scholarly journals Biomechanical study of Tile C3 pelvic fracture fixation using an anterior internal system combined with sacroiliac screws

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lin Liu ◽  
Donggui Zeng ◽  
Shicai Fan ◽  
Yongxing Peng ◽  
Hui Song ◽  
...  

Abstract Background How to perform minimally-invasive surgery on Tile C pelvic fractures is very difficult, and it is also a hot topic in orthopedic trauma research. We applied minimally-invasive treatment using an anterior internal fixator combined with sacroiliac screws. Objectives To compare the biomechanical properties of different fixation models in pelvic facture specimens, using an internal fixation system or a steel plate combined with sacroiliac screws. Methods Sixteen fresh adult cadaver pelvic specimens were randomly separated into four groups named A, B, C, and D. The four groups were respectively stabilized using a two-screwed, three-screwed, or four-screwed anterior internal fixator or a steel plate with sacroiliac screws. All models were tested in both standing and sitting positions. Vertical loads of 600 N were applied increasingly. Shifts of bilateral sacroiliac joints and pubis rupture were measured. Results The shifts in sacroiliac joints and pubis rupture in the standing position were all less than 3.5 mm, and the shifts in the sitting position were all less than 1 mm. In the standing position, the results of shifts in the sacroiliac joints were group C < group D < group B < group A. For comparisons between A:B and C:D, P > 0.05. For comparisons between A, B:C, and D, P < 0.05. The results of shifts in pubis ruptures were group D < group C < group B < group A. In the comparison between C:D, P > 0.05; for comparisons between A:B, A:C, A:D, B:C, and B:D, P < 0.05. In the sitting posture, the results of shifts in the sacroiliac joints were group C < group D < group B < group A, and the shifts in the pubis ruptures were group D < group C < roup B < group A. For comparison between C:D, P > 0.05. For comparisons between A:B, A:C, A:D, B:C, and B:D, P < 0.05. Conclusion Use of an anterior internal fixator combined with sacroiliac screws effectively stabilized Tile C3 pelvic fractures. The stability of specimens increased as the number of screws in the internal fixator increased.

2021 ◽  
Author(s):  
lin liu ◽  
Donggui Zeng ◽  
Shicai Fan ◽  
Yongxing Peng ◽  
Hui Song ◽  
...  

Abstract BackgroundThis study aimed to investigate the effectiveness of different methods of fixation of Tile C3 pelvic fractures. We applied minimally-invasive treatment using an anterior internal fixator combined with sacroiliac screws. ObjectivesTo compare the biomechanical properties of different fixation models in pelvic facture specimens, using an internal fixation system or a steel plate combined with sacroiliac screws. MethodsSixteen fresh adult cadaver pelvic specimens were randomly separated into four groups named A, B, C and D. The four groups were respectively stabilized using a two-screwed, three-screwed, or four-screwed anterior internal fixator or a steel plate with sacroiliac screws. All models were tested in both standing and sitting positions. Vertical loads of 600 N were applied increasingly. Shifts of bilateral sacroiliac joints and pubis rupture were measured. ResultsThe shifts in sacroiliac joints and pubis rupture in the standing position were all less than 3.5 mm and the shifts in the sitting position were all less than 1 mm. In the standing position, the results of shifts in the sacroiliac joints were: Group C < Group D < Group B < Group A. For comparisons between A:B and C:D, P > 0.05. For comparisons between A, B:C, D, P < 0.05. The results of shifts in pubis ruptures were: Group D < Group C < Group B < Group A. In the comparison between C:D, P > 0.05, for comparisons between A:B, A:C, A:D, B:C, and B:D, P < 0.05. In the sitting posture, the results of shifts in the sacroiliac joints were: Group C < Group D < Group B < Group A, the shifts in the pubis ruptures were: Group D < Group C < Group B < Group A. For comparison between C:D, P > 0.05. For comparisons between A:B, A:C, A:D, B:C, and B:D, P < 0.05. ConclusionUse of an anterior internal fixator combined with sacroiliac screws effectively stabilized Tile C3 pelvic fractures. Among the options tested, a two-screwed internal fixator combined with sacroiliac screws was easier to operate. The stability of specimens increased as the number of screws in the internal fixator increased.


