Search results for: invasive procedure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2781

Search results for: invasive procedure

2241 Experimental Investigation of Soil Corrosion and Electrical Resistance in Depth by Geoelectrical Method

Authors: Seyed Abolhassan Naeini, Maedeh Akhavan Tavakkoli

Abstract:

Determining soil engineering properties is essential for geotechnical problems. In addition to high cost, invasive soil survey methods can be time-consuming, so geophysical methods can be an excellent choice to determine soil characteristics. In this study, geoelectric investigation using the Wenner arrangement method has been used to determine the amount of soil corrosion in soil layers in a project site as a case study. This study aims to assess the degree of corrosion of soil layers to a depth of 5 meters and find the variation of soil electrical resistance versus depth. For this purpose, the desired points in the study area were marked and specified, and all withdrawals were made within the specified points. The collected data have been processed by standard and accepted methods, and the results have been presented in the form of calculation tables and curves of electrical resistivity with depth.

Keywords: Wenner array, geoelectric, soil corrosion, electrical soil resistance

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2240 Applying Laser Scanning and Digital Photogrammetry for Developing an Archaeological Model Structure for Old Castle in Germany

Authors: Bara' Al-Mistarehi

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Documentation and assessment of conservation state of an archaeological structure is a significant procedure in any management plan. However, it has always been a challenge to apply this with a low coast and safe methodology. It is also a time-demanding procedure. Therefore, a low cost, efficient methodology for documenting the state of a structure is needed. In the scope of this research, this paper will employ digital photogrammetry and laser scanner to one of highly significant structures in Germany, The Old Castle (German: Altes Schloss). The site is well known for its unique features. However, the castle suffers from serious deterioration threats because of the environmental conditions and the absence of continuous monitoring, maintenance and repair plans. Digital photogrammetry is a generally accepted technique for the collection of 3D representations of the environment. For this reason, this image-based technique has been extensively used to produce high quality 3D models of heritage sites and historical buildings for documentation and presentation purposes. Additionally, terrestrial laser scanners are used, which directly measure 3D surface coordinates based on the run-time of reflected light pulses. These systems feature high data acquisition rates, good accuracy and high spatial data density. Despite the potential of each single approach, in this research work maximum benefit is to be expected by a combination of data from both digital cameras and terrestrial laser scanners. Within the paper, the usage, application and advantages of the technique will be investigated in terms of building high realistic 3D textured model for some parts of the old castle. The model will be used as diagnosing tool of the conservation state of the castle and monitoring mean for future changes.

Keywords: Digital photogrammetry, Terrestrial laser scanners, 3D textured model, archaeological structure

Procedia PDF Downloads 172
2239 Effect of Low Level Laser Therapy versus Ultrasound on Musculoskeletal Conditions

Authors: Andrew Anis Fakhrey Mosaad

Abstract:

This Musculoskeletal (MSK) conditions are a major contributing factor in disability. This becomes more challenging as the world population is witnessing an increase in the geriatric population. Various treatment strategies are being researched to provide the most effective and non-invasive approach. To date, low-level laser therapy (LLLT) is one of the emerging modalities to treat different musculoskeletal conditions in physical therapy practice. Physical therapy practice uses different modalities to control pain and inflammation. LLLT has been under research for the last two decades and has shown varying results. This literature review focuses on the effectiveness of LLLT in different musculoskeletal conditions. Using search engines of PubMed and Google Scholar, a number of articles have been reviewed based on the inclusion and exclusion criteria. LLLT shows promising results in treating different musculoskeletal conditions. However, clinicians need to ensure to follow the recommended dosage parameters for specific musculoskeletal conditions.

Keywords: musculoskeletal conditions, low level laser therapy, ultrasound, wavelength, pain and inflammation

Procedia PDF Downloads 103
2238 Sport-Related Hand and Wrist Injuries Treatment

Authors: Sergei Kosarev

Abstract:

Wrong treatment tactics for hand and wrist sport-related injuries can lead to the inability to play sports in the future. It is especially important for professional athletes. The members of the Russian Olympic Team are treated in our hospital -Federal Clinical Research Center (Moscow). For their treatment, we use minimally invasive methods such as wrist arthroscopy and also orthobiologics procedures. In 2022 we had cases with scaphoid fracture and TFCC injuries. In all the cases, we were using the arthroscopy technic for treatment. The scaphoid fracture was fixed by K-wires with free bone grafting. For TFCC injures we used transossal sutures. Rehabilitation started the next day after surgery. Rehabilitation included hand therapy and physiotherapy. All athletes returned to the sport after 8-12 weeks after surgery. One of them had pain in the wrist after 12 weeks after surgery, not more than 4 point VAS. Pain syndrome was blocked after 2 PRP injections in the ulnar side of the wrist.

Keywords: sport trauma, wrist arthroscopy, wrist pain, scaphoid fracture

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2237 Comprehensive Risk Analysis of Decommissioning Activities with Multifaceted Hazard Factors

Authors: Hyeon-Kyo Lim, Hyunjung Kim, Kune-Woo Lee

Abstract:

Decommissioning process of nuclear facilities can be said to consist of a sequence of problem solving activities, partly because there may exist working environments contaminated by radiological exposure, and partly because there may also exist industrial hazards such as fire, explosions, toxic materials, and electrical and physical hazards. As for an individual hazard factor, risk assessment techniques are getting known to industrial workers with advance of safety technology, but the way how to integrate those results is not. Furthermore, there are few workers who experienced decommissioning operations a lot in the past. Therefore, not a few countries in the world have been trying to develop appropriate counter techniques in order to guarantee safety and efficiency of the process. In spite of that, there still exists neither domestic nor international standard since nuclear facilities are too diverse and unique. In the consequence, it is quite inevitable to imagine and assess the whole risk in the situation anticipated one by one. This paper aimed to find out an appropriate technique to integrate individual risk assessment results from the viewpoint of experts. Thus, on one hand the whole risk assessment activity for decommissioning operations was modeled as a sequence of individual risk assessment steps, and on the other, a hierarchical risk structure was developed. Then, risk assessment procedure that can elicit individual hazard factors one by one were introduced with reference to the standard operation procedure (SOP) and hierarchical task analysis (HTA). With an assumption of quantification and normalization of individual risks, a technique to estimate relative weight factors was tried by using the conventional Analytic Hierarchical Process (AHP) and its result was reviewed with reference to judgment of experts. Besides, taking the ambiguity of human judgment into consideration, debates based upon fuzzy inference was added with a mathematical case study.

