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  • 1.
    Cronskär, Marie
    et al.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics.
    Bäckström, Mikael
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics.
    Modeling of fractured clavicles and reconstruction plates using CAD, finite element analysis and real musculoskeletal forces input2013In: WIT Transactions on Biomedicine and Health, WIT Press, 2013, p. 235-243Conference paper (Refereed)
    Abstract [en]

    This study focuses on the treatment options for clavicle fractures, more specifically the cases with a need for internal fixation: non-unions and some complex fractures. Enhancing the understanding of the loading of the bone and fixation device enables treatment options to be improved. The aim of the study was to develop a method for the realistic simulation of stresses and displacements in the bone and fixation device and to use this method to make comparisons between a conventional reconstruction plate and a customized plate, designed from patient-specific computed tomography (CT) data. In an earlier study, a finite element (FE) mesh of the clavicle geometry was created from CT data, subjected to muscle forces and other boundary conditions from a multibody musculoskeletal model and imported into the FE solver. In this study, a solid 3D model of the same clavicle geometry was created and the mesh was replaced by the solid model to make the FE-model more suitable for the comparison of different plates. An LCP Reco-Plate 3.5 straight, 6 holes (by Synthes) was compared with a customized plate which was designed to follow the anatomy of the bone. The LCP-Reco plate has tapered reconstruction segments throughout the plate to allow for the plate reshaping during surgery. The customized plate was designed without such segments and with a lower width than the LCP plate. The two different plates showed stresses and displacements of similar magnitudes. The customized plate had a more even stress distribution while the LCP plate had higher stress concentrations in the middle of the plate and on the edges of the tapered reconstruction segments. To the authors' best knowledge, this is the first FE model of a clavicle bone with plate and it may, upon further development, serve as a useful instrument for improved clavicle fixation.

  • 2.
    Cronskär, Marie
    et al.
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Engineering and Sustainable Development.
    Rännar, Lars-Erik
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Engineering and Sustainable Development.
    Bäckström, Mikael
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Engineering and Sustainable Development.
    Implementation of digital design and solid free-form fabrication for customization of implants in trauma orthopaedics2012In: Journal of medical and biological engineering, ISSN 1609-0985, Vol. 32, no 2, p. 91-96Article in journal (Refereed)
    Abstract [en]

    Bone plates for the fixation of complex fractures in proximity to joints often have to be reshaped to follow the bone contour. Good adhesion of the screws in areas where the bone is osteoporotic is also a challenge. One possible solution to these issues is to tailor-make plates by creating a digital three-dimensional model of the fracture from a computed tomography (CT) scan, digitally reducing the fracture, designing a plate, and finally manufacturing it directly from the digital model with solid free-form fabrication (SFF) technology. This study designs a custom plate for a distal tibia fracture, and investigates and refines the procedure from the CT scan to the final implant, with the aim of making it usable in trauma orthopaedics. The bone plate is manufactured using electron beam melting (EBM) technology. The challenges of bone plate design using digitalization and SFF are discussed. The virtual models created by the engineer while digitally reducing the fracture and modeling the plate are valuable for the physician while planning the surgery. A combination of surgery planning and digital plate design improves the surgeon's preparations and ensures correspondence between the plan and the designed implant. The proposed procedure, with the approximate required time in brackets, includes the separation of bone in the DICOM file (60 min), the reduction of fracture (5-30 min), revision (30 min), modelling of the plate (30-120 min), confirmation (30 min), manufacturing with SFF (10 h), post-processing (60 min), and finally cleaning and sterilization (90 min). The whole procedure requires about three working days.

  • 3.
    Etehad Tavakol, Mahnaz
    et al.
    Isfahan University of Medical Sciences, Iran.
    Fatemi, Alimohammad
    Isfahan University of Medical Sciences, Iran.
    Karbalaie, Abdolamir
    KTH, Hälso- och systemvetenskap.
    Emrani, Zahra
    Isfahan University of Medical Sciences, Iran.
    Erlandsson, Björn-Erik
    KTH, Systemsäkerhet och organisation.
    Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated?2015In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, Vol. 2015, article id 974530Article in journal (Refereed)
    Abstract [en]

    Video nailfold capillaroscopy (NFC), considered as an extension of the widefield technique, allows a more accurate measuring andstoring of capillary data and a better defining, analyzing, and quantifying of capillary abnormalities. Capillaroscopic study is oftenperformed on the patients suspected of having microcirculation problems such as Raynaud’s phenomenon as the main indicationfor nailfold capillaroscopy. Capillaroscopic findings based on microcirculation studies can provide useful information in the fieldsof pathophysiology, differential diagnosis, and monitoring therapy. Nailfold capillaroscopy provides a vital assessment in clinicalpractices and research; for example, its reputation in the early diagnosis of systemic sclerosis is well established and it is also usedas a classification criterion in this regard. This review focuses on the manner of performing video nailfold capillaroscopy and on acommon approach for measuring capillary dimensions in fingers and toes.

