Functional outcomes of conservatively treated clavicle fractures

OBJECTIVE:

The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function.

METHODS:

Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja''afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique.

RESULTS:

There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion).

CONCLUSION:

This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes.     

Effects of Sintering Temperature Variation on Synthesis of Glass-Ceramic Phosphor Using Rice Husk Ash as Silica Source

In this study, the authors attempted to propose the very first study on fabrication and characterization of zinc-boro-silicate (ZBS) glass-ceramics derived from the ternary zinc-boro-silicate (ZnO)_0.65(B₂O₃)_0.15(RHA)_0.2 glass system through a conventional melt-quenching method by incorporating rice husk ash (RHA) as the silica (SiO₂) source, followed by a sintering process. Optimization of sintering condition has densified the sintered samples while embedded beta willemite (β-Zn₂SiO₄) and alpha willemite (α-Zn₂SiO₄) were proven in X-ray diffraction (XRD) analysis. Field emission scanning electron microscopy (FESEM) has shown the distribution of willemite crystals in rhombohedral shape crystals and successfully form closely-packed grains due to intense crystallization. The photoluminescence (PL) spectra of all sintered ZBS glasses presented various emission peaks at 425, 463, 487, 531, and 643 nm corresponded to violet, blue, green, and red emission, respectively. The correlation between the densification, phase transformation, microstructure, and photoluminescence of Zn₂SiO₄ glass-ceramic phosphor is discussed in detail.     

D-Dimer assay as a non invasive test for the diagnosis of left atrial Thrombi in Indian patients with Rheumatic MS

Background

Systemic embolism is a serious and sometime fatal complication of rheumatic MS.

Objective

We assessed the predictive power of D-Dimer level to predict occurrence of left atrial (LA) thrombi in patients with rheumatic mitral stenosis (MS).

Methods

D-dimer levels were analyzed for 24 patients with rheumatic MS with LA clot and 22 patients with rheumatic MS with no LA clot undergoing transeosophageal echocardiography. A level more than 4 µg/ml was taken as elevated to predict the presence of LA clot in the study groups.

Results

For a cut-off value of 4 µg/ml, sensitivity was 66.67 % and specificity 100 % for prediction of LA clot and AUC 0.710. A cut-off value of less than 1 µg/ml, sensitivity was 91.67 % and 87. 5 % negative predictive value for ruling out presence of LA clot and AUC 0.721.

Conclusion

A higher value of D-dimer can predict the possible presence of a LA clot and very low value can predict absence of clot in patients with rheumatic MS.     

Is there a Reliable Method to Assess the Complete Pathologic Response on the Tumor after Neo‐adjuvant Chemotherapy in Inflammatory Breast Cancer toward Recommendations for the Pathologic Process? Experience in 56 Patients Treated in a Single Institution

Abstract: The aim of this study was to compare the complete pathologic response (CPR) rate in 56 nonmetastatic inflammatory breast cancer patients according to the classification used and to look for a correlation between the CPR and overall survival. Initial biopsies and mastectomy specimens were reviewed by the same pathologist. The clinical response rate was 75%. A CPR was observed in 11 cases according to Sataloff, three according to Chevallier and five according to the NSABP. There was no correlation between the clinical and pathologic responses and none of them was predictive of relapse free survival or overall survival. We propose a standardization of the pathologic process of the mastectomy specimens so that a CPR has a clear definition across the institutions, with a good reproducibility whatever the classification used.     

MCS-18, a novel natural plant product prevents autoimmune diabetes

There is still a vital need for new therapies in order to prevent or treat type I diabetes. In this respect, we report that MCS-18 a novel natural product isolated from the plant Helleborus purpurascens (i.e. Christmas rose) is able to increase diabetes free survival using the NOD-mouse model, which is accompanied with a diminished IFN-γ secretion of splenocytes. In the animal group which has been treated with MCS-18 during week 8 and week 12 of age 70% of the animals showed a diabetes free survival at week 30, whereas in contrast in the untreated animals less than 10% were free of diabetes. MCS-18 treatment significantly reduced islet T-cell infiltrates as well as the rate of T-cell proliferation. Periinsular infiltrates in the MCS-18 treated animals showed a significantly enhanced number of Foxp3(+) CD25(+) T cells, indicating the increased presence of regulatory T cells. These studies show that MCS-18 exerts an efficient immunosuppressive activity with remarkable potential for the therapy of diseases characterized by pathological over-activation of the immune system.