was injected subcutaneously every 2 weeks for 6 weeks. At 6 weeks, the intracavernous pressure (ICP and mean arterial blood pressure (MAP ratio was assessed. Visceral and subcutaneous adipose tissue specimens were collected and analyzed using Image-J software. Results: Body weight at 2, 4, and 6 weeks after TRT was 800.0±35.4 g, 767.5±46.3 g, and 780±40.4 g, respectively (not statistically significant. The ICP/MAP ratio was 0.341±0.015 in the TRT group and 0.274±0.049 in the control group (not statistically significant. The median subcutaneous fat cell size was 4.85×103 (range 0.85–12.53×103 µm2 in the control group and 4.93×103 (range 6.42–19.7×103 µm2 in the TRT group (not statistically significant. In contrast, median visceral fat cell size was significantly

Primary total hip replacement for displaced subcapital fractures of the femur.

Science.gov (United States)

Taine, W H; Armour, P C

1985-03-01

The management of displaced subcapital fracture of the hip is still controversial because of the high incidence of complications after internal fixation or hemiarthroplasty. To avoid some of these complications we have used primary total hip replacement for independently mobile patients over 65 years of age. A total of 163 cases, operated on over four years, have been reviewed. There were relatively more dislocations after operation for fracture than after total replacement for arthritis, and these were associated with a posterior approach to the hip. Only seven revision operations have been required. Of 57 patients who were interviewed an average of 42 months after replacement, 62% had excellent or good results as assessed by the Harris hip score. All the others had major systemic disease which affected their assessment. This inadequacy of current systems of hip assessment is discussed. It is concluded that total hip replacement is the best management for a selected group of patients with this injury, and that further prospective studies are indicated.

Single-slice epicardial fat area measurement. Do we need to measure the total epicardial fat volume?

International Nuclear Information System (INIS)

Oyama, Noriko; Goto, Daisuke; Ito, Yoichi M.

2011-01-01

The aim of this study was to assess a method for measuring epicardial fat volume (EFV) by means of a single-slice area measurement. We investigated the relation between a single-slice fat area measurement and total EFV. A series of 72 consecutive patients (ages 65±11 years; 36 men) who had undergone cardiac computed tomography (CT) on a 64-slice multidetector scanner with prospective electrocardiographic triggering were retrospectively reviewed. Pixels in the pericardium with a density range from -230 to -30 Hounsfield units were considered fat, giving the per-slice epicardial fat area (EFA). The EFV was estimated by the summation of EFAs multiplied by the slice thickness. We investigated the relation between total EFV and each EFA. EFAs measured at several anatomical landmarks - right pulmonary artery, origins of the left main coronary artery, right coronary artery, coronary sinus - all correlated with the EFV (r=0.77-0.92). The EFA at the LMCA level was highly reproducible and showed an excellent correlation with the EFV (r=0.92). The EFA is significantly correlated with the EFV. The EFA is a simple, quick method for representing the time-consuming EFV, which has been used as a predictive indicator of cardiovascular diseases. (author)

Substantial replacement of lactose with fat in a high-lactose milk replacer diet increases liver fat accumulation but does not affect insulin sensitivity in veal calves.

Science.gov (United States)

Pantophlet, A J; Gerrits, W J J; Vonk, R J; van den Borne, J J G C

2016-12-01

In veal calves, the major portion of digestible energy intake originates from milk replacer (MR), with lactose and fat contributing approximately 45 and 35%, respectively. In veal calves older than 4 mo, prolonged high intakes of MR may lead to problems with glucose homeostasis and insulin sensitivity, ultimately resulting in sustained insulin resistance, hepatic steatosis, and impaired animal performance. The contribution of each of the dietary energy sources (lactose and fat) to deteriorated glucose homeostasis and insulin resistance is currently unknown. Therefore, an experiment was designed to compare the effects of a high-lactose and a high-fat MR on glucose homeostasis and insulin sensitivity in veal calves. Sixteen male Holstein-Friesian calves (120±2.8kg of BW) were assigned to either a high-lactose (HL) or a high-fat (HF) MR for 13 consecutive weeks. After at least 7 wk of adaptation, whole-body insulin sensitivity and insulin secretion were assessed by euglycemic-hyperinsulinemic and hyperglycemic clamps, respectively. Postprandial blood samples were collected to assess glucose, insulin, and triglyceride responses to feeding, and 24-h urine was collected to quantify urinary glucose excretion. At the end of the trial, liver and muscle biopsies were taken to assess triglyceride contents in these tissues. Long-term exposure of calves to HF or HL MR did not affect whole-body insulin sensitivity (averaging 4.2±0.5×10 -2 [(mg/kg∙min)/(μU/mL)]) and insulin secretion. Responses to feeding were greater for plasma glucose and tended to be greater for plasma insulin in HL calves than in HF calves. Urinary glucose excretion was substantially higher in HL calves (75±13g/d) than in HF calves (21±6g/d). Muscle triglyceride content was not affected by treatment and averaged 4.5±0.6g/kg, but liver triglyceride content was higher in HF calves (16.4±0.9g/kg) than in HL calves (11.2±0.7g/kg), indicating increased hepatic fat accumulation. We conclude that

Carrageenan type effect on soybean oil/soy protein isolate emulsion employed as fat replacer in panela-type cheese

Directory of Open Access Journals (Sweden)

Rojas-Nery, E.

2015-12-01

Full Text Available In order to modify the fatty acid profile of panela-type cheese (a Mexican fresh cheese, emulsified soybean oil with soy protein isolate and different carrageenan (iota, kappa or lambda was employed as fat replacer. The replacement of milk fat in panela-type cheese resulted in higher cheese yield values and moisture content, besides a concomitant lower fat phase and higher protein content, due to a soy protein isolate in emulsified soybean oil. Fat replacement resulted in a harder but less cohesive, spring and resilient texture, where differences in texture could be attributed to the specific carrageenan-casein interactions within the rennet coagulated cheese matrix. The FTIR analysis showed that the milk fat replacement changed the fatty acid profile, also in function of the type of carrageenan employed. Lambda carrageenan containing emulsions improved moisture retention and maintained the textural properties of panela-type cheese.Para modificar el perfil de ácidos grasos de los quesos tipo panela (queso fresco popular en México, se utilizó aceite de soja emulsionado con aislado de proteína de soja y diferentes carrageninas (iota, kappa o lambda como sustituto de la grasa. Reemplazar la grasa de la leche en el queso tipo panela resultó en mayor rendimiento quesero y mayor contenido de humedad, además de una concomitante menor fase grasa y mayor contenido de proteína, debido al aislado de proteína de soja en el aceite de soja emulsionado. La sustitución de la grasa dio como resultado una textura más dura, pero menos cohesiva, elástica y resiliente, donde estas diferencias podrían ser atribuidas a la interacción especifica entre carrageninas-caseinas en la matriz coagulada del queso. El análisis de FTIR muestra que reemplazar la grasa de la leche cambia el perfil de ácidos grasos, también en función del tipo de carragenina empleado. Las emulsiones con lambda carrageninas mejoraron la retención de humedad y mantuvieron las

BMI, total and abdominal fat distribution, and cardiovascular risk factors in school-age children.

Science.gov (United States)

Gishti, Olta; Gaillard, Romy; Durmus, Busra; Abrahamse, Marieke; van der Beek, Eline M; Hofman, Albert; Franco, Oscar H; de Jonge, Layla L; Jaddoe, Vincent W V

2015-05-01

More specific total body and abdominal fat mass measures might be stronger associated with cardiovascular risk factors in childhood, than BMI. We examined the independent associations of total and abdominal fat measures with cardiovascular risk factors in school age children. We performed a population-based cohort study among 6,523 children. At the age of 6 y, we measured childhood BMI, and general and abdominal fat mass, using dual-energy X-ray absorptiometry, and ultrasound and cardiovascular risk factors. Conditional on BMI, higher fat mass percentage and abdominal fat mass were associated with higher blood pressure, total- and low-density lipoprotein (LDL)-cholesterol, insulin and c-peptide levels, but with lower left ventricular mass and high-density lipoprotein (HDL)-cholesterol (P values children. Higher childhood adiposity measures were associated with increased odds of cardiovascular risk factors clustering, with the strongest effect for fat mass percentage (odds ratios: 3.01 (95% confidence interval: 2.67, 3.9). Our results suggest that general and abdominal fat measures are associated with cardiovascular risk factors in childhood, independent from BMI. These measures may provide additional information for identification of children with an adverse cardiovascular profile.

Radiological examinations of complications after total hip replacement Pt. 1

International Nuclear Information System (INIS)

Luzsa, Gyoergy; Reti, Peter; Lakatos, Jozsef

1985-01-01

The radiological findings of complications after total hip replacement are summarized by analizing the data of control examinations of the operated patients at the National Institute for Rheumatology and Physiotherapy. In this first part the types of total hip replacements and the radiological methods (native x-ray, fistulography, arthrography, needle biopsy and scintigraphy using sup(99m)Tc isotope) are surveyed, and the radiological findings of the septic surgical complications are described. (author)

Primary Total Knee Replacement: Is Suction a Portal of Infection?

Science.gov (United States)

Budnar, Vijaya M; Amirfeyz, Rouin; Ng, Michael; Bannister, Gordon C; Blom, Ashley W

2009-01-01

INTRODUCTION Pulsed lavage during a total knee replacement usually leaves a pool of fluid on the surgical drapes. It is common practice to suck away this fluid using the same suction device used intra-operatively. This could be a cause of direct wound contamination. We hypothesised that bacteria contaminate fluid that collects around the foot in total knee replacement surgery and that suction equipment could be a portal of contamination. We also hypothesised that bacterial count in the fluid is lower if chlorhexidine, rather than saline, is used in the pulsed lavage. PATIENTS AND METHODS Forty patients undergoing primary total knee replacement were divided into two groups. The first group had pulsed lavage with normal saline and the second with 0.05% chlorhexidine. RESULTS At the end of the operation, 20 ml of fluid, pooled on the surgical drapes was aspirated and cultured for bacterial growth. None of the fluid samples showed bacterial growth. CONCLUSIONS Suction device used peri-operatively during knee replacement is unlikely to be a cause of wound contamination. Pulsed lavage with normal saline is as effective as lavage with chlorhexidine. PMID:19335972

Evaluation of a semi-automated computer algorithm for measuring total fat and visceral fat content in lambs undergoing in vivo whole body computed tomography.

Science.gov (United States)

Rosenblatt, Alana J; Scrivani, Peter V; Boisclair, Yves R; Reeves, Anthony P; Ramos-Nieves, Jose M; Xie, Yiting; Erb, Hollis N

2017-10-01

Computed tomography (CT) is a suitable tool for measuring body fat, since it is non-destructive and can be used to differentiate metabolically active visceral fat from total body fat. Whole body analysis of body fat is likely to be more accurate than single CT slice estimates of body fat. The aim of this study was to assess the agreement between semi-automated computer analysis of whole body volumetric CT data and conventional proximate (chemical) analysis of body fat in lambs. Data were collected prospectively from 12 lambs that underwent duplicate whole body CT, followed by slaughter and carcass analysis by dissection and chemical analysis. Agreement between methods for quantification of total and visceral fat was assessed by Bland-Altman plot analysis. The repeatability of CT was assessed for these measures using the mean difference of duplicated measures. When compared to chemical analysis, CT systematically underestimated total and visceral fat contents by more than 10% of the mean fat weight. Therefore, carcass analysis and semi-automated CT computer measurements were not interchangeable for quantifying body fat content without the use of a correction factor. CT acquisition was repeatable, with a mean difference of repeated measures being close to zero. Therefore, uncorrected whole body CT might have an application for assessment of relative changes in fat content, especially in growing lambs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Total knee replacement in patients with diffuse villonodular synovitis

Directory of Open Access Journals (Sweden)

Lucio Flávio Biondi Pinheiro Júnior

Full Text Available ABSTRACT This paper reports a case of diffuse pigmented villonodular synovitis (DPVNS, associated with advanced gonarthrosis, submitted to total knee replacement. The patient had progressive pain and swelling. She had two previous surgeries, firstly arthroscopic , synovectomy and subsequently open synovectomy associated with radiotherapy, with recurrence of the disease. Magnetic resonance imaging revealed diffuse synovitis, advanced arthrosis, and bone cysts. The patient was submitted to a total knee replacement and synovectomy. There was a good postoperative clinical course, with improvement of pain, function, and joint edema on examination. The patient will be followed regarding the possibility of disease recurrence and implant survival.,

The cyclops lesion after bicruciate-retaining total knee replacement

Directory of Open Access Journals (Sweden)

Mark A. Klaassen, MD, FACS

2017-12-01

Full Text Available The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. We present 2 cases (3 knees in which cyclops lesions appeared atypically following bicruciate-retaining total knee replacement. Two lesions occurred in a single patient following bilateral knee replacement. One lesion occurred in an active sportswoman. All 3 resolved following arthroscopic debridement. We describe the presentation of this unusual complication and suggest keys to its diagnosis, treatment, and prevention. Keywords: Cyclops lesion, Bicruciate-retaining, Total knee arthroplasty, Extension deficit

Analgesia after total hip replacement: epidural versus psoas ...

African Journals Online (AJOL)

tive analgesia following total hip replacement surgery. The research design was a ... matoma, intra-abdominal injury and pain due to spasm of the lumbar paravertebral ..... 2. Brown DL. Spinal, epidural, and caudal anesthesia In: Miller RD, ed.

Renal function after elective total hip replacement

DEFF Research Database (Denmark)

Perregaard, Helene; Damholt, Mette B; Solgaard, Søren

2016-01-01

Background and purpose - Acute kidney injury (AKI) is associated with increased short-term and long-term mortality in intensive care populations and in several surgical specialties, but there are very few data concerning orthopedic populations. We have studied the incidence of AKI and the prevale......Background and purpose - Acute kidney injury (AKI) is associated with increased short-term and long-term mortality in intensive care populations and in several surgical specialties, but there are very few data concerning orthopedic populations. We have studied the incidence of AKI...... and the prevalence of chronic kidney disease (CKD) in an elective population of orthopedic patients undergoing primary total hip replacement, hypothesizing that chronic kidney disease predisposes to AKI. Patients and methods - This was a single-center, population-based, retrospective, registry-based cohort study...... involving all primary elective total hip replacements performed from January 2003 through December 2012. Patient demographics and creatinine values were registered. We evaluated the presence of CKD and AKI according to the international guidelines for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013...

Pancreatic enzyme replacement therapy in cystic fibrosis: dose, variability and coefficient of fat absorption

Directory of Open Access Journals (Sweden)

Joaquim Calvo-Lerma

Full Text Available Objectives: Pancreatic enzyme replacement therapy (PERT remains a backbone in the nutritional treatment of cystic fibrosis. Currently, there is a lack of an evidence-based tool that allows dose adjustment. To date, no studies have found an association between PERT dose and fat absorption. Therefore, the aim of the study was to assess the influence of both the PERT dose and the variability in this dose on the coefficient of fat absorption (CFA. Methods: This is a retrospective longitudinal study of 16 pediatric patients (192 food records with three consecutive visits to the hospital over a twelve-month period. Dietary fat intake and PERT were assessed via a four-day food record and fat content in stools was determined by means of a three-day stool sample collection. A beta regression model was built to explain the association between the CFA and the interaction between the PERT dose (lipase units [LU]/g dietary fat and the variability in the PERT dose (standard deviation [SD]. Results: The coefficient of fat absorption increased with the PERT dose when the variability in the dose was low. In contrast, even at the highest PERT dose values, the CFA decreased when the variability was high. The confidence interval suggested an association, although the analysis was not statistically significant. Conclusion: The variability in the PERT dose adjustment should be taken into consideration when performing studies on PERT efficiency. A clinical goal should be the maintenance of a constant PERT dose rather than trying to obtain an optimal value.

Pancreatic enzyme replacement therapy in cystic fibrosis: dose, variability and coefficient of fat absorption.

Science.gov (United States)

Calvo-Lerma, Joaquim; Martínez-Barona, Sandra; Masip, Etna; Fornés, Victoria; Ribes-Koninckx, Carmen

2017-10-01

Pancreatic enzyme replacement therapy (PERT) remains a backbone in the nutritional treatment of cystic fibrosis. Currently, there is a lack of an evidence-based tool that allows dose adjustment. To date, no studies have found an association between PERT dose and fat absorption. Therefore, the aim of the study was to assess the influence of both the PERT dose and the variability in this dose on the coefficient of fat absorption (CFA). This is a retrospective longitudinal study of 16 pediatric patients (192 food records) with three consecutive visits to the hospital over a twelve-month period. Dietary fat intake and PERT were assessed via a four-day food record and fat content in stools was determined by means of a three-day stool sample collection. A beta regression model was built to explain the association between the CFA and the interaction between the PERT dose (lipase units [LU]/g dietary fat) and the variability in the PERT dose (standard deviation [SD]). The coefficient of fat absorption increased with the PERT dose when the variability in the dose was low. In contrast, even at the highest PERT dose values, the CFA decreased when the variability was high. The confidence interval suggested an association, although the analysis was not statistically significant. The variability in the PERT dose adjustment should be taken into consideration when performing studies on PERT efficiency. A clinical goal should be the maintenance of a constant PERT dose rather than trying to obtain an optimal value.

Changing trends in total knee replacement

OpenAIRE

Goudie, Ewan; Robinson, Cal; Walmsley, Phil; Brenkel, Ivan

2017-01-01

Introduction:  This study evaluates a possible change in the demographics and surgical practice observed in a large cohort of patients undergoing total knee replacement (TKR). Patients and methods:  We performed a retrospective analysis of a prospectively collected data on two groups of consecutive patients undergoing primary TKR. Group one consisted of patients who underwent surgery between 1994 and 1998. Group two consisted of patients who had surgery between 2009 and 2012. Results:  The me...

Whey protein concentrate and gum tragacanth as fat replacers in nonfat yogurt: chemical, physical, and microstructural properties.

Science.gov (United States)

Aziznia, S; Khosrowshahi, A; Madadlou, A; Rahimi, J

2008-07-01

The effect of whey protein concentrate (WPC) and gum tragacanth (GT) as fat replacers on the chemical, physical, and microstructural properties of nonfat yogurt was investigated. The WPC (7.5, 15, and 20 g/L) and GT (0.25, 0.5, 0.75, and 1 g/L) were incorporated into the skim milk slowly at 40 to 45 degrees C with agitation. The yogurt mixes were pasteurized at 90 degrees C for 10 min, inoculated with 0.1% starter culture, and incubated at 42 degrees C to pH 4.6, then refrigerated overnight at 5 degrees C. A control nonfat yogurt and control full fat yogurt were prepared as described, but without addition of WPC and GT. Increasing amount of WPC led to the increase in total solids, total protein, acidity, and ash content, whereas GT did not affect chemical parameters. Increasing WPC caused a more compact structure consisting of robust casein particles and large aggregates. Firmness was increased and susceptibility to syneresis was decreased as WPC increased. No significant difference was observed for firmness and syneresis of yogurt fortified with GT up to 0.5 g/L compared with control nonfat yogurt. Increasing the amount of gum above 0.5 g/L produced softer gels with a greater tendency for syneresis than the ones prepared without it. Addition of GT led to the coarser and more open structure compared with control yogurt.

Total ankle joint replacement.

Science.gov (United States)

2016-02-01

Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A 5-year profile of the incidence of total joint replacement in South ...

African Journals Online (AJOL)

During this period there was a 28% increase in the number of TJRs performed annually with an average increase of 20% in total hip replacements and 40% in total knee replacements. The number of surgeons involved in joint replacement during the survey period decreased by 7% in state-subsidised institutions but ...

Chronic asymptomatic dislocation of a total hip replacement: a case report

Directory of Open Access Journals (Sweden)

Lidder Surjit

2009-08-01

Full Text Available Abstract Introduction Dislocation of a prosthetic hip is the second most common complication after thromboembolic disease in patients undergoing total hip arthroplasty, with an incidence reported as 0.5 to 20%. Although the period of greatest risk for dislocation has been reported to be within the first few months after surgery, late dislocation occurs more commonly then previously thought. Case presentation A 60-year-old man underwent a right Exeter cemented total hip replacement and was subsequently discharged after appropriate follow-up. He next presented 8 years later complaining of pain in the left groin. An anterioposterior radiograph of the pelvis revealed degenerative changes in the left hip and a dislocated right total hip replacement. The dislocated femoral component had formed a neoacetabulum within the ilium, in which it was freely articulating. He remained pain-free on this side, had 5 cm of true leg length shortening with a good range of movement and was very pleased with his hip replacement. He was later placed on the waiting list for a left total hip replacement. Conclusion This case illustrates that a dislocated total hip replacement may occasionally not cause symptoms that cause significant discomfort or reduction in range of movement. The prosthetic femoral head can form a neoacetabulum allowing a full range of pain-free movement. Furthermore it emphasises that with an increased trend to earlier hospital discharge and shorter follow-up, potential complications may be missed. We urge a low index of suspicion for potential complications and suggest that regular review with radiographic follow-up should be made.

School-based study found that physical activity and aerobic fitness predicted increases in total body fat and abdominal fat at a mean age of 9.8 years.

Science.gov (United States)

Danielson, Anton; Thorsson, Ola; Karlsson, Magnus K; Wollmer, Per; Andersen, Lars B; Dencker, Magnus

2018-02-22

We assessed whether baseline measurements of physical activity, aerobic fitness, body fat and abdominal fat were predictors of changes in body fat measurements over a two-year period. The study comprised of 204 children aged 9.8 ± 0.6 years with a normal body mass distribution, who recruited from four schools in middle-class areas of Malmö, Sweden, from 2001 to 2004. Peak oxygen uptake and physical activity were measured at baseline. Body fat was measured by dual-energy X-ray absorptiometry at baseline and two years later. Physical activity, aerobic fitness and total body fat or abdominal fat were predictors of change in total body fat or abdominal fat over a period of two years. Changes in the percentage of body fat were not related to any of the baseline measurements. Our two-year follow-up of children with a mean age of 9.8 years at baseline showed that physical activity, aerobic fitness and body fat or abdominal fat predicted changes in total body fat or abdominal fat, but not the percentage of body fat. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

The cyclops lesion after bicruciate-retaining total knee replacement

OpenAIRE

Klaassen, Mark A.; Aikins, Jerry L.

2017-01-01

The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. We present 2 cases (3 knees) in which cyclops lesions appeared atypically following bicruciate-retaining total knee replacement. Two lesions occurred in a single patient following bilateral knee replacement. One les...

Influence of Total Knee Arthroplasty on Gait Mechanics of the Replaced and Non-Replaced Limb During Stair Negotiation.

Science.gov (United States)

Standifird, Tyler W; Saxton, Arnold M; Coe, Dawn P; Cates, Harold E; Reinbolt, Jeffrey A; Zhang, Songning

2016-01-01

This study compared biomechanics during stair ascent in replaced and non-replaced limbs of total knee arthroplasty (TKA) patients with control limbs of healthy participants. Thirteen TKA patients and fifteen controls performed stair ascent. Replaced and non-replaced knees of TKA patients were less flexed at contact compared to controls. The loading response peak knee extension moment was greater in control and non-replaced knees compared with replaced. The push-off peak knee abduction moment was elevated in replaced limbs compared to controls. Loading and push-off peak hip abduction moments were greater in replaced limbs compared to controls. The push-off peak hip abduction moment was greater in non-replaced limbs compared to controls. Future rehabilitation protocols should consider the replaced knee and also the non-replaced knee and surrounding joints. Copyright © 2016 Elsevier Inc. All rights reserved.

Total hip and knee joint replacement: perioperative clinical aspects

Directory of Open Access Journals (Sweden)

Luciana Pereira Almeida de Piano

2010-09-01

Full Text Available Objective: To understand the profile of patients undergoing hip and knee replacement during two years, and to compare the data obtained with the literature. Methods: A total of 323 medical records were reviewed to analyze the perioperative data of patients submitted to hip and knee replacement. Results: Osteoarthritis was the main indication for both procedures and male patients were heavier than females (p < 0.05. Hypertension was the prevalent disease among patients. Blood loss was more frequent in knee surgery than in the hip. Conclusions: The profile of patients undergoing total arthroplasty improved substantially over the past decade due to shorter hospital stay, lower risk of thromboembolic events and no infection as compared to previous reports.

Total hip replacements at Kikuyu Hospital, Kenya | Kingori | East ...

African Journals Online (AJOL)

Background: Total joint arthroplasty is a highly effective procedure that is frequently performed in elderly patients. This is not so in the third world and is not frequently performed. Total hip replacement (THR) relieves the pain and functional disability experienced by patients with moderate to severe arthritis of the hip, ...

Xanthan gum as a fat replacer in goshtaba-a traditional meat product of India: effects on quality and oxidative stability.

Science.gov (United States)

Rather, Sajad A; Masoodi, F A; Akhter, Rehana; Gani, Adil; Wani, S M; Malik, A H

2015-12-01

Goshtaba is a restructured meat product of Kashmiri wazwan prepared from meat emulsion with added fat (20 %), salt, spices and condiments and cooked in the curd. The present study was undertaken for the development of low fat goshtaba with the addition of xanthan gum as a fat replacer and was evaluated for proximate composition, pH, colour, lipid and protein oxidation, texture, microstructure and sensory properties. Low fat goshtaba formulations containing xanthan gum were higher in protein and moisture contents but, lower in fat content and pH value than the high fat control (p product containing 1.5 % xanthan gum. SEM results indicate that xanthan gum lead to formation of an additional gel network which holds more water. Sensory evaluation revealed that goshtaba product with 0.5 % xanthan gum had quality characteristics that were similar to the control product containing 20 % fat.

Fast-track surgery for bilateral total knee replacement

DEFF Research Database (Denmark)

Husted, H; Troelsen, A; Otte, K S

2011-01-01

Bilateral simultaneous total knee replacement (TKR) has been considered by some to be associated with increased morbidity and mortality. Our study analysed the outcome of 150 consecutive, but selected, bilateral simultaneous TKRs and compared them with that of 271 unilateral TKRs in a standardised...

Development and evaluation of chicken nuggets with partial replacement of meat and fat by pea fibre

Directory of Open Access Journals (Sweden)

Yana Jorge POLIZER

2015-03-01

Full Text Available The aim of this study was to develop and evaluate a chicken nugget formulation with partial substitution of the meat or fat by pea fibre. Three formulations were developed: Control (C – commercial formulation, Fibre Less Meat (FLM – reduction of 10% of meat and addition of 2% of pea fibre and Fibre Less Fat (FLF – reduction of 10% of fat and addition of 2% pea fibre. The products were characterized for their pH value, instrumental colour, texture, cooking loss (frying, proximate composition, and sensory properties (acceptance test. The control treatment presented lower (p0.05 amongst the treatments. The texture analysis showed no significant differences amongst the treatments for elasticity and cohesiveness, although the FLF batch was firmer than the others (p0.05 amongst the three treatments for aroma, texture, flavour or overall acceptability. One can conclude that it is possible to partially replace meat and fat by pea fibre in chicken nuggets, without compromising most of the physicochemical characteristics and without altering the sensory acceptance.

The use of synthetic ligaments in the design of an enhanced stability total knee joint replacement.

Science.gov (United States)

Stokes, Michael D; Greene, Brendan C; Pietrykowski, Luke W; Gambon, Taylor M; Bales, Caroline E; DesJardins, John D

2018-03-01

Current total knee replacement designs work to address clinically desired knee stability and range of motion through a balance of retained anatomy and added implant geometry. However, simplified implant geometries such as bearing surfaces, posts, and cams are often used to replace complex ligamentous constraints that are sacrificed during most total knee replacement procedures. This article evaluates a novel total knee replacement design that incorporates synthetic ligaments to enhance the stability of the total knee replacement system. It was hypothesized that by incorporating artificial cruciate ligaments into a total knee replacement design at specific locations and lengths, the stability of the total knee replacement could be significantly altered while maintaining active ranges of motion. The ligament attachment mechanisms used in the design were evaluated using a tensile test, and determined to have a safety factor of three with respect to expected ligamentous loading in vivo. Following initial computational modeling of possible ligament orientations, a physical prototype was constructed to verify the function of the design by performing anterior/posterior drawer tests under physiologic load. Synthetic ligament configurations were found to increase total knee replacement stability up to 94% compared to the no-ligament case, while maintaining total knee replacement flexion range of motion between 0° and 120°, indicating that a total knee replacement that incorporates synthetic ligaments with calibrated location and lengths should be able to significantly enhance and control the kinematic performance of a total knee replacement system.

A comparison between two methods of measuring total fat in the Iranian soldiers

Directory of Open Access Journals (Sweden)

J. Rahmani

2017-04-01

Full Text Available Background: Constant checkup and control of body fat mass is an important parameter for the health and efficiency of individuals in any society. This parameter is especially crucial in army soldiers since physical fitness is a key role in reaching high physical performance, health, and survival in war. Objective: This study was designed to compare two methods of measuring fat, the method of circumference-based military equations (CBEs to estimate body fat mass compared to the method of skinfold thickness-based equation (SBE in Iranian soldiers. Methods: This cross-sectional study was conducted on 246 Iranian soldiers were recruited in Tehran (2016. Height, waist, and neck circumference were measured and the total body fat mass was calculated using CBEs. Then, the results of using Pierson’s correlation and Bland-Altman methods were compared with Jackson and Pollock’s skinfold thickness measurement. Findings: The total body fat mass of the soldiers using CBEs was 18.94±6.30% and using Jakson and Pollock’s skinfold thickness formula was 17.43±4.45%. The correlation between the two methods was r=0.984 and SEE was 1.1% (P<0.001. Conclusion: The more body fat makes the error waist circumference greater. The error is so much that don’t use this method to measure fat.

Twenty-four hour total and dietary fat oxidation in lean, obese and reduced-obese adults with and without a bout of exercise.

Directory of Open Access Journals (Sweden)

Audrey Bergouignan

Full Text Available It has been hypothesized that obese and reduced-obese individuals have decreased oxidative capacity, which contributes to weight gain and regain. Recent data have challenged this concept.To determine (1 whether total and dietary fat oxidation are decreased in obese and reduced-obese adults compared to lean but increase in response to an acute exercise bout and (2 whether regular physical activity attenuates these metabolic alterations.We measured 24-hr total (whole-room calorimetry and dietary fat (14C-oleate oxidation in Sedentary Lean (BMI = 21.5±1.6; n = 10, Sedentary Obese (BMI = 33.6±2.5; n = 9, Sedentary Reduced-Obese (RED-SED; BMI = 26.9±3.7; n = 7 and in Physically Active Reduced-Obese (RED-EX; BMI = 27.3±2.8; n = 12 men and women with or without an acute exercise bout where energy expended during exercise was not replaced.Although Red-SED and Red-EX had a similar level of fatness, aerobic capacity and metabolic profiles were better in Red-EX only compared to Obese subjects. No significant between-group differences were seen in 24-hr respiratory quotient (RQ, Lean: 0.831±0.044, Obese: 0.852±0.023, Red-SED: 0.864±0.037, Red-EX: 0.842±0.039, total and dietary fat oxidation. A single bout of exercise increased total (+27.8%, p<0.0001 and dietary (+6.6%, p = 0.048 fat oxidation across groups. Although exercise did not impact RQ during the day, it decreased RQ during sleep (p = 0.01 in all groups. Red-EX oxidized more fat overnight than Red-SED subjects under both resting (p = 0.036 and negative energy balance (p = 0.003 conditions, even after adjustment for fat-free mass.Obese and reduced-obese individuals oxidize as much fat as lean both under eucaloric and negative energy balance conditions, which does not support the hypothesis of reduced oxidative capacity in these groups. Reduced-obese individuals who exercise regularly have markers of metabolic health similar to those seen in lean

Lessons from the war on dietary fat.

Science.gov (United States)

Walker, Thomas B; Parker, Mary Jo

2014-01-01

Conventional dietary guidelines put forth by health care institutions and providers for the past 40 years have stressed the importance of reducing the amount of dietary fat consumed. Such a diet is purported to mitigate metabolic risk factors and optimize the ability to achieve or maintain a healthy body weight. However, over the past 35 years obesity rates in the United States have risen dramatically though the level of dietary fat consumed by U.S. adults has fallen. This review examines the potential reasons for this paradox. Various meta-analyses, controlled trials, and cohort studies have demonstrated that reducing dietary fat intake provides for very little weight loss unless accompanied by equal or greater reductions in total energy intake. Due to both psychological (e.g., the tendency for people to eat more of what they consider low fat) and physiological (e.g., the low satiety that accompanies carbohydrate intake) factors, reducing total caloric intake while simultaneously reducing fat intake is a difficult challenge. Further, reductions in total carbohydrate intake, increases in protein intake, and adoption of a Mediterranean diet seem to be more effective in inducing weight loss than reductions in fat intake. Traditional claims that simply reducing dietary fat will improve metabolic risk factors are also not borne out by research. There is some evidence that replacing dietary saturated fat with unsaturated fat may improve metabolic risk factors, but that research is not conclusive. • Over the past 40 years, Americans have decreased the percentage of calories they get from dietary fat while rates of overweight and obesity have risen dramatically. • It appears that a decrease in total dietary fat in ad libitum diets may induce a very small decrease in body weight. • Evidence suggests that reductions in total dietary fat intake often occur in conjunction with an increase in total caloric intake. • It seems reasonable to conclude that guiding the

The feasibility of multisectoral policy options aimed at reducing trans fats and encouraging its replacement with healthier oils in India.

Science.gov (United States)

Downs, Shauna M; Thow, Anne-Marie; Ghosh-Jerath, Suparna; Leeder, Stephen R

2015-05-01

The World Health Organization recommends replacement of trans fat with polyunsaturated fat to reduce cardiovascular disease risk. Although several high-income countries have been successful in reducing trans fat in the food supply, low- and middle-income countries such as India may face additional contextual challenges such as the large informal sector, lack of consumer awareness, less enforcement capacity and low availability and affordability of healthier unsaturated fats. The objective of this study was to examine the feasibility and acceptability of multisectoral policy options aimed at supporting trans fat reduction and its replacement with polyunsaturated fats in India. Multisectoral policy options examined in this study were identified using food supply chain analysis. Semi-structured interviews (n = 17) were conducted with key informants from agriculture, trade, finance, retail, industry, food standards, non-governmental organizations and the health professions to gain their views on the feasibility and acceptability of the policy options. Purposive sampling was used to identify key informants. Data were coded and organized based on key themes. There was support for policies aimed at improving the quality of seeds, supporting farmer co-operatives and developing affordable farming equipment suited to smallholders to improve the production of healthier oils. Increasing the role of the private sector to improve links among producers, processors and retailers may help to streamline the fats supply chain in India. Blending healthier oils with oils high in saturated fat, which are currently readily available, could help to improve the quality of fat in the short term. Improving consumer awareness through mass media campaigns and improved labelling may help increase consumer demand for healthier products. Reorienting agricultural policies to support production of healthier oils will help increase their uptake by industry. Policy coherence across sectors will be

Effects of Partial Beef Fat Replacement with Gelled Emulsion on Functional and Quality Properties of Model System Meat Emulsions.

Science.gov (United States)

Serdaroğlu, Meltem; Nacak, Berker; Karabıyıkoğlu, Merve; Keser, Gökçen

2016-01-01

The objective of this study was to investigate the effects of partial beef fat replacement (0, 30, 50, 100%) with gelled emulsion (GE) prepared with olive oil on functional and quality properties of model system meat emulsion (MSME). GE consisted of inulin and gelatin as gelling agent and characteristics of gelled and model system meat emulsions were investigated. GE showed good initial stability against centrifugation forces and thermal stability at different temperatures. GE addition decreased the pH with respect to increase in GE concentration. Addition of GE increased lightness and yellowness but reduced redness compared to control samples. The results of the study showed that partial replacement of beef fat with GE could be used for improving cooking yield without negative effects on water holding capacity and emulsion stability compared to C samples when replacement level is up to 50%. The presence of GE significantly affected textural behaviors of samples ( p <0.05). In conclusion, our study showed that GE have promising impacts on developing healthier meat product formulations besides improving technological characteristics.

Use of Tranexamic Acid during Total Endoprosthetic Replacement of the Hip Joint

Directory of Open Access Journals (Sweden)

D. D. Selivanov

2010-01-01

Full Text Available Objective: to evaluate the blood-saving activity, efficacy, and safety of tranexamic acid. Subjects and methods. Thirty-seven patients allocated into two groups were enrolled in the study of the efficacy of tranexamic acid as an agent in reducing blood loss during hip joint replacement. Group 2 patients were injected tranexamic acid, 10 mg/kg body weight, 20—30 minutes before and 3 hours after surgery in the same dosage. This resulted in a significant (48.5% reduction in total blood loss (from 1089.6 to 560.8 ml (p<0.05. No tranexamic acid-induced complications were found. The administration of tranexamic acid during total endoprosthetic replacement of the hip joint could reduce blood loss by 35 and 59.4% in the intraoperative and postoperative periods, respectively, and total blood loss by 48.4%. The use of tranexamic acid allows one to refuse transfusion of blood components during total endoprosthetic replacement of the hip joint. Key words: hip joint replacement, blood loss, tranexamic acid.

Isoenergetic Replacement of Fat by Starch in Diets for African Catfish (Clarias gariepinus): Effect on Water Fluxes in the Gastro Intestinal Tract

NARCIS (Netherlands)

Harter, T.S.; Verreth, J.A.J.; Heinsbroek, L.T.N.; Schrama, J.W.

2013-01-01

The effect of an isoenergetic replacement of dietary fat by starch, on chyme characteristics and water fluxes in the gastro intestinal tract (GIT) was assessed. Adult African catfish (Clarias gariepinus) were fed a starch (SD) or fat (FD) diet and groups of fish were dissected at 2, 5 and 8 h after

Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study

Directory of Open Access Journals (Sweden)

van Jonbergen Hans-Peter W

2012-06-01

Full Text Available Abstract Background Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal femoral bone mineral density after patellofemoral joint replacement. It is unclear whether this is due to periprosthetic stress shielding. The main objective of the current study was to evaluate the stress shielding effect of prosthetic replacement with 2 different patellofemoral prosthetic designs and with a total knee prosthesis. Methods We developed a finite element model of an intact patellofemoral joint, and finite element models of patellofemoral joint replacement with a Journey PFJ prosthesis, a Richards II prosthesis, and a Genesis II total knee prosthesis. For each of these 4 finite element models, the average Von Mises stress in 2 clinically relevant regions of interest were evaluated during a simulated squatting movement until 120 degrees of flexion. Results During deep knee flexion, in the anterior region of interest, the average Von Mises stress with the Journey PFJ design was comparable to the physiological knee, while reduced by almost 25% for both the Richards II design and the Genesis II total knee joint replacement design. The average Von Mises stress in the supracondylar region of interest was similar for both patellofemoral prosthetic designs and the physiological model, with slightly lower stress for the Genesis II design. Conclusions Patellofemoral joint replacement results in periprosthetic stress-shielding, although to a smaller degree than in total knee replacement. Specific patellofemoral prosthetic design properties may result in differences in femoral stress shielding.

Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study

Science.gov (United States)

2012-01-01

Background Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal femoral bone mineral density after patellofemoral joint replacement. It is unclear whether this is due to periprosthetic stress shielding. The main objective of the current study was to evaluate the stress shielding effect of prosthetic replacement with 2 different patellofemoral prosthetic designs and with a total knee prosthesis. Methods We developed a finite element model of an intact patellofemoral joint, and finite element models of patellofemoral joint replacement with a Journey PFJ prosthesis, a Richards II prosthesis, and a Genesis II total knee prosthesis. For each of these 4 finite element models, the average Von Mises stress in 2 clinically relevant regions of interest were evaluated during a simulated squatting movement until 120 degrees of flexion. Results During deep knee flexion, in the anterior region of interest, the average Von Mises stress with the Journey PFJ design was comparable to the physiological knee, while reduced by almost 25% for both the Richards II design and the Genesis II total knee joint replacement design. The average Von Mises stress in the supracondylar region of interest was similar for both patellofemoral prosthetic designs and the physiological model, with slightly lower stress for the Genesis II design. Conclusions Patellofemoral joint replacement results in periprosthetic stress-shielding, although to a smaller degree than in total knee replacement. Specific patellofemoral prosthetic design properties may result in differences in femoral stress shielding. PMID:22704638

Midflexion instability in primary total knee replacement: a review

Directory of Open Access Journals (Sweden)

Ramappa Manjunath

2015-01-01

Full Text Available Introduction: Midflexion instability in primary total knee replacement (TKR is an evolving concept. Successful treatment of instability requires an understanding of the different types of instability. Methods: A literature review was performed to identify information pertinent to midflexion instability in primary total knee replacement, utilising PRISMA guidelines. Databases searched included Embase, Medline, All of the Cochrane Library, PubMed and cross references. Results: Three factors, i.e., elevated joint line, multiradii femoral component and medial collateral ligament (MCL laxity, were identified to influence midflexion instability. Literature suggested mediolateral instability at 30–60° of flexion as diagnostic of midflexion instability. Literature search also revealed paucity in clinical studies analysing midflexion instability. Most of the evidence was obtained from cadaveric studies for elevated joint line and MCL laxity. Clinical studies on multiradii femoral component were limited by their small study size and early followup period. Conclusion: Elevated joint line, multiradii femoral component and MCL laxity have been suggested to cause midflexion laxity in primary TKR. Due to limitations in available evidence, this review was unable to raise the strength of overall evidence. Future well-designed clinical studies are essential to make definitive conclusions. This review serves as a baseline for future researchers and creates awareness for routine assessment of midflexion instability in primary total knee replacement.

Potential applications of plant based derivatives as fat replacers, antioxidants and antimicrobials in fresh and processed meat products.

Science.gov (United States)

Hygreeva, Desugari; Pandey, M C; Radhakrishna, K

2014-09-01

Growing concern about diet and health has led to development of healthier food products. In general consumer perception towards the intake of meat and meat products is unhealthy because it may increase the risk of diseases like cardiovascular diseases, obesity and cancer, because of its high fat content (especially saturated fat) and added synthetic antioxidants and antimicrobials. Addition of plant derivatives having antioxidant components including vitamins A, C and E, minerals, polyphenols, flavanoids and terpenoids in meat products may decrease the risk of several degenerative diseases. To change consumer attitudes towards meat consumption, the meat industry is undergoing major transformations by addition of nonmeat ingredients as animal fat replacers, natural antioxidants and antimicrobials, preferably derived from plant sources. Copyright © 2014 Elsevier Ltd. All rights reserved.

A longitudinal study of quality of life and functional status in total hip and total knee replacement patients.

Science.gov (United States)

Mandzuk, Lynda L; McMillan, Diana E; Bohm, Eric R

2015-05-01

Primary total hip and primary total knee surgeries are commonly performed to improve patients' quality of life and functional status. This longitudinal retrospective study (N = 851) examined self-reported quality of life and functional status over the preoperative and postoperative periods: 12 months prior to surgery, one month prior to surgery and 12 months following surgery. A linear mixed effects model was used to analyze the changes in quality of life and functional status over the sampling period. Patients in the convenience sample reported improvements in quality of life and functional status utilizing the SF-12 and Oxford Hip and Oxford Knee, although differences were noted by procedure and gender. Total hip patients tended to demonstrate greater improvement than total knee patients and males reported higher levels of physical and mental quality of life as well as functional status when compared to females. Of particular note was that mental health scores were consistently lower in both total hip and total knee replacement patients across the perioperative period and up to one year postoperative. This study identifies an opportunity for health care providers to proactively address the mental health of total hip and total knee replacement patients throughout their joint replacement trajectory. Copyright © 2014 Elsevier Ltd. All rights reserved.

