scholarly journals The impact of vertebral osteomyelitis on spinal stability and principles of surgical stabilization

2020 ◽  
pp. 201-208
Author(s):  
Vlad Catana ◽  
Radu Mircea Gorgan
Keyword(s):  
Early Stage ◽  
Vertebral Osteomyelitis ◽  
Spinal Stability ◽  
Infection Rates ◽  
Spinal Stabilization ◽  
Metal Implants ◽  
Hospitalization Costs ◽  
Thorough Debridement ◽  
The Impact ◽  
Late Stages

Vertebral osteomyelitis (VO) is a disease that responds well to conservative treatment and antibiotherapy if diagnosed in an early stage. Due to the prolonged onset of this pathology, many cases are diagnosed in mid or late stages and require surgery. The surgical treatment is not yet standardized and may only mean decompression of the infectious outbreak without stabilization, or surgical decompression associated with stabilization. Using only bone grafts for surgery or stabilizing the spine through segmental posterior and/or anterior instrumentation is accompanied by many controversies. In this review, we focus on demonstrating that combining a well-conducted antibiotherapy with thorough debridement of the necrotic areas and using metal implants for spinal stabilization lowers the infection rates, provides an early pain-free mobilization of the patient and reduces hospitalization costs.

scholarly journals The Effect of Host, Habitat and Fasting Time on the Gut Microbiota of Amphibian

2021 ◽  
Author(s):  
Qing Tong ◽  
Li-yong Cui ◽  
Zong-fu Hu ◽  
Xiao-peng Du ◽  
Hong-bin Wang
Keyword(s):  
Environmental Factors ◽  
Gut Microbiota ◽  
Environmental Changes ◽  
Early Stage ◽  
Information Criterion ◽  
Shannon Index ◽  
Lifestyle Changes ◽  
Fasting Time ◽  
The Impact ◽  
Late Stages

Abstract Wild animals entering captivity experience radical lifestyle changes resulting in microbiota alterations, in large part due to differences in diet. However, little is known about how external environmental factors influences the gut microbiota and the interaction of the environment-host-microbe interactions in host fasting. The gut microbiota in the early stage (amA and dyA groups) and late stage of hibernation in Rana amurensis and R. dybowskii of entering captivity (amL and dyL groups) and wild environments (amS and dyS groups) was determined, and the effects of host, environmental factors and fasting time on the gut microbiota were investigated via high-throughput Illumina sequencing. The Shannon index differed significantly between the amL and dyL groups and between the amA and amS groups. The PD index differed significantly between the dyL and dyS groups. Eight core OTUs were widely distributed between species, habitats and fasting times and were dominant in abundance. Captive and wild environments, host species, and fasting time significantly affected the composition and structure of the gut microbiota. Akaike information criterion (AIC)-based model results suggested that the environment and host were the variables that needed to be included in redundancy analysis (RDA) to explain the variance in taxa. The pairwise distances between the early and late stages of hibernation of were greater in R. amurensis and R. dybowskii entering captivity than in wild. The average of OTUs shared by early and late stages of hibernation of captive frogs was significantly lower than the average of wild frogs. These results can reveal the impact of environmental changes on the gut microbiota, thereby revealing the important interactions between environment-host-microbes, and helping to protect vertebrate hosts.

scholarly journals Incidence of vertebral osteomyelitis and benefits of spinal stabilization in infection

2020 ◽  
pp. 213-219
Author(s):  
Vlad Catana ◽  
Radu Mircea Gorgan
Keyword(s):  
Medical Records ◽  
Vertebral Osteomyelitis ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
Fast Recovery ◽  
Spinal Decompression ◽  
Spinal Stabilization ◽  
Hospitalization Costs ◽  
Hospital Patients ◽  
Tuberculous Osteomyelitis

In order to evaluate the etiology, characteristics and outcome of the surgical treatment of vertebral osteomyelitis cases in our hospital, patients with vertebral osteomyelitis between January 2014 and December 2018 were included in the study. Clinical and paraclinical data of the patients were collected from the medical records of the patients. Of the 164 patients diagnosed with vertebral osteomyelitis in our clinic 94 underwent surgery and only these last ones were included in the study. Of these 94 patients, 18 cases were diagnosed with tuberculous osteomyelitis and 76 with nontuberculous osteomyelitis. The age of the majority of patients ranged from 40 to 80 years with a peak of incidence between 61-70 years. All of the patients had back pain and regional tenderness of the affected area and many cases presented neurological deficits. The most common involved area affected in our cases was the thoracic spine. Magnetic resonance imaging is the examination that reveals the degree of involvement and excludes other pathologies from the differential diagnosis. The majority of patients had several comorbidities which we included in the study. From all the patients included 76 % underwent surgery with decompression and spinal stabilization using titanium instrumentation and 24 % underwent surgery with only spinal decompression. We also evaluated number hospitalization days of the operated cases. An early diagnosis seems crucial for a fast recovery, lowering the hospitalization costs of both the patient and the hospital and preventing sequelae development. 

