Assessment of a newly designed dynamic condylar screw with an angle of 102° in the treatment of unstable intertrochanteric fractures

The aim of the study was to examine the clinical outcome of fixing unstable intertrochanteric fractures using a newly designed 102° dynamic condylar screw (DCS). Twelve unstable low-energy intertrochanteric fractures were fixed using 102° DCS. Patient ages ranged from 79 to 92 years. The follow-up period was from 6 to 15 months. Patients were assessed clinically and radiographically. Fracture healing was achieved in 11 patients within the follow-up period. Implant failure was seen in one patient, as the screw cut out of the femoral head. In conclusion, the 102° DCS showed promising results when used for fixing unstable intertrochanteric fractures. It is easier to apply in comparison to the 95° DCS, as it offers wider safety zone for insertion in the femoral neck, which allows a secure screw placement in the femoral head. Larger randomised comparative studies would be of value for further evaluation of the new device.     

Chromatographic enzyme immunoassay for T-2 toxin

Both the active ester and maleimide moieties of the cross-linking reagent, N-[(gamma-maleimidobutyryl)oxy]succinimide (GMBS), were found to react with the primary amino groups on ribonuclease (RNase). This largely inactivated RNase towards a polymeric (but not monomeric) substrate. Citraconylating the RNase first, so that essentially only a single primary amino group remained to react with GMBS, overcame this problem. The subsequent maleimido-citraconyl-RNase was used to prepare a 1:1.1 M conjugate of anti-T-2 toxin Fab' and RNase (Fab'-RNase) in a 76% yield. The conjugate was used to detect as little as 0.1 microgram of T-2 toxin based on the ability of T-2 toxin to specifically displace Fab'-RNase complexed to a T-2 agarose affinity gel.     

High-dose therapy and autologous stem cell transplantation for Hodgkin's lymphoma in relapse or failure after initial chemotherapy : results of the Centre National de Greffe de Moelle Osseuse de Tunis

AIM: In the present study we report the clinical outcome of 27 patients with refractory or relapsed Hodgkin's lymphoma (HL) undergoing autologous peripheral stem-cell transplantation (ASCT). METHODS: On transplant, 18 patients had sensitive disease (SD) and 9 resistant disease (RD). The median time between diagnosis and ASCT was 18 months (range, 7 to 96 months). The conditioning consisted of BEAM regimen. RESULTS: The 100-day mortality rate was 3%. Three months after transplant, 12 patients transplanted with SD were in complete remission (CR) and only one of the 9 patients transplanted with RD achieved CR. Overall survival and disease-free survival after 3 years were 68% and 60%, respectively. CONCLUSION: the present results confirm the efficacy and safety of the ASCT in refractory or relapsed HL patients with SD. Other strategies should be investigated for patients with RD.     

Primary and radiation induced skull base osteosarcoma: a systematic review of clinical features and treatment outcomes

Journal of Neuro-Oncology - We aim to systematically review and summarize the demographics, clinical features, management strategies, and clinical outcomes of primary and radiation-induced...     

Synthesis and functionalization of chitosan built hydrogel with induced hydrophilicity for extended release of sparingly soluble drugs

Addressing the functional biomaterials as next-generation therapeutics, chitosan and alginic acid were copolymerized in the form of chemically crosslinked interpenetrating networks (IPNs). The native hydrogel was functionalized via carbodiimide (EDC), catalyzed coupling of soft ligand (1,2-Ethylenediamine) and hard ligand (4-aminophenol) to replace –OH groups in alginic acid units for extended hydrogel- interfaces with the aqueous and sparingly soluble drug solutions. The chemical structure, Lower solution critical temperature (LCST ≈ 37.88 °C), particle size (Z_h,app ≈ 150–200 nm), grain size (160–360 nm), surface roughness (85–250 nm), conductivity (37–74 mv) and zeta potential (16–32 mv) of native and functionalized hydrogel were investigated by using FT-IR, solid state-¹³C-NMR, TGA, DSC, FESEM, AFM and dynamic light scattering (DLS) measurements. The effective swelling, drug loading (47–78%) and drug release (53–86%) profiles were adjusted based on selective functionalization of hydrophobic IPNs due to electrostatic complexation and extended interactions of hydrophilic ligands with the aqueous and drug solutions. Drug release from the hydrogel matrices with diffusion coefficient n ≈ 0.7 was established by Non- Fickian diffusion mechanism. In vitro degradation trials of the hydrogel with a 20% loss of wet mass in simulated gastric fluid (SGF) and 38% loss of wet mass in simulated intestinal fluid (SIF), were investigated for 400 h through bulk erosion. Consequently, a slower rate of drug loading and release was observed for native hydrogel, due to stronger H-bonding, interlocking and entanglement within the IPNs, which was finely tuned and extended by the induced hydrophilic and functional ligands. In the light of induced hydrophilicity, such functional hydrogel could be highly attractive for extended release of sparingly soluble drugs.     