  • 4.
    Högberg, Cecilia
    et al.
    Department of Public Health and Clinical Medicine, Unit of Clinical Research Centre - Östersund, Umeå University, Sweden.
    Karling, Pontus
    Department of Public Health and Clinical Medicine, Medicine/Gastroenterology, Umeå University, Sweden .
    Rutegård, Jörgen
    Department of Surgical and Perioperative Sciences, Umeå University, Sweden .
    Lilja, Mikael
    Department of Public Health and Clinical Medicine, Unit of Clinical Research Centre - Östersund, Umeå University, Sweden.
    Ljung, Thomas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Immunochemical faecal occult blood tests in primary care and the risk of delay in the diagnosis of colorectal cancer2013In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 31, no 4, p. 209-214Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the value, risks, and shortcomings of immunochemical faecal occult blood tests (iFOBTs) in the diagnosis of colorectal cancer (CRC) and adenomas with high-grade dysplasia (HGD) in patients initially presenting to primary care. Design. A retrospective population-based study. Setting and subjects. All 495 cases of CRC and adenomas with HGD diagnosed in the county of Jamtland, Sweden from 2005 to 2009. Results. Of 495 patients 323 (65%) initially presented to primary care. IFOBTs were performed in 215 of 323 (67%) patients. The sensitivity of iFOBT for CRC and adenomas with HGD was 88% (83% when patients with a history of rectal bleeding were excluded). Of 34 patients with anaemia found en passant, 10 had negative iFOBTs. Time to diagnosis was longer for patients with negative iFOBTs (p < 0.0005). Conclusion. IFOBT might be helpful in selecting which patients to refer for colonoscopy. However, iFOBT has a limited sensitivity as a diagnostic test for CRC and adenomas with HGD. Relying only on iFOBT for colonoscopy referral could delay diagnosis, especially for patients with anaemia found en passant.

  • 5.
    Kelmendi, Vjollca
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kellah, Hawa
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Tonåringars upplevelser av diabetes typ 12009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 6.
    Popov, Vladimir V., Jr.
    et al.
    Technion R&D Fdn, Haifa, Israel.
    Muller-Kamskii, Gary
    Technion R&D Fdn, Haifa, Israel.
    Katz-Demyanetz, Alexander
    Technion R&D Fdn, Haifa, Israel.
    Kovalevsky, Aleksey
    Technion R&D Fdn, Haifa, Israel.
    Usov, Stas
    Vet Clin Orthovet, St Petersburg, Russia.
    Trofimcow, Dmitrii
    Vet Clin Beliy Klyk, Moscow, Russia.
    Dzhenzhera, Georgy
    Polygon Med Engn, Moscow, Russia.
    Koptioug, Andrei
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Management and Mechanical Engineering.
    Additive manufacturing to veterinary practice: recovery of bony defects after the osteosarcoma resection in canines2019In: BIOMEDICAL ENGINEERING LETTERS, ISSN 2093-9868, Vol. 9, no 1, p. 97-108Article, review/survey (Refereed)
    Abstract [en]

    The paper outlines the achievements and challenges in the additive manufacturing (AM) application to veterinary practice. The state-of-the-art in AM application to the veterinary surgery is presented, with the focus of AM for patient-specific implants manufacturing. It also provides critical discussion on some of the potential issues design and technology should overcome for wider and more effective implementation of additively manufactured parts in veterinary practices. Most of the discussions in present paper are related to the metallic implants, manufactured in this case using so-called powder bed additive manufacturing (PB-AM) in titanium alloy Ti-6AL-4V, and to the corresponding process of their design, manufacturing and implementation in veterinary surgery. Procedures of the implant design and individualization for veterinary surgery are illustrated basing on the four performed surgery cases with dog patients. Results of the replacement surgery in dogs indicate that individualized additively manufactured metallic implants significantly increase chances for successful recovery process, and AM techniques present a viable alternative to amputation in a large number of veterinary cases. The same time overcoming challenges of implant individualization in veterinary practice significantly contributes to the knowledge directly relevant to the modern medical practice. An experience from veterinary cases where organ-preserving surgery with 3D-printed patient-specific implants is performed provides a unique opportunity for future development of better human implants.

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