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Conjunctival flora in anophthalmic patients: microbiological spectrum and antibiotic sensitivity

International Journal of Ophthalmology(English edition) 2019年第5期12卷 765-773页

作者： Alvaro Toribio Teresa Marrodán Isabel Fernández-Natal Honorina Martínez-Blanco Leandro Rodríguez-Aparicio Miguel á.Ferrero Department of Ophthalmology University Hospital of León Department of Clinical Microbiology University Hospital of León Department of Molecular Biology University of León

AIM: To identify the spectrum and susceptibility pattern of isolated microorganisms from conjunctival flora of anophthalmic ***: A cross-sectional clinical study including 60 patients with unilateral anophthalmia. Patients with use of antibiotic drops in their socket during the last month were also included. From each patient, three microbiological samples were taken from the lower conjunctival sac(healthy eye, pre-prosthesis, and retro-prosthesis space of socket). The 180 samples obtained were cultured. Isolates were identified and their antibiotic sensitivities were ***: A total of 251 isolates were recovered(62 isolates from healthy eye, 93 from pre-prosthesis, and 96 from retro-prosthesis space). The most common organism was Staphylococcus epidermidis, in both healthy eyes(64.5%) and sockets(45.5%). Altogether, coagulasepositive Staphylococci, Streptococci, and Gram-negative bacteria accounted for less than 15% of isolates in healthy eyes and more than 35% in sockets. Regarding the antibiotic sensitivities, there were no significant differences between isolates from sockets and healthy eyes. Nine patients recognized the use of self-prescribed antibiotic drops in their socket. In the healthy eyes of these subjects, Gram-positive microorganisms showed significantly greater resistance to aminoglycosides and ***: Sockets of anophthalmic patients show a greater number of pathogens compared to healthy *** use of antibiotic drops in the socket promotes a resistant flora not only in the socket but also in the healthy eye. Quinolones and macrolides may be better therapeutic options than aminoglycosides for treating conjunctivitis of anophthalmic sockets, since these antibiotics are less active against Staphylococcus epidermidis.

关键词： socket ocular prosthesis antibiotic resistance microflora conjunctival dysbiosis

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Prosthodontic management of hemimandibulectomy patients to restore form and function-A case series

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World Journal of Clinical Cases 2017年第10期5卷 384-389页

作者： Deenadayalan Lingeshwar Rajendran Appadurai Ujjayanthi Sswedheni Challa Padmaja Government Royapettah Hospital

Surgical resection of mandible owing to benign,malignant neoplasm,osteoradionecrosis is common. The resection can be total or segmental depending on the lesion. Loss of mandibular continuity causes deviation of remaining mandibular segment towards the resected side and rotation inferiorly due to muscle pull and scar contracture affecting mastication and esthetics. Surgical reconstruction may not be always possible. Prosthetic rehabilitation plays a major role in these patients. This case series describes different types of guiding flange(GF) prosthesis with modifications for three hemimandibulectomy patients at different time interval after surgery. The article details GF prosthesis combined with physiotherapy to correct deviation of mandible thereby improving mastication,esthetics and speech and thus enhancing the quality of life.

关键词： Hemimandibulectomy Mandibular deviation Guiding flange prosthesis Palatal ramp

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Lower limb amputation rehabilitation status in India: A review

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World Journal of Clinical Cases 2023年第30期11卷 7261-7267页

作者： Raktim Swarnakar Shiv Lal Yadav Darshana Surendran Department of Physical Medicine and Rehabilitation All India Institute of Medical SciencesNew Delhi 110029DelhiIndia

Rehabilitation of lower limb amputation in developing countries is quite *** there are basic to highly advanced prostheses available in India,the set-up is still facing difficulties in developing *** management is difficult due to lack of availability of prostheses and reduced affordability among low income *** this review we highlighted the lower limb amputation and prosthetic rehabilitation status in ***,India is advancing well in the rehabilitation field,but further studies are required to provide more evidence and recommendation.

