Predicting Fracture Healing with Blood Biomarkers: The Potential to Assess Patient Risk of Fracture Nonunion

Biomarkers ◽  
2021 ◽  
pp. 1-41
Author(s):  
Joseph R. Chitwood ◽  
Nabarun Chakraborty ◽  
Rasha Hammamieh ◽  
Sharon M. Moe ◽  
Neal X. Chen ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Blood Biomarkers ◽  
Patient Risk ◽  
Risk Of Fracture ◽  
Fracture Nonunion

scholarly journals Fracture Nonunion Treated with Low-Intensity Pulsed Ultrasound and Monitored with Ultrasonography: A Feasibility Study

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Peizhen Zhang ◽  
Pengdong Li ◽  
Shihai Liao ◽  
Xuan Li ◽  
Wufan Chen ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Bone Fracture ◽  
Soft Tissues ◽  
Callus Formation ◽  
Distal Tibia ◽  
Pulsed Ultrasound ◽  
Low Intensity Pulsed Ultrasound ◽  
Low Intensity ◽  
Cord Injury ◽  
Fracture Nonunion

The positive effect of low-intensity pulsed ultrasound (LIPUS) on bone fracture healing has been proved. However, during the period of LIPUS therapy, it is undetermined whether LIPUS promotes the formation of heterotopic ossification (HO), which usually occurs in muscle tissues after trauma such as bone fracture and spinal cord injury. Here, we used 6-week LIPUS therapy in a 42-year-old Chinese male patient with a fracture nonunion in combination with ultrasonography for monitoring fracture healing and HO formation. After the LIPUS therapy, the mineralized bone formation in the area of defect of the distal tibia was presented in an ultrasound image, which was consistent with the outcome of plain radiography showing callus formation and the blurred fracture line in the area exposed to LIPUS. In addition, ultrasound images revealed no evidence of HO development within soft tissues during the period of LIPUS therapy. This study suggests that ultrasonography is a potential tool to guarantee the performance of LIPUS therapy with monitoring HO formation. Easy to use, the integration of the handheld ultrasound scanner and the ultrasonic therapeutic apparatus is entirely dedicated to help orthopedists make high-quality care and diagnosis.

scholarly journals EndoScreen Chip: Serum Complement C9 Immunoassays Improve Risk Prediction and Early Diagnosis of Esophageal Adenocarcinoma

2021 ◽  
Author(s):  
Julie A. Webster ◽  
Alain Wuethrich ◽  
Karthik B. Shanmugasundaram ◽  
Renee S. Richards ◽  
Wioleta M. Zelek ◽  
...  
Keyword(s):  
Esophageal Adenocarcinoma ◽  
Lectin Binding ◽  
Elevated Serum ◽  
Blood Biomarkers ◽  
Patient Risk ◽  
Translational Study ◽  
Diagnostic Endoscopy ◽  
Blood Biomarker ◽  
Microfluidic Immunoassay ◽  
Complement C9

Esophageal adenocarcinoma (EAC) detection relies on endoscopy-biopsy diagnosis, with routine endoscopic surveillance recommended for Barrett’s esophagus (BE) patients. Here, we examine the utility of blood biomarkers in patient risk stratification by translating the EAC blood biomarker Jacalin lectin binding complement C9 (JAC-C9) into a novel microfluidic immunoassay, the EndoScreen Chip. Cohort evaluation (n=46) showed elevated serum total C9 and JAC-C9 in EAC. Logistic regression modeling demonstrated that addition of C9 and JAC-C9 to patient risk factors (age, body mass index and heartburn/reflux history) improved EAC prediction from AUROC of 0.838 to 0.931. Serum JAC-C9 strongly predicted EAC (vs BE OR= 4.6, 95% CI: 1.6-15.6, p = 0.014; vs Healthy OR=4.1, 95% CI:1.2-13.7, p = 0.024) while total C9 was moderately predictive for BE (vs EAC OR=1.4; 95% CI: 1.0-1.8, p = 0.032; vs Healthy OR=0.8; 95% CI: 0.6-1.0, p = 0.039). This translational study demonstrates the potential utility of blood biomarkers in improving triaging for diagnostic endoscopy.

scholarly journals Pronator quadratus pedicled bone graft for scaphoid non-unions

2020 ◽  
Vol 7 (10) ◽  
pp. 3414
Author(s):  
Harsha Vardhan ◽  
Anto Francis
Keyword(s):  
Bone Graft ◽  
Fracture Healing ◽  
Scaphoid Fracture ◽  
Fracture Site ◽  
Vascularized Bone Graft ◽  
Proximal Pole ◽  
Pronator Quadratus ◽  
Scaphoid Fractures ◽  
Fracture Nonunion ◽  
Vascularized Bone

