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1.
Behav Processes ; 212: 104933, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37643663

RESUMO

Social play in rats is rewarding and important for the development of brain and social skills. There are differences in the amount of play behavior displayed among individuals, with earlier studies suggesting that, despite variation across trials, individual differences tend to be consistent. In the present study, juvenile Lister-hooded rats were paired with a different, unfamiliar same-sex partner on three days and based on the amount of play each individual initiated, it was characterized as a high, medium or low player. Using this categorization, we explored three features related to individual differences. First, we show that by increasing the number of test days from two, as was done in a previous study (Lesscher et al., 2021), to three, characterization was effectively improved. Secondly, while the earlier study only used males, the present study showed that both sexes exhibit a similar pattern of individual differences in the degree of playfulness. Even though low players consistently initiated less play than medium and high players, all rats varied in how much play they initiated from one trial to the next. Thirdly, we assessed two potential mechanisms by which the playfulness of one rat can modify the level of playfulness of the other rat (i.e., emotional contagion vs homeostasis). Analyses of individuals' contribution to the play of dyads suggest that rats consistently adjust their play behavior depending on the behavior displayed by the partner. Since this adjustment can be positive or negative, our data support a homeostatic mechanism, whereby individuals increase or decrease the amount of play they initiate, which results in the experience of an overall stable pattern of play across trials. Future research will investigate the neural bases for individual differences in play and how rats maintain a preferred level of play.

2.
Philos Trans R Soc Lond B Biol Sci ; 377(1863): 20210184, 2022 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-36126668

RESUMO

Social play in rats is a highly rewarding, energetic form of social interaction and important for development of the brain and social skills. The 50 kHz ultrasonic vocalizations (USV) emitted during social play are thought to be an expression of a positive affective state (laughter), which in some situations may also function as communication signals. Heterospecific play, 'tickling' by an experimenter, is thought to simulate conspecific play, and has been used to improve welfare and to study the neurobiology of positive affect. Given that tickling evokes substantial amounts of USV, we investigated whether heterospecific play is simulating conspecific play by comparing USV-behaviour associations in both contexts. If the 50 kHz calls are merely an expression of 'laughter' then the pattern and type of emission in both contexts should be similar. By contrast, as playing with a conspecific involves a two-way exchange of signalling, the additional demands on communication should lead to a different pattern of calling. While calling was prevalent in both types of play, how the different types of 50 kHz calls are used in the two contexts differed markedly. The findings suggest that while conspecific and heterospecific play are positive experiences, tickling is not the equivalent of conspecific play. This article is part of the theme issue 'Cracking the laugh code: laughter through the lens of biology, psychology and neuroscience'.


Assuntos
Ultrassom , Vocalização Animal , Animais , Emoções , Ratos , Recompensa
3.
Curr Protoc ; 2(1): e337, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35030300

RESUMO

Rough-and-tumble play or play fighting is an important experience in the juvenile period of many species of mammals, as it facilitates the development of social skills, and for some species, play fighting is retained into adulthood as a tool for assessing and managing social relationships. Laboratory rats have been a model species for studying the neurobiology of play fighting and its key developmental and social functions. However, play fighting interactions are complex, involving competition and cooperation; therefore, no single measure to quantify this behavior is able to capture all its facets. Therefore, in this paper, we present a multilayered framework for scoring all the relevant facets of play that can be affected by experimental manipulations and the logic of how to match what is measured with the question being asked. © 2022 Wiley Periodicals LLC.


Assuntos
Comportamento Social , Animais , Ratos
4.
eNeuro ; 4(2)2017.
Artigo em Inglês | MEDLINE | ID: mdl-28462394

RESUMO

Adaptation facilitates neural representation of a wide range of diverse inputs, including reward values. Adaptive value coding typically relies on contextual information either obtained from the environment or retrieved from and maintained in memory. However, it is unknown whether having to retrieve and maintain context information modulates the brain's capacity for value adaptation. To address this issue, we measured hemodynamic responses of the prefrontal cortex (PFC) in two studies on risky decision-making. In each trial, healthy human subjects chose between a risky and a safe alternative; half of the participants had to remember the risky alternatives, whereas for the other half they were presented visually. The value of safe alternatives varied across trials. PFC responses adapted to contextual risk information, with steeper coding of safe alternative value in lower-risk contexts. Importantly, this adaptation depended on working memory load, such that response functions relating PFC activity to safe values were steeper with presented versus remembered risk. An independent second study replicated the findings of the first study and showed that similar slope reductions also arose when memory maintenance demands were increased with a secondary working memory task. Formal model comparison showed that a divisive normalization model fitted effects of both risk context and working memory demands on PFC activity better than alternative models of value adaptation, and revealed that reduced suppression of background activity was the critical parameter impairing normalization with increased memory maintenance demand. Our findings suggest that mnemonic processes can constrain normalization of neural value representations.


