Management of Humeral Shaft Fractures; Non-Operative Versus Operative

Context: Functional humeral bracing remains the gold standard for treatment of humeral shaft fractures. There is an increasing trend in the literature to perform operative fixation of these fractures. Evidence Acquisition: The aim of this systematic review was to compare the level one evidence for the outcome of non-operative with operative management of humeral shaft fractures in adults. A comprehensive electronic literature search of Medline and PubMed was performed with specific inclusion criteria to identify randomized controlled trials. Results: In total, seventeen different studies were identified from the search terms and combinations used. Only one study met the inclusion criteria; however, this was a published study protocol of an ongoing trial currently being conducted. One additional published protocol for an ongoing trial was also identified, but this was for a prospective comparative observational study. Although this latter study may not be level one evidence, it would offer great insight into the functional outcome of humeral shaft fractures and economic implications of operative management, which is currently not addressed in the literature. Two retrospective comparative studies were also identified, one of which demonstrated a significantly lower rate of nonunion and malunion in those patients undergoing operative management. Conclusions: This systematic review demonstrated a deficiency in the current literature of level one evidence available for the management of humeral shaft fractures. The current ongoing randomized control trail would offer a greater insight into the management of humeral shaft fractures and help confirm or refute the current literature. If this randomized control trial affirms the reduction in the rate of nonunion with operative fixation, a cost economic analysis is essential. As it would seem to offer operative management to all patients may be over treatment and not to offer this at all would undertreat

Palette of possibilities: developing digital tools for displaying the uncertainty in the virtual archaeological “reconstruction” of the house V 1,7 (Casa del Torello di Bronzo) in Pompeii

This thesis has two major purposes: (1) to create a 3D virtual “reconstructive” model of the peristyle with the nymphaeum wall (room b) of the house V 1,7 (House of the Bronze Bull) in Pompeii, and (2) to prepare a probability map based on this model that will show the reliability level for each individual part. The author underlines the importance of recording paradata of the entire workflow. The aim of this study is to highlight the problems concerned with 3D virtual archaeological reconstructions – in particular, the lack of proper referencing tools and lack of reflexivity when presenting those models to the public. The basic data for this study were scans obtained in a framework of the Swedish Pompeii Project. One set of scans was imported into 3DStudio Max and the reconstruction was modelled with reference to it. After this stage, a probability map was created in order to present the plausibility of every element in the form of a color scale (green being most plausible, red being least plausible). Furthermore, the probability map was geo-referenced and visualized within ArcGIS. Once this task was realized, a database was created and linked in order to connect the different parts of the probability map with the sources used to perform the reconstruction. The project proved that 3D virtual models are useful tools in examining the spatial relations of the objects and the visual representation of the scene. The results obtained show the necessity of documenting the entire scientific process thoroughly. Furthermore, it was concluded that this subject needs to be more discussed by archaeologists, and that the scientific vocabulary concerning these implementations should be standardized

Comparison between operative and non operative treatment of fracture shaft of humerus: an outcome analysis

Background: Humerus shaft fractures account for 3% of all orthopaedic injuries. Many modalities of treatment are available. Conservative treatment has been the mainstay of treatment. But now due to improvements in anaesthesia, implant design many patients having fracture shaft of humerus are operated.Methods: We compared the operative and non operative modalities of treatment in this prospective randomised controlled trial. In 40 patients, twenty patients were treated surgically and twenty were treated non surgically between May 2012 to June 2014 in Hindu Rao Hospital, New Delhi.Results: Our results show faster union in non-operative patients but functional DASH scores are significantly better in operated patients. Complications are comparable in both groups. Conclusions: Operative treatment for fracture shaft humerus gives better functional results in this study. Dynamic compression plating of humerus is better method than conservative method and avoids prolonged immobilization. Larger multicentric trials comparing functional cast bracing and plating are needed

Installing a Fast Orbit Feedback at BESSY

In view of increased processing bandwidth at demanding experiments and the need for rapid compensation of noise spikes and new, yet unknown excitations, a fast orbit feedback aiming at noise suppression in the 1Hz 50Hz range has become mandatory for the 3rd generation light source BESSY II. The fast set point transmission plus the replacement of all corrector power supplies is scheduled as a first step. Later in combination with top up operation orbit stability can be further improved by replacing today s multiplexed analog beam position monitors by state of the art fast digital units. This paper describes how the pilot installation of a small subset of fast corrector power supplies allows to tune performance and study the benefits for today s most sensitive experiment

Semantic Web Technologies Meet BIM for Accessing and Understanding Cultural Heritage

Within the EU funded project INCEPTION – Inclusive Cultural Heritage in Europe through 3D semantic modelling, the key-targeted achievement is the development of a specific cloud based platform, in order to accomplish the main objectives of accessing, understanding and strengthening European Cultural Heritage by means of enriched 3D models. The whole INCEPTION project is based on the close connection between state-of-the-art architectural modeling technologies (BIM, Building Information Modeling) and the latest cutting-edge web technologies. The platform is grounded on semantic web technologies and makes extensive use of WebGL and RESTful APIs, in order to enrich heritage 3D models by using Semantic Web standards. The INCEPTION platform will be a space for interchange of information and for the dialogue among professionals, students, scholars, curators, non-expert users, etc. Furthermore, the Semantic Web structure interlinks the platform with external Cultural Heritage available linked data and makes it gradually enhanced by specific flexible data structures provided as project specific ontologies. The paper will describe solutions based on the match between BIM, Cloud and Semantic Web

Dysphagia revealing diffuse idiopathic skeletal hyperostosis: report of two cases and literature review

Diffuse Idiopathic Skeletal Hyperostosis (DISH) also known as Forestier's disease, is a musculoskeletal disorder characterized by the calcification of ligaments essentially the vertebral longitudinal anterior ligament. Men are generally affected. It is often asymptomatic. The most common extra-spinal clinical manifestation of this disease presents as dysphagia followed by respiratory disturbances such as dyspnea and sleep apnea. In this paper we discuss two cases where the patients have experienced progressive dysphagia. Radiological findings were compatible with DISH. The management was based on diet modification and anti-inflammatory medication

Musculotendinous junction tear

We report a rare case of a partial thickness tear of the supraspinatus at the musculotendinous junction in a softball catcher. Preoperative magnetic resonance images of the shoulder showed high signal intensity areas at the musculotendinous junction, along with discontinuity of the articular side of the supraspinatus. Arthroscopic examination revealed articular-side partial tear at the musculotendinous junction. The patient was able to return to playing softball 20 weeks after arthroscopic side-to-side repair