Biomechanical stability of a supra-acetabular pedicle screw Internal Fixation device (INFIX) vs External Fixation and plates for vertically unstable pelvic fractures

Abstract Background We have recently developed a subcutaneous anterior pelvic fixation technique (INFIX). This internal fixator permits patients to sit, roll over in bed and lie on their sides without the cumbersome external appliances or their complications. The purpose of this study was to evaluate the biomechanical stability of this novel supraacetabular pedicle screw internal fixation construct (INFIX) and compare it to standard internal fixation and external fixation techniques in a single stance pelvic fracture model. Methods Nine synthetic pelves with a simulated anterior posterior compression type III injury were placed into three groups (External Fixator, INFIX and Internal Fixation). Displacement, total axial stiffness, and the stiffness at the pubic symphysis and SI joint were calculated. Displacement and stiffness were compared by ANOVA with a Bonferroni adjustment for multiple comparisons Results The mean displacement at the pubic symphysis was 20, 9 and 0.8 mm for external fixation, INFIX and internal fixation, respectively. Plate fixation was significantly stiffer than the INFIX and external Fixator (P = 0.01) at the symphysis pubis. The INFIX device was significantly stiffer than external fixation (P = 0.017) at the symphysis pubis. There was no significant difference in SI joint displacement between any of the groups. Conclusions Anterior plate fixation is stiffer than both the INFIX and external fixation in single stance pelvic fracture model. The INFIX was stiffer than external fixation for both overall axial stiffness, and stiffness at the pubic symphysis. Combined with the presumed benefit of minimizing the complications associated with external fixation, the INFIX may be a more preferable option for temporary anterior pelvic fixation in situations where external fixation may have otherwise been used

VALSARTAN IN EVERYDAY CLINICAL PRACTICE IN RUSSIA: ANTIHYPERTENSIVE EFFICACY AND INFLUENCE ON SEXUAL FUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION

Aim. To study antihypertensive efficacy and safety of valsartan-based therapy (Diovan, Novartis Pharma) as well as patient’s compliance and influence of treatment on several aspects of sexual function.Material and methods. 114 doctors from 81 medical institutions of Russia participated in this prospective multicenter observation study. 650 hypertensive patients (average age 53,9±0,4 y.o.) were enrolled. The evaluation of therapy efficacy was based on analysis of systolic (SBP) and diastolic (DBP) blood pressure (BP) changes. Safety and compliance of treatment was also analyzed. The evaluation of sexual function was performed with 5 universal questions selected form the International Index of Erectile Function. These questions could be asked in both men and women. The valsartan dose was 80-320 mg OD. A combination of the valsartan with hydrochlorothiazide (12,5-25 mg/d), amlodipine (5-10 mg/d) or any other antihypertensive was allowed.Results. Significant similar decrease of SBP and DBP was observed in smoking and non-smoking patients (37,5/18,5 and 37,6/15,9 mm Hg respectively, р<0,01 vs baseline). 312 patients (56,9% men, 43,1% women) completed sexual function survey. After 12 weeks of treatment the number of patients without sexual activity and with 1-2 successful sexual attempts in the last 4 weeks significantly decreased from 22 to 16% and from 44 to 30% respectively (р<0,05). Significant increase in the number of patients with 5-6 and 7-10 successful sexual attempts was observed (from 7 to 20% and from 0 to 7% respectively, р<0,05). The treatment resulted in significant increase in the number of patients, who characterized their sexual life satisfaction as “very satisfied” (from 11 to 25%, р<0,01).Conclusion. During the course of effective antihypertensive treatment there was a significant increase in sexual function and general satisfaction with sexual life in patients with arterial hypertension, which could have favorable long-term consequences in increased compliance to the antihypertensive therapy

Hybrid HIPIMS and DC magnetron sputtering deposition of TiN coatings: Deposition rate, structure and tribological properties

High power impulse magnetron sputtering (HIPIMS) has the advantage of ultra-dense plasma deposition environment although the resultant deposition rate is significantly low. By using a closed field unbalanced magnetron sputtering system, a hybrid process consisting of one HIPIMS powered magnetron and three DC magnetrons has been introduced in the reactive sputtering deposition of a TiN hard coating on a hardened steel substrate, to investigate the effect of HIPIMS incorporation on the deposition rate and on the microstructure and mechanical and tribological properties of the deposited coating. Various characterizations and tests have been applied in the study, including XRD, FEG-SEM, cross-sectional TEM, Knoop hardness, adhesion tests and unlubricated ball-on-disk tribo-tests. The results revealed that, both the DC magnetron and hybrid-sputtered TiN coatings exhibited dense columnar morphology, a single NaCl-type cubic crystalline phase with strong (220) texture, and good adhesion property. The two coatings showed similar dry sliding friction coefficient of 0.8 – 0.9 and comparable wear coefficient in the range of 1 – 2× 10-15 m3N-1m-1. The overall deposition rate of the hybrid sputtering, being 0.047 μm/min as measured in this study, was governed predominantly by the three DC magnetrons whereas the HIPIMS only made a marginal contribution. However, the incorporated HIPIMS has been found to lead to remarkable reduction of the compressive residual stress from -6.0 to -3.5 GPa and a slight increase in the coating hardness from 34.8 to 38.0 GPa