Change in organic molecule adhesion on α-alumina (sapphire) with change in NaCl and CaCl2 solution salinity.

We investigated the adhesion of two functional groups to α-alumina as a model for the adsorption of organic molecules on clay minerals. Interactions between organic compounds and clay minerals play an important role in processes such as drinking water treatment, remediation of contaminated soil, oil recovery, and fabricating complicated nanomaterials, and there have been claims that organic compound-clay mineral interaction created the ordering that is necessary for the genesis of life. In many organisms, interaction between organic molecules and biominerals makes it possible to control the growth of bones, teeth, and shells. Adhesion of carboxylic acid, -COO(H), and pyridine, -C5H5N(H(+)), on the {0001} plane of α-alumina wafers has been investigated with atomic force microscopy (AFM) in chemical force mapping (CFM) mode. Both functional groups adhered to α-alumina in deionized water at pH < 5, and adhesion decreased as NaCl or CaCl2 concentration increased. X-ray photoelectron spectroscopy (XPS) showed that Na(+) and Ca(2+) adsorbed to the α-alumina surface at pH < 5, decreasing surface interaction with the carboxylic acid and pyridine groups. We interpret the results as evidence that the tips adhere to alumina through hydrogen bonding when only water is present. In solutions containing NaCl and CaCl2, cations are adsorbed but Cl(-) is not. When NaCl solutions are replaced by CaCl2, Ca(2+) replaces Na(+), but rinsing with ultrapure deionized water (pH 5.6) could not restore the original protonated surface. The results demonstrate that the alumina surface at pH 3 has a higher affinity for inorganic cations than for -COO(H) or -C5H5N(H(+)), in spite of the known positive surface charge of α-alumina {0001} wafers. These results demonstrate that solution salinity plays an important role in surface properties, controlling surface tension (i.e., contact angle) and adsorption affinity on α-alumina and, by analogy, on clay minerals.

Catalytic hydration of terminal alkenes to primary alcohols.

Direct catalytic hydration of terminal alkenes to primary alcohols would be an inexpensive route to industrially useful alcohols and a convenient synthetic route for the synthesis of terminal alcohols in general. The reaction between trans- PtHCl(PMe(3))(2) (where Me = CH(3)) and sodium hydroxide in a one-to-one mixture of water and 1-hexene yields a species that, at 60 degrees C and in the presence of the phasetransfer catalyst benzyltriethylammonium chloride, catalyzes selective hydration of 1-hexene to n-hexanol at a rate of 6.9 +/- 0.2 turnovers per hour. Hydration of 1-dodecene to n-dodecanol occurs at a rate of 8.3 +/- 0.4 turnovers per hour at 100 degrees C. Deuterium labeling experiments with trans-PtDCl(PMe(3))(2) show that hydration involves reductive elimination of a C-H bond. At low hydroxide concentrations (<8 equivalents), hydration of the water-soluble olefin 3-butene-1-ol to 1,4-butanediol exhibited a first-order dependence on hydroxide concentration for loss of catalytic activity. This suggests that hydroxide attacks the coordinated alkene slowly. At high hydroxide concentrations, the rate of catalysis was hydroxide-independent and first order in alkene. Substitution of coordinated water (k(1) = 9.3 +/- 0.5 x 10(-3) liters per mol per second) appears to be limitng under these conditions.

Dehydriding reaction of AlH3: in situ microscopic observations combined with thermal and surface analyses.

The dehydriding reaction of single-phase alpha- AlH3 was investigated by in situ microscopic observations combined with thermal and surface analyses. Before the dehydriding reaction, primary AlH3 particles of size 100 nm-1 microm were thought to be covered by an oxide layer with a thickness of less than 5 nm. Both the precipitation/grain-growth of metallic Al of size 1-50 nm and an increase in 'boundary space' were clearly observed inside the particles, while the morphologies of the particles covered by the layer did not change during the dehydriding reaction. This preliminary report provides fundamental information for a further study of AlH3 as a possible hydrogen storage material.

Plate fixation compared with nonoperative treatment of displaced midshaft clavicular fractures: a randomized clinical trial.

