Foot Surgery Using Resorbable Magnesium Screws.

The use of bioabsorbable magnesium (Mg) screws is new in foot surgery. Their relative merit over conventional titanium screws has not yet been proven. This prospective case series study was conducted to compare the clinical and radiological outcomes of bioabsorbable Mg screws and titanium screws. A consecutive series of patients (n = 60; 11 men and 49 women) underwent corrective hallux valgus surgery. The minimum follow-up period was 1 year. The assessment was based on a patient questionnaire, including the American Orthopedic Foot and Ankle Society (AOFAS) hallux valgus score, visual analog scale, patient's global impression of change (PGIC), and fifth metatarsus circumference (IF5C). The radiographic assessment included the intermetatarsal and hallux valgus angles, as well as time to osteotomy union and hardware failure. At 1 year, similar results were obtained radiographically. The healing of the osteotomies was significantly faster in the Mg group. Hardware failure was common in the Mg group (5/26) than in the TI group (0/34) but hardware removal was more common in the TI group (6/34) versus the MG group (0/26). IF5C increased by 8 ± 2 mm in the Mg group. The AOFAS and PGIC scores at 6 months were similar. Validated foot scores and radiographic analysis indicated that there was no detectable difference between the groups. The fast achievement of osteotomy union compensates for a high rate of hardware failure, resulting in patient satisfaction and avoiding reoperation for hardware removal.

Comparison of the clinical efficacy of daily use of L-arginine, tadalafil and combined L-arginine with tadalafil in the treatment of elderly patients with erectile dysfunction.

This study aimed to evaluate the efficacy of the daily oral administrations of L-arginine, tadalafil and combined L-arginine with tadalafil in treatments of elderly patients with erectile dysfunction (ED). It was designed as a single-blind placebo-controlled clinical trial. It was conducted on 120 male patients aged ≥60 years old with ED. Patients were randomised classified into four groups (n = 30 each). Oral daily use of L-arginine (5 g), tadalafil (5 mg), combined L-arginine (5 g) with tadalafil (5 mg) and placebo were taken for 6 weeks in each group of patients respectively. Patients were assessed before and after treatments using the Sexual Health Inventory for Men (SHIM) questionnaire and total serum testosterone. The means of Q1-5, total scores of SHIM and total testosterone, in L-arginine, tadalafil and combined L-arginine with tadalafil groups were significantly higher after treatments (p = .001). Combined L-arginine with tadalafil group had the highest SHIM scores and levels of total testosterone. This clinical trial deduced that the combined daily use of L-arginine with tadalafil therapy for elderly male patients with ED could significantly increase the SHIM scores and levels of total testosterone in comparison to L-arginine, or tadalafil alone.

Self-calibration single-lens 3D video extensometer for high-accuracy and real-time strain measurement.

The accuracy of strain measurement using a common optical extensometer with two-dimensional (2D) digital image correlation (DIC) is not sufficient for experimental applications due to the effect of out-of-plane motion. Although three-dimensional (3D) DIC can measure all three components of displacement without introducing in-plane displacement errors, 3D-DIC requires the stringent synchronization between two digital cameras and requires complicated system calibration of binocular stereovision, which makes the measurement rather inconvenient. To solve the problems described above, this paper proposes a self-calibration single-lens 3D video extensometer for non-contact, non-destructive and high-accuracy strain measurement. In the established video extensometer, a single-lens 3D imaging system with a prism and two mirrors is constructed to acquire stereo images of the test sample surface, so the problems of synchronization and out-of-plane displacement can be solved easily. Moreover, a speckle-based self-calibration method which calibrates the single-lens stereo system using the reference speckle image of the specimen instead of the calibration targets is proposed, which will make the system more convenient to be used without complicated calibration. Furthermore, an efficient and robust inverse compositional Gauss-Newton algorithm combined with a robust stereo matching stage is employed to achieve high-accuracy and real-time subset-based stereo matching. Tensile tests of an Al-alloy specimen were performed to demonstrate the feasibility and effectiveness of the proposed self-calibration single-lens 3D video extensometer.

Medical evidence of human rights violations against non-Arabic-speaking civilians in Darfur: a cross-sectional study.