Scaphoid fractures frequently present with nonunion and proximal pole necrosis, the treatment of which is bone grafting. Pronator quadratus pedicled vascularized bone graft is an option especially in the setting of proximal pole necrosis. We describe our experience of managing such scaphoid non-unions using pronator quadratus pedicled vascularized bone graft. Six patients were managed using pronator quadratus pedicled vascularized bone graft following scaphoid fracture nonunion with proximal pole necrosis. All patients had good fracture healing and symptom resolution. Mild deficit in wrist extension was noted in all patients. Pronator quadratus pedicled vascularized bone graft is an attractive option for managing scaphoid nonunion. Lying adjacent to the fracture site, bone can be harvested and transferred without making any other incisions. This procedure introduces another source of blood supply to the fracture site and hence improves fracture healing.

scholarly journals Predicting Fracture Healing with Biomarkers: The Potential for Precision Medicine to Assess Patient Risk of Fracture Nonunion

2020 ◽  
Vol 3 ◽  
Author(s):  
Joseph Chitwood ◽  
Gremah Adam ◽  
Melissa Kacena ◽  
Roman Natoli
Keyword(s):  
Fracture Healing ◽  
Bone Healing ◽  
Animal Studies ◽  
Treg Cells ◽  
Post Injury ◽  
Bone Formation Markers ◽  
Increased Risk ◽  
Fracture Nonunion ◽  
Comprehensive Survey ◽  
The Individual

Objective:  To provide a comprehensive survey of the literature related to the current efficacy of biomarkers for predicting fracture healing.  Methods:  EMBASE and PubMed, were searched using the following terms: fractures, biomarkers, ununited, and nonunion with the assistance of a medical librarian. The initial search yielded 199 records. Additional search of Google Scholar and review of the references yielded zero additional records. The 165 unique records were screened, of which 105 were excluded due to experimental treatments, non-fracture related bone healing, animal studies, and study group design failure to compare union versus nonunion fracture outcomes. This left 21 articles for full review.  Results:  19 serum biomarkers were reviewed for nonunion predicative capability. From this cohort 9 biomarkers had promising results including; bone formation markers OC and PINP, bone resorption markers TRAP and OPN, growth factors VEGF and PGF-1, TEMRA and TReg cells, and miR-193a-3p. 15 SNPs on 11 genes were examined. The polymorphisms with the greatest potential for increased risk of nonunion based on odds ratio include; SMAD6 rs2053423 T/T genotype OR = 10.27. IL-1b rs2853550 T allele OR = 5.9. NOG rs1372857 G/G genotype OR = 4.56. NOS rs2297514 OR = 3.98. and PDGF CCG haplotype OR = 3.57  Conclusion:  There remains an unmet clinical need to develop predictive parameter(s) for bone healing that are objective, reproducible, preferably continuous, unique to the individual, and optimally based on a readily accessible biologic measurement. Ultimately yielding a biomarker predictive of future nonunion that is additive, or superior, to that of known clinical risk factors for nonunion.  Clinical Implications:   Accurate biomarkers could identify patients at early times post-injury who may benefit from intervention to promote healing, thus circumventing unnecessary delays in nonunion intervention. Additionally, biomarkers could eliminate preemptive surgery in patients with early slow progression who are otherwise on a healing trajectory. 

Risk of fracture in Crohn's disease: A population-based study

2001 ◽  
Vol 120 (5) ◽  
pp. A628-A628
Author(s):  
E LOFTUSJR ◽  
C CROWSON ◽  
W SANDBORN ◽  
W TREAMINE ◽  
W OFALLON ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Population Based ◽  
Population Based Study ◽  
Risk Of Fracture

1385: Stratification of Patient Risk Based on PSA Doubling Time Following Radical Retropubic Prostatectomy

2006 ◽  
Vol 175 (4S) ◽  
pp. 447-447
Author(s):  
Matthew K. Tollefson ◽  
Jeffrey M. Slezak ◽  
Horst Zincke ◽  
Michael L. Blute
Keyword(s):  
Doubling Time ◽  
Radical Retropubic Prostatectomy ◽  
Patient Risk ◽  
Retropubic Prostatectomy ◽  
Psa Doubling Time

Abstract #283 Diabetes Increases Short-Term but not Long-Term Risk of Fracture: A Community-Based Study

2019 ◽  
Vol 25 ◽  
pp. 114
Author(s):  
Alyssa Dufour ◽  
Setareh Williams ◽  
Richard Weiss ◽  
Elizabeth Samelson
Keyword(s):  
Short Term ◽  
Community Based ◽  
Risk Of Fracture
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