Operative Treatment of Pediatric Pelvic and Acetabulum Fractures.

Pediatric pelvic fractures are rare and differ from adults in etiology, fracture type, and associated injuries. They are observed in multitrauma patients, with severe associated injuries. Treatment of these children in specialized hospitals is likely to provide the best outcome because of the rarity of these fractures. Only a small percentage of the fractures, particularly the displaced ones, need operative treatment with the aim to restore the anatomy of the pelvic ring. In a significant proportion of the operated patients, morbidity and mortality were not linked to the pelvic fractures but to the other associated injuries. Long-term prognosis depends on restoring pelvic symmetry. Nondisplaced fractures of the acetabulum or fractures with minimal displacement with a relatively low roof-arc angle or crush injuries of the triradiate physis are managed nonoperatively. In young patients where continuation of growth is expected, fixation that does not cross the physis anatomically could be used. In some very young children, plate removal may be indicated to allow for continued growth of the acetabulum. One of the major complications in this patient cohort is acetabular dysplasia.

Homing of cytokine-induced killer cells during the treatment of acute promyelocytic leukemia.

Cytokine-induced killer (CIK) cells have been shown to be an effective immunotherapy for malignancies. However, their clinical application has been limited due to lack of knowledge on their in vivo kinesis. In this study, we explored their biodistribution by labeling CIK cells with (18)F-FDG and tracking their in vivo migration by PET/CT imaging. In the nine refractory APL patients enrolled in this study, pre-treatment PET/CT scans revealed leukemia burdens in vertebrae, and the bones of the pelvis and limbs. Post-treatment serial PET/CT tracked the localization of CIK cells over time: at 1 h, the majority of these cells accumulated diffusely in the lungs, while the first minor cell activities were observed in brain, liver and spleen; at 4 and 8 h, they not only migrated to the heart, spleen, and liver, but also showed tendencies to accumulate in bone marrow and brain. This specific cell migration route suggested that CIK cells show in vivo functional kinesis and potency as a targeted immunotherapy. The clinical outcome of this small cohort of nine patients supported the efficacy of this regimen: two patients achieved rapid complete remission after three-cycle treatment, and six patients remained stable, subsequently became sensitive to conventional therapy, and also achieved complete remission.

[Pathophysiological grounds of reamberin application in complex treatment of disintegrated factures of pelvic bones].

The investigation showed that reamberin application in the complex treatment of patients with severe disintegrated fractures of pelvic bones is pathogenetically grounded. Despite polyetiological origin of critical conditions in the organism in this case, all these have a common pathophysiological basis of three main processes: hypoxia, intoxication, and immunosuppression. Succinic acid, which is contained in reamberin, is a substrate antihypoxant that stimulates the synthesis of restorative equivalents in the cell. A modifying effect of succinic acid on the processes of tissue metabolism, including cell respiration, LPO/AOS system, and synthesis of proteins, is the basis of pathophysiological ground of reamberin application in a complex treatment of patients with disintegrated fractures of pelvic bones.

Prevention and management of osteitis pubis in the Australian Football League: a qualitative analysis.

OBJECTIVES: To examine current practices and develop a set of recommendations for the management of osteitis pubis in the Australian Football League (AFL). DESIGN: A qualitative study using in-depth interviews to gather data and thematic coding to analyze findings. SETTING: Participants were interviewed in their workplace or at a convenient meeting point. PARTICIPANTS: Thirty-six medical and fitness staff from the 16 AFL clubs. RESULTS: Respondents from all clubs viewed osteitis pubis as an overuse injury and recognized that the key to prevention is balancing pelvic integrity and load. Osteitis pubis was described as the end result of a continuum of groin pathology, and recognition of predisposing factors and early detection were identified as the key elements of optimal management. Management strategies included rest, training modification, cross-training, correction of predisposing factors, physical therapy and a progression back to competition. Most clubs also conduct generic prevention and education programs. CONCLUSIONS: Overall, respondents perceived that awareness and management of osteitis pubis is currently at a high level in the AFL. Management of osteitis pubis requires the balancing of pelvic integrity and mechanical load through the pelvis and the early identification of warning signs.

Histocompatibility (HLA) antigens in heterotopic ossification associated with neurological injury.

Twenty patients with heterotopic ossification were HLA typed. The group consisted of 12 patients with severe cranio-cerebral injury and 8 with spinal cord injury. No significant differences in the frequency of any HLA antigens were found in these patients when compared to 631 healthy matched controls. None of the patients was B27 positive.