Plate on Plate Technique of Minimally Invasive Percutaneous Plate Osteosynthesis in Distal Tibial Fractures, an Easy and Inexpensive Method of Fracture Fixation

Background: Plate on plate technique can lessen operative time and patient morbidity. Objectives: This study aimed to evaluate the outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) using plate on plate technique of locking plate fixation for closed fractures of distal tibia in a prospective study. Patients and Methods: Twenty-five patients with distal tibial fractures were treated by MIPPO using locking plate by plate on plate technique. Preoperative variables including age of patient, mode of trauma, type of fracture and soft tissue status were recorded for each patient. Perioperative variables included surgical time and radiation exposure. Postoperative variables included wound status, time to union, return to activity and the American orthopaedic foot and ankle score (AOFAS). Results: All the fractures had united at one year. The average time to union was 16.8 weeks. There were two cases of superficial infection and two cases of deep infection, which required removal of hardware after the fracture was united. The average AO foot and ankle score was 83.6 in our study population. Conclusions: MIPPO using locking plate by plate on plate technique was a safe, effective, inexpensive and easily reproducible method for the treatment of distal tibial fractures in properly selected patients, which minimized operative time and soft tissue morbidity

Demographic study of craniosynostosis patients in mid-Missouri

Craniosynostosis is a congenital defect in which one or more of the cranial sutures close prematurely, affecting 1 in 2000 to 2500 live births worldwide. Historically, sagittal craniosynostosis has been reported to be the most common form of single-suture craniosynostosis. Our previous retrospective review of craniosynostosis at our institution reported that the incidence of metopic craniosynostosis in mid-Missouri is significantly greater than that of sagittal craniosynostosis, 65% versus 13% (Table 1). Our current aim is to further investigate the demographic characteristics of our institution's craniosynostosis population

Do Patients with Craniosynostosis Have an Increased Incidence of Auditory Neuropathy as Newborns?

Neuroscience - Vision & Functional Brain Imaging Poster SessionOBJECTIVE: To investigate the incidence of auditory neuropathy, abnormal auditory brainstem response (ABR) with normal otoacoustic emissions, in newborn patients with craniosynostosis as compared to published standards. DESIGN: A retrospective review of consecutive patients with single or multiple-suture craniosynostosis who were seen between 2002 and 2009. Patients identified by the diagnostic code of craniosynostosis were divided into groups based on suture involvement. The newborn ABR screening and, if patients were referred, diagnosis from audiologic diagnostic testing were obtained from the Missouri Department of Health. Institutional review board approval was obtained. PATIENTS: One hundred and thirty-five patients were identified. Seventy-two were excluded; 3 were listed as “missed” and 69 were not born in-state. The 63 patients included in the study were grouped by involved sutures: 2 left coronal, 7 right coronal, 2 nonsyndromic bicoronal, 3 syndromic bicoronal, 13 sagittal, 17 operative metopic, 15 nonoperative metopic, 1 pansynostosis, and 3 multiple-suture. MAIN OUTCOME MEASURES: The newborn screening results for each patient were recorded as well as the diagnosis from audiologic diagnostics if the patient was referred. RESULTS: Of the 63 patients, 94% (59/63) passed their ABR screening. Four were referred for diagnostic exam in both ears. Of those, one had a normal exam (right coronal) and three did not have diagnostic exams on file (right coronal, bicoronal syndromic and bicoronal non-syndromic). CONCLUSIONS: According to the Centers for Disease Control, 1.8 percent of newborns failed their ABR screening in 2007. Of those, 37% were found to have normal hearing on diagnostic exam. Although our study was inconclusive due to inadequate state records, it does demonstrate an increased incidence in abnormal ABR's in patients with coronal craniosynostosis. This is consistent with a recent publication that demonstrated higher incidence of abnormal ABR's in syndromic coronal craniosynostosis. If auditory abnormalities are present at birth, as our study suggests, the etiology would be unrelated to increased intracranial pressures

