The legal and ethical framework governing body donation in Europe - 2nd update on current practice.

BACKGROUND: In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. METHODS: For this second update, we have asked authors from all European countries to contribute their national perspectives. By this enquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. RESULTS: Perspectives on the legal and ethical framework governing body donation in Europe. CONCLUSIONS: We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies.

Generation of microdamage around endosseous implants.

OBJECTIVES: The aim of this study was to investigate the occurrence of microdamage as a result of osteotomy preparation and/or insertion of endosseous screw-shaped titanium implants into the dog mandible. MATERIALS AND METHODS: The mandibular premolar regions of four young adult male Beagle dogs were used for the study. Four implant sites were prepared in the edentulous area of each mandible on each side and the sites were divided into four experimental groups. Group I included sites that contained an osteotomy preparation only. Group II included sites that contained an osteotomy preparation and were tapped but did not receive any implant. Group III included sites that contained an osteotomy preparation and were not tapped but received an implant. Group IV included sites that contained an osteotomy preparation and were tapped before implant placement. Control sites (Group V) were randomly selected from different mandibular sites. Ground sections were prepared from biopsies taken at 2 days and were examined using epifluorescence microscopy. Total number and length of microcracks for each side were compared (left vs. right) using descriptive statistical methods. RESULTS: The control group (V) had fewer microcracks compared with the modalities I-IV. There were no differences in microcrack lengths between the jaw sides, treatment modalities, jaw regions and between the treatment modalities and controls. CONCLUSIONS: The results of this study suggest that most of the microcracks were generated by the osteotomy preparation and the other modalities did not appear to have any major additional effects.

Effects of high bone turnover on the biomechanical properties of the L3 vertebra in an ovine model of early stage osteoporosis.

STUDY DESIGN: Investigations of the effects of high bone turnover on the L3 vertebra were carried out, using an ovariectomized (OVX) ovine model of early stage osteoporosis. OBJECTIVE: To assess the contribution of bone turnover to the biomechanics of L3. SUMMARY OF BACKGROUND DATA: Clinically, dual energy x-ray absorptiometry (DEXA) is used to measure bone mineral density (BMD). However, this can only predict 60% to 70% of bone strength; the remainder is due to bone quality. There is currently little information available on how strength is affected by changes in bone quality parameters, particularly bone turnover. Turnover can be assessed clinically using biochemical markers; however, this provides systemic values, whereas localized values are required to predict site-specific fracture risk. METHODS: Thirty-eight sheep were assigned to 2 groups (control, n = 19; OVX, n = 19). Both groups were intravenously administered a fluorochrome dye on the day of surgery and 3, 6, 9, and 12 months thereafter, to label sites of bone turnover. After 12 months, animals were killed and the spinal columns harvested. L3 vertebrae were scanned using DEXA. Bone turnover was quantified using epifluorescence microscopy, and microarchitecture was assessed by microCT scanning. Compressive testing was used to characterize the mechanical properties of the vertebrae. RESULTS: BMD and microarchitecture were unchanged in OVX compared with controls. However, bone turnover, as measured by fluorochrome labeled sites, was significantly increased in the OVX group in cortical and trabecular compartments. As a consequence, the biomechanical properties were significantly reduced in that group. CONCLUSION: These findings show that OVX resulted in changes in bone turnover, which reduced biomechanical properties in a model of early stage osteoporosis. These differences were present despite microarchitecture or BMD remaining unchanged. In the future, the ability to assess site-specific bone turnover would greatly enhance the accuracy with which fracture risk could be predicted.

Lidocaine vaginal gel versus lidocaine paracervical block for analgesia during oocyte retrieval.

BACKGROUND: Evidence from randomized trials suggests that pain relief during oocyte retrieval is superior when adjunctive paracervical block is used in addition to sedation alone. Vaginal application of lidocaine gel is a non-invasive alternative to lidocaine paracervical block. The goal of the present trial was to compare analgesia with lidocaine vaginal gel versus lidocaine paracervical block. METHODS: A parallel-group randomized trial of adjunctive lidocaine vaginal gel versus adjunctive lidocaine paracervical block (with sedation for both groups) was performed in participants undergoing oocyte retrieval. Measured outcomes were subjective pain experiences. Subjects provided self-reported ratings of pain and anxiety. Visual analogue scales were used to measure pain during different procedural stages. The McGill Pain Questionnaire was used to measure pain character and the total pain experience. RESULTS: During application of lidocaine, pain ratings were less for vaginal gel than paracervical block. In contrast, during insertion of the aspiration needle and aspiration of follicles, pain ratings were greater for lidocaine vaginal gel. Total pain experience was greater with lidocaine vaginal gel. CONCLUSIONS: Subjective measures of pain intensity and the total pain experience were greater with lidocaine vaginal gel compared with lidocaine paracervical block.