关键词： Amputation Lower limb amputation prosthesis Rehabilitation Lower limb prosthesis Prosthetic rehabilitation

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Priming the tooth surface with chlorhexidine and antibacterial activity of resin cement

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World Journal of Clinical Cases 2013年第8期1卷 249-255页

作者： Monika Saini Yashpal Singh Rishabh Garg Anita Pandey Department of Prosthodontics Subharti Dental CollegeMeerut 250003India Department of Microbiology Subharti Medical CollegeMeerut 250003India

AIM: To evaluate the effect of priming the tooth surface with 2% chlorhexidine gluconate on antibacteria activity of resin cement. METHODS: Ten patients in whom a single missing tooth was present on both the right and left side in the upper or lower arch were selected. Two fixed partia dentures(FPDs) in each patient on the right and left side were planned. Each FPD was assigned either to the control or test group. In the control group, FPD was luted with resin cement and in the test group, the tooth surface was primed with 2% chlorhexidine gluconate before luting with resin cement. Bacteriological samples were collected at base line level, as the patient came to the outpatient department before the start of any treatment, 5 wk prior to cementation of FPD and at 13 wk(8wk after final cementation). Microbiological processing of all samples was done and the results were statistically analyzed. RESULTS: In the test group, a predominance of aerobic/facultative gram positive cocci rod was seen which indicates a healthy periodontal site, whereas in thecontrol group, a predominance of anaerobic gram negative rods was present which indicates an unhealthy periodontal condition. This is evident by the fact that the anaerobic bacteria percentage in the control sample is 57% and 15% in the test sample after 13 wk, whereas the aerobic/facultative bacteria percentage is 43% in the control sample and 85% in the test sample after 13 wk. The percentage of gram negative bacteria in the control sample is 61% and in the test sample is 20% after 13 wk, whereas the percentage of gram positive bacteria in the control sample is 39% and in the test sample is 80% after 13 wk. The shift from anaerobic gram negative bacteria to aerobic gram positive bacteria is clearly seen from the control to test sample after 13 wk. CONCLUSION: The present study demonstrated that priming the tooth surface with 2% chlorhexidine gluconate may enhance antibacterial activity of the resin cement.

关键词： Fixed prosthesis Antibacterial activity Chlorhexidine Periodontitis Resin cement

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Elastic resistance of the spine:Why does motion preservation surgery almost fail?

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World Journal of Clinical Cases 2013年第4期1卷 134-139页

作者： Alessandro Landi Department of Neurology and Psychiatry Division of Neurosurgery University of Rome "Sapienza" 00181 Rome Italy

Single metamere motility should not be interpreted merely as a movement on the 3 planes but also,and above all,as elastic resistance to dynamic stress on these 3 *** the light of this consideration,the aim of motion preservation is to neutralize excessive movements while preserving the physiological biomechanical properties of the metamere involved to interrupt the progression of degenerative processes and to prevent adjacent segment *** the fact that a myriad of devices have been developed with the purpose of achieving dynamic neutralization of the spine,there are now some doubts regarding the true efficacy of these devices.

关键词： Elastic resistance Disc prosthesis Dynamic implant Interspinous device Biomechanics

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Finite element analysis of stress distribution of obturator prostheses for acquired unilateral maxillary defects

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Journal of Central South University of Technology 2005年第z1期12卷 365-368页

作者： FENG Yun-zhi FENG Hai-lan WU Han-jiang Department of Stomatology the Second Xiangya Hospital Central South University Changsha 410011 China Department of Prosthodontics School of Stomatology Peking University Beijing 100081 China Department of Stomatology the Second Xiangya Hospital Central South University Changsha 410011 China

Objective To assess stresses produced by different obturator prostheses. Methods Three-dimensional finite clement models of unilateral maxillary defects rehabilitated with different obturators were constructed. The different stresses were analyzed by three-dimensional finite element method under different load angle. Results The Von Mises stress values obtained for the remaining tissues adjacent to defect cavity were higher when rehabilitated by inferior hollow obturator in comparison with by superior hollow obturator. The maximum of Von Mises were higher when rehabilitated by resilient hollow obturator than by rigid hollow obturator. It was also observed that in the rigid type stress distribution contours formed in the remaining tissues adjacent to defect cavity, while in resilient hollow obturator prostheses the stress distributed mainly in the prosthesis itself. The oblique load shows the most maximum of Von Mises among all types of obturator prostheses. Conclusions A high lateral wall of an obturator may be more better in preserving the remaining structures than a shorter prosthesis lateral wall. A soft liner may be incorporated to reduce the pain of the residual maxillary structures and mucosa. When load on defect, higher stress would be generated to the residual maxillary structures. The adjustment of occlusual relationship is very important.

