The application of bone cement to fill the surgical defect after resection of a giant-cell tumor: A case report

Background. A case of a large bone defect treated with bone cement filler is discussed, and the usefulness and advantages of this treatment method are assessed. Case report. A 25-year-old male was admitted to our hospital with an intra-articular pathological fracture of the lateral femoral condyle due to an underlying giant cell tumor (stage I according to the Enneking classification). The tumor was surgically resected, and the walls of the post-operative bone defect were treated with a burr. The defect was then filled with bone cement (PMMA). The tumor was found to be histologically benign. Post-surgical treatment included immobilization in a cylinder cast and no weight bearing for a period of 8 weeks. The follow-up included frequent check-ups and repeated radiographs and CT scans. The follow-up period was 7 years, during which time no clinical or radiological signs of tumor recurrence were found. There was visible osteosclerosis surrounding the bone cement filler, which is believed to be a prognostically favorable finding, associated with a low risk of recurrence. The functional outcome of treatment was assessed with the Knee Rating Score. The patient gained a knee score of 100 points and a functional score of 100 points. Conclusions. The use of bone cement in order to fill a bone defect after tumor excision proved to be an effective and safe method to manage a giant-cell tumor of the bone. This method provided good biomechanical circumstances and allowed for good follow-up, as it enabled easy detection of possible tumor recurrence.     

Acute mitral regurgitation caused by infarction-related papillary muscle rupture with successful surgical treatment: case report

We present a case of severe complication of myocardial infarction -- acute mitral regurgitation caused by papillary muscle rupture. A 69-year-old man was admitted with chest pain lasting 1 hour and pulmonary oedema. ECG revealed ST-segment depression in leads II, III, aVF, V2-V6. Soon after admission the patient experienced respiratory disorders and consequently arrest. The patient was transferred in shock to the Department of Cardiothoracic Surgery, where he underwent successful artificial mitral valve implantation. One year later the patient is in good condition (NYHA class I) and the valve is fully functional.     

Safety and efficacy of induction immunochemotherapy with rituximab,methotrexate, ifosfamide,and vincristine (R-MIV) in patients with primary CNS lymphoma including recent COVID-19 pandemic experience

Clinical data on primary central nervous system (CNS) lymphoma (PCNSL) patients is mostly generated from prospective studies, and many frail real-world patients are not included. Recently,the diagnosis and treatment of PCNSL patients was confounded by the COVID-19 pandemic. In particular, treatment with high-dose cytarabine was linked to increased risk of pneumonia and virus persistence. We report on outcome of the induction regimen R-MIV (rituximab, methotrexate, ifosfamide, and vincristine) involving intensive administration of high-dose methotrexate (3.5 g/m²) with ifosfamide, every 2 weeks and rituximab once per week for six doses. The median age and performance status (PS) for 64 patients was 58 years and 2 (PS 3; 22%) respectively. The overall response rate by magnetic resonance imaging/computed tomography (MRI/CT) was 73% (n = 46/63), with an additional 17.5% (n = 11/63) patients without measurable disease at baseline. Grade 3–4 haematological toxicity was low for R-MIV (neutropenia: 25% and thrombocytopenia: 1%). Three patients (4.7%) died from treatment-related toxicity. Co-existence of SARS-CoV-2 infection with cytomegalovirus reactivation and the varicella-zoster virus in two patients was fatal. Fifty patients (78%) were eligible for consolidation. Median progression-free and overall survival were not reached (median follow-up: 44 months). In conclusion, the R-MIV regimen is feasible in routine practice, effective and safe, even during the COVID-19 pandemic.     

RF ablation in a patient with recurrent post-infarction ventricular tachycardia requiring multiple cardioverter-defibrillator interventions

A case of a 51 year old patient with a history of myocardial infarction (MI) and recurrent ventricular tachycardia (VT) is presented. Three months after MI the patient underwent coronary angioplasty and one year later received prophylactic implantable cardioverter-defibrillator (ICD) due to complex ventricular arrhythmias, detected on Holter ECG monitoring, and depressed left ventricular ejection fraction. Later on the patient started to experience palpitations and ICD shocks during physical activity (cycling). Interrogation of the ICD memory showed appropriate shocks due to slow (160 betas/min) VT. The device was reprogrammed and new antitachycardia pacing (ATP) algorithms were enabled, however, it occurred proarrhythmic due to the ATP-induced acceleration of VT rate. Finally, in April 2005 he received 37 appropriate ICD shocks during a few hours. The patient was selected for RF ablation and underwent successful procedure with the use of the electro-anatomical CARTO mapping system.     

Factors influencing employees' eating behaviours in the office‐based workplace: A systematic review

Employees spend a large proportion of their time at work and typically consume a third of their total calories during the working day. Research suggests that the workplace environment can affect employees' eating behaviours, leading to various related health consequences. This systematic review aimed to identify and synthesize the evidence surrounding factors influencing eating behaviours within an office‐based workforce. The literature search was restricted to studies published in English between January 2008 and April 2018. A total of 5,017 articles were screened and assessed for eligibility, of which 22 articles (n=23 studies) were included in the review. All included studies were subjected to quality assessment and were summarized into groups (themes) of “factors” affecting any aspect of eating behaviour at work. The findings revealed a number of factors influencing eating behaviours at work relating to the job role, workplace food environment, and social aspects of the office‐based workplace. Most of the existing research implies the office‐based workplace has a negative influence on eating behaviours. The findings of this review provide an evidence based, comprehensive summary of the possible determinants of eating behaviours in the workplace, which may help researchers to identify factors that are potential targets for intervention.     