Assuntos
Tomada de Decisões/fisiologia , Memória/fisiologia , Córtex Pré-Frontal/fisiologia , Recompensa , Adulto , Feminino , Humanos , Masculino , Estimulação Luminosa/métodos , Tempo de Reação/fisiologia , Risco , Adulto Jovem
5.
Br J Radiol ; 88(1050): 20150086, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25827210

RESUMO

Perforation of gastrointestinal (GI) tract by ingested bone fragments, toothpicks and dentures is rare but remains an important life-threatening condition, and the outcomes are poorer when the diagnosis is delayed. Invariably, clinical and radiographic diagnosis is difficult as most patients will have no recollection of ingesting a foreign body, whereas these subtle objects are often not visible on radiographs. In search for the diagnosis, CT is the modality of choice, but ultrasound imaging may be first requested in patients presenting with symptoms of acute appendicitis, cholecystitis, pyelonephritis or pelvic inflammatory disease when an ingested foreign body is not considered. Although ultrasound has limited value in depicting a foreign body, it can frequently uncover secondary signs of perforation. However, the rarity of this condition combined with non-specific clinical presentation and the propensity of these small perforating objects to be subtle makes establishing the correct diagnosis by the radiologist challenging. Therefore, understanding of the appearances of GI perforation seen on CT images or general abdominal ultrasound will aid the radiologist in the diagnosis of this important yet often unsuspected condition. This will lead to earlier diagnosis and surgical management. In this article, we illustrate the spectrum of CT, radiographic and ultrasound imaging features seen in GI perforation caused by swallowed bone fragments, toothpicks, cocktail sticks and dentures.


Assuntos
Diagnóstico por Imagem , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/etiologia , Deglutição , Diagnóstico Diferencial , Humanos
6.
Clin Radiol ; 68(11): 1089-96, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23932675

RESUMO

Aseptic lymphocyte-dominated vasculitis-associated lesions (ALVAL) are a recognized complication of metal-on-metal bearing hip prostheses. There is an impending concern regarding the future investigation and management of patients who have received such implants. The current literature is discussed, and the current guidelines for management of these patients in the UK are reviewed. The various imaging techniques available, such as computed tomography, metal artefact reduction magnetic resonance imaging, and ultrasound are discussed and evaluated with respect to the assessment of patients with suspected ALVAL. The histopathological findings are discussed with images of the tissue changes provided. Images of the radiological findings are also provided for all general radiological methods. ALVAL and its radiological presentation is an important issue that unfortunately may become a significant clinical problem.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/instrumentação , Reação a Corpo Estranho/etiologia , Prótese de Quadril/efeitos adversos , Doenças Linfáticas/diagnóstico , Doenças Linfáticas/etiologia , Vasculite/diagnóstico , Vasculite/etiologia , Artroplastia de Quadril/métodos , Reação a Corpo Estranho/diagnóstico , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/patologia , Humanos , Imageamento por Ressonância Magnética/métodos , Próteses Articulares Metal-Metal/efeitos adversos , Metais , Desenho de Prótese , Falha de Prótese , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia , Reino Unido
8.
Br J Oral Maxillofac Surg ; 49(4): 261-9, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20381221

RESUMO

Advances in imaging have led to improved sensitivity in the diagnosis of diseases that involve the major salivary glands. Ultrasound (US), plain radiography and sialography, magnetic resonance imaging (MRI), computed tomography (CT), and nuclear scintigraphy/positron emission tomography (PET) all play a part, and imaging often assists in the planning of further management, operative or otherwise. We review the methods used for imaging the major salivary glands, and apply the indications for these methods to the principal pathological processes.


