Atlantoaxial fixation using plate and screw method: a report of 160 treated patients

OBJECTIVE: We review our experience with the use of the plate and screw method of fixation in the treatment of 160 patients with atlantoaxial instability during a 14-year period at our center. We previously described this method of fixation in 1994. METHODS: Between 1988 and 2001, 160 patients with atlantoaxial instability were treated with the use of a plate and screw method of fixation at the Department of Neurosurgery at King Edward Memorial Hospital in Bombay, India. The study group was composed of 91 males and 69 females (mean age, 23 yr; age range, 18 mo-79 yr). Atlantoaxial instability was a result of congenital abnormality in 132 patients (83%) and occurred after trauma in 28 patients (17%). All patients had mobile, completely reducible atlantoaxial dislocation. For 3 months postoperatively, a hard cervical collar was used. The mean follow-up period was 42 months (range, 4 mo-14 yr). RESULTS: Three patients died in the postoperative phase. Successful stabilization of the atlantoaxial region was documented with dynamic radiography in the other 157 patients. There was no incidence of implant rejection. In one patient, one screw was found to be broken 18 months after surgery; however, firm bony fusion was documented in this patient. There were no neurological, vascular, or infective complications. CONCLUSION: The plate and screw method of fixation with the use of intra-articular bone grafts in patients with atlantoaxial instability yielded a 100% fusion rate with a low incidence of complications.     

Relationship between years since menopause and lipid variation in postmenopausal women: A cross-sectional study

Lipid alteration in postmenopausal women is commonly due to hormonal changes. This study aimed to explore the association between the years since menopause and lipid profiles in postmenopausal women. In this cross-sectional study, a total of 1033 postmenopausal women were recruited from the Women’s Hospital of Zhejiang University in China between 2015 and 2022. Each participant was interviewed using questionnaires regarding sociodemographic and reproductive data. Anthropometric measurements, lipid profiles, and reproductive hormone levels were assessed. Participants were divided into 3 groups based on the length of time since menopause: 2, 2 to 5.9, and 6 years. Differences in lipid profiles and reproductive hormones among the groups were compared. Logistic and linear regression analyses were used to examine the relationship between years after menopause and lipid profile. High-density lipoprotein cholesterol (HDL-C) and luteinizing hormone levels were significantly lower in postmenopausal women with time since menopause of ≥6 years than those <2 years (P < .05), whereas low-density lipoprotein cholesterol levels were significantly higher (P < .05). A longer time after menopause was independently associated with lower HDL-C levels (β, −0.059, standard error, 0.023, P = .01) after adjustment for age, body mass index, and other confounders. Compared to women who had menopause for <2 years, those who were postmenopausal for >6 years had lower HDL-C levels after adjustment for age, body mass index, and other covariates (β, −0.123, 95% confidence interval, [−0.221, −0.014], P = .014). Longer time since menopause was associated with an atherogenic lipid profile with appreciably low levels of HDL-C subfraction. Future multicenter studies are necessary to examine postmenopausal population and determine how differences in lipids influence the risk of cardiovascular disease in this group.     

Discovery and evaluation of biphenyl derivatives of 2-iminobenzimidazoles as prototype dual PTP1B inhibitors and AMPK activators with in vivo antidiabetic activity

This work describes the synthesis of series hydrobromides of N-(4-biphenyl)methyl–N′-dialkylaminoethyl-2-iminobenzimidazoles, which, due to the presence of two privileged structural fragments (benzimidazole and biphenyl moieties), can be considered as bi-privileged structures. Compound 7a proved to activate AMP-activated kinase (AMPK) and simultaneously inhibit protein tyrosine phosphatase 1B (PTP1B) with similar potency. This renders it an interesting prototype of potential antidiabetic agents with a dual-target mechanism of action. Using prove of concept in vivo study, we show that dual-targeting compound 7a has a disease-modifying effect in a rat model of type 2 diabetes mellitus via improving insulin sensitivity and lipid metabolism.