Surgical repair of juxta-articular distal femur fractures and posttraumatic conditions

Objective To retrospectively review surgical repair of juxta-articular distal femur fractures and posttraumatic conditions. Material and methods The review included 65 patients with juxta-articular distal femur fractures and posttraumatic conditions repaired with plating (n = 44), intramedullary nailing (n = 16) and transosseous osteosynthesis (n = 5) between 2009 and 2016. The patients were divided into 2 groups depending on time of injury. SOI-1 was used for outcome measure. Results Functional recovery was observed in 71 to 97 % (average, 89.1 ± 0.6 %) of the first group at short-term followup and an average of 94.7 ± 0.45 % of anatomical and function norm at a long term. Short-term anatomical and functional outcomes ranged from 63 to 93 scores in the second group and were an average of 82 ± 0.7 % of the norm. Conclusion Better outcomes were obtained in the first group (an average of 94.7 ± 0.45 % of anatomical and functional norm). Plating with accurate bone reduction and reliable fixation provided throughout consolidation phase showed better outcomes in both groups of patients. Intramedullary nailing was practical for straightforward supracondylar injuries type 33А1. Transosseous osteosynthesis could be advocated for open and gunshot injuries to minimize risk of infection and provide stable bone fixation

Identification of co-expression gene networks, regulatory genes and pathways for obesity based on adipose tissue RNA Sequencing in a porcine model

Background: Obesity is a complex metabolic condition in strong association with various diseases, like type 2 diabetes, resulting in major public health and economic implications. Obesity is the result of environmental and genetic factors and their interactions, including genome-wide genetic interactions. Identification of co-expressed and regulatory genes in RNA extracted from relevant tissues representing lean and obese individuals provides an entry point for the identification of genes and pathways of importance to the development of obesity. The pig, an omnivorous animal, is an excellent model for human obesity, offering the possibility to study in-depth organ-level transcriptomic regulations of obesity, unfeasible in humans. Our aim was to reveal adipose tissue co-expression networks, pathways and transcriptional regulations of obesity using RNA Sequencing based systems biology approaches in a porcine model. Methods: We selected 36 animals for RNA Sequencing from a previously created F2 pig population representing three extreme groups based on their predicted genetic risks for obesity. We applied Weighted Gene Co-expression Network Analysis (WGCNA) to detect clusters of highly co-expressed genes (modules). Additionally, regulator genes were detected using Lemon-Tree algorithms. Results: WGCNA revealed five modules which were strongly correlated with at least one obesity-related phenotype (correlations ranging from -0.54 to 0.72, P <0.001). Functional annotation identified pathways enlightening the association between obesity and other diseases, like osteoporosis (osteoclast differentiation, P = 1.4E(-7)), and immune-related complications (e. g. Natural killer cell mediated cytotoxity, P = 3.8E(-5); B cell receptor signaling pathway, P = 7.2E(-5)). Lemon-Tree identified three potential regulator genes, using confident scores, for the WGCNA module which was associated with osteoclast differentiation: CCR1, MSR1 and SI1 (probability scores respectively 95.30, 62.28, and 34.58). Moreover, detection of differentially connected genes identified various genes previously identified to be associated with obesity in humans and rodents, e.g. CSF1R and MARC2. Conclusions: To our knowledge, this is the first study to apply systems biology approaches using porcine adipose tissue RNA-Sequencing data in a genetically characterized porcine model for obesity. We revealed complex networks, pathways, candidate and regulatory genes related to obesity, confirming the complexity of obesity and its association with immune-related disorders and osteoporosis

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Comparative Characteristics Of Linear Displacement Of Proximal Femoral Department Fragments In Transosseous Fixation. Saratov Journal of Medical Scientific Research

In the present research a comparison of two techniques of transosseous fixation of pertrochanteric fracture has been drawn. By way of example linear relocations of fragments have been measured in 8 biodummies (femurs of cows) in two groups through three series of loadings along the long axis of a femur with a step of 490 N from 980 up to 2940 N. The specific load in the range of 16,08±0,65 N/sm2 — 16,32±0,065 N/sm2 causes linear fragment dislocation within 0,13±0,016 mm — 0,08±0,03 mm. Compressive variant of osteosynthesis improves stability of biomechanical system &quot;a bone-fixator&quot; 3-4 times as muc

Management of Chronic Pain Syndrome in Knee Osteoarthritis with Selective Embolization of Popliteal Artery Branches: Review

Background. Treatment of knee osteoarthritis (OA) in early stages as well as the pain syndrome associated with it usually suggests the combination of medicines and physical therapy means. However, no method has proven its absolute efficiency yet. Transcatheter arterial embolization of popliteal branches is a new minimally invasive treatment that is currently being studied and tested. The objective of our research was the analysis as well as generalization of the outcomes of the pain syndrome in knee OA treatment with the selective embolization of popliteal branches. Materials and Methods. The reviewed articles were retrieved from PubMed database and eLIBRARY digital library considering the criteria like the emboli material, size, and type; possible complications and their effect on the outcome; the patient enrolment criteria for this type of surgical management; the short and long-term outcomes. Results. Transcatheter arterial embolization of popliteal branches is a new minimally invasive method of knee OA treatment. All authors revealed the pathology growth of the vasculature and its complete embolization as a result of the intervention. The review articles present a significant abatement in patients resistant to conventional medical treatment, minimal possible complications, and good long-term outcomes. Conclusion. Since this method of knee OA management is new and understudied, and the number of the published findings does not exceed two hundred it required further thorough investigation and randomized clinical trials