Traumatic facet joint dislocations in Western Australia

Background: Early enlocation of dislocated cervical facets is important to minimize long term neurological deficit. Aims: To assess impact of delay in enlocation on clinical outcome in patients with facet dislocations and propose a scheme for enlocation for rural patients who usually have longer enlocation times. Methods: A retrospective analysis of consecutive cervical spine facet joint dislocations presenting to Royal Perth Hospital from January 2009 to November 2012 was carried out to assess factors affecting final neurological outcome (ASIA score) at discharge. Results: A total of 51 patients were included in the study. More patients in the urban group had higher final ASIA score than in the rural group. Strong correlation in both the urban and rural populations were found between enlocation time final ASIA score Conclusion: Enlocation through closed reduction should be done as early as possible at local centres for awake rural patients having dislocated cervical facets

Vibrations of Cracked Rotors

The analysis of dynamic behavior of rotors with cracks is considerably important for design aspect. In this study the effect of a single open crack on the free vibrational characteristics of a simply supported shaft are investigated using Finite element methodology. The rotor is modelled by using Timoshenko beam element. To account for the presence of the crack, the stiffness matrix of the beam element is modified. The beam element with modified stiffness matrix is then fit into the complete finite element assemblage representing a cracked rotor system. In this study the natural frequencies of cracked and un-cracked rotor are found using Ansys and then the variations in natural frequencies of the rotor with varying depths at a given location are estimated. This analysis is done for two different geometries of shaft and results are compared. Experimental investigations were carried out and frequencies of cracked and un-cracked rotor are determined and the results are compared

Age Related Incidence and Early Outcomes of Hip Fractures: A Prospective Cohort Study of 1177 patients

<p>Abstract</p> <p>Introduction</p> <p>Associated with the increase in the aging population, there is an increase in the incidence of hip fractures worldwide. Outcome following such fractures is affected by age of the patient. This study aims to assess the incidence and early outcome of hip fractures, comparing between different age groups.</p> <p>Methods</p> <p>Data of hip fractures collected over a period of five years was analysed. Patients were divided into three groups, group A (patients under the age of 64), group B (patients between 65 and 84 years of age), and group C (patients over the age of 85).</p> <p>Results</p> <p>Of the 1177 patients included in the study, there were 90 patients in group A, 702 patients in group B and 385 patients in group C. There was a female preponderance across all age groups, and this increased as age advanced (p < 0.0001). A significantly larger number of older patients lived alone and needed aids to walk before the injury (p < 0.0001). There was no significant difference in the type of fracture across the three groups (p = 0.13). A higher proportion of the elderly with intracapsular fractures were treated by replacement arthroplasty. Older patients who had internal fixation of intracapsular fractures had a better walking ability at 4 months. The overall deterioration in mobility was greater in older patients (p < 0.0001). Mortality was higher in older patients.</p> <p>Conclusions</p> <p>Hip fractures are more common among females irrespective of age group. Older patients have a higher mortality and a greater deterioration of walking ability after such injuries. Internal fixation of intracapsular fractures have demonstrated satisfactory early outcome in the immediate period. This could be attributed to retention of native bone, better propioception and shorter operation time.</p

Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty

Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Results. M : F was 7 : 4. The mean age was 57 years. The average shoulder score improved from 49.6 preoperatively to 56 postoperatively at an average followup of 16 months. Two patients showed deterioration in their shoulder scores after revision while the rest showed only marginal improvement. All except one patient stated that they would opt for surgery again if given a second chance. Conclusion. In the group of patients that fail to benefit from the arthroscopic decompression, only a marginal improvement was noted after revision with open decompression

Optimization of linear arrays using modified social group optimization algorithm

In this paper, optimization of the linear array (LA) antenna is performed using modified social group optimization algorithm (SGOA). First step of the work involves in transforming the electromagnetic engineering problem to an optimization problem which is completely described in terms of objectives. Linear array synthesis is inherently considered as a multi-attribute problem. The pattern synthesis of LA is carried out with several objectives involving sidelobe level (SLL), beam-width (BW) and desired nulls. The SLL suppression with BW constraint is considered as first objective of this work and the results are compared with several evolutionary computing algorithms like ant lion (ALO), grey wolf (GWO) and root-runner (RRA). Following this, the MSGOA is further used to synthesise null patterns in which the pattern is completely described in terms of nulls with SLL and BW as constraints. The entire simulation-based experimentation is performed using Matlab® on i5 computing system

Systematic Review and Meta-Analysis of Mid-Term Survival, Reoperation, and Recurrent Mitral Regurgitation for Robotic-Assisted Mitral Valve Repair

Background: Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term data for RMVr. Methods: Electronic searches of five databases were performed to identify all relevant studies reporting minimum five-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and from moderate or worse mitral regurgitation (MR) at five years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Results: Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-year were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at eight-years post RMVr was 95.0%. Freedom from moderate or worse MR at seven years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. Conclusions: RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and from moderate or worse MR recurrence

Robotic Versus Conventional Sternotomy Mitral Valve Surgery: A Systematic Review and Meta-Analysis

Background: Robotic-assisted mitral valve surgery (RMVS) is becoming an increasingly performed procedure in cardiac surgery, however, its true safety and efficacy compared to the gold standard conventional sternotomy approach [conventional sternotomy mitral valve surgery (CSMVS)] remains debated. The aim of this meta-analysis was to provide a comprehensive analysis of all available literature comparing RMVS to CSMVS. Methods: An electronic search of five databases was performed to identify all relevant studies comparing RMVS to CSMVS. Pre-defined primary outcomes of interest included all-cause mortality, cerebrovascular accidents (CVA) and re-operation for bleeding. Secondary outcomes of interest included cross clamp time, cardiopulmonary bypass (CPB) time, intensive care unit (ICU) and hospital length of stay (LOS), postoperative atrial fibrillation (POAF) and red blood cell (RBC) transfusion. Results:The search strategy identified fourteen studies qualifying for inclusion in this meta-analysis comparing RMVS to CSMVS. The outcomes of 6,341 patients (2,804 RMVS and 3,537 CSMVS) were included. RMVS had significantly lower mortality when compared to CSMVS group in both the unmatched [odds ratio (OR) 0.33; 95% confidence interval (CI): 0.19–0.57; P Conclusions: Current evidence on comparative outcomes of RMVS and CSMVS is limited with only lowquality studies currently available. This present meta-analysis suggests that RMVS may have lower mortality and shorter ICU and hospital LOS, however CSMVS may be associated with significantly shorter cross clamp and CPB times. Further analysis of high-quality studies with randomized data is required to verify these results