AIMS: Recent studies of nonoperatively treated displaced midshaft clavicular fractures have shown a high incidence of nonunion and unsatisfactory functional outcome. Some studies have shown superior functional results and higher rates of healing following operative treatment. The aim of this study was to compare the outcome in these patients after nonoperative management with those treated with fixation. PATIENTS AND METHODS: In a multicentre, parallel randomized controlled trial, 146 adult patients with an acute displaced fracture of the midthird of the clavicle were randomized to either nonoperative treatment with a sling (71, 55 men and 16 women with a mean age of 39 years, 18 to 60) or fixation with a pre-contoured plate and locking screws (75, 64 men and 11 women with a mean age of 40 years, 18 to 60). Outcome was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) Score, the Constant Score, and radiographical evidence of union. Patients were followed for one year. RESULTS: A total of 60 patients in the nonoperative group and 64 in the operative group completed one-year follow-up. At three months' follow-up, both the median DASH (1.7 vs 8.3) and median Constant scores (97 vs 90) were significantly better in the operated group (both p = 0.02). After six months and one year, there was no difference in the median DASH or Constant scores. The rate of nonunion was lower in the operative group (2 vs 11 patients, p < 0.02). Nine patients in the nonoperative group underwent surgery for nonunion. The plate was subsequently removed in 16 patients (25%). One patient had a new fracture after removal of the plate and one underwent revision surgery for failure of fixation. CONCLUSION: Fixation of a displaced midshaft clavicular fracture using a pre-contoured plate and locking screws results in faster functional recovery and a higher rate of union compared with nonoperative management, but the function of the shoulder is equal after six months and at one year. Cite this article: Bone Joint J 2018;100-B:1385-91.

Experiences of being diagnosed with osteoporosis: a meta-synthesis.

This systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. Using individuals' experiences and meanings can promote tailored and targeted information and guidance on osteoporosis, bone care and treatment at different stages of the osteoporosis trajectory. INTRODUCTION: To be diagnosed with osteoporosis with or without fragility fractures affects individuals differently. The aim of this review was firstly to aggregate existing qualitative evidence regarding an individual's experience of being diagnosed with osteoporosis at different stages, and secondly, to use a systematic approach to develop a conceptual understanding of central issues relevant for health professionals in order to provide support and guidance to patients/individuals. METHODS: This study used a systematic review methodology and methods for qualitative synthesis as recommended by Cochrane and integrated the findings of qualitative research from eight databases (Medline, PubMed, CINAHL, Embase, SweMed+, PsycINFO, ERIC, Web of Science) to July 2016. Selection and assessment were performed by three authors while four authors were involved in the analysis. Findings were cross-checked with the original article to ensure consistency with the individual's accounts. RESULTS: Our findings have revealed that individuals diagnosed with osteoporosis do not perceive osteoporosis as a biomedical trajectory but as a self-perceived continuum of severity and health. To be diagnosed with osteoporosis affects individuals differently depending on, for example, personal experience, pre-conceived notions of or knowledge about the disease, fragility fractures or pain. Hence, individuals will create a meaning of the diagnosis based on self-perceived fracture risk, self-perceived severity of osteoporosis and at the same time, self-perceived health. CONCLUSIONS: This meta-synthesis provides knowledge for health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. The experience, meaning and significance of osteoporosis must be taken into consideration and can be used to promote tailored and targeted information and guidance on osteoporosis, bone care and treatment at different stages of the osteoporosis trajectory.

Absence of pharmacokinetic drug interaction of levetiracetam with phenytoin in patients with epilepsy determined by new technique.

Levetiracetam has recently been approved as an adjunctive medication for partial seizures and frequently will be added to phenytoin. The objective of this study was to determine the presence or absence of a pharmacokinetic drug interaction of levetiracetam with phenytoin. A stable isotope tracer technique using deuterium-labeled (D10) phenytoin and high-performance liquid chromatography with ultraviolet detection (rather than mass spectrometric detection) was employed. Tracer doses of D10-phenytoin were administered i.v. before and 12 weeks after adding levetiracetam to the regimen of 6 subjects on phenytoin monotherapy for epilepsy. Blood was collected for 96 hours after each infusion. The following pharmacokinetic parameters were determined for phenytoin: Cmax, Cmin, Cavo, AUC, CL, t 1/2, VD, and free (nonprotein bound) fraction. The ratio and the 90% confidence interval of the ratio of log-transformed mean values for phenytoin pharmacokinetic parameters before (denominator) and after (numerator) adding levetiracetam all fell within the range of 0.85 to 1.17 (two one-sided test). The authors conclude that the addition of levetiracetam did not bring about clinically important changes in phenytoin pharmacokinetic parameters and that it is not necessary to change the phenytoin dosing rate when levetiracetam is added to phenytoin.

Biodegradable pins versus Kirschner wires in hand surgery.

