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111.
Ashish D Diwan Anthony Leong Richard Appleyard Divya Bhargav Zhi Ming Fang Aiqun Wei 《Indian Journal of Orthopaedics》2013,47(6):540-546
Background:
Osteoporosis is characterized by low bone mass, bone fragility and increased susceptibility to fracture. Fracture healing in osteoporosis is delayed and rates of implant failure are high with few biological treatment options available. This study aimed to determine whether a single dose of bone morphogenetic protein-7 (BMP-7) in a collagen/carboxy-methyl cellulose (CMC) composite enhanced fracture healing in an osteoporotic rat model.Materials and Methods:
An open femoral midshaft osteotomy was performed in female rats 3 months post-ovarectomy. Rats were randomized to receive either BMP-7 composite (n = 30) or composite alone (n = 30) at the fracture site during surgery. Thereafter calluses were collected on days 12, 20 and 31. Callus cross-sectional area, bone mineral density, biomechanical stiffness and maximum torque, radiographic bony union and histological callus maturity were evaluated at each time point.Results:
There were statistically significant increases in bone mineral density and callus cross-section area at all time points in the BMP-7 group as compared to controls and biomechanical readings showed stronger bones at day 31 in the BMP-7 group. Histological and radiographic evaluation indicated significant acceleration of bony union in the BMP-7 group as compared to controls.Conclusion:
This study demonstrated that BMP-7 accelerates fracture healing in an oestrogen-deficient environment in a rat femoral fracture healing model to scientific relevance level I. The use of BMP-7 composite could offer orthopedic surgeons an advantage over oestrogen therapy, enhancing osteoporotic fracture healing with a single, locally applied dose at the time of surgery, potentially overcoming delays in healing caused by the osteoporotic state. 相似文献112.
Javahir A Pachore Vikram I Shah Ashish N Sheth Kalpesh P Shah Dhiraj P Marothi Rahul Puri 《Indian Journal of Orthopaedics》2013,47(6):572-577
Background:
Failed intertrochanteric fractures in elderly patients are surgical challenge with limited options. Hip arthroplasty is a good salvage procedure even though it involves technical issues such as implant removal, bone loss, poor bone quality, trochanteric nonunion and difficulty of surgical exposure.Materials and Methods:
30 patients of failed intertrochanteric fractures where hip arthroplasty was done between May 2008 and December 2011 were included in study. 13 were males and 17 were females with average age of 67.3 years. There were 2 cemented bipolar arthroplasties, 19 uncemented bipolar, 4 cemented total hip arthroplasty and 5 uncemented total hip arthroplasties. 16 patients had a trochanteric nonunion, which was treated by tension band principles. Total hip was considered where there was acetabular damage due to the penetration of implant.Results:
The average followup was 20 months (range 6-48 months). Patients were followed up from 6 to 48 months with average followup of 20 months. None of the patients were lost to followup. There was no dislocation. All patients were ambulatory at the final followup.Conclusion:
A predictable functional outcome can be achieved by hip arthroplasty in elderly patients with failed intertrochanteric fractures. Though technically demanding, properly performed hip arthroplasty can be a good salvage option for this patient group. 相似文献113.
Ashish Khandelwal Preeti Gupta Ankur Gupta Vivek Virmani 《International urology and nephrology》2013,45(1):285-288
Mucormycosis is associated with a variety of immunocompromised hematological conditions, especially hematological malignancies. The common presentations include rhino-cerebral, pulmonary and disseminated types. However, occurrence of renal mucormycosis in aplastic anemia is rare. We describe the case of a 20-year-old man with such a rare association. 相似文献
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115.
Rothberg MB Steele JR Wheeler J Arora A Priya A Lindenauer PK 《Journal of general internal medicine》2012,27(2):185-189
BACKGROUND
Quality care depends on effective communication between caregivers, but it is unknown whether time spent communicating is associated with communication outcomes. 相似文献116.
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Bertrand Moal Frank Schwab Jason Demakakos Renaud Lafage Paul Riviere Ashish Patel Virginie Lafage 《European spine journal》2013,22(8):1800-1809