Management of Patient Flow in Vascular and Interventional Radiology During MERS-CoV Outbreak

In 2015, an outbreak of Middle East respiratory syndrome coronavirus occurred in Saudi Arabia and necessitated special measures to be implemented to control the spread of the virus. In this article, we will discuss how the outbreak was managed in the vascular and interventional radiology (VIR) suite in a large tertiary care hospital in Saudi Arabia. Various measures were taken to reduce the risk of transmission of infection. Unit-level education played an important role in the care of patients. A hospital-wide educational program was implemented to ensure zero transmission of infection. Special attention was made to monitor staff who acquired the virus. VIR suite was able to handle the situation and control the outbreak.     

The clinical spectrum of postpartum thyroid disease

The clinical and biochemical features of postpartum thyroid disease were analysed in 152 antithyroid peroxidase antibody-positive (anti TPO+ve) women and compared with 239 anti-TPO-ve age-matched control postpartum women. All were assessed monthly for up to 12 months postpartum. Seventy three anti-TPO+ve women developed post-partum thyroiditis (PPT): 19.2% hyperthyroid alone, 49.3% hypothyroid alone, and 31.5% characterized by hyper- followed by hypothyroidism. None of the antibody-negative women developed any thyroid dysfunction. A significant increase in many of eleven symptoms of hypothyroidism and some of eight symptoms of hyperthyroidism compared to control women was observed in all anti-TPO+ve women, independent of thyroid status. This was particularly seen in women who later developed PPT when they were euthyroid, but was also observed in euthyroid anti-TPO+ve women who showed no decline of thyroid function during the postpartum period. Although PPT is usually transient, this condition, and the euthyroid antibody-positive state, may be associated with significant symptomatology, including an increased incidence of minor to moderate depression. Early recognition of this syndrome by antenatal screening of thyroid antibodies may contribute to improved management of women during the postpartum period.      

Vitamin D status and viral response to therapy in hepatitis C infected children

AIM: To study the frequency of vitamin D deficiency in patients with hepatitis C virus(HCV) infection and to evaluate the role of vitamin D supplementation in improving antiviral therapy.METHODS: Sixty-six children aged from 7-14 years(mean ± SD, 11.17 ± 2.293) diagnosed with HCV infection were matched to 28 healthy controls. Serum levels of 25(OH) D3, calcium, phosphorus, alkaline phosphatase and plasma level of parathormone were measured. Quantitative PCR for HCV was performed Bone density was determined by dual energy X-ray absorptiometry. All cases received conventional therapy, and only 33 patients received vitamin D supplementation.RESULTS: Children with HCV showed significantly increased levels of HCV RNA(P 0.001), parathormone(P 0.01) and decreased vitamin D levels(P 0.05)(33.3% deficient and 43.3% insufficient) compared with controls. Abnormal bone status(Z score-1.98 ± 0.75) was found in ribs, L-spine, pelvis and total body. Cases treated with vitamin D showed significant higher early(P 0.04) and sustained(P 0.05) virological response. There was a high frequency of vitamin D deficiency among the Egyptian HCV children, with significant decrease in bone density. The vitamin D level should be assessed before the start of antiviral treatment with the correction of any detected deficiency. CONCLUSION: Adding vitamin D to conventional Peg/RBV therapy significantly improved the virological response and helped to prevent the risk of emerging bone fragility.