Keywords: decommissioning, risk assessment, analytic hierarchical process (AHP), fuzzy inference

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2236 Economical Transformer Selection Implementing Service Lifetime Cost

Authors: Bonginkosi A. Thango, Jacobus A. Jordaan, Agha F. Nnachi

Abstract:

In this day and age, there is a proliferate concern from all governments across the globe to barricade the environment from greenhouse gases, which absorb infrared radiation. As a result, solar photovoltaic (PV) electricity has been an expeditiously growing renewable energy source and will eventually undertake a prominent role in the global energy generation. The selection and purchasing of energy-efficient transformers that meet the operational requirements of the solar photovoltaic energy generation plants then become a part of the Independent Power Producers (IPP’s) investment plan of action. Taking these into account, this paper proposes a procedure that put into effect the intricate financial analysis necessitated to precisely evaluate the transformer service lifetime no-load and load loss factors. This procedure correctly set forth the transformer service lifetime loss factors as a result of a solar PV plant’s sporadic generation profile and related levelized costs of electricity into the computation of the transformer’s total ownership cost. The results are then critically compared with the conventional transformer total ownership cost unaccompanied by the emission costs, and demonstrate the significance of the sporadic energy generation nature of the solar PV plant on the total ownership cost. The findings indicate that the latter play a crucial role for developers and Independent Power Producers (IPP’s) in making the purchase decision during a tender bid where competing offers from different transformer manufactures are evaluated. Additionally, the susceptibility analysis of different factors engrossed in the transformer service lifetime cost is carried out; factors including the levelized cost of electricity, solar PV plant’s generation modes, and the loading profile are examined.

Keywords: solar photovoltaic plant, transformer, total ownership cost, loss factors

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2235 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care

Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

Abstract:

Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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2234 The Legal Procedure of Attestation of Public Servants

Authors: Armen Yezekyan

Abstract:

The main purpose of this research is to comprehensively explore and identify the problems of attestation of the public servants and to propose solutions for these issues through deeply analyzing laws and the legal theoretical literature. For the detailed analysis of the above-mentioned problems we will use some research methods, the implementation of which has a goal to ensure the objectivity and clarity of scientific research and its results.

Keywords: attestation, attestation commission, competition commission, public servant, public service, testing

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2233 Automated Prediction of HIV-associated Cervical Cancer Patients Using Data Mining Techniques for Survival Analysis

Authors: O. J. Akinsola, Yinan Zheng, Rose Anorlu, F. T. Ogunsola, Lifang Hou, Robert Leo-Murphy

Abstract:

Cervical Cancer (CC) is the 2nd most common cancer among women living in low and middle-income countries, with no associated symptoms during formative periods. With the advancement and innovative medical research, there are numerous preventive measures being utilized, but the incidence of cervical cancer cannot be truncated with the application of only screening tests. The mortality associated with this invasive cervical cancer can be nipped in the bud through the important role of early-stage detection. This study research selected an array of different top features selection techniques which was aimed at developing a model that could validly diagnose the risk factors of cervical cancer. A retrospective clinic-based cohort study was conducted on 178 HIV-associated cervical cancer patients in Lagos University teaching Hospital, Nigeria (U54 data repository) in April 2022. The outcome measure was the automated prediction of the HIV-associated cervical cancer cases, while the predictor variables include: demographic information, reproductive history, birth control, sexual history, cervical cancer screening history for invasive cervical cancer. The proposed technique was assessed with R and Python programming software to produce the model by utilizing the classification algorithms for the detection and diagnosis of cervical cancer disease. Four machine learning classification algorithms used are: the machine learning model was split into training and testing dataset into ratio 80:20. The numerical features were also standardized while hyperparameter tuning was carried out on the machine learning to train and test the data. Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), and K-Nearest Neighbor (KNN). Some fitting features were selected for the detection and diagnosis of cervical cancer diseases from selected characteristics in the dataset using the contribution of various selection methods for the classification cervical cancer into healthy or diseased status. The mean age of patients was 49.7±12.1 years, mean age at pregnancy was 23.3±5.5 years, mean age at first sexual experience was 19.4±3.2 years, while the mean BMI was 27.1±5.6 kg/m2. A larger percentage of the patients are Married (62.9%), while most of them have at least two sexual partners (72.5%). Age of patients (OR=1.065, p<0.001**), marital status (OR=0.375, p=0.011**), number of pregnancy live-births (OR=1.317, p=0.007**), and use of birth control pills (OR=0.291, p=0.015**) were found to be significantly associated with HIV-associated cervical cancer. On top ten 10 features (variables) considered in the analysis, RF claims the overall model performance, which include: accuracy of (72.0%), the precision of (84.6%), a recall of (84.6%) and F1-score of (74.0%) while LR has: an accuracy of (74.0%), precision of (70.0%), recall of (70.0%) and F1-score of (70.0%). The RF model identified 10 features predictive of developing cervical cancer. The age of patients was considered as the most important risk factor, followed by the number of pregnancy livebirths, marital status, and use of birth control pills, The study shows that data mining techniques could be used to identify women living with HIV at high risk of developing cervical cancer in Nigeria and other sub-Saharan African countries.