Assuntos
Diagnóstico por Imagem/métodos , Doenças das Glândulas Salivares/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Tomografia por Emissão de Pósitrons , Cálculos das Glândulas Salivares/diagnóstico , Cálculos das Glândulas Salivares/diagnóstico por imagem , Doenças das Glândulas Salivares/diagnóstico por imagem , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/diagnóstico por imagem , Neoplasias das Glândulas Salivares/secundário , Sialadenite/diagnóstico , Sialadenite/diagnóstico por imagem , Sialografia , Tomografia Computadorizada por Raios X , Ultrassonografia
10.
J Paediatr Child Health ; 42(5): 263-7, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16712556

RESUMO

AIM: Glucose transporter 1 deficiency syndrome (GLUT1-DS) is an important condition for the general paediatrician's differential armamentarium. We describe a case series of eight patients in order to raise awareness of this treatable neurometabolic condition. The diagnosis of GLUT1-DS is suggested by a decreased absolute cerebrospinal fluid (CSF) glucose value (<2.2 mmol/L) or lowered CSF: plasma glucose ratio (<0.4). METHODS: This is a review of eight Queensland patients with GLUT1-DS. The clinical presentation, clinical course, laboratory investigations and treatment outcomes are discussed. RESULTS: The clinical features noted in our patient cohort include combinations of ataxia, developmental delay and a severe seizure disorder that is refractory to anticonvulsant medications. Seizures are the most common clinical manifestation and may be exacerbated by phenobarbitone. The paired CSF: plasma glucose results ranged from 0.2 to 0.39 (normal <0.6) with an average of 0.33. 3-O-Methyl-D-Glucose uptake and GLUT1 Genotyping analysis have been performed on five patients thus far. Rapid and impressive seizure control was observed in 100% of our patients once the ketogenic diet was instituted, with half of the cohort being able to wean completely from anticonvulsants. CONCLUSION: Children presenting with a clinical phenotype consisting of a refractory seizure disorder, ataxia and developmental delay should prompt the consideration of Glucose transporter 1 deficiency syndrome. While the diagnostic test of lumbar puncture is an invasive manoeuvre, the diagnosis provides a viable treatment option, the ketogenic diet. GLUT1-DS displays clinical heterogeneity, but the value of early diagnosis and treatment is demonstrated by our patient cohort.


Assuntos
Ataxia/etiologia , Encefalopatias Metabólicas Congênitas/dietoterapia , Encefalopatias Metabólicas Congênitas/etiologia , Deficiências do Desenvolvimento/etiologia , Transportador de Glucose Tipo 1/deficiência , Convulsões/etiologia , 3-O-Metilglucose/farmacocinética , Anticonvulsivantes/uso terapêutico , Encefalopatias Metabólicas Congênitas/diagnóstico , Erros Inatos do Metabolismo dos Carboidratos/dietoterapia , Erros Inatos do Metabolismo dos Carboidratos/etiologia , Criança , Dietoterapia , Feminino , Transportador de Glucose Tipo 1/genética , Humanos , Lactente , Vértebras Lombares , Masculino , Convulsões/tratamento farmacológico , Punção Espinal , Síndrome , Resultado do Tratamento
12.
Artigo em Inglês | MEDLINE | ID: mdl-10099898

RESUMO

The successful use of live attenuated viral and bacterial vaccines depends not only on the proper choice and delivery of the microorganisms, but also on maintaining the sufficient potency required for an immune response. The inherent lability of live organisms presents a particular formulation challenge in terms of stabilizing and preserving vaccine viability during manufacturing, storage, and administration. This review examines pharmaceutical approaches to the stabilization, formulation, and lyophilization of biological macromolecules in general, as well as the specific applicability of these principles to live attenuated viral and bacterial vaccines. Several formulation development case studies with live vaccines are presented. In addition, comparative stability data are summarized for many other live viral and bacterial preparations. Various pharmaceutical issues with conventional and novel delivery systems for administration of parenteral and oral live vaccines are also discussed.


