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1.
J Dairy Sci ; 106(3): 1826-1836, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36710186

RESUMEN

Improving the ability of diet formulation models to more accurately predict AA supply while appropriately describing requirements for lactating dairy cattle provides an opportunity to improve animal productivity, reduce feed costs, and reduce N intake. The goal of this study was to evaluate the sensitivity of a new version of the Cornell Net Carbohydrate and Protein System (CNCPS) to formulate diets for rumen N, Met, and all essential AA (EAA). Sixty-four high-producing dairy cattle were randomly assigned to 1 of the 4 following diets in a 14-wk longitudinal study: (1) limited metabolizable protein (MP), Met, and rumen N (Base), (2) adequate Met but limited MP and rumen N (Base + M), (3) adequate Met and rumen N, but limited MP (Base + MU), and (4) adequate MP, rumen N, and balanced for all EAA (Positive). All diets were balanced to exceed requirements for ME relative to maintenance and production, assuming a nonpregnant, 650-kg animal producing 40 kg of milk at 3.05% true protein and 4.0% fat. Dietary MP was 97.2, 97.5, 102.3, and 114.1 g/kg of dry matter intake for the Base, Base + M, Base + MU, and Positive diets, respectively. Differences were observed for dry matter intake and milk yield (24.1 to 24.7 and 39.4 to 41.1 kg/d, among treatments). Energy corrected milk, fat, and true protein yield were greater (2.9, 0.13, and 0.08 kg/d, respectively) in cows fed the Positive compared with the Base diet. Using the updated CNCPS, cattle fed the Base, Base + M, and Base + MU diets were predicted to have a negative MP balance (-231, -310, and -142 g/d, respectively), whereas cattle fed the Positive diet consumed 33 g of MP/d excess to ME supply. Bacterial growth was predicted to be depressed by 16 and 17% relative to adequate N supply for the Base and Base + M diets, respectively, which corresponded with the measured lower apparent total-tract NDF degradation. The study demonstrates that improvements in lactation performances can be achieved when rumen N and Met are properly supplied and further improved when EAA supply are balanced relative to requirements. Formulation using the revised CNCPS provided predictions for these diets, which were sensitive to changes in rumen N, Met, all EAA, and by extension MP supply.


Asunto(s)
Aminoácidos Esenciales , Metionina , Femenino , Bovinos , Animales , Metionina/metabolismo , Aminoácidos Esenciales/metabolismo , Lactancia , Suplementos Dietéticos , Rumen/metabolismo , Nitrógeno/metabolismo , Estudios Longitudinales , Proteínas de la Leche/análisis , Leche/química , Dieta/veterinaria , Racemetionina/metabolismo , Proteínas en la Dieta/metabolismo
2.
J Dairy Sci ; 98(9): 6361-80, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26142847

RESUMEN

New laboratory and animal sampling methods and data have been generated over the last 10 yr that had the potential to improve the predictions for energy, protein, and AA supply and requirements in the Cornell Net Carbohydrate and Protein System (CNCPS). The objectives of this study were to describe updates to the CNCPS and evaluate model performance against both literature and on-farm data. The changes to the feed library were significant and are reported in a separate manuscript. Degradation rates of protein and carbohydrate fractions were adjusted according to new fractionation schemes, and corresponding changes to equations used to calculate rumen outflows and postrumen digestion were presented. In response to the feed-library changes and an increased supply of essential AA because of updated contents of AA, a combined efficiency of use was adopted in place of separate calculations for maintenance and lactation to better represent the biology of the cow. Four different data sets were developed to evaluate Lys and Met requirements, rumen N balance, and milk yield predictions. In total 99 peer-reviewed studies with 389 treatments and 15 regional farms with 50 different diets were included. The broken-line model with plateau was used to identify the concentration of Lys and Met that maximizes milk protein yield and content. Results suggested concentrations of 7.00 and 2.60% of metabolizable protein (MP) for Lys and Met, respectively, for maximal protein yield and 6.77 and 2.85% of MP for Lys and Met, respectively, for maximal protein content. Updated AA concentrations were numerically higher for Lys and 11 to 18% higher for Met compared with CNCPS v6.0, and this is attributed to the increased content of Met and Lys in feeds that were previously incorrectly analyzed and described. The prediction of postruminal flows of N and milk yield were evaluated using the correlation coefficient from the BLUP (R(2)BLUP) procedure or model predictions (R(2)MDP) and the concordance correlation coefficient. The accuracy and precision of rumen-degradable N and undegradable N and bacterial N flows were improved with reduced bias. The CNCPS v6.5 predicted accurate and precise milk yield according to the first-limiting nutrient (MP or metabolizable energy) with a R(2)BLUP=0.97, R(2)MDP=0.78, and concordance correlation coefficient=0.83. Furthermore, MP-allowable milk was predicted with greater precision than metabolizable energy-allowable milk (R(2)MDP=0.82 and 0.76, respectively, for MP and metabolizable energy). Results suggest a significant improvement of the model, especially under conditions of MP limitation.


