Arthroscopic meniscal repair evaluated by second-look arthroscopy

Of 353 arthroscopic peripheral meniscal repairs per formed using the "outside to inside" suturing technique with rasp preparation of the tear region, 74 repairs (50 medial and 24 lateral) were assessed by second-look arthroscopy and are the basis of this report. Results were graded as either healed, incompletely healed, or failed; these findings were correlated with clinical symp toms and associated ACL deficiency. Overall, asymp tomatic healing occurred in 84%, with 65% healed and 19% incompletely healed. The failure rate was 16%. All failures were symptomatic while all healed and incom pletely healed menisci were asymptomatic. Failure was associated with ACL deficiency in all cases. No failures occurred in either an ACL uninjured knee or an ACL reconstructed knee. Failure was also associated with tear location in the posterior horn of the medial menis cus. Eleven of 12 failures (92%) involved posterior medial meniscal tears with only 1 failure located pos terolaterally. Visual evidence of healing required a 4 month time interval.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68119/2/10.1177_036354659101900614.pd

Radiation Protection Using Carbon Nanotube Derivatives

BHA and BHT are well-known food preservatives that are excellent radical scavengers. These compounds, attached to single-walled carbon nanotubes (SWNTs), could serve as excellent radical traps. The amino-BHT groups can be associated with SWNTs that have carbolyxic acid groups via acid-base association or via covalent association. The material can be used as a means of radiation protection or cellular stress mitigation via a sequence of quenching radical species using nano-engineered scaffolds of SWNTs and their derivatives. It works by reducing the number of free radicals within or nearby a cell, tissue, organ, or living organism. This reduces the risk of damage to DNA and other cellular components that can lead to chronic and/or acute pathologies, including (but not limited to) cancer, cardiovascular disease, immuno-suppression, and disorders of the central nervous system. These derivatives can show an unusually high scavenging ability, which could prove efficacious in protecting living systems from radical-induced decay. This technique could be used to protect healthy cells in a living biological system from the effects of radiation therapy. It could also be used as a prophylactic or antidote for radiation exposure due to accidental, terrorist, or wartime use of radiation- containing weapons; high-altitude or space travel (where radiation exposure is generally higher than desired); or in any scenario where exposure to radiation is expected or anticipated. This invention s ultimate use will be dependent on the utility in an overall biological system where many levels of toxicity have to be evaluated. This can only be assessed at a later stage. In vitro toxicity will first be assessed, followed by in vivo non-mammalian screening in zebra fish for toxicity and therapeutic efficacy

Self assembly of amphiphilic C60 fullerene derivatives into nanoscale supramolecular structures

<p>Abstract</p> <p>Background</p> <p>The amphiphilic fullerene monomer (AF-1) consists of a "buckyball" cage to which a Newkome-like dendrimer unit and five lipophilic C₁₂chains positioned octahedrally to the dendrimer unit are attached. In this study, we report a novel fullerene-based liposome termed 'buckysome' that is water soluble and forms stable spherical nanometer sized vesicles. Cryogenic electron microscopy (Cryo-EM), transmission electron microscopy (TEM), and dynamic light scattering (DLS) studies were used to characterize the different supra-molecular structures readily formed from the fullerene monomers under varying pH, aqueous solvents, and preparative conditions.</p> <p>Results</p> <p>Electron microscopy results indicate the formation of bilayer membranes with a width of ~6.5 nm, consistent with previously reported molecular dynamics simulations. Cryo-EM indicates the formation of large (400 nm diameter) multilamellar, liposome-like vesicles and unilamellar vesicles in the size range of 50–150 nm diameter. In addition, complex networks of cylindrical, tube-like aggregates with varying lengths and packing densities were observed. Under controlled experimental conditions, high concentrations of spherical vesicles could be formed. <it>In vitro </it>results suggest that these supra-molecular structures impose little to no toxicity. Cytotoxicity of 10–200 μM buckysomes were assessed in various cell lines. Ongoing studies are aimed at understanding cellular internalization of these nanoparticle aggregates.</p> <p>Conclusion</p> <p>In this current study, we have designed a core platform based on a novel amphiphilic fullerene nanostructure, which readily assembles into supra-molecular structures. This delivery vector might provide promising features such as ease of preparation, long-term stability and controlled release.</p