Assuntos
Vacinas Bacterianas/administração & dosagem , Vacinas Bacterianas/síntese química , Vacinas Virais/administração & dosagem , Vacinas Virais/síntese química , Química Farmacêutica , Vias de Administração de Medicamentos , Portadores de Fármacos , Estabilidade de Medicamentos , Humanos , Vacinas Atenuadas/administração & dosagem , Vacinas Atenuadas/síntese química
13.
Dev Med Child Neurol ; 41(1): 16-20, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10068045

RESUMO

The placentas of 68 infants with intrauterine growth restriction (IUGR) were examined for evidence of impaired uteroplacental circulation and compared with those of 65 appropriately grown infants. Infarcts and/or accelerated villous maturation were present in the placentas in 27 (40%) of the infants with IUGR compared with seven (11%) of the infants without IUGR (P<0.001). The infants were followed-up at 4 and 12 months of age and growth parameters recorded. Medical and developmental assessments and neuromotor developmental examinations were also performed. The 23 infants in the IUGR group with placentas with evidence of impaired uteroplacental circulation were compared with the 31 infants with IUGR with normal placentas. There was no difference between the groups in growth, cognitive development, or neuromotor abnormality. It was concluded that IUGR is strongly associated with placental markers of impaired uteroplacental blood flow while it would appear that there is no association between placental pathology and growth or neurodevelopment in the first year.


Assuntos
Desenvolvimento Infantil , Retardo do Crescimento Fetal/fisiopatologia , Placenta/patologia , Feminino , Retardo do Crescimento Fetal/complicações , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Sistema Nervoso/crescimento & desenvolvimento , Placenta/irrigação sanguínea , Fluxo Sanguíneo Regional
14.
J Child Neurol ; 13(4): 149-57, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9568757

RESUMO

The N-methyl-D-aspartate (NMDA) subclass of glutamate receptors was examined in newborn infants dying between 25 weeks' gestation and term, either from acute cerebral hypoxia, or from other noncerebral conditions incompatible with life. Frontal, occipital, temporal, and motor cortex tissue samples were obtained at autopsy (post mortem delay: median, 45.9 hr; range, 24-96 hr) and frozen for subsequent [3H]MK801 homogenate binding assays. Whereas no significant variation was observed in ligand affinity (KD), in all cases receptor density (BMAX) increased with gestational age, in occipital cortex (27 weeks, BMAX = 222 +/- 44 fmol x mg protein(-1); 39 weeks, 439 +/- 42 fmol x mg protein[-1]), but not in motor or temporal cortex. The gestational-age increase also occurred in control frontal cortex (27 weeks, 284 +/- 80; 39 weeks, 567 +/- 40 fmol x mg protein[-1]), but was significantly less marked in frontal cortex in hypoxia cases (27 weeks, 226 +/- 90; 39 weeks, 326 +/- 47 fmol x mg protein[-1]). In all cortical areas except temporal, the maximal response to glutamate did not vary across case groups. Hypoxia cases showed an increased response to glutamate enhancement selectively in temporal cortex. Binding site density did not correlate with degree of hypoxia as assessed pathologically, suggesting that receptor differences preceded the hypoxic episode. Regional differences in glutamate-NMDA receptor sites may underlie increased vulnerability to hypoxia at birth.


Assuntos
Córtex Cerebral/crescimento & desenvolvimento , Morte Fetal/fisiopatologia , Hipóxia Fetal/fisiopatologia , Receptores de N-Metil-D-Aspartato/análise , Autopsia , Córtex Cerebral/fisiologia , Feminino , Idade Gestacional , Humanos , Masculino , Gravidez , Receptores de N-Metil-D-Aspartato/metabolismo
15.
Dev Med Child Neurol ; 39(11): 726-30, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9393885

RESUMO

Two hundred and twenty-five consecutive autopsies performed on fetuses >20 weeks' gestation were reviewed, and 37 growth-retarded stillborn fetuses without multiple congenital abnormalities or evidence of intrauterine infection were identified. Histological evidence of ischaemic cerebral injury was found in 31 of the 37 cases and placental infarction was seen in 26 of 36 placentas. Of the 31 cases with cerebral ischaemia, 24 had placental infarcts. Twenty-six of 27 stillborn fetuses >26 weeks' gestation showed histological evidence of cerebral ischaemia. It was concluded that in the group of growth-retarded fetuses studied, there was a high incidence of both cerebral and placental ischaemic abnormality.