Asunto(s)
Carbohidratos de la Dieta/análisis , Proteínas en la Dieta/análisis , Modelos Biológicos , Alimentación Animal/análisis , Animales , Dióxido de Carbono/orina , Bovinos , Dieta/veterinaria , Carbohidratos de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Digestión , Metabolismo Energético , Ácidos Grasos/metabolismo , Heces/química , Femenino , Lactancia , Metano/orina , Leche/química , Leche/metabolismo , Proteínas de la Leche/metabolismo , Nitrógeno/orina , Rumen/metabolismo
3.
J Dairy Sci ; 98(9): 6340-60, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26142848

RESUMEN

The Cornell Net Carbohydrate and Protein System (CNCPS) is a nutritional model that evaluates the environmental and nutritional resources available in an animal production system and enables the formulation of diets that closely match the predicted animal requirements. The model includes a library of approximately 800 different ingredients that provide the platform for describing the chemical composition of the diet to be formulated. Each feed in the feed library was evaluated against data from 2 commercial laboratories and updated when required to enable more precise predictions of dietary energy and protein supply. A multistep approach was developed to predict uncertain values using linear regression, matrix regression, and optimization. The approach provided an efficient and repeatable way of evaluating and refining the composition of a large number of different feeds against commercially generated data similar to that used by CNCPS users on a daily basis. The protein A fraction in the CNCPS, formerly classified as nonprotein nitrogen, was reclassified to ammonia for ease and availability of analysis and to provide a better prediction of the contribution of metabolizable protein from free AA and small peptides. Amino acid profiles were updated using contemporary data sets and now represent the profile of AA in the whole feed rather than the insoluble residue. Model sensitivity to variation in feed library inputs was investigated using Monte Carlo simulation. Results showed the prediction of metabolizable energy was most sensitive to variation in feed chemistry and fractionation, whereas predictions of metabolizable protein were most sensitive to variation in digestion rates. Regular laboratory analysis of samples taken on-farm remains the recommended approach to characterizing the chemical components of feeds in a ration. However, updates to the CNCPS feed library provide a database of ingredients that are consistent with current feed chemistry information and laboratory methods and can be used as a platform to formulate rations and improve the description of biology within the model.


Asunto(s)
Carbohidratos de la Dieta/análisis , Proteínas en la Dieta/análisis , Modelos Biológicos , Alimentación Animal/análisis , Animales , Bovinos , Dieta/veterinaria , Carbohidratos de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Femenino , Modelos Lineales , Sensibilidad y Especificidad
4.
J Dairy Sci ; 96(6): 3857-66, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23548301