Total Knee Replacement in A Resource Constrained Environment: A ...

African Journals Online (AJOL)

2017-03-06

Mar 6, 2017 ... care patronage, and the recent trends of religious/faith healings. • Beliefs ... Prevalence and Pattern of Knee Osteoarthritis in a North Eastern. Nigerian Rural ... epidemiology of total knee replacement in South Korea: national.

Jejunal Replacement of Stomach in Two Children with Total Gastric Necrosis

Directory of Open Access Journals (Sweden)

Onder Ozden

2014-04-01

Full Text Available Total gastrectomy is an extremely rare procedure in children and experience with its replacement is very limited. We present two patients who had jejunal replacement due to total gastric necrosis. The first patient was a- 2-year-old boy who admitted with a history of caustic ingestion. He was taken operation because of gastric perforation and necrosis. Anastomosis was applied by using jejunal segments. The second patient was an 11-years-old girl who left diaphragmatic hernia and acute gastric volvulus. At laparotomy, Total gastrectomy and Hunt-Lawrence type gastroesophostomy were made. Reconstruction with jejunum is thought as a good option in total gastric necrosis according to our 2 patient experiences. [Cukurova Med J 2014; 39(2.000: 403-407

Dislocation of total hip replacement in patients with fractures of the femoral neck.

Science.gov (United States)

Enocson, Anders; Hedbeck, Carl-Johan; Tidermark, Jan; Pettersson, Hans; Ponzer, Sari; Lapidus, Lasse J

2009-04-01

Total hip replacement is increasingly used in active, relatively healthy elderly patients with fractures of the femoral neck. Dislocation of the prosthesis is a severe complication, and there is still controversy regarding the optimal surgical approach and its influence on stability. We analyzed factors influencing the stability of the total hip replacement, paying special attention to the surgical approach. We included 713 consecutive hips in a series of 698 patients (573 females) who had undergone a primary total hip replacement (n = 311) for a non-pathological, displaced femoral neck fracture (Garden III or IV) or a secondary total hip replacement (n = 402) due to a fracture-healing complication after a femoral neck fracture. We used Cox regression to evaluate factors associated with prosthetic dislocation after the operation. Age, sex, indication for surgery, the surgeon's experience, femoral head size, and surgical approach were tested as independent factors in the model. The overall dislocation rate was 6%. The anterolateral surgical approach was associated with a lower risk of dislocation than the posterolateral approach with or without posterior repair (2%, 12%, and 14%, respectively (p replacement in patients with femoral neck fractures.

Evaluation of physicochemical, textural and sensorial characteristics of low-fat or low-sugar synbiotic ice-cream

Directory of Open Access Journals (Sweden)

M Hashemi

2015-08-01

Full Text Available Replacing a part of fat and sugar in ice-cream by inulin and lactulose as prebiotic may create a healthier product. Two low-fat and two low-sugar synbiotic ice-cream samples were manufactured inoculated with Lactobacillus acidophilus or Bacillus coagulans. The physicochemical, textural and sensorial characteristics of the samples were compared with regular ice-cream as control. Low-fat and low-sugar synbiotic ice-cream formulations were prepared by replacing 5% of the fat and sugar contents of the control formula by inulin and lactulose, respectively. According to the results, although the total solids of the ice-cream mixes did not differ significantly, there were significant (p

Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial.

Science.gov (United States)

Ulven, Stine M; Leder, Lena; Elind, Elisabeth; Ottestad, Inger; Christensen, Jacob J; Telle-Hansen, Vibeke H; Skjetne, Anne J; Raael, Ellen; Sheikh, Navida A; Holck, Marianne; Torvik, Kristin; Lamglait, Amandine; Thyholt, Kari; Byfuglien, Marte G; Granlund, Linda; Andersen, Lene F; Holven, Kirsten B

2016-10-01

The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD. However, the extent of food changes needed to achieve these effects is less explored. The aim of the present study was to investigate the effects of exchanging a few commercially available, regularly consumed key food items (e.g. spread on bread, fat for cooking, cheese, bread and cereals) with improved fat quality on total cholesterol, LDL-cholesterol and inflammatory markers in a double-blind randomised, controlled trial. In total, 115 moderately hypercholesterolaemic, non-statin-treated adults (25-70 years) were randomly assigned to an experimental diet group (Ex-diet group) or control diet group (C-diet group) for 8 weeks with commercially available food items with different fatty acid composition (replacing SFA with mostly n-6 PUFA). In the Ex-diet group, serum total cholesterol (PLDL-cholesterol (Pcholesterol and LDL-cholesterol, respectively. No difference in change in plasma levels of inflammatory markers (high-sensitive C-reactive protein, IL-6, soluble TNF receptor 1 and interferon-γ) was observed between the groups. In conclusion, exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol, with no negative effect on levels of inflammatory markers. This shows that an exchange of a few commercially available food items was easy and manageable and led to clinically relevant cholesterol reduction, potentially affecting future CVD risk.

The effect of replacing fat with oat bran on fatty acid composition and physicochemical properties of meatballs.

Science.gov (United States)

Yılmaz, İsmail; Dağlıoğlu, Orhan

2003-10-01

Oat bran was used as a fat substitute in the production of meatballs. The effect of oat bran addition on the fatty acid composition, trans fatty acids, total fat, some physicochemical and sensory properties of the samples was studied. Meatballs were produced with four different formulations; the addition of 5, 10, 15 and 20% oat bran. Control samples were formulated with 25% fat addition as in commercial production. The major fatty acids were cis-oleic, palmitic and stearic acid in all the meatball samples, those with oat bran added as well as the control. Meatballs containing oat bran had lower concentrations of total fat and total trans fatty acids than the control samples. Meatballs made with 20% oat bran had the highest protein, salt and ash contents, L value (lightness), b value (yellowness), and the lowest moisture content and a value (redness). There was no significant difference among the meatball samples with respect to sensory properties, and all samples had high acceptability.

Comparing the effects of meal replacements with an isocaloric reduced-fat diet on nutrient intake and lower urinary tract symptoms in obese men.

Science.gov (United States)

Khoo, J; Ling, P-S; Chen, R Y-T; Ng, K-K; Tay, T-L; Tan, E; Cho, L-W; Cheong, M

2014-06-01

Lower urinary tract symptoms (LUTS) in men are associated with obesity, particularly central obesity as measured by waist circumference (WC), and may improve with weight loss. We aimed to compare effects of a meal-replacement based diet with isocaloric reduced-fat plan on LUTS and nutrient intake in obese Asian men. Obese Asian [mean (range) body mass index of 32.9 (30.5-42.3) kg m(-2) ] men [mean (range) age 40.2 (30-61) years] were randomised to a reduced-fat (meal-replacement-based plan [meal replacement (MR) group; n = 23], to reduce daily intake by 2000 kJ for 12 weeks. CD and MR groups had statistically significant and similar reductions in weight (-2.6 ± 1.9 kg versus -4.2 ± 3.8 kg), overall LUTS severity measured with International Prostate Symptom Scale (IPSS) scores (-1.71 ± 1.93 points versus -2.42 ± 2.12 points) and insulin resistance [homeostasis model assessment (HOMA) calculated from plasma glucose and insulin]. The MR group had significantly greater decreases in WC (-4.8 ± 3.3 cm versus -2.5 ± 2.3 cm), fat mass (-2.47 ± 3.63 kg versus -1.59 ± 2.32 kg), fat intake, plasma C-reactive protein, and in storage LUTS score (-1.59 ± 1.33 points versus -1.00 ± 0.87 points), which was associated with a decreased fat intake (r = 0.48, P = 0.03). A decrease in overall IPSS score was associated with reductions in weight, WC and HOMA. Weight loss as a result of CD or MR had similar efficacy in relieving LUTS. MR produced greater reductions in fat intake, adiposity and storage LUTS. © 2013 The British Dietetic Association Ltd.

Effect of High-Intensity Interval Training on Total, Abdominal and Visceral Fat Mass: A Meta-Analysis.

Science.gov (United States)

Maillard, Florie; Pereira, Bruno; Boisseau, Nathalie

2018-02-01

High-intensity interval training (HIIT) is promoted as a time-efficient strategy to improve body composition. The aim of this meta-analysis was to assess the efficacy of HIIT in reducing total, abdominal, and visceral fat mass in normal-weight and overweight/obese adults. Electronic databases were searched to identify all related articles on HIIT and fat mass. Stratified analysis was performed using the nature of HIIT (cycling versus running, target intensity), sex and/or body weight, and the methods of measuring body composition. Heterogeneity was also determined RESULTS: A total of 39 studies involving 617 subjects were included (mean age 38.8 years ± 14.4, 52% females). HIIT significantly reduced total (p = 0.003), abdominal (p = 0.007), and visceral (p = 0.018) fat mass, with no differences between the sexes. A comparison showed that running was more effective than cycling in reducing total and visceral fat mass. High-intensity (above 90% peak heart rate) training was more successful in reducing whole body adiposity, while lower intensities had a greater effect on changes in abdominal and visceral fat mass. Our analysis also indicated that only computed tomography scan or magnetic resonance imaging showed significant abdominal and/or visceral fat-mass loss after HIIT interventions. HIIT is a time-efficient strategy to decrease fat-mass deposits, including those of abdominal and visceral fat mass. There was some evidence of the greater effectiveness of HIIT running versus cycling, but owing to the wide variety of protocols used and the lack of full details about cycling training, further comparisons need to be made. Large, multicenter, prospective studies are required to establish the best HIIT protocols for reducing fat mass according to subject characteristics.

Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis

DEFF Research Database (Denmark)

Svege, Ida; Nordsletten, Lars; Fernandes, Linda

2015-01-01

Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown.......Exercise treatment is recommended for all patients with hip osteoarthritis (OA), but its effect on the long-term need for total hip replacement (THR) is unknown....

Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

Directory of Open Access Journals (Sweden)

Elaine W Chong

Full Text Available Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49. Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02. The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured

Functional assessment of patients after total knee replacement

Directory of Open Access Journals (Sweden)

Matla Joanna

2017-06-01

Full Text Available Introduction: In the society of the 21st century, osteoarthritis is considered one of the primary causes of the occurrence of pain and disability. Arthroplasty is the treatment of choice for advanced degenerative changes. The aim of the study was to carry out a functional assessment of patients at early stages of rehabilitation after total knee replacement.

Modified broken rice starch as fat substitute in sausages

Directory of Open Access Journals (Sweden)

Valéria Maria Limberger

2011-09-01

Full Text Available The demand for low-fat beef products has led the food industry to use fat substitutes such as modified starch. About 14% of broken rice is generated during processing. Nevertheless, this by-product contains high levels of starch; being therefore, great raw material for fat substitution. This study evaluated the applicability of chemically and physically modified broken rice starch as fat substitute in sausages. Extruded and phosphorylated broken rice was used in low-fat sausage formulation. All low-fat sausages presented about 55% reduction in the fat content and around 28% reduction in the total caloric value. Fat replacement with phosphorylated and extruded broken rice starch increased the texture acceptability of low-fat sausages, when compared to low-fat sausages with no modified broken rice. Results suggest that modified broken rice can be used as fat substitute in sausage formulations, yielding lower caloric value products with acceptable sensory characteristics.

Variation in age and physical status prior to total knee and hip replacement surgery

DEFF Research Database (Denmark)

Ackerman, Ilana N; Dieppe, Paul A; March, Lyn M

2009-01-01

OBJECTIVE: To investigate whether variation exists in the preoperative age, pain, stiffness, and physical function of people undergoing total knee replacement (TKR) and total hip replacement (THR) at several centers in Australia and Europe. METHODS: Individual Western Ontario and McMaster Univers...

Abdominal Obesity and their association with Total Body: Fat Distribution and Composition. Case of Algerian Teenager Male high school students

Directory of Open Access Journals (Sweden)

Mohammed Zerf

2017-06-01

Full Text Available Purpose: Our aim attempted to esteem the impact of abdominal fat on body fat distribution or composition related to total body fat as recommended weight loss among High School Students. Material: For the proposed, 100 male students from the Algerian high school Education Sector's mandate Sidi Bel Abbes, participate in the present study. Their average age 16±1.52 years, distributed into homogeneous groups, according to their body fat percent categories. Examined by saving tests (Body Fat Percentage (BFP - Abdominal circumference (WC - Body mass index (BMI. Results: Based on the test data and the analysis statistics applied, we confirm: a Abdominal obesity is excess body gain correlate with total fat BMI. It highly affected body composition reported as additional fat for overweight in compare with acceptable according to Ideal BFP categories. b Abdominal obesity is an amount deep fat correlates to total BFP. It higher influenced the distribution of total body fat reported as additional excess fat among overweight category compared to the acceptable group. c Waist circumference (WC is the leading marker of abdominal fat deposits located in the central region of the body. While the combination of body mass index (BMI and waist circumference (WC, reflects the combined effects of body build (fat or fatness in individuals at higher risk of excessive body fat. Conclusions: founded on the differences acquired by the research team. We highlight that abdominal obesity is strongly connected to larger WC relate to total body gain located as excess inordinate fatness BMI or fat distribution BFP among our overall sample. Evidence, which guides us to recommend our adolescent students to intensification their hours of sports practice, in order to avoid the consequences of abdominal obesity gain. Announced in the present study as excess abdominal adiposity more metabolically active. Requiring the control of body weight loss (BFP or BMI strongly correlates to

Total Humeral Endoprosthetic Replacement following Excision of Malignant Bone Tumors

Directory of Open Access Journals (Sweden)

Suhel Kotwal

2016-01-01

Full Text Available Humerus is a common site for malignant tumors. Advances in adjuvant therapies and reconstructive methods provide salvage of the upper limb with improved outcomes. Reports of limb salvage with total humeral replacement in extensive humeral tumors are sparse. We undertook a retrospective study of 20 patients who underwent total humeral endoprosthetic replacement as limb salvage following excision of extensile malignant tumor from 1990 to 2011. With an average followup of 42.9, functional and oncological outcomes were analyzed. Ten patients were still alive at the time of review. Mean estimated blood loss was 1131 mL and duration of surgery was 314 minutes. Deep infection was encountered in one patient requiring debridement while mechanical loosening of ulnar component was identified in one patient. Subluxation of prosthetic humeral head was noted in 3 patients. Mean active shoulder abduction was 12.5° and active flexion was 15°. Incompetence of abduction mechanism was the major determinant of poor active functional outcome. Mean elbow flexion was 103.5° with 30.5° flexion contracture in 10 patients with good and useful hand function. Average MSTS score was 71.5%. Total humeral replacement is a reliable treatment option in restoring mechanical stability and reasonable functional results without compromising patient survival, with low complication rate.

Managing infection in the revision total hip replacement patient.

Science.gov (United States)

Halley, D K

1993-01-01

Deep infection is one of the most devastating complications in total hip replacement. This dreaded complication is presented in considerable detail with special emphasis on prevention, diagnosis, and various methods of surgical and antibiotic treatment. Basic fundamentals of antibiotic therapy are reviewed. In addition, guidelines are given for the indications of surgical intervention, the type and staging of operative procedures, with detailed techniques of the various operative procedures used to treat the infected total hip implant patient.

Food Supplement Reduces Fat, Improves Flavor

Science.gov (United States)

2007-01-01

Diversified Services Corporation, seeking to develop a new nutritional fat replacement and flavor enhancement product, took advantage of the NASA Glenn Garrett Morgan Commercialization Initiative (GMCI) for technology acquisition and development and introductions to potential customers and strategic partners. Having developed and commercialized the product, named Nurtigras, the company is now marketing it through its subsidiary, H.F. Food Technologies Inc. The Nutrigras fat substitute is available in liquid, gel, or dry form and can be easily customized to the specific needs of the food manufacturer. It is primarily intended for use as a partial replacement for animal fat in beef patties and other normally high-fat meat products, and can also be used in soups, sauces, bakery items, and desserts. In addition to the nutritional benefits, the fat replacement costs less than the food it replaces, and as such can help manufacturers reduce material costs. In precooked products, Nutrigras can increase moisture content and thereby increase product yield. The company has been able to repay the help provided by NASA by contributing to the Space Agency's astronaut diet-the Nutrigras fat substitute can be used as a flavor enhancer and shelf-life extender for food on the ISS.

Total hip replacement surgery in Ethiopia | Gokcen | East and ...

African Journals Online (AJOL)

Background: Total hip replacement (THR) surgery has evolved over years to the point that it has been considered as "the operation of the century". For developed countries, arthroplasty is well established for the management of various joint disorders and has completely revolutionised the treatment of the arthritic hip.

Total and regional fat distribution is strongly influenced by genetic factors in young and elderly twins

DEFF Research Database (Denmark)

Malis, Charlotte; Rasmussen, Eva L; Poulsen, Pernille

2005-01-01

was to estimate the heritability (h(2)) of total and regional fat distribution in young and elderly Danish twins. RESEARCH METHODS AND PROCEDURES: Monozygotic (108) and dizygotic (88) twins in two age groups (25 to 32 and 58 to 66 years) underwent anthropometric measurements and DXA scans. Intraclass correlations...... and etiologic components of variance were estimated for total and regional fat percentages using biometric modeling. RESULTS: The intraclass correlations demonstrated higher correlations for all fat percentages among monozygotic twins as compared with dizygotic twins. The biometric modeling revealed a major...

Effects of goat milk or milk replacer diet on meat quality and fat composition of suckling goat kids.

Science.gov (United States)

Bañón, S; Vila, R; Price, A; Ferrandini, E; Garrido, M D

2006-02-01

The effects of a diet with goat milk "GM" or milk replacer "MR" on the meat quality and fat composition of suckling Murciano-Granadina kids were studied. MR consisted of powdered skimmed milk, coconut oil and fat, and cereal products and by-products. Raw meat quality (moisture, protein, lipids, ash, collagen, cholesterol, haem pigments, CIELab colour, pH and water retention capacity), fatty acid "FA" composition and eating quality of cooked meat (odour, flavour and texture) were determined. Diet had only a slight effect on raw meat quality but had a pronounced effect on fatty acid composition and eating quality of cooked meat. MR diet increased the water/protein proportion in the muscle. The saturated/unsaturated FA ratio in GM and MR fat was 0.94 and 2.27, respectively. The major FA in GM and MR fat were C16:0 and C18:1, respectively. Short-chain C4-C12 hardly accumulated in the adipose tissue of suckling kid, increasing the relative percentages of C14-C20. This effect was more pronounced in MR fat, due to the fact that MR contained more short-chain fatty acids than GM. MR diet gave cooked meat a more intense characteristic goat meat odour and flavour, more tenderness and more juiciness than the natural suckling diet. This fact could be related to differences in meat and fat composition.

Influence of conformity on the wear of total knee replacement: An experimental study.

Science.gov (United States)

Brockett, Claire L; Carbone, Silvia; Fisher, John; Jennings, Louise M

2018-02-01

Wear of total knee replacement continues to be a significant factor influencing the clinical longevity of implants. Historically, failure due to delamination and fatigue directed design towards more conforming inserts to reduce contact stress. As new generations of more oxidatively stable polyethylene have been developed, more flexibility in bearing design has been introduced. The aim of this study was to investigate the effect of insert conformity on the wear performance of a fixed bearing total knee replacement through experimental simulation. Two geometries of insert were studied under standard gait conditions. There was a significant reduction in wear with reducing implant conformity. This study has demonstrated that bearing conformity has a significant impact on the wear performance of a fixed bearing total knee replacement, providing opportunities to improve clinical performance through enhanced material and design selection.

Physical health problems experienced in the early postoperative recovery period following total knee replacement

DEFF Research Database (Denmark)

Szötz, Kirsten; Pedersen, Preben Ulrich; Hørdam, Britta

2015-01-01

of exercising in the early recovery period after discharge from hospital following total knee replacement. METHOD: A cross-sectional survey was conducted using a questionnaire. A total of 86 patients were included following first-time elective total knee replacement. Descriptive statistics were used. RESULTS......: The majority of the patients experienced leg oedema (90.7%). Secondary to this were pain (81.4%), sleeping disorders (47.7%) problems with appetite (38.4%) and bowel function (34.9%) were the most frequently identified physical health problems. In total, 69.8% of the patients indicated that they did...... not exercise or only partly exercise as recommended, but without associated experience of pain. CONCLUSION: Patients experienced a wide range of physical health problems following total knee replacement and deviation from recommended self-training was identified. These findings are valuable for health...

Matched cohort study of topical tranexamic acid in cementless primary total hip replacement.

Science.gov (United States)

Sanz-Reig, Javier; Mas Martinez, Jesus; Verdu Román, Carmen; Morales Santias, Manuel; Martínez Gimenez, Enrique; Bustamante Suarez de Puga, David

2018-03-29

Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid. This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement. Primary outcomes were hemoglobin and hematocrit drop, and total blood loss. Secondary outcomes were transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. We could match 100 patients to a control group. There were no statistical significantly differences between the two groups. The hemoglobin and hematocrit postoperative values were significantly higher in topical tranexamic acid group than in control group (P tranexamic acid group and 1163 in control group with significant differences (P = 0.001), which meant 34% reduction in total blood loss. Length of stay was lower in topical tranexamic acid group. The risk of deep vein thrombosis and pulmonary events did not increase. A single dose of 2 g tranexamic acid in 50 mL physiological saline solution topical administration was effective and safe in reducing bleeding in patients undergoing unilateral primary non-cemented total hip replacement compared to a matched control group.

The role of total body fat mass and trunk fat mass, combined with other endocrine factors, in menstrual recovery and psychopathology of adolescents with Anorexia Nervosa.

Science.gov (United States)

Karountzos, Vasileios; Lambrinoudaki, Irene; Tsitsika, Artemis; Deligeoroglou, Efthimios

2017-10-01

To determine the threshold of total body and trunk fat mass required for menstrual recovery and to assess the impact of body composition in psychopathology of adolescents with Anorexia Nervosa (AN). Prospective study of 60 adolescents presented with secondary amenorrhea and diagnosed with AN. Anthropometrics, body composition by dual-energy X-ray absorptiometry, hormonal studies and responses to mental health screens (EAT-26), were obtained at the beginning and at complete weight restoration, in all adolescents, independently of menstrual recovery (Group A) or not (Group B). At weight restoration, Group A total body fat mass, trunk fat mass, and trunk/extremities fat ratio were significantly higher (p psychopathology of adolescents with AN.

Internal Fat and Cardiometabolic Risk Factors Following a Meal-Replacement Regimen vs. Comprehensive Lifestyle Changes in Obese Subjects.

Science.gov (United States)

König, Daniel; Zdzieblik, Denise; Deibert, Peter; Berg, Aloys; Gollhofer, Albert; Büchert, Martin

2015-12-01

The aim of the present study was to investigate the effect of a meal-replacement regimen vs. comprehensive lifestyle changes in overweight or obese subjects on intra-abdominal fat stores (Magnetic Resonance Imaging (MRI) measurements) and cardiometabolic risk factors. Forty-two obese men (n = 18) and women (n = 24) (age 49 ± 8 years; weight 96.3 ± 12.1 kg; BMI 32.7 ± 2.3 kg/m2) were selected for this randomized parallel-group design investigation. Subjects in the lifestyle group (LS-G; n = 22) received dietary counselling sessions and instructions how to increase physical activity. In the meal replacement group (MR-G; n = 20) meals were replaced by a low-calorie drink high in soy protein. After six months, subjects in the LS-G lost 8.88 ± 6.24 kg and subjects in the MR-G lost 7.1 ± 2.33 kg; p meal replacement group suggesting an additional effect of soy protein components.

Surface neuromuscular electrical stimulation for quadriceps strengthening pre and post total knee replacement.

LENUS (Irish Health Repository)

Monaghan, Brenda

2010-01-01

Total knee replacement has been demonstrated to be one of the most successful procedures in the treatment of osteoarthritis. However quadriceps weakness and reductions in function are commonly reported following surgery. Recently Neuromuscular Electrical Stimulation (NMES) has been used as an adjunct to traditional strengthening programmes. This review considers the effectiveness of NMES as a means of increasing quadriceps strength in patients before and after total knee replacement.

Non-Traumatic Anterior Dislocation of a Total Knee Replacement Associated with Neurovascular Injury

Science.gov (United States)

Aderinto, Joseph; Gross, Allan E; Rittenhouse, Bryan

2009-01-01

Prosthetic total knee replacements rarely dislocate. When dislocation does occur, it is usually in a posterior direction in association with a posterior stabilised, cruciate-sacrificing prosthesis. Neurovascular injury is unusual. In this report, we describe a case of anterior dislocation of a cruciate-retaining total knee replacement in a 67-year-old woman. The dislocation occurred in the absence of overt trauma and resulted in severe neurovascular injury. PMID:19686618

The role of the posterior cruciate ligament in total knee replacement

Science.gov (United States)

Ritter, M. A.; Davis, K. E.; Meding, J. B.; Farris, A.

2012-01-01

Objectives The purpose of this study was to examine the effect of posterior cruciate ligament (PCL) retention, PCL recession, and PCL excision during cruciate-retaining total knee replacement. Methods A total of 3018 anatomic graduated component total knee replacements were examined; 1846 of these retained the PCL, 455 PCLs were partially recessed, and in 717 the PCL was completely excised from the back of the tibia. Results Clinical scores between PCL groups favored excision for flexion (p knees, 98.2% for recessed knees, and 96.4% for excised knees (p = 0.0934, Wilcoxon; p = 0.0202, log-rank). Conclusions Despite some trade off in clinical performance, if the PCL is detached at the time of operation, conversion to a posterior-stabilised prosthesis may not be necessarily required as long as stability in the anteroposterior and coronal planes is achieved. PMID:23610673

The influence of optimism on functionality after total hip replacement surgery.

Science.gov (United States)

Balck, Friedrich; Lippmann, Maike; Jeszenszky, Csilla; Günther, Klaus-Peter; Kirschner, Stephan

2016-08-01

Among other factors, optimism has been shown to significantly influence the course of some diseases (cancer, HIV, coronary heart disease). This study investigated whether optimism of a patient before a total hip replacement can predict the functionality of the lower limbs 3 and 6 months after surgery. A total of 325 patients took part in the study (age: 58.7 years; w: 55%). The functionality was measured with the Western Ontario and McMaster Universities arthrosis index, and optimism with the Life Orientation Test. To analyse the influences of age, gender and optimism, general linear models were calculated. In optimistic patients, functionality improved significantly over time. The study showed a clear influence of dispositional optimism on the recovery after total hip replacement in the first 3 months after surgery. © The Author(s) 2015.

Food sources of fat may clarify the inconsistent role of dietary fat intake for incidence of type 2 diabetes.

Science.gov (United States)

Ericson, Ulrika; Hellstrand, Sophie; Brunkwall, Louise; Schulz, Christina-Alexandra; Sonestedt, Emily; Wallström, Peter; Gullberg, Bo; Wirfält, Elisabet; Orho-Melander, Marju

2015-05-01

Dietary fats could affect glucose metabolism and obesity development and, thereby, may have a crucial role in the cause of type 2 diabetes (T2D). Studies indicated that replacing saturated with unsaturated fats might be favorable, and plant foods might be a better choice than animal foods. Nevertheless, epidemiologic studies suggested that dairy foods are protective. We hypothesized that, by examining dietary fat and its food sources classified according to fat type and fat content, some clarification regarding the role of dietary fat in T2D incidence could be provided. A total of 26,930 individuals (61% women), aged 45-74 y, from the Malmö Diet and Cancer cohort were included in the study. Dietary data were collected by using a modified diet-history method. During 14 y of follow-up, 2860 incident T2D cases were identified. Total intake of high-fat dairy products (regular-fat alternatives) was inversely associated with incident T2D (HR for highest compared with lowest quintiles: 0.77; 95% CI: 0.68, 0.87; P-trend fat fermented milk (P-trend fat dairy products was associated with increased risk, but this association disappeared when low- and high-fat dairy were mutually adjusted (P-trend = 0.18). Intakes of both high-fat meat (P-trend = 0.04) and low-fat meat (P-trend fat content and T2D (P-trend = 0.24), but intakes of saturated fatty acids with 4-10 carbons, lauric acid (12:0), and myristic acid (14:0) were associated with decreased risk (P-trend fat dairy products suggests that dairy fat partly could have contributed to previously observed protective associations between dairy intake and T2D. Meat intake was associated with increased risk independently of the fat content. © 2015 American Society for Nutrition.

Total knee replacement in a resource constrained environment: A ...

African Journals Online (AJOL)

Introduction: Total knee replacement surgery is relatively new in Nigeria and available in few centres only. It has been evolving at a slow pace because of the lack of facilities, structures and adequate surgical expertise alongside patient ignorance and poverty. Objective: The aim of this article is to review the cases done in a ...

Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study

NARCIS (Netherlands)

van Jonbergen, H.P.; Innocenti, B.; Gervasi, G.L.; Labey, L.; Verdonschot, N.J.

2012-01-01

BACKGROUND: Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal

Multi-ligament instability after early dislocation of a primary total knee replacement - case report.

Science.gov (United States)

Sisak, Krisztian; Lloyd, John; Fiddian, Nick

2011-01-01

Peripheral nerve blocks have found increased popularity in providing prolonged post-operative analgesia following total knee replacement surgery. They generally provide effective analgesia with fewer complications than epidurals. This report describes an acute low-energy knee dislocation after a well balanced, fixed bearing, cruciate-retaining primary total knee replacement performed under a spinal anaesthetic with combined complimentary femoral and sciatic nerve blocks. The dislocation was not accompanied by neurovascular compromise. Due to the subsequent instability and injury to both collaterals, the posterior cruciate ligament and posterolateral corner structures, the knee was treated with a rotating-hinge revision total knee replacement. The dislocation occurred whilst the peripheral nerve blocks (PNB) were still working. We review our incidence of PNB related complications and conclude that PNB remain a safe and effective analgesia for total knee replacements. However, we advocate that ward staff and patients should be sufficiently educated to ensure that unaided post-operative mobilisation is prevented until such a time that patients have regained complete voluntary muscle control. Copyright © 2009 Elsevier B.V. All rights reserved.

Dislocation of total hip replacement in patients with fractures of the femoral neck

OpenAIRE

Enocson, Anders; Hedbeck, Carl-Johan; Tidermark, Jan; Pettersson, Hans; Ponzer, Sari; Lapidus, Lasse J

2009-01-01

Background Total hip replacement is increasingly used in active, relatively healthy elderly patients with fractures of the femoral neck. Dislocation of the prosthesis is a severe complication, and there is still controversy regarding the optimal surgical approach and its influence on stability. We analyzed factors influencing the stability of the total hip replacement, paying special attention to the surgical approach. Patients and methods We included 713 consecutive hips in a series of 698 p...

EXPERIMENTAL RESEARCH OF REGENERATIVE FEATURES IN BONE TISSUES AROUND IMPLANTS AFTER ONE-STAGE BILATERAL TOTAL HIP REPLACEMENT

Directory of Open Access Journals (Sweden)

V. M. Mashkov

2012-01-01

Full Text Available Objective: to research the specific features of regenerative processes of bone tissue around implants after one-stage bilateral total hip replacement in experiment. Material and methods: 27 total hip replacement operations have been performed in 18 rabbits of breed "chinchilla" to which bipolar femoral endoprosthesis made of titanic alloy PT-38, one type-size, with friction pair metal-on-metal and neck-shaft angle 165 degrees have been implanted: total unilateral hip replacement operations have been performed in 9 animals (control group, one-stage bilateral total hip replacement operations have been performed in 9 animals (experimental group. During research they have been on radiological and clinical checking-up. After the experiment the animals had histological tests of the tissues around endoprosthesis components. Results and conclusions: After one-stage bilateral total hip replacement in early terms of research more expressed changes of bone tissue in the form of its thinning and decompaction were found around implants. One-stage bilateral total hip replacement did not essentially influence on the speed of osteogenesis around endoprothesis components in comparison with unilateral total hip replacement, so in late terms of observation in both groups the fixing of endoprothesis components did not differ.

Outcomes of single-stage total arch replacement via clamshell incision

Directory of Open Access Journals (Sweden)

Ishizaka Toru

2011-09-01

Full Text Available Abstract Background Treatment of complex aortic pathologies involving the transverse arch with extensive involvement of the descending aorta remains a surgical challenge. Since clamshell incision provides superior exposure of the entire thoracic aorta, we evaluated the use of this technique for single-stage total arch replacement by arch vessel reconstruction. Methods The arch-first technique combined with clamshell incision was used in 38 cases of aneurysm and aortic disease in 2008 and 2009. Extensive total arch replacement was used with clamshell incision for reconstruction of arch vessels under deep hypothermic circulatory arrest. Results Overall 30-day mortality was 13%. The mean operating time was approximately 8 hours. Deep hypothermia resulted in mean CPB time exceeding 4.5 hours and mean duration of circulatory arrest was 25 minutes. The overall postoperative temporary and permanent neurologic dysfunction rates were 3% and 3% for elective and 3% and 0% for emergency surgery, respectively. All patients except the five who died in hospital were discharged without nursing care after an average post-operative hospital stay of 35 days. Conclusions The arch-first technique, combined with clamshell incision, provides expeditious replacement of the thoracic aorta with an acceptable duration of hypothermic circulatory arrest and minimizes the risk of retrograde atheroembolism by using antegrade perfusion.

Production and characterization of a functional Iranian white brined cheese by replacement of dairy fat with vegetable oils.

Science.gov (United States)

Achachlouei, B Fathi; Hesari, J; Damirchi, S Azadmard; Peighambardoust, Sh; Esmaiili, M; Alijani, S

2013-10-01

Full-fat cheese usually contains high amounts of saturated fatty acids and cholesterol, which may have negative health effects. In this study, full-fat white brined cheese, as a control sample, and experimental cheeses with olive and canola oils (T1, white brined cheese containing 50% canola oil, T2, white brined cheese containing 50% olive oil, T3, white brined cheese containing 100% canola oil and T4, white brined cheese containing 100% olive oil) were prepared from bovine milk. Physicochemical properties, lipolysis, proteolysis patterns and sensorial properties in the prepared samples were determined during 80 days of storage at 20-day intervals. Cheese incorporating vegetable oils showed lower amounts of saturated fatty acids and higher amounts of unsaturated fatty acids compared with the full-fat cheese (control) samples. Moisture, pH, lipolysis value, as assessed by the acid-degree value, and proteolysis values (pH 4.6 SN/TN% and NPN/TN%) significantly (p titrable acidity decreased during 40 days of ripening but then increased slightly. Sensory properties of white brined cheese incorporating with vegetable oils were different from those of full-fat cheese samples. White brined cheese containing olive and canola oils (100% fat substitution) received better sensory scores compared to other samples. The results showed that it is possible to replace dairy fat with olive and canola oils, which can lead to produce a new healthy and functional white brined cheese.

Comparing 30-day all-cause readmission rates between tibiotalar fusion and total ankle replacement.

Science.gov (United States)

Merrill, Robert K; Ferrandino, Rocco M; Hoffman, Ryan; Ndu, Anthony; Shaffer, Gene W

2018-01-12

End-stage ankle arthritis is a debilitating condition that negatively impacts patient quality of life. Tibiotalar fusion and total ankle replacement are treatment options for managing ankle arthritis. Few studies have examined short term readmission rates of these two procedures. The objective of this study was compare all-cause 30-day readmission rates between patients undergoing tibiotalar fusion vs. total ankle replacement. This study queried the Nationwide Readmission Database (NRD) from 2013-2014 and used international classification of disease, 9th revision (ICD-9) procedure codes to identify all patients who underwent a tibiotalar fusion or a total ankle replacement. Comorbidities, insurance status, hospital characteristics, and readmission rates were statistically compared between the two cohorts. Risk factors were then identified for 30-day readmission. A total of 5660 patients were analyzed with 2667 in the tibiotalar fusion cohort and 2993 in the total ankle replacement cohort. Univariate analysis revealed that the readmission rate after tibiotalar fusion (4.4%) was statistically greater than after total ankle replacement (1.4%). Multivariable regression analysis indicated that deficiency anemia (OR 2.18), coagulopathy (OR 3.51), renal failure (OR 2.83), other insurance relative to private (OR 3.40), and tibiotalar fusion (OR 2.51) were all statistically significant independent risk factors for having a readmission within 30-days. These findings suggest that during the short-term period following discharge from the hospital, patients who received a tibiotalar fusion are more likely to experience a 30-day readmission. These findings are important for decision making when a surgeon encounters a patient with end stage ankle arthritis. Level III, cohort study. Published by Elsevier Ltd.

Femoral nerve palsy caused by ileopectineal bursitis after total hip replacement: a case report

Directory of Open Access Journals (Sweden)

Bähr Mathias

2011-05-01

Full Text Available Abstract Introduction Infectious ileopectineal bursitis is a rare complication after total hip replacement and is associated mainly with rheumatoid arthritis. The main complications are local swelling and pain, but communication of the inflamed bursa with the joint can occur, leading to subsequent cartilage damage and bone destruction. Case presentation We report a case of a 47-year-old Caucasian woman without rheumatoid arthritis who reported pain and palsy in her left leg almost one year after total hip replacement. She was diagnosed with an ileopectineal bursitis after total hip replacement, leading to femoral nerve palsy. The diagnosis was obtained by thorough clinical examination, the results of focused computed tomography and magnetic resonance imaging. Conclusion To the best of our knowledge, this is the first report of non-infectious ileopectineal bursitis in a patient without rheumatoid arthritis as a complication of total hip replacement. This rare case underlines the importance of proper neurologic examination of persistent conditions after orthopedic intervention in otherwise healthy individuals. We believe this case should be useful for a broad spectrum of medical specialties, including orthopedics, neurology, radiology, and general practice.

Case Study of a physiotherapy treatment of a patient after total hip replacement

OpenAIRE

Havlíčková, Barbora

2013-01-01

The bachelor's thesis consists of two parts. The general part includes anatomy and kinesiology of the hip joint and also the topic of coxarthrosis as the most common reason for the total hip replacement surgery. An integral part of this part is the elaboration of a rehabilitation plan for patients undergoing such procedure. The practical part of the thesis is conceived a case study of a patient after total hip replacement because of coxarthrosis. Finally, the thesis includes the therapeutic o...

TOTAL HIP REPLACEMENT IN LEGG-CALVÉ-PERTHES DISEASE

DEFF Research Database (Denmark)

Froberg, Lonnie; Christensen, Finn; Pedersen, Niels Wisbech

2009-01-01

INTRODUCTION Poor long-time results in patients with Legg-Calvé-Perthes disease (LCP) are most often due to degenerative hip disease. The purpose of this study was to investigate if patients with LCP have an increased rate of total hip replacement (THR) compared to sex- and age-matched persons....... MATERIAL AND METHODS 167 LCP patients presented to our institution from 1941 to 1962. All patients were treated conservatively by a Thomas splint. Retrospectively medical records and radiographs were retrieved. Data from the Danish Hip Replacement Register and the Registries of the National Board of Health...... to follow-up and 3) patients with previous surgery to pelvis or lower limbs. 135 patients (156 hips) were enrolled in this study and 32 patients (35 hips) were excluded. RESULTS 20 hips out of 156 hips in patients with LCP have had a THR. Mean age at operation for the women was 50 years and 44 years...

Does total hip replacement affect sexual quality of life?

Science.gov (United States)

Harmsen, Rita Th E; Haanstra, Tsjitske M; Sierevelt, Inger N; Jansma, Elise P; Nolte, Peter A; Nicolai, Melianthe P J; Wall, Peter D H; Van Royen, Barend J

2016-05-04

Total Hip Replacement (THR) is an effective treatment for end-stage hip osteoarthritis. Since the introduction of total joint replacement, the effect on the Sexual Quality of Life (SQoL) following THR has been addressed in scant studies. The aim of our study was to systematically review the literature, to summarise effects of THR on patients' SQoL. We searched PubMed, EMBASE and PsycINFO between January 1970 and February 9th, 2015 with search terms including Total Hip, Osteoarthritis, SQoL, and THR. Eligible studies were identified and two independent authors extracted data including details of SQoL, study quality and risk of bias. There were 12 eligible studies, which included a total of 2099 patients with an age range of 20-85 years. The methodological quality of ten studies was rated as low, and of two as moderate. Amongst the majority of patients, SQoL improved after surgery, both in terms of physical-functional and psychosocial well-being. However, changes between pre-operative and postoperative SQoL ranged extensively: for example, Sexual Dysfunction Δ 8-51% and Sexual Activity (SA) Δ 0-77%. Three studies reported that some patients never resumed SA again after surgery. In over 40 years of THR treatment, scant studies have examined the effect of THR on patients' SQoL. This review suggests that SQol improves after THR, although the magnitude of effects varies highly. However, the quality of the supporting evidence was rated as low to moderate. This suggests a need for more high quality evidence about the effects of THR on SQoL.

Wear prediction on total ankle replacement effect of design parameters

CERN Document Server

Saad, Amir Putra Bin Md; Harun, Muhamad Noor; Kadir, Mohammed Rafiq Abdul

2016-01-01

This book develops and analyses computational wear simulations of the total ankle replacement for the stance phase of gait cycle. The emphasis is put on the relevant design parameters. The book presents a model consisting of three components; tibial, bearing and talar representing their physiological functions.

Wear debris. An environmental issue in total joint replacement.

Science.gov (United States)

Manley, M T; Serekian, P

1994-01-01

There is a growing concern that osteolytic lesions, often adjacent to otherwise stable implants, are a recent phenomenon caused by some recent change in polyethylene, metal, or other aspect of the total hip construction. This study investigates the possibility that bearings and modular connections used in modern hip replacements are an unappreciated source of particulate debris. Measurements taken from contemporary femoral bearings show a significant mismatch in both surface finish and sphericity of mating metal and polyethylene components, with sphericity of inserts being much worse then sphericity of femoral heads. The tolerances for sphericity of polyethylene inserts were further changed by the placement of an insert into its metal shell. Hip simulator tests of assembled inserts and shells showed greater polyethylene weight loss for metal-backed shells than for inserts alone. Bending and torsional tests of metal/metal modular connections showed that dynamic loads can release large numbers of debris particles from taper junctions. Because osteolytic lesions clearly are associated with overload of tissue by debris particles, the design, manufacture, and tolerances of modular connections in total hip replacement all seem to require reevaluation.

Solid fat content as a substitute for total polar compound analysis in edible oils

Science.gov (United States)

The solid fat contents (SFC) of heated edible oil samples were measured and found to correlate positively with total polar compounds (TPC) and inversely with triglyceride concentration. Traditional methods for determination of total polar compounds require a laboratory setting and are time intensiv...

Effects of Replacing Pork Back Fat with Canola and Flaxseed Oils on Physicochemical Properties of Emulsion Sausages from Spent Layer Meat

Directory of Open Access Journals (Sweden)

Ki Ho Baek

2016-06-01

Full Text Available The objective of this study was to investigate the effects of canola and flaxseed oils on the physicochemical properties and sensory quality of emulsion-type sausage made from spent layer meat. Three types of sausage were manufactured with different fat sources: 20% pork back fat (CON, 20% canola oil (CA and 20% flaxseed oil (FL. The pH value of the CA was significantly higher than the others (p<0.05. The highest water holding capacity was also presented for CA; in other words, CA demonstrated a significantly lower water loss value among the treatments (p<0.05. CA had the highest lightness value (p<0.05. However, FL showed the highest yellowness value (p<0.05 because of its own high-density yellow color. The texture profile of the treatments manufactured with vegetable oils showed higher values than for the CON (p<0.05; furthermore, CA had the highest texture profile values (p<0.05 among the treatments. The replacement of pork back fat with canola and flaxseed oils in sausages significantly increased the omega-3 fatty acid content (p<0.05 over 15 to 86 times, respectively. All emulsion sausages containing vegetable oil exhibited significantly lower values for saturated fatty acid content and the omega-6 to omega-3 ratios compared to CON (p<0.05. The results show that using canola or flaxseed oils as a pork fat replacer has a high potential to produce healthier products, and notably, the use of canola oil produced characteristics of great emulsion stability and sensory quality.

