scholarly journals The Primary Metatarsalgia: Pathogenesis, Biomechanics and Surgical Treatment

2017 ◽  
Vol 72 (1) ◽  
pp. 53-58
Author(s):  
D. S. Bobrov ◽  
L. J. Slinjakov ◽  
N. V. Rigin
Keyword(s):  
Surgical Treatment ◽  
Treatment Options ◽  
Supporting Surface ◽  
Excessive Pressure ◽  
Functional Changes ◽  
Treatment Techniques ◽  
Tendon Lengthening ◽  
Metatarsal Bones ◽  
Wide Range ◽  
The One

This paper presents a comprehensive review on the current concept of the diagnosis and treatment of central metatarsalgia on the basis of medical literature analyses. Metatarsalgia is the term for pain in the forefoot. This is a set of symptoms corresponding to a wide range of diseases. Central metatarsalgia is a kind of metatarsalgia which arises from structural-functional changes that lead to excessive pressure in the area of metatarsal heads. The data analysis demonstrated that presently various types of osteotomies of metatarsal bones are the main surgical treatment options with the chance of complication ranging from 6 to 50%. Weil-osteotomy is known to be the most popular type of osteotomy for treatment of central metatarsalgia. The most common complication of Weil-osteotomy is floating toe, the one that doesn’t contact with the supporting surface. In case Weil-osteotomy and intraphalangeal arthrodesis with trans acticular fixation are both performed, the complication of floating toe increases up to 50%. When Weil osteotomy, plantar plate repair, extensor digitorum longum tendon lengthening and triple Weil-osteotomy are performed simultaneously, the complication rate is 15% approximately which is much lower. Using combined osteotomy techniques as well as taking into account structural-functional pathologic changes of the forefoot and ligaments repair of metatarsalphalangeal joint will ensure the most successful development of surgical treatment techniques for central metatarsalgia.

scholarly journals THE CURRENT STATE OF DIAGNOSIS AND TREATMENT OF THE CONGENITAL TIBIA PSEUDOARTHROSIS

2021 ◽  
pp. 85-91
Author(s):  
Sergij Khmyzov ◽  
Yelizaveta Katsalap
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Biomechanical Properties ◽  
Early Years ◽  
Treatment Techniques ◽  
Membrane Technique ◽  
Minimal Trauma ◽  
Wide Range ◽  
Induced Membrane Technique ◽  
The Moment

Congenital pseudarthrosis of the tibia (CPT) is a rare disease that is detected with a frequency of 1 in 140–250,000 newborns. The disease is characterized by a wide range of clinical and radiological signs from progressive antecurvature deformation of the tibia to nonunion with a significant bone defect. Changes in the CPT area are caused by the influence of pathologically altered periosteum, which forms a fibrous hamartoma and is responsible for the deformityof the biomechanical properties of bone tissue. CPT can be formed at the moment of birth or developed spontaneously or as a result of minimal trauma in the early years. The main method of treatment of CPT is a surgery. Nowadays a number of surgical techniques, which are actively used and improved by specialists in the world, has been developed, The most used methods are the Ilizarovʼs method, application of intramedullary fixators, techniques with the use of vascularized tibial autograft, «induced membrane» technique. However, there are a few studies on comparing the effectiveness of different techniques or metal fixatives, most of them are presented in the format of a retrospective analysis of clinical cases series. This is due to the rarity of the disease and the lack of unified approaches on the choice of surgical treatment techniques. The main aim of surgical treatment of CPT is to achieveconsolidation in the area of pseudoarthrosis, which may restore the limb resistance. The part of primary consolidation of CPT after using the surgical treatment various techniques varies very much, range from 60 to 100 %. The percentage of children with CPT tibial amputations has decreased significantly over the past 30 years, which generally indicates an improvement of the results of surgical treatment of the mentioned pathology. However, CPT still remains one of the most difficult diseases of pediatric orthopedics due to the large number of unsatisfactory results and complications after surgery.

scholarly journals BIOSIMILARS: OPPORTUNITIES, CHALLENGES, AND THE GENERAL PRINCIPLES GOVERNING THEIR DEVELOPMENT AROUND THE GLOBE

2021 ◽  
pp. 1-9
Author(s):  
ISHITA KATHURIA ◽  
VIKAS KUMAR SRIVASTAVA
Keyword(s):  
Treatment Options ◽  
Genetic Material ◽  
World Health ◽  
European Medicines Agency ◽  
The European Union ◽  
Biologic Drugs ◽  
Wide Range ◽  
The One ◽  
Health Organization ◽  
Rare Illnesses