Author(s):  
Dongdong Xia ◽  
Meijun Yan ◽  
Xin Yin ◽  
Wenhao Hu ◽  
Chi Zhang ◽  
...  

Many studies focused on the annulus fibrosus (AF) injury in rodent tail model for the intervertebral disk degeneration (IDD) research. However, previous studies caused tremendous injury of intervertebral disk (IVD) by penetrating whole disk. This study aimed to build a progressive IDD rodent tail model by a novel device for precise and minimally invasive puncture in AF. A precise puncture device was customized by 3D Printing Technique. 40 rodent tail IVDs were randomly grouped as follows: group A, non-puncture; group B, annulus needle puncture (ANP) for 4 week; group C, ANP for 8 week; and group D, ANP for 12 week. Pre- and post-puncture IVD height on radiographs and IVD signal intensity on T2 magnetic resonance imaging (MRI) were measured. Average bone density (ABD) on the end of coccygeal vertebrae between punctured disk was measured on the radiographs. Hematoxylin and eosin, TUNEL staining methods, immunofluorescence for cleaved-caspas3 and immunohistochemistry for aggrecan and collagen II were performed. Progressively and significantly increasing IVD height loss and degenerative grade were observed following the time points. The ABD was respectively, 81.20 ± 4.63 in group A, 83.93±3.18 in group B, 92.65 ± 4.32 in group C, 98.87 ± 6.69 in group D. In both group C and group D, there were significant differences with group A. In histology, increasing number of AF cells was noted in group B. In both group C and D, the fissures in AF were obviously observed, and a marked reduction of AF cells were also observed. In all ANP groups, there were significant decrease in number of NP cells, as well as aggrecan and collagen II contents. TUNEL assay showed cellular apoptosis were stimulated in all puncture group, especially in group D. A progressive IDD rat model could be standardly established by the micro-injury IVD puncture using a novel 3D printing device. This animal model provided a potential application for research of progressive hyperosteogeny following IDD development.


2019 ◽  
Vol 10 (3) ◽  
pp. 536-551
Author(s):  
Heidi Amezcua Hempel ◽  
María Salud Rubio Lozano ◽  
Eliseo Manuel Hernández Baumgarten ◽  
Pablo Correa Girón † ◽  
Oscar Torres Ángeles ◽  
...  

The study was to determine the presence of Classical Swine Fever virus (CSFv), in the meat of vaccinated pigs with the PAV-250 strain and then challenged using the same strain. Five treatment groups were established (each with four pigs). Group A: Pigs thatwere fed with processed hams from negative animals; Group B: Pigs that were fed with processed hams from commercial pigs inoculated with the ALD (reference strain) (titre of 104.0/ml); Group C: Pigs fed with processed hams from pigs infected with the virulent ALD strain (titre of 102.5/ml); Group D: Pigs fed with processed hams from pigs vaccinated with the PAV-250 strain and challenged with the ALD strain (titre of 101.1/ml); and Group E: Pigs fed with processed hams from pigs vaccinated with two doses of the PAV-250 strain and challenged with the ALD strain (negative). Blood samples were taken at d 1, 5, 10, 15 and 20 for biometric analysis. Groups B, C and D manifested clinical signs of CSFv: 40 °C temperature, anorexia, paralysis, vomiting, diarrhea, tremor, hirsute hair and cyanosis. Pigs were slaughtered and necropsies performed to identify lesions in tissues. Results of direct immunofluorescence testing of tissues were positive and the virus was recovered. Under these study conditions, it was found that CSFv resisted the cooking method at 68 °C for 40 min in hams from unvaccinated pigs, and that the virus was able to transmit the disease to healthy unvaccinated pigs, whereas the hams from the vaccinated animals did not transmit the virus.


Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.


Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Serdar Sahin ◽  
Havva Sezer ◽  
Ebru Cicek ◽  
Yeliz Yagız Ozogul ◽  
Murat Yildirim ◽  
...  