RESUMEN

Nitrogen utilization in grazing cows is often low due to high concentrations of rapidly soluble and degradable protein in the pasture-based diet. Broadly, opportunities to improve N utilization lie in either reducing the amount of N consumed by the animal, or incorporating more N into milk protein. The goal of this study was to compare the relative importance of dietary N intake and productive N output for improving N utilization in grazing cows fed either starch-, fiber-, or sugar-based supplements. Also, the Cornell Net Carbohydrate and Protein System (CNCPS; Cornell University, Ithaca, NY) was evaluated as a tool to assess cow performance and improve N utilization in pasture-based systems. Eighty-five cows were randomly assigned to 1 of 5 treatments at parturition (17 cows per treatment). Treatments consisted of a pasture-only control and pasture with a starch- (St and StN), fiber- (FbN), or a sugar-based supplement. The StN and FbN treatments contained additional dietary N. Diets were formulated using the CNCPS to supply similar levels of dietary metabolizable energy, but differing levels of dietary N and metabolizable protein. Nitrogen utilization ranged from 22 to 26% across the 5 groups. Cows fed the St diet had the lowest levels of milk urea N, blood urea N, and urinary N excretion and had the highest productive N output (149 g/d). Cows fed the FbN treatment had similar productive N output (137 g/d) and consumed approximately 100g/d more dietary N than the St treatment, resulting in greater urinary N excretion. Although milk protein yield was moderately greater in the St treatment, quantitatively the difference in N intake (100g/d) had the greatest effect on N utilization and suggests that controlling dietary N intake should be the first priority when attempting to improve N utilization in grazing cows. No effect was observed of supplementing pasture-fed cattle with sugar on production or N utilization under the conditions of this experiment. Predictions of metabolizable energy and protein availability for milk yield from the CNCPS were similar to actual milk yield for all treatments. Model-predicted N utilization and excretion reflected the trends observed in the measured data and suggests that the CNCPS can be a useful tool for formulating and evaluating diets to improve N utilization in pasture-based systems.


Asunto(s)
Bovinos/metabolismo , Fibras de la Dieta/administración & dosificación , Sacarosa en la Dieta/administración & dosificación , Herbivoria/fisiología , Nitrógeno/metabolismo , Almidón/administración & dosificación , Alimentación Animal , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Industria Lechera , Suplementos Dietéticos , Femenino
5.
J Dairy Sci ; 95(4): 2004-14, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22459846

RESUMEN

Nitrogen excretion is of particular concern on dairy farms, not only because of its effects on water quality, but also because of the subsequent release of gases such as ammonia to the atmosphere. To manage N excretion, accurate estimates of urinary N (UN) and fecal N (FN) are needed. On commercial farms, directly measuring UN and FN is impractical, meaning that quantification must be based on predictions rather than measured data. The purpose of this study was to use a statistical approach to develop equations and evaluate the Cornell Net Carbohydrate and Protein System's (CNCPS) ability to predict N excretion in lactating dairy cows, and to compare CNCPS predictions to other equations in the literature. Urinary N was over-predicted by the CNCPS due to inconsistencies in N accounting within the model that partitioned more N to feces than urine, although predicted total N excretion was reasonable. Data to refine model predictions were compiled from published studies (n=32) that reported total collection N balance results. Considerable care was taken to ensure the data included in the development data set (n=104) accounted for >90% of the N intake (NI). Unaccounted N for the compiled data set was 1.47±4.60% (mean ± SD). The results showed that FN predictions could be improved by using a modification of a previously published equation: FN (g/d) = [[NI (g/kg of organic matter) × (1 - 0.842)] + 4.3 × organic matter intake (kg/d)] × 1.20, which, when evaluated against the compiled N balance data, had a squared coefficient of determination based on a mean study effect R(MP)(2) of 0.73, concurrent correlation coefficient (CCC) of 0.83 and a root mean square error (RMSE) of 10.38 g/d. Urinary N is calculated in the CNCPS as the difference between NI and other N excretion and losses. Incorporating the more accurate FN prediction into the current CNCPS framework and correcting an internal calculation error considerably improved UN predictions (RMSE=12.73 g/d, R(MP)(2)=0.86, CCC=0.90). The changes to FN and UN translated into an improved prediction of total manure N excretion (RMSE=12.42 g/d, R(MP)(2)=0.96, CCC=0.97) and allows nutritionists and farm advisors to evaluate these factors during the ration formulation process.


