Arthroskopische Therapie des degenerativen Meniskusschadens: systematische Übersichtsarbeit und Metaanalyse

Arthroskopische Meniskusoperationen stellen eine der häufigsten Behandlungen in der Orthopädie dar. Ziel der vorliegenden Arbeit ist es, anhand einer Metaanalyse den Behandlungseffekt der arthroskopischen partieller Meniskektomie mit der konservativen Therapie bei Patienten mit degenerativen Meniskusschäden mit geringen Knorpelschäden zu vergleichen. Als Endpunkte wurden Scores als patientenberichtete Ergebnisse anhand der standardisierten Mittelwertdifferenz ausgewertet. Sekundär wurden in einer systematischen Übersicht weitere Parameter untersucht. Als Ergebnis der Literaturrecherche konnten 9 RCTs, sowie davon 3 RCTs mit einem zusätzlichen längeren Nachuntersuchungszeitraum und 6 nicht-randomisierte Studien (NRS) in die Metaanalyse aufgenommen werden (n = 1769). Bei der Gegenüberstellung aller Studien (RCTs u. NRS) zeigte sich ein statistisch nicht signifikanter Gruppenunterschied (p = 0,63). Wurden nur die RCTs einbezogen, ergab sich ein statistisch signifikant besseres Ergebnis der operativen Therapie nach 12 Monaten (p = 0,018). Nach 2 - 3 Jahren zeigte sich sowohl bei der Untersuchung aller Studien (RCTs u. NRS) (p = 0,92) als auch unter Einbezug lediglich der RCTs ein nicht signifikanter Unterschied zwischen den Therapiemethoden. Zusammenfassend zeigte sich nach 12 Monaten ein statistisch signifikant besseres Ergebnis für eine operative Therapie. Eine klinische Bedeutsamkeit kann nicht endgültig geklärt werden. Nach 2 – 3 Jahren gab es keinen Gruppenunterschied mehr. Für einen kurzfristigen Therapieerfolg scheint die operative Therapie der konservativen Therapie überlegen zu sein. Die konservative Therapie bewirkt einen besseren Muskelaufbau, bessere Stabilität und im Gegensatz zur operativen Therapie auf längere Sicht seltener Arthrosen, so dass besonders im Langzeittherapieerfolg die konservative Therapie ihre Berechtigung hat. Es ließen sich Anzeichen dafür finden, dass die verschiedenen Rissarten einen Einfluss auf den Therapiegruppenunterschied haben

Transition from Mott insulator to superconductor in GaNb4_{4}Se8_{8} and GaTa4_{4}Se8_{8} under high pressure

Electronic conduction in GaM$_{4}$Se$_{8}$ (M=Nb;Ta) compounds with the fcc GaMo$_{4}$S$_{8}$-type structure originates from hopping of localized unpaired electrons (S=1/2) among widely separated tetrahedral M$_{4}$ metal clusters. We show that under pressure these systems transform from Mott insulators to a metallic and superconducting state with T$_{C}$=2.9 and 5.8K at 13 and 11.5GPa for GaNb$_{4}$Se$_{8}$ and GaTa$_{4}$Se$_{8}$, respectively. The occurrence of superconductivity is shown to be connected with a pressure-induced decrease of the MSe$_{6}$ octahedral distortion and simultaneous softening of the phonon associated with MSe-bonds.Comment: 10 pages, 5 figure

Comparative Assessment of Microbial Air Contamination in Labor and Postnatal Ward at Mzuzu Central Hospital

Nosocomial infections are rapidly becoming a burden especially in developing countries. Neonates are part of the individuals who are at a high risk and mostly affected. Environmental contamination is one of the key agents of these infections. This study aimed to comparatively assess the microbial air contamination before and after cleaning in the labor and postnatal ward at Mzuzu Central Hospital. A comparative study design was employed, with a sample size of 60 paired culture plates (60 MacConkey agar plates and 60 Blood agar plates). Passive technique of air sampling was used to sample air there after 24 hours of culturing and isolation on blood agar and MacConkey agar for identification and quantification of bacterial colonies. Room observations were also done. There was a significant difference between contaminations before and after cleaning, only when MacConkey agar was used. The microorganisms that were identified include; Staphylococci aureus, Klebsiella, coagulase negative staphylococci and non-hemolytic streptococcus. Factors found to contribute to air contamination were, the size of the rooms, traffic of people in a room and number of people present in a room. This study has identified the hazard that these two wards are containing and suggests interventions to avoid nosocomial infections in the neonates