Effects of Replacing Pork Back Fat with Canola and Flaxseed Oils on Physicochemical Properties of Emulsion Sausages from Spent Layer Meat.

Science.gov (United States)

Baek, Ki Ho; Utama, Dicky Tri; Lee, Seung Gyu; An, Byoung Ki; Lee, Sung Ki

2016-06-01

The objective of this study was to investigate the effects of canola and flaxseed oils on the physicochemical properties and sensory quality of emulsion-type sausage made from spent layer meat. Three types of sausage were manufactured with different fat sources: 20% pork back fat (CON), 20% canola oil (CA) and 20% flaxseed oil (FL). The pH value of the CA was significantly higher than the others (p<0.05). The highest water holding capacity was also presented for CA; in other words, CA demonstrated a significantly lower water loss value among the treatments (p<0.05). CA had the highest lightness value (p<0.05). However, FL showed the highest yellowness value (p<0.05) because of its own high-density yellow color. The texture profile of the treatments manufactured with vegetable oils showed higher values than for the CON (p<0.05); furthermore, CA had the highest texture profile values (p<0.05) among the treatments. The replacement of pork back fat with canola and flaxseed oils in sausages significantly increased the omega-3 fatty acid content (p<0.05) over 15 to 86 times, respectively. All emulsion sausages containing vegetable oil exhibited significantly lower values for saturated fatty acid content and the omega-6 to omega-3 ratios compared to CON (p<0.05). The results show that using canola or flaxseed oils as a pork fat replacer has a high potential to produce healthier products, and notably, the use of canola oil produced characteristics of great emulsion stability and sensory quality.

MRI as a problem-solving tool in unexplained failed total hip replacement following conventional assessment

International Nuclear Information System (INIS)

Johnston, Ciaran; Kerr, Jennifer; Ford, Stephanie; Eustace, Stephen; O'Byrne, John

2007-01-01

To evaluate MRI as a problem-solving tool for patients with an unexplained failed total hip replacement following conventional radiological assessment. Patients' informed consent was obtained in all cases. Institutional review board approval was obtained. Twenty-eight patients with unexplained failed total hip replacements following conventional radiological assessment underwent additional MR imaging with an optimised turbo-spin echo sequence. Images were reviewed by two musculoskeletal radiologists by consensus and compared with findings at surgery, or following response to image-guided intervention or clinical follow-up. Of the 28 patients, MRI revealed an unsuspected diagnosis explaining the cause of prosthesis failure in 15 patients. In eight of 15 patients in this group, subsequent minimally invasive image-guided intervention obviated the need for revision total hip replacement. No cause for prosthesis failure was identified in 13 patients. MRI may be successfully undertaken in patients following total hip replacement, and, when performed, it frequently leads to an unsuspected diagnosis, allowing informed patient treatment. In this study it allowed the identification of an unsuspected diagnosis in over 50% of cases. (orig.)

Embedded piezoelectrics for sensing and energy harvesting in total knee replacement units

Science.gov (United States)

Wilson, Brooke E.; Meneghini, Michael; Anton, Steven R.

2015-04-01

The knee replacement is the second most common orthopedic surgical intervention in the United States, but currently only 1 in 5 knee replacement patients are satisfied with their level of pain reduction one year after surgery. It is imperative to make the process of knee replacement surgery more objective by developing a data driven approach to ligamentous balance, which increases implant life. In this work, piezoelectric materials are considered for both sensing and energy harvesting applications in total knee replacement implants. This work aims to embed piezoelectric material in the polyethylene bearing of a knee replacement unit to act as self-powered sensors that will aid in the alignment and balance of the knee replacement by providing intraoperative feedback to the surgeon. Postoperatively, the piezoelectric sensors can monitor the structural health of the implant in order to perceive potential problems before they become bothersome to the patient. Specifically, this work will present on the use of finite element modeling coupled with uniaxial compression testing to prove that piezoelectric stacks can be utilized to harvest sufficient energy to power sensors needed for this application.

The relationships among total body fat, bone mineral content and bone marrow adipose tissue in early-pubertal girls.

Science.gov (United States)

L Newton, Anna; J Hanks, Lynae; Davis, Michelle; Casazza, Krista

2013-01-01

Investigation of the physiologic relevance of bone marrow adipose tissue (BMAT) during growth may promote understanding of the bone-fat axis and confluence with metabolic factors. The objective of this pilot investigation was two-fold: (1) to evaluate the relationships among total body fat, bone mineral content (BMC) and femoral BMAT during childhood and underlying metabolic determinants and (2) to determine if the relationships differ by race. Participants included white and non-Hispanic black girls (n=59) ages 4-10 years. Femoral BMAT volume was measured by magnetic resonance imaging, BMC and body fat by dual-energy X-ray absorptiometry. Metabolic parameters were assessed in the fasted state. Total fat and BMC were positively associated with BMAT; however, simultaneous inclusion of BMC and body fat in the statistical model attenuated the association between BMC and BMAT. Differences in BMAT volume were observed, non-Hispanic black girls exhibiting marginally greater BMAT at age eight (P=0.05) and white girls exhibiting greater BMAT at age ten (PBMAT and leptin (P=0.02) and adiponectin (P=0.002) in white girls while BMAT and insulin were inversely related in non-Hispanic black girls (P=0.008). Our findings revealed a positive relationship between BMAT, body fat and BMC, although body fat, respective to leptin, contributed partly to the relationship between BMAT and BMC. Despite large differences in total fat between non-Hispanic black and white, the relationship between BMAT and BMC was similar to white girls. However, this relationship appeared to be impacted through different mechanisms according to race.

Replacement of milk fat by mixed vegetable oils in manufacturing soft cheese treated by gamma irradiation

International Nuclear Information System (INIS)

Afifi, E.A.; Anwar, M.M.

2007-01-01

This investigation aimed to study the possibility of substituting milk fat by using blended vegetable oils in manufacturing soft cheese with low salt content, in addition, lo utilize gamma irradiation to prolong the shelf-life of the new manufactured product. Therefore, one hundred (lOOKg) from fresh buffaloes milk containing 5 % milk fal and 3 % salt were divided into tow parts , the first part was used for manufacturing control soft cheese sample (containing milk fat ), while the second part was skimmed, blended with blended vegetable oils and homogenized. The skim homogenized milk containing 5% mixed vegetable oils used for manufacturing soft cheese ( new product filled ). The obtained soft cheese was subjected to 1, 2 and 3 kGy y-irradiation, and stored at refrigerator temperature. During cold storage, the sensory, microbial and chemical properties of control soft cheese and treated one were evaluated. The obtained results indicated that the replacement of milk fat by mixed vegetable oils in the manufacturing soft cheese had no effect on chemical composition and sensory properties except white color and slight oily flavor which have been noticed in treated filled cheese. In addition, irradiation dose of 3 kGy prolonged the shelf-life of treated filled cheese to 42 days compared to 18 days for control sample and scqueiitly, the new product high percentage of iinsaluraled fatly acid and no cholesterol compared with cheese made from natural milk and can be recommended as a healthy food especially for those who need to low or free cholesterol foods

Texture of low-fat Iranian White cheese as influenced by gum tragacanth as a fat replacer.

Science.gov (United States)

Rahimi, J; Khosrowshahi, A; Madadlou, A; Aziznia, S

2007-09-01

The effect of different concentrations of gum tragacanth on the textural characteristics of low-fat Iranian White cheese was studied during ripening. A batch of full-fat and 5 batches of low-fat Iranian White cheeses with different gum tragacanth concentrations (without gum or with 0.25, 0.5, 0.75, or 1 g of gum/kg of milk) were produced to study the effects of fat content reduction and gum concentration on the textural and functional properties of the product during ripening. Cheese samples were analyzed with respect to chemical, color, and sensory characteristics, rheological parameters (uniaxial compression and small-amplitude oscillatory shear), and microstructure. Reducing the fat content had an adverse effect on cheese yield, sensory characteristics, and the texture of Iranian White cheese, and it increased the instrumental hardness parameters (i.e., fracture stress, elastic modulus, storage modulus, and complex modulus). However, increasing the gum tragacanth concentration reduced the values of instrumental hardness parameters and increased the whiteness of cheese. Although when the gum concentration was increased, the low-fat cheese somewhat resembled its full-fat counterpart, the interaction of the gum concentration with ripening time caused visible undesirable effects on cheese characteristics by the sixth week of ripening. Cheeses with a high gum tragacanth concentration became very soft and their solid texture declined somewhat.

Determination of fat and total protein content in milk using conventional digital imaging.

Science.gov (United States)

Kucheryavskiy, Sergey; Melenteva, Anastasiia; Bogomolov, Andrey

2014-04-01

The applicability of conventional digital imaging to quantitative determination of fat and total protein in cow's milk, based on the phenomenon of light scatter, has been proved. A new algorithm for extracting features from digital images of milk samples has been developed. The algorithm takes into account spatial distribution of light, diffusely transmitted through a sample. The proposed method has been tested on two sample sets prepared from industrial raw milk standards, with variable fat and protein content. Partial Least-Squares (PLS) regression on the features calculated from images of monochromatically illuminated milk samples resulted in models with high prediction performance when analysed the sets separately (best models with cross-validated R(2)=0.974 for protein and R(2)=0.973 for fat content). However when analysed the sets jointly with the obtained results were significantly worse (best models with cross-validated R(2)=0.890 for fat content and R(2)=0.720 for protein content). The results have been compared with previously published Vis/SW-NIR spectroscopic study of similar samples. Copyright © 2013 Elsevier B.V. All rights reserved.

Effect of extraction condition on properties of pectin from banana peels and its function as fat replacer in salad cream.

Science.gov (United States)

Maneerat, Nitjaree; Tangsuphoom, Nattapol; Nitithamyong, Anadi

2017-02-01

Banana peels are wasted from banana processing industry. Pectin is a soluble dietary fibre usually prepared from fruit and vegetable processing wastes. Pectin extraction from banana peels thus should be an effective way of waste utilization. This study aimed to determine the effect of extraction condition on the properties of pectin from peels of Nam Wa banana ( Musa (ABB group) 'Kluai Nam Wa') and its role as fat replacer in salad cream. Banana peel pectin (BPP) was extracted with HCl (pH 1.5) and water (pH 6.0) for 30-120 min at 90 ± 5 °C. Acid extraction yielded 7-11% pectin on a dry basis with galacturonic acid content (GalA), degree of methylation (DM), and viscosity-average molecular weight (M v ) of 42-47, 57-61%, and 17-40 kDa, respectively; while water-extracted BPP contained lower DM but higher GalA and M v . Prolonged extraction raised the pectin yield but lowered the M v of BPP and the viscosity of their solutions. Incorporation of BPP obtained from 60 min acid- and water-extraction into salad cream at 30% oil substitution level resulted in the decreases in viscosity and lightness. All reduced-fat samples were stable to cream separation during 3-weeks storage although the formula containing water-extracted BPP had larger oil droplet size and greater extent of droplet flocculation. There was no difference in sensory scores rated by 50 panelists on thickness, smoothness, and overall acceptability of the full- and reduced-fat salad creams. Therefore, Nam Wa banana peels can be an alternative source of pectin with potential application as fat replacer in food products.

Comparative study of total shoulder arthroplasty versus total shoulder surface replacement for glenohumeral osteoarthritis with minimum 2-year follow-up

NARCIS (Netherlands)

Kooistra, B.W.; Willems, W.J.H.; Lemmens, E.; Hartel, B.P.; Bekerom, M.P. van den; Deurzen, D.F.P. van

2017-01-01

BACKGROUND: Compared with total shoulder arthroplasty (TSA), total shoulder surface replacement (TSSR) may offer the advantage of preservation of bone stock and shorter surgical time, possibly at the expense of glenoid component positioning and increasing lateral glenohumeral offset. We hypothesized

The influence of animal fat replacement with vegetable oils on sensorial perception of meat emulsified products

Directory of Open Access Journals (Sweden)

Cristian TUDOSE

2014-12-01

Full Text Available For the purpose of the present study, in an emulsified meat product the pork backfat was replaced with a vegetable oil pre-emulsion and its effect on quality attributes were investigated. In order to do so, a classic and a new meat products were manufactured. Extra virgin olive oil and palm oil pre-emulsion were added instead of animal fat in the new product. Texture and physiochemical properties were analyzed by instrumental measurements. It was observed that during storage moisture and pH decreased. Using vegetable oils determined substantial increase of TBA values. Texture was influenced mainly by storage time for both products, while replacement of pork backfat with vegetable oil pre-emulsion had no influence on sample firmness. The sensory properties of meat products were evaluated by a group of trained panelists using an analitycal sensory evaluation technique. Overall the new product presented good acceptability which recommends it like a new healthier meat product.

Determination of fat and total protein content in milk using conventional digital imaging

DEFF Research Database (Denmark)

Kucheryavskiy, Sergey; Melenteva, Anastasiia; Bogomolov, Andrey

2014-01-01

into account spatial distribution of light, diffusely transmitted through a sample. The proposed method has been tested on two sample sets prepared from industrial raw milk standards, with variable fat and protein content. Partial Least-Squares (PLS) regression on the features calculated from images......The applicability of conventional digital imaging to quantitative determination of fat and total protein in cow’s milk, based on the phenomenon of light scatter, has been proved. A new algorithm for extracting features from digital images of milk samples has been developed. The algorithm takes...... of monochromatically illuminated milk samples resulted in models with high prediction performance when analysed the sets separately (best models with cross-validated R2=0.974 for protein and R2=0.973 for fat content). However when analysed the sets jointly the obtained results were significantly worse (best models...

Rheological, fat bloom, and sensory acceptability effects of mango kernel fat and palm olein blends on chocolate-flavored coatings

OpenAIRE

Nieves María Flores March; Gabriela Cristina Chire Fajardo; Carlos Eduardo Lescano Anadón

2017-01-01

The effects of replacing cocoa butter with different percentages and proportions of a mango kernel fat/palm olein (MKF/POL) blend, are reported. Samples were prepared by melting together mango kernel fat, palm olein, cocoa butter and cocoa mass and powdered sugar combinated. The samples were milled, conched, tempered, and molded to obtain three sets of seven samples as follows: one control omitting mango kernel fat and palm olein, and six samples with cocoa butter replacement of 15 and 22.5% ...

Difference between right and left side in total knee and unicondylar knee replacement: An interesting observation

Directory of Open Access Journals (Sweden)

Vasudevan Thirumal Selvan

2005-02-01

Full Text Available We report an observation made about the differences between right and left side in case of total knee and unicondylar knee replacement. It was found that unicondylar knee replacement was performed more commonly on the left side (66%, as compared to only 34% on right side, where as total knee replacement was more common on the right side (64% as compared to 36% on left side. The exact clinical utility of this difference is yet to be known.

Maternal obesity influences the relationship between location of neonate fat mass and total fat mass.

Science.gov (United States)

Hull, H R; Thornton, J; Paley, C; Navder, K; Gallagher, D

2015-08-01

It is suggested that maternal obesity perpetuates offspring obesity to future generations. To determine whether location of neonate fat mass (FM: central vs. peripheral) is related to total neonate FM and whether maternal obesity influences this relationship. Neonate body composition and skin-fold thicknesses were assessed in healthy neonates (n = 371; 1-3 days old). Linear regression models examined the relationship between total FM and location of FM (central vs. peripheral). Location of FM was calculated by skin-folds: peripheral was the sum of (biceps and triceps)/2 and central was represented by the subscapular skin-fold. A significant interaction was found for location of FM and maternal obesity. Holding all predictors constant, in offspring born to non-obese mothers, a 0.5 mm increase in central FM predicted a 15 g greater total FM, whereas a 0.5 mm increase in peripheral FM predicted a 66 g greater total FM. However, in offspring born to obese mothers, a 0.5 mm increase in central FM predicted a 56 g total FM, whereas a 0.5 mm increase in peripheral FM predicted a 14 g greater total FM. The relationship between total FM and location of FM is influenced by maternal obesity. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

Functional exercise after total hip replacement (FEATHER): a randomised control trial.

LENUS (Irish Health Repository)

Monaghan, Brenda

2012-11-01

Prolonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR). It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life.

Patient outcomes using Wii-enhanced rehabilitation after total knee replacement - the TKR-POWER study.

Science.gov (United States)

Negus, J J; Cawthorne, D P; Chen, J S; Scholes, C J; Parker, D A; March, L M

2015-01-01

Home-based rehabilitation following total knee replacement surgery can be as effective as clinic-based or in-patient rehabilitation. The use of the Nintendo Wii has been postulated as a novel rehabilitation tool that adds an additional focus on balance and proprioception into the recovery protocol. The aim of the proposed clinical trial is to investigate the effectiveness of this novel rehabilitation tool, used at home for three months after total knee replacement surgery and to assess any lasting improvements in functional outcome at one year. This will be a randomised controlled trial of 128 patients undergoing primary total knee replacement. The participants will be recruited preoperatively from three surgeons at a single centre. There will be no change to the usual care provided until 6 weeks after the operation. Then participants will be randomised to either the Wii-Fit group or usual rehabilitative care group. Outcomes will be assessed preoperatively, a 6-week post surgery baseline and then at 18 weeks, 6 months and 1 year. The primary outcome is the change in self-reported WOMAC total score from week 6 to 18 weeks. Secondary outcomes include objective measures of strength, function and satisfaction scores. The results of this clinical trial will be directly relevant for implementation into clinical practice. If beneficial, this affordable technology could be used by many patients to rehabilitate at home. Not only could it optimize the outcomes from their total knee replacement surgery but decrease the need for clinic-based or outpatient therapy for the majority. (ACTRN12611000291987). Copyright © 2014 Elsevier Inc. All rights reserved.

Fetal and infant growth patterns associated with total and abdominal fat distribution in school-age children.

Science.gov (United States)

Gishti, Olta; Gaillard, Romy; Manniesing, Rashindra; Abrahamse-Berkeveld, Marieke; van der Beek, Eline M; Heppe, Denise H M; Steegers, Eric A P; Hofman, Albert; Duijts, Liesbeth; Durmuş, Büşra; Jaddoe, Vincent W V

2014-07-01

Higher infant growth rates are associated with an increased risk of obesity in later life. We examined the associations of longitudinally measured fetal and infant growth patterns with total and abdominal fat distribution in childhood. We performed a population-based prospective cohort study among 6464 children. We measured growth characteristics in the second and third trimesters of pregnancy, at birth, and at 6, 12, and 24 months. Body mass index, fat mass index (body fat mass/height(2)), lean mass index (body lean mass/height(2)), android/gynoid fat ratio measured by dual-energy x-ray absorptiometry, and sc and preperitoneal abdominal fat measured by ultrasound at the median age of 6.0 years (90% range, 5.7-7.4). We observed that weight gain in the second and third trimesters of fetal life and in early, mid, and late infancy were independently and positively associated with childhood body mass index (P fat mass index, android/gynoid fat ratio, and abdominal fat in childhood (P Children with both fetal and infant growth acceleration had the highest childhood body mass index, fat mass index, and sc abdominal fat, whereas children with fetal growth deceleration and infant growth acceleration had the highest value for android/gynoid fat ratio and the lowest value for lean mass index (P fat. Fetal growth deceleration followed by infant growth acceleration may lead to an adverse body fat distribution in childhood.

Experience with Designing and Implementing a Bundled Payment Program for Total Hip Replacement.

Science.gov (United States)

Whitcomb, Winthrop F; Lagu, Tara; Krushell, Robert J; Lehman, Andrew P; Greenbaum, Jordan; McGirr, Joan; Pekow, Penelope S; Calcasola, Stephanie; Benjamin, Evan; Mayforth, Janice; Lindenauer, Peter K

2015-09-01

Bundled payments, also known as episode-based payments, are intended to contain health care costs and promote quality. In 2011 a bundled payment pilot program for total hip replacement was implemented by an integrated health care delivery system in conjunction with a commercial health plan subsidiary. In July 2015 the Centers for Medicare & Medicaid Services (CMS) proposed the Comprehensive Care for Joint Replacement Model to test bundled payment for hip and knee replacement. Stakeholders were identified and a structure for program development and implementation was created. An Oversight Committee provided governance over a Clinical Model Subgroup and a Financial Model Subgroup. The pilot program included (1) a clinical model of care encompassing the period from the preoperative evaluation through the third postoperative visit, (2) a pricing model, (3) a program to share savings, and (4) a patient engagement and expectation strategy. Compared to 32 historical controls-patients treated before bundle implementation-45 post-bundle-implementation patients with total hip replacement had a similar length of hospital stay (3.0 versus 3.4 days, p=.24), higher rates of discharge to home or home with services than to a rehabilitation facility (87% versus 63%), similar adjusted median total payments ($22,272 versus $22,567, p=.43), and lower median posthospital payments ($704 versus $1,121, p=.002), and were more likely to receive guideline-consistent care (99% versus 95%, p=.05). The bundled payment pilot program was associated with similar total costs, decreased posthospital costs, fewer discharges to rehabilitation facilities, and improved quality. Successful implementation of the program hinged on buy-in from stakeholders and close collaboration between stakeholders and the clinical and financial teams.

STUDY OF FUNCTIONAL RESULTS OF CEMENTED TOTAL HIP REPLACEMENT BY MOORE’S APPROACH

Directory of Open Access Journals (Sweden)

Arunim

2016-02-01

Full Text Available INTRODUCTION The total hip replacement (THR has probably become the surgical procedure of choice for vide variety of hip joint disabling diseases. The prosthesis used for THR is often grouped into cemented, cement-less and hybrid ones. There has been increasing trends in use of cement-less components citing more number of complications namely loosening, increased infection rate etc. however with additional cost factors as well. We conducted this study to ascertain whether in a developing country like ours should we really switch over to un-cemented hip replacements dreading such complications or can we still use cemented prosthesis with equally good if not better results. METHODS A study of functional results of cemented total hip replacement was done in patients with varied age groups ranging from 40 years to 75 years with the average age being 54.8 years. 20 patients with 21 diseased hips were treated with cemented total hip replacement by Moore’s posterior approach at NSCB Subharti medical college, Meerut, UP from December 2010 to December 2013 and reviewed thereafter with an average follow-up period of 4.2 years. Average surgical time required was one and half hour. Patients were asked to come for follow up on 1st month, 3rd month and 6th month and then every 6 months and were assessed as per modified Harris Hip Score. RESULTS All the patients were evaluated according to the Modified Harris Hip Scoring system. The results showed 14(67% hips with excellent results, 4(19% with good results, and 3(14% hips with fair results. No poor outcome was noted in this study. 2 cases of dislocation (10% were noted one on the 5th post-operative day and the other occurred after the patient was discharged from the institution. CONCLUSIONS The management of diseased and destroyed hips with chronic pain with cemented total hip replacement is effective and gives stable, mobile and painless hip joint to the patient. Functional results are excellent and

Quality of life: patient-reported outcomes after total replacement of the temporomandibular joint.

Science.gov (United States)

Kunjur, J; Niziol, R; Matthews, N S

2016-09-01

Since publication of the UK guidelines on total replacement of the temporomandibular joint (TMJ) in 2008 by the British Association of Oral and Maxillofacial Surgeons (BAOMS), pain scores, mouth opening, and diet have been used as markers of success. We have looked at quality of life (QoL) as another. We analysed the data from a single surgeon on patients who had had joints replaced and devised a questionnaire to find out about the subjective, functional, psychological, and social aspects of TMJ disease. A total of 18 patients who had the same operation were included (mean (range) age 50 (33 - 73) years, mean (range) follow up 30 (18 - 48) months). Jaw function and facial aesthetics had improved, and patients needed less analgesia. Overall, they reported a better QoL with improvements in mood and social interaction, and the activities of daily life were easier. The NHS uses QoL questionnaires to measure success in fields such as orthopaedic surgery, but currently we know of no nationally accepted questionnaire that measures success after total replacement of the TMJ. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery

Directory of Open Access Journals (Sweden)

Wittbrodt ET

2018-05-01

Full Text Available Eric T Wittbrodt,1 Tong J Gan,2 Catherine Datto,1 Charles McLeskey,1 Meenal Sinha3 1US Medical Affairs, AstraZeneca, Wilmington, DE, USA; 2Department of Anesthesiology, Stony Brook Medicine, Stony Brook, NY, USA; 3Premier Applied Sciences, Premier, Inc., Charlotte, NC, USA Purpose: Constipation is a well-known complication of surgery that can be exacerbated by opioid analgesics. This study evaluated resource utilization and costs associated with opioid-induced constipation (OIC. Patients and methods: This retrospective, observational, and propensity-matched cohort study utilized the Premier Healthcare Database. The study included adults ≥18 years of age undergoing total hip or total knee replacement as inpatients who received an opioid analgesic and were discharged between January 1, 2012, and June 30, 2015. Diagnosis codes identified patients with OIC who were then matched 1:1 to patients without OIC. Generalized linear and logistic regression models were used to compare inpatient resource utilization, total hospital costs, inpatient mortality, and 30-day all-cause readmissions and emergency department visits. Results: Of 788,448 eligible patients, 40,891 (5.2% had OIC. Covariates were well balanced between matched patients with and without OIC (n=40,890 each. In adjusted analyses, patients with OIC had longer hospital lengths of stay (3.6 versus 3.3 days; p<0.001, higher total hospital costs (US$17,479 versus US$16,265; p<0.001, greater risk of intensive care unit admission (odds ratio [OR]=1.12, 95% CI: 1.01–1.24, and increased likelihood of 30-day hospital readmissions (OR=1.16, 95% CI: 1.11–1.22 and emergency department visits (OR=1.38, 95% CI: 1.07–1.79 than patients without OIC. No statistically significant difference was found with inpatient mortality (OR=0.89, 95% CI: 0.59–1.35. Conclusion: OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee

Perinatal, sociodemographic and lifestyle correlates of increased total and visceral fat mass levels in schoolchildren in Greece: the Healthy Growth Study.

Science.gov (United States)

Moschonis, George; Kaliora, Adriana C; Karatzi, Kalliopi; Michaletos, Aggelos; Lambrinou, Christina-Paulina; Karachaliou, Alexandra K; Chrousos, George P; Lionis, Christos; Manios, Yannis

2017-03-01

To identify possibly independent associations of perinatal, sociodemographic and lifestyle factors with childhood total and visceral body fat. A representative sample of 2655 schoolchildren (9-13 years) participated in the Healthy Growth Study, a cross-sectional epidemiological study. Seventy-seven primary schools in four large regions in Greece. A sample of 1228 children having full data on total and visceral fat mass levels, as well as on anthropometric, dietary, physical activity, physical examination, socio-economic and perinatal indices, was examined. Maternal (OR=3·03 and 1·77) and paternal obesity (OR=1·62 and 1·78), maternal smoking during pregnancy (OR=1·72 and 1·93) and rapid infant weight gain (OR=1·42 and 1·96) were significantly and positively associated with children's increased total and visceral fat mass levels, respectively. Children's television watching for >2 h/d (OR=1·40) and maternal pre-pregnancy obesity (OR=2·46) were associated with children's increased total and visceral fat mass level, respectively. Furthermore, increased children's physical activity (OR=0·66 and 0·47) were significantly and negatively associated with children's total and visceral fat mass levels, respectively. Lastly, both father's age >46 years (OR=0·57) and higher maternal educational level (OR=0·45) were associated with children's increased total visceral fat mass level. Parental sociodemographic characteristics, perinatal indices and pre-adolescent lifestyle behaviours were associated with children's abnormal levels of total and visceral fat mass. Any future programme for childhood prevention either from the perinatal age or at late childhood should take these indices into consideration.

Analgesic effect of continuous femoral nerve block combined with infiltration anesthesia after total knee replacement

OpenAIRE

Jian-Guo Tan

2016-01-01

Objective: To study the analgesic effect of continuous femoral nerve block combined with infiltration anesthesia after total knee replacement. Methods: Patients who received unilateral total knee replacement in our hospital from May 2012 to August 2015 were included for study and randomly divided into experimental group who received continuous femoral nerve block combined with infiltration anesthesia and control group who received continuous femoral nerve block, and then the co...

Late rupture of the posterior cruciate ligament after total knee replacement.

OpenAIRE

Montgomery, R. L.; Goodman, S. B.; Csongradi, J.

1993-01-01

To our knowledge there have been no reports of late rupture of the posterior cruciate ligament (PCL) as a cause of instability in PCL-retaining total knee prostheses. In our experience of 150 total knee replacements using PCL-retaining prosthesis, three cases (2.0%) of late rupture of the posterior cruciate ligament have occurred, each leading to chronic instability, disabling pain, and revision arthroplasty. In each case rupture of the posterior cruciate ligament was confirmed at the time of...

The Effect on Long-Term Survivorship of Surgeon Preference for Posterior-Stabilized or Minimally Stabilized Total Knee Replacement: An Analysis of 63,416 Prostheses from the Australian Orthopaedic Association National Joint Replacement Registry.

Science.gov (United States)

Vertullo, Christopher J; Lewis, Peter L; Lorimer, Michelle; Graves, Stephen E

2017-07-05

Controversy still exists as to the optimum management of the posterior cruciate ligament (PCL) in total knee arthroplasty. Surgeons can choose to kinematically substitute the PCL with a posterior-stabilized total knee replacement or alternatively to utilize a cruciate-retaining, also known as minimally stabilized, total knee replacement. Proponents of posterior-stabilized total knee replacement propose that the reported lower survivorship in registries when directly compared with minimally stabilized total knee replacement is due to confounders such as selection bias because of the preferential usage of posterior-stabilized total knee replacement in more complex or severe cases. In this study, we aimed to eliminate these possible confounders by performing an instrumental variable analysis based on surgeon preference to choose either posterior-stabilized or minimally stabilized total knee replacement, rather than the actual prosthesis received. Cumulative percent revision, hazard ratio (HR), and revision diagnosis data were obtained from the Australian Orthopaedic Association National Joint Replacement Registry from September 1, 1999, to December 31, 2014, for 2 cohorts of patients, those treated by high-volume surgeons who preferred minimally stabilized replacements and those treated by high-volume surgeons who preferred posterior-stabilized replacements. All patients had a diagnosis of osteoarthritis and underwent fixed-bearing total knee replacement with patellar resurfacing. At 13 years, the cumulative percent revision was 5.0% (95% confidence interval [CI], 4.0% to 6.2%) for the surgeons who preferred the minimally stabilized replacements compared with 6.0% (95% CI, 4.2% to 8.5%) for the surgeons who preferred the posterior-stabilized replacements. The revision risk for the surgeons who preferred posterior-stabilized replacements was significantly higher for all causes (HR = 1.45 [95% CI, 1.30 to 1.63]; p total knee replacement compared with the patients of

Rheological properties of reduced fat ice cream mix containing octenyl succinylated pearl millet starch.

Science.gov (United States)

Sharma, Monika; Singh, Ashish K; Yadav, Deep N

2017-05-01

The octenyl succinyl anhydride (OSA) esterified pearl millet ( Pennisetum typhoides ) starch was evaluated as fat replacer in soft serve ice cream in comparison to other fat replacers viz. inulin, whey protein concentrate-70 and commercial starch. During temperature sweep test, the yield stress and flow behaviour index of un-pasteurized ice cream mixes increased as the temperature increased from 40 to 80 °C, while the consistency index decreased. Consistency index of aged ice cream mixes containing 2% fat replacer was higher as compared to mixes with 1% level. The aged ice cream mixes exhibited non-Newtonian behaviour as flow behaviour index values were less than one. Apparent viscosity (at 50 s -1 shear rate) of control as well as ice cream mix containing 1% OSA-esterified pearl millet starch samples was 417 and 415 mPas, respectively and did not differ significantly. The overrun of the ice cream (with 5 and 7.5% fat) containing 1 and 2% of above fat replacers ranged between 29.7 and 34.3% and was significantly lower than control (40.3%). The percent melted ice cream was also low for the ice creams containing 2% of above fat replacers at 5% fat content as compared to control. However, sensory acceptability and rheological characteristics of reduced fat ice creams containing 1.0 and 2.0% OSA-esterified pearl millet starch were at par with other fat replacers under the study. Thus, OSA-esterified pearl millet starch has potential to be used as fat replacer in reduced fat ice cream.

Segmental blood pressure after total hip replacement

DEFF Research Database (Denmark)

Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

1992-01-01

Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found...... on the operated side. None of the patients had symptoms from the lowered pressure. We conclude that in patients without signs of ischemia, the postoperative segmental pressure decrease is reversible and therefore not dangerous....

Weight-bearing radiography in total hip replacement

International Nuclear Information System (INIS)

Turula, K.B.; Haajanen, J.; Friberg, O.; Lindholm, T.S.; Tallroth, K.

1985-01-01

Serial anteroposterior (AP) radiographs of the weight-bearing pelvis and hips were taken of 29 patients with total hip replacement (THR). For constant positioning the patient stands with straight knees on a board with a block between the heels. A U-shaped mercury level strapped to the patient provides a horizontal reference line on the radiograph. On the average, individual variation of pelvic tilt in serial films was 1 0 and pelvic rotation 3.5 0 confirming satisfactory reproducibility. The horizontal reference enables estimation of pre- and postoperative leg length inequality (LLI) and of the angle of the acetabular cup (AA). Reproducibility allows assessment of the exact position of the femoral component and quantitative evaluation of radiolucency and bone resorption around the prosthetic implant in the follow-up of THR. (orig.)

Weight Changes and Metabolic Outcomes in Calorie-Restricted Obese Mice Fed High-Fat Diets Containing Corn or Flaxseed Oil: Physiological Role of Sugar Replacement with Polyphenol-Rich Grape.

Science.gov (United States)

Ansar, Hastimansooreh; Zamaninour, Negar; Djazayery, Abolghassem; Pishva, Hamideh; Vafa, Mohammadreza; Mazaheri Nezhad Fard, Ramin; Dilmaghanian, Aydin; Mirzaei, Khadijeh; Shidfar, Farzad

2017-08-01

Because diet components are important during dieting in obesity treatment, we examined possible beneficial effects of substituting corn oil and sugar with flaxseed oil and grape in calorie-restricted high-fat diets on weight changes as well as improvement in some metabolic markers and related gene expression. Seventy-five C57BL/6J male mice were given free access to a high-fat (36% of energy from fat) diet containing corn oil plus sugar (CO + S). After 11 weeks, 15 mice were sacrificed and another 60 were divided among 4 high-fat diet groups with 30% calorie restriction (CR) for the next 12 weeks. The diets contained corn oil (CO) or flaxseed oil (FO) with sugar (S) or grape (G). Despite CR, a weight loss trend was observed only during the first 4 weeks in all groups. CR did not significantly increase SIRT1 gene expression. Higher liver weight was observed in mice consuming FO (p sugar (FBS) was significantly higher than in CO + G-CR. Grape intake increased Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) expression and decreased insulin resistance in CO + G-CR. Sugar replacement with polyphenol-rich grape along with CR improved glucose homeostasis, and substituting corn oil with flaxseed oil in obese mice reduced fat mass, but even with no change in adiponectin levels it could not decrease insulin resistance. However, none of the food item combinations facilitated weight reduction in the long-term CR. Therefore, regardless of the total calorie intake, different diet components and fat contents may have unexpected effects on metabolic regulation.

A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement.

Science.gov (United States)

Łyp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; Włostowska, Ewa; Stanisławska, Iwona; Szypuła, Jan; Tomaszewski, Wiesław

2016-07-25

BACKGROUND Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. MATERIAL AND METHODS A total of 192 patients (the mean age 61.03±10.89) suffering from hip osteoarthritis (OA) were evaluated before and after total hip replacement (THR). The clinical study covered measurements of hip active ranges of motion (HAROM) and the forces generated by pelvis stabilizer muscles. Pain intensity was assessed according to analogue-visual scale of pain (VAS) and according to the Modified Laitinen Questionnaire. The patients were divided into 6 groups (4 treatment and 2 control). We compared 2 rehabilitation programs using kinesitherapy and low-frequency magnetic field. One of them also had specially designed exercises in the water. Statistical analysis was carried out at the significance level α=0.05. This was a cross-sectional study. RESULTS A positive effect of water exercises on a number of parameters was found in patients with OA both before and after total hip replacement surgery. We noted a significant reduction of pain (pwater exercises most significantly reduced pain in patients with OA before and after total hip replacement surgery. 2. Inclusion of water exercises in a rehabilitation program can reduce the use of medicines in patient with OA and after THR.

Obesity and sarcopenia after menopause are reversed by sex hormone replacement therapy

DEFF Research Database (Denmark)

Sørensen, M B; Rosenfalck, A M; Højgaard, L

2001-01-01

OBJECTIVE: Menopause is linked to an increase in fat mass and a decrease in lean mass exceeding age-related changes, possibly related to reduced output of ovarian steroids. In this study we examined the effect of combined postmenopausal hormone replacement therapy (HRT) on the total and regional ......, which in turn, prevents disease in the elderly....

The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty.

Science.gov (United States)

Palsis, John A; Brehmer, Thomas S; Pellegrini, Vincent D; Drew, Jacob M; Sachs, Barton L

2018-02-21

In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods. We compared the methods with respect to the overall costs of hip and knee replacement and the costs for each major cost category. The traditional accounting method resulted in higher cost estimates. The total cost per hip replacement was $22,076 (2014 USD) using traditional accounting and was $12,957 using TDABC. The total cost per knee replacement was $29,488 using traditional accounting and was $16,981 using TDABC. With respect to cost categories, estimates using traditional accounting were greater for hip and knee replacement, respectively, by $3,432 and $5,486 for personnel, by $3,398 and $3,664 for space and equipment, and by $2,289 and $3,357 for indirect costs. Implants and consumables were derived from the actual hospital purchase price; accordingly, both methods produced equivalent results. Substantial cost differences exist between accounting methods. The focus of TDABC only on resources used directly by the patient contrasts with the allocation of all operating costs, including all indirect costs and unused capacity, with traditional accounting. We expect that the true costs of hip and knee replacement care cycles are likely somewhere between estimates derived from traditional accounting methods and TDABC. TDABC offers patient-level granular cost information that better serves in the redesign of care pathways and may lead to more strategic resource-allocation decisions to optimize

A Report Of Two Cases Of Uncemented Total Hip Replacement In ...

African Journals Online (AJOL)

This is a report of two sickle cell patients (HbSS) with advanced osteoarthritis of the right hip. The patients were in Ficat and Arlet\\'s stage 3 and 4 respectively. Both were females aged 23 and 46 years and they had uncemented hydroxyapatite coated omnifit (Stryker Howmedica Osteonics) total hip prosthetic replacement.

Can shared care deliver better outcomes for patients undergoing total hip replacement?

NARCIS (Netherlands)

Rosendal, H.; Beekum, W.T. van; Nijhof, P.; Witte, L.P. de; Schrijvers, A.J.P.

2000-01-01

Objectives: To assess whether shared care for patients undergoing total hip replacement delivers better outcomes compared to care as usual. Design: Prospective, observational cohort study. Setting: Two regions in the Netherlands where different organisational health care models have been

Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement.

Science.gov (United States)

Jerosch, Joerg; Aldawoudy, Akram M

2007-01-01

The purpose of this study was to document the effect of arthroscopic management in patients with knee stiffness after total knee replacement. We present a case series study, in which 32 patients have been treated for moderate arthrofibrosis of the knee after total knee replacement, with the same regimen. We have excluded all cases of stiffness, because of infection, mechanical mal-alignment, loosening of the implants and other obvious reasons of stiffness of the knee, rather than pure arthrofibrosis. All patients first underwent a trial of conservative treatment before going for arthroscopic management. A pain catheter for femoral nerve block was inserted just before anesthesia for post-operative pain management. Arthroscopic arthrolysis of the intra-articular pathology was performed in a standardized technique with release of all fibrous bands in the suprapatellar pouch, reestablishing the medial and lateral gutter, release of the patella, resection of the remaining meniscal tissue or an anterior cyclops, if needed. Intensive physiotherapy and continuous passive motion were to start immediately post-operatively. All the patients were available for the follow up and they were evaluated using the knee society rating system. A total of 25 of the 32 procedures resulted in an improvement of the patients knee score. All the knees operated upon had intra-articular fibrous bands, hypertrophic synovitis and peri-patellar adhesions. A total of eight patients suffered from an anterior cyclops lesion and six patients showed pseudomenicus. In 19 cases a medial and lateral relapse of the patella was performed; only 5 patients got an isolated lateral release. The mean knee flexion was 119 degrees (100-130) at the end of arthroscopy and was 97 degrees (75-115) at the last follow up. The eight patients with extension lags decreased from 27 degrees (10 degrees-35 degrees) pre-operatively to 4 degrees (0-10) at time of follow up. The average knee society ratings increased from 70

Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021.

Science.gov (United States)

Kurtz, Steven M; Ong, Kevin L; Lau, Edmund; Bozic, Kevin J

2014-04-16

Few studies have explored the role of the National Health Expenditure and macroeconomics on the utilization of total joint replacement. The economic downturn has raised questions about the sustainability of growth for total joint replacement in the future. Previous projections of total joint replacement demand in the United States were based on data up to 2003 using a statistical methodology that neglected macroeconomic factors, such as the National Health Expenditure. Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United States Census and National Health Expenditure data to quantify historical trends in total joint replacement rates, including the two economic downturns in the 2000s. Primary and revision hip and knee arthroplasty were identified using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Projections in total joint replacement were estimated using a regression model incorporating the growth in population and rate of arthroplasties from 1993 to 2010 as a function of age, sex, race, and census region using the National Health Expenditure as the independent variable. The regression model was used in conjunction with government projections of National Health Expenditure from 2011 to 2021 to estimate future arthroplasty rates in subpopulations of the United States and to derive national estimates. The growth trend for the incidence of joint arthroplasty, for the overall United States population as well as for the United States workforce, was insensitive to economic downturns. From 2009 to 2010, the total number of procedures increased by 6.0% for primary total hip arthroplasty, 6.1% for primary total knee arthroplasty, 10.8% for revision total hip arthroplasty, and 13.5% for revision total knee arthroplasty. The National Health Expenditure model projections for primary hip replacement in 2020 were higher than a previously projected model, whereas the current model estimates for total

Comparative responsiveness of measures of pain and function after total hip replacement

DEFF Research Database (Denmark)

Nilsdotter, A K; Roos, Ewa M.; Westerlund, J P

2001-01-01

To compare the responsiveness of the Functional Assessment System (FAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Medical Outcomes Study 36-item Short Form (SF-36) in patients with osteoarthritis (OA) scheduled for total hip replacement....