Assuntos
Isquemia Encefálica/complicações , Morte Fetal/etiologia , Retardo do Crescimento Fetal/etiologia , Infarto/complicações , Placenta/irrigação sanguínea , Antropometria , Isquemia Encefálica/patologia , Feminino , Retardo do Crescimento Fetal/classificação , Retardo do Crescimento Fetal/diagnóstico , Idade Gestacional , Humanos , Infarto/patologia , Gravidez , Segundo Trimestre da Gravidez , Estudos Retrospectivos , Fatores de Risco
16.
J Pharm Sci ; 86(6): 666-73, 1997 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9188048

RESUMO

A variety of biophysical techniques have been employed to examine the size and conformational integrity of highly purified hepatitis A virus (HAV) in solution (purified HAV particles are subsequently formalin-inactivated and adsorbed to aluminum salts for use as the vaccine VAQTA). The size of HAV particles was assessed by a combination of electron microscopy, sedimentation velocity, and dynamic light scattering. The effect of ionic strength and temperature on the overall conformational stability of HAV was determined by a combination of intrinsic HAV protein fluorescence, fluorescent probes of both RNA and protein, and UV-visible spectroscopy. A major structural change in HAV occurs near 60 degrees C with the addition of 0.2 M magnesium chloride enhancing the thermal stability of HAV by approximately 10 degrees C. Salt concentrations above 0.2 M, however, decrease the solubility of HAV. The effect of pH on the physical properties of HAV particles was monitored by dynamic light scattering, analytical size exclusion HPLC, and interaction with fluorescent dyes. HAV particles undergo a substantially reversible association/aggregation at pH values below 6 with the concomitant exposure of previously buried hydrophobic surfaces below pH 4. These results are in good agreement with previous studies of HAV thermal stability under extreme conditions in which the irreversible inactivation of the viral particles was measured primarily by the loss of viral infectivity. The wide variety of biophysical measurements described in this work, however, directly monitor structural changes as they occur, thus providing a molecular basis with which to monitor HAV stability during purification and storage.


Assuntos
Vírus da Hepatite A Humana/química , Vacinas de Produtos Inativados/química , Cromatografia Líquida de Alta Pressão , Vacinas contra Hepatite A , Luz , Microscopia Eletrônica , Tamanho da Partícula , Espalhamento de Radiação , Espectrometria de Fluorescência , Espectrofotometria Ultravioleta , Vacinas contra Hepatite Viral
17.
Biotechnol Prog ; 13(1): 1-7, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9041705

RESUMO

We have described a method to reliably measure the free adenine content of yeast extract powders or the adenine concentrations found in chemically-defined and complex fermentation samples. This method relies on the selective precolumn derivatization of adenine with chloroacetaldehyde to form the fluorescent adenine adduct 1,N6-ethenoadenine. The derivatized adenine can then be resolved from other components found in samples with reverse phase HPLC and selectively monitored with fluorescence. This method was then used to study the adenine nutritional requirements of adenine auxotrophs of recombinant Saccharomyces cerevisiae. The adenine content of individual yeast extract powders was examined in relation to the cell mass (dry cell weight, DCW) achieved in culture media formulated with these powders. A general increase in DCW was observed with increasing adenine concentration in the yeast extract. Conversely, we observed that as adenine concentration increased in complex media the expression levels of a heterologous protein decreased. This method also allowed us to examine the adenine/DCW ratio in both steady-state continuous culture and batch culture. In both cases, the total in vivo adenine content as measured by the amount of adenine utilized from the culture media was estimated to be ca. 25-40 mg/g DCW. However, data suggest that this value is in excess of what is strictly required for cell growth and represents the quantity of adenine required to saturate intracellular pools of adenine or adenine metabolites. A minimum requirement for cell growth is at least as low as 12.5 mg of adenine/g of cells.


Assuntos
Adenina/metabolismo , Fermentação , Proteínas Fúngicas/genética , Saccharomyces cerevisiae/genética , Divisão Celular , Cromatografia Líquida de Alta Pressão , Clonagem Molecular , Meios de Cultura , Espectroscopia de Ressonância Magnética , Saccharomyces cerevisiae/citologia , Saccharomyces cerevisiae/metabolismo
18.
Orthopedics ; 19(12): 1019-24, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8972519

RESUMO

Nine high-energy pilon fractures with severe soft tissue injuries were treated by a medial external fixator with an articulated ankle-hinge and limited internal fixation (1.7 screws per case). A 100% union rate was achieved; however, there was a 100% complication rate associated with the fixator. Both B3 fractures required a vertical transarticular pin to maintain reduction. Seven C2 fractures suffered calcaneal screw loosening and drainage, necessitating removal of the fixator prior to union. Due to these complications, the articulated ankle hinge could not be utilized. At a minimum of 6 months follow up, eight of nine fractures had acceptable radiographic and early clinical results.


