Results of using Ilizarov distraction osteogenesis technique for the treatment of cubitus varus deformities in adults

Introduction  

Five adult patients, with posttraumatic cubitus varus deformity underwent corrective surgery by the Ilizarov method of distraction osteogenesis.     

Determining host factors contributing to disease severity in a family cluster of 29 hospitalized SARS‐CoV‐2 patients: Could genetic factors be relevant in the clinical course of COVID‐19?

In this study, we report a large family cluster consisting of 29 genetically related patients hospitalized with coronavirus disease‐2019 (COVID‐19). We sought to determine the clinical characteristics relevant to the clinical course of COVID‐19 by comparing the family cluster to unrelated patients with SARS‐CoV‐2 infection so that the presence of potential determinants of disease severity, other than traditional risk factors previously reported, could be investigated. Twenty‐nine patient files were investigated in group 1 and group 2 was created with 52 consecutive patients with COVID‐19 having age and gender compatibility. The virus was detected for diagnosis. The clinical, laboratory and imaging features of all patients were retrospectively screened. Disease course was assessed using records regarding outcome from patient files retrospectively. Groups were compared with respect to baseline characteristics, disease severity on presentation, and disease course. There was no difference between the two groups in terms of comorbidity and smoking history. In terms of inhospital treatment, use differed not significantly between two groups. We found that all 29 patients in the group 1 had severe pneumonia, 18 patients had severe pneumonia. Hospitalization rates, length of hospital stay, and transferred to intensive care unit were found to be statistically significantly higher in the group 1. In the present study, COVID‐19 cases in the large family cluster were shown to have more severe disease and worse clinical course compared with consecutive patients with COVID‐19 presenting to the same time. We believe further studies into potential genetic mechanisms of host susceptibility to COVID‐19 should include such family clusters.     

Outcomes of emergency surgical treatment in malignant bowel obstructions

BACKGROUND/AIMS: Malignant bowel obstructions are still a challenging problem for surgeons and carry high morbidity and mortality risk. The aim of this study was to review the presentation and outcomes of malignant bowel obstructions and to identify the risk factors related with poor prognosis. METHODOLOGY: One hundred and twenty-five patients underwent emergency surgical treatment for malignant obstructions between January 1997 and January 2002. Data included age, sex, past medical history, presenting symptoms; physical findings on admission, American Society of Anesthesiologists (ASA) class, operative details, postoperative complications, length of hospitalization and hospital mortality were reviewed retrospectively. RESULTS: Seventy-three (58%) of the patients have poor performance status on admission. Potentially curative resection was performed in 74 (60%) patients. Surgical treatment was palliative in 43 (34%) patients. Extended bowel resections were utilized in 20 (16%) patients. Our hospital mortality rate was 21%, and postoperative morbidity rate was 31%. Coexisting cardiopulmonary diseases, presence of generalized perforation, poor general condition and extended bowel resections appeared to be related with unfavorable outcomes. CONCLUSIONS: Emergency surgical treatment for malignant obstruction may be curative in selected patients with good performance status.     

Effects of alendronate on bone mineral density and bone metabolic markers in patients with liver transplantation

