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Biomedical subjects

Nick Bishop

Publications and source records attributed to Nick Bishop.

7 recordsLinked to original sources
PubMed2006

Fractures and recurrent fractures in children; varying effects of environmental factors as well as bone size and mass.

BACKGROUND: Fractures are frequent in childhood and cause considerable morbidity. Previous reports have indicated a variety of potential contributors to fracture risk including low bone mineral content and density, milk avoidance, lack of exercise, asthma, obesity, and a high consumption of carbonated beverages. AIMS: We wished to test the hypothesis that children who sustain recurrent fractures have a lower bone mass and a higher prevalence of underlying risk factors for fracture than those who fracture once or not at all. METHODS: We studied 150 children aged 4-16 years: 50 who had suffered recurrent fractures, 50 who had fractured for the first time, and 50 fracture-free controls. Subjects underwent assessment of bone size and mass by total body (TB) and lumbar spine (L2-4) dual energy X-ray absorptiometry (DXA). Values were adjusted for body size, based on the control group measurements as unadjusted DXA values are substantially influenced by size in children. Anthropometry and grip dynamometry were carried out, and information about factors implicated in fracture aetiology such as milk intake, physical activity levels, asthma prevalence and carbonated beverage consumption were recorded using questionnaires. RESULTS: Children who had sustained one or more fractures had a significantly lower BMC and aBMD at all sites than controls after conversion to size adjusted z scores (L2-4 BMC P = 0.0002; L2-4 aBMD P < 0.0001; TB BMC P < 0.0001; TB aBMD P < 0.0001); estimates for TB excluded fracture sites. There was, however, no difference in adjusted bone mass between children with one and those with recurrent fractures. Children with recurrent fractures had a significantly lower milk intake, lower levels of physical activity, a higher BMI, and a higher consumption of carbonated beverages than controls. The prevalence of risk factors was not, however, significantly higher than controls in children with a single fracture. CONCLUSIONS: Children with fractures have a lower bone mass for body size than children without fractures. Modifiable risk factors such as diet and exercise increase the risk of recurrent fractures.

Adolescent↗
PubMed2005

Significance of the mechanical environment during regeneration of the intervertebral disc.

The prevalence of low back pain is high, and the intervertebral (IV) disc is regarded as one of the major causes. Various approaches have been reported to either slow down disc degeneration or to repair/regenerate the disc. So far, the effect of the mechanical environment has not been addressed in these approaches, although several investigations have shown its influence on other mesenchymal tissues. In this paper, we propose that the biophysical stimuli from the mechanical environment can directly influence cell type, as well as their metabolic activity during repair/regeneration of the IV disc. To demonstrate the potential of this idea, data from the literature, as well as explorative experimental results, are presented.

Animals↗
PubMed2004

Abrasive water jet cutting as a new procedure for cutting cancellous bone--in vitro testing in comparison with the oscillating saw.

The quality of bone cuts is assessed by the accuracy and biological potency of the cut surfaces. Conventional tools (such as saws and milling machines) can cause thermal damage to bone tissue. Water jet cutting is nonthermal; that is, it does not generate heat. This study investigates whether the abrasive jet cutting quality in cancellous bone with a biocompatible abrasive is sufficient for the implantation of endoprostheses or for osteotomies. Sixty porcine femoral condyles were cut with an abrasive water jet and with an oscillating saw. alpha-lactose-monohydrate was used as a biocompatible abrasive. Water pressure (pW = 35 and 70 MPa) and abrasive feed rate (m = 0.5, 1, and 2 g/s) were varied. As a measure of the quality of the cut surface the cutting gap angle (delta) and the surface roughness (Ra) were determined. The surface roughness was lowest for an abrasive feed rate of m = 2 g/s (jet direction: 39 +/- 16 microm, advance direction: 54 +/- 22 microm). However, this was still significantly higher than the surface roughness for the saw group (jet direction: 28 +/- 12 microm, advance direction: 36 +/- 19 microm) (p < 0.001 for both directions). At both pressure levels the greatest cutting gap angle was observed for a mass flow rate of m = 1 g/s (pW = 35 MPa: delta = 2.40 +/- 4.67 degrees ; pW = 70 MPa: delta = 4.13 +/- 4.65 degrees), which was greater than for m = 0.5 g/s (pW = 35 MPa: delta = 1.63 +/- 3.89 degrees ; pW = 70 MPa: delta = 0.36 +/- 1.70 degrees) and m = 2 g/s (pW =70 MPa: delta = 0.06 +/- 2.40 degrees). Abrasive water jets are suitable for cutting cancellous bone. The large variation of the cutting gap angle is, however, unfavorable, as the jet direction cannot be adjusted by a predefined value. If it is possible to improve the cutting quality by a further parameter optimization, the abrasive water jet may be the cutting technique of the future for robotic usage.

