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| 2. |
- Bojan, Alicja J., 1980, et al.
(författare)
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Three-dimensional bone-implant movements in trochanteric hip fractures. Precision and accuracy of radiostereometric analysis in a phantom model.
- 2015
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Ingår i: Journal of orthopaedic research : official publication of the Orthopaedic Research Society. - : Wiley. - 1554-527X. ; 33:5, s. 705-11
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Tidskriftsartikel (refereegranskat)abstract
- The accuracy and precision of RSA was evaluated in the experimental study of screw cut-out complication after fixation of trochanteric fractures. A plastic bone model of a two-part trochanteric fracture was constructed with a Gamma nail implant incorporating RSA markers. The femoral head fragment was attached to a separate rotational table and the femoral shaft was mounted on the micrometer. Three main motions were simulated: femoral head translation and rotation along the axis of the lag screw and fracture fragment translation along anatomical axes. Accuracy and precision were determined according to ISO 16087 and ASTM standard F2385-04. Translations along the lag screw axis were measured with a precision within±0.14mm and an accuracy within±0.03mm. With simultaneous translations along all three anatomical axes, lowest precision was measured for the x-axis (±0.29mm, 0.07mm respectively), but improved when analyzed as a vector (±0.08mm, 0.03mm). The precision and accuracy of femoral head rotations were within 0.5° and 0.18°, respectively. The resolution of the RSA method tested in this model was high, though it varied depending on the type of analyzed motion. This information is valuable when selecting and interpreting outcome parameters evaluating implant migration and osteosynthesis stability in future clinical RSA studies. This article is protected by copyright. All rights reserved.
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| 3. |
- Jönsson, Bodil, 1959, et al.
(författare)
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Molecular epidemiology of Mycobacterium abscessus, with focus on cystic fibrosis.
- 2007
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Ingår i: Journal of clinical microbiology. - 0095-1137. ; 45:5, s. 1497-504
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Tidskriftsartikel (refereegranskat)abstract
- Mycobacterium abscessus has been isolated increasingly often from the respiratory tracts of cystic fibrosis (CF) patients. It is not known whether these organisms are transmitted from person to person or acquired from environmental sources. Here, colony morphology and pulsed-field gel electrophoresis (PFGE) pattern were examined for 71 isolates of M. abscessus derived from 14 CF patients, three non-CF patients with chronic respiratory M. abscessus infection or colonization, one patient with mastoiditis, and four patients with infected wounds, as well as for six isolates identified as environmental contaminants in various clinical specimens. Contaminants and wound isolates mainly exhibited smooth colony morphology, while a rough colony phenotype was significantly associated with chronic airway colonization (P=0.014). Rough strains may exhibit increased airway-colonizing capacity, the cause of which remains to be determined. Examination by PFGE of consecutive isolates from the same patient showed that they all represented a single strain, even in cases where both smooth and rough isolates were present. When PFGE patterns were compared, it was shown that 24 patients had unique strains, while four patients harbored strains indistinguishable by PFGE. Two of these were siblings with CF. The other two patients, one of whom had CF, had not had contact with each other or with the siblings. Our results show that most patients colonized by M. abscessus in the airways have unique strains, indicating that these strains derive from the environment and that patient-to-patient transmission rarely occurs.
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| 5. |
- Arnoldi, Jörg, et al.
(författare)
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In vivo tissue response to ultrasound assisted application of biodegradable pins into cortical and cancellous bone structures: a histological and densitometric analysis in rabbits.
- 2012
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Ingår i: Journal of biomaterials science. Polymer edition. - 1568-5624. ; 23:5, s. 663-76
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Tidskriftsartikel (refereegranskat)abstract
- In orthopaedic traumatology biodegradable pins are increasingly used for fixation of small bone fragments. In the present study, the ultrasound-assisted anchoring technique (SonicFusion technique), a osteosynthesis method being recently introduced in cranial applications, in which ultrasonic energy is used to insert and anchor polymer pins in bone, was compared with the conventional pin application procedure. The aim of the present study was to assess the short and long term thermal impact of two different ultrasonic energy levels on different bone structures in the distal medial femur of rabbits. The treatment groups consisted of customized polylactide pins applied at a low and a high energy level, the Reference Control and a Negative Control. The thermal effect on bone tissues was evaluated by means of qualitative and semi-quantitative histology and micro-computerized tomography. Five days following surgery, all implant sites showed no tissue damage but normal signs of early ongoing tissue repair. Enhancing the energy level by about 30% had no significant impact on the tissue response. At 4 weeks after surgery test sites covered by ultrasound-aided implantation showed a significantly enhanced bone/implant contact as compared to pins applied by conventional application. In conclusion, the ultrasound assisted anchoring technique not only did not impair bone regeneration, but even improved implant integration.
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| 7. |
- Bojan, Alicja J., 1980, et al.
(författare)
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Critical factors in cut-out complication after gamma nail treatment of proximal femoral fractures.