<b><i>Introduction:</i></b> The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. <b><i>Methods:</i></b> We included the patients &#x3e;18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight &#x3c;25 kg/m<sup>2</sup> (Group A), overweight from 25 to &#x3c;30 kg/m<sup>2</sup> (Group B), Class I obesity 30 to &#x3c;35 kg/m<sup>2</sup> (Group C), and ≥35 kg/m<sup>2</sup> (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. <b><i>Results:</i></b> There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [<i>p</i> = 0.017], Group D vs. Group A [<i>p</i> = 0.001], and Group D vs. Group C [<i>p</i> = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [<i>p</i> = 0.025], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> = 0.006], and Group D vs. Group C [<i>p</i> = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [<i>p</i> &#x3c; 0.001], Group C vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> &#x3c; 0.001], and Group D vs. Group C [<i>p</i> = 0.010]). <b><i>Conclusion:</i></b> COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1510.1-1511
Author(s):  
T. Kuga ◽  
M. Matsushita ◽  
K. Tada ◽  
K. Yamaji ◽  
N. Tamura

Background:Cardiovascular disease (CVD) is detected in up to 50% of systemic lupus erythematosus (SLE) patients1and major cause of death2. Even clinically silent SLE patients can develop left ventricular (LV) diastolic dysfunction3. Proper echocardiographic follow up of SLE patients is required.Objectives:To clarify how the prevalence of LV abnormalities changes over follow-up period and identify the associated clinical factors, useful in suspecting LV abnormalities.Methods:29 SLE patients (24 females and 5 men, mean age 52.8±16.3 years, mean disease duration 17.6±14.5 years) were enrolled. All of them underwent echocardiography as the baseline examination and reexamined over more than a year of follow-up period(mean 1075±480 days) from Jan 2014 to Sep 2019. Patients complicated with pulmonary artery hypertension, deep venous thrombosis or pulmonary embolism and underwent cardiac surgery during the follow-up period were excluded. Left ventricular(LV) systolic dysfunction was defined as ejection fraction (EF) < 50%. LV diastolic dysfunction was defined according to ASE/EACVI guideline4. LV dysfunction (LVD) includes one or both of LV systolic dysfunction and LV diastolic function. Monocyte to HDL ratio (MHR) was calculated by dividing monocyte count with HDL-C level.Prevalence of left ventricular abnormalities was analysed at baseline and follow-up examination. Clinical characteristics and laboratory data were compared among patient groups as follows; patients with LV dysfunction (Group A) and without LV dysfunction (Group B) at the follow-up echocardiography, patients with LV asynergy at any point of examination (Group C) and patients free of LV abnormalities during the follow-up period (Group D).Results:At the baseline examination, LV dysfunction (5/29 cases, 13.8%), LV asynergy (6/29 cases, 21.7%) were detected. Pericarditis was detected in 7 patients (24.1%, LVD in 3 patients, LV asynergy in 2 patients) and 2 of them with subacute onset had progressive LV dysfunction, while 5 patients were normal in echocardiography after remission induction therapy for SLE. At the follow-up examination, LV dysfunction (9/29 cases, 31.0%, 5 new-onset and 1 improved case), LV asynergy (6/29 cases, 21.7%, 2 new-onset and 2 improved cases) were detected. Though any significant differences were observed between Group A and Group B at the baseline, platelet count (156.0 vs 207.0, p=0.049) were significantly lower in LV dysfunction group (Group A) at the follow-up examination. Group C patients had significantly higher uric acid (p=0.004), monocyte count (p=0.009), and MHR (p=0.003) than Group D(results in table).Conclusion:LV dysfunction is progressive in most of patients and requires regular follow-up once they developed. Uric acid, monocyte count and MHR are elevated in SLE patients with LV asynergy. Since MHR elevation was reported as useful marker of endothelial dysfunction5, our future goal is to analyse involvement of monocyte activation and endothelial dysfunction in LV asynergy of SLE patients.References:[1]Doria A et al. Lupus. 2005;14(9):683-6.[2]Manger K et al. Ann Rheum Dis. 2002 Dec;61(12):1065-70.[3]Leone P et al. Clin Exp Med. 2019 Dec 17.[4]Nagueh SF et al. J Am Soc Echocardiogr. 2016 Apr;29(4):277-314.[5]Acikgoz N et al. Angiology. 2018 Jan;69(1):65-70.Numbers are median (interquartile range), Mann-Whitney u test were performed, p value less than 0.05 was considered statistically significant.Disclosure of Interests: :None declared


