Pedicled Oblique Para-Umbilical Perforator (OPUP) Flap for Upper Limb Reconstruction

Background: Groin flap has been considered the workhorse flap for hand reconstruction. However it has certain drawbacks when covering defects over elbow or proximal forearm. Pedicled oblique paraumbilical perforator (OPUP) based flaps provide a good alternative in such cases. Methods: We performed OPUP flap in 11 cases of complex upper limb reconstructions over the past one year. We report our experience with this flap. Results: All flaps survived. One patient had marginal necrosis of 1 cm in the proximal end after flap division. Three patients had donor site scar hypertrophy. Conclusions: OPUP flap is superior to groin flap for larger defects or defects around the elbow. The major disadvantage is the donor site scar which is prone to hypertrophy.

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VERSATILITY OF PARAUMBILICAL PERFORATOR FLAP FOR UPPER LIMB RECONSTRUCTION

10.36106/ijsr/3628019 ◽

2020 ◽

pp. 1-5

Author(s):

Biswajit Mishra

Keyword(s):

Soft Tissue ◽

Upper Limb ◽

Demographic Data ◽

Perforator Flap ◽

Soft Tissue Reconstruction ◽

Female Ratio ◽

Limb Reconstruction ◽

Groin Flap ◽

Microvascular Flap ◽

Upper Limb Reconstruction

Background Microvascular flap and groin flap are the most commonly used flaps for upper limb reconstruction. Microvascular flap can not be done in certain situations and groin flap is not convenient for coverage of forearm defect and elbow defect. Paraumbilical perforator (pup) flaps can provide a large amount of tissue for coverage of forearm , elbow defects and mitigates the side effects of groin flap. Material and method A retrospective study was conducted for reconstruction of soft tissue defects from finger tip to elbow between January 2016 to December 2019 with PUP flaps .Demographic data, size of the defect, etiology ,flap design and flap complication were analysed . Result The age of the patients ranged from 12 years to 56 year with mean age of 29.85 years and SD = 11.073. Male to female ratio was 1.5 : 1 (M=12 , F= 8). Size of the defect varied between 20 cm2 to 288cm2 with mean of 88.1 cm 2 and SD = 29.69 .No of cases with flap dimension < 100 cm 2 (n= 13), and > 100 cm2 (n= 7) . Aetiology of injury included vehicular accidents in 10 patients, machine injury in 2 patients, electrical burns in 6 patients post snake bite ulcer 2 patients. The location of the defect included hands, forearm and the elbow, and fingers.Flap was directed Superolaterally in 18 patients , inferolaterally in one case , and combined medially and laterally in one case. There was no case of complete flap failure. Conclusion Paraumbilical perforator flap can be a safe and reliable option for soft tissue reconstruction in varied areas of upper limb.

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Osseointegration interface of calcified bone and endosseous implants

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100130110 ◽

1992 ◽

Vol 50 (2) ◽

pp. 1096-1097

Author(s):

K.E. Krizan ◽

J.E. Laffoon ◽

M.J. Buckley

Keyword(s):

Structure And Function ◽

Titanium Implants ◽

En Bloc ◽

Endosseous Implants ◽

Ultrastructural Studies ◽

The Past ◽

Cacodylate Buffer ◽

One Year ◽

And Function

With increase use of tissue-integrated prostheses in recent years it is a goal to understand what is happening at the interface between haversion bone and bulk metal. This study uses electron microscopy (EM) techniques to establish parameters for osseointegration (structure and function between bone and nonload-carrying implants) in an animal model. In the past the interface has been evaluated extensively with light microscopy methods. Today researchers are using the EM for ultrastructural studies of the bone tissue and implant responses to an in vivo environment. Under general anesthesia nine adult mongrel dogs received three Brånemark (Nobelpharma) 3.75 × 7 mm titanium implants surgical placed in their left zygomatic arch. After a one year healing period the animals were injected with a routine bone marker (oxytetracycline), euthanized and perfused via aortic cannulation with 3% glutaraldehyde in 0.1M cacodylate buffer pH 7.2. Implants were retrieved en bloc, harvest radiographs made (Fig. 1), and routinely embedded in plastic. Tissue and implants were cut into 300 micron thick wafers, longitudinally to the implant with an Isomet saw and diamond wafering blade [Beuhler] until the center of the implant was reached.

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Prolonging Nerve Grafts Using Chemical Extracted Muscle-in-vein with Vein Window Method Chemical acellular nerve grafts

Revista de Chimie ◽

10.37358/rc.17.12.6011 ◽

2018 ◽

Vol 68 (12) ◽

pp. 2936-2940

Author(s):

Irina Mihaela Jemnoschi Hreniuc ◽

Camelia Tamas ◽

Sorin Aurelian Pasca ◽

Bogdan Ciuntu ◽

Roxana Ciuntu ◽

...