Timing of Re-Transfusion Drain Removal Following Total Knee Replacement

Science.gov (United States)

Leeman, MF; Costa, ML; Costello, E; Edwards, D

2006-01-01

INTRODUCTION The use of postoperative drains following total knee replacement (TKR) has recently been modified by the use of re-transfusion drains. The aim of our study was to investigate the optimal time for removal of re-transfusion drains following TKR. PATIENTS AND METHODS The medical records of 66 patients who had a TKR performed between October 2003 and October 2004 were reviewed; blood drained before 6 h and the total volume of blood drained was recorded. RESULTS A total of 56 patients had complete records of postoperative drainage. The mean volume of blood collected in the drain in the first 6 h was 442 ml. The mean total volume of blood in the drain was 595 ml. Therefore, of the blood drained, 78% was available for transfusion. CONCLUSION Re-transfusion drains should be removed after 6 h, when no further re-transfusion is permissible. PMID:16551400

The patient's experience of temporary paralysis from spinal anaesthesia, a part of total knee replacement

DEFF Research Database (Denmark)

Bager, Louise; Konradsen, Hanne; Dreyer, Pia Sander

2015-01-01

AIMS AND OBJECTIVES: The aim of this study was to describe the meaning of being temporary paralysed from spinal anaesthesia when undergoing total knee replacement. BACKGROUND: Total knee arthroplasty is a common procedure, and regional anaesthesia is used as a method for anaesthetising the patient...... of the experience of spinal anaesthesia, as a part of having a total knee replacement. METHODS: Twelve patients were interviewed in March 2014 after undergoing an elective total knee arthroplasty under spinal anaesthesia. The interviews were analysed with a Ricoeur-inspired interpretation method. RESULTS: Three...... TO CLINICAL PRACTICE: The results of this study contribute to insights and deeper knowledge that can enhance staff's ability to provide care for patients undergoing total knee arthroplasty in spinal anaesthesia. The results provide perspectives that argue for care in accordance to individual needs....

Material Science in Cervical Total Disc Replacement

Science.gov (United States)

Pham, Martin H.; Mehta, Vivek A.; Tuchman, Alexander; Hsieh, Patrick C.

2015-01-01

Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

Material Science in Cervical Total Disc Replacement.

Science.gov (United States)

Pham, Martin H; Mehta, Vivek A; Tuchman, Alexander; Hsieh, Patrick C

2015-01-01

Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation.

Total body fat, proinflammatory cytokines and insulin resistance in Indian subjects

International Nuclear Information System (INIS)

Yajnik, C.S.; Lubree, H.G.; Rege, S.S.; Bhat, D.S.; Raut, K.N.; Panchanadikar, A.S.; Joglekar, C.B.; Naik, S.S.; Shetty, P.; Yudkin, J.; Kurpad, A.V.

2002-01-01

We studied cardiovascular risk factors in 30 to 50 year old Indian men in three geographical locations (rural, urban slums and urban middle class) in relation to their body fat. A total of 1,222 subjects, selected by stratified random sampling were screened: 39 reported diabetic or hypertensive. Of the remaining subjects 600 were randomly selected for further testing. This is a report 441 men studied (149 rural, 142 slums, 150 urban middle class). The mean age of these men was 38 y rural, 38 y urban slums, 41 y urban middle class, mean BMI 21.0 kg/m 2 , 22.3 kg/m 2 and 24.3 kg/m 2 respectively, mean body fat percent by bio-impedance 20.4%, 22.5% and 30.4% and by Deuterated water was 19.9%, 21.6% and 27.2% respectively. A 75 g oral glucose tolerance test (WHO 1985) showed no diabetes in rural subjects, while 4% urban slum dwellers and 10 in urban middle class were diabetic; 9% rural men had IGT, compared to 12% in urban slums and 20% in urban middle class. Hypertension (blood pressure ≥ 140/90 mm Bg) was present in 2% rural men, 4% in urban slums and in 10% men in urban middle class. Mean plasma cholesterol concentration was 148 mg% in rural, 53 mg% in urban slums and 64 mg% in urban middle class, mean plasma triglyceride concentrations were 82 mg%, 95 mg% and 108 mg% respectively. All cardiovascular risk factors were strongly related to measures of obesity (body fat % and waist hip ratio). On multivariate analysis 2h plasma glucose (OGTT) concentration and blood pressure were additionally related to geographical location (urban middle class>slums>rural). Our results suggest that urbanisation increases the risk of glucose intolerance and hypertension independent of the body fat percent or its central distribution. This suggests there may he additional environmental factors in the urban environment increasing the risk of diabetes over and above the effect of body fat. (author)

Total body fat, proinflammatory cytokines and insulin resistance in Indian subjects

Energy Technology Data Exchange (ETDEWEB)

Yajnik, C S; Lubree, H G; Rege, S S; Bhat, D S; Raut, K N; Panchanadikar, A S; Joglekar, C B; Naik, S S [Diabetest Unit, KEM Hospital Resarch Centre, Pune (India); Shetty, P [London School of Hygiene and Tropical Medicine, London (United Kingdom); Yudkin, J [International Health and Medical Education Centre, UCL, London (United Kingdom); Kurpad, A V [St. John' s Medical College, Bangalore (India)

2002-07-01

We studied cardiovascular risk factors in 30 to 50 year old Indian men in three geographical locations (rural, urban slums and urban middle class) in relation to their body fat. A total of 1,222 subjects, selected by stratified random sampling were screened: 39 reported diabetic or hypertensive. Of the remaining subjects 600 were randomly selected for further testing. This is a report 441 men studied (149 rural, 142 slums, 150 urban middle class). The mean age of these men was 38 y rural, 38 y urban slums, 41 y urban middle class, mean BMI 21.0 kg/m{sup 2}, 22.3 kg/m{sup 2} and 24.3 kg/m{sup 2} respectively, mean body fat percent by bio-impedance 20.4%, 22.5% and 30.4% and by Deuterated water was 19.9%, 21.6% and 27.2% respectively. A 75 g oral glucose tolerance test (WHO 1985) showed no diabetes in rural subjects, while 4% urban slum dwellers and 10 in urban middle class were diabetic; 9% rural men had IGT, compared to 12% in urban slums and 20% in urban middle class. Hypertension (blood pressure {>=} 140/90 mm Bg) was present in 2% rural men, 4% in urban slums and in 10% men in urban middle class. Mean plasma cholesterol concentration was 148 mg% in rural, 53 mg% in urban slums and 64 mg% in urban middle class, mean plasma triglyceride concentrations were 82 mg%, 95 mg% and 108 mg% respectively. All cardiovascular risk factors were strongly related to measures of obesity (body fat % and waist hip ratio). On multivariate analysis 2h plasma glucose (OGTT) concentration and blood pressure were additionally related to geographical location (urban middle class>slums>rural). Our results suggest that urbanisation increases the risk of glucose intolerance and hypertension independent of the body fat percent or its central distribution. This suggests there may he additional environmental factors in the urban environment increasing the risk of diabetes over and above the effect of body fat. (author)

The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease.

Science.gov (United States)

DiNicolantonio, James J; Lucan, Sean C; O'Keefe, James H

2016-01-01

Dietary guidelines continue to recommend restricting intake of saturated fats. This recommendation follows largely from the observation that saturated fats can raise levels of total serum cholesterol (TC), thereby putatively increasing the risk of atherosclerotic coronary heart disease (CHD). However, TC is only modestly associated with CHD, and more important than the total level of cholesterol in the blood may be the number and size of low-density lipoprotein (LDL) particles that contain it. As for saturated fats, these fats are a diverse class of compounds; different fats may have different effects on LDL and on broader CHD risk based on the specific saturated fatty acids (SFAs) they contain. Importantly, though, people eat foods, not isolated fatty acids. Some food sources of SFAs may pose no risk for CHD or possibly even be protective. Advice to reduce saturated fat in the diet without regard to nuances about LDL, SFAs, or dietary sources could actually increase people's risk of CHD. When saturated fats are replaced with refined carbohydrates, and specifically with added sugars (like sucrose or high fructose corn syrup), the end result is not favorable for heart health. Such replacement leads to changes in LDL, high-density lipoprotein (HDL), and triglycerides that may increase the risk of CHD. Additionally, diets high in sugar may induce many other abnormalities associated with elevated CHD risk, including elevated levels of glucose, insulin, and uric acid, impaired glucose tolerance, insulin and leptin resistance, non-alcoholic fatty liver disease, and altered platelet function. A diet high in added sugars has been found to cause a 3-fold increased risk of death due to cardiovascular disease, but sugars, like saturated fats, are a diverse class of compounds. The monosaccharide, fructose, and fructose-containing sweeteners (e.g., sucrose) produce greater degrees of metabolic abnormalities than does glucose (either isolated as a monomer, or in chains as starch

Quantification of in vivo implant wear in total knee replacement from dynamic single plane radiography

Science.gov (United States)

Teeter, Matthew G.; Seslija, Petar; Milner, Jaques S.; Nikolov, Hristo N.; Yuan, Xunhua; Naudie, Douglas D. R.; Holdsworth, David W.

2013-05-01

An in vivo method to measure wear in total knee replacements was developed using dynamic single-plane fluoroscopy. A dynamic, anthropomorphic total knee replacement phantom with interchangeable, custom-fabricated components of known wear volume was created, and dynamic imaging was performed. For each frame of the fluoroscopy data, the relative location of the femoral and tibial components were determined, and the apparent intersection of the femoral component with the tibial insert was used to calculate wear volume, wear depth, and frequency of intersection. No difference was found between the measured and true wear volumes. The precision of the measurements was ±39.7 mm3 for volume and ±0.126 mm for wear depth. The results suggest the system is capable of tracking wear volume changes across multiple time points in patients. As a dynamic technique, this method can provide both kinematic and wear measurements that may be useful for evaluating new implant designs for total knee replacements.

Quantification of in vivo implant wear in total knee replacement from dynamic single plane radiography

International Nuclear Information System (INIS)

Teeter, Matthew G; Naudie, Douglas D R; Holdsworth, David W; Seslija, Petar; Milner, Jaques S; Nikolov, Hristo N; Yuan Xunhua

2013-01-01

An in vivo method to measure wear in total knee replacements was developed using dynamic single-plane fluoroscopy. A dynamic, anthropomorphic total knee replacement phantom with interchangeable, custom-fabricated components of known wear volume was created, and dynamic imaging was performed. For each frame of the fluoroscopy data, the relative location of the femoral and tibial components were determined, and the apparent intersection of the femoral component with the tibial insert was used to calculate wear volume, wear depth, and frequency of intersection. No difference was found between the measured and true wear volumes. The precision of the measurements was ±39.7 mm 3 for volume and ±0.126 mm for wear depth. The results suggest the system is capable of tracking wear volume changes across multiple time points in patients. As a dynamic technique, this method can provide both kinematic and wear measurements that may be useful for evaluating new implant designs for total knee replacements. (paper)

Bentall operation, total aortic replacement and mitral valve replacement for a young adult with Marfan syndrome: a case of three-staged operation.

Science.gov (United States)

Inui, K; Shimazaki, Y; Watanabe, T; Kuraoka, S; Minowa, T; Miura, M; Oshikiri, S; Toyama, H

1998-08-01

In Marfan syndrome, the most common cardiovascular abnormalities are dilatation of the aorta and aortic valve regurgitation in adult patients. Mitral valve dysfunction is the most common cause of morbidity and mortality in infants and children with Marfan syndrome, and is not frequently operated on in adult Marfan patients who undergo surgery for diseases of the aortic root and total aorta. This report describes a successfully three-staged operation for a 24 year-old man with Marfan syndrome who underwent an emergent Bentall operation and aortic arch replacement, total aortic replacement and mitral valve replacement over 2 years. Mitral valve regurgitation was mild but increased after the second operation. The graft was tightly adhesive and invasive to the sternum. Endoscopic view was helpful to avoid graft damage at resternotomy. The postoperative course was uneventful in each operation. Microscopic examination of the mitral valve leaflets showed abnormal increase of mucopolysaccharides, and disruption and fragmentation of elastic fibers.

Fasting gall bladder volume and lithogenicity in relation to glucose tolerance, total and intra-abdominal fat masses in obese non-diabetic subjects

DEFF Research Database (Denmark)

Hendel, H W; Højgaard, L; Andersen, T

1998-01-01

OBJECTIVE: To investigate whether total body fat mass or fat distribution and associated metabolic disturbances in glucose and lipid metabolism influence the well known gallstone pathogenetic factors in obese subjects in order to explain why some obese subjects develop gallstones and some do not...... with a specific radioimmunoassay. Insulin sensitivity was measured by the Minimal Model and glucose tolerance by an oral glucose tolerance test (OGTT). Serum lipid concentrations were measured by standard methods. RESULTS: The gallbladder volume in the fasting state increased with increasing intra-abdominal fat...... mass (P=0.006) and was increased in subjects with impaired glucose tolerance (41 vs 27 ml, P=0.001). The lithogenic index was > 1 in all subjects and correlated with total fat mass (P=0.04). CONCLUSION: Gallstone pathogenesis in obesity seems to be influenced by the total body fat mass and its regional...

Using different fibers to replace fat in sponge cakes: In vitro starch digestion and physico-structural studies.

Science.gov (United States)

Diez-Sánchez, Elena; Llorca, Empar; Quiles, Amparo; Hernando, Isabel

2018-01-01

This study assessed the effect of substituting 30% of fat by soluble, insoluble fiber, or a mix of both fibers in sponge cake quality, structure, acceptability, and starch digestibility. The apparent viscosity of the different formulations was measured and micro-baking was simulated. Texture profile tests were carried out and the crumb structure was examined. In vitro digestion was performed to study the digestibility of starch and a sensory test was carried out to know consumer acceptance. The soluble fiber (maltodextrin) affected the structure and quality of the cakes less than the insoluble fiber (potato fiber) and the use of soluble fiber in the formulation resulted in lower glucose release under in vitro conditions. Moreover, the consumer did not find differences among the control cake and the cakes prepared with soluble fiber. Considering the results as a whole, soluble fiber may be used for partial replacement of fat in sponge cake formulations and may constitute an appropriate strategy for obtaining healthy sponge cakes.

Sciatic nerve block causing heel ulcer after total knee replacement in 36 patients.

Science.gov (United States)

Todkar, Manoj

2005-12-01

Femoral and sciatic nerve blocks are often used for postoperative analgesia following total knee replacement surgery. In this report, we focus on cases of heel ulcers which occurred following the implementation of peripheral nerve block in concert with knee replacement surgery. In some instances, heel ulcers have resulted in delayed rehabilitation and prolonged hospital stays in this group of patients, which makes this phenomenon a potential burden on the healthcare system. Pressure points in the foot should be protected after the implementation of nerve blocks to prevent pressure sores. An awareness of this unusual complication related to knee replacement surgery is necessary to prevent its occurrence and avoid delays in patient rehabilitation and recovery.

Partial replacement of corn grain by hydrogenated oil in grazing dairy cows in early lactation.

Science.gov (United States)

Salado, E E; Gagliostro, G A; Becu-Villalobos, D; Lacau-Mengido, I

2004-05-01

Thirty-six grazing dairy cows were used to determine milk production and composition, and dry matter and energy intake when corn grain was partially replaced by hydrogenated oil in the concentrate. Four additional cows, each fitted with a ruminal cannula, were used in a crossover design to evaluate effects of supplemental fat on rumen environment and pasture digestion. All cows grazed mixed pastures with an herbage allowance of 30 kg dry matter/cow per day. The control group was fed a concentrate containing corn grain (4.49 kg dry matter/cow per day) and fishmeal (0.37 kg dry matter/cow per day), whereas the other group (fat) received a concentrate containing corn grain (2.87 kg dry matter/cow per day), fishmeal (0.37 kg dry matter/cow per day) and fat (0.7 kg dry matter/cow per day). The fat was obtained by hydrogenation of vegetable oils (melting point 58 to 60 degrees C, 30.3% C16:0, 34.9% C18:0, 21.8% C18:1, 3.3% C18:2). Supplemental fat increased milk production (control = 23.7 vs. fat = 25.0 kg/cow per day), fat-corrected milk (control = 22.5 vs. fat = 24.5 kg/cow per day), milk fat content (control = 3.64% vs. fat = 3.86%) and yields of milk fat (control = 0.86 vs. fat = 0.97 kg/cow per day) and protein (control = 0.74 vs. fat = 0.78 kg/cow per day). Milk percentages of protein, lactose, casein, cholesterol, and urea nitrogen were not affected. Pasture DMI and total DMI of pasture and concentrate and estimated energy intake were unchanged. No differences in loss of body weight or body condition score were detected. Plasma concentrations of nonesterified fatty acids, somatotropin, insulin, and insulin-like growth factor were not affected by supplemental fat. Concentrations of plasma triglyceride and total cholesterol were increased by supplemented fat, and no changes in plasma glucose and urea nitrogen were observed. The acetate-to-propionate ratio was higher in rumen fluid of cows that consumed fat (fat = 3.39 vs. control = 3.27). In situ pasture NDF

Patient-Controlled Oral Analgesia for Postoperative Pain Management Following Total Knee Replacement

Directory of Open Access Journals (Sweden)

Patti Kastanias

2010-01-01

Full Text Available PURPOSE: To investigate whether patient-controlled oral analgesia (PCOA used by individuals receiving a total knee replacement could reduce pain, increase patient satisfaction, reduce opioid use and/or reduce opioid side effects when compared with traditional nurse (RN-administered oral analgesia.

[Mini-subvastus approach for total knee replacement].

Science.gov (United States)

Halder, Andreas; Beier, Alexander; Neumann, Wolfram

2009-03-01

Total knee replacement in minimally invasive technique without any trauma to the extensor apparatus and with soft-tissue-referenced bone resections. Only the subvastus approach preserves the integrity of the extensor apparatus and has therefore been modified to become a minimally invasive technique with a shorter skin incision and lateralization instead of eversion of the patella. Soft-tissue balancing is done through this direct anterior approach. Mild to moderate varus osteoarthritis of the knee up to 15 degrees of malalignment, mild and passively correctable valgus osteoarthritis of the knee up to 10 degrees of malalignment. Severe, contract varus osteoarthritis of the knee, severe and moderate, contract valgus osteoarthritis of the knee, severe obesity, exceptionally muscular patients, decreased skin perfusion. Central skin incision from the superior pole of the patella to the tibial tubercle. Exposure of the medial retinaculum and mobilization of the vastus medialis muscle subcutaneously. Incision of the medial retinaculum and blunt separation of the vastus medialis muscle from the intermuscular septum. Lateralization of the patella and flexion of the knee joint. Resection of the tibia perpendicular to the diaphysis. Adjustment of the anteroposterior (AP) resection block at the level of the anterior femoral cortex and of rotation by applying equal tension to the collateral ligaments. Balancing of soft-tissue tension in flexion gap by release, if necessary. After AP resection fixation of distal resection block in planned valgus angle. Balancing of soft-tissue tension in extension gap by release, if necessary. After distal femur resection facet resection, adaptation of posterior femoral condyles, and implantation of prosthesis. Check on stability and range of motion. Wound closure. Full weight bearing from the 1st postoperative day, CPM (continuous passive motion) with up to 90 degrees flexion with peridural anesthesia as tolerated, stair climbing starting on

Risk factors for renal dysfunction after total hip joint replacement

DEFF Research Database (Denmark)

Hassan, Basim Kamil; Sahlström, Arne; Dessau, Ram Benny Christian

2015-01-01

BACKGROUND AND PURPOSE OF THE STUDY: Renal injury and dysfunction are serious complications after major surgery, which may lead to increased morbidity and mortality. The objective of our study was to identify the possible risk factors for renal dysfunction after total hip joint replacement surger...... creatinine. Smoking, diabetes mellitus, high BMI, gender, and duration of surgery were not identified as significant risk factors........ METHODS: A retrospective study was conducted among 599 consecutive primary hip joint replacements performed between January 2011 and December 2013. According to the RIFLE criteria, increased postoperative serum creatinine was considered indicative of postoperative renal injury. The Welch two-sample test......, hypertension, general anesthesia, high ASA scores, low intra-operative systolic BP, and prophylactic dicloxacillin as significant risk factors. Low baseline systolic BP, low baseline diastolic blood pressure, and hip fracture diagnosis were independent risk factors for postoperative increase in serum...

Material Science in Cervical Total Disc Replacement

Directory of Open Access Journals (Sweden)

Martin H. Pham

2015-01-01

Full Text Available Current cervical total disc replacement (TDR designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti, and cobalt-chrome (CoCr. These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation.

Application of bone scintigrams in total knee replacement (Okayama MK-II type)

Energy Technology Data Exchange (ETDEWEB)

Umeda, T.; Inoue, S.; Matsui, N.; Moriya, H. (Chiba Univ. (Japan). School of Medicine)

1982-02-01

Eighteen patients with 21 total knee replacements (OKAYAMA MK-II type) were examined by radionuclide imaging in order to assess the prosthetic complaints such as loosening, infection, fracture and lasting pain. The following results and conclusions were obtained. 1) Bone imaging can reveal the condition of the attachment of bone and prosthesis. 2) Diffuse uptake gradually diminished until 18 months after surgery. 3) In front view on bone imaging, tibial uptake corresponded highly with the part of the weight area. 4) In cases of high uptake of posterior femoral component in lateral view, the range of knee flexion was mostly restricted. 5) Long-period persistent local uptake suggested loosening of the prosthesis or fracture of the tibial plateau. 6) Patello-femoral uptake showed no relation to the patellofemoral complaints. Radionuclide bone imaging is considered to represent one of the most valuable diagnostic procedures for assessing the clinical results after total knee replacement.

Application of bone scintigrams in total knee replacement (Okayama MK-II type)

International Nuclear Information System (INIS)

Umeda, Tohru; Inoue, Shunichi; Matsui, Nobuo; Moriya, Hideshige

1982-01-01

Eighteen patients with 21 total knee replacements (OKAYAMA MK-II type) were examined by radionuclide imaging in order to assess the prosthetic complaints such as loosening, infection, fracture and lasting pain. The following results and conclusions were obtained. 1) Bone imaging can reveal the condition of the attachment of bone and prosthesis. 2) Diffuse uptake gradually diminished until 18 months after surgery. 3) In front view on bone imaging, tibial uptake corresponded highly with the part of the weight area. 4) In cases of high uptake of posterior femoral component in lateral view, the range of knee flexion was mostly restricted. 5) Long-period persistent local uptake suggested loosening of the prosthesis or fracture of the tibial plateau. 6) Patello-femoral uptake showed no relation to the patellofemoral complaints. Radionuclide bone imaging is considered to represent one of the most valuable diagnostic procedures for assessing the clinical results after total knee replacement. (author)

NEUROLOGICAL SEQUELAE FOLLOWING ANAESTHETIC RECOVERY AFTER BILATERAL TOTAL KNEE REPLACEMENT – TWO CASE REPORTS

Directory of Open Access Journals (Sweden)

Harpreet

2016-03-01

Full Text Available BACKGROUND Thromboembolism is a common and serious complication of joint replacement surgery. Cognitive decline occurs in 5-29% of patients, undergoing major orthopaedic surgery. Many studies show that systemic embolism may occur in the absence of venous-arterial shunts leading to cognitive dysfunction and neurological sequelae. METHODS We present two cases of neurological consequences occurring post bilateral TKR. Cases were successfully done under Combined Spinal Epidural Anaesthesia. Steroids were not used intraoperatively. RESULTS Both cases had neurological complications following completion of surgery. First case had posterior circulation TIA while the other had a right upper motor neuron facial palsy. CONCLUSION We suspect both as cases of cerebral fat microembolism in the absence of any venous-arterial shunt.

Increased perirenal fat area is not associated with adverse outcomes after laparoscopic total mesorectal excision for rectal cancer

DEFF Research Database (Denmark)

Levic, Katarina; Bulut, Orhan; Schødt, Mette

2017-01-01

Introduction Intraabdominal visceral obesity may increase technical challenges during laparoscopic rectal resection and hypothetically therefore increase the risk of perioperative complications. The aim of this study was to analyze intraabdominal obesity by means of perirenal fat against risk...... of adverse outcomes in patients undergoing laparoscopic rectal cancer surgery. Methods This study was a single-institution retrospective analysis of consecutive patients undergoing laparoscopic total mesorectal surgery for rectal cancer between January 2009 and January 2013. Abdominal CT scans...... with intravenous contrast were assessed in a blinded manner to estimate the perirenal fat area (cm2). Result A total of 195 patients were included (median age 70 years (range 27–87), 58 women and 137 men) for analysis. There was a moderate correlation between BMI and perirenal fat area (r = 0.499, p = 0...

Unilateral vs one stage bilateral total knee replacement in rheumatoid and osteoarthritis - A comparative study

Directory of Open Access Journals (Sweden)

Kiran E

2005-01-01

Full Text Available Background : A controversy exists regarding simultaneous or staged bilateral total knee replacement. Methods: Fifty patients undergoing simultaneous bilateral and 50 undergoing unilateral total knee arthroplasty were evaluated prospectively to compare the clinical, radiological results and complication rates. Eighty-four patients belonged to ASA category II or III preoperatively. The study included a high proportion of rheumatoid patients and osteoarthritis patients with severe deformities. Results: Bilateral group had greater blood loss and required more blood transfusion, but there was no difference in requirement of postoperative intensive care and the complication rates. Rheumatoid knees had lower pre and postoperative knee score and functional score as compared to osteoarthritic knees. Morbidity and mortality of one stage bilateral knee replacement was no greater than unilateral operation. Conclusion: Simultaneous bilateral knee replacement in younger patients with advanced rheumatoid arthritis is safe and effective

The infection of Mycoplasma hominis after total knee replacement: Case report and literature review

Directory of Open Access Journals (Sweden)

Hong-Jiu Qiu

2017-08-01

Full Text Available The Mycoplasma hominis infection is a rare postoperative complication after joint replacement. Based on our knowledge, there were only two cases reported by Korea all over the world currently. A case of postoperative Mycoplasma hominis infection after total knee replacement in our hospital was reported in this article. It was confirmed through mass spectrometer and Mycoplasma cultivation and treated by the first stage debridement, polyethylene insert replacement, and then drainage and irrigation combined with sensitive antibiotics after the operation. We observed that the C reactive protein (CRP level correlates with the development of disease, while the erythrocyte sedimentation rate (ESR remains at a high level, indicating the relevance between the Mycoplasma hominis infection caused by knee joint replacement and CRP. This study aims to report the case and review relevant literature.

Parental smoking during pregnancy and total and abdominal fat distribution in school-age children: the Generation R Study.

Science.gov (United States)

Durmuş, B; Heppe, D H M; Taal, H R; Manniesing, R; Raat, H; Hofman, A; Steegers, E A P; Gaillard, R; Jaddoe, V W V

2014-07-01

Fetal smoke exposure may influence growth and body composition later in life. We examined the associations of maternal and paternal smoking during pregnancy with total and abdominal fat distribution in school-age children. We performed a population-based prospective cohort study among 5243 children followed from early pregnancy onward in the Netherlands. Information about parental smoking was obtained by questionnaires during pregnancy. At the median age of 6.0 years (90% range: 5.7-7.4), we measured anthropometrics, total fat and android/gynoid fat ratio by dual-energy X-ray absorptiometry, and preperitoneal and subcutaneous abdominal fat were measured by ultrasound. The associations of maternal smoking during pregnancy were only present among girls (P-value for sex interactionpaternal smoking during pregnancy. Both continued maternal and paternal smoking during pregnancy may be associated with an increased risk of childhood overweight. The corresponding odds ratios were 1.19 (95% CI: 0.98-1.46) and 1.32 (1.10-1.58), respectively. Maternal and paternal smoking during pregnancy are associated with an adverse body and abdominal fat distribution and increased risk of overweight in children. Similar effects of maternal and paternal smoking suggest that direct intrauterine mechanisms and common family-based lifestyle-related factors explain the associations.

Rheological, fat bloom, and sensory acceptability effects of mango kernel fat and palm olein blends on chocolate-flavored coatings

Directory of Open Access Journals (Sweden)

Nieves María Flores March

2017-10-01

Full Text Available The effects of replacing cocoa butter with different percentages and proportions of a mango kernel fat/palm olein (MKF/POL blend, are reported. Samples were prepared by melting together mango kernel fat, palm olein, cocoa butter and cocoa mass and powdered sugar combinated. The samples were milled, conched, tempered, and molded to obtain three sets of seven samples as follows: one control omitting mango kernel fat and palm olein, and six samples with cocoa butter replacement of 15 and 22.5% and MKF/POL ratios of 2.3, 4.0, and 9.0. Casson viscosity, Casson yield stress, fat bloom and sensory acceptability were all measured. In fact, all samples had achieved a low Casson viscosity (ηCA and Casson yield stress (τ_oCA, which indicates molding and enrobing as appropriate uses. In addition, some significant differences (p ≤ 0.05 were found among samples. Fat bloom was accelerated in the samples relative to control, but high MKF proportions tended to retard appearance of fat bloom. No differences were observed in organoleptic properties between samples and control.

Incidence, risk factors and the healthcare cost of falls postdischarge after elective total hip and total knee replacement surgery: protocol for a prospective observational cohort study

Science.gov (United States)

Hill, Anne-Marie; Ross-Adjie, Gail; McPhail, Steven M; Monterosso, Leanne; Bulsara, Max; Etherton-Beer, Christopher; Powell, Sarah-Jayne; Hardisty, Gerard

2016-01-01

Introduction The number of major joint replacement procedures continues to increase in Australia. The primary aim of this study is to determine the incidence of falls in the first 12 months after discharge from hospital in a cohort of older patients who undergo elective total hip or total knee replacement. Methods and analyses A prospective longitudinal observational cohort study starting in July 2015, enrolling patients aged ≥60 years who are admitted for elective major joint replacement (n=267 total hip replacement, n=267 total knee replacement) and are to be discharged to the community. Participants are followed up for 12 months after hospital discharge. The primary outcome measure is the rate of falls per thousand patient-days. Falls data will be collected by 2 methods: issuing a falls diary to each participant and telephoning participants monthly after discharge. Secondary outcomes include the rate of injurious falls and health-related quality of life. Patient-rated outcomes will be measured using the Oxford Hip or Oxford Knee score. Generalised linear mixed modelling will be used to examine the falls outcomes in the 12 months after discharge and to examine patient and clinical characteristics predictive of falls. An economic evaluation will be conducted to describe the nature of healthcare costs in the first 12 months after elective joint replacement and estimate costs directly attributable to fall events. Ethics and dissemination The results will be disseminated through local site networks and will inform future services to support older people undergoing hip or knee joint replacement and also through peer-reviewed publications and medical conferences. This study has been approved by The University of Notre Dame Australia and local hospital human research ethics committees. Trial registration number ACTRN12615000653561; Pre-results. PMID:27412102

Controlling costs without compromising quality: paying hospitals for total knee replacement.

Science.gov (United States)

Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

2010-10-01

Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

Understanding Total Hip Replacement Recovery towards the Design of a Context-Aware Systems

NARCIS (Netherlands)

Jimenez Garcia, Juan

2011-01-01

Total Hip Replacement (THR) is a common procedure to improve the mobility of elderly with osteoarthritis. Presently information about the recovery process after discharge is unclear. As consequence patients and physiotherapists face uncertainties to follow an adequate trajectory for recovery.

Infection after total knee replacement: diagnosis and treatment

Directory of Open Access Journals (Sweden)

Lucio Honorio de Carvalho Junior

2013-09-01

Full Text Available Infection after total knee replacement (IATJ is a rare complication. It is associated with increased morbidity and mortality increasing the final costs. Gram positive coccus and Staphylococcus coagulase-negative and Staphylococcus aureus are the most common isolated germs (>50% of the cases. Conditions related to the patient, to the surgical procedure and even to the post op have been identified as risk factors to IATJ. Many complementary methods together with clinical symptoms are useful to a proper diagnosis. Treatment for IATJ must be individualized but generally is a combination of systemic antibiotic therapy and surgical treatment. Prosthesis exchange in one or two stages is the first choice procedure. Debridement with prosthesis retention is an option in acute cases with stable implants and antibiotic sensible germs.

OPTIMAL IMPROVEMENT IN FUNCTION AFTER TOTAL HIP AND KNEE REPLACEMENT: HOW DEEP DO YOU KNOW YOUR PATIENT’S MIND?

Science.gov (United States)

De Caro, M F; Vicenti, G; Abate, A; Picca, G; Leoncini, V; Lomuscio, M; Casalino, A; Solarino, G; Moretti, B

2015-01-01

Osteoarthritis (OA) of the hip and knee causes pain and loss of joint mobility, leading to limitations in physical function. When conservative treatment fails total hip and knee replacement is a cost-effective surgical option. Patients have high expectations regarding functional outcome after these procedures. If such expectations are not met, they may still be dissatisfied with the outcome of a technically successful procedure. Recently, numerous studies reported that psychological factors can influence the outcome of total knee replacement (tkr) and total hip artrhoplasty with total hip replacement (thr). We conducted a prospective study on a consecutive sample of 280 patients affected by hip or knee OA who underwent total joint replacement. At patients’ admission, Harris Hip Score (HHS) and Knee Society Score (KSS) were used to assess pain and function. Furthermore, SF-36, Mini-Mental Status Examination (MMSE), Symptom Checklist-90-R (SCL-90-R), Coping Orientation to Problems Experienced (BRIEF-COPE) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS) were administered. Patients had clinical and radio graphical follow up at 1, 3 and 6 months post-operatively. The HHS and KSS values before surgery showed a linear correlation with both SCL-90-R and MMSE. None of the investigated variables influenced post-operative HHS and KSS scores; however, the improvement of functional scores resulted conditioned by SCL-90-R values, VAS score, schooling and MMSE. Psychological factors and mental status in primary total hip and knee replacement can affect outcome and patient satisfaction. Strategies focused on identification and facing of these conditions must be considered to improve outcome of total replacement.

The tribology of metal-on-metal total hip replacements.

Science.gov (United States)

Scholes, S C; Unsworth, A

2006-02-01

Total hip surgery is an effective way of alleviating the pain and discomfort caused by diseased or damaged joints. However, in the majority of cases, these joints have a finite life. The main reason for failure is osteolysis (bone resorption). It is well documented that an important cause of osteolysis, and therefore the subsequent loosening and failure of conventional metal- or ceramic-on-ultra-high molecular weight polyethylene joints, is the body's immunological response to the polyethylene wear particles. To avoid this, interest has been renewed in metal-on-metal joints. The intention of this paper is to review the studies that have taken place within different laboratories to determine the tribological performance of new-generation metal-on-metal total hip replacements. These types of joint offer a potential solution to enhance the longevity of prosthetic hip systems; however, problems may arise owing to the effects of metal ion release, which are, as yet, not fully understood.

Do we need a gender-specific total knee replacement?

DEFF Research Database (Denmark)

Thomsen, M G; Husted, H; Bencke, J

2012-01-01

The purpose of this study was to investigate whether a gender-specific high-flexion posterior-stabilised (PS) total knee replacement (TKR) would offer advantages over a high-flex PS TKR regarding range of movement (ROM), 'feel' of the knee, pain and satisfaction, as well as during activity. A total......, satisfaction and daily 'feel' of each knee. Patients underwent gait analysis pre-operatively and at one year, which yielded kinematic, kinetic and temporospatial parameters indicative of knee function during gait. At final follow-up we found no statistically significant differences in ROM (p = 0.......82). The median pain score was 0 (0 to 8) in both groups (p = 0.95). The median satisfaction score was 9 (4 to 10) in the high-flex group and 8 (0 to 10) in the gender-specific group (p = 0.98). The median 'feel' score was 9 (3 to 10) in the high-flex group and 8 (0 to 10) in the gender-specific group (p = 0...

Replacement of cocoa butter with cocoa butter - like fat from modified palm oil in coating chocolate

Directory of Open Access Journals (Sweden)

Jitbunjerdkul, S.

2007-07-01

Full Text Available Chocolate is a confectionery product, mainly containing cocoa mass or liquor, cocoa butter (CB and sugar. Nowadays vegetable fats and modified oil are used instead of CB in chocolate products to lower the cost and to obtain the varieties of products with different characteristics and textures. Cocoa butter-like fat from modified palm oil (CBFMPO at different levels of CB replacement (60,80 and 100% were used to develop a formulation of coating chocolate. When physical and sensory properties were evaluated, the viscosity and coating ability on biscuit sticks were remarkedly decreased with increasing CBFMPO content. Hedonic mean scores of mouthfeel and coating ability of the chocolate containing 100% CBFMPO were greater than those of chocolate containing 60 and 80% CBFMPO (p<0.05. During storage of biscuit sticks dipped in the chocolate coating (chocolate containing 100% CBFMPO at room temperature (27-29oC and low temperature (20-22oC for 30 days, blooming (as shown by whiteness index occurred to a greater extent at higher temperature. At both storage temperatures, the intensity scores of glossiness and hedonic mean scores of overall liking of samples decreased but intensity scores of off-odor increased during the first 6 of days storage (p<0.05.

Partial Meal Replacement Plan and Quality of the Diet at 1 Year: Action for Health in Diabetes (Look AHEAD) Trial.

Science.gov (United States)

Raynor, Hollie A; Anderson, Andrea M; Miller, Gary D; Reeves, Rebecca; Delahanty, Linda M; Vitolins, Mara Z; Harper, Patricia; Mobley, Connie; Konersman, Kati; Mayer-Davis, Elizabeth

2015-05-01

Little is known about diet quality with a reduced-energy, low-fat, partial meal replacement plan, especially in individuals with type 2 diabetes. The Action for Health in Diabetes (Look AHEAD) trial implemented a partial meal replacement plan in the Intensive Lifestyle Intervention. To compare dietary intake and percent meeting fat-related and food group dietary recommendations in Intensive Lifestyle Intervention and Diabetes Support and Education groups at 12 months. A randomized controlled trial comparing Intensive Lifestyle Intervention with Diabetes Support and Education at 0 and 12 months. From 16 US sites, the first 50% of participants (aged 45 to 76 years, overweight or obese, with type 2 diabetes) were invited to complete dietary assessments. Complete 0- and 12-month dietary assessments (collected between 2001 and 2004) were available for 2,397 participants (46.6% of total participants), with 1,186 randomized to Diabetes Support and Education group and 1,211 randomized to Intensive Lifestyle Intervention group. A food frequency questionnaire assessed intake: energy; percent energy from protein, fat, carbohydrate, polyunsaturated fatty acids, and saturated fats; trans-fatty acids; cholesterol; fiber; weekly meal replacements; and daily servings from food groups from the Food Guide Pyramid. Mixed-factor analyses of covariance, using Proc MIXED with a repeated statement, with age, sex, race/ethnicity, education, and income controlled. Unadjusted χ² tests compared percent meeting fat-related and food group recommendations at 12 months. At 12 months, Intensive Lifestyle Intervention participants had a significantly lower fat and cholesterol intake and greater fiber intake than Diabetes Support and Education participants. Intensive Lifestyle Intervention participants consumed more servings per day of fruits; vegetables; and milk, yogurt, and cheese; and fewer servings per day of fats, oils, and sweets than Diabetes Support and Education participants. A greater

Do intra-articular hyaluronic acid injections delay total knee replacement in patients with osteoarthritis - A Cox model analysis.

Science.gov (United States)

Delbarre, Angélique; Amor, Bernard; Bardoulat, Isabelle; Tetafort, Aymeric; Pelletier-Fleury, Nathalie

2017-01-01

This study aimed to describe patients treated for knee osteoarthritis between 2006 and 2013 in France and to compare the delay from diagnosis to total knee replacement between patients who received intra-articular hyaluronic acid injections and those who did not receive the injections. A second objective was to compare direct medical costs for ambulatory care between treatment groups. Patients were selected from a representative sample of the real world administrative claims database using an algorithm developed by experts from the scientific committee of the study. Data were matched with the medico-administrative database for hospital care. A Cox proportional hazards model was stratified for the treatment group and adjusted for available socio-demographic and medical covariates to compare restricted mean survival times at different time points (1, 3, 5 and 7.5 years) between groups. Costs were expressed in 2013 euros. A total of 14,782 patients were treated for knee osteoarthritis (67% women; mean age = 68 years). Among this population, 1,662 patients had total knee replacement (11.2%). At each time point, restricted mean survival time without total knee replacement was significantly higher (p-valueshyaluronic acid group, from +51 to +217 days at 1 and 7.5 years, respectively. For the year preceding total knee replacement, the means for total direct medical costs were similar between groups, €744 vs €805 for treatment and control groups, respectively, (p-value = 0.104). Intra-articular injections accounted for less than 10% of the total costs. This is the first retrospective longitudinal study involving knee osteoarthritis patients using medico-administrative databases in France. The results support the effectiveness of hyaluronic acid injections in delaying total knee replacement and show that patients treated with hyaluronic acid have similar direct medical costs for ambulatory care compared to patients treated with corticosteroids only.

Effect of dietary lignocellulose on ileal and total tract digestibility of fat and fatty acids in broiler chickens.

Science.gov (United States)

Bogusławska-Tryk, M; Piotrowska, A; Szymeczko, R; Burlikowska, K

2016-12-01

The study was conducted to determine the effect of a lignocellulose supplemented diet on apparent ileal and total tract digestibility of fat and fatty acids (FA) in broiler chickens. A total of 48 21-day-old male Ross 308 chickens were divided into four treatment groups (n = 12) with six replicates per treatment. From 21 to 42 days of age, the broilers were fed experimental diets varied in the amount of lignocellulose: 0%, 0.25%, 0.5% and 1%. Total excreta were gathered during the last 3 days of the feeding trial and digesta was collected from the ileum at 42 days of the bird age. Digestibility was determined by the indicator method. The ether extract content in diet/digesta/excreta was determined by the gravimetric method, and fatty acid methyl esters were analysed by gas chromatography-mass spectrometry. Fat digestibility measured to the end of the small intestine and in the whole gastrointestinal tract in birds was high and exceeded 90% and 87% respectively. Addition of lignocellulose (1%) increased (p digestibility but had no significant effect on total tract fat digestion. Absorption of total fatty acids (TFA) as well as myristic (C14:0), palmitoleic (C16:1) and α-linolenic (C18:3n-3) acids, estimated by both methods, was significantly higher in birds fed the diets supplemented with lignocellulose, especially at a dose of 1%. Total tract absorption of some dietary polyunsaturated fatty acids (PUFA) (C20:2, C20:4n-6) was significantly lower from diet supplemented with 0.5% and 0.25% lignocellulose. There was observed a decrease in apparent digestibility of fat and most examined fatty acids, when measured between terminal ileum and total gastrointestinal tract. The results suggest that lignocellulose can affect digestion and FA absorption in broilers but, as the effect of lignocellulose was not studied previously, further investigations are necessary to confirm the results of the present experiment. Journal of Animal Physiology and Animal Nutrition © 2016

Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis.

Science.gov (United States)

2005-01-01

The objective of this health technology policy analysis was to determine, where, how, and when physiotherapy services are best delivered to optimize functional outcomes for patients after they undergo primary (first-time) total hip replacement or total knee replacement, and to determine the Ontario-specific economic impact of the best delivery strategy. The objectives of the systematic review were as follows: To determine the effectiveness of inpatient physiotherapy after discharge from an acute care hospital compared with outpatient physiotherapy delivered in either a clinic-based or home-based setting for primary total joint replacement patientsTo determine the effectiveness of outpatient physiotherapy delivered by a physiotherapist in either a clinic-based or home-based setting in addition to a home exercise program compared with a home exercise program alone for primary total joint replacement patientsTo determine the effectiveness of preoperative exercise for people who are scheduled to receive primary total knee or hip replacement surgery Total hip replacements and total knee replacements are among the most commonly performed surgical procedures in Ontario. Physiotherapy rehabilitation after first-time total hip or knee replacement surgery is accepted as the standard and essential treatment. The aim is to maximize a person's functionality and independence and minimize complications such as hip dislocation (for hip replacements), wound infection, deep vein thrombosis, and pulmonary embolism. THE THERAPY: The physiotherapy rehabilitation routine has 4 components: therapeutic exercise, transfer training, gait training, and instruction in the activities of daily living. Physiotherapy rehabilitation for people who have had total joint replacement surgery varies in where, how, and when it is delivered. In Ontario, after discharge from an acute care hospital, people who have had a primary total knee or hip replacement may receive inpatient or outpatient

The economics of using prophylactic antibiotic-loaded bone cement in total knee replacement.