CMS Software Distribution on the LCG and OSG Grids

The efficient exploitation of worldwide distributed storage and computing resources available in the grids require a robust, transparent and fast deployment of experiment specific software. The approach followed by the CMS experiment at CERN in order to enable Monte-Carlo simulations, data analysis and software development in an international collaboration is presented. The current status and future improvement plans are described.Comment: 4 pages, 1 figure, latex with hyperref

Effect of spinning variables on packing density of cotton yarn

In this study, fibre distribution through the cross-sections of ring-spun yarns and their packing density values has been investigated to provide a better understanding of the internal structures of ring-spun yarns manufactured by changing different spinning variables. After the yarn manufacturing process, diameter, IPI index, uniformity index, single yarn strength, density and hairiness are tested and then evaluation of tests is done on the Minitab and Microsoft Excel. The impact of TPI, spindle speed, count, hairiness and diameter has been analyzed using yarn packing density as a response variable. The aim of present study is to produce a yarn with improved packing density so that the yarn properties could be predetermined. The study shows that the increase in yarn count, TPI and spindle speed increase the yarn packing density

Emerging Role of Immune Checkpoint Blockade in Pancreatic Cancer

Immune checkpoint blockade (ICB) with programmed cell death protein-1(PD-1)/programmed death ligand -1(PD-L1) antibodies has revolutionized the management of several cancers, especially non-small cell lung cancer, melanoma, urothelial, and renal cancer. Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive cancers associated with high morbidity and mortality. Based on available data, it’s obvious that ICB has limited success in PDACs, which can be explained by the low immunogenicity and immunosuppressive tumor microenvironment of these tumors. In this review article, we focus on PD-L1 expression and microsatellite instability (MSI) in PDAC, and their roles as prognostic and predictive markers. We also discuss data supporting combination therapies to augment cancer immunity cycle. Combining anti-PD-1/PD-L1 agents with other modalities such as vaccines, chemotherapy, and radiation could potentially overcome resistance patterns and increase immune responsiveness in PDA

Culturally Adapted Interventions in Mental Health: Global Position Statement

The preponderance of western psychological concepts are often relied upon to conceptualise health-related phenomena. It is hardly surprising therefore that despite the availability of a number of interventions, studies have concluded that outcomes for minority cultural groups are not as good as for Caucasian people (western Europe and North America) in many high and middle income countries (HMIC). The evidence base of most psychosocial interventions is yet to be established in Low and Middle Income Countries (LMICs). There has been a propensity in some quarters to view low and middle income countries as passive beneficiaries of mental health knowledge, rather than as contributors or partners in knowledge production and development. A move towards a more equal bilateral relationship is called for, which should lead to better service provision. This Position Statement aims to highlight the current position and need for culturally adapted interventions. It is a global call for action to achieve a standardised mechanism to achieve parity of access and outcomes across all cultural groups regardless of country of residence

Spinal cord compression: Histologic spectrum of lesions

Histologic diagnosis ultimately determines the prognosis and treatment of lesions causing spinal cord compression. Modem imaging techniques have revolutionized the procedure of localizing lesions pre¬senting with signs and symptoms of spinal cord compression. As a result, these lesions are more accessible for fine needle aspiration and biopsy. A quick diagnosis is possible if cytologic preparation is made. Similarly, intraoperative frozen section facility not only provides rapid diagnosis, but also offers oppor tunity of appropriate management decision there and then. Histology in many cases needs help of special stains and immunocytochemistry. This study looks at the histologic spectrum of these lesions, gender distribution and age range in Pakistani population

Oral Class I and III antiarrhythmic drugs for maintaining sinus rhythm after catheter ablation of atrial fibrillation

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of oral Class I and III antiarrhythmic drugs for maintaining sinus rhythm in patients undergoing catheter ablation, compared to catheter ablation alone, for atrial fibrillation (AF)