73 research outputs found
Patient-Specific Prosthetic Fingers by Remote Collaboration - A Case Study
The concealment of amputation through prosthesis usage can shield an amputee
from social stigma and help improve the emotional healing process especially at
the early stages of hand or finger loss. However, the traditional techniques in
prosthesis fabrication defy this as the patients need numerous visits to the
clinics for measurements, fitting and follow-ups. This paper presents a method
for constructing a prosthetic finger through online collaboration with the
designer. The main input from the amputee comes from the Computer Tomography
(CT) data in the region of the affected and the non-affected fingers. These
data are sent over the internet and the prosthesis is constructed using
visualization, computer-aided design and manufacturing tools. The finished
product is then shipped to the patient. A case study with a single patient
having an amputated ring finger at the proximal interphalangeal joint shows
that the proposed method has a potential to address the patient's psychosocial
concerns and minimize the exposure of the finger loss to the public.Comment: Open Access articl
Immediate continuous passive motion after internal fixation of an ankle fracture
Surgical treatment is usually mandatory in displaced bimalleolar and trimalleolar fractures. Some authors have recommended early mobilization of the ankle joint after surgical treatment of these lesions. In this study, we evaluate the effect of immediate postoperative continuous passive motion in the management of displaced bimalleolar and trimalleolar fractures treated surgically
Bone and joint infections in adults: a comprehensive classification proposal
Ten currently available classifications were tested for their ability to describe a continuous cohort of 300 adult patients affected by bone and joint infections. Each classification only focused, on the average, on 1.3\u2009\ub1\u20090.4 features of a single clinical condition (osteomyelitis, implant-related infections, or septic arthritis), being able to classify 34.8\u2009\ub1\u200924.7% of the patients, while a comprehensive classification system could describe all the patients considered in the study. RESULT AND CONCLUSION: A comprehensive classification system permits more accurate classification of bone and joint infections in adults than any single classification available and may serve for didactic, scientific, and clinical purposes
HFE C282Y and H63D in adults with malignancies in a community medical oncology practice
BACKGROUND: We sought to compare frequencies of HFE C282Y and H63D alleles and associated odds ratios (OR) in 100 consecutive unrelated white adults with malignancy to those in 318 controls. METHODS: Data from patients with more than one malignancy were analyzed according to each primary malignancy. For the present study, OR ≥2.0 or ≤0.5 was defined to be increased or decreased, respectively. RESULTS: There were 110 primary malignancies (52 hematologic neoplasms, 58 carcinomas) in the 100 adult patients. Allele frequencies were similar in patients and controls (C282Y: 0.0850 vs. 0.0896, respectively (OR = 0.9); H63D: 0.1400 vs. 0.1447, respectively (OR = 0.9)). Two patients had hemochromatosis and C282Y homozygosity. With C282Y, increased OR occurred in non-Hodgkin lymphoma, myeloproliferative disorders, and adenocarcinoma of prostate (2.0, 2.8, and 3.4, respectively); OR was decreased in myelodysplasia (0.4). With H63D, increased OR occurred in myeloproliferative disorders and adenocarcinomas of breast and prostate (2.4, 2.0, and 2.0, respectively); OR was decreased in non-Hodgkin lymphoma and B-chronic lymphocytic leukemia (0.5 and 0.4, respectively). CONCLUSIONS: In 100 consecutive adults with malignancy evaluated in a community medical oncology practice, frequencies of HFE C282Y or H63D were similar to those in the general population. This suggests that C282Y or H63D is not associated with an overall increase in cancer risk. However, odds ratios computed in the present study suggest that increased (or decreased) risk for developing specific types of malignancy may be associated with the inheritance of HFE C282Y or H63D. Study of more patients with these specific types of malignancies is needed to determine if trends described herein would remain and yield significant differences
Seaweed polysaccharide-based hydrogels used for the regeneration of articular cartilage
This manuscript provides an overview of the in vitro and in vivo studies reported in the
literature focusing on seaweed polysaccharides based hydrogels that have been proposed for
applications in regenerative medicine, particularly, in the field of cartilage tissue engineering.
