Cannulated screw fixation for dislocated fractures of the calcaneus

IntroductionFractures of the calcaneus still remain some of the most challenging injuries that an orthopedic surgeon should manage. The difficulties about these fractures arise from the specific anatomy of the region, from the unique shape and morphology of the bone, and from the mechanism of the injury (in most cases high energy trauma). Despite the progress of the medical implants that can be used for fracture fixation in the last decade there are a lot of controversies, regarding the best option.AimThe aim of the study is to present our experience with the use of cannulated screws for fixation of dislocated fractures of os calcis.Materials and MethodsTwenty patients with dislocated fractures of os calcis using cannulated screws for fixation were operated on for a period of two years (2017-2018). The classifications used in the study included: the Essex-Lopresti x-ray classification modified by Stulik and Stehlik and the CT classification of Sanders. Two of the patients were with dislocated extraarticular fractures of tuber calcanei, three patients with `extreme beak` type fractures, the remaining 15 patients were with intraarticular fractures with more than 2 mm step off in the subtalar joint: 9 patients with tongue type and 5 patients with joint depression type. Gender distribution: 18 men, 2 women.ResultsEvaluation of the results was made by using the Maryland Foot Score. Satisfaction from the treatment was graded using the Visual Analogue Scale (VAS) score (mean 7,5). The reduction is evaluated by measurement of the angle of Gissane, Bohler and Preis pre- and postoperatively. Assessment of the calcaneal height, length and width was initiated on lateral, axial and Broden views.  ConclusionFixation of displaced calcaneal fractures by cannulated screw is effective and reliable method. These screws are introduced by stab incisions which leads to minimal soft tissue dissection in such complex area of the hindfoot. It is an enormous advantage for fracture healing and reduces the percentage of possible complications

Interaction of Energetic Solar Plasma with the Hermean Magnetosphere during Nominal and ICME Conditions

This dissertation combines work done in modeling plasma interactions in Mercury's near-space environment with MESSENGER observations to create new tools that can be used to further analyze the interactions between the solar wind and the Hermean magnetosphere and surface. This dissertation details the tools we developed, including a particle tracker, a 3-D linear interpolator and a path-sampling method and covers how they can be used to study the Hermean magnetosphere. The Particle Tracker is used to study the high-energy tail of the solar wind particle population and how it interacts with the Hermean magnetosphere by tracing the particle paths through the electric and magnetic fields generated by the multifluid MHD model. The path-sampling method is used to sample the multifluid MHD simulation output along the path of the MESSENGER probe, allowing us to verify the model accuracy.M.S

Performance Analysis of Apollo Navigational Starter Routine

The focus of this project is to recreate and analyze the effectiveness of the original Apollo Starter Routine (ASR) which was used to generate the state vector of the Apollo spacecraft based on a series of radiometric observations. The original Apollo navigation software is unavailable in a modern programming language and the original coding has not been preserved. This necessitates its recreation using the original software documentation. Space Shuttle navigation software does not typically use the ASR or an algorithm like it since the Shuttle s state vector is easily deduced from GPS information or other sources. However, this tactic will be ineffective when trying to determine the state vector of a craft approaching, departing or in orbit around the Moon since the GPS network faces the surface of the Earth, not outer space. The recreation of the ASR from the original documentation is therefore vital as a simulation baseline for the navigation software under development for the Constellation program. The algorithms that make up the ASR will be extracted from the original documentation and adapted for and then implemented in a modern programming language; the majority of it will be coded in Matlab. The ASR s effectiveness will then be tested using simulated tracking data. The ability of the ASR to handle realistically noisy data and the accuracy with which it generates state vectors were analyzed. The ASR proved to be robust enough to process data with range and angle noise as large as 10,000 meters and 10(exp -6) radians together and 300,000 meters and 5x10(exp -4) radians separately at Lunar distances. The ASR was able to handle marginally more noise at distances closer to the Earth where the angle noise was less significant. The ASR is capable of effectively processing 40-80 data points gathered at a rate of one per 20 seconds at close Earth orbit and up to 28-40 data points gathered at a rate of one per minute at distant Earth orbit and Lunar orbit

Tibial plateau fractures - standard and specific surgical approaches

PURPOSE: Every surgeon faces multiple problems when treating tibial plateau fractures. The bony and soft tissue anatomy presents few peculiarities. Thin soft tissue envelope has impaired healing capacity and knee joint function is complex and difficult to restore. Congruency of the joint surfaces, correct load distribution, ligamentous stability and a normal biological quality of the cartilage are necessary prerequisites for the normal joint function. Restoration of these parameters must be the main therapeutic goal in any intraarticular fractures of the proximal tibia. The aim of article is to describe in details the approaches to the tibial plateau and the necessity to apply them depending on the different type of fracture.MATERIAL AND METHODS: A total of 21 patients with tibial plateau fractures were followed-up in the Department of Orthopaedics and Traumatology, St. Anna University Hospital of Varna, during a 2-year period (2010-2012). According to the fracture pattern, primarily anterolateral and posteromedial approach or both were used. Anterolateral approach was applied in six patients, posteromedial - in two, combined (anterolateral and posteromedial) - in six, ventral midline and posterolateral (transfibular) - in three each, and direct posterior - in one case.RESULTS: The average time to union of all the fractures was 3.5 months. Nineteen patients had satisfactory articular reduction (d2 mm step/gap) and two patients presented with articular step of 4 mm. All the patients demonstrated satisfactory coronal and sagittal alignment. Dimensions of knee mobility were extension of 2 and flexion of 112°. There was no anterior, posterior, varus, or valgus knee instability.CONCLUSION: High-energy tibial plateau fractures require good surgeon's knowledge of knee anatomy and possible approaches. This enables the selection of the most appropriate operative technique, a standard or a specific one, especially in complex bicondylar fractures.Scripta Scientifica Medica 2013; 45(3): 74-81