Keywords: associated cervical cancer, data mining, random forest, logistic regression

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2232 Acetalization of Carbonyl Compounds by Using Al2 (HPO4)3 under Green Condition Mg HPO4

Authors: Fariba Jafari, Samaneh Heydarian

Abstract:

Al2(HPO4)3 was easily prepared and used as a solid acid in acetalization of carbonyl compounds at room temperature and under solvent-free conditions. The protection was done in short reaction times and in good to high isolated yields. The cheapness and availability of this reagent with easy procedure and work-up make this method attractive for the organic synthesis.

Keywords: acetalization, acid catalysis, carbonylcompounds, green condition, protection

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2231 Gender Stereotypes in Reproductive Medicine with Regard to Parental Age

Authors: Monika Michałowska, Anna Alichniewicz

Abstract:

Detrimental outcomes of advanced maternal age on the chances of fertilization, pregnancy as well as mother and fetus health have been recognized for several decades. It seemed interesting to investigate whether there is a comparable awareness of the detrimental influence on the reproductive outcomes of late fatherhood, given that it has been already ten years since an intense and growing interest concerning later-age fatherhood commenced in medical research. To address that issue a two-step research was done. First, we performed a review of the subject literature to answer the following questions: 1) What age is defined as advanced?; 2) Is the same age defined as advanced in both genders?; 3) What terminology concerning age issues is used?; 4) Is the same age terminology used regarding both genders? The second part of our studies was devoted to the views of medical students. This part of our research comprised both quantitative and qualitative studies. Opinions of medical students in one of the Polish medical universities on several issues connected with assisted reproduction technology (ART) were gathered: 1) students’ attitude to in vitro fertilization (IVF) for women over 40 and for postmenopausal women; 2) students’ attitude to late fatherhood; 3) students’ reasoning given against acceptability of IVF procedure for all of these group of patients involved in an IVF procedure. Our analyses revealed that: First, there is no universal definition of the term ‘advanced age’; secondly, there is a general tendency to adopt different age limits depending on whether they refer to maternal or paternal age, but no justification is provided by the researchers explaining why they set different age limits for women and men; thirdly, the image of postponed fatherhood stands in stark contrast to postponed motherhood - while postponed fatherhood is frequently portrayed as a reasonable and conscious decision enabling a stable family environment for a child, the reasonableness of postponed motherhood is often questioned; finally, the bias regarding maternal versus paternal age is deeply embedded in medical students’ attitude to IVF for women over 40 and for postmenopausal women.

Keywords: gender stereotypes, reproductive medicine, maternal age, paternal age

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2230 Diagnostic Evaluation of Micro Rna (miRNA-21, miRNA-215 and miRNA-378) in Patients with Colorectal Cancer

Authors: Ossama Abdelmotaal, Olfat Shaker, Tarek Salman, Lamiaa Nabeel, Mostafa Shabayek

Abstract:

Colorectal Cancer (CRC) is an important worldwide health problem. Colonoscopy is used in detecting CRC suffer from drawbacks where colonoscopy is an invasive method. This study validates easier and less time-consuming techniques to evaluate the usefulness of detecting miRNA-21, miRNA-215 and miRNA-378 in the sera of colorectal cancer patients as new diagnostic tools. This study includes malignant (Colo Rectal Cancer patients, n= 64)) and healthy (n=27) groups. The studied groups were subjected to colonoscopic examination and estimation of miRNA-21, miRNA-215 and miRNA-378 in sera by RT-PCR. miRNA-21 showed the statistically significantly highest median fold change. miRNA-378 showed statistically significantly lower value (Both showed over-expression). miRNA-215 showed the statistically significantly lowest median fold change (It showed down-regulation). Overall the miRNA (21-215 and 378) appear to be promising method of detecting CRC and evaluating its stages.

Keywords: colorectal cancer, miRNA-21, miRNA-215, miRNA-378

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2229 Low-Cost Robotic-Assisted Laparoscope

Authors: Ege Can Onal, Enver Ersen, Meltem Elitas

Abstract:

Laparoscopy is a surgical operation, well known as keyhole surgery. The operation is performed through small holes, hence, scars of a patient become much smaller, patients can recover in a short time and the hospital stay becomes shorter in comparison to an open surgery. Several tools are used at laparoscopic operations; among them, the laparoscope has a crucial role. It provides the vision during the operation, which will be the main focus in here. Since the operation area is very small, motion of the surgical tools might be limited in laparoscopic operations compared to traditional surgeries. To overcome this limitation, most of the laparoscopic tools have become more precise, dexterous, multi-functional or automated. Here, we present a robotic-assisted laparoscope that is controlled with pedals directly by a surgeon. Thus, the movement of the laparoscope might be controlled better, so there will not be a need to calibrate the camera during the operation. The need for an assistant that controls the movement of the laparoscope will be eliminated. The duration of the laparoscopic operation might be shorter since the surgeon will directly operate the camera.

Keywords: laparoscope, laparoscopy, low-cost, minimally invasive surgery, robotic-assisted surgery

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2228 Plasmonic Biosensor for Early Detection of Environmental DNA (eDNA) Combined with Enzyme Amplification

Authors: Monisha Elumalai, Joana Guerreiro, Joana Carvalho, Marta Prado

Abstract:

