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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this work three iodine-containing monomers were proposed as new radiopaque agents for acrylic bone cements. In previous studies the addition of iodine-containing methacrylate monomers provided a statistically significant increase in tensile stress, fracture toughness and ductility, with respect to the barium sulphate (BaSO4)-containing cement. However, since fatigue resistance is one of the main properties required to ensure a good long-term performance of permanent prostheses, it is important to compare the fatigue properties of these new bone cement formulations with the radiolucent and BaSO4-containing bone cements. Because the acrylic cements have initial cracks, fatigue crack propagation studies were performed. It can be observed that these acrylic cements followed the Paris-Erdogan model. The results showed that the addition of some organic radiopacifiers (DISMA, TIBMA) increased the fatigue crack propagation resistance as compared to the radiolucent cement, being similar to the BaSO4-containing cement. The radiolucent cement showed a low crack propagation resistance.
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PMID:Propagation of fatigue cracks in acrylic bone cements containing different radiopaque agents. 1523 67

Since the mortality rate for childhood differentiated thyroid carcinoma is nearly zero, the focus must be to minimise morbidity following treatment. Our aim was to analyse early and late adverse events. Twenty-five of 26 children treated between 1962 and 2002 were evaluated. Median follow-up was 14.2 years (range 0.9-39.4 years). All underwent total thyroidectomy, 15 (60%) with lymph node dissection and 15 (60%) with adjuvant radio-iodide therapy. Mortality was zero. Seven developed recurrent disease, two developed a third recurrence. Twenty-one (84%) had > or =1 adverse event. Eight had permanent hypoparathyroidism (PH), six permanent recurrent nerve paralysis (PRNP) and two Horner's syndrome. Risk factors for PH and PRNP were total thyroidectomy with lymph node dissection (RR: 6.45, P = 0.015) and recurrent nerve tumour encasement (RR: 8.00, P = 0.001), respectively. Other adverse events were fatigue (n = 5), scar problems (n = 4) and chronic myeloid leukaemia (n = 1). These results emphasise the need to improve treatment strategies.
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PMID:Frequent adverse events after treatment for childhood-onset differentiated thyroid carcinoma: a single institute experience. 1525 Nov 65

In all acrylic bone cement formulations in clinical use today, radiopacity is provided by micron-sized particles (typical mean diameter of between about 1 and 2 microm) of either BaSO(4) or ZrO(2). However, a number of research reports have highlighted the fact that these particles have deleterious effects on various properties of the cured cement. Thus, there is interest in alternative radiopacifiers. The present study focuses on one such alternative. Specifically, a cement that contains covalently bound iodine in the powder (herein designated the I-cement) was compared with a commercially available cement of comparable composition (C-ment3), in which radiopacity is provided by BaSO(4) particles (this cement is herein designated the B-cement), on the basis of the strength (sigma(b)), modulus (E(b)), and work-to-fracture (U(b)), under four-point bending, plane-strain fracture toughness (K(IC)), Weibull mean fatigue life, N(WM) (fatigue conditions: +/-15 MPa; 2 Hz), activation energy (Q), and frequency factor (ln Z) for the cement polymerization process (both determined by using differential scanning calorimetry at heating rates of 5, 10, 15, and 20 K min(-1)), and the diffusion coefficient for the absorption of phosphate-buffered saline at 37 degrees C (D). For the B-cement, the values of sigma(b), E(b), U(b), K(IC), N(WM), Q, ln Z, and D were 53 +/- 3 MPa, 3000 +/- 120 MPa, 108 +/- 15 kJ m(-3), 1.67 +/- 0.02 MPa check mark m, 7197 cycles, 243 +/- 17 kJ mol(-1), 87 +/- 6, and (3.15 +/- 0.94) x 10(-12) m(2) s(-1), respectively. For the I-cement, the corresponding values were 58 +/- 5 MPa, 2790 +/- 140 MPa, 118 +/- 45 kJ m(-3), 1.73 +/- 0.11 MPa check mark m, 5520 cycles, 267 +/- 19 kJ mol(-1), 95 +/- 9, and (3.83 +/- 0.25) x 10(-12) m(2) s(-1). For each of the properties of the fully cured cement, except for the rate constant of the polymerization reaction, at 37 degrees C (k'), as estimated from the Q and ln Z results, there is no statistically significant difference between the two cements. k' for the I-cement was about a third that for the B-cement, suggesting that the former cement has a higher thermal stability. The influence of various characteristics of the starting powder (mean particle size, particle size distribution, and morphology) on the properties of the cured cements appears to be complex. When all the present results are considered, there is a clear indication that the I-cement is a viable candidate cement for use in cemented arthroplasties in place of the B-cement.
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PMID:Influence of the radiopacifier in an acrylic bone cement on its mechanical, thermal, and physical properties: barium sulfate-containing cement versus iodine-containing cement. 1578 47

