Core decompression for early-stage avascular necrosis of the humeral head: current concepts and techniques

Michael D. Scheidt,Saleh Aiyash,Dane Salazar,Nickolas Garbis 대한견주관절의학회 2023 대한견주관절의학회지 Vol.26 No.2

Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

The impact of modern airport security protocols on patients with total shoulder replacements

Michael D. Scheidt,Neal Sethi,Ballard Matthew,Michael Wesolowski,Dane Salazar,Nickolas Garbis 대한견주관절학회 2023 대한견주관절의학회지 Vol.26 No.4

Background: Advancements in airport screening measures in response to 9/11 have resulted in increased false alarm rates for patients with orthopedic and metal implants. With the implementation of millimeter-wave scanning technology, it is important to assess the changes in airport screening experiences of patients who underwent total shoulder arthroplasty (TSA). Methods: Here, 197 patients with prior anatomic and reverse TSA completed between 2013 and 2020 responded to a questionnaire regarding their experiences with airport travel screening after their operation. Of these patients, 86 (44%) stated that they had traveled by plane, while 111 (56%) had not. The questionnaire addressed several measures including the number of domestic and international flights following the operation, number of false alarm screenings by the millimeter-wave scanner, patient body habitus, and presence of additional metal implants. Results: A total of 53 patients (62%) responded “yes” to false screening alarms due to shoulder arthroplasty. The odds of a false screening alarm for patients with other metal implants was 5.87 times that of a false screening alarm for patients with no other metal implants (P<0.1). Of a reported 662 flights, 303 (45.8%) resulted in false screening alarms. Greater body mass index was not significantly lower in patients who experienced false screening alarms (P=0.30). Conclusions: Patients with anatomic and reverse TSA trigger false alarms with millimeter-wave scanners during airport screening at rates consistent with prior reports following 9/11. Patient education on the possibility of false alarms during airport screening is important until improvements in implant identification are made. Level of evidence: IV.

Characterization of Tifton 85 bermudagrass haylage with different layers of polyethylene film and storage time

Nath, Caroline Daiane,Neres, Marcela Abbado,Scheidt, Kacia Carine,Bersot, Luciano dos Santos,Sunahara, Samantha Mariana Monteiro,Sarto, Jaqueline Rocha Wobeto,Stangarlin, Jose Renato,Gomes, Simone Dam Asian Australasian Association of Animal Productio 2018 Animal Bioscience Vol.31 No.8

Objective: The objective was to characterize the fermentative and microbiological profile of Tifton 85 bermudagrass haylage with different layers of polyethylene film and storage time. Methods: The experimental design consisted of a randomized block design with four and six wrapping layers (100 and 150 microns in total. respectively) allocated in the main plots, through repeated measures analysis (30, 60, and 90 days of storage) with four replicates. Results: The storage time and number of wrapping layers did not show changes in the population of Clostridium and lactic acid bacteria. A decrease was observed in the enterobacteria population with an increase in the storage period in the two wrapping layers studied. Upon opening of the haylage at 30 days, the population of Bacillus was lower in haylages made with six layers of wrapping (3.63 log colony forming units/g). No growth of Listeria sp. or Salmonella sp. was observed during the experimental period. The fungal genera with a greater occurrence were Penicillium sp. and Fusarium sp. The following mycotoxins were not detected: ochratoxin A, fumonisins, and zearalenone. Relative to the organic butyric, propionic, and acetic acids, the haylages presented a low concentration of lactic acid; this may have prevented a drop in the pH, which was high when the silos were opened (5.4). The levels of ammoniacal nitrogen and soluble carbohydrates presented no variation among the number of wrapping layers, with an overall average of 35.55 and 38.04 g/kg. Conclusion: Tifton 85 bermudagrass haylage wrapped with four and six layers presented adequate fermentation and microbiological characteristics in the evaluated periods.