DNA biosensors popularity has been increasing over the past few years. Traditional analytical techniques tend to require complex steps and expensive equipment however DNA biosensors have the advantage of getting simple, fast and economic. Additionally, the combination of DNA biosensors with nanomaterials offers the opportunity to improve the selectivity, sensitivity and the overall performance of the devices. DNA biosensors are based on oligonucleotides as sensing elements. These oligonucleotides are highly specific to complementary DNA sequences resulting in the hybridization of the strands. DNA biosensors are not only an advantage in the clinical field but also applicable in numerous research areas such as food analysis or environmental control. Zebra Mussels (ZM), Dreissena polymorpha are invasive species responsible for enormous negative impacts on the environment and ecosystems. Generally, the detection of ZM is made when the observation of adult or macroscopic larvae's is made however at this stage is too late to avoid the harmful effects. Therefore, there is a need to develop an analytical tool for the early detection of ZM. Here, we present a portable plasmonic biosensor for the detection of environmental DNA (eDNA) released to the environment from this invasive species. The plasmonic DNA biosensor combines gold nanoparticles, as transducer elements, due to their great optical properties and high sensitivity. The detection strategy is based on the immobilization of a short base pair DNA sequence on the nanoparticles surface followed by specific hybridization in the presence of a complementary target DNA. The hybridization events are tracked by the optical response provided by the nanospheres and their surrounding environment. The identification of the DNA sequences (synthetic target and probes) to detect Zebra mussel were designed by using Geneious software in order to maximize the specificity. Moreover, to increase the optical response enzyme amplification of DNA might be used. The gold nanospheres were synthesized and characterized by UV-visible spectrophotometry and transmission electron microscopy (TEM). The obtained nanospheres present the maximum localized surface plasmon resonance (LSPR) peak position are found to be around 519 nm and a diameter of 17nm. The DNA probes modified with a sulfur group at one end of the sequence were then loaded on the gold nanospheres at different ionic strengths and DNA probe concentrations. The optimal DNA probe loading will be selected based on the stability of the optical signal followed by the hybridization study. Hybridization process leads to either nanoparticle dispersion or aggregation based on the presence or absence of the target DNA. Finally, this detection system will be integrated into an optical sensing platform. Considering that the developed device will be used in the field, it should fulfill the inexpensive and portability requirements. The sensing devices based on specific DNA detection holds great potential and can be exploited for sensing applications in-loco.

Keywords: ZM DNA, DNA probes, nicking enzyme, gold nanoparticles

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2227 A Multiple Freezing/Thawing Cycles Influence Internal Structure and Mechanical Properties of Achilles Tendon

Authors: Martyna Ekiert, Natalia Grzechnik, Joanna Karbowniczek, Urszula Stachewicz, Andrzej Mlyniec

Abstract:

Tendon grafting is a common procedure performed to treat tendon rupture. Before the surgical procedure, tissues intended for grafts (i.e., Achilles tendon) are stored in ultra-low temperatures for a long time and also may be subjected to unfavorable conditions, such as repetitive freezing (F) and thawing (T). Such storage protocols may highly influence the graft mechanical properties, decrease its functionality and thus increase the risk of complications during the transplant procedure. The literature reports on the influence of multiple F/T cycles on internal structure and mechanical properties of tendons stay inconclusive, confirming and denying the negative influence of multiple F/T at the same time. An inconsistent research methodology and lack of clear limit of F/T cycles, which disqualifies tissue for surgical graft purposes, encouraged us to investigate the issue of multiple F/T cycles by the mean of biomechanical tensile tests supported with Scanning Electron Microscope (SEM) imaging. The study was conducted on male bovine Achilles tendon-derived from the local abattoir. Fresh tendons were cleaned of excessive membranes and then sectioned to obtained fascicle bundles. Collected samples were randomly assigned to 6 groups subjected to 1, 2, 4, 6, 8 and 12 cycles of freezing-thawing (F/T), respectively. Each F/T cycle included deep freezing at -80°C temperature, followed by thawing at room temperature. After final thawing, thin slices of the side part of samples subjected to 1, 4, 8 and 12 F/T cycles were collected for SEM imaging. Then, the width and thickness of all samples were measured to calculate the cross-sectional area. Biomechanical tests were performed using the universal testing machine (model Instron 8872, INSTRON®, Norwood, Massachusetts, USA) using a load cell with a maximum capacity of 250 kN and standard atmospheric conditions. Both ends of each fascicle bundle were manually clamped in grasping clamps using abrasive paper and wet cellulose wadding swabs to prevent tissue slipping while clamping and testing. Samples were subjected to the testing procedure including pre-loading, pre-cycling, loading, holding and unloading steps to obtain stress-strain curves for representing tendon stretching and relaxation. The stiffness of AT fascicles bundle samples was evaluated in terms of modulus of elasticity (Young’s modulus), calculated from the slope of the linear region of stress-strain curves. SEM imaging was preceded by chemical sample preparation including 24hr fixation in 3% glutaraldehyde buffered with 0.1 M phosphate buffer, washing with 0.1 M phosphate buffer solution and dehydration in a graded ethanol solution. SEM images (Merlin Gemini II microscope, ZEISS®) were taken using 30 000x mag, which allowed measuring a diameter of collagen fibrils. The results confirm a decrease in fascicle bundles Young’s modulus as well as a decrease in the diameter of collagen fibrils. These results confirm the negative influence of multiple F/T cycles on the mechanical properties of tendon tissue.

Keywords: biomechanics, collagen, fascicle bundles, soft tissue

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2226 The Many Faces of Cancer and Knowing When to Say Stop

Authors: Diwei Lin, Amanda Jh. Tan

Abstract:

We present a very rare case of de novo large cell neuroendocrine carcinoma of the prostate (LCNEC) in an 84-year-old male on a background of high-grade, muscle-invasive transitional cell carcinoma of the bladder. While NE tumours account for 1% to 5% of all cases of prostate cancer and scattered NE cells can be found in 10% to 100% of prostate adenocarcinomas, pure LCNEC of the prostate is extremely rare. Most LCNEC of the prostate is thought to originate by clonal progression under the selection pressure of therapy and refractory to long-term hormonal treatment for adenocarcinoma of the prostate. De novo LCNEC is only described in case reports and is thought to develop via direct malignant transformation. Limited data in the English literature makes it difficult to accurately predict the prognosis of LCNEC of the prostate. However, current evidence suggesting that increasing NE differentiation in prostate adenocarcinoma is associated with a higher stage, high-grade disease, and a worse prognosis.