We compared biodegradable pins with standard Kirschner wires in the fixation of fractures, arthrodeses and osteotomies in the hand in a prospective, randomized study. Eleven patients were allocated to the biodegradable pin group and 12 to the Kirschner wire group. Age, gender, operative procedure and postoperative treatment did not differ in the two groups. All patients were evaluated after 6 months. No differences in time to union or complication rates were found, but the number of additional operative procedures in the Kirschner wire group significantly exceeded the number needed in the biodegradable pin group.

A diagnostic problem in tuberculous dactylitis.

We report a case of tuberculous dactylitis. This rare manifestation of extra-pulmonary tuberculosis must be kept in mind in the diagnosis of a slowly-growing bone tumour. The diagnostic problems and pitfalls are discussed.

Amputations in the treatment of Dupuytren's disease.

23 finger amputations in 19 patients operated on for Dupuytren's disease were reviewed 6 months to 8.5 years after operation (mean 4 years). The distribution of amputations were 17 little fingers and six ring fingers. We found a recurrent lack of extension in nine out of 16 finger amputations distal to the MP joint and painful neuroma or phantom limb pain in five out of seven little finger amputations through or proximal to the MP joint. When amputation in the little finger is necessary, disarticulation of the MP joint may be preferable to amputation at a more distal level. Alternatives to finger amputation should be sought in difficult cases of Dupuytren's disease.

Removal of internal fixation--the effect on patients' complaints: a study of 66 cases of removal of internal fixation after malleolar fractures.

To estimate the effect of removal of internal fixation after treatment of malleolar fractures on postoperatively presented complaints, we retrospectively evaluated 66 patients by their records and by personal questionnaires. Of all the patients, 89.4% had one or more complaints. These were typically soreness over implant and cicatrix, reduced movement of the ankle joint, and strain-related pain. About 75% of these patients reported improvement after removal. The AO mode of fixation, i.e., typically by lateral semitubular plating and transsyndesmotic screw and a medial screw or pins, and the Wiberg-Cedell mode, i.e., typically consisting of lateral single or double cerclage and staple and medial pinning, constituted the principal groupings of the patients. The two groups were comparable. In this series, we found significantly more complaints associated with the AO mode in the postoperative period. We conclude that removal of internal fixation after malleolar fractures is indicated when common types of complaints are presented.

Elbow synovectomy in rheumatoid arthritis.

We present the results of a clinical and radiographic follow-up study of patients undergoing elbow synovectomies. Twenty-five elbows in 24 patients with rheumatoid arthritis were followed for a median period of 52 months (range 10-108) after operation. Nineteen (74%) stated they had improvement of pain and function. Two patients reported increased pain. Improvement of motion was noted, but this was not statistically significant. Radiographic classification showed statistically significant progressive changes. Three complications were noted, all without permanent sequels. Moderate elbow destruction can provide a good indication for elbow synovectomy in the treatment of patients suffering from rheumatoid arthritis.

[Synovectomy in rheumatoid arthritis]. / Synovektomi ved reumatoid arthritis.

Surgical synovectomy in the treatment of rheumatoid arthritis has been performed for more than a 100 years, and yet the definite indication has not been made clear. Synovectomy has a convincing, but mostly time-limited effect on pain and articular hydrops, but the radiological progression continues almost undisturbed. Histological evaluation of the regenerating synovial membrane has now shown a tendency towards reversing to baseline within about a year. The difficulties in evaluating the operation are caused by the lack of comparable randomized studies performed on large populations, treated in a double-blind fashion and examined in cooperation between surgeon and rheumatologist.

[Reconstructive joint surgery and rheumatoid arthritis. Status over a developing field]. / Rekonstruktiv ledkirurgi og reumatoid arthritis. Status over et udviklingsområde.

Rheumatoid arthritis has a prevalence of between 1% and 2%. The majority of patients face the prospect of surgical treatment of joints, that do not respond to medical treatment. With respect to the extensive development in joint surgery during the last decade, today's recommendations for surgical treatment of the individual joints are surveyed.

[Infectious arthritis in a patient with rheumatoid arthritis]. / Infektiøs arthritis hos en patient med reumatoid arthritis.

Patients with rheumatoid arthritis are at greater risk of developing joint infections than any other group of patients. Diagnosis is often delayed because of the difficulties in distinguishing between a flare-up and a septic affection of the joint. A case of septic arthritis with multiple joint involvement and lethal outcome despite extensive antibiotic treatment and successive surgical procedures is presented. The patient developed osteomyelitis and multiple organ failure. In order to reduce morbidity and mortality from septic arthritis, early joint puncture and subsequent antibiotic treatment is essential.