Fully Automated Transcranial Doppler Ultrasound for Middle Cerebral Artery Insonation

Michael J. O’Brien,Amber Y. Dorn,Mina Ranjbaran,Zhaojun Nie,Mateo Scheidt,Nasim Mirnateghi,Shankar Radhakrishnan,Robert B. Hamilton 대한신경초음파학회 2022 대한신경초음파학회지 (JNN) Vol.14 No.1

Background: Transcranial Doppler ultrasound (TCD) is utilized in the assessment of neurological conditions in clinical environments such as the intensive care unit and emergency department. However, obstacles for widespread use of TCD include a lack of trained registered vascular technologists (RVT) and operator variability. We present a study comparing RVT and a fully automated robotic TCD system (NovaGuide rTCD) for insonation of the middle cerebral artery (MCA). Methods: A trained RVT and rTCD sequentially collected bilateral MCA cerebral blood flow velocity (CBFV) from 86 healthy subjects. Mean CBFV (mCBFV) and the signal quality assessment (SQA) acquired manually by RVT and autonomously via rTCD were compared. Comparison metrics evaluated include mean accuracy ratio (MAR), and Bland-Altman mean-difference (MD) between rTCD and RVT with paired t-Test for significance. Bootstrapping was used in the accuracy ratio and mean-time to best signal computations to establish 95% confidence intervals. Results: The mCBFVs and SQAs found by rTCD compared to RVT had MAR of 99.7% (97.7-101.7%) and 102.7% (101.1-104.8%), respectively. The rTCD mean-time to best-quality signal was 0.87 min (0.71-1.05) (RVT was not timed). The mean-difference scores for mCBFV and SQA were MD=-0.43cm/s (p=0.053) and MD=-0.36 (p=0.61), respectively. The rTCD had a 3.5% no-window failure rate compared to RVT no-window rate of 4.1%. Conclusion: Comparison of bilateral TCD signals collected by rTCD and RVT demonstrated equivalence in mCBFV and signal quality, suggesting rTCD’s potential to expand utility of TCD in clinical settings that are resource-limited.

Antimicrobial Activity of Polymeric Microfibers Containing Coix Lacryma-Jobi Extract

Gabriela Lauer Breitenbach,Marina Giombelli Rosenberger,Andressa Giombelli Rosenberger,Josiane Caetano,Michelly Cristina Galdioli Pellá,Desirée Tamara Scheidt,Cleide Viviane Buzanello Martins,Edvani C 한국고분자학회 2020 Macromolecular Research Vol.28 No.9

Wound dressings are based on the creation of ideal environments for cell mobility, gas exchanges and to promote tissue healing and regeneration, besides controlling bacterial proliferation. Electrospinning is a simple, cheap and common technique used for such purposes and Ecovio®, a polymeric blend based on biocompatible polymers (poly(butylene adipate-co-terephthalate) (PBAT) and poly(lactic acid) (PLA)), is a good example of polymer with unique properties for wound dressing materials development. To ensure antimicrobial properties, Job’s tears (Coix lacrymajobi) extract was incorporated into the material. The obtained fiber mats were characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), X-ray diffractometry (DRX), optical microscopy (OM), and microbiological analysis. The interaction among the compounds of the extract and the polymeric matrix was inferred by the increase in the crystallinity degree and thermal stability of the fibers/extract. Also, a decrease in the diameter, roughness, and fiber homogeneity was observed. It happened due to the presence of extract in the fibers. Microbiological analysis (antimicrobial activity against S. aureus) indicated the effectiveness of the fibers/extract in preventing this bacteria growth, demonstrating the potential of this material for wound dressing purposes.

Six-minute walk test and incremental shuttle walk test in the evaluation of functional capacity in Chagas heart disease

Henrique Silveira Costa,Márcia Maria Oliveira Lima,Susan Martins Lage,Fábio Silva Martins da Costa,Pedro Henrique Scheidt Figueiredo,Manoel Otávio da Costa Rocha 한국운동재활학회 2018 JER Vol.14 No.5