Keywords: large cell neuroendocrine cancer, prostate cancer, refractory cancer, medical and health sciences

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2225 Right Cerebellar Stroke with a Right Vertebral Artery Occlusion Following an Embolization of the Right Glomus Tympanicum Tumor

Authors: Naim Izet Kajtazi

Abstract:

Context: Although rare, glomus tumor (i.e., nonchromaffin chemodectomas and paragan¬gliomas) is the most common middle ear tumor, with female predominance. Pre-operative embolization is often required to devascularize the hypervascular tumor for better surgical outcomes. Process: A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor, compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Outcome: Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist. Relevance: This case highlights the complex nature of these tumors, which often bring challenges to the patients as well as treatment teams. The multi-disciplinary team approach is necessary to tailor the management plan for individual tumors. Although embolization is a safe procedure, careful attention and thoughtful anatomic knowledge regarding dangerous anastomosis are essential to avoid devastating complications. Complications occur due to encountered vessel anomalies and new anastomoses formed during the gluing and changes in hemodynamics.

Keywords: stroke, embolization, MRI brain, cerebral angiogram

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2224 Comparison of Quality of Life One Year after Bariatric Intervention: Systematic Review of the Literature with Bayesian Network Meta-Analysis

Authors: Piotr Tylec, Alicja Dudek, Grzegorz Torbicz, Magdalena Mizera, Natalia Gajewska, Michael Su, Tanawat Vongsurbchart, Tomasz Stefura, Magdalena Pisarska, Mateusz Rubinkiewicz, Piotr Malczak, Piotr Major, Michal Pedziwiatr

Abstract:

Introduction: Quality of life after bariatric surgery is an important factor when evaluating the final result of the treatment. Considering the vast surgical options, we tried to globally compare available methods in terms of quality of following the surgery. The aim of the study is to compare the quality of life a year after bariatric intervention using network meta-analysis methods. Material and Methods: We performed a systematic review according to PRISMA guidelines with Bayesian network meta-analysis. Inclusion criteria were: studies comparing at least two methods of weight loss treatment of which at least one is surgical, assessment of the quality of life one year after surgery by validated questionnaires. Primary outcomes were quality of life one year after bariatric procedure. The following aspects of quality of life were analyzed: physical, emotional, general health, vitality, role physical, social, mental, and bodily pain. All questionnaires were standardized and pooled to a single scale. Lifestyle intervention was considered as a referenced point. Results: An initial reference search yielded 5636 articles. 18 studies were evaluated. In comparison of total score of quality of life, we observed that laparoscopic sleeve gastrectomy (LSG) (median (M): 3.606, Credible Interval 97.5% (CrI): 1.039; 6.191), laparoscopic Roux en-Y gastric by-pass (LRYGB) (M: 4.973, CrI: 2.627; 7.317) and open Roux en-Y gastric by-pass (RYGB) (M: 9.735, CrI: 6.708; 12.760) had better results than other bariatric intervention in relation to lifestyle interventions. In the analysis of the physical aspects of quality of life, we notice better results in LSG (M: 3.348, CrI: 0.548; 6.147) and in LRYGB procedure (M: 5.070, CrI: 2.896; 7.208) than control intervention, and worst results in open RYGB (M: -9.212, CrI: -11.610; -6.844). Analyzing emotional aspects, we found better results than control intervention in LSG, in LRYGB, in open RYGB, and laparoscopic gastric plication. In general health better results were in LSG (M: 9.144, CrI: 4.704; 13.470), in LRYGB (M: 6.451, CrI: 10.240; 13.830) and in single-anastomosis gastric by-pass (M: 8.671, CrI: 1.986; 15.310), and worst results in open RYGB (M: -4.048, CrI: -7.984; -0.305). In social and vital aspects of quality of life, better results were observed in LSG and LRYGB than control intervention. We did not find any differences between bariatric interventions in physical role, mental and bodily aspects of quality of life. Conclusion: The network meta-analysis revealed that better quality of life in total score one year after bariatric interventions were after LSG, LRYGB, open RYGB. In physical and general health aspects worst quality of life was in open RYGB procedure. Other interventions did not significantly affect the quality of life after a year compared to dietary intervention.

Keywords: bariatric surgery, network meta-analysis, quality of life, one year follow-up

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2223 The Study of Blood Consumption for Stem Cell Transplant Patients in Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran

Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

Abstract:

Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.

Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran

Procedia PDF Downloads 119
2222 An Approach in Design of Large-Scale Hydrogen Plants

Authors: Hamidreza Sahaleh

Abstract:

Because of the stringent prerequisite of low sulfur and heavier raw oil feedstock more hydrogen will be devoured in the refineries. Specifically if huge scale limits are the reaction to an expanded hydrogen request, certain configuration and building background are obliged with, which will be depicted in this paper with an illustration. Chosen procedure plan prerequisite will be recorded and portrayed in agreement to the flowsheet. Also, a determination of imaginative outline elements, similar to process condensate reuse, safe reformer start up and prerequisites will be highlighted.

Keywords: low sulfur, raw oil, refineries, flowsheet

Procedia PDF Downloads 286
2221 Development of Hybrid Materials Combining Biomass as Fique Fibers with Metal-Organic Frameworks, and Their Potential as Mercury Adsorbents

Authors: Karen G. Bastidas Gomez, Hugo R. Zea Ramirez, Manuel F. Ribeiro Pereira, Cesar A. Sierra Avila, Juan A. Clavijo Morales

Abstract:

