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Post-fracture Stimulation of in Vitro Osteogenesis Is Not Systemic
Dutra, Timothy F.,Bernard, George W. Korean Academy of Oral Biology and the UCLA Dental 1998 International Journal of Oral Biology Vol.23 No.4
Locally active post-fracture stimulation of in vitro osteogenesis was observed in this laboratory by Tibone and Bernard (1982). They found that rabbit femoral bone marrow showed a significant increase in the number of in vitro osteogenic colonies when collected 24 hours after antecedent fracture, compared to marrow from unfractured controls. Using the same tissue culture methods for counting bone colonies as a bioassay, we compared bone colonies from marrow cells obtained before and after surgical fracture of the contralateral fenur and found no significant difference in number of bone colonies formed. Comparing these results with those of Tibone and Bernard (1982), our conclusion is that a fracture causes local stimulation of the osteogenic cells of marrow, which is not manifested systemically.
Parastomal hernias after radical cystectomy and ileal conduit diversion
Timothy F. Donahue,Bernard H. Bochner 대한비뇨의학회 2016 Investigative and Clinical Urology Vol.57 No.4
Parastomal hernia, defined as an "incisional hernia related to an abdominal wall stoma", is a frequent complication after conduit urinary diversion that can negatively impact quality of life and present a clinically significant problem for many patients. Parastomal hernia (PH) rates may be as high as 65% and while many patients are asymptomatic, in some series up to 30% of patients require surgical intervention due to pain, leakage, ostomy appliance problems, urinary obstruction, and rarely bowel obstruction or strangulation. Local tissue repair, stoma relocation, and mesh repairs have been performed to correct PH, however, long-term results have been disappointing with recurrence rates of 30%–76% reported after these techniques. Due to high recurrence rates and the potential morbidity of PH repair, efforts have been made to prevent PH development at the time of the initial surgery. Randomized trials of circumstomal prophylactic mesh placement at the time of colostomy and ileostomy stoma formation have shown significant reductions in PH rates with acceptably low complication profiles. We have placed prophylactic mesh at the time of ileal conduit creation in patients at high risk for PH development and found it to be safe and effective in reducing the PH rates over the short-term. In this review, we describe the clinical and radiographic definitions of PH, the clinical impact and risk factors associated with its development, and the use of prophylactic mesh placement for patients undergoing ileal conduit urinary diversion with the intent of reducing PH rates.
Dominique A. Cadilhac,Joosup Kim,Geoffrey Cloud,Craig S. Anderson,Emma K. Tod,Sibilah J. Breen,Steven Faux,Timothy Kleinig,Helen Castley,Richard I. Lindley,Sandy Middleton,Bernard Yan,Kelvin Hill,Bret 대한뇌졸중학회 2022 Journal of stroke Vol.24 No.1
Background and Purpose Changes to hospital systems were implemented from March 2020 in Australia in response to the coronavirus disease 2019 pandemic, including decreased resources allocated to stroke units. We investigate changes in the quality of acute care for patients with stroke or transient ischemic attack during the pandemic according to patients’ treatment setting (stroke unit or alternate ward). Methods We conducted a retrospective cohort study of patients admitted with stroke or transient ischemic attack between January 2019 and June 2020 in the Australian Stroke Clinical Registry (AuSCR). The AuSCR monitors patients’ treatment setting, provision of allied health and nursing interventions, prescription of secondary prevention medications, and discharge destination. Weekly trends in the quality of care before and during the pandemic period were assessed using interrupted time series analyses. Results In total, 18,662 patients in 2019 and 8,850 patients in 2020 were included. Overall, 75% were treated in stroke units. Before the pandemic, treatment in a stroke unit was superior to alternate wards for the provision of all evidence-based therapies assessed. During the pandemic period, the proportion of patients receiving a swallow screen or assessment, being discharged to rehabilitation, and being prescribed secondary prevention medications decreased by 0.58% to 1.08% per week in patients treated in other ward settings relative to patients treated in stroke units. This change represented a 9% to 17% increase in the care gap between these treatment settings during the period of the pandemic that was evaluated (16 weeks). Conclusions During the first 6 months of the pandemic, widening care disparities between stroke units and alternate wards have occurred.