Modified Algorithm for Managing Postoperative Osteomyelitis Following Fracture Fixation with Cierny-Mader Type

2020 ◽  
Author(s):  
Yanbin Tan ◽  
Hang Li ◽  
Zhijun Pan ◽  
Qiang Zheng
Keyword(s):  
Clinical Efficacy ◽  
Fracture Fixation ◽  
Wound Repair ◽  
Ilizarov Technique ◽  
Flap Transfer ◽  
Tissue Reconstruction ◽  
The Stability ◽  
Type 3 ◽  
Postoperative Osteomyelitis ◽  
Modified Algorithm

Abstract Background: No standardized protocol has been suggested in the treatment of postoperative osteomyelitis following fracture fixation. Our team evaluates the clinical efficacy of the modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny-Mader type. Methods: 95wounds were reviewed from March 2009 to February 2016 in our hospital. 61 wounds were treated by the modified algorithm as following： Stable hardware + bone not healed Cierny–Mader 1 type = remove hardware, temporary stabilize; Stable hardware + bone not healed Cierny–Mader 2 type = retain hardware ; Stable hardware + bone not healed Cierny–Mader for type 3 and type 4 = remove hardware, temporary stabilize/ Ilizarov technique; Unstable hardware + bone not healed = remove hardware, temporary stabilize/ Ilizarov technique; Stable hardware + bone healed = remove hardware. 34 wounds were treated by the conventional algorithm. Autodermoplasty, flap transfer, myocutaneous flap and other methods including antibiotic irrigation and drug delivery system were used in wound repair.Results: The patients treated with modified algorithm had a significantly reduced recurrence (P＜0.01) , and increased results of negative bacterial cultures (P＜0.01), but however observed a decrease in the number of retained hardware cases (P＜0.05) . For those treated with tissue reconstruction, there was no significantly (P＞0.05) comparing with the conventional group. Conclusions: The modified algorithm for the postoperative osteomyelitis following fracture fixation according to the stability of the hardware and Cierny-Mader type represent a good clinical efficacy in the management of postoperative osteomyelitis. This procedure is simple and shows promising results, more clinical evidence is needed to confirm the existing findings and optimize the treatment of postoperative osteomyelitis following fracture fixation.

A Modified Management of Implant Associated Postoperative Osteomyelitis With Cierny-Mader Type

2020 ◽  
Author(s):  
Yanbin Tan ◽  
Hang Li ◽  
Zhijun Pan ◽  
Qiang Zheng
Keyword(s):  
Clinical Efficacy ◽  
Wound Repair ◽  
Ilizarov Technique ◽  
Modified Technique ◽  
Flap Transfer ◽  
Tissue Reconstruction ◽  
The Stability ◽  
Type 3 ◽  
Postoperative Osteomyelitis ◽  
Modified Algorithm

Abstract Background: No standardized protocol has been suggested in the treatment of postoperative osteomyelitis. Our team evaluates the clinical efficacy of the modified tactics of implant associated postoperative osteomyelitis patients according to Cierny-Mader type. Methods: 95wounds were reviewed from March 2009 to February 2016 in our hospital. 61 wounds were treated by the modified algorithm as following: Stable hardware + bone not healed Cierny–Mader 1 type = remove hardware, temporary stabilize; Stable hardware + bone not healed Cierny–Mader 2 type = retain hardware ; Stable hardware + bone not healed Cierny–Mader for type 3 and type 4 = remove hardware, temporary stabilize/ Ilizarov technique; Unstable hardware + bone not healed = remove hardware, temporary stabilize/ Ilizarov technique; Stable hardware + bone healed = remove hardware. 34 wounds were treated by the conventional algorithm. Autodermoplasty, flap transfer, myocutaneous flap and other methods including antibiotic irrigation and drug delivery system were used in wound repair. Results: The patients treated with modified algorithm had a significantly reduced recurrence (P＜0.01) , and increased results of negative bacterial cultures (P＜0.01), but however observed a decrease in the number of retained hardware cases (P＜0.05) . For those treated with tissue reconstruction, there was no significantly (P＞0.05) comparing with the conventional group. Conclusions: The modified technique for the implant associated postoperative osteomyelitis according to the stability of the hardware and Cierny-Mader type represent a good clinical efficacy in the management of postoperative osteomyelitis. This procedure is simple and shows promising results, more clinical evidence is needed to confirm the existing findings and optimize the treatment of postoperative osteomyelitis. Key Words: Osteomyelitis, Postoperation, Implant

scholarly journals Gap junctions and connexin hemichannels in the regulation of haemostasis and thrombosis

