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Ahmad M Radaideh, Ziad A Audat, Abdullah A Saleh
BACKGROUND Fractures of the talus are uncommon injuries that usually involve the talar neck, rather than the talar body. This report is of a rare case of combined left talar neck fracture and adjacent joint dislocation with an ipsilateral bimalleolar ankle fracture. CASE REPORT A 37-year-old man presented with an injury to his left foot following a motor vehicle accident. When he presented to the hospital emergency department, his left foot and ankle were swollen, the overlying skin was intact but badly contused, and there was no neurovascular deficit...
March 20, 2018: American Journal of Case Reports
Ravi Gupta, Thomas J Bollyky, Matthew Cohen, Joseph S Ross, Aaron S Kesselheim
OBJECTIVES: To evaluate whether off-patent prescription drugs at risk of sudden price increases or shortages in the United States are available from independent manufacturers approved in other well regulated settings around the world. DESIGN: Observational study. SETTING: Off-patent drugs in the USA and approved by the Food and Drug Administration, up to 10 April 2017. STUDY COHORT: Novel tablet or capsule prescription drugs approved by the FDA since 1939 that were no longer protected by patents or other market exclusivity and had up to three generic versions...
March 19, 2018: BMJ: British Medical Journal
V Perlepe, P Omoumi, A Larbi, D Putineanu, J-E Dubuc, T Schubert, B Vande Berg
PURPOSE: To determine the frequency and causes for limitations in the radiographic evaluation of surgically treated long bone fractures. MATERIALS AND METHODS: Six readers separately scored 140 sets of antero-posterior (AP) and lateral radiographs of surgically treated long bone fractures, using a radiographic union score (RUS). We determined the rate of assessability of the fracture edges at each of the four cortical segments (n=560) seen tangentially on the two radiographs and the causes for non-assessability...
March 16, 2018: Diagnostic and Interventional Imaging
R Siboni, P Beaufils, P Boisrenoult, C Steltzlen, N Pujol
INTRODUCTION: Using locking plates in opening-wedge high tibial osteotomy (OWHTO) via a medial opening theoretically allows early weight-bearing without need for bone or bone-substitute grafting. It incurs a risk of non-consolidation in case of large correction (> 10°), although rates and risk factors of non-union are not known. The present retrospective study compared OWHTO with correction <10° versus >10°, with a view to determining: 1) complications rates (non-union) according to degree of correction, and 2) risk factors for such complications...
March 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Xi Liu, Hui Zhang, Shiqiang Cen, Fuguo Huang
BACKGROUND: Though several systematic reviews concerned have been published, controversy still exists. The current systematic review was designed to clarify the detailed advantages and disadvantages of the negative pressure wound therapy (NPWT) in treatment of open fractures in comparison with the conventional wound dressings. METHODS: A systematic search was performed in Pubmed, Cochrane Library, Embase, and Google Scholar for the published relevant clinical studies...
March 16, 2018: International Journal of Surgery
Antonio López-Uceda, Adela P Galvín, Jesús Ayuso, José Ramón Jiménez, Tom Vanwalleghem, Adolfo Peña
Extensive green roofs are urban construction systems that provide thermal regulation and sound proofing for the buildings involved, in addition to providing an urban heat island mitigation or water retention. On the other hand, policies towards reduction of energy consumption, a circular economy and sustainability are core in the European Union. Motivated by this, an experimental study was carried out to evaluate the environmental risk assessment according to release levels of polluting elements on leachates of different green roof substrate mixtures based on recycled aggregates from construction and demolition waste through (i) the performance in laboratory of two procedures: compliance and percolation tests and (ii) an upscaled experimental leaching test for long-term on-site prediction...