关键词： maxillary defect obturator prosthesis 3-dimention finite element stress

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Applications of finite element simulation in orthopedic and trauma surgery

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World Journal of Orthopedics 2012年第4期3卷 25-41页

作者： Antonio Herrera Elena Ibarz José Cego?ino Antonio Lobo-Escolar Sergio Puértolas Enrique López Jesús Mateo Luis Gracia Department of Orthopaedic and Trauma Surgery Miguel Servet University HospitalMedicine SchoolUniversity of Zaragoza Department of Mechanical Engineering University of Zaragoza

Research in different areas of orthopedic and trauma surgery requires a methodology that allows both a more economic approach and the ability to reproduce different situations in an easy way. Simulation models have been introduced recently in bioengineering and could become an essential tool in the study of any physiological unity, regardless of its complexity. The main problem in modeling with finite elements simulation is to achieve an accurate reproduction of the anatomy and a perfect correlation of the different structures, in any region of the human body. Authors have developed a mixed technique, joining the use of a three-dimensional laser scanner Roland Picza captured together with computed tomography(CT) and 3D CT images, to achieve a perfect reproduction of the anatomy. Finite element(FE) simulation lets us know the biomechanical changes that take place after hipprostheses or osteosynthesis implantation and biological responses of bone to biomechanical changes. The simulation models are able to predict changes in bone stress distribution around the implant, so allowing preventing future pathologies. The development of a FE model of lumbar spine is another interesting application of the simulation. The model allows research on the lumbar spine, not only in physiological conditions but also simulating different load conditions, to assess the impact on biomechanics. Different degrees of disc degeneration can also be simulated to determine the impact on adjacent anatomical elements. Finally, FE models may be useful to test different fixation systems, i.e., pedicular screws, interbody devices or rigid fixations compared with the dynamic ones. We have also developed models of lumbar spine and hip joint to predict the occurrence of osteoporotic fractures, based on densitometric determinations and specific biomechanical models, including approaches from damage and fracture mechanics. FE simulations also allow us to predict the behavior of orthopedic splints applied

关键词： Finite element simulation Hip prosthesis Lumbar spine Lumbar fixations Osteoporotic fractures Splints

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Hip hemi-arthroplasty for neck of femur fracture:What is the current evidence?

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World Journal of Orthopedics 2018年第11期9卷 235-244页

作者： Greg AJ Robertson Alexander M Wood Edinburgh Orthopaedic Trauma Unit Royal Infirmary of Edinburgh Orthopaedic Department Leeds General Infirmary

This editorial reviews and summarises the current evidence(meta-analyses and Cochrane reviews) relating to the use of hip hemi-arthroplasty for neck of femur fractures. Regarding the optimal surgical approach,two recent meta-analyses have found that posterior approaches are associated with: higher rates of dislocation compared to lateral and anterior approaches; and higher rates of re-operation compared to lateral approaches. Posterior approaches should therefore be avoided when performing hip hemi-arthroplasty procedures. Assessing the optimal prosthesis head component,three recent meta-analyses and one Cochrane review have found that while unipolar hemiarthroplasty can be associated with increased rates of acetabular erosion at short-term follow-up(up to 1 year),there is no significant difference between the unipolar hemi-arthroplasty and bipolar hemi-arthroplasty for surgical outcome,complication profile,functional outcome and acetabular erosion rates at longer-term follow-up(2 to 4 years). With bipolar hemi-arthroplasty being the more expensive prosthesis,unipolar hemi-arthroplasty is the recommended option. With regards to the optimal femoral stem insertion technique,three recent metaanalyses and one Cochrane Review have found that,while cemented hip hemi-arthroplasties are associated with a longer operative time compared to uncemented Hip Hemi-arthroplasties,cemented prostheses have lower rates of implant-related complications(particularly peri-prosthetic femoral fracture) and improved postoperative outcome regarding residual thigh pain and mobility. With no significant difference found between the two techniques for medical complications and mortality,cemented hip hemi-arthroplasty would appear to be the superior technique. On the topic of wound closure,one recent meta-analysis has found that,while staples can result in a quicker closure time,there is no significant difference in post-operative infections rates or wound healing outcomes when comparing staples

