ABSTRACT
OBJECTIVE: Cognitive decline is a key characteristic of Huntington's disease (HD). This study aimed to investigate the diagnostic accuracy of a cognitive battery with six tests used by most HD research centers to assess cognitive impairment in HD. METHOD: In total, 106 HD patients in different disease stages with more (HD-CD, N = 30) and less cognitive impairments (HD-NC, N = 70) and 100 healthy controls (NC) were matched by age, sex, and education and were examined using a standardized protocol including cognitive, motor, and functional assessments. RESULTS: One-way between-groups analysis of variance showed that controls performed significantly better than HD patients and that HD-NC significantly outperformed HD-CD patients in all cognitive tests (NC > HD-NC > HD-CD), with all Games-Howell post-hoc tests p < .001. Analyses using area under the receiver-operating characteristic curve (AUC) disclosed the diagnostic accuracy of all tests included in the battery to discriminate between NC and HD patients with AUC ranging from 0.809 to 0.862 (all p < .001) and between HD-CD and HD-NC patients with AUC ranging from 0.833 to 0.899 (all p < .001). In both analysis, Stroop Color Naming Test showed the highest discriminative potential. Additional analyses showed that cognitive deficits in all domains progressed with disease duration. Moreover, cognitive performance correlated with the severity of motor and functional impairment (all p < .001) and with the Disease Burden Score regardless of disease duration and age. CONCLUSION: Our results indicate that the cognitive battery is a suitable tool for assessing cognitive impairment in HD.
Subject(s)
Huntington Disease , Cognition , Cost of Illness , Humans , Huntington Disease/complications , Huntington Disease/diagnosis , Neuropsychological Tests , Physical Functional PerformanceABSTRACT
BACKGROUND: Minimally invasive treatment of vertebral fractures is basically characterized by cement augmentation. Using the combination of a permanent implant plus cement, it is now conceivable that the amount of cement can be reduced and so this augmentation could be an attractive opportunity for use in traumatic fractures in young and middle-aged patients. The objective of this study was to determine the smallest volume of cement necessary to stabilize fractured vertebrae comparing the SpineJack system to the gold standard, balloon kyphoplasty. METHODS: 36 fresh frozen human cadaveric vertebral bodies (T11-L3) were utilized. After creating typical compression wedge fractures (AO A1.2.1), the vertebral bodies were reduced by SpineJack (n=18) or kyphoplasty (n=18) under preload (100N). Subsequently, different amounts of bone cement (10%, 16% or 30% of the vertebral body volume) were inserted. Finally, static and dynamic biomechanical tests were performed. FINDINGS: Following augmentation and fatigue tests, vertebrae treated with SpineJack did not show any significant loss of intraoperative height gain, in contrast to kyphoplasty. In the 10% and 16%-group the height restoration expressed as a percentage of the initial height was significantly increased with the SpineJack (>300%). Intraoperative SpineJack could preserve the maximum height gain (mean 1% height loss) better than kyphoplasty (mean 16% height loss). INTERPRETATION: In traumatic wedge fractures it is possible to reduce the amount of cement to 10% of the vertebral body volume when SpineJack is used without compromising the reposition height after reduction, in contrast to kyphoplasty that needs a 30% cement volume.
Subject(s)
Bone Cements/therapeutic use , Fractures, Compression/surgery , Kyphoplasty/methods , Prostheses and Implants , Spinal Fractures/surgery , Aged , Biomechanical Phenomena , Cadaver , Female , Humans , Male , Middle Aged , Prosthesis Implantation/methods , Plastic Surgery Procedures/methods , Spine/surgeryABSTRACT
Aesthetical and biomechanical requirements on fiber-reinforced endodontic posts play an important role in clinical application. Leading to a long-term clinical success, post systems must ensure an adequate force transmission and optimal retention behavior into the root channel. The aim of this study was to determine the microstructure and morphology of commonly used fiber reinforced endodontic posts in vitro. Post-specific fiber diameter, fiber arrangement over the cross-sections and length, and fiber-matrix ratio could be associated with mechanical properties, such as three-point bending strength and structure modulus. Furthermore, our investigation focused on the quantification of the wettability of the post surface. By using a modified contact-angle measurement, the meniscus on the post surface was characterized. In additional investigations, posts were inserted in artificial root channels and the extraction force was measured. The results show a strong correlation between the extraction force and the wettability of the post surface.
