Bone Healing and Inflammation: Principles of Fracture and Repair

2021 ◽  
Vol 35 (03) ◽  
pp. 198-203
Author(s):  
Hassan ElHawary ◽  
Aslan Baradaran ◽  
Jad Abi-Rafeh ◽  
Joshua Vorstenbosch ◽  
Liqin Xu ◽  
...  
Keyword(s):  
Bone Remodeling ◽  
Bone Healing ◽  
Cell Activation ◽  
Improve Patient Care ◽  
Phosphate Homeostasis ◽  
Integral Role ◽  
Bony Fixation ◽  
Improve Patient ◽  
Affect Bone Healing ◽  
Biomechanical Instability

AbstractBones comprise a significant percentage of human weight and have important physiologic and structural roles. Bone remodeling occurs when healthy bone is renewed to maintain bone strength and maintain calcium and phosphate homeostasis. It proceeds through four phases: (1) cell activation, (2) resorption, (3) reversal, and (4) bone formation. Bone healing, on the other hand, involves rebuilding bone following a fracture. There are two main types of bone healing, primary and secondary. Inflammation plays an integral role in both bone remodeling and healing. Therefore, a tightly regulated inflammatory response helps achieve these two processes, and levels of inflammation can have detrimental effects on bone healing. Other factors that significantly affect bone healing are inadequate blood supply, biomechanical instability, immunosuppression, and smoking. By understanding the different mechanisms of bone healing and the factors that affect them, we may have a better understanding of the underlying principles of bony fixation and thereby improve patient care.

scholarly journals Should interventional radiology gain speciality status within the royal college of radiologists?

2020 ◽  
pp. 20201118
Author(s):  
Yakup Kilic ◽  
Shahzad Illyas
Keyword(s):  
Interventional Radiology ◽  
Treatment Options ◽  
Improve Patient Care ◽  
Minimal Invasive ◽  
Left Behind ◽  
The Past ◽  
Leadership Management ◽  
Integral Role ◽  
Turf Wars ◽  
Improve Patient

Interventional Radiology (IR) medicine’s best kept secret will revolutionise healthcare like never before. The legacy Charles Dotter left behind not only showcases IR’s pursuit of innovative and complex techniques in order to provide better treatment options for patients, it also sparked an opportunity for radiologists to use their imagination and creativity to develop IR into a speciality catering for the 21st century. By utilising imaging as well as clinical and minimal invasive surgical knowledge IRs are able to play an integral role in caring for patients in nearly all specialities. Over the past few decades, the absence of radiology in the leadership management arena has allowed other specialities to perpetuate turf wars and utilise techniques developed by IR. A concerted effort is required by the wider radiology community to address the problems faced by IR and to recognise its true potential as a speciality to further improve patient care.

Analytical Methods for the Determination of Sartans in Pharmaceutical Formulations and Biological Fluids: A Review

2020 ◽  
Vol 16 (3) ◽  
pp. 208-222
Author(s):  
Miglena Smerikarova ◽  
Stanislav Bozhanov ◽  
Vania Maslarska
Keyword(s):  
Biological Fluids ◽  
Pharmaceutical Preparations ◽  
Improve Patient Care ◽  
Pharmaceutical Formulations ◽  
Treatment Of Hypertension ◽  
Therapeutic Doses ◽  
Reliable Methods ◽  
Improve Patient

