1-(3, 4-Dichlorobenzenesulfonyl)-3-Methyl-1H-Imidazolium Chloride: An Efficient Catalyst for the Synthesis of 1, 8-Dioxo-Octahydroxanthenes under Microwave Irradiation

The reaction of 5,5-dimethyl-1,3-cyclohexanedione with various aromatic aldehydes to give corresponding 1,8-dioxo-octahydroxanthenes in aqueous medium has been reported. These reactions were carried out under microwave irradiation and catalyzed by 1-(3, 4- dichlorobenzenesulfonyl)-3-methyl-1H-imidazolium chloride. A plausible mechanism for the synthesis of 1,8-dioxo-octahydroxanthenes catalyzed by[3, 4-dcbsmim][Cl] in water has been given

Stress Shielding in Cemented Hip Implants Assessed From Computed Tomography

Background: Aseptic loosening is the major cause of revisions for hip replacement. This mode of failure is often caused by stress shielding. Stress shielding in the femur occurs when some of the loads are taken by the prosthesis and shielded from going to the bone. There is little information regarding the stress shielding among cemented hip implants. Purpose: The purpose of this study is to investigate the effect of stress shielding on the proximal femur with a femoral prosthesis. Methods: A patient had undergone open reduction and internal fixation (ORIF) due to a comminuted reversed oblique fracture of the right intertrochanteric hip. ORIF had failed and was converted to bipolar hemiarthroplasty. CT scans were performed on both the right and left hips. Housefield units were determined by using the probe tool. By using equations formulated by Carter and Hays, Linde et al., various parameters such as apparent density, Young’s’ modulus and ultimate strength were calculated. The results were compared to that a native hip. Results: The hip with the cemented implant had a significant increase in the apparent density, Young’s modulus and ultimate strength, when compared to the left hip. In addition, it was found that the right hip had a higher strain energy density than that of the left. Interpretation: It has been concluded the most stress shielding occurred in the calcar region of the femur. The instances of stress shielding have been extensively reported for non-cemented or direct bone to implant constructs, this paper reports stress shielding in cemented implants supported by imaging data and biomechanical calculations carried out at the bone-cement-metal interface

Structurational analysis of e-government

Master'sMASTER OF SCIENC

Primary Hemiarthroplasty for the Treatment of Basicervical Femoral Neck Fractures

Purpose Basicervical femoral neck fractures are uncommon injuries that occur at the extracapsular base of the femoral neck at its transition with the intertrochanteric line. Controversy remains in the orthopedic literature as to the optimal method of treatment for this fracture type given the inherent instability and greater rate of implant failure with traditional fixation constructs. The purpose of this study is to quantify the incidence and preferred treatment methods of basicervical hip fractures at a single, regional, Level 1 trauma center and to identify differences in postoperative complications between treatment options. Methods The present study is a retrospective case series from a single regional health network, including 316 patients with hip fractures. Basicervical femoral neck fractures were identified. Reoperation rates within 90 days, implant failures or nonunions, postoperative ambulation distances and range of motion, and discharge dispositions were compared across patients grouped by surgical treatment with either cephalomedullary nail, sliding hip screw, or hemiarthroplasty (HA). Results Basicervical femoral neck fractures represented 6.6% of this study population. The cephalomedullary nail group demonstrated rates of implant failure and return to the operating room within 90 days of 40% (4/10) and 20% (2/10), respectively. No patients who underwent hemiarthroplasty experienced a failure of fixation or return to the operating room. Conclusions This study suggests a much lower rate of fixation failure or need for reoperation with hemiarthroplasty treatment compared to cephalomedullary nail construct for basicervical femoral neck fractures and may be an underutilized treatment method for this fracture type. The promising results seen with this case series should encourage further investigation into HA as a primary treatment for these uncommon, yet challenging, fractures

Correction to: Cluster identification, selection, and description in Cluster randomized crossover trials: the PREP-IT trials

An amendment to this paper has been published and can be accessed via the original article

