Calcium phosphate compatible bone cement: characterization, bonding properties and tissue response

A novel, inorganic, bone cement, containing calcium phosphate, developed for implant fixation was evaluated. Setting properties were determined over a range of temperatures. The flow of the cement was greatly increased by application of vibration. Changes in the cement during hydration and aging were evaluated. Compressive strength of the cement over time was studied under simulated physiological conditions from 1 hour to 1 year after setting. After 1 day, this cement had equivalent compressive strength to commercially used PMMA cement. The strength was found to increase over 1 month and high strength was maintained up to 1 year.;The shear strength of the cement-metal interface was studied in vitro using a pull-out test. Prepared specimens were stored under physiological conditions and tested at 4 hours, 24 hours, and 60 days. Comparable interfacial shear strength values were found at 4 hours, 24 hours and 60 days for the experimental cement and were not significantly different from values obtained for PMMA cement.;In vivo tissue response was evaluated after cement implantation in the femoral medullary canal in canines. Tissue response and bonding at the cement-bone interface were evaluated at 2, 6, and 12 weeks. Cortical bone was found in direct contact with the OC-cement and was healthy. The strength of the cement-bone interface, measured using a push-out test, was significantly higher for the experimental cement than for commercial PMMA bone cement

Analysis of an Evidence-based Pediatric Asthma Management Tool for Providers Confirms Linkages between Asthma and Known Risk Factors in a Vermont Practice

Introduction: Pediatric asthma is one of the largest targets for innovative programs in chronic care management due to its extensive and expanding health burden. A physician-directed asthma management, diagnostic and data tracking tool was implemented in a Vermont pediatric practice. Data were analyzed after one year to enable the Vermont Department of Health (VDH) and practice to describe program participants. Methods: A modified version of a validated pediatric asthma survey, Easy Breathing, was administered during office visits at a pediatric practice located in Burlington, VT. Fisher’s exact test was used to assess relationships between those with and without current asthma, and between those with intermittent versus persistent levels of asthma. Results: Of 206 patients, 150 had no asthma, 55 had a current asthma diagnosis and one (1) was listed as ‘unable to determine.’ Patients with current asthma were significantly more likely to be insured with Medicaid (p=.048), have a family history of asthma (p=.019) and be exposed to environmental tobacco smoke (p=.028). Within the asthma group, persistent asthma was associated with exposure to cat (p=.043). Conclusion: Participants in the Easy Breathing Program at this practice with and without current asthma diagnosis showed differences that reflect established asthma risk factors and related asthma triggers. Further efforts are needed to increase the reliability of the data