Disturbances in Bone Largely Predict Aortic Calcification in an Alternative Rat Model Developed to Study Both Vascular and Bone Pathology in Chronic Kidney Disease

Because current rat models used to study chronic kidney disease (CKD)‐related vascular calcification show consistent but excessive vascular calcification and chaotic, immeasurable, bone mineralization due to excessive bone turnover, they are not suited to study the bone‐vascular axis in one and the same animal. Because vascular calcification and bone mineralization are closely related to each other, an animal model in which both pathologies can be studied concomitantly is highly needed. CKD‐related vascular calcification in rats was induced by a 0.25% adenine/low vitamin K diet. To follow vascular calcification and bone pathology over time, rats were killed at weeks 4, 8, 10, 11, and 12. Both static and dynamic bone parameters were measured. Vascular calcification was quantified by histomorphometry and measurement of the arterial calcium content. Stable, severe CKD was induced along with hyperphosphatemia, hypocalcemia as well as increased serum PTH and FGF23. Calcification in the aorta and peripheral arteries was present from week 8 of CKD onward. Four and 8 weeks after CKD, static and dynamic bone parameters were measurable in all animals, thereby presenting typical features of hyperparathyroid bone disease. Multiple regression analysis showed that the eroded perimeter and mineral apposition rate in the bone were strong predictors for aortic calcification. This rat model presents a stable CKD, moderate vascular calcification, and quantifiable bone pathology after 8 weeks of CKD and is the first model that lends itself to study these main complications simultaneously in CKD in mechanistic and intervention studies. © 2015 American Society for Bone and Mineral Research.     

Computer-assisted surgery as indication of choice: total knee arthroplasty in case of retained hardware or extra-articular deformity

Purpose

The use of traditional cutting guides during knee arthroplasty in some cases could be extremely difficult, if not impossible, because of angular deformities, IM sclerosis, long-stemmed hip implants, or hardware within the femoral canal that cannot be removed. In these difficult cases navigation-assisted knee arthroplasty should be considered as an effective and appealing option.

Methods

We present 14 cases in which ideal mechanical and prosthetic alignment was achieved with different image-free, computer-assisted navigation systems, because of an extra-articular deformity (group A, nine patients) or because of a retained implant or hardware (group B, five patients).

Results

After a mean follow-up of 28 months (range 12–53 months), the average knee score increased overall from a mean of 33 points (range 12–63) to 78 points (range 63–90). The average functional score improved from a mean of 32 points (range 10–65) to 72 points (range 40–90). The postoperative mechanical axis ranged between 3° of varus and 3° of valgus. There was an implant revision in one patient who had a traumatic rupture of medial collateral ligament, which occurred 27 months after the index procedure.

Conclusions

Based on our results we think that the navigation-assisted technique provides an alternative approach to the traditional instrumentation for treating these difficult patients in an effective and less invasive manner.     

Reactions with coumarinohydrazidoyl halides: Synthesis of some new coumarinoyl pyrazole and 1,2,4-traizole derivativies via dipolar cycloaddition reactions

Several new coumarinoyl pyrazole and coumarionyl-1,2,4-triazole derivatives were synthesised via dipolar cycloaddition reactions with 3-coumarinohydraziodoyl halide. Structure were based on elemental analysis and spectral data.     

Thromboembolic complications after total hip arthroplasty

Thromboembolic disorders are worrisome complications following total hip arthroplasty, and the best way to address such complications is by prevention. Several regimens have been advocated to decrease the risk of thromboembolic disorders. A combination of pharmacologic and nonpharmacologic measures helps reduce the incidence of deep venous thrombosis and, hence, pulmonary embolization.     

Aspergillus infection after total knee arthroplasty

The literature includes little information about the treatment protocol for Aspergillus infection after total knee arthroplasty. In this article, we describe the case of a nonimmunocompromised patient who lacked predisposing risk factors and who initially presented with aseptic loosening of a total knee prosthesis that postoperatively had grown Aspergillus niger. Intraoperative culture and frozen-section results for the pseudocapsule were negative. Two days postoperatively, culture results showed heavy growth of A niger. The patient was treated with a 6-week course of amphotericin B followed by oral antifungal therapy. She was doing well and had no symptoms 12 months after surgery.     

Synthesis of substituted 3-hydroxy-1H,5H-pyrido[1,2-a]benzimidazol-1-ones as possible antimicrobial and antineoplastic agents

Syntheses of the title compounds 3 as possible antimicrobial and antineoplastic agents were achieved by reacting the active malonates 1 with the benzimidazoles 2a,b . On the other hand, reaction of 1c,d with 2-methylbenzimidazole (2c) yielded the imidazoquinolinones 4a,b . Four compounds in the series 3 displayed in vitro antibacterial and antifungal activities.     

Syntheses and in vitro antimicrobial activities of thiazolo-[3,2-a]benzimidazol-3(2H)-ones

Taking advantage of the nucleophilic reactivity of the 2-methylene carbon atom in thiazolo[3,2-a]-benzimidazol-3(2H)-one, a number of 2-isatinylidene and 2-arylazo derivatives have been prepared. The novel compounds were subjected to antimicrobial testing.     

Automated sphygmomanometer in spinal cord injured patients during head-up tilt: an evaluation

Fifteen patients with spinal cord injury above T6 who were complete or had sensory sparing only were monitored during head-up tilt to evaluate the clinical application of an indirect blood pressure monitoring device, Vital Signs Measurement System. Comparisons of the machine's auscultatory and oscillometric modes were made to simultaneously auscultated blood pressures obtained by a physician. Mean differences and standard deviations were calculated. The comparison between automatic auscultatory and manual pressures yielded a mean difference and standard deviation of 1.8 mmHg and 4.2 mmHg for systolic, and -0.8 mmHg and 4.9 mmHg for diastolic pressures. The comparison between automatic oscillometric and manual pressures yielded a mean difference and standard deviation of 2.2 mmHg and 7.1 mmHg for systolic, and -12.7 mmHg and 7.5 mmHg for diastolic. All automatically obtained values except oscillometric diastolic pressure indicate machine accuracy suitable for clinical testing when compared to standards set by the Association for the Advancement of Medical Instrumentation for ideal test conditions. Uncontrolled patient or tubing movement, room noise, and the small subject population may have contributed to the less favorable values. This study suggests that the automatic sphygmomanometer tested is capable of clinically acceptable accuracy in a very dynamic setting.