2015 ◽  
Vol 43 (3) ◽  
pp. 489-494 ◽  
Author(s):  
Sakthivel Vaiyapuri ◽  
Gagan D. Flora ◽  
Jonathan M. Gibbins
Keyword(s):  
Gap Junctions ◽  
Intercellular Communication ◽  
Heart Attack ◽  
Wound Repair ◽  
Future Directions ◽  
Tissue Responses ◽  
The Stability ◽  
And Control ◽  
Connexin Hemichannels

Platelets are involved in the maintenance of haemostasis but their inappropriate activation leads to thrombosis, a principal trigger for heart attack and ischaemic stroke. Although platelets circulate in isolation, upon activation they accumulate or aggregate together to form a thrombus, where they function in a co-ordinated manner to prevent loss of blood and control wound repair. Previous report (1) indicates that the stability and functions of a thrombus are maintained through sustained, contact-dependent signalling between platelets. Given the role of gap junctions in the co-ordination of tissue responses, it was hypothesized that gap junctions may be present within a thrombus and mediate intercellular communication between platelets. Therefore studies were performed to explore the presence and functions of connexins in platelets. In this brief review, the roles of hemichannels and gap junctions in the control of thrombosis and haemostasis and the future directions for this research will be discussed.

scholarly journals The Versatility of Paramyxovirus RNA Polymerase Stuttering

1999 ◽  
Vol 73 (7) ◽  
pp. 5568-5576 ◽  
Author(s):  
Stéphane Hausmann ◽  
Dominique Garcin ◽  
Christophe Delenda ◽  
Daniel Kolakofsky
Keyword(s):  
Sendai Virus ◽  
Editing Site ◽  
Parainfluenza Virus ◽  
Virus Infections ◽  
Mrna Editing ◽  
P Gene ◽  
Nucleotide Insertions ◽  
The Stability ◽  
Type 3 ◽  
Natural Virus

ABSTRACT Paramyxoviruses cotranscriptionally edit their P gene mRNAs by expanding the number of Gs of a conserved AnGnrun. Different viruses insert different distributions of guanylates, e.g., Sendai virus inserts a single G, whereas parainfluenza virus type 3 inserts one to six Gs. The sequences conserved at the editing site, as well as the experimental evidence, suggest that the insertions occur by a stuttering process, i.e., by pseudotemplated transcription. The number of times the polymerase “stutters” at the editing site before continuing strictly templated elongation is directed by acis-acting sequence found upstream of the insertions. We have examined the stuttering process during natural virus infections by constructing recombinant Sendai viruses with mutations in theircis-acting sequences. We found that the template stutter site is precisely determined (C1052) and that a relatively short region (∼6 nucleotides) just upstream of the AnGn run can modulate the overall frequency of mRNA editing as well as the distribution of the nucleotide insertions. The positions more proximal to the 5′ AnGn run are the most important in this respect. We also provide evidence that the stability of the mRNA/template hybrid plays a determining role in the overall frequency and range of mRNA editing. When the template U run is extended all the way to the stutter site, adenylates rather than guanylates are added at the editing site and their distribution begins to resemble the polyadenylation associated with mRNA 3′ end formation by the viral polymerase. Our data suggest how paramyxovirus mRNA editing and polyadenylation are related mechanistically and how editing sites may have evolved from poly(A)-termination sites or vice versa.

scholarly journals A New Data-Driven Control System for MEMSs Gyroscopes: Dynamics Estimation by Type-3 Fuzzy Systems

Micromachines ◽  
2021 ◽  
Vol 12 (11) ◽  
pp. 1390
Author(s):  
Khalid A. Alattas ◽  
Ardashir Mohammadzadeh ◽  
Saleh Mobayen ◽  
Ayman A. Aly ◽  
Bassem F. Felemban ◽  
...  
Keyword(s):  
Fuzzy System ◽  
Measurement Errors ◽  
Fuzzy Systems ◽  
Data Driven ◽  
Output Data ◽  
Data Set ◽  
Control Scheme ◽  
Mems Gyroscopes ◽  
The Stability ◽  
Type 3

