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[PMID]:29414988
[Au] Autor:Morgan SJ; McDonald CL; Halsne EG; Cheever SM; Salem R; Kramer PA; Hafner BJ
[Ad] Endereço:Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States of America.
[Ti] Título:Laboratory- and community-based health outcomes in people with transtibial amputation using crossover and energy-storing prosthetic feet: A randomized crossover trial.
[So] Source:PLoS One;13(2):e0189652, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Contemporary prosthetic feet are generally optimized for either daily or high-level activities. Prosthesis users, therefore, often require multiple prostheses to participate in activities that span a range of mobility. Crossover feet (XF) are designed to increase the range of activities that can be performed with a single prosthesis. However, little evidence exists to guide clinical prescription of XF relative to traditional energy storing feet (ESF). The objective of this study was to assess the effects of XF and ESF on health outcomes in people with transtibial amputation. A randomized crossover study was conducted to assess changes in laboratory-based (endurance, perceived exertion, walking performance) and community-based (step activity and self-reported mobility, fatigue, balance confidence, activity restrictions, and satisfaction) outcomes. Twenty-seven participants were fit with XF and ESF prostheses with standardized sockets, interfaces, and suspensions. Participants were not blinded to the intervention, and wore each prosthesis for one month while their steps were counted with an activity monitor. After each accommodation period, participants returned for data collection. Endurance and perceived exertion were measured with the Six-Minute Walk Test and Borg-CR100, respectively. Walking performance was measured using an electronic walkway. Self-reported mobility, fatigue, balance confidence, activity restrictions, and satisfaction were measured with survey instruments. Participants also reported foot preferences upon conclusion of the study. Differences between feet were assessed with a crossover analysis. While using XF, users experienced improvements in most community-based outcomes, including mobility (p = .001), fatigue (p = .001), balance confidence (p = .005), activity restrictions (p = .002), and functional satisfaction (p < .001). Participants also exhibited longer sound side steps in XF compared to ESF (p < .001). Most participants (89%) reported an overall preference for XF; others (11%) reported no preference. Results indicate that XF may be a promising alternative to ESF for people with transtibial amputation who engage in a range of mobility activities. TRIAL REGISTRATION: ClinicalTrials.gov NCT02440711.
[Mh] Termos MeSH primário: Amputação
Membros Artificiais

Próteses e Implantes
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Estudos Cross-Over
Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180208
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189652


  2 / 38517 MEDLINE  
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[PMID]:29377928
[Au] Autor:Büren C; Lögters T; Oezel L; Rommelfanger G; Scholz AO; Windolf J; Windolf CD
[Ad] Endereço:Department for Trauma- and Hand Surgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf Moorenstraße 5, Düsseldorf, Germany.
[Ti] Título:Effect of hyperbaric oxygen therapy (HBO) on implant-associated osteitis in a femur fracture model in mice.
[So] Source:PLoS One;13(1):e0191594, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hyperbaric oxygen therapy (HBO) is applied very successfully in treatment of various diseases such as chronic wounds. It has been already suggested as adjunctive treatment option for osteitis by immune- and fracture modulating effects. This study evaluates the importance of HBO in an early implant-associated localized osteitis caused by Staphylococcus aureus (SA) compared to the standard therapy. In a standardized murine model the left femur of 120 BALB/c mice were osteotomized and fixed by a titanium locking plate. Osteitis has been induced with a defined amount of SA into the fracture gap. Debridément and lavages were progressed on day 7, 14, 28 and 56 to determine the local bacterial growth and the immune reaction. Hyperbaric oxygen (2 ATA, 90%) was applied for 90 minutes on day 7 to 21 for those mice allocated to HBO therapy. To evaluate the effect of HBO therapy the following groups were analyzed: Two sham-groups (12 mice / group) with and without HBO therapy, two osteotomy groups (24 mice / group) with plate osteosynthesis of the femur with and without HBO therapy, and two osteotomy SA infection groups (24 mice / group) with and without HBO therapy. Fracture healing was also quantified on day 7, 14, 28 and 56 by a.p. x-ray and bone healing markers from blood samples. Progression of infection was assessed by estimation of colony-forming units (CFU) and immune response was analyzed by determination of polymorphonuclear neutrophils (PMN), Interleukin (IL) - 6, and the circulating free DNA (cfDNA) in lavage samples. Osteitis induced significantly higher IL-6, cfDNA- and PMN-levels in the lavage samples (on day 7 and 14, each p < 0.05). HBO-therapy did not have a significant influence on the CFU and immune response compared to the standard therapy (each p > 0.05). At the same time HBO-therapy was associated with a delayed bone healing assessed by x-ray radiography and a higher rate of non-union until day 28. In conclusion, osteitis led to significantly higher bacterial count and infection parameters. HBO-therapy neither had a beneficial influence on local infection nor on immune response or fracture healing compared to the standard therapy in an osteitis mouse model.
[Mh] Termos MeSH primário: Modelos Animais de Doenças
Fraturas do Fêmur/fisiopatologia
Oxigenação Hiperbárica
Osteíte/etiologia
Próteses e Implantes
[Mh] Termos MeSH secundário: Animais
Feminino
Fraturas do Fêmur/complicações
Camundongos
Camundongos Endogâmicos BALB C
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191594