Biologic drugs have revolutionized the treatment of many life-threatening and rare illnesses such as cancer and autoimmune diseases. Biologics are broadly referred as substances that are produced by living cells and are used in the treatment, prevention, or diagnosis of diseases. They include a wide range of substances, such as genetic material, antibodies, vaccines, or processes which act by influencing cellular processes that block disease or affect diseased cells. Biologics have become striking treatment options and the size of the market has grown hastily. It is expected that by 2023, most of the patents will expire in the European Union opening a large potential market. Keeping this in mind, the ability to launch substitutes to original biologics, also known as biosimilars, presents many opportunities to generic companies. The field of biosimilars seems to be “breaking” the traditional division between the creations of innovative NCE-based medicines by research-based companies, on the one hand, and, on the other hand, mapping of these medicines by the generic companies. The field of biosimilars so far presents some considerable challenges, namely, regulatory, safety, economic, and legal which are still being debated and discussed in different forums. In this article, we have tried to summarize the general principles and regulations governing the development of biosimilars by regulatory authorities such as the World Health Organization, European Medicines Agency, US Food and Drug Administration, and Health Canada. Furthermore, we have tried to throw some light on the opportunities, challenges, and current scenarios pertaining to biosimilars.

scholarly journals TAKING THE RISK IN SURGERY

2019 ◽  
Vol 6 (1) ◽  
pp. 187-188
Author(s):  
Eugen Brătucu
Keyword(s):  
Surgical Treatment ◽  
Informed Consent ◽  
Minimally Invasive ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Postoperative Bleeding ◽  
Polarized Light ◽  
Postoperative Outcome ◽  
Technological Changes ◽  
Wide Range

One of the most difficult to accept treatment options by the patient remains surgical intervention. The patient resorts to a wide range of therapies, more or less appropriate, with the hope that he will solve his health problems by non-surgical ways. Only the idea of a surgical treatment triggers a reaction of fear, sometimes going to panic. The patient resorts to the most unusual solutions: natural medication, bioenergy, homeopathy, magnetism, polarized light, acupuncture, and more others just to avoid the operating room. The patient's reaction is natural and is the expression of a preservation instinct in front of aggression. Surgery remains, however, the most radical therapeutic remedy. Whether it is done in a classical way or minimally invasive, the surgical solution brings almost instantaneous resolution of the disease to which it is addressed. The therapeutic outcome, often spectacular, is accompanied by a number of risks that must be accepted by the patient. Hence retention and fear for surgery. The idea of being "cut" accepting aggression on your own anatomy is a difficult obstacle to overcome.There have been many changes in surgery. Advances have been made rapidly, in line with technological changes: endoscopy, laparoscopy and thoracoscopy, robotics, mechanical sutures, surgical lasers, ultrasonic disks, and so on. But the risks are almost unchanged: anesthetics complications, intraoperative hemorrhages, visceral lesions, eviscerations, postoperative bleeding or peritonitis and so on. How can the patient accept “this list of nightmares”? How can he accept the percentage of 0.1-10% of post-operative deaths, a number which varies according to the extent of the surgery and the patient's biological status? The informed consent cannot cover all possible surgical and non-surgical complications. However, the therapeutic act is inseparably linked and conditioned by obtaining this consent. During a few hours, the surgeon is responsible for the life and the future of his patient. A great surgeon, Robert Soupault, once said that the operator has "plein pouvoir sur la vie". These powers should be used with utmost discernment, with the sense of measure, consistent with the illness being treated and with the condition of the patient. Any exaggeration will, unfortunately, be reflected in the postoperative outcome. Overestimating or underestimating the disease are equally risky. "Better is the enemy of good" is an old saying well known in the surgical world.Rightly, paraphrasing Iuliu Hațieganu, "surgery is science and consciousness, both heated by respect and love for people.". And then, if things are so, in surgery it's good to think you can, but realize on time when you cannot.