BACKGROUND: Ongoing conflict in the Darfur region of Sudan has resulted in a severe humanitarian crisis. We sought to characterize the nature and geographic scope of allegations of human rights violations perpetrated against civilians in Darfur and to evaluate their consistency with medical examinations documented in patients' medical records. METHODS AND FINDINGS: This was a retrospective review and analysis of medical records from all 325 patients seen for treatment from September 28, 2004, through December 31, 2006, at the Nyala-based Amel Centre for Treatment and Rehabilitation of Victims of Torture, the only dedicated local provider of free clinical and legal services to civilian victims of torture and other human rights violations in Darfur during this time period. Among 325 medical records identified and examined, 292 (89.8%) patients from 12 different non-Arabic-speaking tribes disclosed in the medical notes that they had been attacked by Government of Sudan (GoS) and/or Janjaweed forces. Attacks were reported in 23 different rural council areas throughout Darfur. Nearly all attacks (321 [98.8%]) were described as having occurred in the absence of active armed conflict between Janjaweed/GoS forces and rebel groups. The most common alleged abuses were beatings (161 [49.5%]), gunshot wounds (140 [43.1%]), destruction or theft of property (121 [37.2%]), involuntary detainment (97 [29.9%]), and being bound (64 [19.7%]). Approximately one-half (36 [49.3%]) of all women disclosed that they had been sexually assaulted, and one-half of sexual assaults were described as having occurred in close proximity to a camp for internally displaced persons. Among the 198 (60.9%) medical records that contained sufficient detail to enable the forensic medical reviewers to render an informed judgment, the signs and symptoms in all of the medical records were assessed to be consistent with, highly consistent with, or virtually diagnostic of the alleged abuses. CONCLUSIONS: Allegations of widespread and sustained torture and other human rights violations by GoS and/or Janjaweed forces against non-Arabic-speaking civilians were corroborated by medical forensic review of medical records of patients seen at a local non-governmental provider of free clinical and legal services in Darfur. Limitations of this study were that patients seen in this clinic may not have been a representative sample of persons alleging abuse by Janjaweed/GoS forces, and that most delayed presenting for care. The quality of documentation was similar to that available in other conflict/post-conflict, resource-limited settings.

Long-term follow-up (18-35 years) of male patients with history of bladder exstrophy (BE) repair in childhood: erectile function and fertility potential outcome.

INTRODUCTION: Bladder exstrophy is a rare condition that may lead to severe psychosexual malformation and require a lifelong follow-up. AIM: We describe the long-term sexual outcome of patients with bladder exstrophy treated at our institution at early stage. METHODS: Thirty patients with mean age of 26 years (range 18-35 years) were included in the study. Fifteen patients underwent staged primary reconstruction, five patients underwent complete primary repair, and 10 patients underwent primary or secondary ureterosigmoidostomy. MAIN OUTCOME MEASURES: Evaluation consisted of pediatric medical records, interview questionnaire including the psychosexual history, International Index of Erectile Function (IIEF), and semen analysis. RESULTS: Erectile functions were maintained in 28 patients based on IIEF domain score. In all cases, penile length was objectively less than average (mean 7.65 cm). Seven patients were not satisfied with their penile length, and four cases complained of slight curvature. Ten patients were married (33%), of whom four patients had children (after normal conception in three, and after assisted reproductive technique in one). The remaining 20 patients were not married because of the feeling of sexual inadequacy to be able to engage in sexual intercourse (six patients), afraid of the cosmetic appearance of the genitalia (10 patients), and incontinence (four patients). Retrograde ejaculation was documented in 16 cases (53.5%), low volume ejaculate in eight cases (26.5%), and anejaculation in six cases (20%). Cosmetic outcome was considered satisfactory by 50% of the patients. Sixteen patients voided per urethra, four performed clean intermittent catheterization, and 10 patients had ureterosigmoidostomy diversion. Urinary tract infection was documented in 20% of the cases, and recurrent attacks of pyelonephritis in 10% of the cases. CONCLUSION: Long-term outcome of bladder exstrophy repair in male patients showed fair results with respect to sexual function with more or less stable sexual relationship. We should do our best to solve the problem of those with restricted sexual lives.