Asunto(s)
Bovinos/metabolismo , Carbohidratos de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Lactancia/fisiología , Nitrógeno/análisis , Necesidades Nutricionales , Animales , Bovinos/orina , Dieta/veterinaria , Heces/química , Femenino , Estiércol/análisis , Modelos Teóricos , Nitrógeno/orina
6.
Biomaterials ; 24(7): 1159-66, 2003 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12527256

RESUMEN

To evaluate the bonding strength of the interfaces within the cemented arthroplasty system, various mechanical tests have been used. Conventional push-out and pull-out tests cannot reveal the actual bonding property of the interface because of the significant influence of surface roughness on the measured adhesion and the failure to account for the mismatch of elastic modulus across the interface. An alternative fracture mechanics approach, which considers the mix of opening and shear modes of the crack tip loading associated with the testing system and the elastic mismatch of materials across the interface, was used to evaluate the bonding ability of various cements. The four-point bend interfacial delamination test by Charalambides et al. (J. Appl. Mech. 56 (1989) 77; Mech. Mater. 8 (1990) 269) was used to quantify the bonding ability of cements. This method is arguably more suitable since the applied loading mode is comparable to the nature of loading within the prosthetic system, which is primarily bending. The bovine bone specimens were polished to mirror finish to eliminate bonding by mechanical interlocking. The results revealed minimal bonding for the conventional bone cement (PMMA) whereas substantial bonding was evident for the glass-ionomer cements tested. However, only the conventional glass-ionomer cements showed evidence of bonding on testing, while the resin-modified glass-ionomer cement (poly-HEMA) did not. The latter appeared to debond before testing because of excessive expansion stresses associated with swelling in water.


Asunto(s)
Cementos para Huesos/química , Huesos/química , Adhesividad , Animales , Bovinos , Fracturas Óseas , Cementos de Ionómero Vítreo/química , Ensayo de Materiales/instrumentación , Ensayo de Materiales/métodos , Resistencia a la Tracción
7.
J Biomed Mater Res A ; 64(1): 93-104, 2003 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-12483701

RESUMEN

Over the past decade, orthopedic surgery has embraced an increase in the depth of cement penetration into the adjacent cancellous bone structure. The resultant interdigitation transforms this zone into a thick layer of continuous interpenetrating composite material. The failure behavior of the composite formed with a number of potential bone cements with different bonding ability was investigated. The cancellous bone-cement composites exhibit considerable resistance to crack extension, and in situ optical observation indicates that the contribution of the cancellous bone is analogous to that of a typical fiber bridging process. The critical stress intensity factor and the work of fracture have been used to quantify the failure characteristics of the cancellous bone-cement composites. The nature of the crack propagation through these cement-bone composites was also captured via optical microscopy, and scanning electron microscopic images were taken of the failure surfaces. The R-curve behavior, or crack extension characteristic, of the cancellous bone-cement composite was also determined. The interesting outcome is that the cancellous bone-PMMA (poly-methylmethacrylate) composite, despite the absence of chemical bonding with bone, required the highest energy to fracture. In addition, the dimensional stability of the cement has a great effect on the interface.


Asunto(s)
Cementos para Huesos/química , Huesos/química , Animales , Huesos/ultraestructura , Bovinos , Ensayo de Materiales , Microscopía Electrónica de Rastreo
8.
J Mater Sci Mater Med ; 13(8): 745-50, 2002 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-15348560

RESUMEN

The mechanical properties of glass-ionomer cements (GICs) have been satisfactory for dental applications and have shown their potential in orthopedic surgery. Because the physiological environment in orthopedics is different from dentistry by unavoidable contamination with blood and other fluids such as normal saline used during an operation, the determination of GICs for orthopedic applications should be performed in an appropriate environment. The properties of a novel resin-modified GIC, S430, for orthopedic applications were evaluated in simulated orthopedic conditions by an early exposure to and long-term storage in normal saline. An early exposure to normal saline caused 20-60% reduction of its compressive and flexural properties, whereas long-term storage in normal saline showed slight changes of its mechanical properties. The effects were probably due to the disturbance of the cross-linking formation in the acid-base reaction and also the reduction of electrostatic interactions of the cross-linking polymeric chain of hydroxyethyl methacrylate (HEMA) in resin-modified GIC.

