Supercritical CO2 fluid-foaming of polymers to increase porosity: A method to improve the mechanical and biocompatibility characteristics for use as a potential alternative to allografts in impaction bone grafting?

Disease transmission, availability and cost of allografts have resulted in significant efforts to find an alternative for use in impaction bone grafting (IBG). Recent studies identified two polymers with both structural strength and biocompatibility characteristics as potential replacements. The aim of this study was to assess whether increasing the polymer porosity further enhanced the mechanical and cellular compatibility characteristics for use as an osteogenic biomaterial alternative to allografts in IBG. Solid and porous poly(DL-lactide) (P(DL)LA) and poly(DL-lactide-co-glycolide) (P(DL)LGA) scaffolds were produced via melt processing and supercritical CO(2) foaming, and the differences characterized using scanning electron microscopy (SEM). Mechanical testing included milling and impaction, with comparisons made using a shear testing rig as well as a novel agitation test for cohesion. Cellular compatibility tests for cell number, viability, and osteogenic differentiation using WST-1 assays, fluorostaining, and ALP assays were determined following 14 day culture with skeletal stem cells. SEM showed excellent porosity throughout both of the supercritical-foam-produced polymer scaffolds, with pores between 50 and 200 μm. Shear testing showed that the porous polymers exceeded the shear strength of allograft controls (P<0.001). Agitation testing showed greater cohesion between the particles of the porous polymers (P<0.05). Cellular studies showed increased cell number, viability, and osteogenic differentiation on the porous polymers compared to solid block polymers (P<0.05). The use of supercritical CO(2) to generate porous polymeric biodegradable scaffolds significantly improves the cellular compatibility and cohesion observed compared to non-porous counterparts, without substantial loss of mechanical shear strength. These improved characteristics are critical for clinical translation as a potential osteogenic composite for use in IBG.     

Is early marriage practice a problem for women living in Istanbul? A qualitative study

Archives of Women's Mental Health - Early marriages (EM) adversely affect women’s physical and mental health, education, and social status. The current study aimed to analyze effects of...     

Evaluation of a new press-fit in situ setting composite porous scaffold for cancellous bone repair: Towards a “surgeon-friendly” bone filler?

In this study, a composite porous material obtained by coating a poly(ester urethane) foam with a calcium phosphate cement is proposed as novel cancellous bone filler with easy handling, in situ hardening and press-fitting properties. The coating can be applied to the foam in the surgical theater, allowing refinement of scaffold shape to the needs of the ongoing surgery. An innovative experiment was developed in order to determine the setting curve of the composite scaffold as well as the time of manipulation available to the surgeon without risk of material damage. This composite material is soft and can be press-fit in a cavity without damaging the scaffold in the first 5 min after coating application. The composite scaffold hardens quickly (22 min) and, once the cement has set, its compressive strength and fracture energy are increased by over an order of magnitude as compared to the initial poly(ester urethane) foam. This set of interesting properties makes calcium phosphate cement-coated elastomeric scaffolds a new promising strategy for cancellous bone filling.     

Is there an association between inhaled corticosteroids and bone density in postmenopausal women?

BACKGROUND: During the last decades, there has been increased concern about the association between oral corticosteroid (OC) therapy and osteoporosis. OBJECTIVE: The question currently discussed is whether inhaled corticosteroids (ICs) in recommended doses have any clinically relevant effects on bone mineral density (BMD). METHODS: We compared BMD in postmenopausal women exposed to corticosteroids only in inhaled form (IC group, n = 106) with that in women not exposed to corticosteroids (unexposed group, n = 674). BMD was also studied in 49 women exposed to OCs, intra-articular injections, or both in addition to ICs (OC group). The women were recruited from a population-based prospective cohort study. METHODS: We used a dietary survey, bone density measurement of the forearm, and a health questionnaire including an interview about past and present medication use. RESULTS: Mean BMD did not significantly differ between the IC group (0.434 g/cm2) and the unexposed group (0.429 g/cm2). The mean duration and dose of ICs was 8.2 +/- 5.03 years and 853 microg daily. Within the IC group, BMD stratified for cumulative dose of IC, duration, or current dose greater than or less than 1000 microg did not differ. BMD in the OC group was lower than that in the IC group (0.408 vs 0.434 g/cm2). CONCLUSION: No difference in BMD was noted between the IC group and unexposed control subjects, nor was any dose-response relationship observed between IC therapy and BMD.     

