Bone stump formation against the background of post-amputation pain syndrome

Introduction: Bone is the basis of the stump. Aim: To study the impact of post-amputation pain syndrome on the nature of reparative processes in the bone residual limb. Material and methods: Three series of experiments were performed on 45 rabbits, 15 in each with mid-third thigh amputation and muscular plasty. In series 1, 2, a perineural catheter was attached to the sciatic nerve stump during amputation, and mechanical irritation of the nerve was performed daily for 20 minutes in series 1 for 20 days. In series 2, 0.3 mL of lidocaine (1%) was injected through the catheter into the circumference of the nerve twice daily for 20 days. Series 3 is a control. The follow-up periods were 1, 3, 6 months. The study method was histological with infusion of the vessels with ink-gelatin mixture. Results and discussion: In series 1, there was a sharp disturbance of the reparative process, which consisted in shape changes, resorption of the cortical diaphyseal plate, fractures, stump deformity, absence of bone closure plate formation, and microcirculatory disturbances. In the overall majority of experiments of series 2, the stumps retained the shape and structure characteristic of diaphysis with normalization of microcirculation. In series 3, the results of the residual limb formation were better than in series1, but worse than in series 2. Conclusions: When the pain syndrome is resolved within 20 days after amputation, a bone stump is formed with an organotypic shape and structure characteristic of the diaphysis, the formation of a compact closure plate of mature bone tissue, normalization of the medullary tissues and blood circulation. In post-amputation pain syndrome, organotypic formation of the residual limb does not occur.

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Impact of post- amputation pain syndrome on the results of bone stump formation

Morphologia ◽

10.26641/1997-9665.2021.3.50-56 ◽

2021 ◽

Vol 15 (3) ◽

pp. 50-56

Author(s):

Y.O. Bezsmertnyi ◽

V.I. Shevchuk ◽

Y. Jiang ◽

H.V. Bezsmertna ◽

O.Yu. Bezsmertnyi

Keyword(s):

Pain Syndrome ◽

Medullary Canal ◽

High Rate ◽

Cylindrical Shape ◽

Residual Limb ◽

Support Element ◽

In Series ◽

Reparative Process ◽

Postamputation Pain ◽

The Impact

Background. To the present day, a high rate of unsatisfactory amputation results still exists. The healing of the bone residual limb, the main support element of the residual limb, is of particular importance. Objective. To study the impact of postamputation pain syndrome on the nature of reparative processes in the bone residual limb. Methods. Three series of experiments were performed on 45 rabbits, 15 in each with mid-third thigh amputation and muscular plasty. In series 1 and 2, a perineural catheter was attached to the sciatic nerve stump during amputation, and mechanical irritation of the nerve was performed daily for 20 minutes in series 1 for 20 days. In series 2, 0.3 ml of 1% lidocaine was injected through the catheter into the circumference of the nerve twice daily for 20 days. Animals of series 3 served as a control. The follow-up periods were 1, 3, 6 months. The study method was histological with infusion of the vessels with ink-gelatin mixture. Results. In series 1, there was a sharp disturbance of the reparative process, which consisted in shape changes, resorption of the cortical diaphyseal plate, stump deformity, absence of bone closure plate formation, and microcirculatory disturbances. In most experiments of the 2nd series, organotypic stumps were formed with normalized microcirculation. In series 3, the results of the residual limb formation were better than in series 1, but worse than in series 2. Conclusion. In the absence of pain syndrome, the bone stump after amputation at the diaphysis level over a period of 1, 3, 6 months retains its cylindrical shape, the structure of the cortical diaphyseal plate, the content of the medullary canal with normal microcirculation, the formation of the bone closure plate, and the completion of the reparative process. The presence of postamputation pain syndrome in the stump distorts the course of the reparative process with the development of pathological remodeling of bone tissue.

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BIOMECHANICAL FACTORS IN RESIDUAL LIMB FORMATION AFTER AMPUTATION

Wiadomości Lekarskie ◽

10.36740/wlek202107106 ◽

2021 ◽

Vol 74 (7) ◽

pp. 1581-1586

Author(s):

Viktor I. Shevchuk ◽

Yurii O. Bezsmertnyi ◽

Halyna V. Bezsmertna ◽

Tetyana V. Dovgalyuk ◽

Yankai Jiang

Keyword(s):