Introduction The purpose of this study was to evaluate the effects of alendronate (ALN) on bone mineral density (BMD) and bone turnover markers in patients with orthotopic liver transplantation (OLT). Methods In the prospective, controlled, open study with 24 months of follow-up, 98 patients with OLT were randomised to receive ALN 70 mg weekly or no ALN; calcium (Ca) 1,000 mg daily and 0.5 mcg calcitriol daily were provided to all patients. Lumbar spine (LS) and hip BMDs were measured at 6-month intervals by dual-energy X-ray absorptiometry (DEXA). Spinal radiographs were obtained to assess vertebral fractures. Additionally, bone turnover markers, serum parathyroid hormone (PTH) and biochemical parameters were determined every 3 months. Results Compared with the control group, the ALN group showed significant increases in BMD of the LS (5.1±3.9% vs 0.4±4.2%, p<0.05 at 12 months, 8.9±5.7% vs 1.4±4.9%, p<0.05 at 24 months), femoral neck (4.3±3.8% vs −1.1±3.1%, p<0.05 at 12 months, 8.7±4.8% vs 0.6±4.5%, p<0.05 at 24 months) and total femur (3.6±3.8% vs −0.6±4.0%, p<0.05 at 12 months, 6.2±3.8% vs 0.3±4.6%, p<0.05 at 24 months). In the ALN group, osteocalcin and urinary deoxypyridinoline (DPD) decreased significantly at the sixth month, with no further change, by −35.6% and −63.0%, on average, respectively (p<0.05). In the control group, a significant increase in biochemical markers of bone turnover was observed in comparison to baseline values (p<0.05). PTH increased within reference levels without a difference between groups. Two nonvertebral fractures (4.2%) and nine vertebral fractures (18.8%) in the control group and three vertebral fractures (6.8%) in the ALN group occurred during the follow-up. The weekly ALN was well tolerated, and no severe side effects occurred. Conclusion This is the first randomised study including a control group to demonstrate that weekly ALN was able to significantly increase BMD in patients with OLT when compared with Ca and calcitriol alone. However, ALN did not appear to offer protection against fractures. This study was awarded the “Novartis Young Investigator Award” at the Second Joint Meeting of the European Calcified Tissue Society and the International Bone and Mineral Society, Geneva, 25–29 June 2005.     

The design of anisotropic diffusion phantoms for the validation of diffusion weighted magnetic resonance imaging

Diffusion weighted magnetic resonance imaging offers a non-invasive tool to explore the three-dimensional structure of brain white matter in clinical practice. Anisotropic diffusion hardware phantoms are useful for the quantitative validation of this technique. This study provides guidelines on how to manufacture anisotropic fibre phantoms in a reproducible way and which fibre material to choose to obtain a good quality of the diffusion weighted images. Several fibre materials are compared regarding their effect on the diffusion MR measurements of the water molecules inside the phantoms. The diffusion anisotropy influencing material properties are the fibre density and diameter, while the fibre surface relaxivity and magnetic susceptibility determine the signal-to-noise ratio. The effect on the T(2)-relaxation time of water in the phantoms has been modelled and the diffusion behaviour inside the fibre phantoms has been quantitatively evaluated using Monte Carlo random walk simulations.     

Cisplatin-induced acute renal failure is ameliorated by erdosteine in a dose-dependent manner

The aim of this study was to investigate the optimum dosage of erdosteine to ameliorate cisplatin-induced nephrotoxicity. Three different doses of erdosteine at 25, 50 and 75 mg kg(-1) were studied in rats. Intraperitoneal administration of 7 mg kg(-1) cisplatin led to acute renal failure, as indicated by kidney histology and increases in plasma creatinine and blood urea nitrogen (BUN) levels. At 5 days after cisplatin injection the BUN level was increased significantly from 15.1 +/- 4.3 to 126.7 +/- 152.6 mg dl(-1) and plasma creatinine levels increased from 0.37 +/- 0.005 to 1.68 +/- 1.9 mg dl(-1). When the rats were administered 50 and 75 mg kg(-1) erdosteine 24 h before cisplatin injection that was continued until sacrifice (total of 6 days), the BUN and creatinine levels remained similar to control levels and the grade of histology was similar. Erdosteine at doses of 50 and 75 mg kg(-1) ameliorates cisplatin-induced renal failure. The optimum dose of erdosteine may be 50 mg kg(-1) in this study.     

Incidence and management of epithelial loosening after LASIK

To determine the incidence of recurrent epithelial loosening (REL) following laser in situ keratomileusis (LASIK) and evaluate the efficacy of anterior stromal micropuncture (ASP) and the application of bandage contact lenses (BCLs) in the management of REL after LASIK. A retrospective study including all individuals who underwent LASIK with a microkeratome between January 2006 and January 2007. Medical records were reviewed to identify patients who were diagnosed as having epithelial loosening with or without epithelial defects. Data were collected on 5,566 eyes that underwent LASIK with a microkeratome. Eight eyes (0.14 % or one in 696 eyes) of seven patients had REL with or without epithelial defects. Frequent lubrication, BCL application, and ASP were needed for four eyes (50 %) in the management of REL, respectively. All patients remained free of symptoms after completion of ASP. REL following LASIK is uncommon. Follow-up of patients showed that BCL application and ASP were effective in the management of REL following LASIK.