We report a 17-year-old male patient with tubulointerstitial nephritis and uveitis (TINU) associated with hyperthyroidism. He presented with a 2-month history of fatigue, loss of appetite, low-grade fever, and a 12-kg weight loss when he was admitted to our hospital. He had iritis, which was complicated by fibrin in the anterior chamber, diagnosed by slit-lamp examination. On laboratory examinations, deteriorated renal function (blood urea nitrogen level was 25.9 mg/dl and creatinine level was 2.82 mg/dl) and elevated urinary levels of N-acetyl-beta-D-glucosaminidase (33.1 U/l) and beta2-microglobulin (78,600 microg/l) were observed. Serum thyroid-stimulating hormone (TSH) was undetectable, at less than 0.01 microIU/ml, and free triiodothyronine and free thyroxine were elevated, up to 5.23 pg/ml and 2.85 ng/dl, respectively. The titers of antithyroglobulin and antithyroid microsomal and TSH-receptor antibodies were not elevated. Abdominal and thyroidal ultrasonography showed evident bilateral enlargement of the kidneys and diffuse enlargement of the thyroid gland. Iodine-123 scintigraphy showed low uptake in the thyroid gland. The biopsied renal specimen showed mild edema and severe diffuse infiltration of mononuclear cells and few eosinophils in the interstitium, without any glomerular or vascular abnormalities. Based on the clinical features and pathological findings, a diagnosis of TINU syndrome with associated hyperthyroidism was made. Treatment was started with 30 mg/day of prednisolone. The iritis disappeared, and the patient's clinical status improved remarkably. This case suggests the possibility of thyroid dysfunction in some patients with TINU syndrome, and we believe thyroid function should be measured in all TINU patients. Moreover, histopathological diagnosis of the thyroid glands before treatment is necessary for TINU patients with thyroid dysfunction.
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PMID:Tubulointerstitial nephritis and uveitis syndrome associated with hyperthyroidism. 1700 80

The objective of this update is to give an overview of the effects of dietary nutrients on the structure and certain functions of the brain. As any other organ, the brain is elaborated from substances present in the diet (sometimes exclusively, for vitamins, minerals, essential amino-acids and essential fatty acids, including omega- 3 polyunsaturated fatty acids). However, for long it was not fully accepted that food can have an influence on brain structure, and thus on its function, including cognitive and intellectuals. In fact, most micronutrients (vitamins and trace-elements) have been directly evaluated in the setting of cerebral functioning. For instance, to produce energy, the use of glucose by nervous tissue implies the presence of vitamin B1; this vitamin modulates cognitive performance, especially in the elderly. Vitamin B9 preserves brain during its development and memory during ageing. Vitamin B6 is likely to benefit in treating premenstrual depression. Vitamins B6 and B12, among others, are directly involved in the synthesis of some neurotransmitters. Vitamin B12 delays the onset of signs of dementia (and blood abnormalities), provided it is administered in a precise clinical timing window, before the onset of the first symptoms. Supplementation with cobalamin improves cerebral and cognitive functions in the elderly; it frequently improves the functioning of factors related to the frontal lobe, as well as the language function of those with cognitive disorders. Adolescents who have a borderline level of vitamin B12 develop signs of cognitive changes. In the brain, the nerve endings contain the highest concentrations of vitamin C in the human body (after the suprarenal glands). Vitamin D (or certain of its analogues) could be of interest in the prevention of various aspects of neurodegenerative or neuroimmune diseases. Among the various vitamin E components (tocopherols and tocotrienols), only alpha-tocopherol is actively uptaken by the brain and is directly involved in nervous membranes protection. Even vitamin K has been involved in nervous tissue biochemistry. Iron is necessary to ensure oxygenation and to produce energy in the cerebral parenchyma (via cytochrome oxidase), and for the synthesis of neurotransmitters and myelin; iron deficiency is found in children with attention-deficit/hyperactivity disorder. Iron concentrations in the umbilical artery are critical during the development of the foetus, and in relation with the IQ in the child; infantile anaemia with its associated iron deficiency is linked to perturbation of the development of cognitive functions. Iron deficiency anaemia is common, particularly in women, and is associated, for instance, with apathy, depression and rapid fatigue when exercising. Lithium importance, at least in psychiatry, is known for a long time. Magnesium plays important roles in all the major metabolisms: in oxidation-reduction and in ionic regulation, among others. Zinc participates among others in the perception of taste. An unbalanced copper metabolism homeostasis (due to dietary deficiency) could be linked to Alzheimer disease. The iodine provided by the thyroid hormone ensures the energy metabolism of the cerebral cells; the dietary reduction of iodine during pregnancy induces severe cerebral dysfunction, actually leading to cretinism. Among many mechanisms, manganese, copper, and zinc participate in enzymatic mechanisms that protect against free radicals, toxic derivatives of oxygen. More specifically, the full genetic potential of the child for physical growth ad mental development may be compromised due to deficiency (even subclinical) of micronutrients. Children and adolescents with poor nutritional status are exposed to alterations of mental and behavioural functions that can be corrected by dietary measures, but only to certain extend. Indeed, nutrient composition and meal pattern can exert either immediate or long-term effects, beneficial or adverse. Brain diseases during aging can also be due to failure for protective mechanism, due to dietary deficiencies, for instance in anti-oxidants and nutrients (trace elements, vitamins, non essential micronutrients such as polyphenols) related with protection against free radicals. Macronutrients are presented in the accompanying paper.
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PMID:Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. 1706 9