Bone Marrow ◽

Electrical Stimulation ◽

Bone Formation ◽

Muscle Tension ◽

Reparative Regeneration ◽

Residual Limb ◽

Plate Formation ◽

Reparative Process ◽

Series Of Experiments ◽

Biomechanical Factors

The aim: To study the influence of biomechanical factors on the character of morphological disorders in the process of reparative regeneration at the end of the residual limb after amputation. Materials and methods: 10 series of experiments on 144 rabbits were conducted. We used myodesis with normal, insufficient and excessive muscle tension, their electrical stimulation, tight and leaky closure of the bone marrow canal. Terms of observation 1, 3, 6 months. The method of research – histological with the filling of vessels with inkgelatin mixture. Results: Dense closure of the meduallary cavity and uniform muscle tension during plasty in the first three series of experiments allow to obtain a cylindrical residual limb with preservation of the cortical diaphyseal plate, formation of the bone closing plate, normalization of intraosseous microcirculation, completion of the reparative process. In the majority of observations of the IV-X series there was a reparative regeneration disorder connected with the incorrect tension of muscles and the absence of normalization of intraosseous circulation, the reparative process was not observed to be complete, which led to the pathological reorganization of bone tissue with the formation of stumps of various shapes. Conclusions: Uneven muscle tension and lack of closure of the intramedually canal except for microcirculation disorders leads to increased periosteum bone formation, formation of periosteum cartilage exostases, clavate stumps, resorption and fractures of the cortical diaphyseal plate with curvature and stump axis disorders, formation of a conical stump.

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REPARATIVE REGENERATION AT THE END OF BONE FILING AFTER OSTOPLASTIC AMPUTATION

Wiadomości Lekarskie ◽

10.36740/wlek202103106 ◽

2021 ◽

Vol 74 (3) ◽

pp. 413-417

Author(s):

Viktor I. Shevchuk ◽

Yurii O. Bezsmertnyi ◽

Halyna V. Bezsmertna ◽

Tetyana V. Dovgalyuk ◽

Yankai Jiang

Keyword(s):

Bone Structure ◽

Compact Bone ◽

Cortical Plate ◽

Cylindrical Shape ◽

Marrow Cavity ◽

In Series ◽

Reparative Process ◽

Microcirculatory Disorders ◽

Series Of Experiments ◽

Incomplete Closure

The aim: To study the role and place of bone grafting in the formation of bone stump after amputation. Materials and methods: 3 series of experiments were carried out on 44 rabbits with amputation of the thigh in the middle third and stump grafting using osteoplastic hermetic closure of the canal with a thin cortical plate (series I), closure of the canal with a spongy bone (series II), and loose closure of the canal with a cortical graft located at the entrance to the canal at an angle of 30° (ІІІ series). Observation period: 1, 3, 6 months. Histological examination method with vascular filling with 10% mascara-gelatin mixture. Results: In series I, in the majority of observations, a stump of a cylindrical shape with a bone locking plate of an osteon-beam structure and normalization of intraosseous microcirculation was formed. A slight displacement of the graft caused a violation of microcirculation. In series II, organotypic stumps were formed in all observations. In series III, incomplete closure of the bone marrow cavity led to sharp microcirculatory disorders and the course of the reparative process with pathological bone remodeling. Conclusions: The parameters of the favorable course of the reparative process and the formation of the organotypic bone stump are the safety of its cylindrical shape, the presence of a compact bone structure, normalization of intraosseous microcirculation.

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Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-19-00110 ◽

2020 ◽

pp. 1-16

Author(s):

Julie L. Wambaugh ◽

Lydia Kallhoff ◽

Christina Nessler

Keyword(s):

Retrospective Analysis ◽

Sound Production ◽

Apraxia Of Speech ◽

Practice Schedule ◽

Practice Schedules ◽

Baseline Performance ◽

The Mean ◽

Number Of Treatment ◽

The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

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Research Participation Experiences of Informants of Suicide and Control Cases

Crisis ◽

10.1027/0227-5910/a000025 ◽

2010 ◽

Vol 31 (5) ◽

pp. 238-246 ◽

Cited By ~ 9

Author(s):

Paul W. C. Wong ◽

Wincy S. C. Chan ◽

Philip S. L. Beh ◽

Fiona W. S. Yau ◽

Paul S. F. Yip ◽

...