Is there a link between subjective daytime somnolence and sickness absenteeism? A study in a working population

A number of studies have highlighted the increasing incidence and financial cost of sleep-related disorders in the general population, but little research has been carried out on the impact of subjective daytime somnolence on health status. The existence of a survey of the health of employees of the French National Gas and Electricity Board has allowed us to investigate this question and measure the link between subjective daytime somnolence and sickness absenteeism, used here as a general health indicator. In order to evaluate the quality of sleep over the previous 3 months, a questionnaire was given to each participant. The association between subjective daytime somnolence and absence as a result of sickness was explored using the data of sickness absenteeism provided by the company's social security department during a 12-month follow-up period. Of our 1105 subjects, 6.7% reported severe subjective daytime somnolence of 3 days or more a week and 30% of our study population had at least one spell of sickness absence during the 12-month period of follow-up. A strong association was observed between subjective daytime somnolence and sickness absence, which remained significant even after adjustment for potential confounding variables (age, sex, employment grade, sleep symptoms and self-reported diseases). The odds-ratio for absence as a result of sickness during the follow-up period associated with subjective daytime somnolence of 3 days or more a week was 2.2 (95% CI: 1.3--3.8). Employees suffering from severe subjective daytime somnolence lose more working days for health reasons than their more alert colleagues. This may have long-term implications for employees' health.     

Is inguinal hernia a defect in human evolution and would this insight improve concepts for methods of surgical repair?

In Homo sapiens sapiens and many mammalian quadrupeds, there is an absence of the posterior rectus sheath below the arcuate line (of Douglas) and an insubstantial transversalis fascia in the groin. This anatomical arrangement presents no particular functional anatomic difficulty for quadrupeds as their inguinal canal is directed “uphill” during ambulation and therefore is not subjected to significant gravitational stress. In humans, however, gravitational stress necessitated by erect posture, including bearing the weight of the intra-abdominal organs directed toward the lower abdomen, considerably amplifies this intrinsic anatomic weakness. It allows a significant number of pathologic inguinal hernias, both direct and indirect, to become clinically manifest and associated with a coincident increase in morbidity and mortality, especially in patients with strangulated hernias and/or delayed treatment. The morbidity is associated with a significant national economic loss secondary to work hour loss from pain, discomfort, surgical treatment, and rehabilitation following therapy. The mortality is usually associated with strangulation, especially in those in patients with delayed treatment. The lack of the evolutionary development of a strong posterior rectus sheath and transversalis fascia in the lower abdomen is thought to represent a significant specific anatomic defect in the evolution of humankind. If so, then perhaps methods for surgical repair will be directed toward correction of this defect and avoid, not encourage, such methods as the utilization of the weak or absent transversalis “fascia,” which are doomed to a high recurrence rate, or other methods that are unnecessarily complicated, such as certain laparoscopic repairs of inguinal hernia. Clin. Anat. 10:47–55, 1997 © 1997 Wiley-Liss, Inc.     

Is there an association between pemphigus and hepatitis viruses? A population-based large-scale study

The association between pemphigus and hepatitis viruses has not been investigated sufficiently and remains unclear. Our objective was to assess the association between pemphigus and chronic hepatitis B (HBV) and hepatitis C (HCV) infections using a large-scale real-life computerized database. This study was conducted as a cross-sectional study utilizing the database of Clalit Health Services. The proportion of chronic HBV and HCV infections was compared between patients diagnosed with pemphigus and age-, sex-, and ethnicity-matched controls. Univariate analysis was performed using chi-square and Student’s t test, and multivariate analysis was performed using a logistic regression model. A total of 1985 pemphigus patients and 9874 controls were enrolled in the study. The prevalence of HBV chronic infection in patients with pemphigus was significantly higher than in control subjects (1.2 vs. 0.6%, respectively, p = 0.008). The prevalence rate of HCV carrier state was comparable between pemphigus patients and control subjects (1.1 vs. 1.0, respectively, p = 0.732). A multivariate analysis revealed a significant association between pemphigus and HBV with a multivariate odds ratio (OR) of 1.9 [95% confidence interval (CI), 1.2–3.90], whereas no association between pemphigus and HCV was identified (OR 1.1, 95% CI, 0.7–1.7). In conclusion, patients with pemphigus have a greater proportion of chronic HBV but not HCV infection relative to matched controls.     

Is There an Association Between Rumination and Self-Reported Physical Health? A One-Year Follow-Up in a Young and an Elderly Sample

Cross-sectional studies have suggested an association between rumination and subjective health. The aim of the present study was to investigate in a longitudinal design whether rumination was related to self-reported physical health. A total of 96 young (age range 20-35) and 110 elderly (age range 70-85) participants completed questionnaires measuring rumination, negative affect, life events, and self-reported physical health at baseline and at 1-year follow-up. Multiple linear regressions showed a significant association between self-reported physical health at time I only for the elderly and negative affect mediated the association. At follow-up, rumination was significantly associated with self-reported physical health only for the young and the association was only partly mediated by negative affect. In conclusion, rumination is associated with poorer self-reported physical health, but the association depends on the age of the individual as well as time span studied.     