  3 / 38517 MEDLINE  
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[PMID]:28460835
[Au] Autor:Madularu D; Kumaragamage C; Mathieu AP; Kulkarni P; Rajah MN; Gratton AP; Near J
[Ad] Endereço:Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; Brain Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada. Electronic address: dan.madularu@gmail.com.
[Ti] Título:A chronic in situ coil system adapted for intracerebral stimulation during MRI in rats.
[So] Source:J Neurosci Methods;284:85-95, 2017 Jun 01.
[Is] ISSN:1872-678X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We describe the fabrication and performance of a chronic in situ coil system designed to allow focal brain stimulation in rats while acquiring functional MRI data. NEW METHOD: An implantable receive-only surface radiofrequency coil (iCoil) was designed to be fitted subcutaneously, directly onto to the rat skull surface during the intracerebral cannulation procedure. The coil is fixed in place using acrylic dental cement anchored to four screws threaded into the skull. To demonstrate the use of this coil system in situ, whole-brain functional MRI scans were acquired during various stimuli, including intracranial microinfusions of bicuculline and morphine in the prefrontal cortex and ventral tegmental area, respectively. RESULTS/COMPARISON TO OTHER METHODS: SNR performance of the iCoil was superior to three commercially-available coils, in some instances by a factor of two. Widespread BOLD activation was observed in response to bicuculline and morphine microinfusions. CONCLUSION: A new approach was demonstrated for high-SNR MR imaging of the brain in rats with intracranial implants using an implantable surface coil. This approach enables mapping the functional response to highly targeted stimuli such as intracranial microinfusions.
[Mh] Termos MeSH primário: Encéfalo/diagnóstico por imagem
Estimulação Encefálica Profunda/instrumentação
Estimulação Encefálica Profunda/veterinária
Bombas de Infusão Implantáveis
Imagem por Ressonância Magnética/instrumentação
Imagem por Ressonância Magnética/veterinária
Microinjeções/veterinária
[Mh] Termos MeSH secundário: Animais
Desenho de Equipamento
Análise de Falha de Equipamento
Masculino
Microinjeções/instrumentação
Próteses e Implantes
Ratos
Ratos Long-Evans
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Transdutores/veterinária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28456893
[Au] Autor:Kanazawa M; Tsuru K; Fukuda N; Sakemi Y; Nakashima Y; Ishikawa K
[Ad] Endereço:Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
[Ti] Título:Evaluation of carbonate apatite blocks fabricated from dicalcium phosphate dihydrate blocks for reconstruction of rabbit femoral and tibial defects.
[So] Source:J Mater Sci Mater Med;28(6):85, 2017 Jun.
[Is] ISSN:1573-4838
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to evaluate in vivo behavior of a carbonate apatite (CO Ap) block fabricated by compositional transformation via a dissolution-precipitation reaction using a calcium hydrogen phosphate dihydrate [DCPD: CaHPO ·2H O] block as a precursor. These blocks were used to reconstruct defects in the femur and tibia of rabbits, using sintered dense hydroxyapatite (HAp) blocks as the control. Both the CO Ap and HAp blocks showed excellent tissue response and good osteoconductivity. HAp block maintained its structure even after 24 weeks of implantation, so no bone replacement of the implant was observed throughout the post-implantation period in either femoral or tibial bone defects. In contrast, CO Ap was resorbed with increasing time after implantation and replaced with new bone. The CO Ap block was resorbed approximately twice as fast at the metaphysis of the proximal tibia than at the epiphysis of the distal femur. The CO Ap block was resorbed at an approximately linear change over time, with complete resorption was estimated by extrapolation of data at approximately 1-1.5 years. Hence, the CO Ap block fabricated in this study has potential value as an ideal artificial bone substitute because of its resorption and subsequent replacement by bone.
[Mh] Termos MeSH primário: Apatitas/química
Substitutos Ósseos
Fosfatos de Cálcio/química
[Mh] Termos MeSH secundário: Animais
Durapatita
Epífises
Fêmur
Próteses e Implantes
Coelhos
Tíbia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Apatites); 0 (Bone Substitutes); 0 (Calcium Phosphates); 55326-60-8 (carboapatite); 91D9GV0Z28 (Durapatite); O7TSZ97GEP (calcium phosphate, dibasic, dihydrate)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE
[do] DOI:10.1007/s10856-017-5896-5


