Articles: function.
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Despite the high number of studies evaluating the outcomes following tibial shaft fractures, the literature lacks studies including objective assessment of patients' recovery regarding gait pattern. The purpose of the present study was to evaluate whether gait patterns at 6 and 12 months post-operatively following intramedullary nailing of a tibial shaft fracture are different compared with a healthy reference population. ⋯ In patients treated by intramedullary nailing following a tibial shaft fracture, gait asymmetry accompanied with slower speed and cadence are common during the first 6 months and become normalized compared with a healthy reference population between 6 and 12 months post-operatively.
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The aim of this study was to increase our understanding of the role that spatial qualities of pain (location and extent) play in functioning, among youths with disabilities and chronic pain. ⋯ The findings support the need to take into account pain extent in the assessment and treatment of youths with physical disabilities and chronic pain, call our attention about the need to identify potential risk factors of pain extent, and develop and evaluate the benefits of treatments that could reduce pain extent and target pain at specific sites.
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Platinum-based chemotherapeutic agents, such as cisplatin, are still frequently used for treating various types of cancer. Besides its high effectiveness, cisplatin has several serious side effects. One of the most common side effects is dorsal root ganglion (DRG) neurotoxicity. ⋯ EM and histology showed no evidence of any structural damage, apoptosis or necrosis in DRG cells after cisplatin exposure for 26 days. Furthermore, no nuclear DNA damage in sensory neurons was observed. Here, we provide evidence for a mainly functionally driven induction of neuropathic pain by cisplatin.
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Critical care medicine · Jan 2017
Systemic Adenosine Triphosphate Impairs Neutrophil Chemotaxis and Host Defense in Sepsis.
Sepsis remains an unresolved clinical problem. Therapeutic strategies focusing on inhibition of neutrophils (polymorphonuclear neutrophils) have failed, which indicates that a more detailed understanding of the underlying pathophysiology of sepsis is required. Polymorphonuclear neutrophil activation and chemotaxis require cellular adenosine triphosphate release via pannexin-1 channels that fuel autocrine feedback via purinergic receptors. In the current study, we examined the roles of endogenous and systemic adenosine triphosphate on polymorphonuclear neutrophil activation and host defense in sepsis. ⋯ Systemic adenosine triphosphate impairs polymorphonuclear neutrophil functions by disrupting the endogenous purinergic signaling mechanisms that regulate cell activation and chemotaxis. Removal of systemic adenosine triphosphate improves polymorphonuclear neutrophil function and host defenses, making this a promising new treatment strategy for sepsis.
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Arch Orthop Trauma Surg · Jan 2017
Does a positioning rod or a patient-specific guide result in more natural femoral flexion in the concept of kinematically aligned total knee arthroplasty?
Flexion of the femoral component in 5° increments downsizes the femoral component, decreases the proximal reach and surface area of the trochlea, delays the engagement of the patella during flexion, and is associated with a higher risk of patellar-femoral instability after kinematically aligned TKA. The present study evaluated flexion of the femoral component after use of two kinematic alignment instrumentation systems. We determined whether a distal cutting block attached to a positioning rod inserted perpendicular to the distal femoral joint line in the axial plane and 8-10 cm into the distal femur anterior and posterior to the distal cortex of the femur in the sagittal plane or a femoral patient-specific cutting guide sets the femoral component in more natural flexion. ⋯ Because a distal cutting block attached to a positioning rod sets the femoral component in 5° less flexion and with less variability than a femoral patient-specific cutting guide, we prefer this instrumentation system when performing kinematically aligned TKA to reduce the risk of patellar-femoral instability. Each surgeon should determine the repeatability of setting the flexion of the femoral component with this instrumentation system.