- 2013
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Ingår i: BMC musculoskeletal disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The most common mechanical failure in the internal fixation of trochanteric hip fractures is the cut-out of the sliding screw through the femoral head. Several factors that influence this complication have been suggested, but there is no consensus as to the relative importance of each factor.The purpose of this study was to analyse the cut-out complication with respect to the following variables: patients' age, fracture type, fracture reduction, implant positioning and implant design. METHODS: 3066 consecutive patients were treated for trochanteric fractures with Gamma Nails between 1990 and 2002 at the Centre de Traumatologie et de l`Orthopedie (CTO), Strasbourg, France. Cut-out complications were identified by reviewing all available case notes and radiographs. Subsequently, the data were analysed by a single reviewer (AJB) with focus on the studied factors. RESULTS: Seventy-one cut-out complications were found (2.3%) of the 3066 trochanteric fractures. Cut-out failure associated with avascular head necrosis, pathologic fracture, deep infection or secondary to prior failure of other implants were excluded from the study (14 cases). The remaining 57 cases (1.85 %, median age 82.6, 79% females) were believed to have a biomechanical explanation for the cut-out failure. 41 patients had a basicervical or complex fracture type. A majority of cut-outs (43 hips, 75%) had a combination of the critical factors studied; non-anatomical reduction, non-optimal lag screw position and the characteristic fracture pattern found. CONCLUSIONS: The primary cut-out rate of 1.85% was low compared with the literature. A typical cut-out complication in our study is represented by an unstable fracture involving the trochanteric and cervical regions or the combination of both, non-anatomical reduction and non-optimal screw position. Surgeons confronted with proximal femoral fractures should carefully scrutinize preoperative radiographs to assess the primary fracture geometry and fracture classification. To reduce the risk of a cut-out it is important to achieve both anatomical reduction and optimal lag screw position as these are the only two factors that can be controlled by the surgeon.
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| 8. |
- Brodin, Anders, et al.
(författare)
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Optimal energy allocation and behaviour in female raptorial birds during the nestling period
- 2003
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Ingår i: Ecoscience. - : University Laval. - 1195-6860. ; 10:2, s. 140-150
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Tidskriftsartikel (refereegranskat)abstract
- In many raptors and owls the male is the main provider of food in the early phase of the nestling period while the female incubates the eggs and broods the young. In the nestling period the female often helps the male to feed the young, but the factors affecting whether and when she leaves the brood to hunt have not been investigated in detail. We present a dynamic state variable model that analyses female behaviour and fat storage dynamics over the nestling period. The results show that in the first half of the nestling period the female faces a conflict between the need to brood the young and the need to hunt to provision them with food. This conflict arises because the energy needs of the young peak early in the nestling period, at a time when they still cannot thermoregulate and therefore need brooding from the female. The most critical period is the second nestling week, when both female and nestling fat reserves will decrease to low levels. Large female fat reserves in the early nestling period provide a solution to this conflict and are essential for successful breeding. Stochasticity in male provisioning is thus not needed to explain why females should be fat when the eggs hatch. Under normal circumstances, the female broods during the first two weeks and leaves the young only if hunting is absolutely necessary. After the second week the energy requirements are relaxed, and whether the female assists the male in hunting or not depends on factors such as male hunting success, environmental stochasticity, and energy requirements of the young. Our model provides a framework for empirical investigations on female behaviour during breeding in raptors, owls, and other birds with marked division of labour.
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| 9. |
- Carlsson, Per-Inge, 1959-, et al.
(författare)
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Severe to profound hearing impairment : quality of life, psychosocial consequences and audiological rehabilitation
- 2014
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Ingår i: Disability and Rehabilitation. - Oxon, United Kingdom : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 37:20, s. 1849-1856
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To study the quality of life (QoL) and psychosocial consequences in terms of sick leave and audiological rehabilitation given to patients with severe to profound hearing impairment.Method: A retrospective study of data on 2319 patients with severe to profound hearing impairment in The Swedish Quality Register of Otorhinolaryngology, followed by a posted questionnaire including The Hospital Anxiety and Depression Scale (HADS). Results: The results indicate greater levels of anxiety and depression among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo had strong negative effects on QoL. The proportion of sick leave differed between the studied dimensions in the study. The proportion of patients who received extended audiological rehabilitation was 38% in the present study. Conclusions: Treatment focused on anxiety, depression, tinnitus and vertigo must be given early in the rehabilitation process in patients with severe or profound hearing impairment. Because sick leave differs greatly within this group of patients, collaboration with the regional Social Insurance Agency is crucial part of the rehabilitation. The study also shows that presently, only a small proportion of patients in Sweden with severe to profound hearing impairment receive extended audiological rehabilitation. Implications for RehabilitationGreater levels of anxiety and depression have been found among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo have strong negative effects on QoL in this group of patients.Only a small proportion of patients with severe to profound hearing impairment receive extended audiological rehabilitation today, including medical, technical and psychosocial efforts.Extended audiological rehabilitation focused on anxiety, depression, tinnitus and vertigo must be given, together with technical rehabilitation, early in the rehabilitation process in patients with severe or profound hearing impairment.
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| 10. |
- Jönsson, Anders, 1959, et al.
(författare)
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Effects of amide local anaesthetics on eicosanoid formation in burned skin.
- 1999
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Ingår i: Acta anaesthesiologica Scandinavica. - 0001-5172. ; 43:6, s. 618-22
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have demonstrated potent inhibition of burn oedema and progressive ischaemia by local anaesthetics. Since eicosanoids have been suggested to play an important role in the pathophysiology of burns, we compared in the present ex vivo study the effects of topical lidocaine/prilocaine cream (EMLA, ASTRA, Sweden) and intravenous lidocaine with that of saline on eicosanoid formation by normal and burned rat skin.
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