9.
J Mater Sci Mater Med ; 13(2): 203-10, 2002 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-15348644

RESUMEN

In vivo biocompatibility of glass ionomer cements (GICs) was evaluated for use in orthopaedic surgery using a rat model and compared with conventional bone cement, Polymethyl methacrylate, PMMA. The unset GICs and PMMA were inserted into the marrow cavities of rat femora and retained in situ for various periods of time. The PMMA bone cement showed complete biocompatibility with no interference with reparative bone. The conventional GIC with smaller glass particles and lower powder/liquid ratio showed an initial minor toxic effect on rat bone tissue with later disturbance of adjacent bone formation. The conventional GIC with larger-size glass particles and higher powder/liquid ratio and resin-modified GIC showed more severe toxic effect on rat tissue with the resin-modified GIC affecting the rat bone tissue later. The causes of toxicity associated with the conventional GIC with larger glass particles and higher powder/liquid ration and the resin-modified GIC are thought to be related with the unreacted acid component of both materials and longer ongoing metallic ion release.

10.
Biomaterials ; 22(23): 3127-32, 2001 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11603584

RESUMEN

Using the single-edge notched bending (SENB) test, two fracture toughness parameters of longitudinal and transverse bovine bone specimens were evaluated: the critical stress intensity factor, Kc, determined from the peak load to initiate fracture, and the energy or work of fracture, Wf, the energy required to extend a crack through a notched specimen. It was found that preservation of bone in alcohol resulted in a 25-45% higher Kc value compared to control specimens stored in physiological saline; whereas the work of fracture, Wf, demonstrated the opposite behaviour, with the alcohol stored specimens having a 28-56% lower value than the saline control specimens. It was established that the effect of alcohol is reversible upon the bone being restored in saline. Consistent with previous studies, it was found that cracks oriented in the longitudinal direction resulted in both a significantly lower fracture toughness and lower work of fracture than those cracks directed transversely. The results are discussed in terms of the proposed deformation and fracture mechanisms known to occur in bone.


Asunto(s)
Huesos , Fracturas Óseas , Animales , Fenómenos Biomecánicos , Bovinos
12.
Biomaterials ; 22(12): 1583-90, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11374458

RESUMEN

Frequently, bone cement strengths are evaluated from uniaxial tests, such as three- or four-point flexure. Measurement of material strength in this manner may not provide an accurate characterisation of a bone cements true load-bearing capacity. In most orthopaedic applications, there exists a state of biaxial stress and so biaxial strength information is most useful. To address this issue, the biaxial flexure strength of two polymethylmethacrylate orthopaedic (PMMA) bone cements and two glass-ionomer dental cements have been determined. The biaxial strength of orthopaedic bone cements have been compared to the three-point bending strength. Furthermore, the calculated theoretical biaxial strength was compared with a value of biaxial strength utilising the finite element method. For all materials tested the calculated biaxial strength is significantly greater than the three-point bending strength. The biaxial test offers several advantages over three-point bending because it critically explores surface flaws--as it does not matter in which orientation the crack lies. However, it does minimise the volume or surface area investigated and also the edge effect. The difference in strength calculated for the two testing methods can be explained quantitatively in terms of the volume of material under stress. This work has demonstrated that the biaxial flexure test can be used for the testing of orthopaedic bone cements.


Asunto(s)
Resinas Acrílicas/química , Cementos para Huesos/química , Cementos de Ionómero Vítreo/química , Ensayo de Materiales/métodos , Polimetil Metacrilato/química , Humanos , Modelos Teóricos , Reproducibilidad de los Resultados , Estrés Mecánico , Soporte de Peso
13.
Nucl Med Commun ; 22(1): 73-7, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11233555

RESUMEN

A unique scintigraphic appearance has been noted in uncomplicated hip prostheses which have the acetabular component inserted after under-reaming or where a cone-shaped cup is inserted. We hypothesized that the pattern of increased uptake around the superior and inferior third of the cup with relatively reduced uptake in the medial third is due to preferential loading of the rim of the cup. A prospective study of ten patients with uncomplicated hip prostheses supports the hypothesis.