Background: Sartans are mostly used as a part of combination with additional medicines in the therapy of essencial hypertension. Preferred combinations are ARB and thiazide diuretics (Hydrochlorothiazide (HCT) and Chlorthalidone (CHL)) or ARB and calcium antagonists. The number of sartans mostly prescribed by specialists is only seven - Candesartan (CDS), Eprosartan (EPS), Irbesartan (IBS), Losartan (LOS), Olmesartan (OMS), Telmisartan (TMS) and Valsartan (VLS). Methods: The widespread use of sartans in the treatment of hypertension requires reliable methods of analysis. Bulk drugs and pharmaceutical preparations should be analyzed to ensure the quality of the medicinal products reaching patients. On the other hand, the analysis of drugs in biological fluids aims to trace and improve patient care by adjusting the therapeutic doses of drugs. According to our knowledge, a review devoted to the analysis of sartans was published in 2014. Results: Spectral methods are widely used in the analysis of bulk drugs and pharmaceutical dosage forms due to their relatively simple procedures, low reagent and sample consumption, speed, precision and accuracy combined with accessibility and comparatively low cost of common apparatus. Many papers for determination of sartans in bulk drugs and pharmaceutical preparations based on liquid chromatographic techniques were published in the available literature. Among these methods, HPLC takes the leading place but UPLC and HPTLC are also present. Conclusion: The widespread use of sartans in the treatment of hypertension requires reliable methods of analysis. Bulk drugs and pharmaceutical preparations should be analyzed to ensure the quality of the medicinal products reaching patients. On the other hand, the analysis of drugs in biological fluids aims to trace and improve patient care by adjusting the therapeutic doses of drugs. Since 2014, many articles have been published on the sartans analysis and this provoked our interest to summarize the latest applications in the analysis of sartans in pharmaceutical formulations and biological media. Articles published from 2014 to 2018 are covered.

Comparison of bone wax and chitosan usage on post-sternotomy bone healing

2020 ◽  
pp. 021849232098409
Author(s):  
Ihsanul Amal ◽  
Heroe Soebroto ◽  
Puruhito
Keyword(s):  
Foreign Body ◽  
Bone Healing ◽  
Postoperative Bleeding ◽  
Giant Cells ◽  
Operative Field ◽  
Inflammatory Reactions ◽  
Foreign Body Giant Cells ◽  
New Zealand White Rabbits ◽  
Affect Bone Healing ◽  
Chitosan Powder

Background Sternotomy is a standard approach performed in almost every surgical procedure on the heart and mediastinum. Effective hemostasis of the sternum is required to keep the operative field dry, avoid excessive blood transfusions during surgery, and prevent reoperation due to massive postoperative bleeding, which can further increase morbidity and mortality in patients. Bone wax is a mechanical hemostat commonly used after sternotomy and has been known to affect bone healing, trigger chronic inflammatory reactions, and increase the rate of infection. The application of chitosan, which has intrinsic hemostat ability, as hemostatic material is believed to improve bone healing following sternotomy. This study aimed to compare the effectiveness of bone wax and chitosan on bone healing after sternotomy. Methods Median sternotomies were performed on 2 groups of New Zealand White rabbits. Each group of 16 animals received either bone wax or chitosan powder as hemostatic material. The degree of bone healing, the number of foreign-body giant cells, and the number of osteoblasts were evaluated after 6 weeks. Results Radiographs showed that significantly more animals in the chitosan group had total sternal healing ( p = 0.033). Histopathology revealed that the number of foreign-body giant cells was significantly less ( p = 0.036) and the number of osteoblasts was significantly greater ( p < 0.0001) in the group of animals that received chitosan. Conclusion The use of chitosan as hemostatic material can promote better bone healing compared to bone wax.

scholarly journals How will artificial intelligence and bioinformatics change our understanding of IgA in the next decade?

2021 ◽  
Author(s):  
Roman David Bülow ◽  
Daniel Dimitrov ◽  
Peter Boor ◽  
Julio Saez-Rodriguez
Keyword(s):  
Artificial Intelligence ◽  
Multidisciplinary Approach ◽  
Immunoglobulin A ◽  
Improve Patient Care ◽  
Integrated Analysis ◽  
Clinical Expertise ◽  
End Stage ◽  
The Complement System ◽  
Improve Patient ◽  
Generation Sequencing