DYNAMICS OF THE INTEREST AND MOTIVATION IN SPORT-RECREATIONAL ANIMATION WITH CHILDREN

The current research follows the dynamics of the interest and motivation of 10-12 year-olds in the process of Sport-Recreational animation program, including purposefully planned and realized activities. The role of the interest as well as the motivation of the achievements as basic determiners for the quality of the Sport-Recreational animation programs for children are presented together with opportunities for their diagnostics. The analysis of the results performed in the process of the empirical study gives the chance for the outlining of the basic tendencies and the basic improvement of the attractiveness of the Sport-Recreational animation programs for children in the context of their motivation and interest.  Article visualizations

Treating distal fingertip traumatic amputations with semi-occlusive foil dressings—preliminary results

Introduction: Traumatic amputations of the fingertip are a common injury, often encountered in the emergency department, resulting from work-related or domestic incidents, mainly blunt-force trauma or laceration with sharp objects. Many treatment strategies for such injuries exist without any one taking precedence.Aim: The aim of this study is to evaluate the effectiveness of a novel technique, which implements semi-occlusive foil dressings to treat such injuries.Materials and Methods: Fifteen patients with distal fingertip injuries were treated with foil dressings and were followed up for 4 months. Bandages were changed weekly and no antibiotic treatment was prescribed to any of them. After the tip of the finger granulated, patients were given instructions to treat the area of intact skin with epithelializing unguents.Results: The treatment regimen continued for 3–4 weeks, patients were able to get back to activity as early as 1–3 days after injury. Full use of the injured finger during treatment was advocated. After the treatment the pulp of the finger had normal shape, bulk, and size with full range of motion and regained sensitivity.Conclusion: Fingertip amputations are injuries associated with the professional occupation or following domestic incidents, commonly presented in the emergency departments. Historically many treatment methods have been proposed. Our work presents a fast, simple, cheap, and effective treatment method, which is a safe alternative to flap plastic reconstructions. The duration of treatment was 3–4 weeks on average, depending on the severity of the injury, and resulted in a nearly complete restoration of sensitivity and an excellent cosmetic outcome

A DIGITALLY MANIPULATED GUNSHOT SOUND IDENTIFICATION

It is actual problem to distinguish between real gunshot sound pictures from tactical weapons and from fabricated or manipulated ones. In this work, some possible approaches to digital manipulation detection in gunshot records are described. The study uses methods of temporal and spectral analysis, revealing fine changes in signals, in a comprehensive dataset that consist of the raw data of gunshot sounds. The purpose of the work is to consider some approaches to digital manipulation detection in gunshot records High accuracy in the identification of manipulated sounds is demonstrated, with a low percentage of false positives and a high percentage of true positives. This research lays the groundwork for a comprehensive database of gunshot signals. This database has potential value for further analysis using methods like the Continuous Wavelet Transform. 

Vitamin D status in patients with psoriasis

Introduction: Vitamin D may act as immune modulator in psoriasis and be related with disease characteristics. Our study aimed to evaluate the vitamin D status in patients admitted for diagnostics or exacerbation of psoriasis.Material and methods: 92 patients (50 male, 42 female, mean age 55 years) were included in analysis. Disease severity was assessed by Psoriasis Area and Severity Index (PASI). Type of disease was classified according to age at presentation as early (up to 40 years) and late (above 40 years). Serum levels of 25-hydroxyvitamin D, 25(OH)D, were tested with immune fluorescent method (ADVIA Centaur Vitamin D Total, Siemens).Results: The mean level of 25(OH)D in psoriatic patients was 12.07 ng/ml (30.18 nmol/l), found at low limit of insufficiency; related 95% CI range was 10.55 - 13.60 ng/ml (26.38 - 33.99 nmol/l). A total of 45 of 92 patients (48.9%) had vitamin D insufficiency (defined as 25 (OH) D level of 10 to 30 ng/ml), 44 patients (47.82%) had deficiency (< 10 ng/ml) and only in 3 patients 25(OH)D was assessed at level of sufficiency. Vitamin D level correlate with PASI (r=-0.508), but does not correlate with C-reactive protein. No significant difference in vitamin D status was observed in patients with obesity and early type 1 psoriasis.Conclusion: High prevalence (47.83%) of vitamin D deficiency in patients with moderate and severe psoriasis suspects the role of vitamin D in pathogenesis of disease exacerbation. Vitamin D therapeutic supplementation needs to be clarified by further studies