Science.gov (United States)

Gutowski, C J; Zmistowski, B M; Clyde, C T; Parvizi, J

2014-01-01

The rate of peri-prosthetic infection following total joint replacement continues to rise, and attempts to curb this trend have included the use of antibiotic-loaded bone cement at the time of primary surgery. We have investigated the clinical- and cost-effectiveness of the use of antibiotic-loaded cement for primary total knee replacement (TKR) by comparing the rate of infection in 3048 TKRs performed without loaded cement over a three-year period versus the incidence of infection after 4830 TKRs performed with tobramycin-loaded cement over a later period of time of a similar duration. In order to adjust for confounding factors, the rate of infection in 3347 and 4702 uncemented total hip replacements (THR) performed during the same time periods, respectively, was also examined. There were no significant differences in the characteristics of the patients in the different cohorts. The absolute rate of infection increased when antibiotic-loaded cement was used in TKR. However, this rate of increase was less than the rate of increase in infection following uncemented THR during the same period. If the rise in the rate of infection observed in THR were extrapolated to the TKR cohort, 18 additional cases of infection would have been expected to occur in the cohort receiving antibiotic-loaded cement, compared with the number observed. Depending on the type of antibiotic-loaded cement that is used, its cost in all primary TKRs ranges between USD $2112.72 and USD $112 606.67 per case of infection that is prevented.

Effect of lime treatment of olive meal on in vitro utilization of total mixed ration containing olive meal as partial maize replacer

Directory of Open Access Journals (Sweden)

Ajmal Ashraf

Full Text Available Aim: Present study pertains to lime treatment of olive meal to improve its digestibility. The objective of the present study was to assess the in vitro dry matter degradability of total mixed ration containing lime treated olive meal at varied levels of maize replacement to know the optimum level of lime and treated olive meal as maize replacement in small ruminant diets. Materials and methods: Study was carried out in two phases. In phase I, A complete diet was formulated and treated with lime at variable concentrations (0-8% at 25% of maize replacement and subjected to in vitro studies as per Tilley and Terry. On the basis of the results of this phase, a concentration of lime for olive treatment was selected and tested at variable levels of maize replacement (0-50% by treated olive cake in phase II. Data was analyzed as per the procedures suggested by Snedecor and Cochran. Results: The in vitro dry matter digestibility (IVDMD of composite diet increased from 43.95% at 0% lime treatment to 48.68% on treating with 8% lime with significant (P<0.05 increase at 6% treatment level. Lime treatment beyond 6% had no further significant effect on improving the digestibility. Graded levels of maize replacement by olive meal treated with 6% lime (lime percentage selected from phase I showed that the in vitro digestibility of mixed ration was not compromised up to 40% replacement level of maize by treated olive meal. Improved digestibility with lime treatment may be due to weakening of internal Hydrogen bonding, thereby disrupting the fiber structure in olive meal. Further lime may be saponifying the high level of fat present in olive meal, which may otherwise negatively impact the digestibility values. Conclusion: It can be concluded that the treatment with up to 6% of lime can effectively increase the digestibility of olive meal. Treated olive meal can replace up to 40% of maize from daily ration without affecting the digestibility of composite ration

Posterior Slope of the Tibia Plateau in Malaysian Patients Undergoing Total Knee Replacement

Directory of Open Access Journals (Sweden)

R Yoga

2009-05-01

Full Text Available The posterior slope of the tibial plateau is an important feature to preserve during knee replacement. The correct slope aids in the amount of flexion and determines if the knee will be loose on flexion. This is a study on the posterior tibial plateau slope based on preoperative and postoperative radiographs of 100 consecutive patients who had total knee replacements. The average posterior slope of the tibia plateau was 10.1 degrees. There is a tendency for patients with higher pre-operative posterior tibial plateau slope to have higher post-operative posterior tibial plate slope.

Flowtron foot-pumps for prevention of venous thromboembolism in total hip and knee replacement.

Science.gov (United States)

Pitto, Rocco P; Koh, Chuan K

2015-03-01

Mechanical prophylaxis with foot-pumps provides an interesting alternative to chemical agents in the prevention of venous thomboembolism following major orthopaedic surgery procedures. The aim of this prospective study was to assess efficacy and safety of the Flowtron(®) foot-pumps system following total hip and knee replacement. The foot pumps were used as main tool for prevention of thromboembolic events, in most cases in association with a variety of chemicals. The primary endpoint of the study was to assess the incidence of deep vein thrombosis and pulmonary embolism after total hip and knee replacement. The secondary endpoints included postoperative bleeding, swelling, bruising and wound ooze. 424 consecutive patients were included in the study. Symptomatic deep vein thrombosis was detected in 7 patients (1.6%). All symptomatic deep vein thromboses were detected after discharge before the six week follow-up clinic. Five non-fatal pulmonary embolisms occurred (1.2%). Only one patient presented a major wound bleeding (0.2%). The mean difference of swelling of thigh pre-versus postoperatively was only 22.8 mm. In conclusion, thromboembolism prophylaxis after total hip and knee replacement using Flowtron(®) foot-pumps as main prevention tool of an individualised protocol appears effective and safe. This is the first clinical report related to this popular brand of foot pumps.

Hemiarch versus total aortic arch replacement in acute type A dissection: a systematic review and meta-analysis.

Science.gov (United States)

Poon, Shi Sum; Theologou, Thomas; Harrington, Deborah; Kuduvalli, Manoj; Oo, Aung; Field, Mark

2016-05-01

Despite recent advances in aortic surgery, acute type A aortic dissection remains a surgical emergency associated with high mortality and morbidity. Appropriate management is crucial to achieve satisfactory outcomes but the optimal surgical approach is controversial. The present systematic review and meta-analysis sought to access cumulative data from comparative studies between hemiarch and total aortic arch replacement in patients with acute type A aortic dissection. A systematic review of the literature using six databases. Eligible studies include comparative studies on hemiarch versus total arch replacement reporting short, medium and long term outcomes. A meta-analysis was performed on eligible studies reporting outcome of interest to quantify the effects of hemiarch replacement on mortality and morbidity risk compared to total arch replacement. Fourteen retrospective studies met the inclusion criteria and 2,221 patients were included in the final analysis. Pooled analysis showed that hemiarch replacement was associated with a lower risk of post-operative renal dialysis [risk ratio (RR) =0.72; 95% confidence interval (CI): 0.56-0.94; P=0.02; I(2)=0%]. There was no significant difference in terms of in-hospital mortality between the two groups (RR =0.84; 95% CI: 0.65-1.09; P=0.20; I(2)=0%). Cardiopulmonary bypass, aortic cross clamp and circulatory arrest times were significantly longer in total arch replacement. During follow up, no significant difference was reported from current studies between the two operative approaches in terms of aortic re-intervention and freedom from aortic reoperation. Within the context of publication bias by high volume aortic centres and non-randomized data sets, there was no difference in mortality outcomes between the two groups. This analysis serves to demonstrate that for those centers doing sufficient total aortic arch activity to allow for publication, excellent and equivalent outcomes are achievable. Conclusions on

Evaluation of two milk replacers fed to hand-reared cheetah cubs (Acinonyx jubatus): nutrient composition, apparent total tract digestibility, and comparison to maternal cheetah milk.

Science.gov (United States)

Bell, Katherine M; Rutherfurd, Shane M; Cottam, Yvette H; Hendriks, Wouter H

2011-01-01

Commercially prepared milk replacers are frequently used to provide the sole source of nutrition for hand-reared cheetah cubs (Acinonyx jubatus). The nutrient composition of two commonly used milk replacers was determined. Using titanium dioxide as an indigestible marker, nutrient digestibility was calculated from the analyses of fecal samples collected from each cub (n = 4 on formula 1, and n = 2 on formula 2). Mean apparent total tract digestibility for both formulas was >90% for all nutrients analyzed (crude protein, amino acids, crude fat (CF), and dry matter). However, the total CF content and the concentration of the essential fatty acids, such as α-linolenic, linolenic, and arachidonic acid, of both formulas was lower than reported for maternal cheetah milk. Additionally, one formula contained a comparatively high amount of carbohydrate, at the expense of protein. Although data were lacking for cheetah maternal milk, comparison with domestic cat milk revealed high concentrations of a number of minerals (K, Fe, Zn, and Cu), while vitamin D(3) was not detected in one formula. Both formulas were low in the majority of essential amino acids compared with domestic cat maternal milk. Despite their apparently high digestibility, neither formula was complete or balanced in terms of nutrient concentrations and ratios when maternal cheetah milk and/or the requirements established for growth in domestic cats were used as estimates of ideal. On this basis, although all cubs in this study were healthy and maintained good body conditions for the duration of the trial, the results of dietary analyses indicate that these milk replacers may not provide optimal nutrition for growth in cheetah cubs when used for extended periods. © 2010 Wiley-Liss, Inc.

Mangaba (Hancornia speciosa Gomez ice cream prepared with fat replacers and sugar substitutes Sorvete de mangaba (Hancornia speciosa Gomez preparado com substitutos de gordura e açúcar

Directory of Open Access Journals (Sweden)

Grazielle Gebrim Santos

2012-09-01

Full Text Available The effect of replacing shortening and sugar on the physical and chemical properties of mangaba ice cream and its acceptability were evaluated. Ice cream formulations were tested with the following fat replacers: Selecta Light, Litesse, and Dairy Lo and the following sugar substitutes: Lactitol and Splenda. All formulations were subjected to physical, chemical, and microbiological analyses and evaluated by acceptability tests. In the sensory analysis, it was observed a larger acceptance of the formulations containing Selecta Light (SL and the combination of Litesse, Lactiol, and Splenda (LLS. The largest reduction in total energetic value (50% was observed in the formulation LLS. The use of fat and/or sugar substitutes caused a reduction in the air incorporation (overrun and affected viscosity. The highest melting speed was observed in the formulation with Dairy-Lo, Lactitol, and Splenda. All formulations showed good levels of global acceptability and appearance. The substitution of shortening for fat replacers caused a reduction in air incorporation and changes in ice-cream viscosity. The low-fat mangaba ice-cream elaborated with Selecta Light was the best formulation in terms of viscosity and air incorporation when compared with the control. It also showed a good level of acceptability and low fat content.O efeito da substituição de gordura vegetal hidrogenada e sacarose nas propriedades físicas, químicas e aceitabilidade de sorvete com mangaba foi avaliado. As formulações de sorvete foram testadas com os substitutos de gordura: Selecta Light, Litesse e Dairy-Lo e os substitutos de sacarose: Lactitol e Splenda. As formulações foram submetidas às análises físicas, químicas, microbiológicas e teste de aceitação. Verificou-se no teste sensorial uma maior aceitação das formulações elaboradas com Selecta Light (SL e combinação de Litesse, Lactitol e Splenda (LLS. A maior redução do valor energético (50% foi observada na

Characteristic of sausages as influenced by partial replacement of pork back-fat using pre-emulsified soybean oil stabilized by fish proteins isolate

Directory of Open Access Journals (Sweden)

Nopparat Cheetangdee

2017-08-01

Full Text Available Substitution of animal fat with oils rich in n-3 is a feasible way to improve the nutritive value of comminuted meat product. The effect on the characteristics of sausages was investigated of partial replacement of porcine fat with soybean oil (SBO using a pre-emulsification technique. Fish protein isolate (FPI produced from yellow stripe trevally (Selaroides leptolepis was used as an emulsifier to prepare pre-emulsified SBO (preSBO, and its concentration effect (1%, 2% and 3%, w/v was observed in comparison with soy protein isolate (SPI. Substitution of porcine fat using preSBO enhanced the product stability. SPI exhibited better emulsifying ability than FPI. However, FPI was more effective at reinforcing the protein matrix of the sausages than SPI, as suggested by a lowered cooking loss and the restored textural attributes of the sausages formulated with FPI stabilized preSBO. The effective concentration of FPI to improve the product stability was 2%. This work suggested that FPI was promising in the preparation of emulsified meat products.

Scientific Opinion on the essential composition of total diet replacements for weight control

DEFF Research Database (Denmark)

Tetens, Inge

2015-01-01

or authoritative bodies. Derived from the minimum content of macronutrients, the Panel proposed a minimum energy content of total diet replacements for weight control of 2 510 kJ/day (600 kcal/day). The Panel also advised on potential conditions and restrictions of use for these products....

The Association of Serum Total Peptide YY (PYY) with Obesity and Body Fat Measures in the CODING Study.

Science.gov (United States)

Cahill, Farrell; Ji, Yunqi; Wadden, Danny; Amini, Peyvand; Randell, Edward; Vasdev, Sudesh; Gulliver, Wayne; Sun, Guang

2014-01-01

PYY is an appetite suppressing hormone. Low circulating PYY has been linked to greater BMI. However data is controversial and this association has not been verified in large human populations. The purpose of this study was to investigate if fasting serum total PYY is associated with obesity status and/or adiposity at the population level. A total of 2094 subjects (Male-523, Female-1571) participated in this investigation. Total PYY was measured in fasting serum by enzyme-linked immunosorbent assay. Obesity status (NW-normal-weight, OW-overweight and OB-obese) was determined by the Bray Criteria according to body fat percentage measured by dual-energy x-ray absorptiometry and the WHO criteria according to BMI. One-way ANOVA and multiple regression was used to assess the adiposity-specific association between PYY and the following; weight, BMI, waist-circumference, hip-circumference, waist-hip ratio, percent body fat (%BF), trunk fat (%TF), android fat (%AF) and gynoid fat (%GF). PYY was not significantly different among NW, OW and OB groups defined by neither %BF nor BMI for both men and women. However among women, fasting PYY was positively associated with adiposity measures. Women with the highest (Top 33%) waist-circumference, %BF and %TF had significantly higher PYY (10.5%, 8.3% and 9.2% respectively) than women with the lowest (Bottom 33%). Age, smoking, medication use and menopause were all positively associated with PYY levels in women but not in men. To our knowledge this is the largest population based study, with the most comprehensive analysis and measures of confounding factors, to explore the relationship of circulating PYY with obesity. Contrary to initial findings in the literature we discovered that PYY was positively associated with body fat measures (waist-circumference, %BF and %TF) in women. Although the effect size of the positive association of PYY with obesity in women is small, and potentially negligible, it may in fact represent a protective

Flow-mediated vasodilation is not impaired when HDL-cholesterol is lowered by substituting carbohydrates for monounsaturated fat

NARCIS (Netherlands)

de Roos, NM; Bots, ML; Siebelink, E; Katan, MB

Low-fat diets, in which carbohydrates replace some of the fat, decrease serum cholesterol. This decrease is due to decreases in LDL-cholesterol but in part to possibly harmful decreases in HDL-cholesterol. High-oil diets, in which oils rich in monounsaturated fat replace some of the saturated fat,

Dietary fats and prevention of type 2 diabetes.

Science.gov (United States)

Risérus, Ulf; Willett, Walter C; Hu, Frank B

2009-01-01

Although type 2 diabetes is determined primarily by lifestyle and genes, dietary composition may affect both its development and complications. Dietary fat is of particular interest because fatty acids influence glucose metabolism by altering cell membrane function, enzyme activity, insulin signaling, and gene expression. This paper focuses on the prevention of type 2 diabetes and summarizes the epidemiologic literature on associations between types of dietary fat and diabetes risk. It also summarizes controlled feeding studies on the effects of dietary fats on metabolic mediators, such as insulin resistance. Taken together, the evidence suggests that replacing saturated fats and trans fatty acids with unsaturated (polyunsaturated and/or monounsaturated) fats has beneficial effects on insulin sensitivity and is likely to reduce risk of type 2 diabetes. Among polyunsaturated fats, linoleic acid from the n-6 series improves insulin sensitivity. On the other hand, long-chain n-3 fatty acids do not appear to improve insulin sensitivity or glucose metabolism. In dietary practice, foods rich in vegetable oils, including non-hydrogenated margarines, nuts, and seeds, should replace foods rich in saturated fats from meats and fat-rich dairy products. Consumption of partially hydrogenated fats should be minimized. Additional controlled, long-term studies are needed to improve our knowledge on the optimal proportion of different types of fats to prevent diabetes.

Clinical Outcomes of Dietary Replacement of Saturated Fatty Acids with Unsaturated Fat Sources in Adults with Overweight and Obesity: A Systematic Review and Meta-Analysis of Randomized Control Trials.

Science.gov (United States)

Hannon, Bridget A; Thompson, Sharon V; An, Ruopeng; Teran-Garcia, Margarita

2017-01-01

Obesity and dyslipidemia are frequently treated with dietary interventions before pharmacotherapy is given. Diets high in unsaturated fat have proven advantageous to disease treatment. The purpose of this systematic review and meta-analysis was to assess the evidence of the effect of saturated fatty acids (SFA) replacement with unsaturated fatty acids (UFA) in metabolically healthy adults with overweight and obesity on markers of dyslipidemia and body composition. Keyword search was performed in PubMed, CINAHL, and Cochrane Library for randomized controlled trials (RCTs) evaluating the effects of fatty acid substitution in adults with overweight and obesity. Meta-analysis was performed on interventions assessing lipoprotein levels and body composition. Publication bias was assessed by funnel plot inspection, Begg's, and Egger's test. Eight RCTs enrolling 663 participants were included in the review, with intervention durations between 4 and 28 weeks. Although nonsignificant (p = 0.06), meta-analysis found UFA replacement to reduce total cholesterol concentrations by 10.68 mg/dL (95%CI -21.90 to 0.53). Reductions in low-density lipoprotein cholesterol and triglycerides were statistically nonsignificant. Due to null results and a small number of studies included, there is no strong evidence that replacement of SFA with UFA may benefit lipid profiles in this population. © 2017 S. Karger AG, Basel.

Effects of fat supplementations on milk production and composition, ruminal and plasma parameters of dairy cows

Directory of Open Access Journals (Sweden)

L. Bailoni

2010-04-01

Full Text Available The effects on milk yield and quality caused by the same amount (325 g/d/cow of lipids provided by 3 different fat sources (hydrogenate palm fat, HF; calcium salt palm fat, CaSF; full-fat toasted soybean, TS, top dressed to a common total mixed ration, were investigated. Supplementations did not affect feed intake and milk yield, but markedly changed the acidic profile of milk fat. CaSF and TS significantly increased the proportions of unsaturated fatty acids of milk fat with respect to control and to HF. The 3 fat sources did not affect the concentrations of ammonia and VFA of rumen fluid. TS only slightly increased (P<0.10 plasma urea content because of a higher dietary protein supply, with respect to the other treatments. The use of a low amount of toasted and cracked full fat soybean seem to be interesting to increase the energy concentration of diets in replacement to commercial fat products and it can be use to modify the milk fat quality increasing the fraction with benefit effects on human health.

Total homocysteine is positively correlated with body mass index, waist-to-hip ratio, and fat mass among overweight reproductive women: A cross-sectional study.

Science.gov (United States)

Al-Bayyari, Nahla; Hamadneh, Jehan; Hailat, Rae'd; Hamadneh, Shereen

2017-12-01

Conflicting associations between total homocysteine (tHcy), body mass index (BMI) lean body mass, and fat mass in the general population have been reported. We investigated the hypothesis that elevated tHcy levels are associated with increased BMI, waist-to-hip ratio (WHR), and body fat mass percent. In Jordan, obesity and overweight are prevalent among reproductive women and hyperhomocysteinemia, along with obesity and overweight, are independent risk factors for cardiovascular diseases. The participants used in this cross-sectional study were 325 overweight Jordanian women aged between 18 and 49 years old. The main outcome measures were tHcy, BMI, WHR, fat mass, fat-free mass, and total body water. Serum tHcy was analyzed using a liquid chromatography tandem mass spectrophotometry (LC-MS/MS) complete kit. The body compositions were measured using a bioelectrical impedance analyzer. Study participants were stratified according to their tHcy level into two groups, ≤10 μmol/L and >10 μmol/L, and the difference between mean values of body compositions was evaluated. The tHcy was significantly and negatively correlated with age, fat-free mass, and total body water, and significantly and positively correlated with BMI, hip circumference, WHR, fat mass, and dry lean weight. The chi-square and the independent sample t-tests showed statistically significant (P ≤ .05) differences between tHcy and BMI, WHR, fat and fat-free mass, and total body water percentages. In conclusion, BMI, WHR and body fat mass were found to be associated with elevated tHcy levels among overweight reproductive women, and they might be used as independent predictors of the tHcy level. Copyright © 2017 Elsevier Inc. All rights reserved.

Survival of Lactobacillus acidophilus and Bacillus coagulans in probiotic and low-fat synbiotic ice-creams

Directory of Open Access Journals (Sweden)

M Hashemi

2013-11-01

Full Text Available In this study, survival of Lactobacillus acidophilus and Bacillus coagulans after freezing and during 90 days of storage at -18○C in probiotic and low-fat synbiotic ice-cream was evaluated. Addition to a control group (which was ordinary ice-cream, two probiotic ice-creams were formulated using L. acidophilus and B. coagulans and two synbiotic ice-creams were prepared using the aforementioned microorganisms but replacing 5% of milk-fat with inulin. The total solids of the ice-cream mixes did not differ significantly, however there was a significant difference (p

Catastrophizing and Depressive Symptoms as Prospective Predictors of Outcomes Following Total Knee Replacement

Directory of Open Access Journals (Sweden)

Robert R Edwards

2009-01-01

Full Text Available Several recent reports suggest that pain-related catastrophizing is a risk factor for poor acute pain outcomes following surgical interventions. However, it has been less clear whether levels of catastrophizing influence longer-term postoperative outcomes. Data were analyzed from a relatively small number (n=43 of patients who underwent total knee replacement and were followed for 12 months after their surgery. Previous research has suggested that high levels of both catastrophizing and depression are associated with elevated acute postoperative pain complaints among patients undergoing knee surgery. In this sample, catastrophizing and depression at each of the assessment points were studied as prospective predictors of pain (both global pain ratings and pain at night at the subsequent assessment point over the course of one year. The predictive patterns differed somewhat across measures of pain reporting; depressive symptoms were unique predictors of greater global pain complaints, while catastrophizing was a specific and unique predictor of elevated nighttime pain. While surgical outcomes following total knee replacement are, on average, quite good, a significant minority of patients continue to experience long-term pain. The present findings suggest that high levels of catastrophizing and depression may promote enhanced pain levels, indicating that interventions designed to reduce catastrophizing and depressive symptoms may have the potential to further improve joint replacement outcomes.

Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss.

Science.gov (United States)

Volquind, Daniel; Zardo, Remi Antônio; Winkler, Bruno Costamilan; Londero, Bruno Bertagnolli; Zanelatto, Natália; Leichtweis, Gisele Perondi

2016-01-01

The use of tranexamic acid in primary total knee replacement surgeries has been the subject of constant study. The strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In this study we evaluated the use of tranexamic acid in reducing bleeding, need for blood transfusion, and prevalence of postoperative deep vein thrombosis in primary total knee replacement. 62 patients undergoing primary total knee replacement were enrolled in the study, from June 2012 to May 2013, and randomized to receive a single dose of 2.5g of intravenous tranexamic acid (Group TA) or saline (Group GP), 5min before opening the pneumatic tourniquet, respectively. Hemoglobin, hematocrit, and blood loss were recorded 24h after surgery. Deep vein thrombosis was investigated during patient's hospitalization and 15 and 30 days after surgery in review visits. There was no demographic difference between groups. Group TA had 13.89% decreased hematocrit (p=0.925) compared to placebo. Group TA had a decrease of 12.28% (p=0.898) in hemoglobin compared to Group GP. Group TA had a mean decrease of 187.35mL in blood loss (25.32%) compared to group GP (p=0.027). The number of blood transfusions was higher in Group GP (p=0.078). Thromboembolic events were not seen in this study. Tranexamic acid reduced postoperative bleeding without promoting thromboembolic events. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Acute normovolaemic haemodilution decreases postoperative allogeneic blood transfusion after total knee replacement.

Science.gov (United States)

Olsfanger, D; Fredman, B; Goldstein, B; Shapiro, A; Jedeikin, R

1997-09-01

We hypothesized that the success of postoperative blood conservation after acute normovolaemic haemodilution (NVHD) is influenced by the extent of intraoperative bleeding and surgical trauma, and the timing of autologous blood transfusion. As total knee replacement is associated with minimal intraoperative but extensive postoperative blood loss, this procedure is ideally suited to acute NVHD. Therefore, to test our hypothesis, 30 patients undergoing elective total knee replacement were enrolled in a prospective, randomized, controlled study. In groups NVHD-2 and NVHD-6, before induction of anaesthesia patients were bled to a target packed cell volume (PCV) of 28-30%, and in the post-anaesthesia care unit autologous blood was transfused over a 2-h period terminating after operation at 2 and 6 h, respectively. In the control group, NVHD was not performed. After operation, platelets, fibrinogen, prothrombin and partial thromboplastin time, and liver function, urea and electrolytes were measured and compared with preoperative baseline values. Significantly (P conservation strategy. However, there was no difference in allogeneic blood administration between the two NVHD groups. Coagulation and liver function, and urea and electrolyte concentrations were unaffected by treatment.

Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials.

Science.gov (United States)

Beswick, Andrew D; Wylde, Vikki; Gooberman-Hill, Rachael

2015-05-12

Total knee replacement can be a successful operation for pain relief. However, 10-34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. We conducted a systematic review of randomised controlled trials using appropriate search strategies in the Cochrane Library, MEDLINE and EMBASE from inception to October 2014. No language restrictions were applied. Adult patients receiving total knee replacement. Predictive models to guide treatment for prevention of chronic pain. Interventions for management of chronic pain. Reporting of specific outcomes was not an eligibility criterion but we sought outcomes relating to pain severity. No studies evaluated the effectiveness of predictive models in guiding treatment and improving outcomes after total knee replacement. One study evaluated an intervention for the management of chronic pain. The trial evaluated the use of a botulinum toxin A injection with antinociceptive and anticholinergic activity in 49 patients with chronic postsurgical pain after knee replacement. A single injection provided meaningful pain relief for about 40 days and the authors acknowledged the need for a large trial with repeated injections. No trials of multidisciplinary interventions or individualised treatments were identified. Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome.

Science.gov (United States)

Moran, Lisa J; Noakes, Manny; Clifton, Peter M; Wittert, Gary A; Williams, Gemma; Norman, Robert J

2006-07-01

Polycystic ovary syndrome (PCOS), a common condition in women, improves with weight loss. Meal replacements in short-term weight loss and strategies for weight maintenance have not been investigated in PCOS. We compared in overweight women with PCOS the effects of meal replacements in short-term weight-loss and longer-term carbohydrate- or fat-restriction strategies on weight maintenance and improvements in reproductive and metabolic variables. Overweight women with PCOS (n = 43; x +/- SD age: 32.1 +/- 5.2 y; weight: 96.1 +/- 18.4 kg) followed an 8-wk weight-loss regimen (2 meal replacements/d, 4904.4 +/- 127 kJ; phase 1) and then a 6-mo weight-maintenance carbohydrate- (weight (5.6 +/- 2.4 kg), waist circumference (6.1 +/- 2.5 cm), body fat (4.1 +/- 2.2 kg), insulin (2.8 +/- 1.1 mU/L), total testosterone (0.3 +/- 0.7 nmol/L), and free androgen index (3.1 +/- 4.6) occurred; these changes were sustained during phase 2. No significant differences between diet groups were seen for any variables. At 6 mo, both approaches resulted in a net weight loss of 4.7 +/- 4.6 kg. Improvements in menstrual cyclicity occurred for 16 (57.1%) of 28 subjects. Meal replacements are an effective strategy for the short-term management of PCOS. Advice on moderate fat or carbohydrate restriction was equally effective in maintaining weight reduction and improving reproductive and metabolic variables.

Replacement of Pork Meat with Pork Head Meat for Frankfurters

Science.gov (United States)

Choi, Yun-Sang; Hwang, Ko-Eun; Kim, Hyun-Wook; Song, Dong-Heon; Jeon, Ki-Hong; Park, Jong-Dae; Sung, Jung-Min; Kim, Young-Boong; Kim, Cheon-Jei

2016-01-01

The effect of reducing pork meat concentrations from 50% to 30% and replacing it with up to 20% pork head meat on chemical composition, cooking characteristics, physicochemical and textural properties, apparent viscosity, and sensory characteristics of frankfurters was determined. The highest moisture content in frankfurters was found in the control and T1 (frankfurter with 45% pork meat + 5% pork head). Protein and fat contents in frankfurters with pork head meat added were significantly (ppork head meat was increased from 0% to 20%, cooking loss, total expressible fluid separation, fat separation, and pH of frankfurters were increased, while the lightness, redness, yellowness, and apparent viscosity of frankfurters were decreased. Ash contents, cohesiveness, color, and tenderness of sensory characteristics of frankfurters added with different amounts of pork meat or pork head meat were not significantly (p>0.05) different from those of the control or there treatments. Frankfurters in T4 (frankfurter with 30% pork meat + 20% pork head) had the lowest (p0.05) from that in the control. Frankfurters with higher pork head meat concentrations had lower flavor, juiciness, and overall acceptability scores. Therefore, replacing pork meat with pork head meat in the formulation could successfully produce results similar to those of control frankfurters. The best results were obtained when 10% pork head meat was used to replace pork meat. PMID:27621683

Reduced or modified dietary fat for preventing cardiovascular disease

Directory of Open Access Journals (Sweden)

Lee Hooper

changes on total mortality (RR 0.98, 95% CI 0.93 to 1.04, 71,790 participants or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants. This did not alter with sub-grouping or sensitivity analysis. Few studies compared reduced with modified fat diets, so direct comparison was not possible. AUTHORS' CONCLUSIONS: The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear.

Reduced or modified dietary fat for preventing cardiovascular disease

Science.gov (United States)

Hooper, Lee; Summerbell, Carolyn D; Thompson, Rachel; Sills, Deirdre; Roberts, Felicia G; Moore, Helen; Smith, George Davey

2014-01-01

.98, 95% CI 0.93 to 1.04, 71,790 participants) or cardiovascular mortality (RR 0.94, 95% CI 0.85 to 1.04, 65,978 participants). This did not alter with sub-grouping or sensitivity analysis. Few studies compared reduced with modified fat diets, so direct comparison was not possible. Authors’ conclusions The findings are suggestive of a small but potentially important reduction in cardiovascular risk on modification of dietary fat, but not reduction of total fat, in longer trials. Lifestyle advice to all those at risk of cardiovascular disease and to lower risk population groups, should continue to include permanent reduction of dietary saturated fat and partial replacement by unsaturates. The ideal type of unsaturated fat is unclear. PMID:21735388

The relationships among total body fat, bone mineral content and bone marrow adipose tissue in early-pubertal girls

OpenAIRE

L Newton, Anna; J Hanks, Lynae; Davis, Michelle; Casazza, Krista

2013-01-01

Investigation of the physiologic relevance of bone marrow adipose tissue (BMAT) during growth may promote understanding of the bone-fat axis and confluence with metabolic factors. The objective of this pilot investigation was two-fold: (1) to evaluate the relationships among total body fat, bone mineral content (BMC) and femoral BMAT during childhood and underlying metabolic determinants and (2) to determine if the relationships differ by race. Participants included white and non-Hispanic bla...

Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review

Science.gov (United States)

Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

2015-03-01

The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.

Fetal and infant growth patterns associated with total and abdominal fat distribution in school-age children

NARCIS (Netherlands)

Gishti, O.; Gaillard, R.; Manniesing, R.; Abrahamse-Berkeveld, M.; Beek, E.M. van der; Heppe, D.H.M.; Steegers, E.A.P.; Hofman, A.; Duijts, L.; Durmus, B.u.; Jaddoe, V.W.

2014-01-01

Context: Higher infant growth rates are associated with an increased risk of obesity in later life. Objective: We examined the associations of longitudinally measured fetal and infant growth patterns with total and abdominal fat distribution in childhood. Design, Settings and participants:We

Characterization and tribology of PEG-like coatings on UHMWPE for total hip replacements.

Science.gov (United States)

Kane, Sheryl R; Ashby, Paul D; Pruitt, Lisa A

2010-03-15

A crosslinked hydrogel coating similar to poly(ethylene glycol) (PEG) was covalently bonded to the surface of ultrahigh molecular weight polyethylene (UHMWPE) to improve the lubricity and wear resistance of the UHWMPE for use in total joint replacements. The chemistry, hydrophilicity, and protein adsorption resistance of the coatings were determined, and the wear behavior of the PEG-like coating was examined by two methods: pin-on-disk tribometry to evaluate macroscale behavior, and atomic force microscopy (AFM) to simulate asperity wear. As expected, the coating was found to be highly PEG-like, with approximately 83% ether content by x-ray photoelectron spectroscopy and more hydrophilic and resistant to protein adsorption than uncoated UHMWPE. Pin-on-disk testing showed that the PEG-like coating could survive 3 MPa of contact pressure, comparable to that experienced by total hip replacements. AFM nanoscratching experiments uncovered three damage mechanisms for the coatings: adhesion/microfracture, pure adhesion, and delamination. The latter two mechanisms appear to correlate well with wear patterns induced by pin-on-disk testing and evaluated by attenuated total reflection Fourier transform infrared spectroscopy mapping. Understanding the mechanisms by which the PEG-like coatings wear is critical for improving the behavior of subsequent generations of wear-resistant hydrogel coatings. (c) 2009 Wiley Periodicals, Inc.

Ankle replacement

Science.gov (United States)

Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... Ankle replacement surgery is most often done while you are under general anesthesia. This means you will ...

In Vivo Wear Performance of Cobalt-Chromium Versus Oxidized Zirconium Femoral Total Knee Replacements.

Science.gov (United States)

Gascoyne, Trevor C; Teeter, Matthew G; Guenther, Leah E; Burnell, Colin D; Bohm, Eric R; Naudie, Douglas R

2016-01-01

This study examines the damage and wear on the polyethylene (PE) inserts from 52 retrieved Genesis II total knee replacements to identify differences in tribological performance between matched pairs of cobalt-chromium (CoCr) and oxidized zirconium (OxZr) femoral components. Observer damage scoring and microcomputed tomography were used to quantify PE damage and wear, respectively. No significant differences were found between CoCr and OxZr groups in terms of PE insert damage, surface penetration, or wear. No severe damage such as cracking or delamination was noted on any of the 52 PE inserts. Observer damage scoring did not correlate with penetrative or volumetric PE wear. The more costly OxZr femoral component does not demonstrate clear tribological benefit over the standard CoCr component in the short term with this total knee replacement design. Copyright © 2016 Elsevier Inc. All rights reserved.

A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing.

Science.gov (United States)

van Jonbergen, H P W; Scholtes, V A B; van Kampen, A; Poolman, R W

2011-08-01

The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in total knee replacement in the absence of patellar resurfacing. Patients requiring knee replacement for primary osteoarthritis were randomly assigned circumpatellar electrocautery (intervention group) or no electrocautery (control group). The primary outcome measure was the incidence of anterior knee pain. A secondary measure was the standardised clinical and patient-reported outcomes determined by the American Knee Society scores and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. A total of 131 knees received circumpatellar electrocautery and 131 had no electrocautery. The overall incidence of anterior knee pain at follow-up at one year was 26% (20% to 31%), with 19% (12% to 26%) in the intervention group and 32% (24% to 40%) in the control group (p = 0.02). The relative risk reduction from electrocautery was 40% (9% to 61%) and the number needed to treat was 7.7 (4.3 to 41.4). The intervention group had a better mean total WOMAC score at follow-up at one year compared with the control group (16.3 (0 to 77.7) versus 21.6 (0 to 76.7), p = 0.04). The mean post-operative American Knee Society knee scores and function scores were similar in the intervention and control groups (knee score: 92.4 (55 to 100) versus 90.4 (51 to 100), respectively (p = 0.14); function score: 86.5 (15 to 100) versus 84.5 (30 to 100), respectively (p = 0.49)). Our study suggests that in the absence of patellar resurfacing electrocautery around the margin of the patella improves the outcome of total knee replacement.

Dietary fat, fat subtypes and hepatocellular carcinoma in a large European cohort

NARCIS (Netherlands)

Duarte-Salles, Talita; Fedirko, Veronika; Stepien, Magdalena; Aleksandrova, Krasimira; Bamia, Christina; Lagiou, Pagona; Laursen, Anne Sofie Dam; Hansen, Louise; Overvad, Kim; Tjønneland, Anne; Boutron-Ruault, Marie Christine; Fagherazzi, Guy; His, Mathilde; Boeing, Heiner; Katzke, Verena; Kühn, Tilman; Trichopoulou, Antonia; Valanou, Elissavet; Kritikou, Maria; Masala, Giovanna; Panico, Salvatore; Sieri, Sabina; Ricceri, Fulvio; Tumino, Rosario; Bueno-De-Mesquita, H. B.; Peeters, Petra H.; Skeie, Guri; Weiderpass, Elisabete; Ardanaz, Eva; Bonet, Catalina; Chirlaque, Maria Dolores; Dorronsoro, Miren; Quirõs, J. Ramõn; Johansson, Ingegerd; Ohlsson, Bodil; Sjöberg, Klas; Wennberg, Maria; Khaw, Kay Tee; Travis, Ruth C.; Wareham, Nick; Ferrari, Pietro; Freisling, Heinz; Romieu, Isabelle; Cross, Amanda J.; Gunter, Marc; Lu, Yunxia; Jenab, Mazda

2015-01-01

The role of amount and type of dietary fat consumption in the etiology of hepatocellular carcinoma (HCC) is poorly understood, despite suggestive biological plausibility. The associations of total fat, fat subtypes and fat sources with HCC incidence were investigated in the European Prospective

Late results of total shoulder replacement in patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Søjbjerg, J.O.; Frich, Lars Henrik; Johannsen, H.V.

1999-01-01

at the authors' institution. Total shoulder replacement yields satisfactory short and long term results even in patients with severely destructed joints. Pain relief is reliable and significant as reported in short and long term studies. In most patients the functional result is good or acceptable. Although...... range of motion is only slightly increased, a satisfactory overall range of motion is achieved by most patients because of the unaffected scapulothoracic motion. However, deteriorating results, emphasizing the complexity of shoulder arthroplasty, were seen with increasing observation time in patients...

Embolization of Spontaneous Hemarthrosis Post Total Knee Replacement

International Nuclear Information System (INIS)

Given, M. F.; Smith, P.; Lyon, S. M.; Robertson, D.; Thomson, K. R.

2008-01-01

Spontaneous nonhemophiliac hemarthrosis is an unusual entity, which has been little described. We present three cases of spontaneous recurrent hemarthrosis post total knee replacement (TKR) and successful management with embolization. Three male patients were referred to our service for angiography and treatment of recurrent hemarthrosis post TKR. In all three patients antegrade ipsilateral common femoral artery punctures and selective angiography of the geniculate branches were performed with a microcatheter. Abnormal vasculature was noted in all cases. Subsequent embolization was performed with Contour (Boston Scientific, Target Vascular, Cork, Ireland) embolization particles (150-250 and 250-355 μm) in two patients and microcoils in the third (TornadoR; Cook Inc., Bloomington, IN, USA). Technical success was 100%. One patient had a recurrence of symptoms requiring a repeat procedure 6 months later. No complications were encountered. Selective angiography and particle embolization is an effective technique for management of this unusual but problematic postoperative sequelae.

Analgesic effect of continuous femoral nerve block combined with infiltration anesthesia after total knee replacement

Directory of Open Access Journals (Sweden)

Jian-Guo Tan

2016-06-01

Full Text Available Objective: To study the analgesic effect of continuous femoral nerve block combined with infiltration anesthesia after total knee replacement. Methods: Patients who received unilateral total knee replacement in our hospital from May 2012 to August 2015 were included for study and randomly divided into experimental group who received continuous femoral nerve block combined with infiltration anesthesia and control group who received continuous femoral nerve block, and then the contents of postoperative serum pain-promoting-related mediators, painsuppressing-related mediators and pain-related signal molecules were detected. Results: Serum CGRP, PS, Hist, 5-HT, AM and BK contents of experimental group were significantly lower than those of control group, AEA, β-EP, RvE1, LXA4 and LXB4 contents were significantly higher than those of control group, and P2X2, P2X7, P2X3, P2X4, P2Y1, P2Y2, P2Y4, P2Y6, P2Y 13, P2Y14, p38MAPK and PI3K contents were significantly lower than those of control group. Conclusions: Continuous femoral nerve block combined with infiltration anesthesia after total knee replacement can increase the generation of pain-suppressing mediators, decrease the generation of pain-promoting mediators and achieve more exact analgesic effect.

Comparison of femoral neck fracture healing and affected limb pain after anterolateral-approach minimally invasive total hip replacement and hemiarthroplasty

Directory of Open Access Journals (Sweden)

Xiao-Dong Cao

2017-04-01

Full Text Available Objective: To study the differences in femoral neck fracture healing and affected limb pain after anterolateral-approach minimally invasive total hip replacement and hemiarthroplasty. Methods: A total of 92 patients with femoral neck fracture who received hip replacement in our hospital between May 2013 and December 2015 were selected and randomly divided into total hip and half hip group, total hip group received anterolateral-approach minimally invasive total hip replacement, half hip group received anterolateral-approach minimally invasive hemiarthroplasty, and 1 month after operation, serum was collected to detect the levels of bone metabolism markers, osteocyte cytokines, SP and CGRP. Results: 1 month after operation, serum PINP, PICP, BMP, TGF-β, FGF, IGF-I and IGF-II levels of total hip group were significantly higher than those of half hip group while TRAP5b and CatK levels were significantly lower than those of half hip group; the day after operation, serum pain media SP and CGRP levels were not significantly different between the two groups of patients; 36 h after operation, serum SP and CGRP levels of total hip group were significantly lower than those of half hip group. Conclusion: The bone metabolism after anterolateral-approach minimally invasive total hip replacement is better than that after hemiarthroplasty, and the degree of pain is less than that after hemiarthroplasty.

Physiochemical properties, microstructure, and probiotic survivability of nonfat goats' milk yogurt using heat-treated whey protein concentrate as fat replacer.

Science.gov (United States)

Zhang, Tiehua; McCarthy, James; Wang, Guorong; Liu, Yanyan; Guo, Mingruo

2015-04-01

There is a market demand for nonfat fermented goats' milk products. A nonfat goats' milk yogurt containing probiotics (Lactobacillus acidophilus, and Bifidobacterium spp.) was developed using heat-treated whey protein concentrate (HWPC) as a fat replacer and pectin as a thickening agent. Yogurts containing untreated whey protein concentrate (WPC) and pectin, and the one with only pectin were also prepared. Skim cows' milk yogurt with pectin was also made as a control. The yogurts were analyzed for chemical composition, water holding capacity (syneresis), microstructure, changes in pH and viscosity, mold, yeast and coliform counts, and probiotic survivability during storage at 4 °C for 10 wk. The results showed that the nonfat goats' milk yogurt made with 1.2% HWPC (WPC solution heated at 85 °C for 30 min at pH 8.5) and 0.35% pectin had significantly higher viscosity (P yogurts and lower syneresis than the goats' yogurt with only pectin (P yogurt samples did not change much throughout storage. Bifidobacterium spp. remained stable and was above 10(6) CFU g(-1) during the 10-wk storage. However, the population of Lactobacillus acidophilus dropped to below 10(6) CFU g(-1) after 2 wk of storage. Microstructure analysis of the nonfat goats' milk yogurt by scanning electron microscopy revealed that HWPC interacted with casein micelles to form a relatively compact network in the yogurt gel. The results indicated that HWPC could be used as a fat replacer for improving the consistency of nonfat goats' milk yogurt and other similar products. © 2015 Institute of Food Technologists®

Effect of modified dairy fat on postprandial and fasting plasma lipids and lipoproteins in healthy young men

DEFF Research Database (Denmark)

Tholstrup, T.; Sandström, B.; Hermansen, J.E.

