Gait analysis: An effective tool to mechanically monitor the bone regeneration of critical-sized defects in tissue engineering applications

by Pablo Blázquez-Carmona, Juan Mora-Macías, Juan Morgaz, María del Mar Granados, Jaime Domínguez, Esther Reina-Romo

Introduction

Tissue engineering has emerged as an innovative approach to treat critical-size bone defects using biocompatible scaffolds, thus avoiding complex distraction surgeries or limited stock grafts. Continuous regeneration monitoring is essential in critical-size cases due to the frequent appearance of non-unions. This work evaluates the potential clinical use of gait analysis for the mechanical assessment of a tissue engineering regeneration as an alternative to the traditional and hardly conclusive manual or radiological follow-up.

Materials and methods

The 15-mm metatarsal fragment of eight female merino sheep was surgically replaced by a bioceramic scaffold stabilized with an external fixator. Gait tests were performed weekly by making the sheep walk on an instrumented gangway. The evolution of different kinematic and dynamic parameters was analyzed for all the animal’s limbs, as well as asymmetries between limbs. Finally, potential correlation in the recovery of the gait parameters was evaluated through the linear regression models.

Results

After surgery, the operated limb has an altered way of carrying body weight while walking. Its loading capacity was significantly reduced as the stance phases were shorter and less impulsive. The non-operated limbs compensated for this mobility deficit. All parameters were normalizing during the consolidation phase while the bone callus was simultaneously mineralizing. The results also showed high levels of asymmetry between the operated limb and its contralateral, which exceeded 150% when analyzing the impulse after surgery. Gait recovery significantly correlated between symmetrical limbs.

Conclusions

Gait analysis was presented as an effective, low-cost tool capable of mechanically predicting the regeneration of critical-size defects treated by tissue engineering, as comparing regeneration processes or novel scaffolds. Despite the progressive normalization as the callus mineralized, the bearing capacity reduction and the asymmetry of the operated limb were more significant than in other orthopedic alternatives.

Como extraer una gasometría arterial (GSA) en UCI

Debido a la necesidad de personal de enfermería en las unidades de cuidados intensivos por la pandemia del Covid-19, por falta de tiempo y de formación en las contrata-ciones masivas, muchos profesionales carecen de los conocimientos y de la experiencia en las tareas "básicas" de una UCI. Entre ellas, se encuentra la extracción de gasometrías arteriales y más ahora puesto que la patología persistente debido al Covid -19 es la neumonía bilateral, la cual requiere de GSA para obtener datos sustanciales de los procedimientos a llevar a cabo con estos pacientes (vgr. pronaciones, supinaciones, cambios de modos ventilatorios, etc.) [Fragmento de texto].

Influencia del nivel de triaje asignado sobre el ingreso de pacientes atendidos en el Servicio de Urgencias según motivo de consulta

Objetivo principal: Analizar la influencia del nivel de triaje asignado mediante Sistema de Triaje Manchester sobre la probabilidad de ingreso en pacientes que acuden a urgencias con los motivos de consulta Disnea, Dolor Abdominal y Problemas en Extremidades. Metodología: Estudio analítico retrospectivo de los pacientes que acudieron al Servicio de Urgencias. Resultados principales: El nivel de triaje asignado se relaciona con una mayor probabilidad de ingreso en el caso de niveles de triaje naranja Dolor Abdominal y rojo en Disnea (p<0,05). En pacientes con Problemas en Extramidades el nivel de triaje asignado no influye en la probabilidad de ingreso manejando como covariables la edad y el sexo. La edad es un predictor significativo de ingreso en pacientes con los tres motivos de ingreso (p<0,001). Conclusión principal: El nivel de triaje asignado se asocia de manera diferencial con la probabilidad de ingreso según el motivo de consulta del paciente.