KAJIAN DAMPAK KEBIJAKAN PENUTUPAN LOKALISASI TELEJU OLEH PEMERINTAH KOTA PEKANBARU

2017 ◽  
Vol 15 (2) ◽  
pp. 78
Author(s):  
M. Zainuddin
Keyword(s):  
Social Order ◽  
Qualitative Method ◽  
Negative Impact ◽  
Early Stage ◽  
Policy Research ◽  
Research Approach ◽  
Policy Content ◽  
The Government ◽  
Closure Policy ◽  
The Impact

This research to analyze the impact of closure policy Teleju brothel by Pekanbaru govermentin 2010. Guidelines for works are Pekanbaru Local Regulations No. 12 of 2008 on Social Order-liness. Closure this brothel inflicts positive and negative impact for society.The research wasconducted to obtain early stage formula for the government to take action against the prostitu-tion activities. This research uses policy research approach with a qualitative method, becausein prostitution activities and prohibition by goverment is an assessment that needs to be done byanalyzing documents and unstructured interview.The results showed that after the closing of the Teleju brothel have an impact on the deploy-ment of a prostitution and affect the economy of the surrounding residents. Government seeksto tackle prostitution in Pekanbaru by moving the brothel, conduct regular raids and providetraining. The effort is considered to be less than the maximum because the handling is not basedon the root of the problem and not programmed properly. There are several causes of failure ofgovernment to overcome the prostitution problem in Pekanbaru, including: policy content isless focus on the prostitution problem, the government did not proceeds with data, lack of finan-cial support, contra productive programs between local government with the police and TNI,and the policy object is difficult to be given understanding.

Fluoxetine Protects against Dendritic Spine Loss in Middle-aged APPswe/PSEN1dE9 Double Transgenic Alzheimer’s Disease Mice

2020 ◽  
Vol 17 (1) ◽  
pp. 93-103 ◽  
Author(s):  
Jing Ma ◽  
Yuan Gao ◽  
Wei Tang ◽  
Wei Huang ◽  
Yong Tang
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dendritic Spines ◽  
Dendritic Spine ◽  
Early Stage ◽  
Learning Ability ◽  
Middle Aged ◽  
Protein Levels ◽  
Spine Pathology ◽  
The Impact

Background: Studies have suggested that cognitive impairment in Alzheimer’s disease (AD) is associated with dendritic spine loss, especially in the hippocampus. Fluoxetine (FLX) has been shown to improve cognition in the early stage of AD and to be associated with diminishing synapse degeneration in the hippocampus. However, little is known about whether FLX affects the pathogenesis of AD in the middle-tolate stage and whether its effects are correlated with the amelioration of hippocampal dendritic dysfunction. Previously, it has been observed that FLX improves the spatial learning ability of middleaged APP/PS1 mice. Objective: In the present study, we further characterized the impact of FLX on dendritic spines in the hippocampus of middle-aged APP/PS1 mice. Results: It has been found that the numbers of dendritic spines in dentate gyrus (DG), CA1 and CA2/3 of hippocampus were significantly increased by FLX. Meanwhile, FLX effectively attenuated hyperphosphorylation of tau at Ser396 and elevated protein levels of postsynaptic density 95 (PSD-95) and synapsin-1 (SYN-1) in the hippocampus. Conclusion: These results indicated that the enhanced learning ability observed in FLX-treated middle-aged APP/PS1 mice might be associated with remarkable mitigation of hippocampal dendritic spine pathology by FLX and suggested that FLX might be explored as a new strategy for therapy of AD in the middle-to-late stage.