Patients with severe back pain, attributed to a herniation of the nucleus pulposus of the intervertebral disc, can benefit from a replacement of only the nucleus pulposus, provided the annulus fibrosus is still functional. This study investigated four intrinsically radiopaque hydrogel biomaterials, which were designed specifically to replace the herniated nucleus pulposus. The important characteristic of these hydrogels is that they can be visualized entirely with both MRI and X-rays. The materials are based on copolymers of N-vinyl-2-pyrrolidinone (NVP) or 2-hydroxyethyl methacrylate (HEMA) and a radiopacity introducing monomer, 2-(4'-iodobenzoyl)-oxo-ethyl methacrylate (4IEMA). Two of the formulations also contain the chemical crosslinker allyl methacrylate (AMA). Physical-mechanical properties like the water-uptake, biocompatibility, stiffness, and fatigue and creep behavior were studied, while keeping an eye on the intended application. All four materials were designed with 5-6 mass % of iodine to ensure sufficient X-ray visibility between two vertebrae. It was found that the materials display appropriate stiffness and biocompatibility. The crosslinked materials hold most promise as a functional nucleus prosthesis, as they combine these properties also with high water content, fatigue resistance, and recovery after loading.
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PMID:Towards a functional radiopaque hydrogel for nucleus pulposus replacement. 1741 76

A 22-year-old otherwise healthy woman presented to the Vanderbilt University Dermatology Clinics with a 5-year history of painful, red plaques and nodules on her shins and tops of her feet. She had initially been seen by a rheumatologist, who diagnosed her with erythema nodosum (EN) and prescribed oral prednisone. After 1 month of therapy, the condition had not improved and she discontinued the treatment. She had undertaken no additional therapy in the interim. At the onset of her condition, she was taking no medications, using only etonogestrel/ethinyl estradiol vaginal ring for contraception. Her condition did not change after beginning this hormonal contraception. Her lesions were constant, with variable waxing and waning and without any discernible precipitants. They were tender to palpation but were otherwise without symptoms. She denied any history of fever, joint pain, fatigue, cough, gastrointestinal symptoms, malaise, mucosal ulcerations, foreign travel, infectious exposures, or illicit drug use. Clinically, her anterior legs displayed moderately well demarcated patches and nodules with dusky erythema. The lesions were tender to palpation but were not present on the feet or above the knees. Darkened, bruise-like areas were also appreciated and corresponded to older, quiescent lesions. Results from a chest x-ray, complete blood cell count, and metabolic panel were normal. She declined a biopsy. She was treated with supersaturated solution of potassium iodide, indomethacin, methotrexate, and dapsone, all without benefit. She was then begun on etanercept 25 mg administered subcutaneously twice weekly. After 1 month she noticed the lesions beginning to fade with a concomitant decrease in their discomfort, and by 4 months she was clear of her disease. Results of all monitoring blood work were normal. At 6 months, her disease had resolved and her etanercept dose was reduced by half without any flare of her condition. She has continued 25 mg weekly for 12 months without developing any new lesions.
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PMID:Etanercept treatment of erythema nodosum. 1761 79