关键词： Hemi-arthroplasty prosthesis Stem Head Hip Femoral Neck Fracture Cement

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Essential neural anatomy for creating a clinically translatable osseointegrated neural interface for prosthetic control in sheep

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Plastic and Aesthetic Research 2023年第1期10卷 600-614页

作者： Kirsten A.Gunderson Scott K.Odorico Zeeda H.Nkana Lucas Sears Grant Seils Rashea L.Minor Weifeng Zeng Samuel O.Poore Aaron M.Dingle Division of Plastic Surgery University of Wisconsin School of Medicine and Public HealthMadisonWI 53792USA University of Wisconsin-Madison School of Veterinary Medicine MadisonWI 53706USA

Aim:Ovine models for osseointegrated prosthetics research are well established,but do not consider neural control of advanced *** validity of interfacing technologies,such as the Osseointegrated Neural Interface(ONI),in their ability to provide communication between native nerves and advanced prosthetics is required,necessitating a stable,longitudinal large animal model for *** objective of this study is to provide a detailed anatomic description of the major nerves distal to the carpal and tarsal joints,informing the creation of a chronic ONI for prosthetic control in ***:Six pelvic and six thoracic cadaveric limbs from mature female,non-lactating sheep were *** were obtained to determine average bone length,medullary canal diameter,and cortical bone *** dissection was performed to discern topographical neuroanatomy and average circumferences of the major nerves of the pelvic and thoracic *** analysis was performed.A surgical approach for the creation of ONI was ***:Average metacarpal and metatarsal length was 15.0 cm(±0.0)and 19.7 cm(±1.0),*** intramedullary canal diameter was 12.91 mm(±3.69)for forelimbs and 12.60 mm(±3.69)for *** thoracic limb nerves consisted of one dorsal and three ventral nerves,with an average circumference of 5.14 mm(±2.00)and 5.05 mm(±1.06),*** limb nerves consisted of two dorsal and one ventral nerve with an average circumference of 6.27 mm(±1.79)and 5.40 mm(±0.53),***:These anatomic data inform the surgical approach and manufacture of a sensory ONI for chronic testing in awake,freely ambulating animals for future clinical translation.

关键词： Amputation prosthesis prostheses neural interface clinical translation large animal osseointegration neuroprosthesis

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Overweight and obesity in hip and knee arthroplasty:Evaluation of 6078 cases

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World Journal of Orthopedics 2015年第1期6卷 137-144页

作者： Daniel Guenther Stefan Schmidl Till O Klatte Harald K Widhalm Mohamed Omar Christian Krettek Thorsten Gehrke Daniel Kendoff Carl Haasper Orthopaedic Department Helios-Endo Klinik Hamburg Trauma Department Hannover Medical School (MHH) Department of Trauma Handand Reconstructive SurgeryUniversity Medical Center Hamburg-Eppendorf Department of Trauma Surgery Medical University of Vienna

AIM: To evaluate a possible association between thevarious levels of obesity and peri-operative characteristics of the procedure in patients who underwent endoprosthetic joint replacement in hip and knee joints. METHODS: We hypothesized that obese patients were treated for later stage of osteoarthritis, that more conservative implants were used, and the intraand perioperative complications increased for such patients. We evaluated all patients with body mass index(BMI) ≥ 25 who were treated in our institution from January 2011 to September 2013 for a primary total hip arthroplasty(THA) or total knee arthroplasty(TKA). Patients were split up by the levels of obesity according to the classification of the World Health Organization. Average age at the time of primary arthroplasty, preoperative Harris Hip Score(HHS), Hospital for Special Surgery score(HSS), gender, type of implanted prosthesis, and intra-and postoperative complications were ***: Six thousand and seventy-eight patients with a BMI ≥ 25 were treated with a primary THA or TKA. Age decreased significantly(P < 0.001) by increasing obesity in both the THA and TKA. HHS and HSS were at significantly lower levels at the time of treatment in the super-obese population(P < 0.001). Distribution patterns of the type of endoprostheses used changed with an increasing BMI. Peri- and postoperative complications were similar in form and quantity to those of the normal population. CONCLUSION: Higher BMI leads to endoprosthetic treatment in younger age, which is carried out at significantly lower levels of preoperative joint function.

关键词： Adiposity Total knee arthroplasty Total hip arthroplasty Obesity Overweight prosthesis

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