Project 1
2.UTI:
A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra.
Women are at greater risk of developing a UTI than are men. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.
Symptoms:
Urinary tract infections don’t always cause signs and symptoms, but when they do they may include:
A strong, persistent urge to urinate
A burning sensation when urinating
Passing frequent, small amounts of urine
Urine that appears cloudy
Urine that appears red, bright pink or cola-colored — a sign of blood in the urine
Strong-smelling urine
Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone
UTIs may be overlooked or mistaken for other conditions in older adults.
UTI diagnosis:
UTIs can be found by analyzing a urine sample. The urine is examined under a microscope for bacteria or white blood cells, which are signs of infection. Your health care provider may also take a urine culture. This is a test that detects and identifies bacteria and yeast in the urine, which may be causing a UTI.
Tests and procedures used to diagnose urinary tract infections include:
Analyzing a urine sample. Doctor may ask for a urine sample for lab analysis to look for white blood cells, red blood cells or bacteria. To avoid potential contamination of the sample, you may be instructed to first wipe your genital area with an antiseptic pad and to collect the urine midstream.
Growing urinary tract bacteria in a lab.
Creating images of your urinary tract.
Using a scope to see inside your bladder.
Analysing a urine sample:
UTIs can be found by analyzing a urine sample. The urine is examined under a microscope for bacteria or white blood cells, which are signs of infection. Your health care provider may also take a urine culture. This is a test that detects and identifies bacteria and yeast in the urine, which may be causing a UTI.
Cardiac arrest:
Sudden cardiac arrest is the abrupt loss of heart function, breathing and consciousness. The condition usually results from a problem with your heart’s electrical system, which disrupts your heart’s pumping action and stops blood flow to your body.
Symptoms
Signs of sudden cardiac arrest are immediate and drastic and include:
Sudden collapse
No pulse
No breathing
Loss of consciousness
Sometimes signs and symptoms occur before sudden cardiac arrest. These might include:
Chest discomfort
Shortness of breath
Weakness
Fast-beating, fluttering or pounding heart (palpitations)
But sudden cardiac arrest often occurs with no warning.
When to see a doctor
If you experience any of these signs and symptoms:
Chest pain or discomfort
Heart palpitations
Rapid or irregular heartbeats
Unexplained wheezing
Shortness of breath
Fainting or near fainting
Lightheadedness or dizziness
Diagnosis of cardiac arrest:
Electrocardiogram:
Blood tests to check the levels of potassium, magnesium, hormones and other chemicals that may affect your heart’s ability to function properly.
Imaging tests like chest X-ray, echocardiogram, nuclear scan:
Other tests like Electrical system (electrophysiological) testing and mapping, Coronary catheterization (angiogram), Ejection fraction testing.
Electrocardiogram (ECG)
An electrocardiogram (ECG) is a simple test that can be used to check your heart’s rhythm and electrical activity.
Sensors attached to the skin are used to detect the electrical signals produced by your heart each time it beats.
These signals are recorded by a machine and are looked at by a doctor to see if they’re unusual.
An ECG may be requested by a heart specialist (cardiologist) or any doctor who thinks you might have a problem with your heart, including your GP.
The test can be carried out by a specially trained healthcare professional at a hospital, a clinic or at your GP surgery.
Despite having a similar name, an ECG isn’t the same as an echocardiogram, which is a scan of the heart.
Thyroid gland:
The thyroid gland is an endocrine gland in your neck. It makes two hormones that are secreted into the blood: thyroxine (T4) and triiodothyronine (T3). These hormones are necessary for all the cells in your body to work normally.
Symptoms
Thyroid gland
The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone deficiency. Problems tend to develop slowly, often over a number of years.
At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and weight gain. Or you may simply attribute them to getting older. But as your metabolism continues to slow, you may develop more-obvious problems.
Hypothyroidism signs and symptoms may include:
Fatigue
Increased sensitivity to cold
Constipation
Dry skin
Weight gain
Puffy face
Hoarseness
Muscle weakness
Elevated blood cholesterol level
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Heavier than normal or irregular menstrual periods
Thinning hair
Slowed heart rate
Depression
Impaired memory
Enlarged thyroid gland (goiter)
Diagnosis of thyroid gland:
Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with those of other conditions. You may experience similar symptoms when you are pregnant or aging and you would when developing a thyroid disease. Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue. These tests include:
Blood tests.