1998-01-01

Fatty acid profile of milk fat can be modified by cow feeding strategies. Our aim was postprandially and after 4 wk to compare the effect of a modified milk fat(M diet) [with 16% of the cholesterolemic saturated fatty acid (C12-16) replaced by mainly oleic and stearic acids] with the effect of D...... diet than M diet (interaction effect, diet x timesP stearic acids may havebeen obscured by the high content of cholesterol-raising saturated fatty acids in milk fat...... diet, including aconventional Danish milk fat on plasma lipids and lipoproteins. A side effect of the cow feeding regime was a 5% (w/w) increase in trans fatty acid in M diet.Eighteen subjects were fed for two periods of 4 wk strictly controlled isoenergetic test diets with 40% of energy from total fat...

The current state of bearing surfaces in total hip replacement.

Science.gov (United States)

Rajpura, A; Kendoff, D; Board, T N

2014-02-01

We reviewed the literature on the currently available choices of bearing surface in total hip replacement (THR). We present a detailed description of the properties of articulating surfaces review the understanding of the advantages and disadvantages of existing bearing couples. Recent technological developments in the field of polyethylene and ceramics have altered the risk of fracture and the rate of wear, although the use of metal-on-metal bearings has largely fallen out of favour, owing to concerns about reactions to metal debris. As expected, all bearing surface combinations have advantages and disadvantages. A patient-based approach is recommended, balancing the risks of different options against an individual's functional demands.

Patterns of pharmacotherapy and health care utilization and costs prior to total hip or total knee replacement in patients with osteoarthritis.

Science.gov (United States)

Berger, Ariel; Bozic, Kevin; Stacey, Brett; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

2011-08-01

To examine patterns of pharmacotherapy and health care utilization and costs prior to total knee replacement (TKR) or total hip replacement (THR) in patients with osteoarthritis (OA). Using a large US health insurance claims database, we identified all patients with OA who were ages ≥40 years and had undergone TKR or THR between January 1, 2006 and December 31, 2007. Patients with care utilization and costs over the 2-year period preceding surgery. A total of 16,527 patients met all study entry criteria. Their mean ± SD age was 56.6 ± 6.1 years, and 56% of them were women. In the 2 years preceding surgery, 55% of patients received prescription nonsteroidal antiinflammatory drugs, 58% received opioids, and 50% received injections of corticosteroids. The numbers of patients receiving these drugs increased steadily during the presurgery period. The mean ± SD total health care costs in the 2 years preceding surgery were $19,466 ± 29,869, of which outpatient care, inpatient care, and pharmacotherapy represented 45%, 20%, and 20%, respectively. Costs increased from $2,094 in the eighth calendar quarter prior to surgery to $3,100 in the final quarter. Patients with OA who undergo THR or TKR have relatively high levels of use of pain-related pharmacotherapy and high total health care costs in the 2-year period preceding surgery. Levels of utilization and cost increase as the date of surgery approaches. Copyright © 2011 by the American College of Rheumatology.

Differential fat harvesting

Directory of Open Access Journals (Sweden)

Sebastian Torres Farr

2014-12-01

Full Text Available Aim: Volume replacement with fillers is regularly performed with the use of diverse volumetric materials to correct different structures around the face, depending on the volume enhancement required and the thickness of the soft tissue envelope. Differential fat harvesting and posterior grafting is performed to place the correct fat parcel size for each target area, expanding the potential applications of fat. Methods: Sixty patients consecutively recruited on a first come basis undergone a facial fat grafting procedure, in private practice setting between March 2012 and October 2013. Fat grafting quantity and quality was predicted for each case. Differential harvesting was performed, with 2 fat parcels size. Processing was performed through washing. Fat infiltration was carried out through small cannulas or needles depending on the treated area. Outcomes were analysed both by the physicians and the patients at 7 days, 1 month, 3 months and 6 months through a perceived satisfaction questionnaire. Parameters considered were downtime or discomfort, skin benefits, volume restoration, reabsorption rate estimated and overall improvement. Results: Full facial differential fat grafting procedure lasted an average of 1.5-2.5 h. Average downtime was 3-4 days. Follow-up was performed to a minimum of 6 months. Both patient and physician overall satisfaction rates were mostly excellent. Adverse events like lumps or irregularities were not encountered. Conclusion: Differential fat harvesting and posterior grafting is a valid alternative, to expand the repertoire of fat use, allow a more homogeneous effect, reduce the potential complications, speed up the process, improve graft survival, and to enhance overall aesthetic outcome.

Preoperative information provided to Swedish and immigrant patients before total hip replacement.

Science.gov (United States)

Krupic, Ferid; Määttä, Sylvia; Garellick, Göran; Lyckhage, Elisabeth Dahlborg; Kärrholm, Johan

2012-01-01

Total hip replacement is an operation that usually leads to pain relief and improved health related quality of life (HRQoL). Previous studies have demonstrated the importance of information about upcoming surgery. Therefore, it was of interest to study how both immigrants, whose first language was not Swedish, and Swedish patients described pre-operative information. Individual interviews were conducted with 10 immigrants and 10 Swedish participants. The data were analysed using qualitative content analysis. The study was carried out in western Sweden from March to November 2010. The findings revealed that pre-operative information for all patients undergoing elective total hip replacement was limited. Patients from both groups expressed concern about inadequate preoperative information pertaining to the surgery, implant selection, pain relief, choice of anaesthesia, no or too short a time to put questions to the surgeon and an overall stressful situation. Adequate preoperative information is important for optimising pain relief and shortening the hospital stay. The fact that the patients overwhelmingly rated the preoperative information as inadequate may be due to several reasons. Mental distress and the two-week interval between the time when the patient received the information and the operation might have contributed to the low degree of retention.

Fat intake and energy-balance effects.

Science.gov (United States)

Westerterp-Plantenga, M S

2004-12-30

This paper focuses on the effects of dietary fats or fatty acids on key targets of metabolic intermediates for body-weight control, i.e. satiety, thermogenesis, fat oxidation and body composition. With respect to sensory satiety, it appeared, e.g. that linoleic acid tasters showed a different mechanism for meal termination than non-tasters did. They stopped eating linoleic acid containing food based upon satiety, whereas the non-tasters stopped eating based upon the change in pleasantness of taste. Moreover, in the normal range of body mass index, an inverse relationship was shown between % 'tasters' and BMI. In a high fat diet vs. a low fat high protein high carbohydrate diet, metabolic satiety appeared to be continuously lower and correlated positively to diet-induced energy expenditure. However, with respect to the intermeal interval, satiety appeared to be more sustained following a high fat vs. a high CHO preload, resulting in a lower meal frequency. Covert fat replacement during breakfast by sucrose polyester was successful in combination with dietary restraint, yet overt fat replacement in snacks was successful in the dietary-unrestrained subjects, i.e. those who habitually ate snacks. With respect to fat oxidation, from a respiration-chamber experiment on the effects of diacylglycerol compared (DG) to triacylglycerol (TG) intake, it was concluded that consumption of DG increased fat oxidation and beta-hydroxy-butyrate levels, but did not affect energy metabolism or triacylglycerol level. Parameters of appetite were all lowered by DG compared to TG. With respect to body composition, the effects of 13 weeks CLA supplementation in overweight subjects during weight regain were assessed. Although CLA did not affect %body-weight regain, the regain of fat-free mass was increased by CLA, independently of %body-weight regain and physical activity, and as a consequence resting metabolic rate was increased. At the same time, appetite was reduced and satiety and

Rehabilitation of patients aged 65 and over after total hip replacement

DEFF Research Database (Denmark)

Hørdam, Britta

by a randomised clinical trial by using telephone interviews and counseling postoperatively, and testing improvement in patients´health status after THR. The last study involved testing the effect of nursing intervention by providing a measurement of patients´healthrelated quality of life.......The overall aim of this thesis was to investigate improvement in health status of patients aged 65 and over after total hip replacement (THR) as a result of nursing rehabilitation. The projects conssits of three studies, first a description of patients´health status after THR, followed...

Influence of Minimally Invasive Total Hip Replacement on Hip Reaction Forces and Their Orientations

NARCIS (Netherlands)

Weber, Tim; Al-Munajjed, Amir A.; Verkerke, Gijsbertus Jacob; Dendorfer, Sebastian; Renkawitz, Tobias

2014-01-01

Minimally invasive surgery (MIS) is becoming increasingly popular. Supporters claim that the main advantages of MIS total hip replacement (THR) are less pain and a faster rehabilitation and recovery. Critics claim that safety and efficacy of MIS are yet to be determined. We focused on a

Do intra-articular hyaluronic acid injections delay total knee replacement in patients with osteoarthritis – A Cox model analysis

Science.gov (United States)

Amor, Bernard; Bardoulat, Isabelle; Tetafort, Aymeric; Pelletier-Fleury, Nathalie

2017-01-01

Due to the growing worldwide prevalence of knee osteoarthritis, the optimal management of this issue is critical for reducing its burden. Objectives This study aimed to describe patients treated for knee osteoarthritis between 2006 and 2013 in France and to compare the delay from diagnosis to total knee replacement between patients who received intra-articular hyaluronic acid injections and those who did not receive the injections. A second objective was to compare direct medical costs for ambulatory care between treatment groups. Materials and methods Patients were selected from a representative sample of the real world administrative claims database using an algorithm developed by experts from the scientific committee of the study. Data were matched with the medico-administrative database for hospital care. A Cox proportional hazards model was stratified for the treatment group and adjusted for available socio-demographic and medical covariates to compare restricted mean survival times at different time points (1, 3, 5 and 7.5 years) between groups. Costs were expressed in 2013 euros. Results A total of 14,782 patients were treated for knee osteoarthritis (67% women; mean age = 68 years). Among this population, 1,662 patients had total knee replacement (11.2%). At each time point, restricted mean survival time without total knee replacement was significantly higher (p-valueshyaluronic acid group, from +51 to +217 days at 1 and 7.5 years, respectively. For the year preceding total knee replacement, the means for total direct medical costs were similar between groups, €744 vs €805 for treatment and control groups, respectively, (p-value = 0.104). Intra-articular injections accounted for less than 10% of the total costs. Conclusion This is the first retrospective longitudinal study involving knee osteoarthritis patients using medico-administrative databases in France. The results support the effectiveness of hyaluronic acid injections in delaying total knee

Nutrient intake, rumen fermentation and growth performance of dairy calves fed extruded full-fat soybean as a replacement for soybean meal.

Science.gov (United States)

ZeidAli-Nejad, A; Ghorbani, G R; Kargar, S; Sadeghi-Sefidmazgi, A; Pezeshki, A; Ghaffari, M H

2018-04-01

The objective of this study was to investigate the effects of extruded full-fat soybean (ESB) as a replacement for soybean meal (SBM) on nutrient intake, rumen fermentation, and growth performance of dairy calves. A total of 45 male Holstein dairy calves (42.0±0.5 kg of BW) were randomly assigned to one of three experimental diets: (1) 0% ESB (Control): 35.3% SBM no ESB; (2) 25% ESB: 27.0% SBM+9.0% ESB; and (3) 50% ESB: 19.0% SBM+19.0% ESB. All calves were weaned on day 56 of age and remained in the study until day 70 of age. During the pre-weaning and overall periods, substituting of SBM with ESB had no effect on intake of starter feed, metabolizable energy (ME), CP and non-fiber carbohydrate (NFC). Compared with the control, 50% ESB resulted in a decrease in starter feed intake, and intakes of other nutrients including CP, NFC and ME during the post-weaning period. Substituting SBM with ESB decreased intake of C16 : 0 and increased intakes of n-9 C18 : 1, n-6 C18 : 2 and n-3 C18 : 3 during the pre-weaning, post-weaning and overall periods. Using ESB as a replacement for SBM did not affect average daily gain, feed efficiency, rectal temperature and fecal score over the trial periods. Compared with control, the rumen concentration of NH3-N decreased for 50% ESB on days 35 and 56 of age but not when compared with 25% ESB. Rumen pH, total volatile fatty acids concentrations, and the molar proportions of ruminal acetate, propionate and butyrate were not different among treatments. Body measurements were not affected by the treatments. In conclusion, substitution of SBM with ESB may improve nitrogen utilization efficiency in dairy calves but slightly reduce post-weaning starter intake with no negative outcomes on growth performance and rumen fermentation.

Preoperative therapeutic exercise in frail elderly scheduled for total hip replacement: A randomized pilot trial

NARCIS (Netherlands)

Hoogeboom, T.J.; Dronkers, J.J.; Ende, C.H.M. van den; Oosting, E.; Meeteren, N.L.U. van

2010-01-01

Objective: To evaluate the feasibility and preliminary effectiveness of therapeutic exercise before total hip replacement in frail elderly. Design: A single-blind, randomized clinical pilot trial. Setting: Outpatient physiotherapy department. Subjects: Frail elderly with hip osteoarthritis awaiting

Addition of chia seed mucilage for reduction of fat content in bread and cakes.

Science.gov (United States)

Fernandes, Sibele Santos; Salas-Mellado, Myriam de Las Mercedes

2017-07-15

In this study, breads and chocolate cakes were prepared with different levels of chia mucilage dried at 50°C or lyophilized as fat, resulting in healthier products. Results indicated that breads and chocolate cakes made with chia mucilage can replace up to 50% of fat without affecting the technological and physical characteristics. The replacement of 75% of fat, for both types of mucilage, had a significant reduction in fat content of 56.6% in breads and 51.6% in cakes, producing a slight decrease in the technological characteristics of the products. Sensorial parameters showed good acceptability, with greater purchase intent for both products when added with chia mucilage dried at 50°C. Therefore, chia mucilage proved to be a new alternative for replacing fat in food products, preserving the quality attributes and making them healthier foods. Copyright © 2017 Elsevier Ltd. All rights reserved.

The stability of the femoral component of a minimal invasive total hip replacement system.

NARCIS (Netherlands)

Willems, M.M.M.; Kooloos, J.G.M.; Gibbons, P.; Minderhoud, N.; Weernink, T.; Verdonschot, N.J.J.

2006-01-01

In this study, the initial stability of the femoral component of a minimal invasive total hip replacement was biomechanically evaluated during simulated normal walking and chair rising. A 20 mm diameter canal was created in the femoral necks of five fresh frozen human cadaver bones and the femoral

The relationship of hospital charges and volume to surgical site infection after total hip replacement.

Science.gov (United States)

Boas, Rebecca; Ensor, Kelsey; Qian, Edward; Hutzler, Lorraine; Slover, James; Bosco, Joseph

2015-05-01

The purpose of this study was to analyze the effect of hospital volume and charges on the rate of surgical site infections for total hip replacements (THRs) in New York State (NYS). In NYS, higher volume hospitals have higher charges after THR. The study team analyzed 93,620 hip replacements performed in NYS between 2008 and 2011. Hospital charges increased significantly from $43,713 in 2008 to $50,652 in 2011 (P<.01). Compared with lower volume hospitals, patients who underwent THR at the highest volume hospitals had significantly lower surgical site infection rates (P=.003) and higher total hospital charges (P<.0001). The study team found that in the highest volume hospitals, preventing one surgical site infection was associated with $1.6 million dollars in increased charges. © 2014 by the American College of Medical Quality.

Process optimized minimally invasive total hip replacement

Directory of Open Access Journals (Sweden)

Philipp Gebel

2012-02-01

Full Text Available The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA in total hip replacement (THR in combination with the leg positioner (Rotex- Table and a modified retractor system (Condor. We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS. All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years, with a mean BMI of 26.5 (17 to 43. The mean time of surgery was 80 min. (55 to 130 min. The blood loss showed an average of 511.5 mL (200 to 1000 mL. No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.

FTO gene associated fatness in relation to body fat distribution and metabolic traits throughout a broad range of fatness

DEFF Research Database (Denmark)

Kring, Sofia I I; Holst, Claus; Zimmermann, Esther

2008-01-01

A common single nucleotide polymorphism (SNP) of FTO (rs9939609, T/A) is associated with total body fatness. We investigated the association of this SNP with abdominal and peripheral fatness and obesity-related metabolic traits in middle-aged men through a broad range of fatness present already...

Study on the change of total fat content and fatty acid composition of the ethanol extract from cooking drips of thunnus thynnus by ionizing irradiation

Energy Technology Data Exchange (ETDEWEB)

Lee, Hee Sub; Choi, Jong Il; Kim, Hyun Joo; Kim, Jin Kyu; Byun, Myung Woo; Lee, Ju Woon [Team for Radiation Food Science and Biotechnology, Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup (Korea, Republic of); Yoo, Cheon Woo; Kim, Ju Bong [Dongwon Research and Development Center, Seongnam (Korea, Republic of); Hwang, Young Jung [Division of Food Science, Jinju International University, Jinju (Korea, Republic of); Chung, Young Jin [Dept. of Food and Nutrition, Chungnam National University, Daejeon (Korea, Republic of)

2008-05-15

This study was conducted to examine the effect of a gamma irradiation (GM) and an electron-beam irradiation (EB) on the total fat content and fatty acid composition of ethanol extract from cooking drips of Thunnus thynnus (ECT). The total fat content of samples were determined by fat extraction (Folch method) and fatty acid composition was by gas chromatography mass spectrometry (GC-MS) after fat extraction. The results showed that total fat contents were not changed by GM and EB up to the dose of 50 kGy. The content of unsaturated fatty acids (USFA) such as vaccenic acid and DHA, was decreased by irradiation. But, the content of palmitoleic acid was not changed by GM. In contrast, the content of saturated fatty acids(SFA) such as myristic acid and palmitic acid, was increased by the irradiation. But, the content of stearic acid was decreased with the increase of irradiation dose. Also, it has been shown that the GM had further affected the change of fatty acid content than EB.

Study on the change of total fat content and fatty acid composition of the ethanol extract from cooking drips of thunnus thynnus by ionizing irradiation

International Nuclear Information System (INIS)

Lee, Hee Sub; Choi, Jong Il; Kim, Hyun Joo; Kim, Jin Kyu; Byun, Myung Woo; Lee, Ju Woon; Yoo, Cheon Woo; Kim, Ju Bong; Hwang, Young Jung; Chung, Young Jin

2008-01-01

This study was conducted to examine the effect of a gamma irradiation (GM) and an electron-beam irradiation (EB) on the total fat content and fatty acid composition of ethanol extract from cooking drips of Thunnus thynnus (ECT). The total fat content of samples were determined by fat extraction (Folch method) and fatty acid composition was by gas chromatography mass spectrometry (GC-MS) after fat extraction. The results showed that total fat contents were not changed by GM and EB up to the dose of 50 kGy. The content of unsaturated fatty acids (USFA) such as vaccenic acid and DHA, was decreased by irradiation. But, the content of palmitoleic acid was not changed by GM. In contrast, the content of saturated fatty acids(SFA) such as myristic acid and palmitic acid, was increased by the irradiation. But, the content of stearic acid was decreased with the increase of irradiation dose. Also, it has been shown that the GM had further affected the change of fatty acid content than EB

Resumption of car driving after total hip replacement.

Science.gov (United States)

Abbas, Ghulam; Waheed, Abdul

2011-04-01

To assess periods required for resuming car driving in 130 patients who had undergone total hip replacement (THR). 80 men and 50 women aged 39 to 80 years who had been driving automatic (n=49) or manual (n=81) cars in the previous 3 months and underwent unilateral primary THR of the right (n=85) or left (n=45) hip were recruited. Patients were advised to resume driving after 6 weeks if they felt comfortable to do so. 105 (81%) patients were able to resume driving at week 6 to 8; 67 (64%) had had a right THR and 65 (62%) were manual car drivers. 22 (17%) patients were able to do so at week 12. The remaining 3 (2%) patients were not confident to drive even at week 12. No patient reported deterioration in driving ability, whereas 48 (38%) felt a subjective improvement in their driving ability. The time to resume driving varies in different patients. The advice should be individualised, depending on the patient's recovery and confidence level.

Lifetime risk of primary total hip replacement surgery for osteoarthritis from 2003-2013

DEFF Research Database (Denmark)

Ackerman, Ilana N; Bohensky, Megan A; de Steiger, Richard

2017-01-01

OBJECTIVE: To compare the lifetime risk of total hip replacement surgery (THR) for osteoarthritis (OA) between countries, and over time. METHODS: Data on primary THR procedures performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland, N....... These multi-national risk estimates can inform resource planning for OA service delivery. This article is protected by copyright. All rights reserved....

A Water Rehabilitation Program in Patients with Hip Osteoarthritis Before and After Total Hip Replacement

OpenAIRE

?yp, Marek; Kaczor, Ryszard; Cabak, Anna; Tederko, Piotr; W?ostowska, Ewa; Stanis?awska, Iwona; Szypu?a, Jan; Tomaszewski, Wies?aw

2016-01-01

Background Pain associated with coxarthrosis, typically occurring in middle-aged and elderly patients, very commonly causes considerable limitation of motor fitness and dependence on pharmacotherapy. This article provides an assessment of a rehabilitation program with tailored water exercises in patients with osteoarthritis before and after total hip replacement. Material/Methods A total of 192 patients (the mean age 61.03?10.89) suffering from hip osteoarthritis (OA) were evaluated before an...

Feeding dairy cows with full fat extruded or toasted soybean seeds as replacement of soybean meal and effects on milk yield, fatty acid profile and CLA content

Directory of Open Access Journals (Sweden)

Giovanni Bittante

2010-01-01

Full Text Available The aim of this study was to evaluate the effects of the replacement of about 70% of soybean meal (SBM with extruded(ES or toasted (TS full-fat soybean seeds in diets for lactating cows on milk quality, fatty acid profile, and conjugatedlinoleic acid (CLA content. Eighteen lactating cows were assigned to 3 groups which received a basal diet, supplementedwith 1.8, 2.1 and 2.1 kg/head, respectively, of SBM, ES and TS. There was no significant effect on milk yield,calculated as the difference between daily yield during the experimental period and the mean of the last 5 days of adaptation(-1.65, -1.29 and -0.20 kg/d, respectively, for SBM, ES and TS; P>0.10 and milk quality parameters (fat, protein,urea and cheese making parameters among treatments. In the ES group there was a decrease in the short chainFA content (from C4 to C13 in milk fat (9.2 vs 11.0 and 10.8 g/100 g lipids, respectively, for ES, SBM and TS; PMedium chain FA (from C14 to C17 content in milk fat was lower for ES and TS groups compared with SBM (46.8 and48.0 vs 54.8 g/100 g lipids respectively; PSBM group compared to the others (34.3 vs 44.2 and 41.2 g/100 g lipids, respectively, for SBM, ES and TS; PThe replacement of SBM with ES enhanced oleic and linoleic acid and, particularly, CLA content. Intermediate values wereobserved for the TS group. CLA content (0.91, 0.62 and 0.56 g/100 g lipids, respectively, for ES, TS and SBM; Pincreased throughout the trial in all groups. ES also reduced the proportion of SFA with respect to SBM (65.2, 68.2 and70.9 g/100 g lipids, respectively, for ES, TS and SBM; Pin the same order; Pimproving the health-quality of milk. The various soybean products did not affect either metabolic profile (protein, urea,glucose, cholesterol, NEFA, triglycerides, liver parameters and mineral serum content or rumen parameters (pH, ammoniaand VFAs. The replacement of SBM with ES and TS permitted an improvement in the nutritional properties of milkwithout negatively

Carcass characteristics of lambs fed spineless cactus as a replacement for sugarcane.

Science.gov (United States)

de Oliveira, Juliana Paula Felipe; de Andrade Ferreira, Marcelo; Alves, Adryanne Marjorie Souza Vitor; de Melo, Ana Caroline Cerqueira; de Andrade, Ida Barbosa; Urbano, Stela Antas; Suassuna, Juraci Marcos Alves; de Barros, Leonardo José Assis; de Barros Melo, Tobias Tobit

2018-04-01

Fresh sugarcane has been a new roughage source for ruminant's in semiarid regions, a function of the decline of sugar and alcohol industry in recent years. However, there is little data published regarding lambs fed sugarcane associated with spineless cactus. This study evaluated the effect of sugarcane replacement with spineless cactus (0%, 33%, 66%, and 100%) in the diet of Santa Inês lambs on carcass characteristics. Thirty-six non-castrated Santa Ines lambs at four months of age and an initial body weight of 22±2.3 kg were assigned in a randomized block design and slaughtered after 70 days of confinement. The effects of spineless cactus as a replacement for sugarcane in the diet of the lambs on the carcass characteristics, commercial cut weight and yield, leg tissue composition, and carcass measurements were studied. The study revealed quadratic behavior in slaughter body weight, and hot and cold carcass weight, with maximum values of 38.60, 18.60, and 18.11 kg and replacement levels of 40.18%, 44.42%, and 43.14%, respectively. The cold carcass yield presented an increasing linear behavior. The compactness index of carcass and leg presented a quadratic effect, with estimated maximal values of 0.28 and 0.57 kg/cm and replacement levels of 43.37% and 45.5%, respectively. The weights of commercial cuts of leg, loin, shoulder, and breast showed quadratic behavior, with maximum values of 2.79, 0.852, 1.46, and 1.30 kg and replacement levels of 49.5, 45.32, 39.0, and 40.7, respectively. For tissue composition, quadratic behavior was verified for leg weight, subcutaneous fat, and total fat. The replacement of sugarcane by spineless cactus at level 44% is recommended for finishing lambs considering that this level improved most of the carcass characteristics, weights, and yields of commercial cuts and leg tissue composition.

Numerical Modelling of the Weight-Bearing Total Knee Joint Replacement and Usage in Practice

Czech Academy of Sciences Publication Activity Database

Daněk, Josef; Nedoma, Jiří; Hlaváček, Ivan; Vavřík, P.; Denk, F.

2007-01-01

Roč. 76, č. 1-3 (2007), s. 49-56 ISSN 0378-4754 R&D Projects: GA MPO FT-TA/087 Institutional research plan: CEZ:AV0Z10300504 Keywords : total knee joint replacement * contact problem * non-overlapping domain decomposition method Subject RIV: BA - General Mathematics Impact factor: 0.738, year: 2007

Pain and senzitisation after total knee replacement or nonsurgical treatment in patients with knee osteoarthritis

DEFF Research Database (Denmark)

Arendt-Nielsen, Lars; Simonsen, Ole; Laursen, Mogens Berg

2018-01-01

BACKGROUND: This study is a secondary analysis of 12-month follow-ups from two parallel, randomised controlled trials (RCT) in painful knee osteoarthritis patients. RCT1: Total knee replacement (TKR) followed by non-surgical treatment compared with non-surgical treatment. RCT2: Non...

The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic.

Science.gov (United States)

Losina, Elena; Thornhill, Thomas S; Rome, Benjamin N; Wright, John; Katz, Jeffrey N

2012-02-01

Total knee replacement utilization in the United States more than doubled from 1999 to 2008. Although the reasons for this increase have not been examined rigorously, some have attributed the increase to population growth and the obesity epidemic. Our goal was to investigate whether the rapid increase in total knee replacement use over the past decade can be sufficiently attributed to changes in these two factors. We used data from the Nationwide Inpatient Sample to estimate changes in total knee replacement utilization rates from 1999 to 2008, stratified by age (eighteen to forty-four years, forty-five to sixty-four years, and sixty-five years or older). We obtained data on obesity prevalence and U.S. population growth from federal sources. We compared the rate of change in total knee replacement utilization with the rates of population growth and change in obesity prevalence from 1999 to 2008. In 2008, 615,050 total knee replacements were performed in the United States adult population, 134% more than in 1999. During the same time period, the overall population size increased by 11%. While the population of forty-five to sixty-four-year-olds grew by 29%, the number of total knee replacements in this age group more than tripled. The number of obese and non-obese individuals in the United States increased by 23% and 4%, respectively. Assuming unchanged indications for total knee replacement among obese and non-obese individuals with knee osteoarthritis over the last decade, these changes fail to account for the 134% growth in total knee replacement use. Population growth and obesity cannot fully explain the rapid expansion of total knee replacements in the last decade, suggesting that other factors must also be involved. The disproportionate increase in total knee replacements among younger patients may be a result of a growing number of knee injuries and expanding indications for the procedure.

Time-based analysis of total cost of patient episodes: a case study of hip replacement.

Science.gov (United States)

Peltokorpi, Antti; Kujala, Jaakko

2006-01-01

Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue. Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year. The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency. Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

Patterns of Ninety-Day Readmissions Following Total Joint Replacement in a Bundled Payment Initiative.

Science.gov (United States)

Behery, Omar A; Kester, Benjamin S; Williams, Jarrett; Bosco, Joseph A; Slover, James D; Iorio, Richard; Schwarzkopf, Ran

2017-04-01

Alternative payment models aim to improve quality and decrease costs associated with total joint replacement. Postoperative readmissions within 90 days are of interest to clinicians and administrators as there is no additional reimbursement beyond the episode bundled payment target price. The aim of this study is to improve the understanding of the patterns of readmission which would better guide perioperative patient management affecting readmissions. We hypothesize that readmissions have different timing, location, and patient health profile patterns based on whether the readmission is related to a medical or surgical diagnosis. A retrospective cohort of 80 readmissions out of 1412 total joint replacement patients reimbursed through a bundled payment plan was analyzed. Patients were grouped by readmission diagnosis (surgical or medical) and the main variables analyzed were time to readmission, location of readmission, and baseline Perioperative Orthopaedic Surgical Home and American Society of Anesthesiologists scores capturing pre-existing state of health. Nonparametric tests and multivariable regressions were used to test associations. Surgical readmissions occurred earlier than medical readmissions (mean 18 vs 33 days, P = .011), and were more likely to occur at the hospital where the surgery was performed (P = .035). Perioperative Orthopaedic Surgical Home and American Society of Anesthesiologists scores did not predict medical vs surgical readmissions (P = .466 and .879) after adjusting for confounding variables. Readmissions appear to follow different patterns depending on whether they are surgical or medical. Surgical readmissions occur earlier than medical readmissions, and more often at the hospital where the surgery was performed. The results of this study suggest that these 2 types of readmissions have different patterns with different implications toward perioperative care and follow-up after total joint replacement. Copyright © 2016 Elsevier Inc

Cardiac stroke following total knee replacement in an ochronotic arthropathy: Case report and literature review

Directory of Open Access Journals (Sweden)

Saurabh Jain

2016-01-01

Full Text Available Alkaptonuria is a rare autosomal recessive disorder caused by defective metabolism of homogentisic acid (HGA which on accumulation in the connective tissues causes arthritis, darkening of urine and connective tissue pigmentation. Knee is most commonly affected joint whereas pigment deposition is seen in entire body causing cardiovascular, genitourinary, ocular, cutaneous, and musculoskeletal complications. We here report such a case of bilateral ochronotic arthropathy, who was diagnosed to be alkaptonuric only during joint exploration. He sustained a cardiac catastrophic stroke on 3 rd post operative day of the left knee replacement which was done one week after the right knee replacement. With prompt treatment and good hospital care, the patient was revived successfully, without valvulotomy or valvular replacement. The spectrum of clinical manifestations are discussed in the report with emphasis on thorough history and clinical examination of the patient, before taking the patient to the total knee replacement to make accurate diagnosis before hand and be prepared for the complications or catastrophic by a multidisciplinary approach.

Oxygenation impairment after total arch replacement with a stented elephant trunk for type-A dissection.

Science.gov (United States)

Shen, Yuwen; Liu, Chuanzhen; Fang, Changcun; Xi, Jie; Wu, Shuming; Pang, Xinyan; Song, Guangmin

2018-06-01

To study the risk factors of oxygenation impairment in patients with type-A acute aortic dissection who underwent total arch replacement with a stented elephant trunk. In this study, 169 consecutive patients were enrolled who were diagnosed with type-A acute aortic dissection and underwent a total arch replacement procedure at the Qilu Hospital of Shandong University between January 2015 and February 2017. Postoperative oxygenation impairment was defined as arterial oxygen partial pressure/inspired oxygen fraction ≤ 200 with positive end expiratory pressure ≥ 5 cm H 2 O that occurred within 72 hours of surgery. Perioperative clinical characteristics of all patients were collected and univariable analyses were performed. Risk factors associated with oxygenation impairment identified by univariable analyses were included in the multivariable regression analysis. The incidence of postoperative oxygenation impairment was 48.5%. Postoperative oxygenation impairment was associated with prolonged mechanical ventilation time, intensive care unit stay, and hospital stay. Multivariable regression analysis demonstrated that body mass index (odds ratio [OR], 1.204; 95% confidence interval [CI], 1.065-1.361; P = .003), preoperative oxygenation impairment (OR, 9.768; 95% CI, 4.159-22.941; P impairment. Postoperative oxygenation impairment is a common complication of surgery for type-A acute aortic dissection. Body mass index, preoperative oxygenation impairment, preoperative homocysteine, circulatory arrest time, and plasma transfusion were independent risk factors for oxygenation impairment after a total arch replacement procedure. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Body fat, abdominal fat and body fat distribution related to cardiovascular risk factors in prepubertal children

DEFF Research Database (Denmark)

Dencker, Magnus; Wollmer, Per; Karlsson, Magnus K

2012-01-01

Aim:  We analysed whether total body fat (TBF), abdominal fat and body fat distribution are associated with higher composite risk factor scores for cardiovascular disease (CVD) in young children. Methods:  Cross-sectional study of 238 children aged 8-11 years. TBF and abdominal fat mass (AFM) wer......, separately, and used as composite risk factor score. Results:  Pearson correlations between ln BF%, ln AFM and AFM/TBF versus composite risk factor score for boys were r = 0.56, r = 0.59 and r = 0.48, all p ...

Total body fat, pro-inflammatory cytokines and insulin resistance in Indian subjects

Energy Technology Data Exchange (ETDEWEB)

Yajnik, C S [Diabetes Unit, KEM Hospital Research Centre, Pune (India); Yudkin, J S [Whittington Hospital, University College of London, London (United Kingdom); Shetty, P S [London School of Hygiene and Tropical Medicine, London (United Kingdom); Kurpad, A [St. John' s Medical College, Bangalore (India)

1999-07-01

There is a growing epidemic of insulin resistance syndrome (IRS) in Indians. We postulate that increased susceptibility of the urban Indians to insulin resistance is a result of a tendency to increased fat deposition from the time of intrauterine life (thrifty phenotype), exaggerated in the urban environment by a positive energy balance. The pro-inflammatory cytokines secreted by the inflammatory cells as well by the adipose tissue could aggravate insulin resistance and endothelial damage and therefore, increase the susceptibility to type 2 diabetes and coronary heart disease (CHD) independent of the previously proposed glucose fatty acid cycle mechanism. In a preliminary study, we propose to make detailed measurements of the proposed mechanisms in a selected population from 3 geographical locations in and near the city of Pune, India and also validate simple 'epidemiologic' measurements of body composition with 'reference' measurements. One hundred men (30 to 50y) each from the three geographical locations (rural, urban slum-dwellers and urban middle class in Pune) will be studied for: (i) Body composition: Anthropometric and bioimpedance measurement of total body fat (to be calibrated against deuterated water in 30 subjects from each location), and muscle mass by anthropometry and urinary creatinine excretion; (ii) Body fat distribution by subscapular- triceps ratio, waist-hip ratio; (iii) Metabolic: Glucose tolerance and insulin resistance variables (insulin, lipids, NEFA) and leptin; (iv) Endothelial markers: e-Selectin and von Willebrand Factor (vWF); (v) Inflammatory markers and pro-inflammatory cytokines: C-reactive protein (CRP), Interleukin-6 (IL-6) and tumour necrosis factor (TNF- {alpha}); (vi) Energy Balance: Assessment of nutritional intake (calories, carbohydrates, proteins and fats, n3 and n6 fatty acids) and physical activity by a questionnaire. Insulin resistance variables, endothelial markers, cytokines and obesity parameters will be compared in

Total body fat, pro-inflammatory cytokines and insulin resistance in Indian subjects

International Nuclear Information System (INIS)

Yajnik, C.S.; Yudkin, J.S.; Shetty, P.S.; Kurpad, A.

1999-01-01

There is a growing epidemic of insulin resistance syndrome (IRS) in Indians. We postulate that increased susceptibility of the urban Indians to insulin resistance is a result of a tendency to increased fat deposition from the time of intrauterine life (thrifty phenotype), exaggerated in the urban environment by a positive energy balance. The pro-inflammatory cytokines secreted by the inflammatory cells as well by the adipose tissue could aggravate insulin resistance and endothelial damage and therefore, increase the susceptibility to type 2 diabetes and coronary heart disease (CHD) independent of the previously proposed glucose fatty acid cycle mechanism. In a preliminary study, we propose to make detailed measurements of the proposed mechanisms in a selected population from 3 geographical locations in and near the city of Pune, India and also validate simple 'epidemiologic' measurements of body composition with 'reference' measurements. One hundred men (30 to 50y) each from the three geographical locations (rural, urban slum-dwellers and urban middle class in Pune) will be studied for: (i) Body composition: Anthropometric and bioimpedance measurement of total body fat (to be calibrated against deuterated water in 30 subjects from each location), and muscle mass by anthropometry and urinary creatinine excretion; (ii) Body fat distribution by subscapular- triceps ratio, waist-hip ratio; (iii) Metabolic: Glucose tolerance and insulin resistance variables (insulin, lipids, NEFA) and leptin; (iv) Endothelial markers: e-Selectin and von Willebrand Factor (vWF); (v) Inflammatory markers and pro-inflammatory cytokines: C-reactive protein (CRP), Interleukin-6 (IL-6) and tumour necrosis factor (TNF- α); (vi) Energy Balance: Assessment of nutritional intake (calories, carbohydrates, proteins and fats, n3 and n6 fatty acids) and physical activity by a questionnaire. Insulin resistance variables, endothelial markers, cytokines and obesity parameters will be compared in the 3

A comprehensive combined experimental and computational framework for pre-clinical wear simulation of total knee replacements.

Science.gov (United States)

Abdelgaied, A; Fisher, J; Jennings, L M

2018-02-01

A more robust pre-clinical wear simulation framework is required in order to simulate wider and higher ranges of activities, observed in different patient populations such as younger more active patients. Such a framework will help to understand and address the reported higher failure rates for younger and more active patients (National_Joint_Registry, 2016). The current study has developed and validated a comprehensive combined experimental and computational framework for pre-clinical wear simulation of total knee replacements (TKR). The input mechanical (elastic modulus and Poisson's ratio) and wear parameters of the moderately cross-linked ultra-high molecular weight polyethylene (UHMWPE) bearing material were independently measured from experimental studies under realistic test conditions, similar to the loading conditions found in the total knee replacements. The wear predictions from the computational wear simulation were validated against the direct experimental wear measurements for size 3 Sigma curved total knee replacements (DePuy, UK) in an independent experimental wear simulation study under three different daily activities; walking, deep squat, and stairs ascending kinematic conditions. The measured compressive mechanical properties of the moderately cross-linked UHMWPE material were more than 20% lower than that reported in the literature under tensile test conditions. The pin-on-plate wear coefficient of moderately cross-linked UHMWPE was significantly dependant of the contact stress and the degree of cross-shear at the articulating surfaces. The computational wear predictions for the TKR from the current framework were consistent and in a good agreement with the independent full TKR experimental wear simulation measurements, with 0.94 coefficient of determination of the framework. In addition, the comprehensive combined experimental and computational framework was able to explain the complex experimental wear trends from the three different daily

Extramedullary versus intramedullary tibial cutting guides in megaprosthetic total knee replacement

Directory of Open Access Journals (Sweden)

Karade Vikas

2012-10-01

Full Text Available Abstract Background In a standard total knee replacement, tibial component alignment is a key factor for the long term success of the surgery. The purpose of this study is to compare the accuracy of extramedullary and intramedullary tibial cutting guides used in indigenous and imported implants respectively, in positioning of the tibial components in megaprosthetic knee replacements. Methods A comparative study of the accuracy of extramedullary and intramedullary tibial cutting guides was carried out in 92 megaprosthetic knee replacements for distal femoral tumors. For the proximal tibia cut for tibial component placement, an extramedullary guide was used in 65 patients and an intramedullary guide was used in 27 patients. Tibial component alignment angles were measured in postoperative X-rays with the help of CAD software. Results There was more varus placement in coronal plane with extramedullary cutting guide (−1.18 +/− 2.4 degrees than the intramedullary guide (−0.34 +/− 2.31 degrees but this did not reach statistical significance. The goal of 90 +/− 2 degrees alignment of tibial component was achieved in 54% of patients in the extramedullary group versus 67% in the intramedullary group. In terms of sagittal plane alignment, extramedullary guide showed less accurate results (2.09 +/− 2.4 degrees than intramedullary guide (0.50 +/− 3.80 degrees for tibial component alignment, though 78% of patients were aligned within the goal of 0–5 degrees of tibial slope angle in extramedullary group versus 63% in intramedullary group. The mean error in the measurements due to rotation of the knee during taking the X-rays was less than 0.1 degrees and distribution of the X-rays with the rotation of knee was similar in both the groups. Conclusions Overall, in megaprosthetic knee replacement intramedullary guides gave more accurate results in sagittal plane and exhibited similar variability as of extramedullary guides in coronal plane.

Quantification of liver fat using magnetic resonance spectroscopy

DEFF Research Database (Denmark)

Thomsen, C; Becker, Povl Ulrik; Winkler, K

1994-01-01

significant correlation was found between the fat concentration measured in the liver biopsies, and the concentration calculated from the spectroscopic experiments (r = 0.9, p methods based on differences...... in relaxation times, and can be used to estimate the fat concentration over the full range of fat content in contrast to the spectroscopic imaging methods. Localized spectroscopy may replace liver biopsy in the diagnosis of diffuse fatty infiltrations, and can be used for follow-up, due to its noninvasive...

A Numerical Study of Effects of the Manufacture Perturbations to Contacts of the Total Hip Replacement

Czech Academy of Sciences Publication Activity Database

Koukal, M.; Fuis, Vladimír; Florian, Z.; Janíček, P.

2011-01-01

Roč. 18, č. 1 (2011), s. 33-42 ISSN 1802-1484 Institutional research plan: CEZ:AV0Z20760514 Keywords : total hip replacement * FEM * roundness * contact pressure * frictional moment Subject RIV: BO - Biophysics

Opinions among Danish knee surgeons about indications to perform total knee replacement showed considerable variation

DEFF Research Database (Denmark)

Troelsen, Anders; Schrøder, Henrik; Husted, Henrik

2012-01-01

During the past decade, the incidence of primary total knee replacement (TKA) surgery in Denmark has approximately doubled. This increase could be due to weakened indications to perform TKA surgery. We aimed to investigate variation in opinions about indications to perform TKA among Danish knee...

[Effect of fats on cardiovascular disease prevention in Denmark].

Science.gov (United States)

Astrup, Arne; Larsen, Mogens Lytken; Stender, Steen; Dyerberg, Jørn

2014-05-05

In Denmark death from cardiovascular disease (CVD) has decreased, mainly due to a 72% reduction since 1990 in death from ischaemic heart disease from reduced smoking, elimination of industrial trans fatty acids in the diet, and more effective medical treatment. Replacement of saturated fat by carbohydrate and/or n-6 polyunsaturated fat may increase CVD, but it is reduced by substitution with n-3 fats, monounsaturated fat, or low glycaemic index carbohydrates. Despite a high saturated fat content dark chocolate and cheese may reduce CVD and diabetes risk and eggs may be neutral, and less restrictive dietary recommendations are indicated.

