No abstract

Introduction: NSAIDs inhibit osteogenesis and may result in delayed union or nonunion. The purpose of this meta-analysis was to determine whether their use leads to delayed union or nonunion. Methods: We systematically reviewed the literature reporting the effect of NSAIDs on bone healing. We included studies of pediatric and adult patients NSAID exposure and healing bone. The outcomes of interest were delayed union, nonunion, or pseudarthrosis with at least six months of follow-up. A maximum likelihood random-effects model was used to conduct meta-analysis and meta-regression. Results: NSAID exposure increased delayed union or nonunion (odds ratio [OR], 2.07; confidence interval [CI], 1.19 to 3.61). No effect was noted in pediatrics (OR, 0.58; CI, 0.27 to 1.21) or low dose/short duration of exposure (OR, 1.68; CI, 0.63 to 4.46). Conclusion: Analysis of the literature indicates a negative effect of NSAIDs on bone healing. In pediatric patients, NSAIDs did not have a significant effect. The effect may be dose or time dependent because low-dose/short-duration exposure did not affect union rates.

In a contextual cuing paradigm, we examined how memory for the spatial structure of a natural scene guides visual search. Participants searched through arrays of objects that were embedded within depictions of real-world scenes. If a repeated search array was associated with a single scene during study, then array repetition produced significant contextual cueing. However, expression of that learning was dependent on instantiating the original scene in which the learning occurred: Contextual cueing was disrupted when the repeated array was transferred to a different scene. Such scene-specific learning was not absolute, however. Under conditions of high scene variability, repeated search array were learned independently of the scene background. These data suggest that when a consistent environmental structure is available, spatial representations supporting visual search are organized hierarchically, with memory for functional sub-regions of an environment nested within a representation of the larger scene.