March 19, 2018: Environmental Science and Pollution Research International
Andras P Durko, Ruben L Osnabrugge, Nicolas M Van Mieghem, Milan Milojevic, Darren Mylotte, Vuyisile T Nkomo, A Pieter Kappetein
Aims: The number of transcatheter aortic valve implantation (TAVI) procedures is rapidly increasing. This has a major impact on health care resource planning. However, the annual numbers of TAVI candidates per country are unknown. The aim of this study was to estimate current and future number of annual TAVI candidates in 27 European countries, the USA and Canada. Methods and results: Systematic literature searches and meta-analyses were performed on aortic stenosis (AS) epidemiology and decision-making in severe symptomatic AS...
March 12, 2018: European Heart Journal
Christopher J Rendina
Purpose: To present a case that benefited from utilizing hyperbaric oxygen therapy in conjunction with antibiotics for a non-healing mandibular fracture that was highly suspicious of osteomyelitis. Also, to discuss research set forth by Undersea and Hyperbaric Medical Society that supports the use hyperbaric oxygen in such cases. Case: A 25-year-old male status post fist to face resulting in bilateral mandibular fracture. He underwent two surgeries in an attempt to plate the fracture with the assistance of a bone graft...
March 13, 2018: Military Medicine
Jason C Tee, Sheree Bekker, Rob Collins, Jannie Klingbiel, Ivan van Rooyen, David van Wyk, Kevin Till, Ben Jones
OBJECTIVES: Due to the complex systems nature of injuries, the responsibility for injury risk management cannot lie solely within a single domain of professional practice. Interdisciplinary collaboration between technical/tactical coaches, strength and conditioning coaches, team doctors, physical therapists and sport scientists is likely to have a meaningful impact on injury risk. This study describes the application and efficacy of a multidisciplinary approach to reducing team injury risk in professional rugby union...
February 14, 2018: Journal of Science and Medicine in Sport
Yan Li, Dewen Ye, Mingxi Li, Ming Ma, Ning Gu
The paper provides a brief overview of the use of iron oxide nanoparticles (IONPs) in the areas of bone regenerative medicine. Reconstruction of bone defects caused by trauma, non-union, and bone tumour excision still faces many challenges despite the intense investigations and advancement in bone tissue engineering and bone regeneration over the past decades. IONPs have promising prospects in this field due to their controlled responsive characteristics in specific external magnetic fields and have been of great interest during the last few years...
March 14, 2018: Chemphyschem: a European Journal of Chemical Physics and Physical Chemistry
Claudia Schlundt, Christian H Bucher, Serafeim Tsitsilonis, Hanna Schell, Georg N Duda, Katharina Schmidt-Bleek
PURPOSE OF REVIEW: Impaired healing outcomes or even non-unions after bone injury are still a highly relevant problem in the daily clinical life. Especially within an aging population, the occurrence of bone fractures increases and thus novel treatment approaches to overcome compromised bone regeneration are needed. RECENT FINDINGS: The gold standard to treat delayed or non-healing bone injuries is still the use of autologous bone grafts to foster regeneration. Besides its successful treatment outcome, it also has disadvantages: a second surgery is needed in order to harvest the bone material and the material is highly limited...
March 13, 2018: Current Osteoporosis Reports
Seif Sawalha, Inigo Guisasola
An important consideration when counselling patients with midshaft clavicle fractures is whether operative treatment of non-union, if it develops after non-operative treatment, is associated with higher complication rate than acute fracture fixation. The aim of this study is to compare complications and re-operations after open reduction and plate fixation for acute midshaft clavicle fractures versus non-unions. The study was retrospective. There were 90 patients in the acute fixation group and 20 patients in the non-union group...
March 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Lester W M Chan, Antony W Gardner, Merng Koon Wong, Kenon Chua, Ernest B K Kwek
INTRODUCTION: Non-prosthetic peri-implant fractures (NPPIFs) are an under-reported entity. Management is challenging because of alterations in anatomy, the presence of orthopaedic implants and phenomena such as stress shielding, disuse osteopenia and fracture remodeling. The aims of this paper were to review patterns of injury, management and outcomes and to propose a classification system to aid further research. MATERIALS AND METHODS: This study is a multi-centered retrospective case series...