Imaging tests.
Physical exams.
Blood tests:
One of the most definitive ways to diagnose a thyroid problem is through blood tests. Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. These tests are done by taking blood from a vein in your arm. Thyroid blood tests are used to see if you have:
Hyperthyroidism.
Hypothyroidism.
Thyroid blood tests are used to diagnose thyroid disorders associated with hyper- or hypothyroidism. These include:
Thyroiditis.
Graves’ disease.
Hashimoto’s disease.
Goiter.
Thyroid nodule.
Thyroid cancer.
3.
UTI Treatment:
Antibiotics usually are the first line treatment for urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacteria found in your urine.
Simple infection
Drugs commonly recommended for simple UTIs include:
Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
Fosfomycin (Monurol)
Nitrofurantoin (Macrodantin, Macrobid)
Cephalexin (Keflex)
Ceftriaxone
The group of antibiotic medicines known as fluoroquinolones — such as ciprofloxacin (Cipro), levofloxacin and others — isn’t commonly recommended for simple UTIs, as the risks of these medicines generally outweigh the benefits for treating uncomplicated UTIs. In some cases, such as a complicated UTI or kidney infection, your doctor might prescribe a fluoroquinolone medicine if there are no other treatment options.
Often, UTI symptoms clear up within a few days of starting treatment. But you may need to continue antibiotics for a week or more. Take the entire course of antibiotics as prescribed.
For an uncomplicated UTI that occurs when you’re otherwise healthy, your doctor may recommend a shorter course of treatment, such as taking an antibiotic for one to three days. But whether this short course of treatment is enough to treat your infection depends on your particular symptoms and medical history.
Your doctor may also prescribe a pain medication (analgesic) that numbs your bladder and urethra to relieve burning while urinating, but pain usually is relieved soon after starting an antibiotic.
Cardiac arrest Treatment:
Treatment
Sudden cardiac arrest requires immediate action for survival.
CPR
Immediate CPR is crucial for treating sudden cardiac arrest. By maintaining a flow of oxygen-rich blood to the body’s vital organs, CPR can provide a vital link until more-advanced emergency care is available.
If you don’t know CPR and someone collapses unconscious near you, call 911 or emergency medical help. Then, if the person isn’t breathing normally, begin pushing hard and fast on the person’s chest — at a rate of 100 to 120 compressions a minute, allowing the chest to fully rise between compressions. Do this until an automated external defibrillator (AED) becomes available or emergency personnel arrive.
Defibrillation
Advanced care for ventricular fibrillation, a type of arrhythmia that can cause sudden cardiac arrest, generally includes delivery of an electrical shock through the chest wall to the heart. The procedure, called defibrillation, momentarily stops the heart and the chaotic rhythm. This often allows the normal heart rhythm to resume.
Defibrillators are programmed to recognize ventricular fibrillation and send a shock only when it's appropriate. These portable defibrillators, such as AEDs, are increasingly available in public places, including airports, shopping malls, casinos, health clubs, and community and senior citizen centers.
At the emergency room
Once you arrive in the emergency room, the medical staff will work to stabilize your condition and treat a possible heart attack, heart failure or electrolyte imbalances. You might be given medications to stabilize your heart rhythm.
Long-term treatment
After you recover, your doctor will discuss with you or your family what other tests might help determine the cause of the cardiac arrest. Your doctor will also discuss preventive treatment options with you to reduce your risk of another cardiac arrest.
Thyroid gland Treatment:
Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levo-T, Synthroid, others). This oral medication restores adequate hormone levels, reversing the signs and symptoms of hypothyroidism.
You’ll likely start to feel better soon after you start treatment. The medication gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment with levothyroxine will likely be lifelong, but because the dosage you need may change, your doctor is likely to check your TSH level every year.