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Huo ◽  
Hansheng Liang ◽  
Yi Feng

Abstract Background Pernicious placenta previa (PPP) can increase the risk of perioperative complications. During caesarean section in patients with adherent placenta, intraoperative blood loss, hysterectomy rate and transfusion could be reduced by interventional methods. Our study aimed to investigate the influence of maternal hemodynamics control and neonatal outcomes of prophylactic temporary abdominal aortic balloon (PTAAB) occlusion for patients with pernicious placenta previa. Methods This was a retrospective study using data from the Peking University People’s Hospital from January 2014 through January 2020. Clinical records of pregnant women undergoing cesarean section were collected. Patients were divided into two groups: treatment with PTAAB placement (group A) and no balloon placement (group B). Group A was further broken down into two groups: prophylactic placement (Group C) and balloon occlusion (group D). Results Clinical records of 33 cases from 5205 pregnant women underwent cesarean section were collected. The number of groups A, B, C, and D were 17, 16, 5 and 12.We found that a significant difference in the post-operative uterine artery embolism rates between group A and group B (0% vs.31.3%, p = 0.018). There was a significant difference in the Apgar scores at first minute between group A and group B (8.94 ± 1.43 vs 9.81 ± 0.75,p = 0.037),and the same significant difference between two groups in the pre-operative central placenta previa (29.4% vs. 0%,p = 0.044), complete placenta previa (58.8% vs 18.8%, p = 0.032),placenta implantation (76.5% vs 31.3%, p = 0.015). We could also observe the significant difference in the amount of blood cell (2.80 ± 2.68vs.10.66 ± 11.97, p = 0.038) and blood plasma transfusion (280.00 ± 268.32 vs. 1033.33 ± 1098.20, p = 0.044) between group C and group D. The significant differences in the preoperative vaginal bleeding conditions (0% vs 75%, p = 0.009), the intraoperative application rates of vasopressors (0% vs. 58.3%, p = 0.044) and the postoperative ICU (intensive care unit) admission rates (0% vs. 58.3%, p = 0.044) were also kept. Conclusions PTAAB occlusion could be useful in reducing the rate of post-operative uterine artery embolism and the amount of transfusion, and be useful in coping with patients with preoperative vaginal bleeding conditions, so as to reduce the rate of intraoperative applications of vasopressors and the postoperative ICU (intensive care unit) admission. In PPP patients with placenta implantation, central placenta previa and complete placenta previa, we advocate the utilization of prophylactic temporary abdominal aortic balloon placement.


Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 164
Author(s):  
Labrini V. Athanasiou ◽  
Victoria M. Spanou ◽  
Eleni G. Katsogiannou ◽  
Panagiotis D. Katsoulos

Exposure of sheep to Borreliaburgdorferi sensulato (s.I.) complex, the causative agent of Lyme borreliosis (LB), has been reported in tick-abundant areas worldwide, while no data have been reported in Greece. The aim of the study was to identify the hematological alterations in sheep with seropositivity against Borrelia burgdorferi (s.I.). Blood samples were obtained from 318 tick infested sheep for blood analysis and serological determination of IgG and IgM antibodies against B. burgdorferi by indirect immunofluorescence antibody (IFA) assay after exclusion of endo-ectoparasites and other tick-borne infections. A total number of 162 sheep met the inclusion criteria, allocated in four groups based on the presence or absence of IgG and/or IgM; sheep found negative for IgM and IgG (Group A), positive for IgM (Group B), positive for both IgM and IgG (Group C) and positive for IgG (Group D). Anemia, thrombocytopenia and normal or decreased leukocyte count, mainly due to lymphopenia were the main hematological features observed in seropositive sheep. The presence of these features raises the suspicion of Borrelia infection in tick infested sheep. The seropositivity of 23.58% in sheep raises concerns of Borrelia circulation, especially in rural areas and potential risk of transmission to humans.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 516.1-516
Author(s):  
S. H. Chang ◽  
J. S. Lee ◽  
J. S. Lee ◽  
C. H. Park ◽  
M. U. Kim ◽  
...  