Stress Shielding in Cemented Hip Implants Assessed From Computed Tomography

Background: Aseptic loosening is the major cause of revisions for hip replacement. This mode of failure is often caused by stress shielding. Stress shielding in the femur occurs when some of the loads are taken by the prosthesis and shielded from going to the bone. There is little information regarding the stress shielding among cemented hip implants. Purpose: The purpose of this study is to investigate the effect of stress shielding on the proximal femur with a femoral prosthesis. Methods: A patient had undergone open reduction and internal fixation (ORIF) due to a comminuted reversed oblique fracture of the right intertrochanteric hip. ORIF had failed and was converted to bipolar hemiarthroplasty. CT scans were performed on both the right and left hips. Housefield units were determined by using the probe tool. By using equations formulated by Carter and Hays, Linde et al., various parameters such as apparent density, Young’s’ modulus and ultimate strength were calculated. The results were compared to that a native hip. Results: The hip with the cemented implant had a significant increase in the apparent density, Young’s modulus and ultimate strength, when compared to the left hip. In addition, it was found that the right hip had a higher strain energy density than that of the left. Interpretation: It has been concluded the most stress shielding occurred in the calcar region of the femur. The instances of stress shielding have been extensively reported for non-cemented or direct bone to implant constructs, this paper reports stress shielding in cemented implants supported by imaging data and biomechanical calculations carried out at the bone-cement-metal interface

Risk factors of metabolic bone disease of prematurity

To identify the factors that increase risk of metabolic bone disease of prematurity (MBD). A retrospective case-control study of infants born between January 2013–April 2014 with gestation age <30weeks and birth weight <1000g. MBD was defined as serum alkaline phosphatase above 500U/L and characteristic radiographic changes. Information was obtained on the presence of specific comorbidities. Of 76 infants evaluated, 40 met criteria for MBD. Median gestational age was 25weeks in both groups (p=0.512). Median birth weight of infants with MBD was significantly lower than that of controls (560 vs. 765g, p<0.01). Longer period of parenteral nutrition and dexamethasone use was observed in MBD group. Cholestasis was associated with the highest likelihood of MBD (OR 16.6, 95% CI 4.8–56.9). Seizures (OR 5.2, 95% CI 1.3–20.5) and the prolonged use of diuretics (OR 2.6, 95% CI 1.0–7.0) also significantly increased the likelihood of MBD. Only cholestasis remained significant (OR 9.6, 95% CI 2.1–45.3) after multiple regression analysis. Cholestasis is a significant risk factor for the development of MBD. Our future studies will be directed towards determining the causal relationship between cholestasis and MBD. •Metabolic Bone Disease (MBD) is a common problem among preterm infants•Cholestasis carries the highest likelihood of developing likelihood of developing MBD•Lower birth weight, longer duration of parenteral nutrition and steroid use are also observed in preterm infants with MB

The Popularity of Outcome Measures Used in Shoulder Arthroplasty Literature

Introduction Patient-reported outcomes (PROs) are frequently utilized within orthopaedics to determine the extent of patient disease and the efficacy of surgical treatments. Shoulder arthroplasty is a common treatment option for a range of pathologies; however, substantial variety exists regarding the instruments used within the published literature, limiting their quality and generalizability. The purpose of the present systematic review is to evaluate the overall number and frequency of outcome measures used in all clinical studies evaluating outcomes following shoulder arthroplasty. Methods This systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies that assessed patient reported outcomes following total shoulder arthroplasty, reverse shoulder arthroplasty, and shoulder hemiarthroplasty were obtained from PubMed, MEDLINE, and EMBASE databases. For each manuscript, the journal, authors, region of origin, level of evidence, and subject/pathology were recorded. The frequency of each reported outcome measure and category. Associations between study characteristics and measure categories were tested using Poisson regression with robust error variance. Results A total of 682 articles were included in the analysis, reporting 42 different PROs. The most popular tools were the Constant-Murley score (49.7%), the American Shoulder and Elbow Surgeons Evaluation Form (37.7%), and the Visual Analog Scale (34.3%). A generic outcome tool was used in 287 studies (42.1%), while 645 (94.6%) utilized a shoulder-specific measure and 49 (7.2%) used a disease-specific measure. The use of generic (p Conclusion Studies assessing patient outcomes following shoulder arthroplasty employ a large range of PRO measuring tools, many of which are non-validated. Furthermore, only a small percentage of studies utilize a combination of tools from different categories despite current recommendations. Consensus on validated and clinically-meaningful tools from multiple categories is necessary to increase the generalizability and applicability of published studies in shoulder arthroplasty literature. Level of Evidence