Polymethylmethacrylate(PMMA) bone cement technology has progressed from industrial Plexiglass administration in the 1950 s to the recent advent of nanoparticle additives. Additives have been trialed to address problem...Polymethylmethacrylate(PMMA) bone cement technology has progressed from industrial Plexiglass administration in the 1950 s to the recent advent of nanoparticle additives. Additives have been trialed to address problems with modern bone cements such as the loosening of prosthesis, high post-operative infection rates, and inflammatory reduction in interface integrity. This review aims to assess current additives used in PMMA bone cements and offer an insight regarding future directions for this biomaterial. Low index(< 15%) vitamin E and low index(< 5 g) antibiotic impregnated additives significantly address infection and inflammatory problems, with only modest reductions in mechanical strength. Chitosan(15% w/w PMMA) and silver(1% w/w PMMA) nanoparticles have strong antibacterial activity with no significant reduction in mechanical strength. Future work on PMMA bone cements should focus on trialing combinations of these additives as this may enhance favourable properties.展开更多
Patient satisfaction is a goal of effective health care delivery and its assessment is important to the improvement of health care, especially in the context of a more consumerist culture. Patient education and inform...Patient satisfaction is a goal of effective health care delivery and its assessment is important to the improvement of health care, especially in the context of a more consumerist culture. Patient education and information has been shown to improve patient satisfaction with care. Lack of sufficient patient information (specifically related to post-discharge care) was identified in our patient population by means of a broad ranging post-discharge satisfaction survey. Targeted intervention, in the form of a discharge information sheet for patients, was trialled with the aim of improving specific satisfaction parameters related to post-discharge care, and overall patient satisfaction. Patient satisfaction was measured for six months before and after the intervention, and data from both groups compared. There was no statistically significant difference in patient satisfaction directly related to the provision of the additional discharge information or overall patient satisfaction between the two groups. Providing patients with specific information alone at discharge is not sufficient to improve overall or discharge-specific patient satisfaction. More active interventions may be required.展开更多
文摘Polymethylmethacrylate(PMMA) bone cement technology has progressed from industrial Plexiglass administration in the 1950 s to the recent advent of nanoparticle additives. Additives have been trialed to address problems with modern bone cements such as the loosening of prosthesis, high post-operative infection rates, and inflammatory reduction in interface integrity. This review aims to assess current additives used in PMMA bone cements and offer an insight regarding future directions for this biomaterial. Low index(< 15%) vitamin E and low index(< 5 g) antibiotic impregnated additives significantly address infection and inflammatory problems, with only modest reductions in mechanical strength. Chitosan(15% w/w PMMA) and silver(1% w/w PMMA) nanoparticles have strong antibacterial activity with no significant reduction in mechanical strength. Future work on PMMA bone cements should focus on trialing combinations of these additives as this may enhance favourable properties.
文摘Patient satisfaction is a goal of effective health care delivery and its assessment is important to the improvement of health care, especially in the context of a more consumerist culture. Patient education and information has been shown to improve patient satisfaction with care. Lack of sufficient patient information (specifically related to post-discharge care) was identified in our patient population by means of a broad ranging post-discharge satisfaction survey. Targeted intervention, in the form of a discharge information sheet for patients, was trialled with the aim of improving specific satisfaction parameters related to post-discharge care, and overall patient satisfaction. Patient satisfaction was measured for six months before and after the intervention, and data from both groups compared. There was no statistically significant difference in patient satisfaction directly related to the provision of the additional discharge information or overall patient satisfaction between the two groups. Providing patients with specific information alone at discharge is not sufficient to improve overall or discharge-specific patient satisfaction. More active interventions may be required.