58 Use of Abdominal Wall or Sucutaneous Drain to Reduce the Risk of Surgical Site Infections

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Mistry ◽  
B Woolner ◽  
A John
Keyword(s):  
Surgical Site Infection ◽  
Open Cholecystectomy ◽  
Surgical Site Infections ◽  
Standard Operating Procedure ◽  
Site Infection ◽  
Infection Rates ◽  
Local Evidence ◽  
Audit Data ◽  
The Impact ◽  
To Receive

Abstract Introduction Open abdominal surgery confers potentially greater risk of surgical site infections, and local evidence suggests use of drains can reduce this. Our objectives were: Assessing local rates and risk factors of infections and if use of drains can reduce the rates of infections. Method Retrospectively looking from 01/01/2018 to 31/12/2018, at patients following laparotomy or open cholecystectomy. Data collection on demographics, smoking/alcohol status, heart, respiratory or renal disease or diabetes, steroid use and CEPOD status, as well as use of drain and the outcome of infection using inpatient and online patient records. Results 84 patients included, 25 had drains inserted. There were 13 documented cases of surgical site infection, all of whom had no drain post-op. Other parameters shown to be most prevalent in the patients with a surgical site infection include being current/ex-smoker (8/13), having heart disease (9/13), and elective procedures. Conclusions Aiming to reduce the risk of surgical site infections can improve morbidity and potentially mortality outcomes. Our audit data showed that there appears to be a benefit of inserting intra-abdominal or subcutaneous drains. We will create a standard operating procedure of all patient to receive drains post-op and then re-audit to assess the impact this has on infection rates.

scholarly journals Effect of COVID-19 on Thoracic Oncology Surgery in Spain: A Spanish Thoracic Surgery Society (SECT) Survey

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2897
Author(s):  
Néstor Martínez-Hernández ◽  
Usue Caballero Silva ◽  
Alberto Cabañero Sánchez ◽  
José Luis Campo-Cañaveral de la Cruz ◽  
Andrés Obeso Carillo ◽  
...  
Keyword(s):  
Overall Response Rate ◽  
Early Stage ◽  
Care Delivery ◽  
Public Hospitals ◽  
Clinical Activity ◽  
Spanish Society ◽  
Lung Cancer Patients ◽  
Oncological Patients ◽  
Multiple Choice Questionnaire ◽  
The Impact

After the first wave of COVID-19, the Spanish Society of Thoracic Surgeons (SECT) surveyed its members to assess the impact of the pandemic on thoracic oncology surgery in Spain. In May 2020, all SECT members were invited to complete an online, 40-item, multiple choice questionnaire. The questionnaire was developed by the SECT Scientific Committee and sent via email. The overall response rate was 19.2%. The respondents answered at least 91.5% of the items, with only one exception (a question about residents). Most respondents (89.3%) worked in public hospitals. The reported impact of the pandemic on routine clinical activity was considered extreme or severe by 75.5% of respondents (25.5% and 50%, respectively). Multidisciplinary tumour boards were held either with fewer members attending or through electronic platforms (44.6% and 35.9%, respectively). Surgical activity decreased by 95.7%, with 41.5% of centers performing surgery only on oncological patients and 11.7% only in emergencies. Nearly 60% of respondents reported modifying standard protocols for early-stage cancer and in the preoperative workup. Most centers (≈80%) reported using full personal protective equipment when operating on COVID-19 positive patients. The COVID-19 pandemic severely affected thoracic oncology surgery in Spain. The lack of common protocols led to a variable care delivery to lung cancer patients.

scholarly journals Miniaturization and Automation of a Human In Vitro Blood–Brain Barrier Model for the High-Throughput Screening of Compounds in the Early Stage of Drug Discovery

Pharmaceutics ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 892
Author(s):  
Elisa L. J. Moya ◽  
Elodie Vandenhaute ◽  
Eleonora Rizzi ◽  
Marie-Christine Boucau ◽  
Johan Hachani ◽  
...  
Keyword(s):  
Drug Discovery ◽  
Blood Brain Barrier ◽  
Early Stage ◽  
Molecular Transport ◽  
Brain Barrier ◽  
Blood Brain ◽  
Cns Drugs ◽  
The Impact ◽  
The Brain