Determining proper dosage may take time
To determine the right dosage of levothyroxine initially, your doctor generally checks your level of TSH after six to eight weeks. After that, blood levels are generally checked six months later. Excessive amounts of the hormone can cause side effects, such as:
Increased appetite
Insomnia
Heart palpitations
Shakiness
If you have coronary artery disease or severe hypothyroidism, your doctor may start treatment with a smaller amount of medication and gradually increase the dosage. Progressive hormone replacement allows your heart to adjust to the increase in metabolism.
Levothyroxine causes virtually no side effects when used in the appropriate dose and is relatively inexpensive. If you change brands, let your doctor know to ensure you’re still receiving the right dosage.
Also, don’t skip doses or stop taking the drug because you’re feeling better. If you do, the symptoms of hypothyroidism will gradually return.
Proper absorption of levothyroxine
Certain medications, supplements and even some foods may affect your ability to absorb levothyroxine. Talk to your doctor if you eat large amounts of soy products or a high-fiber diet or you take other medications, such as:
Iron supplements or multivitamins that contain iron
Aluminum hydroxide, which is found in some antacids
Calcium supplements
Levothyroxine is best taken on an empty stomach at the same time every day. Ideally, you’ll take the hormone in the morning and wait an hour before eating or taking other medications. If you take it at bedtime, wait four hours after your last meal or snack.
If you miss a dose of levothyroxine, take two pills the next day.
Subclinical hypothyroidism
If you have subclinical hypothyroidism, discuss treatment with your doctor. For a relatively mild increase in TSH, you probably won’t benefit from thyroid hormone therapy, and treatment could even be harmful. On the other hand, for a higher TSH level, thyroid hormones may improve your cholesterol level, the pumping ability of your heart and your energy level.
4.
COLON, RECTUM, PELVIS, AND PERINEUM
Colonic resections (right hemicolectomy, extended right hemicolectomy, segmental resection transverse colon, left hemicolectomy, extended left hemicolectomy, sigmoid resection, total colectomy); rectum, mesorectum, presacral space, and lymphatic drainage; rectal resections (LAR, APR and colostomy); prepubic space and extraperitoneal approach to pelvic viscera (bladder, pelvic urethra; prostate, vas deferens and seminal vesicles OR ovaries, uterine tubes, uterus and vagina; pelvic floor; male and female perineum.
Endoluminal surgery may be defined as procedures performed in a hollow organ using typical surgical techniques, such as dissection, suturing and stapling. By their nature, these procedures must be performed under endoscopic control. Applications of endoluminal surgery to the gastrointestinal tract should ideally be performed via natural orifices. Gastric endoluminal procedures, such as tissue resection by means of strip biopsy or polypectomy, are becoming increasingly common, especially in Japan. The laparoscopic transgastric approach has also been described recently. Endoluminal rectal surgery using retractors started many centuries ago. Complex surgical techniques under endoscopic vision can be performed by transanal endoscopic microsurgery (TEM). Today TEM is widely accepted, but not in every country. With the current impact of new technology, numerous potential endoluminal applications can be foreseen. Ongoing projects in endoluminal surgery include the treatment of bleeding ulcers of the gastrointestinal tract, antireflux techniques for gastro-oesophageal reflux disease (GERD) and the full-thickness resection of early gastrointestinal lesions. Compared with laparoscopic surgery, endoluminal surgery is a further important step in reducing the invasiveness of procedures. In combination with future endoscopic screening programmes for early tumours of the gastrointestinal tract, a revolution in the surgical treatment of these diseases can be foreseen.
Cardiac arrest Treatment:
Technology has given us the automated external defibrillator (AED). This is a small, lightweight, battery operated, portable defibrillator. You may see these devices in schools and public buildings, airports, malls, sports arenas, health clubs, golf courses, and some businesses.
Automated external defibrillator machine on wall.
Defibrillation is needed when a heart starts to beat abnormally, and so fast that very little blood can be pumped out to the body. An AED uses an electric shock to help the heart return to its normal rhythm.
An automated external defibrillator:
The automated external defibrillator (AED) is a computerized medical device. It’s battery powered with adhesive defibrillator pads that are applied to the chest to allow an electrical current to pass through to the heart to reset the heart’s normal electrical current. A normal, regular or organized electrical rhythm through the heart is necessary for the muscle to contract and pump blood to the body.