Keyword(s):

Classical Group ◽

Donor Site ◽

Good Alternative ◽

Nerve Graft ◽

Male Rats ◽

Chemical Extraction ◽

Nerve Grafting ◽

Nerve Grafts ◽

Local Resources ◽

Window Method

Nerve injuries are a common pathology in hand trauma. The consequences are drastic both for patients and doctors/medical system. In many cases direct coaptation is impossible. A nerve graft should be used in the case of a neuroma, trauma or tumor, for restoration of nervous influx. The aim of this study is demonstrate that by grafting restant nerve stumps with muscle-in-vein nerve grafts we obtain good result in terms of functional and sensibility recovery and also our method �window-vein� is a good way of prolonging nerve grafts. The method of study is experimental. We worked in the laboratory in optimal conditions for carrying out of muscles-in-vein nerve grafts (nerve grafts size 1.5 cm-3 cm). We used acellular muscle grafts with the chemical extraction method.The study was conducted on experimental animals (Wistar male rats).We used 30 experience animals in 3 equal groups (classical group and muscle-in-vein nerve grafts-2 nerve grafts of 1,5 cm central sutured and the third group with muscle-in-vein nerve grafts, window-vein method, 3 cm). At 4 and respectively 6 weeks postoperative at the quality tests we observed the progress with the footprint test. The operated hind in comparison with the healthy hind was 86% recovered and similar with classic nerve grafts. Quantitatively the number of regenerated axons in the group with muscle-in-vein nerve grafts was significant bigger in comparison with the classical group (15%).The method using muscle-in-vein nerve graft with windows-vein it�s a good alternative for nerve grafting in comparison with classical nerve grafting. When the local possibilities are limited, this method is good for prolonging the grafts. The relationship between cost and benefit in this case it�s an advantage because we use the local resources of the affected area. The motor results of nerve grafting ingroup 2 in comparison with group 3 were similar and in some cases better in group 1. Grafting with MVNG offers a better alternative for donor site regeneration in comparison with classical nerve grafts. This method is useful to prolong nerve grafts without adding morbidity.

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Hepatitis and tuberculosis testing are much less common than HIV testing among adults in Kisumu, Kenya: results from a cross-sectional assessment

BMC Public Health ◽

10.1186/s12889-021-11164-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Joshua Tunnage ◽

Adam Yates ◽

Chiaka Nwoga ◽

Valentine Sing’oei ◽

John Owuoth ◽

...

Keyword(s):

Secondary Education ◽

Viral Hepatitis ◽

Hiv Testing ◽

Spatial Location ◽

Tuberculosis Screening ◽

Cross Sectional ◽

The Past ◽

Prior Testing ◽

Testing Uptake ◽

One Year

Abstract Background Kenya has a high burden of HIV, viral hepatitis, and tuberculosis. Screening is necessary for early diagnosis and treatment, which reduces morbidity and mortality across all three illnesses. We evaluated testing uptake for HIV, viral hepatitis, and tuberculosis in Kisumu, Kenya. Methods Cross-sectional data from adults aged 18–35 years who enrolled in a prospective HIV incidence cohort study from February 2017 to May 2018 were analyzed. A questionnaire was administered to each participant at screening for study eligibility to collect behavioral characteristics and to assess prior testing practices. Among participants without a history of previously-diagnosed HIV, multivariable robust Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for factors potentially associated with HIV testing in the 12 months prior to enrollment. A hierarchical model was used to test for differential access to testing due to spatial location. Results Of 671 participants, 52 (7.7%) were living with HIV, 308 (45.9%) were female, and the median age was 24 (interquartile range 21–28) years. Among 651 (97.0%) who had ever been tested for HIV, 400 (61.2%) reported HIV testing in the past 6 months, 129 (19.7%) in the past 6–12 months, and 125 (19.1%) more than one year prior to enrollment. Any prior testing for viral hepatitis was reported by 8 (1.2%) participants and for tuberculosis by 51 (7.6%). In unadjusted models, HIV testing in the past year was more common among females (PR 1.08 [95% CI 1.01, 1.17]) and participants with secondary education or higher (PR 1.10 [95% CI 1.02, 1.19]). In the multivariable model, only secondary education or higher was associated with recent HIV testing (adjusted PR 1.10 [95% CI 1.02, 1.20]). Hierarchical models showed no geographic differences in HIV testing across Kisumu subcounties. Conclusions Prior HIV testing was common among study participants and most had been tested within the past year but testing for tuberculosis and viral hepatitis was far less common. HIV testing gaps exist for males and those with lower levels of education. HIV testing infrastructure could be leveraged to increase access to testing for other endemic infectious diseases.