Flexible manufacturing for photonics device assembly

The assembly of photonics devices such as laser diodes, optical modulators, and opto-electronics multi-chip modules (OEMCM), usually requires the placement of micron size devices such as laser diodes, and sub-micron precision attachment between optical fibers and diodes or waveguide modulators (usually referred to as pigtailing). This is a very labor intensive process. Studies done by the opto-electronics (OE) industry have shown that 95 percent of the cost of a pigtailed photonic device is due to the use of manual alignment and bonding techniques, which is the current practice in industry. At Lawrence Livermore National Laboratory, we are working to reduce the cost of packaging OE devices through the use of automation. Our efforts are concentrated on several areas that are directly related to an automated process. This paper will focus on our progress in two of those areas, in particular, an automated fiber pigtailing machine and silicon micro-technology compatible with an automated process

Comparison of Interactions Between Control and Mutant Macrophages

This paper presents a preliminary study on macrophages migration in Drosophila embryos, comparing two types of cells. The study is carried out by a framework called macrosight which analyses the movement and interaction of migrating macrophages. The framework incorporates a segmentation and tracking algorithm into analysing motion characteristics of cells after contact. In this particular study, the interactions between cells is characterised in the case of control embryos and Shot3 mutants, where the cells have been altered to suppress a specific protein, looking to understand what drives the movement. Statistical significance between control and mutant cells was found when comparing the direction of motion after contact in specific conditions. Such discoveries provide insights for future developments in combining biological experiments to computational analysis

Preterm birth: associated risk factors and outcome in tertiary care center

Background: The major cause of infant mortality and morbidity is preterm birth. WHO has defined it as any birth before 37 completed weeks of gestation or fewer than 259 days since the last day of menstrual period. Objective of present study was to identify major etiological factors associated with preterm birth, and their effects on mode of delivery and neonatal mortality and morbidity.Methods: Retrospective cohorts study, which was conducted in M. S. Ramaiah Medical College, over period of 12 months (January 2015 to December 2015). The study included 343 women who delivered preterm they were followed from admission to discharge. Various parameters were analyzed like maternal characteristics, gestational age, associated risk factors, tocolysis, administration of steroids, and neonatal outcome.Results: The incidence of preterm birth among the total deliveries was approximately 18.01%. Although the risk factors included many, the most common occurring were hypertensive disorders during pregnancy approximately 32.9%, followed by preterm rupture of membranes (18.1%), idiopathic 14.9%, and previous LSCS at 12.2%. Neonatal mortality was 6.9% (24 neonates), and stillborn were 0.5% (2 neonates).Conclusions: Various risk factors for preterm labour are modifiable hence early detection and treatment prevents maternal morbidity and neonatal morbidity and mortality. Specific emphasis on regular antenatal checkups

Recurrent pregnancy loss: challenge to obstetricians

Background: Recurrent pregnancies loss (RPL) is physically and emotionally devastating situation for the parents, along with difficult situation for obstetrician to handle. Present study aimed at investigation of the significance of various etiology in relation to pregnancy outcome in cases of recurrent pregnancy loss.Methods: It is a retrospective analysis of patients who presented to M. S. Ramaiah Medical college with recurrent miscarriage between April 2014 and August 2015. ANA was done on the basis of clinical and laboratory data which was obtained and eventually diagnosis was made. The study results were analysed in terms of term live births, maternal and fetal complications.Results: Out of the RPL cases that were studied, 78 patients came with recurrent pregnancy loss. Out of these cases, endocrine abnormalities, like diabetes mellitus and hypothyroidism were the maximum 26.92% and 12.82% respectively. Followed by unexplained causes were 37.3%. Thrombophila and APLA positive cases constituted for 16.66% and 3.4% respectively. ANA positive and cervical incompetence were 6.4% each.Conclusions: Recurrent pregnancy loss is very difficult situation to handle. Various etiology need various specialists, and requirements, and management mainly depends on the cause for recurrent pregnancy loss