Isolated noncompaction of the ventricular myocardium

Isolated left ventricular noncompaction is a primary, genetic cardiomyopathy thought to be caused by arrest of normal embryogenesis of endocardium and myocardium, characterised by a pattern of excessively prominent trabecular meshwork and deep intertrabecular recesses with to-and-from flow in continuity with the ventricular flow and the absence of other structural heart diseases. Isolated noncompaction of the ventricular myocardium is considered to predominantly affect the left ventricle. Our earlier observations suggest that both ventricles may be involved. We present another case of isolated noncompaction of both ventricles.     

Aberrant DNA methylation is a dominant mechanism in MDS progression to AML

Myelodysplastic syndromes (MDSs) are clonal hematologic disorders that frequently represent an intermediate disease stage before progression to acute myeloid leukemia (AML). As such, study of MDS/AML can provide insight into the mechanisms of neoplastic evolution. In 184 patients with MDS and AML, DNA methylation microarray and high-density single nucleotide polymorphism array (SNP-A) karyotyping were used to assess the relative contributions of aberrant DNA methylation and chromosomal deletions to tumor-suppressor gene (TSG) silencing during disease progression. Aberrant methylation was seen in every sample, on average affecting 91 of 1505 CpG loci in early MDS and 179 of 1505 loci after blast transformation (refractory anemia with excess blasts [RAEB]/AML). In contrast, chromosome aberrations were seen in 79% of early MDS samples and 90% of RAEB/AML samples, and were not as widely distributed over the genome. Analysis of the most frequently aberrantly methylated genes identified FZD9 as a candidate TSG on chromosome 7. In patients with chromosome deletion at the FZD9 locus, aberrant methylation of the remaining allele was associated with the poorest clinical outcome. These results indicate that aberrant methylation can cooperate with chromosome deletions to silence TSG. However, the ubiquity, extent, and correlation with disease progression suggest that aberrant DNA methylation is the dominant mechanism for TSG silencing and clonal variation in MDS evolution to AML.     

Determinants of inappropriate circadian blood pressure variability in children with essential hypertension

BACKGROUND:

Inappropriate daily profile of blood pressure deteriorates the clinical outcome of hypertension and increases distant cardiovascular risk. The problem is important, especially in children and adolescents in whom early intervention helps to prevent complications of hypertension such as left ventricular hypertrophy and hypertensive retinopathy.

OBJECTIVES:

To assess circadian blood pressure profile and basic determinants of inappropriate daily blood pressure variability in hypertensive children.

METHODS:

The project was conducted retrospectively in 106 children six to 18 years of age (mean [± SD] 14.9±2.5 years) with essential hypertension and no use of antihypertensive drugs. The study group included 43 children with inappropriate daily blood pressure variability (‘nondippers’) and 63 controls with appropriate daily blood pressure variability (‘dippers’).

RESULTS:

Nondippers, compared with dippers, had higher systolic and diastolic blood pressure at night (systolic, 123.9±10.3 mmHg versus 113.9±8.2 mmHg; diastolic, 65.1±7.6 mmHg versus 59.5±6.5 mmHg; P<0.0001), and higher blood pressure load at night (systolic, 61.9% versus 27.6%; diastolic, 20.0% versus 9.6%; P<0.0001). Male sex increased the risk for nondipping by 2.5 times (logistic OR=2.45; 95% CI 0.87 to 6.87). However, the increase was statistically nonsignificant (P=0.08). No differences were observed between dippers and nondippers in terms of anthropometric profile, family history of hypertension, morphological and biochemical blood parameters, and birth weight.

CONCLUSIONS:

Among hypertensive children, nondippers have a more severe degree of hypertension. Male sex increases the risk of nondipping. To assess determinants of nondipping more precisely, further clinical investigations are needed.     

The Influence of Annealing on the Optical Properties and Microstructure Recrystallization of the TiO2 Layers Produced by Means of the E-BEAM Technique

Titanium dioxide films, about 200 nm in thickness, were deposited using the e-BEAM technique at room temperature and at 227 °C (500K) and then annealed in UHV conditions (as well as in the presence of oxygen (at 850 °C). The fabricated dielectric films were examined using X-ray powder diffraction, Raman spectroscopy, X-ray photoelectron spectroscopy, atomic force microscopy, scanning electron microscopy, transmission electron microscopy, and spectroscopic ellipsometry. The applied experimental techniques allowed us to characterize the phase composition and the phase transformation of the fabricated TiO₂ coatings. The films produced at room temperature are amorphous but after annealing consist of anatase crystallites. The layers fabricated at 227 °C contain both anatase and rutile phases. In this case the anatase crystallites are accumulated near the substrate interface whilst the rutile crystallites were formed closer to the surface of the TiO₂ film. It should be emphasized that these two phases of TiO₂ are distinctly separated from each other.     

Influence of Relative Displacement on Surface Roughness in Longitudinal Turning of X37CrMoV5-1 Steel

The shaping process of surface texture is complicated and depends on many factors and phenomena accompanying them. This article presents the author’s test stand for the measurement of relative displacements in a tool–workpiece system during longitudinal turning. The aim of this study was to determine the influence of edge radius on the relative displacement between the tool and workpiece. The cutting process was carried out with inserts with different edge radii for X37CrMoV5-1 steel. As a result of the research, vibration charts of the tool–workpiece system were obtained. In the range of feed 0.03–0.18 mm/rev, the values of the standard deviation of relative displacements in the x-axis were obtained in the range of 0.36–0.78 μm for the insert with an edge radius of r_n = 48.8 μm. As a result of the work, it was determined that for the feed value of 0.12 mm/rev for all inserts, the relative displacements are the smallest. As the final effect, the formula for forecasting the Ra roughness parameter was presented.