Medial Reefing Without Lateral Release for Recurrent Patellar Instability

Background: There is no consensus on the optimal surgical technique for recurrent patellofemoral instability. Despite many different surgical procedures discussed in the literature, there are few studies with long-term outcomes. Hypothesis/Purpose: The purpose of this study was to compare subjective and objective preoperative data from patients with recurrent patellar instability and normal alignment to midterm and long-term outcomes after an arthroscopically assisted medial reefing technique. The hypothesis was that the previously reported successful outcomes at 60 months would be well maintained over time. Study Design: Case series; Level of evidence, 4. Methods: A total of 19 patients (20 knees) with recurrent patellar instability and normal bony anatomy underwent arthroscopically assisted medial reefing without lateral release. They were evaluated preoperatively and then at midterm (average, 63 months) and long-term (average, 142 months) follow-ups. Patients underwent a history assessment, physical examination, and radiographic evaluation. Outcomes evaluated included Lysholm and Tegner scores, subjective data, and examination and radiographic findings. Operative reports were reviewed for the presence of chondral lesions. Comparative statistics were utilized ( P &lt; .05). Results: All patients were satisfied with their surgery results and would undergo the procedure again. There was 1 recurrent subluxation and no recurrent dislocations. Subjective symptom scores demonstrated significant improvement from preoperative to midterm and long-term follow-ups for pain, instability, and swelling. Both Lysholm and Tegner scores improved significantly from preoperative to midterm and long-term follow-ups. At long-term follow-up, 70% of the patients reported excellent or good results, 5 patients reported fair results, and 1 patient reported a poor result. However, Tegner activity scores decreased significantly from midterm to long-term follow-ups. Significant improvement from preoperative to midterm and long-term follow-ups was demonstrated in physical examination findings including decreases in patellar apprehension and patellar quadrant glide; however, there was no significant difference in retropatellar pain or range of motion. For radiographic measurements, the lateral patellofemoral angle was significantly improved from preoperative to midterm and long-term follow-ups. At long-term radiographic analysis, 5 knees (25%) had narrowing of the patellofemoral joint space, 10 knees (50%) revealed patellofemoral osteophytes, and 7 knees (35%) demonstrated a medial ossicle. The presence of preoperative chondral lesions resulted in significantly lower Lysholm and Tegner scores and increased findings of osteoarthritis at long-term follow-up. Conclusion: Arthroscopically assisted medial reefing, without lateral release, is an effective long-term treatment for patients with recurrent patellar instability and normal bony anatomy. </jats:sec

Toxic Gas Sensors and Biosensors

Используемые программы Adobe AcrobatКнига посвящена новым сенсорным материалам и их применению в окружающей среде и здравоохранении, таким как обнаружение NO2, токсичных газов и биосенсор, определение гидразина, определение уровня глюкозы и обнаружение токсинов и загрязняющих веществ на поверхностях. Рассматриваемые материалы включают каталитические наноматериалы, оксиды металлов, перовскиты, цеолиты, шпинели, газовые сенсоры на основе графена, нанокомпозиты CNT/Ni, биосенсоры глюкозы, однослойные и многослойно уложенные MXenes, черный фосфор, дихалькогениды переходных металлов и тонкие пленки P3OT.The book focuses on novel sensor materials and their environmental and healthcare applications, such as NO2 detection, toxic gas and biosensing, hydrazine determination, glucose sensing and the detection of toxins and pollutants on surfaces. Materials covered include catalytic nanomaterials, metal oxides, perovskites, zeolites, spinels, graphene-based gas sensors, CNT/Ni nanocomposites, glucose biosensors, single and multi-layered stacked MXenes, black phosphorus, transition metal dichalcogenides and P3OT thin films

Effect of MWCNTs on Improvement of Fracture Toughness of Spark Plasma Sintered SiC Nano-Composites