Central nervous system (CNS) diseases are one of the top causes of death worldwide. As there is a difficulty of drug penetration into the brain due to the blood–brain barrier (BBB), many CNS drugs treatments fail in clinical trials. Hence, there is a need to develop effective CNS drugs following strategies for delivery to the brain by better selecting them as early as possible during the drug discovery process. The use of in vitro BBB models has proved useful to evaluate the impact of drugs/compounds toxicity, BBB permeation rates and molecular transport mechanisms within the brain cells in academic research and early-stage drug discovery. However, these studies that require biological material (animal brain or human cells) are time-consuming and involve costly amounts of materials and plastic wastes due to the format of the models. Hence, to adapt to the high yields needed in early-stage drug discoveries for compound screenings, a patented well-established human in vitro BBB model was miniaturized and automated into a 96-well format. This replicate met all the BBB model reliability criteria to get predictive results, allowing a significant reduction in biological materials, waste and a higher screening capacity for being extensively used during early-stage drug discovery studies.

scholarly journals Quality assurance of radiotherapy in the ongoing EORTC 1420 “Best of” trial for early stage oropharyngeal, supraglottic and hypopharyngeal carcinoma: results of the benchmark case procedure

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
J-J Stelmes ◽  
E. Vu ◽  
V. Grégoire ◽  
C. Simon ◽  
E. Clementel ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Early Stage ◽  
Prospective Trial ◽  
Similarity Index ◽  
Phase Iii ◽  
Current Phase ◽  
Hypopharyngeal Carcinoma ◽  
Transoral Surgery ◽  
Swallowing Function ◽  
The Impact

Abstract Introduction The current phase III EORTC 1420 Best-of trial (NCT02984410) compares the swallowing function after transoral surgery versus intensity modulated radiotherapy (RT) in patients with early-stage carcinoma of the oropharynx, supraglottis and hypopharynx. We report the analysis of the Benchmark Case (BC) procedures before patient recruitment with special attention to dysphagia/aspiration related structures (DARS). Materials and methods Submitted RT volumes and plans from participating centers were analyzed and compared against the gold-standard expert delineations and dose distributions. Descriptive analysis of protocol deviations was conducted. Mean Sorensen-Dice similarity index (mDSI) and Hausdorff distance (mHD) were applied to evaluate the inter-observer variability (IOV). Results 65% (23/35) of the institutions needed more than one submission to achieve Quality assurance (RTQA) clearance. OAR volume delineations were the cause for rejection in 53% (40/76) of cases. IOV could be improved in 5 out of 12 OARs by more than 10 mm after resubmission (mHD). Despite this, final IOV for critical OARs in delineation remained significant among DARS by choosing an aleatory threshold of 0.7 (mDSI) and 15 mm (mHD). Conclusions This is to our knowledge the largest BC analysis among Head and neck RTQA programs performed in the framework of a prospective trial. Benchmarking identified non-common OARs and target delineations errors as the main source of deviations and IOV could be reduced in a significant number of cases after this process. Due to the substantial resources involved with benchmarking, future benchmark analyses should assess fully the impact on patients’ clinical outcome.

scholarly journals Evidence-Based Design in Architectural Education: Designing the First Maggie’s Centre in Israel

2021 ◽  
pp. 193758672110079
Author(s):  
Nirit Putievsky Pilosof ◽  
Yasha Jacob Grobman
Keyword(s):  
Literature Review ◽  
Architectural Design ◽  
Early Stage ◽  
Scientific Research ◽  
Well Being ◽  
Architectural Education ◽  
Local Context ◽  
Evidence Based ◽  
Architecture Education ◽  
The Impact

Objective The study examines the integration of the Evidence-based Design (EBD) approach in healthcare architecture education in the context of an academic design studio. Background Previous research addressed the gap between scientific research and architectural practice and the lack of research on the use of the EBD approach in architectural education. Methods The research examines an undergraduate architectural studio to design a Maggie’s Centre for cancer care in Israel and evaluates the impact of the EBD approach on the design process and design outcomes. The research investigates the impact of the integration of three predesign tasks: (1) literature review of healing architecture research, (2) analysis and comparison of existing Maggie’s Centres, and (3) analysis of the context of the design project. Results The literature review of scientific research supported the conceptual design and development of the projects. The analysis of existing Maggie’s centers, which demonstrated the interpretation of the evidence by different architects, developed the students’ ability to evaluate EBD in practice critically, and the study of the projects’ local context led the students to define the relevance of the evidence to support their vision for the project. Conclusions The research demonstrates the advantages of practicing EBD at an early stage in healthcare architectural education to enhance awareness of the impact of architectural design on the users’ health and well-being and the potential to support creativity and innovative design. More studies in design studios are needed to assess the full impact of integrating EBD in architectural education.

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