Prolonged controlled hemorrhagic shock in a swine model: is there a role for mechanical circulatory assistance?

Outcomes of mechanical circulatory assistance during hemorrhagic shock were evaluated in a swine model. Pigs were bled to a mean arterial pressure of 35 mm Hg (group I, n = 3) or 40 mm Hg (group II, n = 5; group III, n = 5), maintained there for 30 minutes, and then resuscitated with fluids alone (groups I and II) or fluids plus mechanical circulatory assistance (group III). Mean blood loss was greater in group I than in groups II or III (1,037 +/- 212 vs. 862 +/- 387 ml vs. 681 +/- 117 ml, respectively; I vs. III, p < 0.05) and survival was shorter (230 +/- 25.5 min vs. 709 +/- 251 min vs. 662 +/- 428 min, respectively; I vs. II or III, p < 0.05). Cardiac arrhythmia caused death in most cases. Mean biochemical parameters increased progressively in all cases. Left anterior descending coronary artery flow stayed relatively constant in group II but increased in group III. Superior mesenteric artery flow returned to baseline in group II but increased in group III. Cardiac output was similar in groups II and III, but SGOT levels significantly differed (750 +/- 135 U/L vs. 359 +/- 157 U/L; p < 0.005). These results suggest that the swine model will be useful for studying ways to improve outcomes after prolonged hemorrhagic shock.     

Is there an association between alopecia areata and systemic lupus erythematosus? A population-based study

Immunologic Research - The coexistence of alopecia areata (AA) and systemic lupus erythematosus (SLE) has been described, but the association between these conditions is yet to be firmly...     

Is there a role for isofurans and neuroprostanes in pre-eclampsia and normal pregnancy?

Pre-eclampsia is a complex disorder of pregnancy that adversely affects the mother and baby. Arachidonic acid and docosahexaenoic acid are essential for fetal development and can undergo free radical oxidation to F(2)-isoprostanes (F(2)-IsoPs) and isofurans (IsoFs); and F(4)-neuroprostanes (F(4)-NeuroPs), respectively. These metabolites may be relevant to pre-eclampsia and fetal development. We examined IsoFs, F(4)-NeuroPs, and F(2)-IsoPs in maternal plasma and cord blood plasma of 23 women with pre-eclampsia and 21 normal pregnancies. Women with pre-eclampsia had significantly elevated maternal IsoFs and F(4)-NeuroPs, but not F(2)-IsoPs. Cord blood F(4)-NeuroPs were elevated among neonates of women with pre-eclampsia. In women with pre-eclampsia, birth weight was predicted by gestation at delivery. The latter was also true in normal pregnancy, but birth weight was negatively related to maternal F(2)-IsoPs, IsoFs, and F(4)-NeuroPs. We have shown that in women with pre-eclampsia, IsoFs and F(4)-NeuroPs are elevated, and cord blood F(4)-NeuroPs are increased. The inverse relationship between maternal F(2)-IsoPs, IsoFs, and F(4)-NeuroPs and birth weight may be relevant as predictors of low birth weight in normal pregnancy. Future studies should examine whether these markers in maternal blood at early stages of pregnancy relate to subsequent maternal, fetal, and neonatal complications.     

Is neck circumference measurement an indicator for abdominal obesity? A pilot study on Turkish Adults

Background

Neck circumference (NC) measurement is one of the simple screening measurements which can be used as an index of upper body fat distribution to identify obesity.

Objectives

The aim of this study was to determine the relationship between neck circumferences and obesity.

Methods

A total 411 volunteer adults participated in this study (174 men, 237 women). A questionnaire which consisted of anthropometric measurements and demographic features was used. Patients with NC ≥37 cm for men and ≥34 cm for women require evaluation of overweight status.

Results

The percentages of the men and women with BMI ≥ 25kg/m² were 55.2% and 27.0% respectively and with high neck circumferences were 85.1% and 38.8%, respectively. The percentages of the men and women with high waist circumference were 31.6% and 79.3%, respectively. In both gender there were positive significant correlations between neck circumference, body weight (men, r=0.576; women, r=0.702; p=0.000), waist circumferences (men, r=0.593; women r=0.667; p=0.000), hip circumferences (men, r=0.568; women, r=0.617; p=0.000) and BMI (men, r=0.587; women, r=0.688; p=0.000).

Conclusions

This study indicates that NC was associated with body weight, BMI, waist and hip circumferences and waist/hip ratio for men and women. A significant association was found between NC and conventional overweight and obesity indexes. NC was associated with waist/hip ratio for men and women.