Animals↗
PubMed2004

Are inhaled corticosteroids associated with an increased risk of fracture in children?

Inhaled corticosteroids are widely used in the long-term management of asthma in children. Data on the relationship between inhaled corticosteroid therapy and osteoporotic fracture are inconsistent. We address this issue in a large population-based cohort of children aged 4-17 years in the UK (the General Practice Research Database). The incidence rates of fracture among children aged 4-17 years taking inhaled corticosteroids (n=97,387), taking bronchodilators only (n=70 984) and a reference group (n=345,758) were estimated. Each child with a non-vertebral fracture (n=23,984) was subsequently matched by age, sex, practice, and calendar time to one child without a fracture. Fracture incidence was increased in children using inhaled corticosteroids, as well as in those receiving bronchodilators alone. With an average daily beclomethasone dose of 200 microg or less, the crude fracture risk relative to nonusers was 1.10 [95% confidence interval (CI), 0.96-1.26]; with dosage of 201-400 microg, it was 1.23 (95% CI, 1.08-1.39); and with dosages over 400 microg, it was 1.36 (95% CI, 1.11-1.67). This excess risk disappeared after adjustment for indicators of asthma severity. The increased risk of fracture associated with use of inhaled corticosteroids is likely to be the result of the underlying illness, rather than being directly attributable to inhaled corticosteroid therapy.

Administration, Inhalation↗
PubMed2003

Rickets.

Rickets, once thought vanquished, is reappearing. In some less developed countries it hardly went away. This seminar reviews the effects of genes, stage of development, and environment on clinical expression of the disease. Rickets can be secondary to disorders of the gut, pancreas, liver, kidney, or metabolism; however, it is mostly due to nutrient deficiency and we concentrate on this form. Although calcium deficiency contributes in communities where little cows' milk is consumed, deficiency of vitamin D is the main cause. There are three major problems: the promotion of exclusive breastfeeding for long periods without vitamin D supplementation, particularly for babies whose mothers are vitamin D deficient; reduced opportunities for production of the vitamin in the skin because of female modesty and fear of skin cancer; and the high prevalence of rickets in immigrant groups in more temperate regions. A safety net of extra dietary vitamin D should be re-emphasised, not only for children but also for pregnant women. The reason why many immigrant children in temperate zones have vitamin D deficiency is unclear. We speculate that in addition to differences in genetic factors, sun exposure, and skin pigmentation, iron deficiency may affect vitamin D handling in the skin or gut or its intermediary metabolism.

Adolescent↗
PubMed2003

The water jet as a new tool for endoprosthesis revision surgery--an in vitro study on human bone and bone cement.

In revision surgeries of endoprostheses, the interface between implant and bone cement or bone must be loosened. Conventional tools have many disadvantages because of their size and limited range. Taking advantage of the selective and athermic cutting process, a plain water jet is already used in order to cut soft tissues. This study investigates the possibilities of both a plain and an abrasive water jet as cutting tools for revision surgery. Samples of the mid-diaphysis of human femora and bone cement (CMW3) were cut with a plain water jet (PWJ) and an abrasive water jet (AWJ) at two different jet-to-surface angles (30 degrees,90 degrees ) and at five different pressure levels (30, 40, 50, 60, 70 MPa). For a PWJ a selective pressure range was identified, where only bone cement was cut. Injecting a bio-compatible abrasive (lactose) to the jet stream resulted in significantly higher cut depths in both materials. Material removal in bone was significantly less at the smaller jet-to-surface angle for both techniques. No clear selectivity between bone and bone cement was observed for application of the AWJ. However, the material removal rate was significantly higher for bone cement than for bone at all pressure levels. The results indicate that an AWJ might be an alternative tool for cement removal. The possibility for localised cutting at interfaces could be an advantage for revision of a non-cemented prosthesis.

Aged↗