When a person is in cardiac arrest, they have either no electrical current, a rapid rhythm that doesn’t allow for the heart pumping chambers to fill properly (ventricular tachycardia), or a disorganized electrical rhythm or current that doesn’t allow the heart muscle to contract and circulate blood to the body (ventricular fibrillation). Ventricular fibrillation and ventricular tachycardia can be stopped with an electric shock to restore normal heart rhythm and circulation to the body. This is called either cardioversion or defibrillation.
An AED can check a person's heart rhythm through monitors that are in the defibrillator pads, so you don’t have to be a trained expert to recognize irregular heart rhythms to save someone’s life using an AED. The AED can recognize a rapid or irregular heart rhythm that requires a shock. And, it can advise the rescuer when a shock is needed. The AED uses voice prompts, lights, and text messages to tell the rescuer the steps to take.
AEDs are very accurate and easy to use. There are many different brands of AEDs, but the same basic steps apply to all of them. The American Heart Association doesn’t recommend a specific model.
Thyroid gland Treatment:
If our healthcare provider determines that your thyroid needs to be removed, there are a couple of ways that can be done. Your thyroid may need to be completely removed or just partially. This will depend on the severity of your condition. Also, if your thyroid is very big (enlarged) or has a lot of growths on it, that could prevent you from being eligible for some types of surgery.
The surgery to remove your thyroid is called a thyroidectomy. There are two main ways this surgery can be done:
• With an incision on the front of your neck.
• With an incision in your armpit.
The incision on the front of your neck is more of the traditional version of a thyroidectomy. It allows your surgeon to go straight in and remove the thyroid. In many cases, this might be your best option. You may need this approach if your thyroid is particularly big or has a lot of larger nodules.
Alternatively, there is a version of the thyroid removal surgery where your surgeon makes an incision in your armpit and then creates a tunnel to your thyroid. This tunnel is made with a special tool called an elevated retractor. It creates an opening that connects the incision in your armpit with your neck. The surgeon will use a robotic arm that will move through the tunnel to get to the thyroid. Once there, it can remove the thyroid back through the tunnel and out of the incision in your armpit.
This procedure is often called scarless because the incision is under your armpit and out of sight. However, it’s more complicated for the surgeon and the tunnel is more invasive for you. You may not be a candidate for this type of thyroid removal if you:
• Are not at a healthy body weight.
• Have large thyroid nodules.
• Have a condition like thyroiditis or Graves’s disease.
5.
Defibrillation:
Advanced care for ventricular fibrillation, a type of arrhythmia that can cause sudden cardiac arrest, generally includes delivery of an electrical shock through the chest wall to the heart. The procedure, called defibrillation, momentarily stops the heart and the chaotic rhythm. This often allows the normal heart rhythm to resume.
Defibrillators are programmed to recognize ventricular fibrillation and send a shock only when it’s appropriate. These portable defibrillators, such as AEDs, are increasingly available in public places, including airports, shopping malls, casinos, health clubs, and community and senior citizen centers.
Devices:
If you have a known risk of cardiac arrest, your doctor might recommend an implantable cardioverter-defibrillator. You might consider purchasing an automated external defibrillator for home use. Discuss this with your doctor. AEDs can be expensive and aren’t always covered by health insurance.
Defibrillator:
Implantable cardioverter-defibrillator (ICD)
Implantable cardioverter-defibrillator (ICD)Open pop-up dialog box
An implantable cardioverter-defibrillator (ICD) is a small battery-powered device placed in the chest to detect and stop irregular heartbeats (arrhythmias). An ICD continuously monitors the heartbeat and delivers electric shocks, when needed, to restore a regular heart rhythm.
You might need an ICD if you have a dangerously fast heartbeat that keeps your heart from supplying enough blood to the rest of your body (such as ventricular tachycardia or ventricular fibrillation) or if you are at high risk of such a heart rhythm problem (arrhythmia), usually because of a weak heart muscle.
An ICD differs from a pacemaker — an implantable device that can prevent dangerously slow heartbeats.
