| 1. |
- Buciuto, Robert
(författare)
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Treatment of unstable trochanteric hip fractures : A clinical, mechanical and radiographic evaluation of the RAB-plate
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The problems associated with the management of proximal femoral fractures gain more attention as the elderly population continue to increase. It has been estimated that the total number of hip fractures in the world will increase from 1.7 million per year in 1990 to 6.3 million per year in 2050 (Cooper et al 1992). Operative treatment of these fractures is a challenge for the orthopaedic surgeon mainly due to poor bone quality, which increases the risk of fixation failure.More than 50% of the total number of hip fractures are extracapsular fractures. Mortality, morbidity and costs as a result of trochanteric fracture are higher than those for a cervical fracture. The consequence is increased resource consumption in the national health-care system. The estimated total cost of treatment increase 3-fold in case of a complication. Therefore, a variety of different devices have been designed in order to decrease the ratio of complications. However, in spite of this, the reported ratio of fixation failure continues be high and may reach 25% following treatment of unstable trochanteric fractures. We evaluated a new type of fixation device, the RAB-plate (Rigidity Augmentation Baixauli), for the treatment of unstable trochanteric hip fractures. The RAB-plate is a fixed 120-degree angle blade-plate with a buttress rod.We performed three clinical trials where 391 unstable trochanteric fractures were stabilised with the RAB-plate or a Sliding Hip Screw (SHS). The results showed a statistically significant lower number of complications in fractures stabilised with the RAB-plate.The fatigue resistance of the RAB-plate was evaluated in a cyclic loading test model. The RAB-plate had a statistically significant higher fatigue strength than two different designs of the SHS.Stability of the fixation and modes of failure were radiographically analysed in a series of 218 unstable trochanteric fractures treated with the RAB-plate or the SHS. The RAB-plate provided a more stable fixation especially with regard to maintained postoperative alignment. However, positive predictors for fixation failure e.g.implant position within the femoral head, varus reduction in anteroposterior projection and screw/neck angle deviation in the lateral projection were identical for both devices.Spontaneous femoral neck fracture after removal of the fixation device in healed unstable trochanteric fractures was investigated in a series of 7 patients. Our results indicate that implant-induced osteoporosis (stress protection) is a possible cause of subsequent fracture.Our conclusions are that the RAB-plate is a safe implant for fixation of unstable trochanteric hip fractures and results in lower incidence of complications compared to SHS. Therefore, the RAB can be recommended for fixation of unstable trochanteric fractures.
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| 2. |
- Jensen, Per, 1956-, et al.
(författare)
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Feather pecking in chickens is genetically related to behavioural and developmental traits.
- 2005
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Ingår i: Physiology & behavior. - : Elsevier BV. - 0031-9384 .- 1873-507X. ; 86:1-2, s. 52-60
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Tidskriftsartikel (refereegranskat)abstract
- Feather pecking (FP) is a detrimental behaviour in chickens, which is performed by only some individuals in a flock. FP was studied in 54 red junglefowl (ancestor of domestic chickens), 36 White Leghorn laying hens, and 762 birds from an F(2)-intercross between these two lines. From all F(2)-birds, growth and feed consumption were measured. Age at sexual maturity and egg production in females, and corticosterone levels in males were also measured. From 333 F(2)-birds of both sexes, and 20 parental birds, body composition with respect to bone mineral content, muscle and fat was obtained by post-mortem examinations using Dual X-Ray Absorptiometry (DXA). In femurs of the same birds, the bone density and structure were analysed using DXA and Peripheral Quantitative Computerized Tomography (pQCT), and a biomechanical analysis of bone strength was performed. Furthermore, plumage condition was determined in all birds as a measure of being exposed to feather pecking. Using 105 DNA-markers in all F(2)-birds, a genome-wide scan for Quantitative Trait Loci (QTL), associated with the behaviour in the F(2)-generation was performed. FP was at least as frequent in the red junglefowl as in the White Leghorn strain studied here, and significantly more common among females both in the parental strains and in the F(2)-generation. In the F(2)-birds, FP was phenotypically linked to early sexual maturation, fast growth, weak bones, and, in males, also high fat accumulation, indicating that feather peckers have a different resource allocation pattern. Behaviourally, F(2) feather peckers were more active in an open field test, in a novel food/novel object test, and in a restraint test, indicating that feather pecking might be genetically linked to a proactive coping strategy. Only one suggestive QTL with a low explanatory value was found on chromosome 3, showing that many genes, each with a small effect, are probably involved in the causation of feather pecking. There were significant effects of sire and dam on the risk of being a victim of feather pecking, and victims grew faster pre- and post-hatching, had lower corticosterone levels and were less active in a restraint test. Hence, a wide array of behavioural and developmental traits were genetically linked to FP.