  5 / 38517 MEDLINE  
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[PMID]:28453827
[Au] Autor:Gagliardi AR; Lehoux P; Ducey A; Easty A; Ross S; Bell CM; Trbovich P; Takata J; Urbach DR
[Ad] Endereço:Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, Toronto, M5G2C4, Canada.
[Ti] Título:Factors constraining patient engagement in implantable medical device discussions and decisions: interviews with physicians.
[So] Source:Int J Qual Health Care;29(2):276-282, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: Patient engagement (PE) is warranted when treatment risks and outcomes are uncertain, as is the case for higher risk medical devices. Previous research found that patients were not engaged in discussions or decisions about implantable medical devices. This study explored physician views about engaging patients in such discussions. Design: Qualitative interviews using a basic descriptive approach. Setting: Canada. Participants: Practicing cardiovascular and orthopaedic physicians. Main outcome measures: Level, processes and determinants of PE in medical device discussions and decisions. Results: Views were largely similar among 10 cardiovascular and 12 orthopaedic physicians interviewed. Most said that it was feasible to inform and sometimes involve patients in discussions, but not to partner with them in medical device decision-making. PE was constrained by patient (comfort with PE, technical understanding, physiologic/demographic characteristics, prognosis), physician (device preferences, time), health system (purchasing contracts) and device factors (number of devices on market, comparative advantage). A framework was generated to help physicians engage patients in discussions about medical devices, even when decisions may not be preference sensitive due to multiple constraints on choice. Conclusions: This study identified that patients are not engaged in discussions or decisions about implantable medical devices. This may be due to multiple constraints. Further research should establish the legitimacy, prevalence and impact of constraining factors, and examine whether and how different levels and forms of PE are needed and feasible.
[Mh] Termos MeSH primário: Tomada de Decisões
Participação do Paciente/métodos
Médicos/psicologia
Próteses e Implantes
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Canadá
Cardiologistas/psicologia
Seres Humanos
Cirugiões Ortopédicos/psicologia
Relações Médico-Paciente
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzx013


  6 / 38517 MEDLINE  
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[PMID]:29469558
[Au] Autor:Bourguignon T; Espitalier F; Aupart M
[Ad] Endereço:Tours University Hospital, Tours, France
[Ti] Título:Prosthesis Type for Aortic- and Mitral-Valve Replacement.
[So] Source:N Engl J Med;378(8):777-8, 2018 02 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aorta
Próteses e Implantes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180223
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1716336


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[PMID]:29469559
[Au] Autor:Chikwe J; Blackstone EH; Adams DH
[Ad] Endereço:Icahn School of Medicine at Mount Sinai, New York, NY
[Ti] Título:Prosthesis Type for Aortic- and Mitral-Valve Replacement.
[So] Source:N Engl J Med;378(8):778, 2018 02 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aorta
Próteses e Implantes
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180223
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1716336


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[PMID]:29469557
[Au] Autor:Raza S; Kalra A; Sabik JF
[Ad] Endereço:University Hospitals Cleveland Medical Center, Cleveland, OH
[Ti] Título:Prosthesis Type for Aortic- and Mitral-Valve Replacement.
[So] Source:N Engl J Med;378(8):777, 2018 02 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aorta
Próteses e Implantes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180223
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1716336


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[PMID]:29469556
[Au] Autor:McGregor CGA; Byrne GW
[Ad] Endereço:University College London, London, United Kingdom
[Ti] Título:Prosthesis Type for Aortic- and Mitral-Valve Replacement.
[So] Source:N Engl J Med;378(8):776-7, 2018 02 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aorta
Próteses e Implantes
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180223
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1716336


  10 / 38517 MEDLINE  
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[PMID]:28462423
[Au] Autor:Xie W; Lewis WM; Kaser J; Ross Welch C; Li P; Nelson CA; Kothari V; Terry BS
[Ad] Endereço:Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, W342 Nebraska Hall, Lincoln, NE 68588-0526.
[Ti] Título:Design and Validation of a Biosensor Implantation Capsule Robot.
[So] Source:J Biomech Eng;139(8), 2017 Aug 01.
[Is] ISSN:1528-8951
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We have proposed a long-term, noninvasive, nonrestrictive method of delivering and implanting a biosensor within the body via a swallowable implantation capsule robot (ICR). The design and preliminary validation of the ICR's primary subsystem-the sensor deployment system-is discussed and evidence is provided for major design choices. The purpose of the sensor deployment system is to adhere a small biosensor to the mucosa of the intestine long-term, and the modality was inspired by tapeworms and other organisms that employ a strategy of mechanical adhesion to soft tissue via the combined use of hooks or needles and suckers. Testing was performed to refine the design of the suction and needle attachment as well as the sensor ejection features of the ICR. An experiment was conducted in which needle sharpness, needle length, and vacuum volume were varied, and no statistically significant difference was observed. Finally, preliminary testing, coupled with prior work within a live porcine model, provided evidence that this is a promising approach for implanting a biosensor within the small intestine.
[Mh] Termos MeSH primário: Técnicas Biossensoriais/instrumentação
Próteses e Implantes
Robótica/instrumentação
[Mh] Termos MeSH secundário: Animais
Cápsulas
Desenho de Equipamento
Suínos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Capsules)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1115/1.4036607



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