General Trend of Negative Transference Number in Li Salt/Ionic Liquid Mixtures

2019 ◽  
Author(s):  
Nicola Molinari ◽  
Jonathan P. Mailoa ◽  
Boris Kozinsky
Keyword(s):  
Ionic Liquid ◽  
Transference Number ◽  
Liquid Mixtures ◽  
Single Linkage ◽  
Self Diffusion ◽  
Wide Range ◽  
Single Linkage Cluster ◽  
Concentrated Solution ◽  
The One ◽  
Dynamics Simulations

We show that strong cation-anion interactions in a wide range of lithium-salt/ionic liquid mixtures result in a negative lithium transference number, using molecular dynamics simulations and rigorous concentrated solution theory. This behavior fundamentally deviates from the one obtained using self-diffusion coefficient analysis and agrees well with experimental electrophoretic NMR measurements, which accounts for ion correlations. We extend these findings to several ionic liquid compositions. We investigate the degree of spatial ionic coordination employing single-linkage cluster analysis, unveiling asymmetrical anion-cation clusters. Additionally, we formulate a way to compute the effective lithium charge that corresponds to and agrees well with electrophoretic measurements and show that lithium effectively carries a negative charge in a remarkably wide range of chemistries and concentrations. The generality of our observation has significant implications for the energy storage community, emphasizing the need to reconsider the potential of these systems as next generation battery electrolytes.<br>

The Future of Plasma-Based Surface Engineering Techniques in Tribology (Keynote)

2005 ◽  
Author(s):  
Allan Matthews ◽  
Adrian Leyland
Keyword(s):  
Surface Engineering ◽  
Performance Enhancement ◽  
Bulk Material ◽  
Cost Savings ◽  
Cost Effective ◽  
Ceramic Coatings ◽  
Performance Improvements ◽  
Treatment Techniques ◽  
Wide Range ◽  
Macro Scale

Over the past twenty years or so, there have been major steps forward both in the understanding of tribological mechanisms and in the development of new coating and treatment techniques to better “engineer” surfaces to achieve reductions in wear and friction. Particularly in the coatings tribology field, improved techniques and theories which enable us to study and understand the mechanisms occurring at the “nano”, “micro” and “macro” scale have allowed considerable progress to be made in (for example) understanding contact mechanisms and the influence of “third bodies” [1–5]. Over the same period, we have seen the emergence of the discipline which we now call “Surface Engineering”, by which, ideally, a bulk material (the ‘substrate’) and a coating are combined in a way that provides a cost-effective performance enhancement of which neither would be capable without the presence of the other. It is probably fair to say that the emergence and recognition of Surface Engineering as a field in its own right has been driven largely by the availability of “plasma”-based coating and treatment processes, which can provide surface properties which were previously unachievable. In particular, plasma-assisted (PA) physical vapour deposition (PVD) techniques, allowing wear-resistant ceramic thin films such as titanium nitride (TiN) to be deposited on a wide range of industrial tooling, gave a step-change in industrial productivity and manufactured product quality, and caught the attention of engineers due to the remarkable cost savings and performance improvements obtained. Subsequently, so-called 2nd- and 3rd-generation ceramic coatings (with multilayered or nanocomposite structures) have recently been developed [6–9], to further extend tool performance — the objective typically being to increase coating hardness further, or extend hardness capabilities to higher temperatures.

scholarly journals Modes of Interaction in Naturally Occurring Medical Encounters With General Practitioners: The “One in a Million” Study

2021 ◽  
pp. 104973232199379
Author(s):  
Olaug S. Lian ◽  
Sarah Nettleton ◽  
Åge Wifstad ◽  
Christopher Dowrick
Keyword(s):  
General Practitioners ◽  
Narrative Analysis ◽  
Mode Competition ◽  
General Applicability ◽  
Naturally Occurring ◽  
Wide Range ◽  
The One ◽  
Narrative Mode ◽  
Modes Of Interaction

In this article, we qualitatively explore the manner and style in which medical encounters between patients and general practitioners (GPs) are mutually conducted, as exhibited in situ in 10 consultations sourced from the One in a Million: Primary Care Consultations Archive in England. Our main objectives are to identify interactional modes, to develop a classification of these modes, and to uncover how modes emerge and shift both within and between consultations. Deploying an interactional perspective and a thematic and narrative analysis of consultation transcripts, we identified five distinctive interactional modes: question and answer (Q&A) mode, lecture mode, probabilistic mode, competition mode, and narrative mode. Most modes are GP-led. Mode shifts within consultations generally map on to the chronology of the medical encounter. Patient-led narrative modes are initiated by patients themselves, which demonstrates agency. Our classification of modes derives from complete naturally occurring consultations, covering a wide range of symptoms, and may have general applicability.

