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Background Exposure to magnetic fields may alter the settings of programmable ventriculoperitoneal shunt valves or even cause permanent damages to these devices. There is little information about this topic, none on live patients. Objective To investigate the effects of 1.5-tesla magnetic resonance imaging (MRI) on Hakim-Codman (HC) pressure programmable valves implanted in our hospital. Methods A single-center prospective study to assess the rate of perturbations of HC programmable valve implanted. One hundred consecutive patients implanted for different clinical reasons between 2008 and 2012 were examined. A conventional skull x-ray before and after a standard MRI on 1.5 tesla. We evaluated before and after results, analyzed modification rate, and verified eventual damages to the implanted devices. Results Implanted HC valves are extremely handy and durable, even if they are likely to change often due to the exposure to magnetic fields. None of the patients complained of heating effects. Oscillations range from 10–30 mm H 2 O with a patient who reached 50 mm H 2 O and 1 who reached 60 mm H 2 O. Global alteration rate was 40%: 10 patients (10%) experienced a 10 mm H 2 O change; 14 patients (14%) had a 20 mm H 2 O change; 6 patients (6%) had a 30 mm H 2 O change; 8 patients (8%) had a 40 mm H 2 O change; 1 patient had a 50 mm H 2 O change; and 1 patient had a 60 mm H 2 O change. Conclusions HC valves presented a variable perturbation rate, with an alteration rate of 40% with 1.5-telsa MRI. We have not observed malfunctioning hardware as a result of magnetic influence. We claim ​ a cranial x-ray immediately after the MRI because of a high risk (40%) of decalibration, especially in patients with low ventricles compliance.

An innovative epiphyseal device has been recently proposed claiming an effective bone–prosthesis load transfer and a nearly physiological bone stresses distribution. However preliminary experimental tests showed a 23% weakening of the femoral neck after implantation. Aim of this study was to revise the prosthesis geometry with the goal of enhancing the femoral neck strength after implantation, while maintaining unchanged the initial conceptual design. To this aim, the risk of femoral neck fractures, prosthesis fractures, aseptic loosening and excessive bone resorption were addressed through a validated finite element procedure following a systematic approach. The initial prosthesis geometry was revised to reduce each investigated failure risk below the threshold of acceptance (100%). The new geometry was re-assessed to verify the effectiveness of the revision. The first design was predicted to locally induce high bone strains and cement stresses, which translated in a risk of bone and cement failure exceeding the threshold of acceptance (>100%). The revised design preserved a good stability of the device, contemporary reducing the risk for bone (45%) and cement (60%) failure. If results will be confirmed by statistical and clinical experimentations, current clinical indications for hip epiphyseal devices might be extended.

Evaluation of medical devices retrieved after in vivo service provides unique evidence related to the physiological environment in which the biomaterials performed. This study implements a training procedure for evaluating polyethylene bearings of joint prostheses obtained after pre-clinical tests or explanted after in vivo function. A total of 161 damage regions on 45 bearings were evaluated by four observers. An illustrated Damage Mode Atlas was developed as a reference guide, inclusive of both photographs and concise written descriptions of 16 specific damage modes that are typical for polyethylene bearings. Utilizing the Damage Mode Atlas to train new researchers improved the damage pattern analysis, including more accurate identification of damage modes and improved inter-rater reliability. This Damage Mode Atlas is a useful supplementary tool for conducting Stage II non-destructive analysis of explanted polyethylene bearings used for joint replacement, in accordance with international guidelines for evaluating explanted medical devices.

We have illustrated the fabrication of nano-structures as a surface enhanced Raman scattering (SERS) substrate using electro-plating and electron-beam lithography techniques to obtain an array of gold nanograin-aggregate structures of diameter ranging between 80 and 100 nm with interstitial gap of 10-30 nm. The nanostructure based SERS substrate permits us to have better control and reproducibility on generation of plasmon polaritons. The calculation shows the possible detection of myoglobin concentration down to attomole. This SERS substrate is used to investigate the structural changes of different proteins; lysozyme, ribonuclease-B, bovin serum albumin and myoglobin in the temperature range between -65 and 90 degrees C. The in-depth analysis even for small conformational changes is performed using 2D Raman correlation analysis and difference Raman analysis in order to gain straightforward understanding of proteins undergoing thermodynamical perturbation.

The present work aims to evaluate the mobility of the polyethylene bearing in 25 patients implanted with a mobile-bearing PCL-retaining TKR (Interax ISA, Striker Howmedica) under in vivo, weight-bearing conditions over 3 years' follow-up. We compared the bearing motion in response to specific tests in two consecutive follow-ups with Roentgen Stereophotogrammetric Analysis (RSA). Results showed that polyethylene continued to displace on the tibial baseplate over time: longitudinal rotations and medio-lateral translations tended to increase at the second follow-up (mean increases 0.7 ± 2.5° and 0.34 ± 1.08 mm, respectively), while sagittal translations did not show any relevant change. Longitudinal rotations and AP translations were preserved when present at both follow-ups. Nevertheless, no statistical evidence of repeatable pattern of motion was found, since bearings frequently reversed their pattern of motion between the two follow-ups. The unconstrained polyethylene mobility resulted in an unrepeatable, erratic pattern of bearing motion intra-patient and over time. The changes in knee motion were found not to affect the clinical results over the first 3 years of follow-up. As in a fixed-bearing design, mobile-bearing design was not able to reproduce normal knee kinematics. © 2006 Elsevier B.V. All rights reserved.

Background The ultrasonic industry has recently produced echocardiographic Hand Held Devices (miniaturized, compact and battery-equipped echocardiographic systems). Their potential usefulness has been successfully assessed in a wide range of clinical conditions. The aim of the study was to verify if the routine use of a basic model of echocardiographic Hand Held Device (HHD) could be an important diagnostic tool during outpatient cardiologic consulting or in non-cardiologic hospital sections. Methods 87 consecutive patients were included in this study; they underwent routine physical examination, resting ECG and echocardiographic evaluation using a basic model of HHD performed by trained echocardiographists; the cardiologist, whenever possible, formulated a diagnosis. The percentage of subjects in whom the findings were judged reasonably adequate for final diagnostic and therapeutic conclusions was used to quantify the "conclusiveness" of HHD evaluation. Successively, all patients underwent a second echocardiographic evaluation, by an examiner with similar echocardiographic experience, performed using a Standard Echo Device (SED). The agreement between the first and the second echocardiographic exam was also assessed. Results Mean examination time was 6.7 ± 1.5 min. using HHD vs. 13.6 ± 2.4 min. using SED. The echocardiographic examination performed using HHD was considered satisfactory in 74/87 patients (85.1% conclusiveness). Among the 74 patients for whom the examination was conclusive, the diagnosis was concordant with that obtained with the SED examination in 62 cases (83.8% agreement). Conclusion HHD may generally allow a reliable cardiologic basic evaluation of outpatient or subjects admitted to non-cardiologic sections, more specifically in particular subgroups of patients, with a gain in terms of time, shortening patient waiting lists and reducing healthy costs.