The contamination of water sources with heavy metals such as mercury has been an environmental problem; it has generated a high impact on the environment and human health. In countries such as Colombia, mercury contamination due to mining has reached levels much higher than the world average. This work proposes the use of fique fibers as adsorbent in mercury removal. The evaluation of the material was carried out under five different conditions (raw, pretreated by organosolv, functionalized by TEMPO oxidation, fiber functionalized plus MOF-199 and fiber functionalized plus MOF-199-SH). All the materials were characterized using FTIR, SEM, EDX, XRD, and TGA. Regarding the mercury removal, it was done under room pressure and temperature, also pH = 7 for all materials presentations, followed by Atomic Absorption Spectroscopy. The high cellulose content in fique is the main particularity of this lignocellulosic biomass since the degree of oxidation depends on the number of hydroxyl groups on the surface capable of oxidizing into carboxylic acids, a functional group capable of increasing ion exchange with mercury in solution. It was also expected that the impregnation of the MOF would increase the mercury removal; however, it was found that the functionalized fique achieved a greater percentage of removal, resulting in 81.33% of removal, 44% for the fique with the MOF-199 and 72% for the MOF-199-SH with. The pretreated fiber and raw also showed 74% and 56%, respectively, which indicates that fique does not require considerable modifications in its structure to achieve good performances. Even so, the functionalized fiber increases the percentage of removal considerably compared to the pretreated fique, which suggests that the functionalization process is a feasible procedure to apply with the purpose of improving the removal percentage. In addition, this is a procedure that follows a green approach since the reagents involved have low environmental impact, and the contribution to the remediation of natural resources is high.

Keywords: biomass, nanotechnology, science materials, wastewater treatment

Procedia PDF Downloads 112
2220 Finite Element Analysis of the Anaconda Device: Efficiently Predicting the Location and Shape of a Deployed Stent

Authors: Faidon Kyriakou, William Dempster, David Nash

Abstract:

Abdominal Aortic Aneurysm (AAA) is a major life-threatening pathology for which modern approaches reduce the need for open surgery through the use of stenting. The success of stenting though is sometimes jeopardized by the final position of the stent graft inside the human artery which may result in migration, endoleaks or blood flow occlusion. Herein, a finite element (FE) model of the commercial medical device AnacondaTM (Vascutek, Terumo) has been developed and validated in order to create a numerical tool able to provide useful clinical insight before the surgical procedure takes place. The AnacondaTM device consists of a series of NiTi rings sewn onto woven polyester fabric, a structure that despite its column stiffness is flexible enough to be used in very tortuous geometries. For the purposes of this study, a FE model of the device was built in Abaqus® (version 6.13-2) with the combination of beam, shell and surface elements; the choice of these building blocks was made to keep the computational cost to a minimum. The validation of the numerical model was performed by comparing the deployed position of a full stent graft device inside a constructed AAA with a duplicate set-up in Abaqus®. Specifically, an AAA geometry was built in CAD software and included regions of both high and low tortuosity. Subsequently, the CAD model was 3D printed into a transparent aneurysm, and a stent was deployed in the lab following the steps of the clinical procedure. Images on the frontal and sagittal planes of the experiment allowed the comparison with the results of the numerical model. By overlapping the experimental and computational images, the mean and maximum distances between the rings of the two models were measured in the longitudinal, and the transverse direction and, a 5mm upper bound was set as a limit commonly used by clinicians when working with simulations. The two models showed very good agreement of their spatial positioning, especially in the less tortuous regions. As a result, and despite the inherent uncertainties of a surgical procedure, the FE model allows confidence that the final position of the stent graft, when deployed in vivo, can also be predicted with significant accuracy. Moreover, the numerical model run in just a few hours, an encouraging result for applications in the clinical routine. In conclusion, the efficient modelling of a complicated structure which combines thin scaffolding and fabric has been demonstrated to be feasible. Furthermore, the prediction capabilities of the location of each stent ring, as well as the global shape of the graft, has been shown. This can allow surgeons to better plan their procedures and medical device manufacturers to optimize their designs. The current model can further be used as a starting point for patient specific CFD analysis.

Keywords: AAA, efficiency, finite element analysis, stent deployment

Procedia PDF Downloads 188
2219 Main Puteri Traditional Malay Healing Ceremony

Authors: M. G. Nasuruddin, S. Ishak

Abstract:

This paper deals with the traditional Malay healing ritualistic ceremony known as Main Puteri. This non-invasive intervention uses the vehicle of performance to administer the healing process. It employs the performance elements of Makyung, that is, music, movements/dance, and dramatic dialogue to heal psychosomatic maladies. There are two perspectives to this therapeutic healing process, one traditional and the other scientific. From the traditional perspective, the psychosomatic illness is attributed to the infestations/possessions by malevolent spirits. To heal such patients, these spirits must be exorcised through placating them by making offerings. From the scientific perspective, the music (sonic orders), movements (kinetic energy), and smell (olfactory) connect with the brain waves to release the chemicals that would activate the internal healing energy. Currently, in Main Puteri, the therapeutic healing ritual is no longer relevant as modern clinical medicine has proven to be more effective. Thus, Main Puteri is an anachronism in today’s technologically advanced Malaysia.

Keywords: exorcism, main puteri, shamans, therapeutic healing

Procedia PDF Downloads 352
2218 A Radiofrequency Spectrophotometer Device to Detect Liquids in Gastroesophageal Ways

Authors: R. Gadea, J. M. Monzó, F. J. Puertas, M. Castro, A. Tebar, P. J. Fito, R. J. Colom

Abstract:

There exists a wide array of ailments impacting the structural soundness of the esophageal walls, predominantly linked to digestive issues. Presently, the techniques employed for identifying esophageal tract complications are excessively invasive and discomforting, subjecting patients to prolonged discomfort in order to achieve an accurate diagnosis. This study proposes the creation of a sensor with profound measuring capabilities designed to detect fluids coursing through the esophageal tract. The multi-sensor detection system relies on radiofrequency photospectrometry. During experimentation, individuals representing diverse demographics in terms of gender and age were utilized, positioning the sensors amidst the trachea and diaphragm and assessing measurements in vacuum conditions, water, orange juice, and saline solutions. The findings garnered enabled the identification of various liquid mediums within the esophagus, segregating them based on their ionic composition.

