3D printing of porous hydroxyapatite scaffolds intended for use in bone tissue engineering applications.

A systematic characterisation of bone tissue scaffolds fabricated via 3D printing from hydroxyapatite (HA) and poly(vinyl)alcohol (PVOH) composite powders is presented. Flowability of HA:PVOH precursor materials was observed to affect mechanical stability, microstructure and porosity of 3D printed scaffolds. Anisotropic behaviour of constructs and part failure at the boundaries of interlayer bonds was highlighted by compressive strength testing.

Quantitative topographic anatomy of the femoral ACL footprint: a micro-CT analysis.

The femoral footprint of the anterior cruciate ligament (ACL) is a much-studied anatomic structure, predominantly due to its importance during ACL reconstruction surgery. A new technique utilising high-resolution micro-computed tomography (micro-CT) is described, allowing detailed three-dimensional (3D) quantitative analysis of this structure. Seven cadaveric knees were scanned using micro-CT, yielding 3D data with a reconstructed voxel size of 60 μm.

Inconsistency in 9 mm bullets: correlation of jacket thickness to post-impact geometry measured with non-destructive X-ray computed tomography.

Fundamental to any ballistic armour standard is the reference projectile to be defeated. Typically, for certification purposes, a consistent and symmetrical bullet geometry is assumed, however variations in bullet jacket dimensions can have far reaching consequences. Traditionally, characteristics and internal dimensions have been analysed by physically sectioning bullets--an approach which is of restricted scope and which precludes subsequent ballistic assessment.

Functional outcomes of children with index pollicizations for thumb deficiency.

Purpose: To gain a comprehensive perspective on outcomes by performing an array of tests on patients who had undergone index pollicization for isolated thumb aplasia or severe hypoplasia in the absence of clinical radial dysplasia; this led us to create a graphical snapshot for future comparison. Another purpose was to compare the function of the contralateral hand and to compare parent and patient perspectives.

Methods: We evaluated 22 hands (18 patients) by grip as well as lateral and tripod pinch strength tests; the pegboard Functional Dexterity Test (FDT); the Jebsen Hand Function Test (JHFT); and a parent/patient questionnaire.

Hypnosis treatment for chronic low back pain.

Chronic low back pain (CLBP) is a significant healthcare problem, and many individuals with CLBP remain unresponsive to available interventions. Previous research suggests that hypnosis is effective for many chronic pain conditions; however, data to support its efficacy for CLBP are outdated and have been limited primarily to case studies. This pilot study indicated that a brief, 4-session standardized self-hypnosis protocol, combined with psycho-education, significantly and substantially reduced pain intensity and pain interference.

Risk factors and outcomes of fungal ventricular-assist device infections.

Background: Infection is a common complication of ventricular-assist devices (VADs) and is associated with rehospitalization, thromboembolic events, VAD malfunction, delay in heart transplantation, and a high mortality rate. The objectives of this study were to investigate the frequency of fungal VAD infections and assess various risk factors and their effects on mortality as compared with bacterial VAD infections.

Methods: We conducted a retrospective chart review of patients with infected VADs at a single tertiary care center.

Meta-analysis of EEG biofeedback in treating epilepsy.

About one third of patients with epilepsy do not benefit from medical treatment. For these patients electroencephalographic (EEG) biofeedback is a viable alternative. EEG biofeedback, or neurofeedback, normalizes or enhances EEG activity by means of operant conditioning.

Psychiatric consultation with medical evacuees of Hurricane Katrina.

Objective: To study the scope of clinical activities and the postoperational attitudes of mental health professionals responding emergently to a mass urban evacuation.

Methods: Eleven mental health care providers participating in a reception team for medical evacuees after Hurricane Katrina were asked to complete a survey seeking data regarding cases encountered, psychopharmacologic interventions, and mental health support for evacuated medical personnel. Participants rated their levels of agreement with statements characterizing various aspects of the clinical experience.

beta-Blockade in noncardiac surgery: outcome at all levels of cardiac risk.

Hypothesis: We hypothesized that the relationship among beta-blocker use, heart rate control, and perioperative cardiovascular outcome would be similar in patients at all levels of cardiac risk.

Design: Retrospective cohort study.

Setting: Michael E.

A 5-year interval evaluation of function after pollicization for congenital thumb aplasia using multiple outcome measures.

Background: The authors aimed to determine the functional improvement rate over a 5-year interval among patients who had undergone index finger pollicization for isolated thumb absence compared with age-matched controls. They also investigated suggestions in previous reports that tissue remodeling in reconstructed thumbs causes improvements in function outpacing normal development.

Methods: Five patients (seven hands) evaluated 5 years earlier with grip, lateral pinch, and tripod pinch strength tests; the pegboard Functional Dexterity Test; the Jebsen Hand Function Test; standard radiographs; and parent questionnaires on appearance, social interactions, and functionality were reevaluated.

Impact of three-dimensional vision in laparoscopic training.

Background: Simulators are being used to teach laparoscopic skills before residents get to the operating room. It is unknown whether the use of three-dimensional (3D) vision will facilitate laparoscopic training. Therefore, our objective was to compare the effectiveness of using 3D imaging over the traditional two-dimensional (2D) imaging to teach laparoscopic simulator skills to novice individuals and assess whether 3D imaging ameliorates laparoscopic performance for surgeons who have already adapted to working within a 2D surgical environment.

Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy.

Objective: To show fatigue prevention and quality of life (QOL) improvement from cardiovascular exercise during radiotherapy.

Design: Prospective enrollment (n=21), randomized to exercise (n=11) and control groups (n=10), with pre- and post-radiotherapy between- and within-group comparisons.

Setting: Academic medical center.

Coating urinary catheters with an avirulent strain of Escherichia coli as a means to establish asymptomatic colonization.

We investigated whether insertion of urinary catheters that had been coated with Escherichia coli HU2117 could establish bladder colonization with this nonvirulent organism. Ten of 12 subjects were successfully colonized for 14 days or more. The rate of symptomatic UTI during colonization was 0.

Using cranial electrotherapy stimulation to treat pain associated with spinal cord injury.

Treatments for chronic pain in persons with spinal cord injury (SCI) have been less than effective. Cranial electrotherapy stimulation (CES), a noninvasive technique that delivers a microcurrent to the brain via ear clip electrodes, has been shown to effectively treat several neurological and psychiatric disorders. The present study examined the effects of daily 1-hour active CES or sham CES treatment (randomly assigned) for 21 days on pain intensity and interference with activities in 38 males with SCI.

Are patient ratings of chronic pain services related to treatment outcome?

Consumer ratings of satisfaction with treatment are rarely used as measures of treatment outcome. This study examined the relationships between service ratings and psychometric outcomes of patients receiving pain-management services in a tertiary teaching hospital. A group of 122 patients who completed a multidisciplinary pain-management program rated their satisfaction with and effectiveness of services received and changes in their pain condition and quality of life (QOL).

Mortality risk factors in chronic haemodialysis patients with infective endocarditis.

Background: It is well documented that infective endocarditis (IE) is strongly associated with morbidity and mortality in haemodialysis (HD) patients. Less clear are the mortality risk factors for IE, particularly in an urban African-American dialysis population.

Methods: IE patients were identified from the medical records for the period from January 1999 to February 2004 and confirmed by Duke criteria.

Bacterial interference for prevention of urinary tract infection: a prospective, randomized, placebo-controlled, double-blind pilot trial.

This prospective, randomized, placebo-controlled, double-blind pilot trial examined the efficacy of bacterial interference in preventing urinary tract infection (UTI) in 27 patients with spinal cord injury. Patients whose bladders became colonized with Escherichia coli 83972 were half as likely (P=.01) than noncolonized patients to develop UTI during the subsequent year.

Functional outcome for children with thumb aplasia undergoing pollicization.

Background: Hand function is difficult to evaluate in young patients. It is helpful to assess young children after surgery for trauma or congenital anomaly to see how they cope as they progress through their developmental milestones.

Methods: Functional outcome in 10 children (12 upper extremities) who had previous pollicization for a congenitally absent or severely hypoplastic thumb were evaluated by standard radiographs, thumb total active range of motion, grip and pinch strength, parent questionnaire, modified Jebsen functional testing, and a pegboard Functional Dexterity Test.

Longitudinal study of quality of life in patients with localized prostate cancer undergoing radiotherapy.

This study prospectively evaluated quality of life (QOL) in localized prostate cancer patients undergoing radiotherapy, and it examined the relationships between QOL, depression, fatigue, and sleep disturbance. Instruments that were used are Functional Assessment of Cancer Therapy for Prostate (FACT-P), Beck Depression Inventory (BDI), Piper Fatigue Scale (PFS), and Epworth Sleepiness Scale (ESS). We evaluated patients at preradiotherapy (PRT), midway radiotherapy (MRT), completion of radiotherapy (CRT), follow-up radiotherapy (4 to 8 wk) (FRT), and long-term follow-up radiotherapy (FRT2) (12 mo or more).

Alcohol has no effect on hepatitis C virus replication: a meta-analysis.

Background: Patients with chronic hepatitis C virus (HCV) infection who consume large quantities of alcohol have more severe liver disease compared with HCV patients without a history of alcohol consumption. The mechanism by which alcohol worsens HCV related liver disease is not properly understood. One possibility is that alcohol stimulates HCV replication, and the present meta-analysis was performed to examine this issue.

Does resident hours reduction have an impact on surgical outcomes?

Background: We assessed the impact of restricting surgical resident work hours as required by the Accreditation Council for Graduate Medical Education (ACGME), on postoperative outcomes.

Materials And Methods: The divisions of General and Vascular Surgery at the Michael E. DeBakey Houston Veteran Affairs Medical Center implemented a limited work hours schedule effective October 1, 2002.

MRI identifies MCI subtypes: vascular versus neurodegenerative.

As life expectancy increases worldwide, pandemics of cognitive impairment and dementia are emerging as major public health problems. Mild cognitive impairment (MCI), prodromal for dementia, is a descriptive term used for those clinical states showing early and subtle cognitive decline among the elderly, preceding the dementias. Psychometric screening combining Mini-Mental Status (MMSE) and Cognitive Capacity Screening (CCSE) Examinations, when combined now called CMC with C standing for Combined, M for MMSE, and C for CCSE, confirms diagnosis of MCI.