The stability of the femoral component of a minimal invasive total hip replacement system.

Item does not contain fulltextIn this study, the initial stability of the femoral component of a minimal invasive total hip replacement was biomechanically evaluated during simulated normal walking and chair rising. A 20 mm diameter canal was created in the femoral necks of five fresh frozen human cadaver bones and the femoral heads were resected at the smallest cross-sectional area of the neck. The relatively short, polished, taper-shaped prostheses were cemented centrally in this canal according to a standardized procedure. A servohydraulic testing machine was used to apply dynamic loads to the prosthetic head. Radiostereophotogrammetric analysis was used to measure rotations and translations between the prosthesis and bone. In addition, the reconstructions were loaded until failure in a static, displacement-controlled test. During the dynamic experiments, the femoral necks did not fail and no macroscopical damage was detected. Maximal values were found for normal walking with a mean rotation of about 0.2 degrees and a mean translation of about 120 microm. These motions stabilized during testing. The mean static failure load was 4714 N. The results obtained in this study are promising and warrant further development of this type of minimal invasive hip prosthesis

Vertical distribution of benthic community responses to fish predators, and effects on algae and suspended material

The vertical positioning of benthic invertebrates should be a trade-off between the risky, but productive, sediment surface and the safer, but physiologically harsher, conditions deeper down in the sediment. This is because the foraging efficiency of benthic fish decreases with sediment depth, whereas the sediment surface is generally better oxygenated and has a higher resource quality than lower layers. We studied how two benthic fish predators, bream (Abramis brama) and ruffe (Gymnocephalus cernuus), affected the community composition and vertical distribution of benthos, and their indirect effects on algae and suspended material, in field enclosures. Whereas bream had significant effects on the density, composition and distribution of the benthos, ruffe had no such effects. The total benthos biomass in bream treatments was an-order of magnitude lower in the upper sediment layer (0–1 cm) and three times lower in the middle layer (1–3 cm) than in the controls, whereas there were no significant effects in the deepest layer (3–10 cm). Bivalves persisted in the deepest layer although their density was reduced in shallow sediment, whereas gastropods faced the risk of local extinction in the presence of bream. As indirect effects, small-bodied cladocerans, phytoplankton, periphyton and both organic and inorganic suspended material were higher in the bream treatments. We␣conclude that the impact of bream diminished substantially with increasing sediment depth, enabling invertebrates to survive in the sediment and to persist in the presence of bream. However, there were␣no␣indications of any group adjusting their vertical position behaviourally as a response to predation threat

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement