Removal of instrumentation for postoperative spine infection: systematic review

OBJECTIVE Currently, no consensus exists as to whether patients who develop infection of the surgical site after undergoing instrumented fusion should have their implants removed at the time of wound debridement. Instrumentation removal may eliminate a potential infection nidus, but removal may also destabilize the patient’s spine. The authors sought to summarize the existing evidence by systematically reviewing published studies that compare outcomes between patients undergoing wound washout and instrumentation removal with outcomes of patients undergoing wound washout alone. The primary objectives were to determine 1) whether instrumentation removal from an infected wound facilitates infection clearance and lowers morbidity, and 2) whether the chronicity of the underlying infection affects the decision to remove instrumentation. METHODS PRISMA guidelines were used to review the PubMed/MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov databases to identify studies that compared patients with implants removed and patients with implants retained. Outcomes of interest included mortality, rate of repeat wound washout, and loss of correction. RESULTS Fifteen articles were included. Of 878 patients examined in these studies, 292 (33%) had instrumentation removed. Patient populations were highly heterogeneous, and outcome data were limited. Available data suggested that rates of reoperation, pseudarthrosis, and death were higher in patients who underwent instrumentation removal at the time of initial washout. Three studies recommended that instrumentation be uniformly removed at the time of wound washout. Five studies favored retaining the original instrumentation. Six studies favored retention in early infections but removal in late infections. CONCLUSIONS The data on this topic remain heterogeneous and low in quality. Retention may be preferred in the setting of early infection, when the risk of underlying spine instability is still high and the risk of mature biofilm formation on the implants is low. However, late infections likely favor instrumentation removal. Higher-quality evidence from large, multicenter, prospective studies is needed to reach generalizable conclusions capable of guiding clinical practice.

Rehydration Characteristics of Mushrooms using Different Drying Techniques

Mushroom may be baked, fried, boiled, creamed, roasted, pickled and stuffed. In India, it is mainly consumed fresh and a negligible amount is used for processing. They can be processed as canned, dried and frozen mushrooms. The dried mushrooms are packed in hermetically sealed air tight tins for quality retention and stored in a cool dry place. The study’s main objective is to know the effect of different drying methods on the quality of mushrooms and its dehydration, rehydration characteristics. Sun-drying and Cabinet tray drying methods were selected in the study. The rehydration ratio and coefficient of rehydration were calculated and compared for both the drying methods. An expert Committee did an Organoleptic evaluation. The results showed that cabinet tray dried mushrooms were reconstituted better compared to the sundried ones. The values of coefficient of rehydration and the rehydration ratio for cabinet dried mushrooms were found as 0.498 and 1:3.3 which were higher than sundried mushrooms. Cabinet tray dried mushrooms showed it’s superiority in sensory assessment. The study concluded that mushrooms dehydrated by the cabinet tray drying have better rehydration characteristics than sun drying.

Aloe vera Gel Drying by Refractance Window®: Drying Kinetics and High-Quality Retention

In most cases, conventional drying produces inferior quality products and requires higher drying times. A continuous pilot Refractance Window® equipment was used to dry Aloe vera gel slabs of 5 and 10 mm thick at 60, 70, 80, and 90 °C, seeking a dry product with high-quality retention. Based on five empirical models, drying kinetics, diffusion coefficient, and activation energy were analyzed. Midilli–Kuck was the best predicting model. Short drying times (55–270 min) were needed to reach 0.10 g water/g solid. In addition, the technique yielded samples with high rehydration capacity (24–29 g water/g solid); high retention of color (∆E, 3.74–4.39); relatively low losses of vitamin C (37–59%) and vitamin E (28–37%). Regardless of the condition of temperature and sample thickness, a high-quality dried Aloe vera gel could be obtained. Compared with other methods, Refractance Window® drying of Aloe vera achieved shorter drying times with higher quality retention in terms of color, vitamins C and E, and rehydration. Finally, the dried Aloe vera gel could be reconstituted to a gel close to its fresh state by rehydration.

Effect of treatment and drying method (Solar and convective) on physico-chemical quality of dried moringa leaves

Moringa is one of the promising crop high nutritional and therapeutic values. While drying of moringa leaves, there is significant loss in physical, chemical and nutritional composition of leaves. So, the present study was conducted to investigate the effect of different treatment and drying method (solar and convective) on physico-chemical quality of moringa leaves. Moringa leaves that were sorted, washed and surface dried were considered non-treated whereas leaves that were blanched at 7.5 min after sorting were considered treated. The following samples were dried in three dryers viz., PAU advanced domestic solar dryer, PAU domestic solar dryer and convective tray dryer. Samples that were treated had better physico-chemical quality than untreated sample. Similarly, samples dried in PAU advanced domestic solar dryer had better quality retention i.e. had low moisture content, low colour change, higher protein content, higher ascorbic acid and higher total antioxidant activity.

An Overview of Physico-chemical Characteristics and Postharvest Treatments of litchi (Litchi chinensis Sonn.)

Background: Litchi chinensis is evergreen and arboreal tree with grey-black bark, shiny branches, and deep green lanceolate dense round shape leaves. The litchi peel is very thin and rigid that comes out easily, revealing jelly-like white color pulp having excellent flavor due to sugar and acid content. Litchi is an excellent source of antioxidant, vitamin C, vitamin B-complex, and flavonoids that help in the prevention of chronic diseases. Aim: The quality of litchi fruit is generally estimated by aroma volatiles, color, physio-chemical parameters, and fruit composition (minerals and vitamins). The concern regarding the use of sulfating agents in vegetables and fresh fruits is rising worldwide. Therefore, there is a requirement of declaration from U.S. Food and Drug Administration regulations for its acceptable levels as sulfur dioxide (SO2) are officially defined as a pesticide that is nowadays used as a fumigant for litchi. Conclusion: This review summarizes the outcome of diverse post-harvest treatments, types of packaging, storage period and their effects on physicochemical characters, sensory evaluation, quality retention, and changes during storage of litchi fruit along with exploring suitable alternative technologies to replace SO2 fumigation.