Types:
An ICD is a type of cardiac therapy device. There are two basic types:
A traditional ICD is implanted in the chest, and the wires (leads) attach to the heart. The implant procedure requires invasive surgery.
A subcutaneous ICD (S-ICD) is another option that’s implanted under the skin at the side of the chest below the armpit. It’s attached to an electrode that runs along the breastbone. An S-ICD is larger than a traditional ICD but doesn’t attach to the heart.
An ICD constantly monitors for irregular heartbeats and instantly tries to correct them. It helps when the heart stops beating effectively (cardiac arrest).
Your health care provider may recommend an ICD if you’ve had signs or symptoms of a certain type of irregular heart rhythm called sustained ventricular tachycardia, including fainting. An ICD might also be recommended if you survived a cardiac arrest. Other reasons you may benefit from an ICD are:
• A history of coronary artery disease and heart attack that has weakened the heart
• An enlarged heart muscle
• A genetic heart condition that increases the risk of dangerously fast heart rhythms, such as some types of long QT syndrome
• Other rare conditions that may affect the heartbeat.
Risks:
Possible risks of having an ICD implanted include:
• Infection at the implant site
• Swelling, bleeding or bruising
• Blood vessel damage from ICD leads
• Bleeding around the heart, which can be life-threatening
• Blood leaking through the heart valve (regurgitation) where the ICD lead is placed
• Collapsed lung (pneumothorax)
• Movement (shifting) of the device or leads, which could lead to cardiac perforation (rare).
Part B
The bones in your skull can be divided into the cranial bones, which form your cranium, and facial bones, which make up your face.
There are several types of bones within your body, including:
• Long bones
• Short bones
• Flat bones
• Irregular bones
• Sesamoid bones
There are two types in your cranium:
Flat bones. As their name suggests, these bones are thin and flat, though some of them have a slight curve.
Irregular bones. These are bones with complex shapes that don’t fit into any of the other categories.
Anatomy and function
There are eight cranial bones, each with a unique shape:
Frontal bone:
This is the flat bone that makes up your forehead. It also forms the upper portion of your eye sockets.
Parietal bones:
This a pair of flat bones located on either side of your head, behind the frontal bone.
Temporal bones:
This is a pair of irregular bones located under each of the parietal bones.
Occipital bone:
This is a flat bone located in the very back of your skull. It has an opening that allows your spinal cord to connect to your brain.
Sphenoid bone:
This is an irregular bone that sits below the frontal bone. It spans the width of your skull and forms a large part of the base of your skull.
Ethmoid bone:
This is an irregular bone located in front of the sphenoid bone. It makes up part of your nasal cavity.
Cranial bones are held together by unique joints called sutures, which are made of thick connective tissue. They’re irregularly shaped, allowing them to tightly join all the uniquely shaped cranial bones. The sutures don’t fuse until adulthood, which allows your brain to continue growing during childhood and adolescence.
Cranial bone conditions
Several injuries and health conditions can impact your cranial bones, including fractures and congenital conditions.
Fracture
A fracture refers to any type of break in a bone. There are several types of skull fracture that can affect cranial bones, such as:
Depressed. This refers to a fracture that makes part of your skull appear sunken.
Linear. A linear fracture in a cranial bone means there’s a break in the bone, but the bone itself hasn’t moved.
Basilar. This type involves a break in one of the bones near the base of your skull, such as the sphenoid bone. This is a serious condition requiring immediate treatment.
Diastatic. A diastatic fracture occurs along one of the sutures of your skull, making it wider than usual. It’s usually seen in infants.
In many cases, skull fractures aren’t as painful as they sound, and they often heal on their own without surgery. However, more severe fractures may require surgery.
Craniosynostosis:
Some infants are born with a condition called craniosynostosis, which involves the premature closing of skull sutures. This leads to an unusually shaped skull and can sometimes affect facial features.
There are several types of craniosynostosis, depending on the sutures they affect:
Bicoronal synostosis. Infants with this type may have a flattened and elevated forehead.
Coronal synostosis. This type can cause flattening on one side of the forehead and impact the shape of the eye socket and nose.