In this study, a novel data-driven control scheme is presented for MEMS gyroscopes (MEMS-Gs). The uncertainties are tackled by suggested type-3 fuzzy system with non-singleton fuzzification (NT3FS). Besides the dynamics uncertainties, the suggested NT3FS can also handle the input measurement errors. The rules of NT3FS are online tuned to better compensate the disturbances. By the input-output data set a data-driven scheme is designed, and a new LMI set is presented to ensure the stability. By several simulations and comparisons the superiority of the introduced control scheme is demonstrated.

scholarly journals A New Event-Triggered Type-3 Fuzzy Control System for Multi-Agent Systems: Optimal Economic Efficient Approach for Actuator Activating

Electronics ◽  
2021 ◽  
Vol 10 (24) ◽  
pp. 3122
Author(s):  
Shurong Yan ◽  
Ayman A. Aly ◽  
Bassem F. Felemban ◽  
Meysam Gheisarnejad ◽  
Manwen Tian ◽  
...  
Keyword(s):  
Sufficient Conditions ◽  
Total Sample ◽  
Multi Agent Systems ◽  
Agent Systems ◽  
Actuator Failures ◽  
Approximation Errors ◽  
Multi Agent ◽  
The Stability ◽  
Type 3 ◽  
Event Triggered

This study presents a new approach for multi-agent systems (MASs). The agent dynamics are approximated by the suggested type-3 (T3) fuzzy logic system (FLS). Some sufficient conditions based on the event-triggered scheme are presented to ensure the stability under less activation of the actuators. New tuning rules are obtained for T3-FLSs form the stability and robustness examination. The effect of perturbations, actuator failures and approximation errors are compensated by the designed adaptive compensators. Simulation results show that the output of all agents well converged to the leader agent under disturbances and faulty conditions. Additionally, it is shown that the suggested event-triggered scheme is effective and the actuators are updated about 20–40% of total sample times.

Efficacy, Safety and Tolerability of a Novel High-Purity, Double Virus-Inactivated VWF/FVIII-Concentrate in the Treatment of Von Willebrand Disease (VWD) - Clinical Experience in the Treatment of Bleeding and Surgery.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2144-2144
Author(s):  
B.A. Schwartz ◽  
J. Windyga ◽  
M. von Depka ◽  
O. Walter ◽  
M. Jansen ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Surgical Procedures ◽  
Von Willebrand Disease ◽  
Efficacy And Safety ◽  
Open Label ◽  
Prophylactic Regimen ◽  
Acute Bleeding ◽  
Good Efficacy ◽  
Bleeding Episodes ◽  
Type 3

Abstract Introduction: Wilate is a highly purified, double viral inactivated, VWF/FVIII-concentrate developed for the treatment of VWD. A program of prospective studies was conducted in VWD patients to investigate the clinical efficacy and safety of Wilate® in acute bleeding episodes, prophylaxis and surgical procedures. Methods: In these prospective open label studies 70 VWD patients (37 VWD of type 3) were treated with the VWF/FVIII concentrate Wilate and followed to assess clinical efficacy and tolerability. Dosing and monitoring were performed using FVIII assays. This is standard practice in most of the study sites and was feasible because of the product’s physiological 1:1 ratio and parallel PK profiles of FVIII and VWF. Dosing decisions were based on established guidelines and the investigators’ clinical judgment. The efficacy of the product was rated on a four-point scale by the investigator. Results: Bleeding- 43 patients (25 of type 3) were treated for a total number of 1088 bleeding episodes (BE). The median dose per exposure day (ED) was calculated to be 31 IU VWF/FVIII:C/kg and were treated for a median of 1.2 days, with excellent or good efficacy achieved in 96% of treatments. Surgery- Efficacy and safety was also studied in 31 VWD patients who underwent 54 elective or urgent surgical procedures of which 27 were classified as major; the overall efficacy was rated as excellent or good in most cases (94%), with a mean dose per infusion being 34 IU VWF/FVIII:C/kg. Pediatric Use- A total of 8 children below 12 years of age with 310 BE s were treated, with an excellent/good efficacy in 98% of bleedings. Prophylaxis- 19 patients were on a prophylactic regimen for more than 10 consecutive weeks (total of 2,338 ED), with an overall reduction of bleeding frequency. Tolerability - Out of 5,662 rated infusions in all studies, the tolerability was assessed as “very good” or “good” in 99% of the cases. Conclusions: The results of the prospective clinical trial program demonstrate the safety, efficacy and tolerability of this VWF/FVIII concentrate for the treatment of acute bleeding episodes, prophylaxis and surgical procedures in patients with VWD.

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