Asunto(s)
Acetábulo/diagnóstico por imagen , Acetábulo/cirugía , Artroplastia de Reemplazo de Cadera , Acetábulo/anatomía & histología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Prótesis de Cadera , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Cintigrafía
14.
J Biomed Mater Res ; 58(2): 188-95, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11241338

RESUMEN

Accurate determination of the elastic modulus of surgical bone cements is of primary importance, when evaluating the stresses within the cement mantle in Total Joint Arthroplasty. This article presents a new method of determining the modulus of surgical bone cements from the biaxial flexural test. The biaxial flexural test is not currently employed in mainstream orthopedic mechanical testing, which is surprising because most loading in orthopedic applications is biaxial in nature. Nor has this method been utilized for dental materials, even though the biaxial flexure test has been used for many years in this field. It has been demonstrated that the modulus of surgical bone cements can be determined from the biaxial flexural test, and these results are in agreement with results from compressive and bending tests.


Asunto(s)
Cementos para Huesos , Elasticidad , Humanos , Dispositivos de Fijación Ortopédica
15.
J Mater Sci Mater Med ; 12(5): 453-60, 2001 May.
Artículo en Inglés | MEDLINE | ID: mdl-15348286

RESUMEN

The intrinsic benefits of low exotherm and bioactivity have generated interest in utilizing glass-ionomer cements (GIC) as a bone cement replacement in orthopaedic surgery. This paper is concerned with evaluating the mechanical properties of compressive strength, flexural strength, and fracture toughness for two traditional GICs, one resin-modified GIC (an experimental bone cement) and two polymethylmethacrylate (PMMA) cement systems. To determine the suitability of a GIC system for use in the clinical orthopaedic setting, the additional characteristics of setting exotherm and setting time have also been evaluated. The characterization of these two vastly different cement systems has raised some concern as to the applicability of using the current orthopaedic standards for the testing of GIC systems. In particular, issues relating to the strain rate dependence of PMMA cement and the exothermic basis for determining setting time are not applicable as these factors are not characteristic of GIC systems. Whilst the intrinsic benefits of current GIC systems are well understood and generally accepted, this study has shown their intrinsic mechanical properties to be inferior to current PMMA cements. Improvement in the mechanical properties of traditional GICs have been achieved with the addition of a resin component (HEMA).

16.
Phys Ther ; 78(12): 1277-87, 1998 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-9859947

RESUMEN

BACKGROUND AND PURPOSE: Evaluation of posteroanterior (PA) movement in the spine is commonly used in the clinic, but little is known about the mechanisms involved. The purposes of this study were to examine variations in PA stiffness along the thoracolumbar spine and to investigate possible factors that might determine the pattern of stiffness. SUBJECTS: Twenty-one pain-free volunteers (10 male, 11 female), aged 18 to 41 years (mean age=26.6, SD=7.5), participated. METHODS: Posteroanterior stiffness was measured at 5 locations (L4, L1, T10, T7, T4), together with various subject characteristics. RESULTS: Mean PA stiffness varied among locations, with the greatest stiffness at L4 (13.3 N/mm) and the lowest stiffness at L1 (10.4 N/mm). A relatively small, but important, proportion (22% or less) of the variance in stiffness data at some vertebral levels was accounted for by the variables describing subject characteristics. CONCLUSION AND DISCUSSION: Posteroanterior stiffness varies along the spine in a manner consistent with the nature of support for the spine. The observed pattern of variation of PA stiffness along the spine appears to be influenced by some factors other than those relating to the spine.