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Impact of Coronavirus Outbreaks on Science and Society: Insights from Temporal Bibliometry of SARS and COVID-19

Entropy ◽

10.3390/e23050626 ◽

2021 ◽

Vol 23 (5) ◽

pp. 626

Author(s):

Ramya Gupta ◽

Abhishek Prasad ◽

Suresh Babu ◽

Gitanjali Yadav

Keyword(s):

Published Data ◽

Science And Society ◽

Time Dimension ◽

Scientific Publications ◽

The Past ◽

Economic Trends ◽

Global Events ◽

One Year ◽

Personal Devices ◽

Share Information

A global event such as the COVID-19 crisis presents new, often unexpected responses that are fascinating to investigate from both scientific and social standpoints. Despite several documented similarities, the coronavirus pandemic is clearly distinct from the 1918 flu pandemic in terms of our exponentially increased, almost instantaneous ability to access/share information, offering an unprecedented opportunity to visualise rippling effects of global events across space and time. Personal devices provide “big data” on people’s movement, the environment and economic trends, while access to the unprecedented flurry in scientific publications and media posts provides a measure of the response of the educated world to the crisis. Most bibliometric (co-authorship, co-citation, or bibliographic coupling) analyses ignore the time dimension, but COVID-19 has made it possible to perform a detailed temporal investigation into the pandemic. Here, we report a comprehensive network analysis based on more than 20,000 published documents on viral epidemics, authored by over 75,000 individuals from 140 nations in the past one year of the crisis. Unlike the 1918 flu pandemic, access to published data over the past two decades enabled a comparison of publishing trends between the ongoing COVID-19 pandemic and those of the 2003 SARS epidemic to study changes in thematic foci and societal pressures dictating research over the course of a crisis.

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One Year of the COVID-19 Pandemic in Galicia: A Global View of Age-Group Statistics during Three Waves

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105104 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5104

Author(s):

Iván Area ◽

Henrique Lorenzo ◽

Pedro J. Marcos ◽

Juan J. Nieto

Keyword(s):

Intensive Care Unit ◽

Hospital Admissions ◽

Age Groups ◽

Age Group ◽

Nw Spain ◽

The Past ◽

Global View ◽

Time Period ◽

Key Variables ◽

One Year

In this work we look at the past in order to analyze four key variables after one year of the COVID-19 pandemic in Galicia (NW Spain): new infected, hospital admissions, intensive care unit admissions and deceased. The analysis is presented by age group, comparing at each stage the percentage of the corresponding group with its representation in the society. The time period analyzed covers 1 March 2020 to 1 April 2021, and includes the influence of the B.1.1.7 lineage of COVID-19 which in April 2021 was behind 90% of new cases in Galicia. It is numerically shown how the pandemic affects the age groups 80+, 70+ and 60+, and therefore we give information about how the vaccination process could be scheduled and hints at why the pandemic had different effects in different territories.

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Public Policy Administration

News for Teachers of Political Science ◽

10.1017/s0197901900003226 ◽

1985 ◽

Vol 47 ◽

pp. 1-16

Author(s):

Richard A. Brumback

Keyword(s):

Rhode Island ◽

General Level ◽

American Government ◽

Introductory Course ◽

The Past ◽

Business Colleges ◽

Business College ◽

Large Numbers ◽

The Subject ◽

One Year

The teaching of an introductory course in American Government can be a difficult and frustrating endeavor under even the best of circumstances. Given the general level of cynicism and/or lack of interest by large numbers of Americans regarding politics and politicians, the task of generating student enthusiasm, or even mild interest, toward the subject matter can indeed be an arduous one. When the teaching of such a course takes place in a business college, and when the student audience is “captive” to a college requirement that all students must take the course, the task can be rendered considerably more formidable.For the past six years I have been teaching such courses at business colleges — one year at Bryant College in Rhode Island, and the following five years at Bentley College in Massachusetts.

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Cognitive impairment in long-term benzodiazepine users

Psychological Medicine ◽

10.1017/s0033291700007911 ◽

1988 ◽

Vol 18 (2) ◽

pp. 365-374 ◽

Cited By ~ 119

Author(s):

Susan Golombok ◽

Parimala Moodley ◽

Malcolm Lader

Keyword(s):

Neuropsychological Tests ◽

Matched Control ◽

Control Group ◽

Therapeutic Practice ◽

The Past ◽

Visual Spatial ◽

Wide Range ◽

High Doses ◽

One Year

SynopsisIn view of the very extensive and often prolonged use of benzodiazepines in therapeutic practice, this study was designed to investigate whether or not cognitive ability is impaired in longterm benzodiazepine users, and to determine the nature and extent of any deficit. Fifty patients currently taking benzodiazepines for at least one year, thirty-four who had stopped taking benzodiazepines, and a matched control group of subjects who had never taken benzodiazepines or who had taken benzodiazepines in the past for less than one year were administered a battery of neuropsychological tests designed to measure a wide range of cognitive functions. It was found that patients taking high doses of benzodiazepines for long periods of time perform poorly on tasks involving visual-spatial ability and sustained attention. This is consistent with deficits in posterior cortical cognitive function.

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