Keywords: radiofrequency spectrophotometry, medical device, gastroesophageal disease, photonics

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2217 Somatic Delusional Disorder Subsequent to Phantogeusia: A Case Report

Authors: Pedro Felgueiras, Ana Miguel, Nélson Almeida, Raquel Silva

Abstract:

Objective: Through the study of a clinical case of delusional somatic disorder secondary to phantogeusia, we aim to highlight the importance of considering psychosomatic conditions in differential diagnosis, as well as to emphasize the complexity of its comprehension, treatment, and respective impact on patients’ functioning. Methods: Bearing this in mind, we conducted a critical analysis of a case series based on patient observations, clinical data, and complementary diagnostic methods, as well as a non-systematic review of the literature on the subject. Results: A 61-year-old female patient with no history of psychiatric conditions. Family psychiatric history of mood disorder (depression), with psychotic features found in her mother. Medical history of many comorbidities affecting different organ systems (endocrine, gastrointestinal, genitourinary, ophthalmological). Documented neuroticism traits of personality. The patient’s family described a persistent concern about several physical symptoms across her life, with a continuous effort to obtain explanations about any sensation out of her normal perception. Since being subjected to endoscopy in 2018, she started complaints of persistent phantogeusia (acid taste) and developed excessive thoughts, feelings, and behaviors associated with this somatic symptom. The patient was evaluated by several medical specialties, and an extensive panel of medical exams was carried out, excluding any disease. Besides all the investigation and with no evidence of disease signs, acute anxiety, time, and energy dispended to this symptom culminated in severe psychosocial impairment. The patient was admitted to a psychiatric ward for investigation and treatment of this clinical picture, leading to the diagnosis of the delusional somatic disorder. In order to exclude the acute organic etiology of this psychotic disorder, an analytic panel was carried out with no abnormal results. In the context of a psychotic clinical picture, a CT scan was performed, which revealed a right cortical vascular lesion. Neuropsychological evaluation was made, with the description of cognitive functioning being globally normative. During treatment with an antipsychotic (pimozide), a complete remission of the somatic delusion was associated with the disappearance of gustative perception disturbance. In follow-up, a relapse of gustative sensation was documented, and her thoughts and speech were dominated by concerns about multiple somatic symptoms. Conclusion: In terms of abnormal bodily sensations, the oral cavity is one of the frequent sites of delusional disorder. Patients with these gustatory perception distortions complain about unusual sensations without corresponding abnormal findings in the oral area. Its pathophysiology has not been fully elucidated yet. In terms of its comprehensive psychopathology, this case was hypothesized as a paranoid development of a delusional somatic disorder triggered by a post-invasive procedure phantogeusia (which is described as a possible side effect of an endoscopy) in a patient with an anankastic personality. This case presents interesting psychopathology, reinforcing the complexity of psychosomatic disorders in terms of their etiopathogenesis, clinical treatment, and long-term prognosis.

Keywords: psychosomatics, delusional somatic disorder, phantogeusia, paranoid development

Procedia PDF Downloads 122
2216 Evaluation of Rheological Properties, Anisotropic Shrinkage, and Heterogeneous Densification of Ceramic Materials during Liquid Phase Sintering by Numerical-Experimental Procedure

Authors: Hamed Yaghoubi, Esmaeil Salahi, Fateme Taati

Abstract:

The effective shear and bulk viscosity, as well as dynamic viscosity, describe the rheological properties of the ceramic body during the liquid phase sintering process. The rheological parameters depend on the physical and thermomechanical characteristics of the material such as relative density, temperature, grain size, and diffusion coefficient and activation energy. The main goal of this research is to acquire a comprehensive understanding of the response of an incompressible viscose ceramic material during liquid phase sintering process such as stress-strain relations, sintering and hydrostatic stress, the prediction of anisotropic shrinkage and heterogeneous densification as a function of sintering time by including the simultaneous influence of gravity field, and frictional force. After raw materials analysis, the standard hard porcelain mixture as a ceramic body was designed and prepared. Three different experimental configurations were designed including midpoint deflection, sinter bending, and free sintering samples. The numerical method for the ceramic specimens during the liquid phase sintering process are implemented in the CREEP user subroutine code in ABAQUS. The numerical-experimental procedure shows the anisotropic behavior, the complete difference in spatial displacement through three directions, the incompressibility for ceramic samples during the sintering process. The anisotropic shrinkage factor has been proposed to investigate the shrinkage anisotropy. It has been shown that the shrinkage along the normal axis of casting sample is about 1.5 times larger than that of casting direction, the gravitational force in pyroplastic deformation intensifies the shrinkage anisotropy more than the free sintering sample. The lowest and greatest equivalent creep strain occurs at the intermediate zone and around the central line of the midpoint distorted sample, respectively. In the sinter bending test sample, the equivalent creep strain approaches to the maximum near the contact area with refractory support. The inhomogeneity in Von-Misses, pressure, and principal stress intensifies the relative density non-uniformity in all samples, except in free sintering one. The symmetrical distribution of stress around the center of free sintering sample, cause to hinder the pyroplastic deformations. Densification results confirmed that the effective bulk viscosity was well-defined with relative density values. The stress analysis confirmed that the sintering stress is more than the hydrostatic stress from start to end of sintering time so, from both theoretically and experimentally point of view, the sintering process occurs completely.