Background:Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). However, the effect of RA disease activity on the course of ILD is not yet known.Objectives:To assess the natural course of lung physiology of RA-ILD and the relation between arthritis activity and pulmonary physiology in patients with RA-ILD.Methods:The Korean Rheumatoid Arthritis ILd (KORAIL) cohort is the prospective observational cohort and aims to investigate the natural course of RAILD. Based on either 1987 or 2020 ACR criteria, patients diagnosed with RA and ILD based on CT scan were recruited from six tertiary medical hospitals in Korea since January 2015. RA disease activity was assessed using disease activity (DAS)28-ESR and CRP, annually. Pulmonary function tests (PFT), including FVC and DLCO were conducted annually. According to the transition of DAS28-ESR status, we classified patients into four groups: Group A. persistent remission or low disease activity, Group B. improvement, Group C. worsening, Group D. persistent moderate to high disease activity.Results:We analyzed 143 patients who completed a 2-year follow-up (visit 2) or had died with available PFT results at least twice. Mean duration since RA diagnosis and since ILD diagnosis was 7.6±8.0 and 2.7±3.1 years, respectively. Twenty-four patients were Group A, 33 Group B, 10 Group C and 30 Group D. The mean of FVC (mL) and % of the predicted value in FVC was significantly lower in Group D than in other groups (Table 1). The annual rate of decline in FVC was -42 (95% CI -93~10) mL·year-1 in Group B while -113 (95% CI -206~-21) mL·year-1 in Group C (Figure 1A). The annual decline rate in Group C was further exaggerated in patients with ≥ 80% of FVC predicted (-141, 95% CI -251~-32 mL·year-1). During two years of follow-up, patients ever experienced a relative decline of ≥10% from the enrollment in FVC predicted was 27.3%(n-9/33) in Group B whereas 30.0% (3/10) in Group C. The annual rate of decline in % of DLco predicted value was also the largest in Group C (-4.6 %·year-1, 95%CI -8.5~-0.7), which further exaggerated in patients with ≥ 80% of FVC predicted (-4.9%·year-1, 95 %CI -8.3~-1.5, Figure 1B). Of note, about half of patients with maintained not only low disease activity (Group A) but also moderate to severe disease activity (Group D) improved in DLco at least 10% or more from the enrollment of DLco predicted value (Group A: 54.2%, n=13/24, Group D: 46.7%, n=14/30).Conclusion:RA disease activity is associated with the change of lung physiology in patients with RA-ILD; worsening disease activity associated with a further decrease of annual change in FVC and maintaining low disease activity associated with a further increase of annual change in % of DLco predicted value.Table 1.The analysis of forced vital capacity (FVC) according to disease activity transition group.Group AGroup BGroup CGroup DFVC (mL), mean±SD2810.0±771.12528.8±735.32801.0±952.72048.3±575.7FVC % of predicted, mean±SD87.5±14.586.5±16.693.0±15.677.2±17.3Rate of FVC decline, mL·year-1 (95% CI)-52 (-112,7)-42 (-93,10)-113 (-206, -21)1 (-52, 54)A 10-point decline from V1 in predicted FVC value, n (%)29 (20.3)6 (25.0)6 (18.2)3 (30.0)Relative decline of 10% from the enrollment in predicted FVC value, n (%)35 (24.5)5 (20.8)9 (27.3)3 (30.0)Figure 1.The annual change of pulmonary physiology according to disease activity transition group.Acknowledgements:This work was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant no.HI14C1277).Disclosure of Interests:None declared


Author(s):  
Elizabeth Hirakauva ◽  
Ana Bianchi-Ferraro ◽  
Eliana Zucchi ◽  
Marcio Kajikawa ◽  
Manoel Girão ◽  
...  

Introduction The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study. Methods Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS. Results We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria. We didn't observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group. Conclusion The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.


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