AbstractIgA nephropathy (IgAN) is the most common glomerulonephritis. It is characterized by the deposition of immune complexes containing immunoglobulin A (IgA) in the kidney’s glomeruli, triggering an inflammatory process. In many patients, the disease has a progressive course, eventually leading to end-stage kidney disease. The current understanding of IgAN’s pathophysiology is incomplete, with the involvement of several potential players, including the mucosal immune system, the complement system, and the microbiome. Dissecting this complex pathophysiology requires an integrated analysis across molecular, cellular, and organ scales. Such data can be obtained by employing emerging technologies, including single-cell sequencing, next-generation sequencing, proteomics, and complex imaging approaches. These techniques generate complex “big data,” requiring advanced computational methods for their analyses and interpretation. Here, we introduce such methods, focusing on the broad areas of bioinformatics and artificial intelligence and discuss how they can advance our understanding of IgAN and ultimately improve patient care. The close integration of advanced experimental and computational technologies with medical and clinical expertise is essential to improve our understanding of human diseases. We argue that IgAN is a paradigmatic disease to demonstrate the value of such a multidisciplinary approach.

scholarly journals Bargain Hunting for Buffered Lidocaine: A Collaborative Discovery of Cost-saving Strategies That Can Improve Patient Care

2020 ◽  
Author(s):  
Curtis L Simmons ◽  
Laura K Harper ◽  
Kathryn J Holst ◽  
Nathan J Brinkman ◽  
Christine U Lee
Keyword(s):  
Sodium Bicarbonate ◽  
Hospital Pharmacy ◽  
Cost Savings ◽  
Improve Patient Care ◽  
Medical Waste ◽  
Radiology Department ◽  
Access Pricing ◽  
Bundled Payments ◽  
Improve Patient ◽  
Procedure Room

Abstract Buffered lidocaine is a local anesthetic option during percutaneous needle-directed procedures in the breast. At our institution, sodium bicarbonate (the buffer) is dispensed in volumes that frequently lead to medical waste and shortages. In this study, we describe how moving the buffering of lidocaine from the procedure room to our clinical hospital pharmacy results in a reduction in costs and improves satisfaction across the breast radiology department. While cost savings are difficult to tease out in practices that opt for bundled payments, we were able to access pricing and supply data and coordinate with our pharmacy to change our practice. Making these changes saves our practice $26 000 a year and allows us to continue to offer buffered lidocaine even during sodium bicarbonate shortages. This manuscript describes how these changes came about and their economic impact.

Sports Medicine and Artificial Intelligence: A Primer

2021 ◽  
pp. 036354652110086
Author(s):  
Prem N. Ramkumar ◽  
Bryan C. Luu ◽  
Heather S. Haeberle ◽  
Jaret M. Karnuta ◽  
Benedict U. Nwachukwu ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Sports Medicine ◽  
Injury Risk ◽  
Industrial Revolution ◽  
Improve Patient Care ◽  
Great Promise ◽  
Patient Reported ◽  
Athlete Injury ◽  
Improve Patient ◽  
Applications Of Ai

Artificial intelligence (AI) represents the fourth industrial revolution and the next frontier in medicine poised to transform the field of orthopaedics and sports medicine, though widespread understanding of the fundamental principles and adoption of applications remain nascent. Recent research efforts into implementation of AI in the field of orthopaedic surgery and sports medicine have demonstrated great promise in predicting athlete injury risk, interpreting advanced imaging, evaluating patient-reported outcomes, reporting value-based metrics, and augmenting the patient experience. Not unlike the recent emphasis thrust upon physicians to understand the business of medicine, the future practice of sports medicine specialists will require a fundamental working knowledge of the strengths, limitations, and applications of AI-based tools. With appreciation, caution, and experience applying AI to sports medicine, the potential to automate tasks and improve data-driven insights may be realized to fundamentally improve patient care. In this Current Concepts review, we discuss the definitions, strengths, limitations, and applications of AI from the current literature as it relates to orthopaedic sports medicine.

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