Detecting thermal discrepancies in vessel walls

An infrared, heat-sensing catheter particularly useful for identifying potentially fatal arterial plaques in patients with disease of the coronary or other arteries and its use are detailed. In one embodiment, an infrared fiberoptic system (with or without ultrasound) is employed at the tip of the catheter to locate inflamed, heat-producing, atherosclerotic plaque, which is at greater risk for rupture, fissure, or ulceration, and consequent thrombosis and occlusion of the artery. In another embodiment, a catheter with an infrared detector (with or without ultrasound) employed at its tip will likewise locate inflamed heat-producing atherosclerotic plaque. The devices and methods of the invention may be used to detect abscesses, infection, and cancerous regions by the heat such regions differentially display over the ambient temperature of immediately adjacent tissues. The methods and devices of the invention may also be used to detect regions of cooler than ambient tissue in a vessel or organ which indicate cell death, thrombosis, cell death, hemorrhage, calcium or cholesterol accumulations, or foreign materials

Telephone Survey to Assess Influenza-like Illness, United States, 2006

This method offers a potentially feasible means to monitor patients at home

Doctor, what does my positive test mean? From Bayesian textbook tasks to personalized risk communication

Most of the research on Bayesian reasoning aims to answer theoretical questions about the extent to which people are able to update their beliefs according to Bayes' Theorem, about the evolutionary nature of Bayesian inference, or about the role of cognitive abilities in Bayesian inference. Few studies aim to answer practical, mainly health-related questions, such as, "What does it mean to have a positive test in a context of cancer screening?" or "What is the best way to communicate a medical test result so a patient will understand it?". This type of research aims to translate empirical findings into effective ways of providing risk information. In addition, the applied research often adopts the paradigms and methods of the theoretically-motivated research. But sometimes it works the other way around, and the theoretical research borrows the importance of the practical question in the medical context. The study of Bayesian reasoning is relevant to risk communication in that, to be as useful as possible, applied research should employ specifically tailored methods and contexts specific to the recipients of the risk information. In this paper, we concentrate on the communication of the result of medical tests and outline the epidemiological and test parameters that affect the predictive power of a test-whether it is correct or not. Building on this, we draw up recommendations for better practice to convey the results of medical tests that could inform health policy makers (What are the drawbacks of mass screenings?), be used by health practitioners and, in turn, help patients to make better and more informed decisions

Appraising and applying evidence about a diagnostic test during a performance-based assessment

BACKGROUND: The practice of Evidence-based Medicine requires that clinicians assess the validity of published research and then apply the results to patient care. We wanted to assess whether our soon-to-graduate medical students could appraise and apply research about a diagnostic test within a clinical context and to compare our students with peers trained at other institutions. METHODS: 4(th )year medical students who previously had demonstrated competency at probability revision and just starting first-year Internal Medicine residents were used for this research. Following an encounter with a simulated patient, subjects critically appraised a paper about an applicable diagnostic test and revised the patient's pretest probability given the test result. RESULTS: The medical students and residents demonstrated similar skills at critical appraisal, correctly answering 4.7 and 4.9, respectively, of 6 questions (p = 0.67). Only one out of 28 (3%) medical students and none of the 15 residents were able to correctly complete the probability revision task (p = 1.00). CONCLUSIONS: This study found that most students completing medical school are able to appraise an article about a diagnostic test but few are able to apply the information from the article to a patient. These findings raise questions about the clinical usefulness of the EBM skills possessed by graduating medical students within the area of diagnostic testing