Lambdoid synostosis. This can lead to flattening on one side of the back of the skull. It can also affect the positioning of the ear or cause the skull to tilt sideways.
Metopic synostosis. This can cause a triangle-shaped skull or pointed forehead. It can also make the eyes appear closer together.
Sagittal synostosis. This type may cause the forehead to bulge out. The area around the temples might also appear very narrow, making the head look elongated.
Craniosynostosis requires surgical treatment to avoid later complications.
Other :
Some other conditions that can affect the cranial bones include:
Cleidocranial dysplasia:
Mutations to a specific gene cause unusual development of the teeth and bones, including the cranial bones. Common symptoms include a sloped forehead, extra bone within skull sutures, and an enlarged skull.
Craniometaphyseal dysplasia:
This is an inherited condition that causes thickening of the cranial bones, which can lead to a protruding forehead and wide-set eyes.
Paget’s disease of bone. New bone tissue is rapidly made due to unusual behavior of osteoclasts, which are a type of bone cell. People with this condition are more prone to fractures because the affected bone is usually weaker.
Fibrous dysplasia:
This causes the development of scarlike tissue instead of bone tissue due to a mutation in bone-producing cells. It tends to only affect a single bone at a time, though more may be involved in some cases.
Osteomas:
An osteoma is a benign overgrowth of bone on the skull. People with osteomas typically have no symptoms. However, if the growth puts pressure on a nerve, it can cause hearing and vision problems. These usually resolve once the growth is removed.
Symptoms of a cranial bone condition:
With all the structures in your head and neck, it’s sometimes hard to pinpoint when symptoms are coming from an issue with the cranial bones.
Symptoms that suggest some type of cranial bone fracture include:
• Bruising around the eyes or behind your ears
• Clear fluid or blood draining from your ears or nose
• A feeling of weakness in your face
Symptoms of a structural issue with the cranial bones include:
• A dull, aching pain
• Numbness or tingling in your face
• Hearing or vision problems
• Unusually shaped head or facial features.
Skull implant:
Large skull reconstruction, with the use of customized cranial implants, restores cerebral protection, physiologic homeostasis, and one’s preoperative appearance. Cranial implants may be composed of either bone or a myriad of alloplastic biomaterials. Recently, patient-specific cranial implants have been fabricated using clear polymethylmethacrylate (PMMA), a visually transparent and sonolucent variant of standard opaque PMMA. Given the new enhanced diagnostic and therapeutic applications of clear PMMA, we present here a study evaluating all outcomes and complications in a consecutive patient series.
Methods:
A single-surgeon, retrospective, 3-year study was conducted on all consecutive patients undergoing large cranioplasty with clear PMMA implants (2016-2019). Patients who received clear PMMA implants with embedded neurotechnologies were excluded due to confounding variables. All outcomes were analyzed in detail and compared with previous studies utilizing similar alloplastic implant materials.
Results:
Fifty-five patients underwent cranioplasty with customized clear PMMA implants. Twenty-one (38%) were performed using a single-stage cranioplasty method (ie, craniectomy and cranioplasty performed during the same operation utilizing a prefabricated, oversized design and labor-intense, manual modification), whereas the remaining 34 (62%) underwent a standard, 2-stage reconstruction (craniectomy with a delayed surgery for cranioplasty and minimal-to-no implant modification necessary). The mean cranial defect size was 101.8 cm. The mean follow-up time was 9 months (range, 1.5-39). Major complications requiring additional surgery occurred in 7 patients (13%) consisting of 2 (4%) cerebrospinal fluid leaks, 2 (4%) epidural hematomas, and 3 (4%) infections. In addition, 3 patients developed self-limiting or nonoperative complications including 2 (4%) with new onset seizures and 1 (2%) with delayed scalp healing.
Conclusions:
This is the first reported consecutive case series of cranioplasty reconstruction using customized clear PMMA implants, demonstrating excellent results with regard to ease of use, safety, and complication rates well below published rates when compared with other alloplastic materials. Clear PMMA also provides additional benefits, such as visual transparency and sonolucency, which is material specific and unavailable with autologous bone. Although these early results are promising, further studies with multicenter investigations are well justified to evaluate long-term outcomes.