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| 3. |
- Olofsson, Christina, et al.
(författare)
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A multicenter clinical study of the safety and activity of maleimide-polyethylene glycol-modified Hemoglobin (Hemospan) in patients undergoing major orthopedic surgery.
- 2006
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Ingår i: Anesthesiology. - : Ovid Technologies (Wolters Kluwer Health). - 0003-3022 .- 1528-1175. ; 105:6, s. 1153-63
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hemospan (Sangart Inc., San Diego, CA), a polyethylene glycol-modified hemoglobin with unique oxygen transport properties, has successfully completed a phase I trial in healthy volunteers. Because adverse events are expected to increase with age, the authors conducted a phase II safety study of Hemospan in elderly patients undergoing elective hip arthroplasty during spinal anesthesia. METHODS: Ninety male and female patients, American Society of Anesthesiologists physical status I-III, aged 50-89 yr, in six Swedish academic hospitals were randomly assigned to receive either 250 or 500 ml Hemospan or Ringer's acetate (30 patients/group) before induction of spinal anesthesia. Safety assessment included vital signs and Holter monitoring from infusion to 24 h, evaluation of laboratory values, and fluid balance. The hypothesis to be tested was that the incidence of adverse events would be no more frequent in patients who received Hemospan compared with standard of care (Ringer's acetate). RESULTS: Three serious adverse events were noted, none of which was deemed related to study treatment. Liver enzymes, amylase, and lipase increased transiently in patients in all three groups. There were no significant differences in electrocardiogram or Holter parameters, but there was a suggestion of more bradycardic events in the treated groups. Hypotension was less frequent in the treated patients compared with controls. CONCLUSIONS: In comparison with Ringer's acetate, Hemospan mildly elevates hepatic enzymes and lipase and is associated with less hypotension and more bradycardic events. The absence of a high frequency of serious adverse events suggests that further clinical trials should be undertaken.
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| 4. |
- Rubin, Carl-Johan, et al.
(författare)
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Quantitative Trait Loci for BMD and Bone Strength in an Intercross Between Domestic and Wildtype Chickens
- 2007
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Ingår i: Journal of Bone and Mineral Research. - : Wiley. - 0884-0431 .- 1523-4681. ; 22:3, s. 375-384
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Tidskriftsartikel (refereegranskat)abstract
- With chicken used as a model species, we used QTL analysis to examine the genetic contribution to bone traits. We report the identification of four QTLs for femoral traits: one for bone strength, one for endosteal circumference, and two affecting mineral density of noncortical bone. Introduction: BMD is a highly heritable phenotype, governed by elements at numerous loci. In studies examining the genetic contribution to bone traits, many loci have been identified in humans and in other species. The goal of this study was to identify quantitative trait loci (QTLs) controlling BMD and bone strength in an intercross between wildtype and domestic chickens. Materials and Methods: A set of 164 markers, covering 30 chromosomes (chr.), were used to genotype 337 F 2-individuals from an intercross of domesticated white Leghorn and wildtype red junglefowl chicken. DXA and pQCT were used to measure BMD and bone structure. Three-point bending tests and torsional strength tests were performed to determine the biomechanical strength of the bone. QTLs were mapped using forward selection for loci with significant marginal effects. Results: Four QTLs for femoral bone traits were identified in QTL analysis with body weight included as a covariate. A QTL on chr. 1 affected female noncortical BMD (LOD 4.6) and is syntenic to human 12q21-12q23. Also located on chr. 1, a locus with synteny to human 12q 13-1.4 affected endosteal circumference (LOD 4.6). On chr. 2, a QTL corresponding to human 5p13-p15, 7p12, 18q12, 18q21, and 9q22-9q31 affected BMD in females; noncortical (LOD 4.0) and metaphyseal (LOD 7.0) BMD by pQCT and BMD by DXA (LOD 5.9). A QTL located on chr. 20 (LOD 5.2) affected bone biomechanical strength and had sex-dependent effects. In addition to the significant QTLs, 10 further loci with suggestive linkage to bone traits were identified. Conclusions: Four QTLs were identified: two for noncortical BMD, one for endosteal circumference, and one affecting bone biomechanical strength. The future identification of genes responsible for these QTLs will increase the understanding of vertebrate skeletal biology.
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