Kyphoplasty versus percutaneous vertebroplasty using the traditional and the new side-opening cannula for osteoporotic vertebral fracture.

AIM: The aim of this article was to study the results of two different types of percutaneous vertebroplasty (PV) and kyphoplasty (KPs) to osteoporotic vertebral fractures (OVF). METHODS: It was prospectively analyzed a series of 47 PVs from January 2003 to February 2008, and a consecutive series 30 KPs from March 2008 to January 2010, performed for patients with painful OVFs. Twenty-five PVs were performed using the frontal-opening cannula (FOC) and 22 using the new side-opening cannula (SOC), randomly distributed in the PV group. RESULTS: The incidence of cement extrusion was 16.7% with KP, comparing with PV, it was 27.3% using the SOC (P<0.05) and 68,0% with the FOC (P<0.05), but comparing SOC with FOC, the cement extrusion was significantly lower using the SOC (P<0.05), all asymptomatic. The pain control was similar for all groups (P<0.05), with good improvement of pain in most of the patients, and there were no clinical relevant complications. CONCLUSION: The cement leakage was significantly reduced with the KP (16.7%) and the SOC (27.3%) for PV, in comparison with the FOC (68.0%). The cement extrusion was slightly lower with KP, but not a significant difference, comparing with SOC, increasing the safety of the procedure using both the KP and this new SOC.

Clinical effectiveness of a low-tech versus high-tech pressure-redistributing mattress.

OBJECTIVE: To compare the effectiveness of a high-specification foam mattress (control) with a high-tech (Duo2, Hill Rom) alternating/continuous low-pressure mattress (treatment) in the prevention of pressure ulceration. The study also evaluated if there is a difference in performance between the two working modalities (alternating and continuous low pressure) of the high-tech mattress in a comparable sample of patients. METHOD: Thirty-three patients were observed for two weeks in the control group. In the treatment group, 86 patients were randomised to receive alternating low pressure and 84 continuous low pressure. Incidence of pressure ulcers in both arms was recorded. Student's t-test was used to compare all Braden scores, and the chi-square test and Fisher's exact test to evaluate differences between groups. RESULTS: There was a high difference in the number of new pressure ulcers in the control group when compared with the treatment group. There was no difference in performance between the alternating and continuous low-pressure modes. However, the sample size is too small to prove or disprove a statistically significant difference between the two modalities. CONCLUSION: The high-tech mattress was markedly more effective than the high-specification foam mattress in preventing the onset of pressure ulcers. Initial data suggest that the use of alternating or continuous low pressure made little or no difference to the results.

Is there a role for sustainable medicine in wound care?

Is it ethical to prolong life by providing aggressive palliative care to chronically ill patients with a short life expectancy? Here, Andrea Cavicchioli argues that epidemiology studies can help us to resolve this difficult ethical dilemma.

Analysis of S-phenyl-L-cysteine in globin as a marker of benzene exposure.

An assay has been developed to determine S-phenylcysteine (SPC) in globin as a potential biomarker for exposure to benzene. The sensitivity of the assay is less than 20 pmol SPC g(-1) globin. Following acidic hydrolysis of the protein, the modified amino acid is purified by reverse phase cartridge chromatography and HPLC, prior to conversion to the tert-butyldimethylsilyl derivative and GC-MS selected ion recording. Quantitation is achieved using the internal standard [(2)H5]-SPC, and calibration lines were established using a synthetic peptide Leu-His-SPC-Asp-Lys. Control human globin was found to contain ca 30 pmol SPC g(-1) globin in two populations. The source of the apparent background level of SPC is unknown.