For a better understanding of the main requisites for these specific applications, the main
aspects of the native cartilage structure, as well as recognized diseases that affect this tissue are
briefly described. Current available treatments are also presented to emphasize the need for
alternative techniques. The following part of this review is centered on the description of the
general characteristics of algae polysaccharides, as well as relevant properties required for
designing hydrogels for cartilage tissue engineering purposes. An in-depth overview of the
most well known seaweed polysaccharide, namely agarose, alginate, carrageenan and ulvan
biopolymeric gels, that have been proposed for engineering cartilage is also provided. Finally,
this review describes and summarizes the translational aspect for the clinical application of
alternative systems emphasizing the importance of cryopreservation and the commercial
products currently available for cartilage treatment.Authors report no declarations of interest. Authors thank the Portuguese Foundation for Science and Technology (FCT) for the PhD fellowship of Elena G. Popa (SFRH/BD/64070/2009) and research project (MIT/ECE/0047/2009). The research leading to these results has received funding from the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement no REGPOT-CT2012-316331-POLARIS
Tendon Fascicle-Inspired Nanofibrous Scaffold of Polylactic acid/Collagen with Enhanced 3D-Structure and Biomechanical Properties
Surgical treatment of tendon lesions still yields unsatisfactory clinical outcomes. The use of bioresorbable scaffolds represents a way forward to improve tissue repair. Scaffolds for tendon reconstruction should have a structure mimicking that of the natural tendon, while providing adequate mechanical strength and stiffness. In this paper, electrospun nanofibers of two crosslinked PLLA/Collagen blends (PLLA/Coll-75/25, PLLA/Coll-50/50) were developed and then wrapped in bundles, where the nanofibers are predominantly aligned along the bundles. Bundle morphology was assessed via SEM and high-resolution x-ray computed tomography (XCT). The 0.4-micron resolution in XCT demonstrated a biomimetic morphology of the bundles for all compositions, with a predominant nanofiber alignment and some scatter (50-60% were within 12° from the axis of the bundle), similar to the tendon microstructure. Human fibroblasts seeded on the bundles had increased metabolic activity from day 7 to day 21 of culture. The stiffness, strength and toughness of the bundles are comparable to tendon fascicles, both in the as-spun condition and after crosslinking, with moderate loss of mechanical properties after ageing in PBS (7 and 14 days). PLLA/Coll-75/25 has more desirable mechanical properties such as stiffness and ductility, compared to the PLLA/Coll-50/50. This study confirms the potential to bioengineer tendon fascicles with enhanced 3D structure and biomechanical properties
Free vascularized fibular grafts for reconstruction of skeletal defects
Nourished by the peroneal vessels, the versatile free vascularized
fibular graft can be transferred to reconstruct skeletal defects of the
extremities. It may be combined with skin, fascia, muscle, and
growth-plate tissue to address the needs of the recipient site. It may
be cut transversely and folded to reconstruct the length and width of
tibial or femoral defects. The main indications for this graft are
defects larger than 5 to 6 cm or with poor vascularity of the
surrounding soft tissues. Detailed preoperative planning, experience in
microvascular techniques, and careful postoperative follow-up are
necessary to minimize complications and improve outcome. The free
vascularized fibular graft has been successfully applied as a
reconstruction option in patients with traumatic or septic skeletal
defect, after tumor resection, and has shown promise in patients with
congenital pseudarthrosis
Diagnosis and management of the osteonecrotic triad of the knee
Generalized osteonecrosis of the knee may include, in addition to
osteonecrosis of the medial femoral condyle that occurs most frequently,
osteonecrosis of the patella or the tibial plateau. Such involvement is
known as the osteonecrotic triad of the knee. Although the clinical
picture of idiopathic osteonecrosis of the medial femoral condyle seems
similar to several other disorders, certain distinct features, including
its typical location, clinical symptoms, and late onset of cartilaginous
erosion, facilitate differential diagnosis. Despite the progress made in
the diagnosis and treatment of idiopathic osteonecrosis of the medial
femoral condyle, the prognosis remains severe. More than 80% of the
patients deteriorate to the extent that surgical reconstruction is
necessary, whereas only about 20% of the patients demonstrate
spontaneous resolution or no additional deterioration of the
osteonecrotic lesion
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