A 65-year-old woman presented with dyspnea and bilateral leg edema for 1 week, worsening fatigue for 1 month, and a 7-lb weight loss over the last summer. She was clinically and biochemically hyperthyroid. Echocardiography revealed a left atrial myxoma measuring 6.2 x 3.3 cm protruding into the mitral orifice and left ventricle during diastole. She was treated for Graves' disease with Iodine-131. Six weeks later, her left atrial myxoma measuring 10.1 x 6.2 x 2.4 cm was resected. She became euthyroid before surgery and then biochemically hypothyroid 6 weeks after radioiodine treatment, for which she subsequently required thyroxine replacement. Atrial myxomas are the most common primary cardiac neoplasms. At least 5% to 10% can be attributed to Carney's complex. More than two-thirds of patients with Carney's complex develop one or more cardiac myxomas. Although atrial myxomas in Carney's complex are histologically indistinguishable from the sporadic form, their clinical presentation and course is distinct. This is the first case of newly diagnosed Graves' disease that has been reported in association with an atrial myxoma. The features discussed in this article help differentiate between syndromic and sporadic atrial myxomas.
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PMID:Hyperthyroidism and atrial myxoma--an intriguing cardio-endocrine association. 1762 4

Vertebroplasty and balloon kyphoplasty are widely used for the augmentation of osteoporosis-induced vertebral compression fractures. Almost invariably, an injectable poly(methyl methacrylate) (PMMA) bone cement that contains a large amount of BaSO(4) particles is used in these procedures. The deleterious effects of this radiopacifier on various properties of PMMA cement have been detailed in the literature. The objective of the present study was therefore to avoid such high levels of inorganic contrast agent and thus to develop an all-polymeric bone cement, for which radiopacity was provided by 60 wt % of an iodine-containing methacrylic copolymer, incorporated into the powder (IO cement), ultimately leading to 6.6 wt % of iodine in the cement. A large array of properties of this cement were determined, ranging from setting time and injectability to fatigue life under fully-reversed tension-compression loading and cytotoxicity, and a comprehensive comparison with a cement containing 30 wt % BaSO(4) in the powder component (BA cement) has been made (11 wt % of Ba in the cement). Statistical analyses of the results showed that, for the majority of the properties, the difference between the means for the two cements was not significant. It is therefore suggested that the IO cement is a suitable alternative to the BA cement for use in the aforementioned procedures.
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PMID:Evaluation of a highly-radiopaque iodine-containing acrylic bone cement for use in augmentation of vertebral compression fractures. 1794 Oct 18

The article describes a case of Graves' disease treated with methimazole and examines the influence of methimazole-induced alterations of thyroid hormone concentrations during warfarin therapy. A 22-year-old woman presented at our endocrinology outpatient clinic with palpitations, sweating, fatigue, tremors, and diarrhea. She had a pain in her right leg and had difficulty walking. Her thyroid profile was consistent with hyperthyroidism. The patient was treated with warfarin 5 mg once a day for deep vein thrombosis for 2 days. Since a therapeutic range of International Normalized Ratio levels could not be achieved, methimazole was stopped due to drug-drug interaction. Lithium was started instead. A euthyroid state was obtained in 2 weeks together with a therapeutic International Normalized Ratio level. Interactions between warfarin and drugs that alter thyroid hormone concentrations have been reported; however, the extent and significance of the interaction between methimazole and warfarin have been inadequately described. Concomitant therapy with warfarin and antithyroid drugs should be managed by frequent monitoring of both thyroid function and the International Normalized Ratio. Lithium is employed only to provide temporary control of thyrotoxicosis in patients who cannot take thionamide and iodide. The administration of lithium alone or in combination with other drugs is shown to be an effective method of controlling hyperthyroidism when conventional antithyroid drugs show adverse effects or become insufficient. When warfarins are used together with antithyroid medications, adequate anticoagulation may not be obtained due to drug-drug interactions. Lithium can be an alternative drug for antithyroid medication in patients on warfarin therapy.
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PMID:Effect of methimazole on warfarin anticoagulation in a case of Graves' disease. 1818 Jun 22


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