Inhibition of bone repair in a rat model for chronic and excessive alcohol consumption.

Alcohol abuse is associated with increases in both the incidence of fractures and complications in fracture healing. The purpose of this study was to determine the dose-dependent effects of ethanol on bone repair in a rat model. Three-month-old male Wistar rats were continuously fed liquid diets containing ethanol as either 36% or 26% of total calories or control diets for 6 weeks. Then, a bone repair model was created in all rats. Bone healing and liver metabolism were evaluated 7 weeks after bone injury. For each dose, there were three ethanol-feeding groups receiving (1) ethanol for 13 weeks, (2) control diet for 13 weeks (pair-fed), and (3) ethanol before bone injury and control diet (pair-fed) after injury. Another group was fed ethanol (36%) before injury and given control diet ad libitum after injury. There were also two nutritional controls consuming control diet and standard rat chow ad libitum for 13 weeks. Abnormal liver metabolism was evident at the higher ethanol dose - increases in cytochrome P4502E1 specific activity (5-fold; P < .01), triglyceride content (4-fold; P < .02), and liver weight (25%; P = .05) - compared with pair-fed controls. The higher dose of ethanol resulted in deficient bone repair when compared with rats receiving ethanol-free control diet by pair-feeding: 26% less (P = .02) rigidity of the repaired bone, 41% less (P = .02) intrinsic stiffness, 24% less intrinsic strength (P = .05), and 14% less (P = .001) ash density of the repair tissue. The reduced food consumption of ethanol-fed rats compared with that in the nutritional controls did not contribute to this deficiency. Furthermore, removal of ethanol (as 36% of calories) from the diet after bone injury completely restored normal bone healing and nearly normalized the liver metabolism. The lower ethanol dose (26% of calories) had a minimal effect on liver metabolism and bone repair. We conclude that ethanol (as 36% of calories) in the rat diet, especially during the postinjury period, was solely responsible for the observed inhibition of bone repair.     

CT-Based Needle Marking of Superficial Intracranial Lesions for Minimal Invasive Neurosurgery

A CT-based method of marking superficial intracranial lesions with a needle is presented. This form of neuronavigation can be applied in every neurosurgical centre. Owing to its rapid application it is also suitable for cases of emergency. The neurosurgical approach can be centred precisely over the lesion providing for a minimally invasive operation. The method has proved its efficacy in numerous cases of haematomas and cystic lesions.     

Nasal continuous positive airway pressure (n-CPAP) does not change cardiac output in preterm infants

Our objective was to study how invasive mechanical ventilation impairs cardiac output (CO) in children and adults. Although the application of continuous positive airway pressure (CPAP) is widely practiced in neonatal intensive care, its hemodynamic consequences have not yet been investigated. A prospective study to assess the hemodynamic effects was conducted in 21 preterm infants < 1500 g using two-dimensional M-mode and pulsed Doppler echocardiography during and 1 hour after discontinuation of nasal CPAP (n-CPAP). Gestational age was 28.0 +/- 1.9 weeks (mean +/- standard deviation); birthweight, 1000 +/- 238 g; age at study entry, 200 +/- 155 hours; total maintenance fluid, 154 +/- 42 mL/kg/day; and n-CPAP level, 4.4 +/- 0.9 cm H(2)O. None of the infants received inotropic support, and n-CPAP did not cause any significant difference in the parameters measured: stroke volume, 3.1 +/- 1.0 mL (with n-CPAP) versus 3.1 +/- 1.0 mL (without n-CPAP); cardiac output, 487 +/- 156 mL/minute versus 500 +/- 176 mL/minute; left ventricular diastolic diameter, 1.22 +/- 0.15 cm versus 1.24 +/- 0.14 cm; fractional shortening, 0.30 +/- 0.05% versus 0.29 +/- 0.04%; and aortic velocity-time integral, 8.64 +/- 1.80 cm versus 8.70 +/- 1.65 cm. The n-CPAP level did not influence CO; n-CPAP (up to 7 cm H (2)O) has no echocardiographically detectable hemodynamic effect in preterm infants. Our data imply there is no need to withhold n-CPAP support to prevent circulatory compromise in these infants.     

Surgical treatment of stress urinary incontinence using the tension-free vaginal tape-obturator system (TVT-O) technique

OBJECTIVE: The purpose of the research was to provide a review of the efficacy of the TVT-O technique for the surgical treatment of stress urinary incontinence (SUI) and to assess surgical and postsurgical complications related to this technique. STUDY DESIGN: An initial assessment was carried out on 44 women who underwent TVT-O surgery between 16 September 2004 and 1 February 2005. The follow-ups after 3 and 12 months were attended by 37 and 35 patients, respectively. All 44 patients were included for the statistical estimation of intra- and postoperative complications, whereas improvement in the quality of life was assessed only in those patients who came for a follow-up visit. To assess the efficacy of the treatment, the participants were surveyed using the King questionnaire on the day preceding surgery and during a follow-up visit 3 and 12 months after surgery. The participants whose scores from the two questionnaires changed > or =90% were deemed to be cured. A considerable improvement in quality of life was recorded when the score was 89-75%. With scores of 74-50%, there was a reduction in SI symptoms. However, when the score was 50-0%, no improvement in quality of life was reported, and in participants with scores <0% the quality of life deteriorated. Statistical analysis was carried out using the Statistical Package for Social Sciences (SPSS) V. 10.0, with the Spearman correlation and Chi-squared tests. The results were considered statistically significant when P<0.05. RESULTS: After 12 months, total cure was achieved in 15 participants (42.8%), significant improvement was noted in 6 (17.1%), SUI symptoms abated in 4 (11.4%), no improvement was noted in 7 (20%), and quality of life deteriorated in 3 (8.7%). CONCLUSION: TVT-O surgery is an efficient and reasonably safe method of SUI treatment in women. The ease of use, short duration of surgery and hospitalisation, minor postsurgical discomfort and a small proportion of complications make this method acceptable to patients. With regard to the results of treatment, additional patients should be analysed for a longer period of time.