Spondylodiscitis due to anaerobic bacteria Veillonella parvula: Case report and literature review

Background: While pyogenic spondylodiscitis due to Gram-positive aerobic bacteria and its treatment is well known, spondylodiscitis caused by anaerobic Gram-negative pathogen is rare. In particular, the spondylodiscitis caused by Veillonella species is an absolute rarity. Thus no established management recommendations exist. Case Description: A case report of a 79-year-old man with spondylodiscitis caused by Veillonella parvula with intramuscular abscess collection managed conservatively with stand-alone antibiotic therapy without a spinal stabilization procedure. A review of literature of all reported spondylodiscitis caused by Veillonella species was performed. After 3 week-intravenous therapy with the ceftriaxone in combination with the metronidazole followed by 3 weeks per oral therapy with amoxicillin/clavulanate, the complete recovery of the patient with the V. parvula infection was achieved. Conclusion: Treatment of the spondylodiscitis caused by Veillonella species should contain a beta-lactam with beta-lactamase inhibitor or third-generation cephalosporine. Six weeks of treatment seem to be sufficient for the complete recovery of the patient.

Management of hipovascular non-union of ulna with implant destabilization in patient treated due to both forearm bone shafts fracture – a case report

A clinical case report of a 26-year-old patient with an open fracture of both forearm shafts without known comorbidities, who, during treatment, developed a non-union of the ulna with destabilization of the implants. After another fracture stabilization procedure, debridgement of the fracture ends and filling the bone gap with frozen allogenic bone grafts, union was obtained. In this paper, the authors consider possible causes of fracture healing problems in this patient based on the available literature.

Patellofemoral Stabilization: Postoperative Redislocation and Risk Factors Following Surgery

Background: Patellofemoral instability is a common knee problem that is difficult to manage owing to its multifactorial etiology as well as the fact that predisposing pathoanatomic features vary from individual to individual. There is limited knowledge regarding the demographic and pathoanatomic risk factors or the relationship between these risk factors and the redislocation rate after surgical stabilization for this challenging condition. Purpose: To analyze the postoperative redislocation rates and the prevalence of demographic and pathoanatomic risk factors for patients undergoing a patellofemoral stabilization. Study Design: Case series; Level of evidence, 4. Methods: Patients with symptomatic recurrent patellofemoral instability underwent a soft tissue patellofemoral stabilization procedure. A total of 342 patellofemoral stabilization procedures (reconstruction, n = 256; imbrication, n = 86) were assessed at a mean follow-up of 24.3 months. Concomitant procedures were performed in accordance with the à la carte concept of addressing significant anatomic or biomechanical characteristics. Two surgical cohorts were analyzed separately for reconstruction or imbrication to address laxity of the medial patellofemoral ligament (MPFL). Failure of the patellofemoral stabilization procedure was defined as postoperative redislocation of the patella. Prevalence of demographic and pathoanatomic risk factors was determined for all patients. Disease-specific patient-reported outcomes were assessed with the Banff Patella Instability Instrument (BPII). Results: A redislocation rate of 5.1% was identified for MPFL reconstruction and 20.9% for MPFL imbrication. For both MPFL procedures, age at time of surgery was significantly younger for the failed group as compared with the intact group. Postoperative BPII scores were significantly lower for patients who subsequently experienced a surgical failure as compared with intact surgery for both MPFL reconstruction ( P = .048) and MPFL imbrication ( P = .003). Conclusion: Patellofemoral stabilization with an à la carte approach to surgical selection demonstrated a low postoperative redislocation rate and good clinical results. Younger age at time of surgery was associated with surgical failure. This information may be used to guide surgical decision making and patient education.

Assessing reproducibility of matrix factorization methods in independent transcriptomes

Motivation Matrix factorization (MF) methods are widely used in order to reduce dimensionality of transcriptomic datasets to the action of few hidden factors (metagenes). MF algorithms have never been compared based on the between-datasets reproducibility of their outputs in similar independent datasets. Lack of this knowledge might have a crucial impact when generalizing the predictions made in a study to others. Results We systematically test widely used MF methods on several transcriptomic datasets collected from the same cancer type (14 colorectal, 8 breast and 4 ovarian cancer transcriptomic datasets). Inspired by concepts of evolutionary bioinformatics, we design a novel framework based on Reciprocally Best Hit (RBH) graphs in order to benchmark the MF methods for their ability to produce generalizable components. We show that a particular protocol of application of independent component analysis (ICA), accompanied by a stabilization procedure, leads to a significant increase in the between-datasets reproducibility. Moreover, we show that the signals detected through this method are systematically more interpretable than those of other standard methods. We developed a user-friendly tool for performing the Stabilized ICA-based RBH meta-analysis. We apply this methodology to the study of colorectal cancer (CRC) for which 14 independent transcriptomic datasets can be collected. The resulting RBH graph maps the landscape of interconnected factors associated to biological processes or to technological artifacts. These factors can be used as clinical biomarkers or robust and tumor-type specific transcriptomic signatures of tumoral cells or tumoral microenvironment. Their intensities in different samples shed light on the mechanistic basis of CRC molecular subtyping. Availability and implementation The RBH construction tool is available from http://goo.gl/DzpwYp Supplementary information Supplementary data are available at Bioinformatics online.

Quality of life after different surgical procedures for the treatment of spinal metastases: results of a single-center prospective case series

OBJECTIVE The performance of surgery for spinal metastases is rapidly increasing. Different surgical procedures, ranging from stabilization alone to stabilization combined with corpectomy, are thereby performed for various indications. Little is known about the impact of these different procedures on patient quality of life (QOL), but this factor is crucial when discussing the various therapeutic options with patients and their families. Thus, the authors of this study investigated the effect of various surgical procedures for spinal metastases on patient QOL. METHODS The authors prospectively followed a cohort of 113 patients with spinal metastases who were referred to their clinic for surgical evaluation between July 2012 and July 2014. Quality of life was assessed using the EQ-5D at intake and at 3, 6, 9, and 12 months after treatment. RESULTS Nineteen patients were treated conservatively, 41 underwent decompressive surgery with or without stabilization, 47 underwent a piecemeal corpectomy procedure with stabilization and expandable cage reconstruction, and 6 had a stabilization procedure without decompression. Among all surgical patients, the mean EQ-5D score was significantly increased from 0.44 pretreatment to 0.59 at 3 months after treatment (p < 0.001). Mean EQ-5D scores at 1 year after surgery further increased to 0.84 following decompression with stabilization, 0.74 after corpectomy with stabilization, and 0.94 after stabilization without decompression. Frankel scores also improved after surgery. There were no significant differences in improvements in EQ-5D scores and Frankel grades among the different surgical procedures. In addition, mortality and complication rates were similar. CONCLUSIONS Quality of life can improve significantly after various extensive and less extensive surgical procedures in patients with spinal metastases. The relatively invasive corpectomy procedure, as compared with alternative less invasive techniques, does not negatively affect outcome.

The boron–boron triple bond? A thermodynamic and force field based interpretation of the N-heterocyclic carbene (NHC) stabilization procedure

From thermodynamic and force constant discussion a new description of bonding of B2(NHC)2 (NHC = N-heterocyclic carbene C3N2H2(C6H3Pri2-2,6)2) as NHCBBNHC rather than NHC→BB←NHC is given.