Background: Silicon carbide (SiC) ceramics are promising engineering material due to its phenomenal properties, such as strong corrosion resistance, high-temperature hardness, wear resistance, high thermal conductivity and high stability in aggressive environment. The key problem of SiC is low fracture toughness due to its brittle nature and to circumvent this, herein high ductile material like MWCNT was used as reinforcement by different proportions. Methods: Nanocrystalline powdered Silicon Carbide (SiC) of particle size of 40 nm and x % weight ratio of SiC (x = 95%, 90% and 85%) + y % weight ratio of multiwalled carbon nanotubes (MWCNTs) of particle size of 20 nm (y= 5%, 10% and 15%) composites were ball milled and fabricated using spark plasma sintering process with temperature rate of 100 oC/min and external pressure of 50 MPa. The sintered samples were tested according to ASTM standards to verify the mechanical properties of the samples. Further, lattice strain, crystalline size was determined by XRD and crack bridging mechanism was studied by FESEM. Results: It was observed that the uniform distributions of MWCNTs were achieved through ultrasonication and ball milling processes, which play a predominant role in increasing fracture toughness. The fracture toughness of the composite improves drastically from 3.71 MPa m1/2 (100% SiC) to 10.21 MPa m1/2 (85% SiC-15% MWCNT). The theoretical and relative densities of the materials were gradually reduced due to the increase in MWCNTs which is due to the lower density of the reinforcement material and an increase in porosity of the samples. Conclusion: The MWCNTs act as a bridging aid in sintered samples, FESEM image signifies some pull-outs and crack branching mechanism of MWCNTs which is the reason for increase in the fracture toughness of SiC. </jats:sec

The Effectiveness of SGLT2 Inhibitors in CKD Patients

Sodium-glucose cotransporter-2 inhibitors, often known as SGLT2Is, are a class of medications used largely for anti-diabetic activity in oral dose form that lowers blood glucose levels. In recent years, numerous trials have documented the use of medications for conditions including renal and cardiovascular illness that go beyond only decreasing blood sugar. Other benefits of SGLT2Is' glucose-lowering activities include slowing or halting the progression of chronic kidney disease, lowering estimated glomerular filtration rate, lowering albuminuria, improving renal and cardiovascular health, and reducing estimated glomerular filtration rate. Published clinical trials reported all of these SGLT2I effects. The studies that we reviewed for this article are the Canagliflozin CardioVascular Assessment Study (CANVAS), Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE), Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA - CKD) trial, Effects of SGLT2I dapagliflozin on Proteinuria in Non-Diabetic Patients with The clinical studies, SGPLT2I class of medications, and their impact on cardiovascular and renal illnesses in diabetic and non-diabetic individuals are adequately covered in this review study. Keywords: SGLT2Is, Chronic kidney disease, dapagliflozin, Canagliflozi

Genetic analysis of SRD5A2 gene in Indian patients with 5 alpha reductase deficiency

Background. 5a-Reductase deficiency (5RD) is uncommon autosomal recessive disorder of sexual differentiation. It results from impaired conversion of testosterone to dihydrotestosterone due to mutations in the steroid 5a-reductase type 2 gene (SRD5A2). Mutations in SRD5A2 have not been previously reported in Indian patients with 5RD. Aim: To delineate the clinical features and mutations in the SRD5A2 gene in Indian patients with 5RD. Patients and Methods: The SRD5A2 gene was sequenced in two unrelated patients with elevated testosterone/dihydrotestosterone ratio and in one patient with classical clinical features and virilization at puberty (in whom the ratio could not be measured due to prior gonadectomy). The prevalence of SRD5A2 mutations was also studied in 52 healthy ethnic control subjects by PCR-RFLP. Results: Two patients, both from the north Indian state of Uttar Pradesh, carried the homozygous missense mutation p.R246Q in exon 5. Parents of both probands were heterozygous for the mutation. The mutation was absent in 52 control subjects. The third patient, with severe perineoscrotal hypospadias and micropenis, was detected to have a novel heterozygous missense mutation p.Q56H, as well as the homozygous polymbrohism, p.V89L, both in exon 1. The p.Q56H, mutation was absent in 52 control subjects. Conclusion: p.R246Q is a common SRD5A2 mutation in 5RD patients from the Indian subcontinent. © Freund Publishing House Ltd