Asunto(s)
Vértebras Lumbares/fisiología , Vértebras Torácicas/fisiología , Adolescente , Adulto , Fenómenos Biomecánicos , Diseño de Equipo , Femenino , Humanos , Vértebras Lumbares/fisiopatología , Masculino , Manipulación Espinal/instrumentación , Valores de Referencia , Análisis de Regresión , Vértebras Torácicas/fisiopatología
17.
Clin Nucl Med ; 21(11): 838-43, 1996 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-8922843

RESUMEN

The aim of this study was to evaluate the utility of scintigraphy using leukocytes labeled with Tc-99m stannous colloid in the assessment of painful arthroplasties. The results of three-phase bone scintigraphy and imaging with Tc-99m-labeled leukocytes in 40 patients with painful joint prostheses, requiring the exclusion of infection are reported. Results were compared with microbiologic culture and/or long-term clinical review. Bone scintigraphy had a sensitivity of 100%, a specificity of 64%, and a diagnostic accuracy of 73% in detecting prosthetic infection. Tc-99m-labeled leukocytes yielded a sensitivity of 70%, a specificity of 100%, and a diagnostic accuracy of 93%. Leukocyte scintigraphy improves the specificity of bone scintigraphy in the assessment of the painful prosthetic joint. A positive study is highly suggestive of infection and warrants appropriate treatment.


Asunto(s)
Prótesis de Cadera/efectos adversos , Prótesis de la Rodilla/efectos adversos , Leucocitos , Infecciones Relacionadas con Prótesis/diagnóstico por imagen , Compuestos de Tecnecio , Compuestos de Estaño , Adulto , Anciano , Anciano de 80 o más Años , Huesos/diagnóstico por imagen , Coloides , Femenino , Articulación de la Cadera/diagnóstico por imagen , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Dolor/etiología , Curva ROC , Cintigrafía , Sensibilidad y Especificidad
18.
Man Ther ; 1(2): 67-75, 1996 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11386840

RESUMEN

Optimal use of lumbar mobilisation requires a theoretical knowledge of the mechanical effects that occur. When a mobilisation force is applied the target vertebra will move with accompanying intervertebral displacements at many intervertebral joints. In addition, displacements and deformations of other tissues will contribute to the movement of the skin surface under the therapist's hands. The responses can be quantified in terms of the movements of the skin surface (described by the force-displacement relation), the absolute movement of the target vertebra, or the relative intervertebral movements. There are at least seven variables related to the manner of application of the mobilisation force that can be controlled by the therapist to alter the nature of the response. The patient's response is also determined by a number of variables related to the mechanical properties of the tissues of the spine, extra-spinal structures and the interaction between the patient and the treatment couch. Currently there is a moderate amount of information available about the effects of technique variations but there is very little data to directly link variations in the properties of specific anatomical structures with variations in either absolute or relative spinal movements or tissue loads.

20.
Calcif Tissue Int ; 47(5): 270-5, 1990 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-2257519

RESUMEN

We examined femoral head bone from 50 cadavers and from 21 patients who had suffered pathologic fracture of the femoral neck. We used a histochemical technique for lactate dehydrogenase (LDH) activity to demonstrate osteocyte viability. The femoral heads were removed within 36 hours of death or fracture, as LDH activity persists in the cytoplasm of viable cells for this time at 37 degrees after interruption of the blood supply. In the controls, there was an age-related reduction in mean osteocyte viability, from 88 +/- 7% (mean +/- SD) at age 10-29 years to 58 +/- 12% at age 70-89 years. In the hip fracture patients, mean osteocyte viability was 58 +/- 21% but there was much variability in both osteocyte viability and bone mass. In 5 fracture patients, there was extensive osteocyte death, suggesting that most of the femoral head bone was nonviable; these patients had little microfracture callus. Others had predominantly viable bone which was usually osteoporotic, and their bone frequently showed microfracture callus. Osteomalacia was not seen in any patient. It is suggested that bone death, in addition to osteoporosis, may sometimes contribute to hip fracture in the elderly.


Asunto(s)
Fracturas del Cuello Femoral/patología , Anciano , Anciano de 80 o más Años , Supervivencia Celular , Femenino , Cabeza Femoral/patología , Humanos , Masculino , Osteocitos/patología
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