Keywords: anisotropic shrinkage, ceramic material, liquid phase sintering process, rheological properties, numerical-experimental procedure

Procedia PDF Downloads 337
2215 Effects of Aerodynamic on Suspended Cables Using Non-Linear Finite Element Approach

Authors: Justin Nwabanne, Sam Omenyi, Jeremiah Chukwuneke

Abstract:

This work presents structural nonlinear static analysis of a horizontal taut cable using Finite Element Analysis (FEA) method. The FEA was performed analytically to determine the tensions at each nodal point and subsequently, performed based on finite element displacement method computationally using the FEA software, ANSYS 14.0 to determine their behaviour under the influence of aerodynamic forces imposed on the cable. The convergence procedure is adapted into the method to prevent excessive displacements through the computations. The work compared the two FEA cases by examining the effectiveness of the analytical model in describing the response with few degrees of freedom and the ability of the nonlinear finite element procedure adopted to capture the complex features of cable dynamics with reference to the aerodynamic external influence. Results obtained from this work explain that the analytic FEM results without aerodynamic influence show a parabolic response with an optimum deflection at nodal points 12 and 13 with the cable weight at nodes 12 and 13 having the value -1.002936N while for the cable tension shows an optimum deflection value for nodes 12 and 13 at -189396.97kg/km. The maximum displacement for the cable system was obtained from ANSYS 14.0 as 4483.83 mm for X, Y and Z components of displacements at node number 2 while the maximum displacement obtained is 4218.75mm for all the directional components. The dynamic behaviour of a taut cable investigated has application in a typical power transmission line. Aerodynamic influences on the cables were considered using FEA approach by employing ANSYS 14.0 showed a complex modal behaviour as expected.

Keywords: aerodynamics, cable tension and weight, finite element analysis, nodal, non-linear model, optimum deflection, suspended cable, transmission line

Procedia PDF Downloads 270
2214 A Thermo-mechanical Finite Element Model to Predict Thermal Cycles and Residual Stresses in Directed Energy Deposition Technology

Authors: Edison A. Bonifaz

Abstract:

In this work, a numerical procedure is proposed to design dense multi-material structures using the Directed Energy Deposition (DED) process. A thermo-mechanical finite element model to predict thermal cycles and residual stresses is presented. A numerical layer build-up procedure coupled with a moving heat flux was constructed to minimize strains and residual stresses that result in the multi-layer deposition of an AISI 316 austenitic steel on an AISI 304 austenitic steel substrate. To simulate the DED process, the automated interface of the ABAQUS AM module was used to define element activation and heat input event data as a function of time and position. Of this manner, the construction of ABAQUS user-defined subroutines was not necessary. Thermal cycles and thermally induced stresses created during the multi-layer deposition metal AM pool crystallization were predicted and validated. Results were analyzed in three independent metal layers of three different experiments. The one-way heat and material deposition toolpath used in the analysis was created with a MatLab path script. An optimal combination of feedstock and heat input printing parameters suitable for fabricating multi-material dense structures in the directed energy deposition metal AM process was established. At constant power, it can be concluded that the lower the heat input, the lower the peak temperatures and residual stresses. It means that from a design point of view, the one-way heat and material deposition processing toolpath with the higher welding speed should be selected.

Keywords: event series, thermal cycles, residual stresses, multi-pass welding, abaqus am modeler

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2213 Application of Sensory Thermography on Workers of a Wireless Industry in Mexico

Authors: Claudia Camargo Wilson, Enrique Javier de la Vega Bustillos, Jesús Everardo Olguín Tiznado, Juan Andrés López Barreras, Sandra K. Enriquez

Abstract:

This study focuses on the application of sensory thermography, as a non-invasive method to evaluate the musculoskeletal injuries that industry workers performing Highly Repetitive Movements (HRM) may acquire. It was made at a wireless company having the target of analyze temperatures in worker’s wrists, elbows and shoulders in workstations during their activities, this thru sensorial thermography with the goal of detecting maximum temperatures (Tmax) that could indicate possible injuries. The tests were applied during 3 hours for only 2 workers that work in workstations where there’s been the highest index of injuries and accidents. We were made comparisons for each part of the body that were study for both because of the similitude between the activities of the workstations; they were requiring both an immediate evaluation. The Tmax was recorder during the test of the worker 2, in the left wrist, reaching a temperature of 35.088ºC and with a maximum increase of 1.856°C.

Keywords: thermography, maximum temperaturas (Tmax), highly repetitive movements (HRM), operator

Procedia PDF Downloads 394
2212 Arthroscopic Assisted Fibertape Technique For Recurrent MPFL Reconstruction - Case Series Done In The UK Population

Authors: Naufal Ahmed, Michael Lwin

Abstract:

Background: MPFL reconstructions are ideally performed with au-tografts like gracilis semitendinosus tendon, which may be associated with donor site morbidity and complications. In this case series, we have tried to use fiber tape, which avoids the above complications and also keeps the graft virgin. This kind of synthetic graft has been used successfully in rotator cuffs and ACJ reconstructions with good results. Materials and methods: It was a retrospective data analysis of 45 patients who underwent this procedure from 2014-2020 under a single consultant in a DGH . These patiens have been followed up at 6 weeks, 6 months, 1 year, and 1 ½ years with clinical assessment and KOOS scores. We compared the results with the NJR and also with the Belgium report and was found to be satisfactory and comparable with them. Surgical technique : We used Arthrex fiber tape for the reconstruction of MPFL . Initially, two parallel holes drilled over sup aspect of the patella with help of an image intensifier, and then fiber wire passed through them from the medial to the lateral side and back to the medial side. The fiber wire was attached to the schottle point on the femoral side, giving a good extra articular internal brac-ing to the MPFL. All patients were scoped before the procedure, and the final tightening over the femoral side was done directly under vision to see the position of the patella. Results: We had 45 MPFL reconstructions along with 4 additional procedures 1 ACLR, 2 ACL REPAIR, 1 TTT advancement ( revision MPFL ). There were 14 males and 31 females, and their average age was 25 (13-55 ). We did not have any donor site morbidity, no infection, no fractures, no recurrent dislocations, no reoperations yet. Conclusion: Fiber tape is a feasible and appropriate option for MPFL reconstruction. We haven’t seen any re -operation in our 5 year follow up. This technique avoids the use of autograft, which can be used in the future if needed for revision surgeries. We don’t lose anything by following this simple novel technique.

Keywords: arthroscopy, fibertape, MPFL reconstruction, recurrent patella dislocation

Procedia PDF Downloads 135