“Proximalization is Advancement”—Zone 3 Frozen Elephant Trunk vs Zone 2 Frozen Elephant Trunk: A Literature Review

2021 ◽  
pp. 153857442110024
Author(s):  
Rozina Yasmin Choudhury ◽  
Kamran Basharat ◽  
Syeda Anum Zahra ◽  
Tien Tran ◽  
Lara Rimmer ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Literature Review ◽  
Treatment Options ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Descending Aorta ◽  
Cord Injury ◽  
Aortic Pathologies

Over the decades, the Frozen Elephant Trunk (FET) technique has gained immense popularity allowing simplified treatment of complex aortic pathologies. FET is frequently used to treat aortic conditions involving the distal aortic arch and the proximal descending aorta in a single stage. Surgical preference has recently changed from FET procedures being performed at Zone 3 to Zone 2. There are several advantages of Zone 2 FET over Zone 3 FET including reduction in spinal cord injury, visceral ischemia, neurological and cardiovascular sequelae. In addition, Zone 2 FET is a technically less complicated procedure. Literature on the comparison between Zone 3 and Zone 2 FET is scarce and primarily observational and anecdotal. Therefore, further research is warranted in this paradigm to substantiate current surgical treatment options for complex aortic pathologies. In this review, we explore literature surrounding FET and the reasons for the shift in surgical preference from Zone 3 to Zone 2.

scholarly journals Why Do Our Cancer Patients Sleep So Badly? Sleep Disorders in Cancer Patients: A Frequent Symptom with Multiple Causes

2021 ◽  
pp. 1-7
Author(s):  
Herwig Strik ◽  
Werner Cassel ◽  
Michael Teepker ◽  
Thomas Schulte ◽  
Jorge Riera-Knorrenschild ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Cancer Patients ◽  
Treatment Options ◽  
Ethics Committee ◽  
Breathing Disorders ◽  
The One ◽  
Diagnosis Therapy ◽  
The University ◽  
Insomnia Symptoms

<b><i>Introduction:</i></b> On the one hand, sleep disorders in cancer patients are reported in 30–50% of cancer patients. On the other hand, specific causes for these sleep disorders are little known. This study was done to evaluate factors which may affect sleep of cancer patients. To our knowledge, this is the first study which includes return to work as one factor of sleep disturbance. <b><i>Methods:</i></b> 107 patients with various types of cancer treated in 2 hospitals were interviewed with a battery of questionnaires after having given informed consent. The questionnaires intended to detect abnormalities of sleep and related pain, breathing disorders, restless legs syndrome, depression, rumination, medication, and psychosocial distress. The study was approved by the ethics committee of the University of Marburg. <b><i>Results:</i></b> The analysis of the 6 sleep-related questionnaires indicated a sleep disorder of any kind in 68% of all patients. Insomnia symptoms were present in 48 patients (44.9%). Pain, depression, anxiety, and worries about the workplace were significantly related to sleep disorders. <b><i>Conclusion:</i></b> Sleep disorders are common in cancer patients. The causes are manifold and should be considered by caregivers during diagnosis, therapy, and aftercare of cancer patients. Tumour patients should actively be asked about sleep disorders. If these are present, they should be addressed, and as they have a large impact on quality of life, treatment options should be offered in cooperation with sleep specialists.

scholarly journals Entangling Lattice-Trapped Bosons with a Free Impurity: Impact on Stationary and Dynamical Properties

Entropy ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 290
Author(s):  
Maxim Pyzh ◽  
Kevin Keiler ◽  
Simeon I. Mistakidis ◽  
Peter Schmelcher
Keyword(s):  
Structural Changes ◽  
Many Body ◽  
Wide Range ◽  
Entropy Measures ◽  
Particle Level ◽  
The Many ◽  
The One ◽  
Tunneling Dynamics ◽  
The Individual ◽  
Trapped Bosons

We address the interplay of few lattice trapped bosons interacting with an impurity atom in a box potential. For the ground state, a classification is performed based on the fidelity allowing to quantify the susceptibility of the composite system to structural changes due to the intercomponent coupling. We analyze the overall response at the many-body level and contrast it to the single-particle level. By inspecting different entropy measures we capture the degree of entanglement and intraspecies correlations for a wide range of intra- and intercomponent interactions and lattice depths. We also spatially resolve the imprint of the entanglement on the one- and two-body density distributions showcasing that it accelerates the phase separation process or acts against spatial localization for repulsive and attractive intercomponent interactions, respectively. The many-body effects on the tunneling dynamics of the individual components, resulting from their counterflow, are also discussed. The tunneling period of the impurity is very sensitive to the value of the impurity-medium coupling due to its effective dressing by the few-body medium. Our work provides implications for engineering localized structures in correlated impurity settings using species selective optical potentials.

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