Hip joint replacement

Science.gov (United States)

Hip arthroplasty; Total hip replacement; Hip hemiarthroplasty; Arthritis - hip replacement; Osteoarthritis - hip replacement ... Your hip joint is made up of 2 major parts. One or both parts may be replaced during surgery: ...

Assessment and validation of CT scanogram to compare per-operative and post-operative mechanical axis after navigated total knee replacement

Science.gov (United States)

Jain, Sunil

2008-01-01

Our objective was to assess and validate low-dose computed tomography (CT) scanogram as a post-operative imaging modality to measure the mechanical axis after navigated total knee replacement. A prospective study was performed to compare intra-operative and post-operative mechanical axis after navigated total knee replacements. All consecutive patients who underwent navigated total knee replacement between May and December 2006 were included. The intra-operative final axis was recorded, and post-operatively a CT scanogram of lower limbs was performed. The mechanical axis was measured and compared against the intra-operative measurement. There were 15 patients ranging in age from 57 to 80 (average 70) years. The average final intra-operative axis was 0.56° varus (4° varus to 1.5° valgus) and post-operative CT scanogram axis was 0.52° varus (3.1° varus to 1.8° valgus). The average deviation from final axes to CT scanogram axes was 0.12° valgus with a correlation coefficient of 0.9. Our study suggests that CT scanogram is an imaging modality with reasonable accuracy for measuring mechanical axis despite significantly low radiation. It also confirms a high level of correlation between intra-operative and post-operative mechanical axis after navigated total knee replacement. PMID:18696064

Shoulder replacement - discharge

Science.gov (United States)

Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; Arthroplasty - shoulder - discharge

Ankle replacement - discharge

Science.gov (United States)

... total - discharge; Total ankle arthroplasty - discharge; Endoprosthetic ankle replacement - discharge; Osteoarthritis - ankle ... You had an ankle replacement. Your surgeon removed and reshaped ... an artificial ankle joint. You received pain medicine and were ...

Intrinsic constraint of unlinked total elbow replacements--the ulnotrochlear joint.

Science.gov (United States)

Kamineni, S; O'Driscoll, S W; Urban, M; Garg, A; Berglund, L J; Morrey, B F; An, K N

2005-09-01

Many unlinked total elbow replacement designs with radically differing articular geometries exist, suggesting that there is no consensus regarding an optimal design. A feature inherent to the articular design is the intrinsic constraint afforded to the joint by the implant. Our aim was to compare the intrinsic constraints of unlinked implants with that of the normal ulnotrochlear joint. We tested twelve cadaveric ulnotrochlear joints with a custom-made multiple-axis materials testing machine. With compressive loads ranging from 10 to 100 N, the joints were moved in either valgus or varus directions at 90 degrees of flexion. The ulnotrochlear components from a single example of five medium-sized unlinked elbow replacements (Ewald, Kudo, Pritchard ERS, Sorbie-Questor, and Souter-Strathclyde) were also tested. The recorded measurements included the torques and forces, angular displacement, and axial displacement of the humerus relative to the ulna. In general, the peak torque and the constraint ratio significantly increased with increasing compressive load for the implants as well as for the normal elbow. In valgus displacement, the Souter-Strathclyde implant had the highest and the Sorbie-Questor had the smallest peak torque and the Souter-Strathclyde had the highest and the Ewald had the smallest constraint ratio. In varus displacement, the Kudo had the highest and the Ewald had the smallest peak torque and constraint ratio. The constraint ratio is a characteristic that is useful for describing elbow joint behavior and for comparing the behavior of implants with that of the human elbow. Of the unlinked implants tested, the Souter-Strathclyde and Kudo prostheses most closely approximated the behavior of the human elbow joint. Implants that resemble the human elbow in appearance do not replicate normal behavior consistently, whereas other implants that do not resemble the human elbow closely do not deviate markedly from human behavior. Thus, much basic information

The role of hinges in primary total knee replacement.

Science.gov (United States)

Gehrke, T; Kendoff, D; Haasper, C

2014-11-01

The use of hinged implants in primary total knee replacement (TKR) should be restricted to selected indications and mainly for elderly patients. Potential indications for a rotating hinge or pure hinge implant in primary TKR include: collateral ligament insufficiency, severe varus or valgus deformity (>20°) with necessary relevant soft-tissue release, relevant bone loss including insertions of collateral ligaments, gross flexion-extension gap imbalance, ankylosis, or hyperlaxity. Although data reported in the literature are inconsistent, clinical results depend on implant design, proper technical use, and adequate indications. We present our experience with a specific implant type that we have used for over 30 years and which has given our elderly patients good mid-term results. Because revision of implants with long cemented stems can be very challenging, an effort should be made in the future to use shorter stems in modular versions of hinged implants. ©2014 The British Editorial Society of Bone & Joint Surgery.

Effects of different corn silage: Alfalfa silage ratios and full fat ...

African Journals Online (AJOL)

Full fat extruded soybeans addition increased the ether extract in diets and content of conjugated linoleic acids in milk, but it had no effect on fat, protein and lactose content in milk. Milk fat and lactose were not affected by replacing corn silage with alfalfa silage in diets. Increasing alfalfa silage content in the diets increased ...

Alfalfa silage ratios and full fat extruded soybeans on milk

African Journals Online (AJOL)

USER

2010-08-16

Aug 16, 2010 ... Treatments were arranged in a 2 × 3 factorial with 0 or 5% full fat extruded soybeans meal (dry matter basis) and ... Milk fat and lactose were not affected by replacing corn .... The oven temperature was initially 180°C for 45.

Vegetable fats and oils as functional ingredients in meat products

Directory of Open Access Journals (Sweden)

Alfonso Totosaus

2011-12-01

Full Text Available Sausages are a widely consumed food in México, and due to their low fat content (ca. 10% they can be employed to enrich diet by including functional or nutraceutic ingredients as vegetable fats and oils. The replace or incorporation of vegetable fats or oils in cooked sausages is a way to improve their nutritional profile to offer functional meat products.

A new three-dimensional, print-on-demand temporomandibular prosthetic total joint replacement system: Preliminary outcomes.

Science.gov (United States)

Dimitroulis, George; Austin, Stephen; Sin Lee, Peter Vee; Ackland, David

2018-05-16

The aim of this study is to present the preliminary clinical data on the OMX Temporomandibular Joint (TMJ) Prosthetic total joint replacement system. A prospective, cohort, clinical study was undertaken of consecutive adult patients with Category 5 end-stage joint disease who were implanted with the OMX TMJ prosthesis between May 2015 and April 2017. A total of 50 devices were implanted in 38 patients, with 12 patients receiving bilateral prosthetic joints. There were 31 females and 7 males in this cohort, who ranged in age from 20 to 66 years, with a mean of 43.8 years (±14.0 years). Ten of the 50 prosthetic joints (20%) were fully customized, while the remaining were patient matched using virtual planning software. Based on a mean follow-up period of 15.3 months (range 12-24 months) following the TMJ total joint replacement, preliminary results suggest the OMX TMJ prosthesis has made a positive impact on clinical outcomes, with a mean 74.4% reduction in joint pain levels and significant improvements (p < 0.05) in jaw function as measured by the visual analogue scales for mouth opening (30.8%), diet (77.1%), and function (59.2%). No device failures were reported during the study period. This study suggests that the print-on-demand OMX TMJ prosthesis, designed for rapid delivery of both patient-matched and fully customize devices, represents a safe, reliable and versatile implantable joint replacement system for the treatment of category 5 end-stage TMJ disease. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Parental Smoking During Pregnancy and Total and Abdominal Fat Distribution in School-age Children: the Generation R Study

NARCIS (Netherlands)

Durmus, B.; Heppe, D.H.M.; Taal, H.R.; Manniesing, R.; Raat, H.; Hofman, A.; Steegers, E.A.P.; Gaillard, R.; Jaddoe, V.W.

2014-01-01

Objective:Fetal smoke exposure may influence growth and body composition later in life. We examined the associations of maternal and paternal smoking during pregnancy with total and abdominal fat distribution in school-age children.Methods:We performed a population-based prospective cohort study

Parental smoking during pregnancy and total and abdominal fat distribution in school-age children: The Generation R Study

NARCIS (Netherlands)

B. Durmus (Busra); D.H.M. Heppe (Denise); H.R. Taal (Rob); R. Manniesing (Rashindra); H. Raat (Hein); A. Hofman (Albert); E.A.P. Steegers (Eric); R. Gaillard (Romy); V.W.V. Jaddoe (Vincent)

2014-01-01

textabstractObjective: Fetal smoke exposure may influence growth and body composition later in life. We examined the associations of maternal and paternal smoking during pregnancy with total and abdominal fat distribution in school-age children. Methods: We performed a population-based prospective

Autologous fat grafting for cosmetic enhancement of the perioral region.

Science.gov (United States)

Glasgold, Mark; Lam, Samuel M; Glasgold, Robert

2007-11-01

The role of volume loss in the progression of facial aging is widely accepted as an important cause. The aging appearance of the perioral region and lower face is significantly affected by this volume loss, which contributes to the development of labiomental folds, the loss of definition of the jawline, and worsening of skin texture, among other manifestations. Autologous fat transfer can effectively replace this lost volume and contribute to any facial rejuvenation plan. Fat can replace larger volumes than off-the-shelf fillers and provides a potentially permanent solution.

Frying process in the relation fat/degenerative diseases.

Directory of Open Access Journals (Sweden)

Varela, G.

1998-08-01

Full Text Available Among the various components of the diet, fat receives very dose attention because of its relationship to several chronic degenerative diseases (CDD. Currently most of the available information on these relationships is derived from epidemiologic or experimental studies in which lipid intake is calculated using food composition tables. In most of these tables the quoted lipid content is that of raw food, whereas most foods are usually consumed only after being subjected to several culinary processes. Often there is no indication of the type of fat used in food processing in general or in frying in particular. But as it known, in the course of these processes the lipid content undergoes important qualitative and quantitative changes and not keeping them in mind may be the underlying cause of the difficulties an the confounding results in studies trying to establish the relationship between lipid intake an health. In the Mediterranean diet, about 50% of total dietary fat is derived not from the food itself but from the cooking fat, of which only a small fraction is eaten raw (as dressings and the greatest proportion is used in thermal culinary processes, mainly deep-frying. The scientific study of the process whereby fat penetrates into fried foods has shown the benefits of this cooking method. If the process is correctly carried out, the amount of fat ingested with fried foodstuffs is not greater than when other procedures involving fat are used (for example, sautening, stewing or canning in oil. Very schematically deep-frying is a technique that replaces a fraction of the water content of food by cooking fat. Consecuently, the fat composition of the fried lean foods will be the same as that cooking fat. The process is more complex with fatty foods, and there are not great changes in the total quantity of fat in the fried food before and after frying. However, there are notable quality changes and these depend on the concentration gradients

Patients' journeys through total joint replacement: patterns of medication use.

Science.gov (United States)

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

2014-06-01

Medication is used to manage pain that results from both osteoarthritis and total joint replacement (TJR). Research has provided insight into how people living with osteoarthritis use pain relief medication. However, it is not known whether elective TJR affects existing attitudes and behaviours with regard to pain medications. Using qualitative methods, the present study explored patterns of pain relief use around the time of TJR. In-depth face-to-face qualitative interviews were carried out with 24 patients two to four weeks after they had undergone TJR for hip or knee osteoarthritis. Participants were asked to reflect on their use of pain medication pre-surgery, while in hospital and while recovering from their operation at home. Transcripts of the audio-recorded interviews were imported into Atlas.ti® and thematic analysis was used. Attitudes to pain relief medication and their use are not static. Many participants change their use of pain medication around the time of surgery. This shift was influenced by interactions with health professionals and changing views on the acceptability, necessity and value of pain relief in helping to manage an altered pain experience. Understanding reasons for medication-taking behaviour during the journey through joint replacement may be helpful to health professionals. Health professionals have a fundamental role to play in challenging or reinforcing different treatment beliefs, which is the basis for effective use of pain relief over the pre- to postoperative period. © 2013 John Wiley & Sons, Ltd.

Is Lumbosacral Plexus Block an Effective and Safe Alternative as Surgical Anesthesia for Total Hip Replacement?

DEFF Research Database (Denmark)

Nielsen, Niels Dalsgaard; Larsen, Jens Rolighed; Børglum, Jens

BACKGROUND An increasing number of patients for total hip replacement presents with cardiovascular comorbidities, that render them fragile to traditional methods of anesthesia. The aim of this intended study is to compare lumbosacral plexus blockade with continuous spinal anesthesia for surgical ...

Efficacy of low-calorie, partial meal replacement diet plans on weight and abdominal fat in obese subjects with metabolic syndrome: a double-blind, randomised controlled trial of two diet plans - one high in protein and one nutritionally balanced.

Science.gov (United States)

Lee, K; Lee, J; Bae, W K; Choi, J K; Kim, H J; Cho, B

2009-02-01

Little is known about the relative efficacy of high-protein vs. conventional diet plans that include partial meal replacements on body fat loss in obese subjects with metabolic syndrome. We aimed to evaluate the efficacy of two low-calorie diets with partial meal replacement plans-a high-protein plan (HP) and a nutritionally balanced conventional (C) plan-on reducing obesity in obese subjects with metabolic syndrome. In a 12-week, double-blind study, we randomised 75 participants to either the HP- or the C-plan group. We recorded key metrics at 0 and 12 weeks. The overall mean weight loss was 5 kg in the HP-plan group and 4.9 kg in the C-plan group (p = 0.72). Truncal fat mass decreased 1.6 kg in the HP-plan group (p or = 70% dietary compliance, however, truncal and whole body fat mass decreased more in the HP-plan group (Delta 2.2 kg and Delta 3.5 kg respectively) than in the C-plan group (Delta 1.3 kg and Delta 2.3 [corrected] kg respectively) (p < 0.05). The HP- and C-plans had a similar effect on weight and abdominal fat reduction, but the HP-plan was more effective in reducing body fat among compliant subjects.

Radiography, radionuclide imaging, and asthrography in the evaluation of total hip and knee replacement

International Nuclear Information System (INIS)

Gelman, M.I.; Coleman, R.E.; Stevens, P.M.; Davey, B.W.

1978-01-01

Twenty patients with 21 total joint replacements including 17 hips and 4 knees were studied by plain film radiography, radionuclide imaging, and subtraction arthrography to evaluate these procedures for assessing prosthetic complications. Surgery was performed in 14 patients and confirmed loosening of 8 femoral and 7 acetabular hip prosthesis components and 1 femoral and 4 tibial knee prosthesis components. Plain films suggested loosening of only 9 hip components and no knee components. In contrast, radionuclide imaging and subtraction arthrography were considerably more effective in demonstrating loosening as well as other causes of the painful total joint prosthesis

Effect of pre-operative neuromuscular training on functional outcome after total knee replacement

DEFF Research Database (Denmark)

Huber, Erika O; de Bie, Rob A; Roos, Ewa M.

2013-01-01

Total Knee Replacement (TKR) is the standard treatment for patients with severe knee osteoarthritis (OA). Significant improvement in pain and function are seen after TKR and approximately 80% of patients are very satisfied with the outcome. Functional status prior to TKR is a major predictor...... of outcome after the intervention. Thus, improving functional status prior to surgery through exercise may improve after surgery outcome. However, results from several previous trials testing the concept have been inconclusive after surgery....

[Clinical evaluation of the ceramic femoral component used for reconstruction of total knee replacement].

Science.gov (United States)

Vavrík, P; Landor, I; Denk, F

2008-12-01

The study evaluates mid-term results of total knee replacement with a zirconia ceramic (ZrO2) femoral component. The evaluated group comprised 20 knees in 19 patients (4 men and 15 women). In one patient the replacement was performed bilaterally. Two patients had in the contralateral knee the same type of prosthesis with a femoral chrome-cobalt component.The mean age at the time of operation was 65.2 years (range, 38-81 years).The primary indication was 14 times osteoarthritis and 5 times rheumatoid arthritis. The average follow-up period was 6.5 years (range, 2.1-8.5 years). Patients included in the study regardless of age, body mass and the basic diagnosis, agreed with the use of the ceramic femoral component. The evaluation covered a range of motion, mechanical axis, joint stability, pain, swelling, ability to walk on level ground and on stairs, subjective satisfaction (EULAR Knee Chart). Radiograph were assessed at one year intervals in two projections to identify the incidence of radiolucency around the implant. The Kaplan-Meier survival curve was used and compared with the survival curve in identical chrome-cobalt implants. At he final follow-up, 14 knees were evaluated, because 3 patients died without any connection with the implant, in one case the tibial component migrated due to necrosis of the tibial condyle in a patient with RA and two implants had to be revised and replaced due to polyethylene wear. No infection or negative tissue reaction was recorded in the evaluated group. The average flexion range was 109 degrees. All knees were stable and without swelling, in two cases there occurred slight femoropatellar pain. Twelve patients were fully satisfied, 2 patients were satisfied with a certain reservation. The differences in the course of the survival curves of chrome-cobalt and ceramic implants were statistically insignificant. Although the use of zirconia ceramics in vitro reduces the amount of polyethylene wear, the clinical outcomes of total knee

Negative Outcomes of Poly(l-Lactic Acid) Fiber-Reinforced Scaffolds in an Ovine Total Meniscus Replacement Model.

Science.gov (United States)

Patel, Jay M; Merriam, Aaron R; Kohn, Joachim; Gatt, Charles J; Dunn, Michael G

2016-09-01

Our objective was to test the efficacy of collagen-hyaluronan scaffolds reinforced with poly(l-lactic acid) (PLLA) fibers in an ovine total meniscus replacement model. Scaffolds were implanted into 9 sheep (n = 1 at 8 weeks, n = 2 at 16 weeks, n = 3 at both 24, 32 weeks) following total medial meniscectomy. From 16 weeks on, explants were characterized by confined compression creep, histological, and biochemical analyses. Articular surfaces were observed macroscopically and damage was ranked histologically using the Mankin score. At sacrifice, three of the nine PLLA scaffolds had completely ruptured, and the intact scaffolds experienced progressive shape changes and severe narrowing in the body region at 16, 24, and 32 weeks. Aggregate compressive modulus and permeability did not improve with time. Histological and biochemical analyses showed significantly less extracellular matrix and less matrix organization compared to native tissue. Osteophytes, bone erosion, and cartilage damage were observed, increasing with time postimplantation. A buildup of lactic acid and/or the rapid loss of scaffold mechanical integrity due to PLLA degradation are probable causes for the joint abnormalities observed in this study. These results are in sharp contrast to those of our previous successful total meniscus replacement studies using polyarylate [p(DTD DD)] fiber-reinforced scaffolds. This suggests that PLLA fiber as produced in this study cannot be used as reinforcement for a meniscus replacement scaffold.

Intravenous dex medetomidine or propofol adjuvant to spinal anesthesia in total knee replacement surgery

International Nuclear Information System (INIS)

AlOweidi, A.S.; Al-Mustafa, M.M.; Alghanem, S.M.; Qudaisat, Y.; Halaweh, S.A.; Massad, I.M.; Al Ajlouni, J.M; Mas'ad, D. F.

2011-01-01

The purpose of this study was to compare effect of intravenous dex medetomidine with the intravenous propofol adjuvant to spinal intrathecal anesthesia on the duration of spinal anesthesia and hemodynamic parameters during total knee replacement surgery. Supplementation of spinal anesthesia with intravenous dexemedetomidine or propofol produces good sedation levels without significant clinical hemodynamic changes. Adding dex medetomidine produces significantly longer sensory and motor block than propofol . (authors).

Impact of sarcopenia on the outcomes of elective total arch replacement in the elderly†.

Science.gov (United States)

Ikeno, Yuki; Koide, Yutaka; Abe, Noriyuki; Matsueda, Takashi; Izawa, Naoto; Yamazato, Takahiro; Miyahara, Shunsuke; Nomura, Yoshikatsu; Sato, Shunsuke; Takahashi, Hiroaki; Inoue, Takeshi; Matsumori, Masamichi; Tanaka, Hiroshi; Ishihara, Satoshi; Nakayama, Shinichi; Sugimoto, Koji; Okita, Yutaka

2017-06-01

The purpose of this study was to identify the cut-off value of sarcopenia based on the psoas muscle area index and evaluate early and late outcomes following elective total arch replacement in the elderly. Sarcopenia was assessed by the psoas muscle area index [defined as the psoas muscle area at the L3 level on computed tomography (cm 2 )/body surface area (m 2 )]. The cut-off value for sarcopenia was defined as > 2 standard deviations below the mean psoas muscle area index value obtained from 464 normal control patients. Between October 1999 and July 2015, 266 patients who were ≥ 65 years and had undergone psoas muscle area index measurement underwent elective total arch replacement. These patients were classified into the sarcopenia (Group S, n  = 81) and non-sarcopenia (Group N, n  = 185) groups. The mean age was 76.2 ± 5.6 years in Group S and 75.7 ± 5.7 years in Group N ( P  = 0.553). Hospital mortality was 3.7% (3/81) in Group S and 2.2% (4/185) in Group N ( P  = 0.483). Mean follow-up was 48.3 ± 38.7 months. Five-year survival was significantly worse in Group S (S: 63.2 ± 6.6% vs N: 88.7 ± 2.6%, P  sarcopenia significantly predicted poor survival (hazard ratio 2.59; 95% confidence interval 1.27-5.29; P  = 0.011). Sarcopenia did not predict hospital death following total arch replacement, but it was negatively associated with overall survival. Sarcopenia can be an additional risk factor to estimate the outcomes of thoracic aortic surgery. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) in primary care using total diet replacement products: a protocol for a randomised controlled trial.

Science.gov (United States)

Jebb, Susan A; Astbury, Nerys M; Tearne, Sarah; Nickless, Alecia; Aveyard, Paul

2017-08-04

The global prevalence of obesity has risen significantly in recent decades. There is a pressing need to identify effective interventions to treat established obesity that can be delivered at scale. The aim of the Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) study is to determine the clinical effectiveness, feasibility and acceptability of referral to a low-energy total diet replacement programme compared with usual weight management interventions in primary care. The DROPLET trial is a randomised controlled trial comparing a low-energy total diet replacement programme with usual weight management interventions delivered in primary care. Eligible patients will be recruited through primary care registers and randomised to receive a behavioural support programme delivered by their practice nurse or a referral to a commercial provider offering an initial 810 kcal/d low-energy total diet replacement programme for 8 weeks, followed by gradual food reintroduction, along with weekly behavioural support for 24 weeks. The primary outcome is weight change at 12 months. The secondary outcomes are weight change at 3 and 6 months, the proportion of participants achieving 5% and 10% weight loss at 12 months, and change in fat mass, haemoglobin A1c, low-density lipoprotein cholesterol and systolic and diastolic blood pressure at 12 months. Data will be analysed on the basis of intention to treat. Qualitative interviews on a subsample of patients and healthcare providers will assess their experiences of the weight loss programmes and identify factors affecting acceptability and adherence. This study has been reviewed and approved by the National Health ServiceHealth Research Authority (HRA)Research Ethics Committee (Ref: SC/15/0337). The trial findings will be disseminated to academic and health professionals through presentations at meetings and peer-reviewed journals and to the public through the media. If the intervention is effective, the results

Is Total Femur Replacement a Reliable Treatment Option for Patients With Metastatic Carcinoma of the Femur?

Science.gov (United States)

Sevelda, Florian; Waldstein, Wenzel; Panotopoulos, Joannis; Kaider, Alexandra; Funovics, Philipp Theodor; Windhager, Reinhard

2018-05-01

The majority of metastatic bone lesions to the femoral bone can be treated without surgery or with minimally invasive intramedullary nailing. In rare patients with extensive metastatic disease to the femur, total femur replacement may be the only surgical alternative to amputation; however, little is known about this approach. In a highly selected small group of patients with metastatic carcinoma of the femur, we asked: (1) What was the patient survivorship after this treatment? (2) What was the implant survivorship free from all-cause revision and amputation, and what complications were associated with this treatment? (3) What functional outcomes were achieved by patients after total femur replacement for this indication? Eleven patients (three men, eight women) with a mean age of 64 years (range, 41-78 years) received total femur replacements between 1986 and 2016; none were lost to followup. The most common primary disease was breast cancer. In general, during this period, our indications for this procedure were extensive metastatic disease precluding internal fixation or isolated proximal or distal femur replacement, and an anticipated lifespan exceeding 6 months. Our contraindication for this procedure during this time was expected lifespan less than 6 months. Patient survival was assessed by Kaplan-Meier analysis; implant survival free from revision surgery and amputation were assessed by competing risk analysis. Function was determined preoperatively and 6 to 12 weeks postoperatively with the Musculoskeletal Tumor Society (MSTS) score normalized to a 100-point scale, with higher scores representing better function from a longitudinally maintained institutional database. Eleven patients died at a median of 5 months (range, 1-31 months) after surgery. One-year revision-free and limb survival were 82% (95% CI, 51%-98%) and 91% (95% CI, 61%-99%), respectively. Reasons for reoperation were hip dislocation, infection and local recurrence in one patient each. The

Concerns of patients actively contemplating total knee replacement: differences by race and gender.

Science.gov (United States)

Chang, Huan J; Mehta, Priya S; Rosenberg, Aaron; Scrimshaw, Susan C

2004-02-15

To examine differences by race/ethnicity and gender in patients' concerns regarding total knee replacement (TKR). Focus groups of patients actively considering TKR were conducted. Discussion included patients' questions and concerns regarding TKR. The software ATLAS.ti was used to tabulate themes by race/ethnicity and gender. Concerns raised by focus group participants were compared with thematic content from patient joint replacement information materials. This comparison used patient literature from 3 high-volume academic TKR centers, the Arthritis Foundation, and the American Academy of Orthopedic Surgeons. All groups shared similar concerns. However, some issues were more prevalent among certain gender and racial groups. For instance, concerns regarding anesthesia were more important to white Americans and concerns regarding recovery were more important to women. Some of these concerns were not addressed in the available patient literature. Different gender and racial subgroups focus on different concerns when considering TKR. These differences may contribute to gender and race/ethnicity disparity seen in TKR use.

Periprosthetic femoral fracture within two years after total hip replacement:

DEFF Research Database (Denmark)

Thien, T. M.; Chatziagorou, G.; Garellick, G.

2014-01-01

BACKGROUND: We used the Nordic Arthroplasty Register Association database to evaluate whether age, sex, preoperative diagnosis, fixation, and implant design influence the risk of revision arthroplasty due to periprosthetic fracture within two years from operation of a primary total hip replacement....... METHODS: Included in the study were 325,730 cemented femoral stems and 111,899 uncemented femoral stems inserted from 1995 to 2009. Seven frequently used stems (two cemented stems [Exeter and Lubinus SP II] and five uncemented stems [Bi-Metric, Corail, CLS Spotorno, ABG I, and ABG II]) were specifically...... studied. RESULTS: The incidence of revision at two years was low: 0.47% for uncemented stems and 0.07% for cemented stems. Uncemented stems were much more likely to have this complication (relative risk, 8.72 [95% confidence interval, 7.37 to 10.32]; p

Total knee replacement and non-surgical treatment of knee osteoarthritis

DEFF Research Database (Denmark)

Skou, Søren T; Roos, Ewa M; Laursen, Mogens B

2018-01-01

OBJECTIVES: To compare 2-year outcomes of total knee replacement (TKR) followed by non-surgical treatment to that of non-surgical treatment alone and outcomes of the same non-surgical treatment to that of written advice. DESIGN: In two randomized trials, 200 (mean age 66) adults with moderate...... to severe knee osteoarthritis (OA), 100 eligible for TKR and 100 not eligible for TKR, were randomized to TKR followed by non-surgical treatment, non-surgical treatment alone, or written advice. Non-surgical treatment consisted of 12 weeks of supervised exercise, education, dietary advice, use of insoles......, and pain medication. The primary outcome was the mean score of the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, covering pain, symptoms, activities of daily living (ADL), and quality of life (QOL). RESULTS: Patients randomized to TKR had greater improvements than patients randomized...

[Prevention and treatment of perioperative period complication of total ankle replacement].

Science.gov (United States)

Liao, Xiang; Gao, Zhizeng; Huang, Shanhu; Yang, Shuhua

2008-01-01

To explore the cause of the perioprative period complication of scandinavian total ankle replacement (STAR) and to summarize the experience in the treatment and prevention. From March 1999 to November 2006, 35 patients were given total ankle replacement (TAR) with STAR system. There were 19 males and 16 females with an average age of 50.5 years (27 to 68 years), including 12 cases of posttraumatic arthritis, 8 cases of osteoarthritis and 15 cases of rheumatoid arthritis. All patients had pain of ankle joint, swelling and limitation of joint motion. The disease course was 9-64 months. The curative effect was estimated by Kofoed total ankle scoring system. The mean preoperative ankle score was 29 (6-48); the mean pain score was 18.3 (0-35); the mean function score was 11.7 (6-18); and the mean activity score was 9.2 (3-12). The type of all complications were record, and its cause, prevetion and treatment were analyszed. Thirty-three patients achieved healing by first intention, 2 achieved delayed union because of infection. Twenty-eight patients were followed up 3-80 months (mean 43.5 months). Medial malleolus fracture occurred in 2 cases, unstable ankle joint introversion in 2 cases, limitation of ankle dorsiextension in 1 case and 1 case had hypoesthesia at intermediate dorsal skin of foot and 3rd-5th metatarsal skin without obvious dysfunction; all were treated with symptomatic medication. The postoperative mean ankle score was 85.5 (58-95); the mean pain score was 48.3 (35-50); the mean function score was 20.7 (18-30); the mean activity score was 17.2 (16-20). There were statistically significant differences when compared with preoperative score (P<0.01). The clinical results were excellent in 16 patients, good in 9 patients and fair in 3 patients. The X-ray films showed no loosening and subsidence of prosthesis. Although STAR can retain the functions of the operated joint, it has its special complications. It is important to obey operation principle with

The comparison of clinical features and quality of life after total knee replacement.

Science.gov (United States)

Lee, Jiyeon; Kim, Jung-Hee; Jung, Eun-Jung; Lee, Byoung-Hee

2017-06-01

[Purpose] The purpose of this study is to provide fundamental information for efficient management of patients after a total knee replacement (TKR) through the evaluation of changes of range of motion, pain, functional level, and quality of life. [Subjects and Methods] For a total of 63 knee osteoarthritis patients, VAS, KSKS, KSFS, HSS, WOMAC scores and quality of life were evaluated for functional levels at pre-operation, post-operation, six months after operation, and 12 months after operation. [Results] After the TKR operations, participants showed significant improvement in KSKS, KSFS, WOMAC, and SF-36 scores when compared to pre-operation. [Conclusion] After a TKR operation, ROM, and pain management, along with a therapeutic program for improvement of function, should be conducted 6 months after the operation.

Body Fat, Abdominal Fat, and Body Fat Distribution Is Related to Left Atrial Diameter in Young Children

DEFF Research Database (Denmark)

Dencker, Magnus; Thorsson, Ola; Karlsson, Magnus K

2012-01-01

such as lean body mass, blood pressure, gender, age, and Tanner stage revealed that TBF, AFM, and AFM/TBF were all independently related to LA diameter. Differences in the different body fat measurements explained 6-9% of the variance in LA size. These results demonstrated that both total body fat, AFM...

Partial fat and sugar replacement with soy milk, inulin and sucralose ...

African Journals Online (AJOL)

Thai Pandanus custard samples replaced with coconut milk, and sugar with soy milk, inulin and sucralose, were compared with quality characteristics of the regular formulation (control). With increasing levels of coconut milk replacement, the product pH and redness increased, whereas there was no significant difference in ...

Association of body mass index and visceral fat with aortic valve calcification and mortality after transcatheter aortic valve replacement: the obesity paradox in severe aortic stenosis.

Science.gov (United States)

Mancio, Jennifer; Fonseca, Paulo; Figueiredo, Bruno; Ferreira, Wilson; Carvalho, Monica; Ferreira, Nuno; Braga, Pedro; Rodrigues, Alberto; Barros, Antonio; Falcao-Pires, Ines; Leite-Moreira, Adelino; Ribeiro, Vasco Gama; Bettencourt, Nuno

2017-01-01

Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC) and poor outcomes in aortic stenosis (AS). However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. To determine the association of body mass index (BMI) and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR). This was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF) and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years. Higher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05). At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1-4.9; p = 0.021) and HR with obese/high VAF was 2.5 (95% CI 1.1-5.8; p = 0.031) compared with obese/low VAF patients. In AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.

Use of Tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement

Directory of Open Access Journals (Sweden)

Umer Chaudhry Muhammad

2011-05-01

Full Text Available Abstract Background & Purpose Allogenic blood transfusion in elective orthopaedic surgery is best avoided owing to its associated risks. Total knee replacement often requires blood transfusion, more so when bilateral surgery is performed. Many strategies are currently being employed to reduce the amount of peri-operative allogenic transfusions. Anti-fibrinolytic compounds such as aminocaproic acid and tranexamic acid have been used systemically in perioperative settings with promising results. This study aimed to evaluate the effectiveness of tranexamic acid in reducing allogenic blood transfusion in total knee replacement surgery. Methodology This was a retrospective cohort study conducted on patients undergoing total knee replacement during the time period November 2005 to November 2008. Study population was 99 patients, of which 70 underwent unilateral and 29 bilateral knee replacement. Forty-seven patients with 62 (49.5% knees (group-I had received tranexamic acid (by surgeon preference while the remaining fifty-two patients with 66 (51.5% knees (group-II had did not received any tranexamic acid either pre- or post-operatively. Results The mean drop in the post-operative haemoglobin concentration in Group-II for unilateral and bilateral cases was 1.79 gm/dl and 2.21 gm/dl, with a mean post-operative drainage of 1828 ml (unilateral and 2695 ml (bilateral. In comparison, the mean drop in the post-op haemoglobin in Group-I was 1.49 gm/dl (unilateral and 1.94 gm/dl (bilateral, with a mean drainage of 826 ml (unilateral and 1288 ml (bilateral (p-value Interpretation Tranexamic acid is effective in reducing post-operative drainage and requirement of blood transfusion after knee replacement.

Reduced Fat Food Emulsions: Physicochemical, Sensory, and Biological Aspects.

Science.gov (United States)

Chung, Cheryl; Smith, Gordon; Degner, Brian; McClements, David Julian

2016-01-01

Fat plays multiple important roles in imparting desirable sensory attributes to emulsion-based food products, such as sauces, dressings, soups, beverages, and desserts. However, there is concern that over consumption of fats leads to increased incidences of chronic diseases, such as obesity, coronary heart disease, and diabetes. Consequently, there is a need to develop reduced fat products with desirable sensory profiles that match those of their full-fat counterparts. The successful design of high quality reduced-fat products requires an understanding of the many roles that fat plays in determining the sensory attributes of food emulsions, and of appropriate strategies to replace some or all of these attributes. This paper reviews our current understanding of the influence of fat on the physicochemical and physiological attributes of food emulsions, and highlights some of the main approaches that can be used to create high quality emulsion-based food products with reduced fat contents.

Total knee replacement influences both knee and hip joint kinematics during stair climbing

OpenAIRE

Saari, Tuuli; Tranberg, Roy; Zügner, Roland; Uvehammer, Johan; Kärrholm, Johan

2004-01-01

A gait analysis system was used to evaluate the kinematics of the hip and knee during stair ascending and descending after operation with total knee replacement. Patients with 5° varus/valgus alignment or less were selected randomly to receive either a flat or a concave tibial component with retention of the posterior cruciate ligament. Patients who had more than 5° varus/valgus alignment and/or an extension defect of 10° or more were selected randomly to receive the concave or posterior-stab...

Concordant lipoprotein and weight responses to dietary fat changein identical twins with divergent exercise levels

Energy Technology Data Exchange (ETDEWEB)

Williams, Paul T.; Blanche, Patricia J.; Rawlings, Robin; Krauss, Ronald M.

2004-06-01

Background/Objective: The purpose of this study is to testthe extent that individual lipoprotein responses to diet can beattributed to genes in the presence of divergent exercise levels.Design:Twenty-eight pairs of male monozygotic twins (one mostly sedentary, theother running an average of 50 km/week more than the sedentary twin) wentfrom a 6-week 40 percent fat diet to a 6-week 20 percent fat diet in acrossover design. The diets reduced fat primarily by reducing saturatedand polyunsaturated fat (both from 14 percent to 4 percent), whileincreasing carbohydrate intake from 45 percent to 65 percent. Results:Despite the twins' differences in physical activity, the dietarymanipulation produced significantly correlated changes (P<0.05) in thetwin's total cholesterol (r=0.56), low-density lipoprotein(LDL)-cholesterol (r=0.70), large, buoyant LDL (Sf7-12, r=0.52), apo A-I(r=0.49), Lp(a) (r=0.49), electrophoresis measurements of LDL-I (LDLsbetween 26 and 28.5 nm diameter, r=0.48), LDL-IIB (25.2-24.6 nm, r=0.54),LDL-IV (22-24.1 nm, r=0.50), and body weights (r=0.41). Replacing fatswith carbohydrates significantly decreased the size and ultracentrifugeflotation rate of the major LDL, the LDL mass concentrations of Sf7-12,LDL-I, high-density lipoprotein (HDL)-cholesterol and apo A-I, andsignificantly increased LDL-IIIA (24.7-25.5 nm diameter) and Lp(a).Conclusions: Even in the presence of extreme exercise difference, genessignificantly affect changes in LDL, apo A-I, Lp(a) and body weight whendietary fats are replaced with carbohydrates.

Dietary fat type, meat quality and fatty acid metabolism in swine

NARCIS (Netherlands)

Mitchaothai, J.

2007-01-01

This thesis focuses on the replacement of animal fat by vegetable oil in the diet for growing-finishing pigs. Generally, but not exclusively, fats of animal origin contain higher proportions of saturated fatty acids (SFA) than vegetable oils that are commonly rich in polyunsaturated fatty acids

Effects of balance and proprioceptive training on total hip and knee replacement rehabilitation: A systematic review and meta-analysis.

Science.gov (United States)

Domínguez-Navarro, Fernando; Igual-Camacho, Celedonia; Silvestre-Muñoz, Antonio; Roig-Casasús, Sergio; Blasco, José María

2018-05-01

Balance and proprioceptive deficits are frequently persistent after total joint replacement, limiting functionality and involving altered movement patterns and difficulties in walking and maintaining postural control among patients. The goal of this systematic review was to evaluate the short- and mid-term effects of proprioceptive and balance training for patients undergoing total knee and hip replacement. This is a systematic review of literature. MEDLINE, Embase, Cochrane Library, PEDro, and Scopus were the databases searched. The review included randomized clinical trials in which the experimental groups underwent a training aimed at improving balance and proprioception, in addition to conventional care. The studies had to assess at least one of the following outcomes: self-reported functionality or balance (primary outcomes), knee function, pain, falls, or quality of life. Eight trials were included, involving 567 participants. The quantitative synthesis found a moderate to high significant effect of balance and proprioceptive trainings on self-reported functionality and balance after total knee replacement. The effects were maintained at mid-term in terms of balance alone. Conversely, preoperative training did not enhance outcomes after total hip arthroplasty. The synthesis showed that, in clinical terms, balance trainings are a convenient complement to conventional physiotherapy care to produce an impact on balance and functionality after knee replacement. If outcomes such as improvement in pain, knee range of movement, or patient quality of life are to be promoted, it would be advisable to explore alternative proposals specifically targeting these goals. Further research is needed to confirm or discard the current evidence ultimately, predominantly in terms of the effects on the hips and those yielded by preoperative interventions. Copyright © 2018 Elsevier B.V. All rights reserved.

Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis.

Science.gov (United States)

Shan, Leonard; Shan, Bernard; Suzuki, Arnold; Nouh, Fred; Saxena, Akshat

2015-01-21

Total knee replacement is a highly successful and frequently performed operation. Technical outcomes of surgery are excellent, with favorable early postoperative health-related quality of life. This study reviews intermediate and long-term quality of life after surgery. A systematic review and meta-analysis of all studies published from January 2000 onward was performed to evaluate health-related quality of life after primary total knee replacement for osteoarthritis in patients with at least three years of follow-up. Key outcomes were postoperative quality of life, function, and satisfaction compared with the preoperative status. Strict inclusion and exclusion criteria were applied. Quality appraisal and data tabulation were performed with use of predefined criteria. Data were synthesized by narrative review and random-effects meta-analysis utilizing standardized mean differences. Heterogeneity was assessed with the tau(2) and I(2) statistics. Nineteen studies were included in the review. Intermediate and long-term postoperative quality of life was superior to the preoperative level in qualitative and quantitative analyses. The pooled effect in combined WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and KSS (Knee Society Score) outcomes was a marked improvement from baseline with respect to the total score (2.17; 95% CI [confidence interval], 1.13 to 3.22; p Total knee replacement confers significant intermediate and long-term benefits with respect to both disease-specific and generic health-related quality of life, especially pain and function, leading to positive patient satisfaction. Recommendations for necessary future studies are provided. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Sexual activity after total hip replacement in Korean patients: how they do, what they want, and how to improve.

Science.gov (United States)

Yoon, Byung-Ho; Lee, Kyung-Hag; Noh, Serae; Ha, Yong-Chan; Lee, Young-Kyun; Koo, Kyung-Hoi

2013-12-01

Concerns of patients on sexual activity after total hip arthroplasty have not been well studied in Asian patients. This study aimed to determine the following: (1) what are the concerns of patients related to sexual activity after total hip arthroplasty? (2) what are the changes in sexual activity after total hip replacement in Korean patients? Details of sexual activity and concerns were obtained using a questionnaire designed specifically for the study. The questionnaire was administered to 64 patients in a face-to-face interview at an outpatient clinic. Preoperatively, 53.1% of patients experienced difficulties, primarily due to hip pathology and limitations of motion. The median time to the resumption of sexual activity was 3 months postoperatively, and most patients had no increase in the frequency of sexual activity after the total hip replacement. In 39.1% of patients were seen having difficulties with leg positioning following total hip replacement, and they were likely to change coital positions. The most common concern regarding sexual activity of patients was the fear of dislocation. Furthermore, patients with a higher stress level had lower satisfaction rates. Most patients were unable to obtain information on sexual activity following the total hip arthroplasty, and they did not consult with a physician due to the private nature of the topic. Dislocation was the most common concern of patients during sexual activity following a total hip arthroplasty, and a higher stress level was found to be associated with a lower satisfaction rate. Because most patients were unprepared to consult a physician, the provision of appropriate information before a consultation might be beneficial.

Effect of replacing a soy diet with Vicia faba and Pisum sativum on performance, meat and fat traits of Cinta Senese pigs

Directory of Open Access Journals (Sweden)

Francesco Sirtori

2015-02-01

Full Text Available The aim of this study was to investigate the effect of diets containing genetically modified organism-free legumes as a replacement of soybean on the basis of performance, carcass composition and quality of local pig meat (Cinta Senese. Twenty-four Cinta Senese barrows were divided into 3 dietary groups and were each fed with a diet containing different protein sources: soybean meal (SOY, Vicia faba (FABA and Pisum sativum (PEA (8 pigs for each group. The diets were isonitrogenous and isocaloric and contained approximately 14.5% crude protein and 14.8 MJ/kg of digestible energy (on dry matter. Each group was reared outdoors in a paddock of 3500 m2. In vivo performances were not different among groups. At slaughter, differences in subcutaneous fat thickness appeared only in the outer layer, at the last thoracic vertebra level, which was lowest in the PEA group. No differences were found in the sample joint composition. With regard to the chemico-physical traits of meat and fat, the FABA group had the highest values of redness in lean and backfat, while the PEA group showed higher moisture and lower fat content in meat compared to the SOY group. Differences in the fatty acid profile of backfat were found only for the C16:1 percentage that was higher in FABA than SOY pigs. In conclusion, Vicia faba and Pisum sativum could be a good alternative to soybean in the growing-fattening of Cinta Senese pigs.

