In orthopedics, bone fixation imposes the use of implants in almost all cases. Over time, the materials used for the implant have evolved from inert materials to those that mimic the morphology of the bone. Therefore, bioabsorbable, biocompatible, and bioactive materials have emerged. Our study aimed to review the main types of implant materials used in orthopedics and present their advantages and drawbacks. We have searched for the pros and cons of the various types of material in the literature from over the last twenty years. The studied data show that consecrated metal alloys, still widely used, can be successfully replaced by new types of polymers. The data from the literature show that, by manipulating their composition, the polymeric compounds can simulate the structure of the different layers of human bone, while preserving its mechanical characteristics. In addition, manipulation of the polymer composition can provide the initiation of desired cellular responses. Among the implanting materials, polyurethane is distinguished as the most versatile polymeric material for use both as orthopedic implants and as material for biomechanical testing of various bone reduction and fixation techniques.

We aimed to investigate the effects of two nitric oxide donors in acute inflammation in rats. The experiment was carried out on white Wistar rats, randomly distributed in 4 groups of 5 animals each; the substances were administered intraperitoneally as follows: Group 1 (SS): saline solution 0.1mL/100 g body weight (control); Group 2 (IND): indometacin 150 mg/kg body weight; Group 3 (NEB): nebivolol 1 mg/kg body weight; Group 4 (GSNO): S-nitroso-glutathione 1 mg/kg body weight. An experimental model of acute hind paw inflammation with carrageenan was used for the researches. The influence of the nitric oxide donors on blood parameters, specific inflammatory and immune markers was evaluated 24 h, respectively 72 hours after the injection of irritant agent. The experimental protocol was implemented according to the recommendations of our University Committee for Research and Ethical Issues. The administration of nitric oxide donors nebivolol and S-nitroso-glutathione was accompanied by a substantial diminution of paw edema, as well as by an important decrease in the percent of lymphocytes, a reduction of interleukin 6 and tumor necrosis factor alpha values. The effects of nebivolol were more accentuated than of S-nitroso-glutathione, but less intense than of indomethacin in the experiment. The treatment with nebivolol and S-nitroso-glutathione produced anti-inflammatory effects on local acute inflammation in the carrageenan-induced paw edema test in rats.

Bone fracture fixation uses both consecrated materials, such as metals/metal alloys, as well as synthetic materials. Synthetic materials are extremely versatile in terms of simulating biological structures, biocompatibility and, in some cases, avoid the subsequent interventions for removing the prosthetic material. Fixing an osteoporotic fracture presents major risks of failure due mainly to the bone fragility. To reduce the risk of failure, prosthetic materials have been improved with various cements. The purpose of the current study was to assess the mechanical properties of different orthopedic screws covered with a new polyurethane acrylate polymer (PUA) in order to improve the stability of the screw for the subsequent fixation of the fragility fracture. To test the efficiency of the new polymer, the breaking/fracture strength of the orthopedic screws coated with PUA was evaluated, in comparison with the screws without coating material. Our data shows that tested PUA improves the bond between the screw and bone. We estimate that the effect obtained is caused by the partial damping of the loading force due to the elastic component of the polymer.

Fragility fractures of the pelvis have lately gained interest due to the increased incidence caused by aging populations. The aim of the study was to evaluate the results of the therapy in patients with pelvic fragility fracture admitted between January 2015 and September 2018 St. Spiridon Emergency Hospital in Iasi in order to improve the therapeutic approach. We assessed the correlation between pain and the early mobilization under the weight bearing condition in patients with and without osteoporotic therapy in history. The study emphasizes the role of pain in recovery process and underline the serious consequences of the late detection of bone fragility. Our study had revealed that previous osteoporotic treatment has benefits in the event of a fracture. As a result of this analysis, we consider that the age for the prophylactic measures in bone fragility should go below 60 years.

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The fragility fracture fixation confronts with the major problem of implant loosening due to the altered bone structure. Techniques used to fragility fracture stabilization includes metals devices, cements or adhesives. Different types of cements and adhesive can be obtained by chemical manipulation in order to provide a more efficient transition between the metal surface and the real bone. Thus, by selecting the appropriate chemical composition and ration between the components, synthetic cement and adhesive can provide a proper interface that ensure a perfect cohesion between the implant material and the natural bone. Most of the studies point the benefit of these synthetic materials in improving screw fixation strength. That is why, currently, the synthetic materials used in prosthesis are improved by associating with natural components of the bone, such as hydroxyapatite. For osteoporosis, which is characterized by demineralization, the association of the implanted material with hydroxyapatite is expected to be a suited solution for bone matrix regeneration after implantation. The aim of the current study was to assess the mechanical properties of orthopedic screws coated with a new polyurethane acrylate polymer containing hydroxyapatite in order to improve the stability of the screw for the subsequent fixation of the fragility fracture. To test the efficiency of the new hydroxyapatite containing polymer, the mechanical behavior of the coated screws was evaluated. Our data show that the augmented screw can be obtained by incorporating lower hydroxyapatite concentrations.

AbstractWe studied the release of nicotinic acid from a macromolecular pro-drug containing niacin bound to a polymeric support of dextran. Using a modified High-performance Liquid Chromatography (HPLC) method to provide an improved separation between nicotinic acid and its metabolites, we compared the plasma levels of nicotinic acid 24 h after administration of the pro-drug or a similar dose of unbound nicotinic acid to rats. Nicotinic acid exerts a number of pharmacological activities among which is the hypolipidemic effect. To determine the hypolipidemic effect of the pro-drug, we measured the triglyceride levels and examined the correlation with the plasma levels of nicotinic acid.Starting 6 h after administration of the pro-drug, the plasma levels of nicotinic acid were high enough to cause a decrease in the triglyceride level. These results suggest that nicotinic acid was gradually released from the polymeric support, leading to the sustained presence of the active substance and, therefore, a reduction in the level of triglycerides.

The aim of study was to investigate the relationship between oral health and nutritional status in a population of elderly patients with systemic chronic or acute pathology. Materials and method: Prospective cross-sectional clinical investigation of 115 aged patients (] 60 yo; mean age 66.2) from the Clinical Foundation, Faculty of Dental Medicine, University of Medicine and Pharmacy of Iasi. In the first stage of the study, the patients (able to understand and communicate) were submitted to a mini-test for the assessment of the mental status (MMSE) . In the second stage of the study, a questionnaire was used to record demographic and socioeconomic data of the subjects as well as information regarding systemic status and nutritional facts. In the third stage of the study, the nutritional status was evaluated by using Mini-Nutritional Assessment questionnaire (MNA). Finally, the oral status was evaluated by using clinical and radiographical exams as well as geriatric oral health assessment index (GOHAI). Results: Of the 60 old adults, 6% were severely malnourished, and 37.4% presented malnourished risk. 49.6% of the old people had difficulties eating firm foods, 25% of them being unable to prepare meals. Regarding oral status, only 5.2% had at least 20 natural teeth, 55.6% required dental care for decayed or broken teeth, 69.6% were affected by xerostomia, 21% of the completely or partial edentulous people were untreated by removable dentures, 25% of the edentulous patients complained by ill-fitted removable dentures. Conclusion: Lack of education, treatment with over 3 drugs daily, physical inability to buy foods or to prepare meals, as well as the difficulties eating firm foods are strongly associated with poor nutritional status. Also, the need for dental care was associated to nutritional deficiency.