Assuntos
Fixadores Externos , Fraturas da Tíbia/cirurgia , Adulto , Desenho de Equipamento , Fixadores Externos/efeitos adversos , Feminino , Fraturas Fechadas/cirurgia , Fraturas Expostas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Lesões dos Tecidos Moles/cirurgia , Resultado do Tratamento
19.
Clin Orthop Relat Res ; (329): 152-9, 1996 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-8769447

RESUMO

Eighty patients with pelvic fractures, without hip, spine injuries with neurologic deficits, or traumatic cognitive deficits, 61% treated with external fixators, were reviewed with greater than 5 years of followup. The Short Form-36 General Health Survey, the Iowa pelvic scores, and additional questionnaires concerning return to previous sexual function, occupation, and recreation, and a perception of the worst sequelae of their pelvic trauma were administered. Fractures were classified according to Tile as 25 undisplaced Class A, 31 rotationally displaced Class B, and 24 vertically displaced Class C fractures. Injury severity scores, associated injuries, and mechanisms of injuries were similar across Tile classes. Statistical analysis compared Tile Classes A with B with C and Classes A with B and C. Variations by Tile class among the Short Form-36 survey, Iowa pelvic score, or questionnaire result's were not seen. Approximately 75% of patients returned to their previous sexual function and 80% to their previous occupation. Similarities comparing undisplaced with displaced pelvic fractures question whether reduction of pelvic ring injuries can alter patient long term functional outcomes.


Assuntos
Fixação de Fratura , Fraturas Fechadas/cirurgia , Ossos Pélvicos/lesões , Adolescente , Adulto , Idoso , Feminino , Fixação Interna de Fraturas , Fraturas Fechadas/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
20.
Orthopedics ; 19(2): 109-16, 1996 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8834286

RESUMO

Twenty-nine patients with tibial diaphyseal fractures had external fixators applied to treat their initial fractures and underwent nonreamed solid core nailing for nonunion (> 22 weeks). Fifteen Alta, 11 Lottes, and 3 Rush nails were used. The original fracture grades were: 1 closed, 1 grade I, 7 grade II, 3 grade IIIA, and 17 grade IIIB. The duration of nonunion was 51 weeks (average: 22 to 173). The average duration of external fixation was 19 weeks (range: 9 to 47). The average interval from fixator removal to nail was 32 weeks (range: 0 to 156). Twenty-eight patients were seen at > 12 months' follow up (average: 35; range: 10 to 58) and completion of treatment. Twenty-seven patients' fractures united at an average of 14 weeks (range: 6 to 40). One patient required a reamed exchange nailing at 39 weeks and united 58 weeks post-exchange nailing. One patient had a persistent asymptomatic nonunion. One patient developed a stress fracture 49 months post nail requiring an exchange nailing. Eleven fractures had a pre-nail deformity of 10 degrees or more; 9 were corrected. Eight patients had pre-nail wound and five had pre-nail pin tract infections. Except for two cases, all of these infections were treated successfully with surgical debridement and/or antibiotics prior to nail insertion. Two patients had their nail inserted through active infections that could not be controlled with an unstable fracture. One patient healed uneventfully in 6 weeks. One required two subsequent debridements. There were no other infections. The authors conclude that nonreamed solid core nailing is an acceptable treatment for tibial diaphyseal nonunions following external fixation.


Assuntos
Fixadores Externos , Fixação Intramedular de Fraturas/instrumentação , Fraturas não Consolidadas/cirurgia , Complicações Pós-Operatórias/cirurgia , Fraturas da Tíbia/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Consolidação da Fratura/fisiologia , Fraturas não Consolidadas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Radiografia , Reoperação , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Infecção da Ferida Cirúrgica/cirurgia , Fraturas da Tíbia/diagnóstico por imagem
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