Prosthetic liner wear in total hip replacement: a longitudinal 13-year study with computed tomography.

Science.gov (United States)

Weidenhielm, Lars; Olivecrona, Henrik; Maguire, Gerald Q; Noz, Marilyn E

2018-06-01

This case report follows a woman who had a total hip replacement in 1992 when she was 45 years old. Six serial computed tomography (CT) examinations over a period of 13 years provided information that allowed her revision surgery to be limited to liner replacement as opposed to replacement of the entire prosthesis. Additionally, they provided data that ruled out the presence of osteolysis and indeed none was found at surgery. In 2004, when the first CT was performed, the 3D distance the femoral head had penetrated into the cup was determined to be 2.6 mm. By 2017, femoral head penetration had progressed to 5.0 mm. The extracted liner showed wear at the thinnest part to be 5.5 mm, as measured with a micrometer. The use of modern CT techniques can identify problems, while still correctable without major surgery. Furthermore, the ability of CT to assess the direction of wear revealed that the liner wear changed from the cranial to dorsal direction.

Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

International Nuclear Information System (INIS)

Hader, H.; Gadoth, N.; Heifetz, H.

1983-01-01

The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen

Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

Energy Technology Data Exchange (ETDEWEB)

Hader, H.; Gadoth, N.; Heifetz, H.

1983-11-01

The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen.

Aquatic exercises versus land based exercises for elderly patients after a total hip replacement

OpenAIRE

Miroljub Jakovljevič; Renata Vauhnik

2011-01-01

Background: Aquatic therapy allows secure, active exercise with pain reduction using a combination of the water’s buoyancy, hydrostatic pressure, resistance and warmth. By aquatic therapy, elderly patients after total hip replacement can achieve more positive effects than by land-based exercise. The aim of the study was to investigate the use of aquatic-based exercises in the rehabilitation programme after a hip fracture surgery in elderly adults. Results: Both groups, regardless of the ty...

No Effect of Acupuncture as Adjunctive Therapy for Patients with Total Knee Replacement

DEFF Research Database (Denmark)

Petersen, Tom; Hautopp, Holger; Duus, Benn

2018-01-01

Objective: Acupuncture is a low risk option in pain management following total knee replacement as an alternative to opioid analgesics. Therefore, the benefit of acupuncture as adjunct to an exercise program was investigated. Furthermore, the modifying effect of previous benefit from acupuncture...... was explored. Design: Three weeks postoperatively, eligible patients were randomized to acupuncture and exercises or exercises alone. Setting: An outpatient rehabilitation centre in the municipality of Copenhagen, Denmark. Subjects: A total of 172 patients were included. Methods: Main outcome was proportion...... of the course of treatment were assessed. Results: No additional benefit of acupuncture was found on any of the main outcomes. Between-group differences were non-significant in proportions of patients with a clinically important reduction of night pain (Relative Risk: 0.98; 95% Confidence Interval (CI): 0...

In vitro degradability and total gas production of biodiesel chain byproducts used as a replacement for cane sugar feed

Directory of Open Access Journals (Sweden)

Milenna Nunes Moreira

2014-09-01

Full Text Available This study aimed to determine the in vitro degradability of dry matter and the total gas production of oil seed press cake from biodiesel production (Gossypium hirsutum L., Helianthus annuus L., Ricinus communis, Moringa oleífera L. and Pinhão manso curcas L. at four different levels of replacement (0, 30, 50, and 70% for cane sugar (Saccharum officinarum RB. in ruminant feed. Inocula were prepared using the ruminal fluid of three Holstein cows, and data were collected after 48 hours of incubation. The byproducts of Moringa had the highest degradability, and castor presented the lowest values at all evaluated levels of replacement. Castor bean byproduct showed the highest total gas production, cotton showed the lowest production, and the byproduct of Moringa at the 70% level showed the best ruminal fermentation results. These results demonstrate that the use of oil seed press cake from biodiesel production (Helianthus annuus L. and Ricinus communis can replace cane sugar in ruminant feed.

CT-based quantification of bone stock in large head metal-on-metal unilateral total hip replacements

NARCIS (Netherlands)

Boomsma, Martijn F.; Slouwerhof, Inge; van Lingen, Christiaan; Pakvis, Dean F. M.; van Dalen, Jorn A.; Edens, Mireille A.; Ettema, Harmen B.; Verheyen, Cees C. P. M.; Maas, Mario

2016-01-01

To explore ipsilateral and contralateral acetabular roof bone stock density in unilateral large head MoM THA whether there is a significant lower acetabular bone stock in the hip with a metal-on-metal (MoM) total hip replacement compared to the contralateral side. Second part of this study is to

Dietary fat, fat subtypes and hepatocellular carcinoma in a large European cohort.

Science.gov (United States)

Duarte-Salles, Talita; Fedirko, Veronika; Stepien, Magdalena; Aleksandrova, Krasimira; Bamia, Christina; Lagiou, Pagona; Laursen, Anne Sofie Dam; Hansen, Louise; Overvad, Kim; Tjønneland, Anne; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; His, Mathilde; Boeing, Heiner; Katzke, Verena; Kühn, Tilman; Trichopoulou, Antonia; Valanou, Elissavet; Kritikou, Maria; Masala, Giovanna; Panico, Salvatore; Sieri, Sabina; Ricceri, Fulvio; Tumino, Rosario; Bueno-de-Mesquita, H B As; Peeters, Petra H; Hjartåker, Anette; Skeie, Guri; Weiderpass, Elisabete; Ardanaz, Eva; Bonet, Catalina; Chirlaque, Maria-Dolores; Dorronsoro, Miren; Quirós, J Ramón; Johansson, Ingegerd; Ohlsson, Bodil; Sjöberg, Klas; Wennberg, Maria; Khaw, Kay-Tee; Travis, Ruth C; Wareham, Nick; Ferrari, Pietro; Freisling, Heinz; Romieu, Isabelle; Cross, Amanda J; Gunter, Marc; Lu, Yunxia; Jenab, Mazda

2015-12-01

The role of amount and type of dietary fat consumption in the etiology of hepatocellular carcinoma (HCC) is poorly understood, despite suggestive biological plausibility. The associations of total fat, fat subtypes and fat sources with HCC incidence were investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which includes 191 incident HCC cases diagnosed between 1992 and 2010. Diet was assessed by country-specific, validated dietary questionnaires. A single 24-hr diet recall from a cohort subsample was used for measurement error calibration. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazard models. Hepatitis B and C viruses (HBV/HCV) status and biomarkers of liver function were assessed separately in a nested case-control subset with available blood samples (HCC = 122). In multivariable calibrated models, there was a statistically significant inverse association between total fat intake and risk of HCC (per 10 g/day, HR = 0.80, 95% CI: 0.65-0.99), which was mainly driven by monounsaturated fats (per 5 g/day, HR = 0.71, 95% CI: 0.55-0.92) rather than polyunsaturated fats (per 5 g/day, HR = 0.92, 95% CI: 0.68-1.25). There was no association between saturated fats (HR = 1.08, 95% CI: 0.88-1.34) and HCC risk. The ratio of polyunsaturated/monounsaturated fats to saturated fats was not significantly associated with HCC risk (per 0.2 point, HR = 0.86, 95% CI: 0.73-1.01). Restriction of analyses to HBV/HCV free participants or adjustment for liver function did not substantially alter the findings. In this large prospective European cohort, higher consumption of monounsaturated fats is associated with lower HCC risk. © 2015 UICC.

BRICKS WITH TOTAL REPLACEMENT OF CLAY BY FLY ASH MIXED WITH DIFFERENT MATERIALS

OpenAIRE

J.N Akhtar; J.Alam; M.N Akhtar

2011-01-01

Fly ash is a powdery substance obtained from the dust collectors in the Thermal power plants that use coal as fuel. From the cement point of view the mineralogy of Fly ash is important as it contains 80% - 90% of glass. The impurities in coal-mostly clays, shale’s, limestone & dolomite; they cannot be burned so they turn up as ash. The Fly ash of class C category was used as a raw material to total replacement of clay for making Fly ash bricks. In present study the effect of Fly ash with high...

Fatty acid composition and quality characteristics of low-fat cooked sausages made with beef and chicken meat, tomato juice and sunflower oil.

Science.gov (United States)

Yılmaz, Í; Simşek, O; Işıklı, M

2002-10-01

Low-fat (5.9-10.3% fat) cooked sausages were produced with seven different formulations. Sausages produced with total replacement of fat with sunflower oil had significantly lower oleic acid (C18:1) and higher linoleic (C18:2) and behenic (C22:0) fatty acid contents. Their ratio of TUFA/TS was 3.65 compared to 0.95-1.14 for the other sausages. Also these sausages had the lowest moisture content, highest overall palatability and were less firm. Sausages with tomato juice had the lowest pH value, total aerobic count and nitrite content, but were firmer. Sausages produced with reduced beef contents had lower fat contents, lower stearic (C18:0) and higher oleic (C18:1) fatty acid contents than sausages of high beef content, their texture was very soft and had the lowest score for juiciness. Finally the sausages with chicken meat had the lowest fat and highest salt contents, and lower stearic (C18:0) and higher linoleic (C18:3) fatty acid contents than those made with beef . Also their colour was lighter, less red and more yellow and they had the lowest flavor intensity and overall acceptability.

Total knee replacement with retention of both cruciate ligaments: a 22-year follow-up study.

Science.gov (United States)

Sabouret, P; Lavoie, F; Cloutier, J-M

2013-07-01

We report on the long-term results of 163 bicruciate-retaining Hermes 2C total knee replacements in 130 patients at a mean follow-up of 22.4 years (20.3 to 23.5). Even when the anterior cruciate ligament had a partially degenerative appearance it was preserved as long as the knee had a normal anterior drawer and Lachman's test pre-operatively. The description and surgical technique of this minimally constrained prosthesis were published in 1983 and the ten-year clinical results in 1999. A total of 12% of the knees (20 of 163) in this study were revised because of wear of the polyethylene tibial insert. Excellent stability was achieved and the incidence of aseptic component loosening was 4.3% (seven of 163). The survival rate using revision for any reason as the endpoint was 82% (95% confidence interval 76.2 to 88.0). Although this series included a relatively small number of replacements, it demonstrated that the anterior cruciate ligament, even when partially degenerated at the time of TKR, remained functional and provided adequate stability at a long-term follow-up.

Association of body mass index and visceral fat with aortic valve calcification and mortality after transcatheter aortic valve replacement: the obesity paradox in severe aortic stenosis

Directory of Open Access Journals (Sweden)

Jennifer Mancio

2017-10-01

Full Text Available Abstract Background Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC and poor outcomes in aortic stenosis (AS. However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. Aims To determine the association of body mass index (BMI and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR. Methods This was a prospective cohort of 170 severe AS patients referred to TAVR. We quantified AVC mass score and fat depots including epicardial adipose tissue, intrathoracic fat, and abdominal visceral (VAF and subcutaneous fats by computed tomography. Fat depots were indexed to body surface area. All-cause and cardiovascular-related deaths after TAVR were recorded over a median follow-up of 1.2 years. Results Higher AVC mass was independently associated with low BMI and low VAF. All-cause mortality risk increased with the decrease of BMI and increment of VAF. A stratified analysis by obesity showed that in non-obese, VAF was inversely associated with mortality, whereas in obese, high VAF was associated with higher mortality (p value for interaction < 0.05. At long-term, hazard ratio [HR] with non-obese/low VAF was 2.3 (95% confidence interval [CI] 1.1–4.9; p = 0.021 and HR with obese/high VAF was 2.5 (95% CI 1.1–5.8; p = 0.031 compared with obese/low VAF patients. Conclusions In AS patients submitted to TAVR, BMI and VAF were inversely associated with AVC. Pre-intervention assessment of VAF by computed tomography may provide a better discrimination of mortality than BMI alone.

Diets with high-fat cheese, high-fat meat, or carbohydrate on cardiovascular risk markers in overweight postmenopausal women

DEFF Research Database (Denmark)

Thorning, Tanja Kongerslev; Raziani, Farinaz; Bendsen, Nathalie Tommerup

2015-01-01

BACKGROUND: Heart associations recommend limited intake of saturated fat. However, effects of saturated fat on low-density lipoprotein (LDL)-cholesterol concentrations and cardiovascular disease risk might depend on nutrients and specific saturated fatty acids (SFAs) in food. OBJECTIVE: We explored...... the effects of cheese and meat as sources of SFAs or isocaloric replacement with carbohydrates on blood lipids, lipoproteins, and fecal excretion of fat and bile acids. DESIGN: The study was a randomized, crossover, open-label intervention in 14 overweight postmenopausal women. Three full-diet periods of 2-wk...... duration were provided separated by 2-wk washout periods. The isocaloric diets were as follows: 1) a high-cheese (96-120-g) intervention [i.e., intervention containing cheese (CHEESE)], 2) a macronutrient-matched nondairy, high-meat control [i.e., nondairy control with a high content of high-fat processed...

Effect of total lumbar disc replacement on lumbosacral lordosis.

Science.gov (United States)

Kasliwal, Manish K; Deutsch, Harel

2012-10-01

Original article : To study effect of lumbar disc replacement on lumbosacral lordosis. There has been a growing interest in total disc replacement (TDR) for back pain with the rising concern of adjacent segment degeneration. Lumbar fusion surgery has been shown to lead to decrease in lumbar lordosis, which may account for postfusion pain resulting in less acceptable clinical outcome after successful fusion. TDR has recently emerged as an alternative treatment for back pain. There have been very few studies reporting lumbar sagittal outcome after TDR. Retrospective study of radiographic data of 17 patients who underwent TDR for single level degenerative disc disease at the author's institution was carried out. Study included measurement of preoperative and postoperative segmental and global lumbar lordosis and angle of lordosis. Patients age varied from 19 to 54 (mean, 35) years. Follow-up ranged from 12 to 24 months. TDR was performed at L4-5 level in 3 patients and L5-S1 level in 14 patients. The average values for segmental lordosis, global lordosis, and angle of lordosis at the operated level before and after surgery were 17.3, 49.7, and 8.6 degrees and 21.6, 54, and 9.5 degrees, respectively. There was a trend toward significant (P=0.02) and near significant (P=0.057) increase in segmental and global lordosis, respectively after TDR. Although prosthesis increased angle of lordosis at the level implanted in majority of the patients, the difference in preoperative and postoperative angle of lordosis was not significant (P=0.438). In addition, there was no correlation between the angle of implant of chosen and postoperative angle of lordosis at the operated level. The effect of TDR on sagittal balance appears favorable with an increase in global and segmental lumbar lordosis after single level TDR for degenerative disc disease. The degree of postoperative angle of lordosis was not affected by the angle of implant chosen at the operated level and varied

Replacing American snacks with tree nuts increases consumption of key nutrients among US children and adults: results of an NHANES modeling study.

Science.gov (United States)

Rehm, Colin D; Drewnowski, Adam

2017-03-07

Replacing typical American snacks with tree nuts may be an effective way to improve diet quality and compliance with the 2015-2020 Dietary Guidelines for Americans (DGAs). To assess and quantify the impact of replacing typical snacks with composite tree nuts or almonds on diet metrics, including empty calories (i.e., added sugars and solid fats), individual fatty acids, macronutrients, nutrients of public health concern, including sodium, fiber and potassium, and summary measures of diet quality. Food pattern modeling was implemented in the nationally representative 2009-2012 National Health and Examination Survey (NHANES) in a population of 17,444 children and adults. All between-meal snacks, excluding beverages, were replaced on a per calorie basis with a weighted tree nut composite, reflecting consumption patterns in the population. Model 1 replaced all snacks with tree nuts, while Model 2 exempted whole fruits, non-starchy vegetables, and whole grains (>50% of total grain content). Additional analyses were conducted using almonds only. Outcomes of interest were empty calories (i.e., solid fats and added sugars), saturated and mono- and polyunsaturated fatty acids, fiber, protein, sodium, potassium and magnesium. The Healthy Eating Index-2010, which measures adherence to the 2010 Dietary Guidelines for Americans, was used as a summary measure of diet quality. Compared to observed diets, modeled food patterns were significantly lower in empty calories (-20.1% and -18.7% in Model 1 and Model 2, respectively), added sugars (-17.8% and -16.9%), solid fats (-21.0% and -19.3%), saturated fat (-6.6% and -7.1%)., and sodium (-12.3% and -11.2%). Modeled patterns were higher in oils (65.3% and 55.2%), monounsaturated (35.4% and 26.9%) and polyunsaturated fats (42.0% and 35.7%), plant omega 3 s (53.1% and 44.7%), dietary fiber (11.1% and 14.8%), and magnesium (29.9% and 27.0%), and were modestly higher in potassium (1.5% and 2.9%). HEI-2010 scores were significantly

Knee injury and Osteoarthritis Outcome Score (KOOS – validation and comparison to the WOMAC in total knee replacement

Directory of Open Access Journals (Sweden)

Roos Ewa M

2003-05-01

Full Text Available Abstract Background The Knee injury and Osteoarthritis Outcome Score (KOOS is an extension of the Western Ontario and McMaster Universities Osteoarthrtis Index (WOMAC, the most commonly used outcome instrument for assessment of patient-relevant treatment effects in osteoarthritis. KOOS was developed for younger and/or more active patients with knee injury and knee osteoarthritis and has in previous studies on these groups been the more responsive instrument compared to the WOMAC. Some patients eligible for total knee replacement have expectations of more demanding physical functions than required for daily living. This encouraged us to study the use of the Knee injury and Osteoarthritis Outcome Score (KOOS to assess the outcome of total knee replacement. Methods We studied the test-retest reliability, validity and responsiveness of the Swedish version LK 1.0 of the KOOS when used to prospectively evaluate the outcome of 105 patients (mean age 71.3, 66 women after total knee replacement. The follow-up rates at 6 and 12 months were 92% and 86%, respectively. Results The intraclass correlation coefficients were over 0.75 for all subscales indicating sufficient test-retest reliability. Bland-Altman plots confirmed this finding. Over 90% of the patients regarded improvement in the subscales Pain, Symptoms, Activities of Daily Living, and knee-related Quality of Life to be extremely or very important when deciding to have their knee operated on indicating good content validity. The correlations found in comparison to the SF-36 indicated the KOOS measured expected constructs. The most responsive subscale was knee-related Quality of Life. The effect sizes of the five KOOS subscales at 12 months ranged from 1.08 to 3.54 and for the WOMAC from 1.65 to 2.56. Conclusion The Knee injury and Osteoarthritis Outcome Score (KOOS is a valid, reliable, and responsive outcome measure in total joint replacement. In comparison to the WOMAC, the KOOS improved validity

Validation of anthropometry and foot-to-foot bioelectrical resistance against a three-component model to assess total body fat in children: the IDEFICS study.

Science.gov (United States)

Bammann, K; Huybrechts, I; Vicente-Rodriguez, G; Easton, C; De Vriendt, T; Marild, S; Mesana, M I; Peeters, M W; Reilly, J J; Sioen, I; Tubic, B; Wawro, N; Wells, J C; Westerterp, K; Pitsiladis, Y; Moreno, L A

2013-04-01

To compare different field methods for estimating body fat mass with a reference value derived by a three-component (3C) model in pre-school and school children across Europe. Multicentre validation study. Seventy-eight preschool/school children aged 4-10 years from four different European countries. A standard measurement protocol was carried out in all children by trained field workers. A 3C model was used as the reference method. The field methods included height and weight measurement, circumferences measured at four sites, skinfold measured at two-six sites and foot-to-foot bioelectrical resistance (BIA) via TANITA scales. With the exception of height and neck circumference, all single measurements were able to explain at least 74% of the fat-mass variance in the sample. In combination, circumference models were superior to skinfold models and height-weight models. The best predictions were given by trunk models (combining skinfold and circumference measurements) that explained 91% of the observed fat-mass variance. The optimal data-driven model for our sample includes hip circumference, triceps skinfold and total body mass minus resistance index, and explains 94% of the fat-mass variance with 2.44 kg fat mass limits of agreement. In all investigated models, prediction errors were associated with fat mass, although to a lesser degree in the investigated skinfold models, arm models and the data-driven models. When studying total body fat in childhood populations, anthropometric measurements will give biased estimations as compared to gold standard measurements. Nevertheless, our study shows that when combining circumference and skinfold measurements, estimations of fat mass can be obtained with a limit of agreement of 1.91 kg in normal weight children and of 2.94 kg in overweight or obese children.

Computer Assisted Surgery and Current Trends in Orthopaedics Research and Total Joint Replacements

Science.gov (United States)

Amirouche, Farid

2008-06-01

Musculoskeletal research has brought about revolutionary changes in our ability to perform high precision surgery in joint replacement procedures. Recent advances in computer assisted surgery as well better materials have lead to reduced wear and greatly enhanced the quality of life of patients. The new surgical techniques to reduce the size of the incision and damage to underlying structures have been the primary advance toward this goal. These new techniques are known as MIS or Minimally Invasive Surgery. Total hip and knee Arthoplasties are at all time high reaching 1.2 million surgeries per year in the USA. Primary joint failures are usually due to osteoarthristis, rheumatoid arthritis, osteocronis and other inflammatory arthritis conditions. The methods for THR and TKA are critical to initial stability and longevity of the prostheses. This research aims at understanding the fundamental mechanics of the joint Arthoplasty and providing an insight into current challenges in patient specific fitting, fixing, and stability. Both experimental and analytical work will be presented. We will examine Cementless total hip arthroplasty success in the last 10 years and how computer assisted navigation is playing in the follow up studies. Cementless total hip arthroplasty attains permanent fixation by the ingrowth of bone into a porous coated surface. Loosening of an ingrown total hip arthroplasty occurs as a result of osteolysis of the periprosthetic bone and degradation of the bone prosthetic interface. The osteolytic process occurs as a result of polyethylene wear particles produced by the metal polyethylene articulation of the prosthesis. The total hip arthroplasty is a congruent joint and the submicron wear particles produced are phagocytized by macrophages initiating an inflammatory cascade. This cascade produces cytokines ultimately implicated in osteolysis. Resulting bone loss both on the acetabular and femoral sides eventually leads to component instability. As

Replacement of animal protein with vegetable protein in the diets of Astyanax altiparanae

Directory of Open Access Journals (Sweden)

Fábio Rosa Sussel

2014-09-01

Full Text Available The aim of this study was to evaluate the effect of replacing animal protein with vegetable protein sources on the productive performance of Astyanax altiparanae (lambari-do-rabo-amarelo. Five experimental diets were formulated with increasing replacement levels of animal protein by vegetable protein. A total of 9000 individuals (initial mean weight 1.18 ± 0.12 g, initial mean length 2.1 ± 0.3 cm were distributed in 20 net cages (1 m3 with a density of 450 ind. m-3. Cages were randomly placed in a pond (180 m2, 1.5 m deep, 10% water renewal per day. After 63 days of cultivation, total count and individual biometrics from 20% of each experimental unit were taken. Mean weight, total length, survival, feed conversion, biomass weight gain and proximate body composition were evaluated. The experimental design was completely randomized with five treatments and four replications. The reduction in the formulation cost achieved by increasing levels of vegetable protein compensated the slight decrease in biomass gain. Besides that, inclusion of vegetable protein resulted in greater fat deposition, suggesting future exploration of A. altiparanae as a functional food.

Effect of low-carbohydrate diets high in either fat or protein on thyroid function, plasma insulin, glucose, and triglycerides in healthy young adults.

Science.gov (United States)

Ullrich, I H; Peters, P J; Albrink, M J

1985-01-01

A low-carbohydrate diet, frequently used for treatment of reactive hypoglycemia, hypertriglyceridemia, and obesity may affect thyroid function. We studied the effects of replacing the deleted carbohydrate with either fat or protein in seven healthy young adults. Subjects were randomly assigned to receive seven days of each of two isocaloric liquid-formula, low-carbohydrate diets consecutively. One diet was high in polyunsaturated fat (HF), with 10%, 55%, and 35% of total calories derived from protein, fat, and carbohydrate, respectively. The other was high in protein (HP) with 35%, 30%, and 35% of total calories derived from protein, fat, and carbohydrate. Fasting blood samples were obtained at baseline and on day 8 of each diet. A meal tolerance test representative of each diet was given on day 7. The triiodothyronine (T3) declined more (P less than .05) following the HF diet than the HP diet (baseline 198 micrograms/dl, HP 138, HF 113). Thyroxine (T4) and reverse T3 (rT3) did not change significantly. Thyroid-stimulating hormone (TSH) declined equally after both diets. The insulin level was significantly higher 30 minutes after the HP meal (148 microU/ml) than after the HF meal (90 microU/ml). The two-hour glucose level for the HP meal was less, 85 mg/dl, than after the HF meal (103 mg/dl). Serum triglycerides decreased more after the HF diet (HF 52 mg/dl, HP 67 mg/dl). Apparent benefits of replacing carbohydrate with polyunsaturated fat rather than protein are less insulin response and less postpeak decrease in blood glucose and lower triglycerides. The significance of the lower T3 level is unknown.

Custom total knee replacement in a dog with femoral condylar bone loss.

Science.gov (United States)

Liska, William D; Marcellin-Little, Denis J; Eskelinen, Esa V; Sidebotham, Christopher G; Harrysson, Ola L A; Hielm-Björkman, Anna K

2007-06-01

To report surgical planning, technique, and outcome of custom total knee replacement (TKR) performed to manage a medial femoral condylar nonunion in a dog. Clinical case report. A 3-year-old, 20 kg Karelian Bear Hound. Computed tomographic scan of the left pelvic limb was used to build a stereolithography model of the distal portion of the femur. The model was used to create a custom augment to replace the missing medial femoral condyle and a custom stem for intramedullary condylar cemented fixation. The augment and stem were adapted to femoral and tibial components already available. The model was used to rehearse the surgery and then the custom prosthesis was implanted. Weight bearing returned 8 hours after surgery and improved thereafter. Joint alignment was normal and prosthetic joint motion was 60-165 degrees postoperatively. The dog resumed moose hunting 3 months after surgery. Peak vertical force and impulse of the operated limb measured 17 months after surgery were 65% and 47% of the normal, contralateral limb. Based on short-term follow-up, cemented canine TKR was successfully achieved for management of a severely abnormal stifle joint. With further refinement and development of commercially available prostheses, TKR should be possible for canine patients.

Short Term Evaluation of an Anatomically Shaped Polycarbonate Urethane Total Meniscus Replacement in a Goat Model.

Directory of Open Access Journals (Sweden)

A C T Vrancken

Full Text Available Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU, total meniscus replacement was developed. This study evaluates the in vivo performance of the implant in a goat model, with a specific focus on the implant location in the joint, geometrical integrity of the implant and the effect of the implant on synovial membrane and articular cartilage histopathological condition.The right medial meniscus of seven Saanen goats was replaced by the implant. Sham surgery (transection of the MCL, arthrotomy and MCL suturing was performed in six animals. The contralateral knee joints of both groups served as control groups. After three months follow-up the following aspects of implant performance were evaluated: implant position, implant deformation and the histopathological condition of the synovium and cartilage.Implant geometry was well maintained during the three month implantation period. No signs of PCU wear were found and the implant did not induce an inflammatory response in the knee joint. In all animals, implant fixation was compromised due to suture breakage, wear or elongation, likely causing the increase in extrusion observed in the implant group. Both the femoral cartilage and tibial cartilage in direct contact with the implant showed increased damage compared to the sham and sham-control groups.This study demonstrates that the novel, anatomically shaped PCU total meniscal replacement is biocompatible and resistant to three months of physiological loading. Failure of the fixation sutures may have increased implant mobility, which probably induced implant extrusion and potentially stimulated cartilage degeneration. Evidently, redesigning the fixation method is necessary. Future animal studies should evaluate the improved fixation method and compare implant performance to current treatment standards, such as allografts.

Monitoring the quality of total hip replacement in a tertiary care department using a cumulative summation statistical method (CUSUM).

Science.gov (United States)

Biau, D J; Meziane, M; Bhumbra, R S; Dumaine, V; Babinet, A; Anract, P

2011-09-01

The purpose of this study was to define immediate post-operative 'quality' in total hip replacements and to study prospectively the occurrence of failure based on these definitions of quality. The evaluation and assessment of failure were based on ten radiological and clinical criteria. The cumulative summation (CUSUM) test was used to study 200 procedures over a one-year period. Technical criteria defined failure in 17 cases (8.5%), those related to the femoral component in nine (4.5%), the acetabular component in 32 (16%) and those relating to discharge from hospital in five (2.5%). Overall, the procedure was considered to have failed in 57 of the 200 total hip replacements (28.5%). The use of a new design of acetabular component was associated with more failures. For the CUSUM test, the level of adequate performance was set at a rate of failure of 20% and the level of inadequate performance set at a failure rate of 40%; no alarm was raised by the test, indicating that there was no evidence of inadequate performance. The use of a continuous monitoring statistical method is useful to ensure that the quality of total hip replacement is maintained, especially as newer implants are introduced.

Patient-controlled oral analgesia for postoperative pain management following total knee replacement.

Science.gov (United States)

Kastanias, Patti; Gowans, Sue; Tumber, Paul S; Snaith, Kianda; Robinson, Sandra

2010-01-01

To investigate whether patient-controlled oral analgesia (PCOA) used by individuals receiving a total knee replacement could reduce pain, increase patient satisfaction, reduce opioid use and/or reduce opioid side effects when compared with traditional nurse (RN)-administered oral analgesia. Patients who underwent an elective total knee replacement at a quaternary care centre (Toronto Western Hospital, Toronto, Ontario) were randomly assigned to either PCOA or RN-administered short-acting oral opioids on postoperative day 2. Subjects in the RN group called the RN to receive their prescribed short-acting opioid. Subjects in the PCOA group kept a single dose of their prescribed oral opioid at their bedside and took this dose when they felt they needed it, to a maximum of one dose every 2 h. Study outcomes, collected on postoperative day 2, included pain (measured by the Brief Pain Inventory - Short Form), patient satisfaction (measured by the Pain Outcome Questionnaire Satisfaction subscale - component II), opioid use (oral morphine equivalents), opioid side effects (nausea, pruritus and/or constipation) and knee measures (maximum passive knee flexion and pain at maximum passive knee flexion, performed on the operative knee). Study outcomes were analyzed twice. First, for a subset of 73 subjects who remained in their randomly assigned group (PCOA group, n=36; RN group, n=37), randomized analyses were performed. Second, for the larger sample of 88 subjects who were categorized by their actual method of receiving oral opioids (PCOA group, n=41; RN group, n=47), as-treated analyses were performed. There were no differences in study outcomes between the PCOA and RN groups in either analysis. PCOA was not superior to RN administration on study outcomes. However, PCOA did not increase opioid use or pain. PCOA remains an important element in the patient-centred care facility.

Ruminal, Intestinal, and Total Digestibilities of Nutrients in Cows Fed Diets High in Fat and Undegradable Protein

DEFF Research Database (Denmark)

Palmquist, D.L.; Weisbjerg, Martin Riis; Hvelplund, Torben

1993-01-01

To study relationships of high undegradable intake protein and dietary fat on intestinal AA supply, the ruminal, intestinal, and total digestibilities of diets with or without added fat (5% of DM) and animal protein (blood meal: hydrolyzed feather meal, 1:1; 8% of DM) were examined with four cows...... with cows cannulated 100-cm distal to the pylorus, but only when cows were fed protein-supplemented diets; the estimates from those diets caused calculated microbial protein efficiency to exceed theoretical values. We postulated that blood meal and feather meal segregated near the pylorus, yielding high...... estimates of duodenal AA N flow. Removal of data for protein-supplemented diets obtained from cows cannulated at the pylorus yielded estimates of microbial protein synthetic efficiency consistent with literature values. Microbial synthesis of AA N was related linearly to ruminal digestion of carbohydrate...

Return to work and workplace activity limitations following total hip or knee replacement.

Science.gov (United States)

Sankar, A; Davis, A M; Palaganas, M P; Beaton, D E; Badley, E M; Gignac, M A

2013-10-01

Total hip (THR) and knee (TKR) replacements increasingly are performed on younger people making return to work a salient outcome. This research evaluates characteristics of individuals with early and later return to work following THR and TKR. Additionally, at work limitations pre-surgery and upon returning to work, and factors associated with work limitations were evaluated. 190 THR and 170 TKR of a total 931 cohort participants were eligible (i.e., working or on short-term disability pre-surgery). They completed questionnaires pre-surgery and 1, 3, 6 and 12 months post-surgery that included demographics, type of occupation, and the Workplace Activity Limitations Scale (WALS). 166 (87%) and 144 (85%) returned to work by 12 months following THR and TKR, respectively. Early (1 month) return to work was associated with, male gender, university education, working in business, finance or administration, and low physical demand work. People with THR returned to work earlier than those with TKR. For both groups, less pain and every day functional limitations were associated with less workplace activity limitations at the time return to work. The majority of individuals working prior to surgery return to work following hip or knee replacement for osteoarthritis (OA) and experience fewer limitations at work than pre-surgery. The changing workforce dynamics and trends toward surgery at younger ages mean that these are important outcomes for clinicians to assess. Additionally, this is important information for employers in understanding continued participation in employment for people with OA. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Utilization of Oleogels as a Replacement for Solid Fat in Aerated Baked Goods: Physicochemical, Rheological, and Tomographic Characterization.

Science.gov (United States)

Kim, Joo Young; Lim, Jeongtaek; Lee, JaeHwan; Hwang, Hong-Sik; Lee, Suyong

2017-02-01

Canola oil-carnauba wax oleogels were evaluated as a replacement for shortening in a baked cake system. The use of oleogels produced cake batters with a lower pseudoplastic property and also contributed to their viscous nature. The shortening replacement with oleogels at up to 50% was effective in maintaining the ability to hold air cells into the cake batters. The volume of cakes had an overall tendency to decrease with increasing shortening replacement with oleogels, leading to increased cake firmness. The tomographic analysis demonstrated that the total porosity and fragmentation index were reduced in the oleogel cakes, showing a more connected solid structure. The levels of saturated fatty acids in the cakes containing oleogels were significantly reduced to 13.3%, compared to the control with shortening (74.2%). As a result, the use of oleogels for shortening up to 25% produced cakes with lower levels of saturated fatty acids without quality loss. © 2016 Institute of Food Technologists®.

Association of total-mixed-ration chemical composition with milk, fat, and protein yield lactation curves at the individual level

NARCIS (Netherlands)

Caccamo, M.; Veerkamp, R.F.; Licitra, G.; Petriglieri, R.; Terra, La F.; Pozzebon, A.; Ferguson, J.D.

2012-01-01

The objective of this study was to examine the effect of the chemical composition of a total mixed ration (TMR) tested quarterly from March 2006 through December 2008 for milk, fat, and protein yield curves for 27 herds in Ragusa, Sicily. Before this study, standard yield curves were generated on

Knee joint loading in knee osteoarthritis: influence of abdominal and thigh fat.

Science.gov (United States)

Messier, Stephen P; Beavers, Daniel P; Loeser, Richard F; Carr, J Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J; Hunter, David J; Devita, Paul

2014-09-01

Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee joint loads in older overweight and obese adults with knee osteoarthritis (OA). Fat depots were quantified using computed tomography, and total lean and fat mass were determined with dual energy x-ray absorptiometry in 176 adults (age, 66.3 yr; body mass index, 33.5 kg·m) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Higher total body mass was significantly associated (P ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (P knee extensor moments (P = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (P = 0.0001), shear (P knee extension moment (P = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (P = 0.002). A regression model that included total thigh and total abdominal fat found that both were significantly associated with knee compressive and shear forces (P ≤ 0.04). Thigh fat was associated with knee abduction (P = 0.03) and knee extension moment (P = 0.02). Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA.

Effect of Testosterone Administration on Liver Fat in Older Men With Mobility Limitation: Results From a Randomized Controlled Trial

Science.gov (United States)

2013-01-01

Background. Androgen receptor (AR) knockout male mice display hepatic steatosis, suggesting that AR signaling may regulate hepatic fat. However, the effects of testosterone replacement on hepatic fat in men are unknown. The aim of this study was to determine the effects of testosterone administration on hepatic fat in older men with mobility limitation and low testosterone levels who were participating in a randomized trial (the Testosterone in Older Men trial). Methods. Two hundred and nine men with mobility limitation and low total or free testosterone were randomized in the parent trial to either placebo or 10-g testosterone gel daily for 6 months. Hepatic fat was determined by magnetic resonance imaging in 73 men (36 in placebo and 37 in testosterone group) using the volumetric method. Insulin sensitivity (homeostatic model assessment–insulin resistance) was derived from fasting glucose and insulin. Results. Baseline characteristics were similar between the two groups, including liver volumes (1583±363 in the testosterone group vs 1522±271mL in the placebo group, p = .42). Testosterone concentrations increased from 250±72 to 632±363ng/dL in testosterone group but did not change in placebo group. Changes in liver volume during intervention did not differ significantly between groups (p = .5) and were not related to on-treatment testosterone concentrations. The change in homeostatic model assessment–insulin resistance also did not differ significantly between groups and was not related to either baseline or change in liver fat. Conclusion. Testosterone administration in older men with mobility limitation and low testosterone levels was not associated with a reduction in hepatic fat. Larger trials are needed to determine whether testosterone replacement improves liver fat in men with nonalcoholic hepatic steatosis. PMID:23292288

Increased body mass index is a predisposition for treatment by total hip replacement

DEFF Research Database (Denmark)

Jacobsen, Steffen; Sonne-Holm, Stig

2005-01-01

We investigated the radiological and epidemiological data of 4,151 subjects followed up from 1976 to 2003 to determine individual risk factors for hip osteoarthritis (OA), hip pain and/or treatment by total hip replacement (THR). Pelvic radiographs recorded in 1992 were assessed for evidence of hip......-joint degeneration and dysplasia. Sequential body mass index (BMI) measurements from 1976 to 1992, age, exposure to daily lifting and hip dysplasia were entered into logistic regression analyses. The prevalence of hip dysplasia ranged from 5.4% to 12.8% depending on the radiographical index used. Radiological hip OA...

Effect of fat hardness on large deformation rheology of emulsion-filled gels

NARCIS (Netherlands)

Oliver, L.; Scholten, E.; Aken, van G.A.

2015-01-01

The aim of this work was to investigate the impact on the texture properties of emulsion-filled gels when saturated solid fat is replaced by unsaturated liquid oil. Whey protein aggregate, gelatin and micellar casein, were chosen to form different types of gel matrices and the fat hardness was

Longitudinal changes in abdominal fat distribution with menopause.

Science.gov (United States)

Franklin, Ruth M; Ploutz-Snyder, Lori; Kanaley, Jill A

2009-03-01

Increases in abdominal fat have been reported with menopause, but the impact of menopause on abdominal fat distribution (visceral vs subcutaneous) is still unclear. The objective of the study was to determine if abdominal fat content (volume) or distribution is altered with menopause. Magnetic resonance imaging was used to quantify total abdominal, subcutaneous, and visceral fat in 8 healthy women, both in the premenopausal state and 8 years later in the postmenopausal state. Physical activity (PA) and blood lipids were also measured. Body weight and waist circumference did not change with menopause (pre- vs postmenopause: body weight, 63.2 +/- 3.1 vs 63.9 +/- 2.5 kg; waist circumference, 92.1 +/- 4.6 vs 93.4 +/- 3.7 cm); however, total abdominal fat, subcutaneous fat, and visceral fat all significantly (P fat distribution was not significantly different after menopause (pre- vs postmenopause: subcutaneous, 73% +/- 3% vs 71% +/- 3%; visceral, 26% +/- 3% vs 28% +/- 3%). Lean mass, fat mass, and PA, along with total cholesterol and triglyceride levels, did not change with menopause. High-density lipoprotein and low-density lipoprotein both increased (P abdominal fat content increased with menopause despite no change in PA, body weight, or waist circumference; however, menopause did not affect the relative abdominal fat distribution in these women.

Feasibility of Early-Initiated Progressive Resistance Training after Total Hip Replacement

DEFF Research Database (Denmark)

Mikkelsen, Lone Ramer; Mechlenburg, Inger; Petersen, Annemette Krintel

during the exercises were measured at each training session. Isometric muscle strength was measured before and 4 weeks after the THR. Findings / Results: Pain during exercises and resting pain before and after each training session was unchanged or decreased during the 4 weeks of training. Averaged...... across exercises pain during training decreased from 3.6 (sd: 2.8) at the first session to 1.52 (sd: 1.8) VAS-mm at the last session, ptraining load increased progressively for all 4 exercises during the 4 weeks of training. For example: 2nd, 5th and 8th training session. Hip......Background: Muscle atrophy, reduced hip muscle strength and function are documented within the first weeks after Total Hip Replacement (THR). Purpose / Aim of Study: The purpose of this study was to evaluate the feasibility of early-initiated progressive resistance training (PRT) after THR...

Proton density-weighted MR imaging of the knee: fat suppression versus without fat suppression

Energy Technology Data Exchange (ETDEWEB)

Lee, So-Yeon; Kim, Sun Ki [Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, Seoul (Korea, Republic of); Jee, Won-Hee [Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, Seoul (Korea, Republic of); Catholic University of Korea, Diagnostic Radiology, Seoul St. Mary' s Hospital, School of Medicine, Seoul (Korea, Republic of); Kim, Jung-Man [Catholic University of Korea, Department of Orthopedic Surgery, Seoul St. Mary' s Hospital, Seoul (Korea, Republic of)

2011-02-15

To prospectively evaluate the diagnostic accuracy of proton density-weighted imaging with and without fat suppression for detecting meniscal tears. The study involved 48 patients who underwent arthroscopy less than 3 months after proton density-weighted imaging with and without fat suppression. Sagittal images were independently reviewed by two radiologists for the presence of meniscal tears. Medial and lateral menisci were separately analyzed in terms of anterior horn, body, and posterior horn. Interobserver agreement was assessed using {kappa} coefficients. The McNemar test was used to determine any differences between the two methods in terms of sensitivity and specificity. Arthroscopy findings were used as the diagnostic reference standard. Arthroscopy revealed 71 tears involving 85 meniscal segments: 34 medial meniscal segments and 51 lateral meniscal segments. The sensitivity, specificity, and accuracy of each radiologist were 95% (81/85), 92% (186/203), and 93% (267/288), and 93% (79/85), 93% (189/203), and 93% (268/288) when using fat-suppressed proton density-weighted imaging, and 91% (77/85), 93% (189/203), and 92% (266/288), and 91% (77/85), 93% (188/203), and 92% (265/288) when using proton density-weighted imaging without fat suppression, respectively. Interobserver agreement for meniscal tears was very high with proton-weighted imaging with ({kappa} = 0.87) or without ({kappa} = 0.86) fat suppression. There were no significant differences for detection of medial meniscal tears when using proton density-weighted imaging with or without fat suppression for both readers (p > 0.05). Fat-suppressed proton density-weighted imaging can replace proton density-weighted imaging without fat suppression for the detection of meniscal tears. (orig.)