Keyword(s):

Ethical Issues ◽

Research Participation ◽

Self Report ◽

Initial Contact ◽

Psychological Autopsy ◽

Autopsy Study ◽

The People ◽

And Control ◽

The Impact

Background: Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. Aims: (1) To investigate whether informants of suicide cases recruited by two approaches (coroners’ court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. Methods: A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. Results: The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. Limitations: The acceptance rate for our original psychological autopsy study was modest. Conclusions: The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

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Coexistent Osteoarthritis and Parkinson’s Disease: Data from the Parkinson’s Foundation Outcomes Project

Journal of Parkinson s Disease ◽

10.3233/jpd-202170 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1601-1610

Author(s):

Jaimie A. Roper ◽

Abigail C. Schmitt ◽

Hanzhi Gao ◽

Ying He ◽

Samuel Wu ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Study Data ◽

Functional Mobility ◽

Quality Improvement Initiative ◽

Timed Up And Go ◽

Mobility Performance ◽

Risk Of Mortality ◽

The Impact

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

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Assessment of parental knowledge, attitude and practice towards antibiotic use in children

International Journal of Review in Life Sciences ◽

10.26452/ijrls.v10i2.1228 ◽

2020 ◽

Vol 10 (2) ◽

pp. 25-41

Author(s):

Thejaswini Karanth ◽

Someswar Deb ◽

Lal Ruatpuii Zadeng ◽

Rajeswari Ramasamy ◽

Teena Nazeem ◽

...

Keyword(s):

Parental Knowledge ◽

Antibiotic Use ◽

Case Report Form ◽

Standard Case ◽

Attitude And Practice ◽

Validated Questionnaire ◽

Antibiotics Use ◽

The Impact ◽

Knowledge Attitude And Practice

Objective to assess the impact of pharmacist assisted counselling in improving Parental Knowledge, Attitude and Practice [KAP] towards antibiotic use in children. A Prospective, Educational Interventional Study was conducted in 200 subjects, from the randomly chosen communities in Bangalore. The investigators did door to door visit. The primary demographics data of parents and their children were collected using standard Case Report Form (CRF), and the baseline towards antibiotic use in Children was obtained from parents using validated Questionnaire. In the presence of both parents, only one was supposed to answer the Questionnaire. Pharmacist assisted parent centred interventional counselling was provided with the help of Patient Information Leaflet1s (PIL). Follow-up and post interventional KAP assessment were done after two months from the baseline measurement. The changes in parental KAP towards antibiotics use in children were being assessed by comparing the Pretest and Posttest responses using statistical analysis. The knowledge of parents towards antibiotic use in children was medium to good in the baseline KAP assessment; however, in the majority of the participating parents it was not satisfactory in attitude and practice domains. A statistically significant improvement was seen in the KAP of parents towards antibiotic use in children after the pharmacist assisted interventional counselling. Thus, Investigators could bring excellent changes in the knowledge part; whereas the result for changes in the Attitude and Practice was good to medium respectively.

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The impact of statin therapy after surgical or endovascular treatment of cerebral aneurysms

Journal of Neurosurgery ◽

10.3171/2019.3.jns183500 ◽

2020 ◽

Vol 133 (1) ◽

pp. 182-189

Author(s):

Tae-Jin Song ◽

Seung-Hun Oh ◽

Jinkwon Kim

Keyword(s):

Statin Therapy ◽

Coil Embolization ◽

Primary Outcome ◽

Cox Regression ◽

Cerebral Aneurysms ◽

Time Dependent ◽

Lipid Lowering ◽

Surgical Clipping ◽

The Impact

OBJECTIVECerebral aneurysms represent the most common cause of spontaneous subarachnoid hemorrhage. Statins are lipid-lowering agents that may expert multiple pleiotropic vascular protective effects. The authors hypothesized that statin therapy after coil embolization or surgical clipping of cerebral aneurysms might improve clinical outcomes.METHODSThis was a retrospective cohort study using the National Health Insurance Service–National Sample Cohort Database in Korea. Patients who underwent coil embolization or surgical clipping for cerebral aneurysm between 2002 and 2013 were included. Based on prescription claims, the authors calculated the proportion of days covered (PDC) by statins during follow-up as a marker of statin therapy. The primary outcome was a composite of the development of stroke, myocardial infarction, and all-cause death. Multivariate time-dependent Cox regression analyses were performed.RESULTSA total of 1381 patients who underwent coil embolization (n = 542) or surgical clipping (n = 839) of cerebral aneurysms were included in this study. During the mean (± SD) follow-up period of 3.83 ± 3.35 years, 335 (24.3%) patients experienced the primary outcome. Adjustments were performed for sex, age (as a continuous variable), treatment modality, aneurysm rupture status (ruptured or unruptured aneurysm), hypertension, diabetes mellitus, household income level, and prior history of ischemic stroke or intracerebral hemorrhage as time-independent variables and statin therapy during follow-up as a time-dependent variable. Consistent statin therapy (PDC > 80%) was significantly associated with a lower risk of the primary outcome (adjusted hazard ratio 0.34, 95% CI 0.14–0.85).CONCLUSIONSConsistent statin therapy was significantly associated with better prognosis after coil embolization or surgical clipping of cerebral aneurysms.

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