March 12, 2018: Archives of Orthopaedic and Trauma Surgery
Karen Benjamin Guzzo
Cohabiting unions increasingly involve children, either born during the union and/or from prior relationships (i.e., stepchildren). Drawing from arguments about the institutionalization of cohabitation and stepfamilies as well as the family systems perspective, this paper examines dissolution and marriage risks among women's cohabiting unions by stepfamily status, configuration (which partner has children) and shared intended and unintended fertility using the 2006-2013 National Survey of Family Growth. A minority (32%) of 1st cohabitations, but the majority of 2nd (65%) and 3rd (75%) cohabitations, are stepfamilies...
2018: Journal of Family Issues
James Rafferty, Craig Ranson, Giles Oatley, Mohamed Mostafa, Prabhat Mathema, Tom Crick, Isabel S Moore
OBJECTIVES: To investigate concussion injury rates, the likelihood of sustaining concussion relative to the number of rugby union matches and the risk of subsequent injury following concussion. METHODS: A four-season (2012/2013-2015/2016) prospective cohort study of injuries in professional level (club and international) rugby union. Incidence (injuries/1000 player-match-hours), severity (days lost per injury) and number of professional matches conferring a large risk of concussion were determined...
March 12, 2018: British Journal of Sports Medicine
Sherif Galal
OBJECTIVES: The best fixation method for open tibial fractures has long been a matter of debate, many studies have recommended the use of intramedullary nails over external fixation for treating such fractures, recent studies also showed favorable results for the use of plates in managing open tibial fractures. However, there are very few (if any) reports in the literature comparing the use of minimally invasive plate osteosynthesis to reamed intramedullary nails in the fixation of open tibial fractures...
March 8, 2018: Injury
Danielle H Dube
"Drug Discovery" is a 13-week lecture and laboratory-based course that was developed to introduce non-science majors to foundational chemistry and biochemistry concepts as they relate to the unifying theme of drug discovery. The first part of this course strives to build students' understanding of molecules, their properties, the differences that enable them to be separated from one another, and their abilities to bind to biological receptors and elicit physiological effects. After building students' molecular worldview, the course then focuses on four classes of drugs: antimicrobials, drugs that affect the mind, steroid-based drugs, and anti-cancer drugs...
March 12, 2018: Biochemistry and Molecular Biology Education
Hakan Ömeroğlu
This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Yalan Bi, Yang Qu, Zhiyong Liang, Zichen Liu, Hui Zhang, Xiaolong Liang, Yufeng Luo, Jinling Cao, Haiqing Zhang, Ruie Feng
OBJECTIVE: The definition of large cell lung carcinoma (LCC) has undergone an extensive modification in the World Health Organization (WHO) Classification (2015). Present study aimed to investigate the clinicopathological characteristics of patients diagnosed as LCC according to current WHO criteria. METHODS: LCCs diagnosed based on the previous WHO classification were reevaluated, and 17 cases of LCC were finally identified at Peking Union Medical College Hospital and Beijing Chest Hospital between 2009 and 2015...
February 14, 2018: Pathology, Research and Practice
Xin Wang, Yi Zhang, Wenjun Ji, Jun Ao
Fracture hematoma formation describes a transitional phase that involves a dynamic and tightly choreographed interaction between the fibrin matrix, cells, and cytokines that guides the ensuing bone repair. Here we propose a novel hypothesis to explain why hematomas in conjunction with critical sized bone defects are prone to differentiate into fibrous tissues, which eventually results in non-unions of the bone. We postulate that certain hematoma qualities are triggers that influence cell biological behaviours and that the release of certain growth factors determines what pattern of remodelling will prevail: intramembranous or endochondral ossification...
April 2018: Medical Hypotheses
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