Engineering Venom’s Toxin-Neutralizing Antibody Fragments and Its Therapeutic Potential

Serum therapy remains the only specific treatment against envenoming, but anti-venoms are still prepared by fragmentation of polyclonal antibodies isolated from hyper-immunized horse serum. Most of these anti-venoms are considered to be efficient, but their production is tedious, and their use may be associated with adverse effects. Recombinant antibodies and smaller functional units are now emerging as credible alternatives and constitute a source of still unexploited biomolecules capable of neutralizing venoms. This review will be a walk through the technologies that have recently been applied leading to novel antibody formats with better properties in terms of homogeneity, specific activity and possible safety.     

Comparative Efficacy of the Different Surgical Approaches in Total Knee Arthroplasty: A Systematic-Review and Network Meta-Analysis

BackgroundSeveral surgical approaches including midvastus, subvastus, mini-parapatellar, quadriceps-sparring (QS) and parapatellar are currently used to perform total knee arthroplasty (TKA). Since none of published study exhibited a simultaneous comparison of all of them, a network meta-analysis has been conducted to compare the most widely used knee surgical approaches regarding the improvement of functional outcomes and the range of motion (ROM).MethodsRandomised controlled trials (RCTs) comparing TKA approaches were searched in electronic databases, major orthopedics journals, and oral communications, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform until May 1st, 2020. Two reviewers independently selected trials and extracted data. The primary outcomes were functional scores at 6 months post-surgeryevaluated by KSS and WOMAC, and the ROM.ResultsSixty RCTs involving 5042 patients with 5107 TKA were included. No significant differences between different approaches were found for the KSS assessment or the WOMAC at 6 months. The mean of ROM at 6 months post-surgery were higher in the subvastus group than in all the others surgical approaches. The difference of ROM with subvastus approach was 7.3° (95% CI ?14.1 to ?0.1) with the midvastus approach, 11.1° (95% CI ?18.7 to ?2.8) with mini-parapatellar, 8.9° (95% CI ?14.2 to ?3.1) with standard parapatellar, and 9.2° (95% CI ?16.1 to ?1.8) with QS.ConclusionNo differences were found in functional outcomes over short or medium terms but subvastus seemed to increase the ROM at 6 months post-surgery. Until or unless future studies can demonstrate a long-term benefit, based on these results all studied surgical approaches to perform a TKA are equal.Level of EvidenceNetwork meta-analysis. Level 1.     

Developmental expression of the rat somatostatin gene

The developmental expression of the somatostatin (SRIF) gene was investigated in rat brain and stomach, two SRIF-rich tissues. The accumulation of mRNA encoding SRIF was determined in these organs during fetal and early (1-4 weeks) postnatal development using a sensitive radiodensitometric cDNA hybridization assay and a cloned preprosomatostatin cDNA. A single band of mRNA which hybridized specifically to the rat SRIF cDNA was detected in both tissues examined throughout ontogenesis, suggesting that the same SRIF gene is expressed in these tissues in the developing as well as in the adult rat. Whereas SRIF mRNA was undetectable in fetal stomach and rose gradually only after birth, brain SRIF mRNA was already detectable by day 7 of embryonic life and reached concentrations corresponding to those in the adult brain by embryonic day 20. These marked differences may reflect basic differences in the developmental regulation of SRIF gene expression in neural vs. nonneural tissues or may be related to the onset of functional activity in the organs studied.     

Influence of a soft tissue layer covering the kidney upon blunt impact

International Journal of Legal Medicine - Blunt abdominal organ injury is an abundant and relevant topic in forensic medicine, yet comparatively few experimental studies have been performed to...     

Simultaneous bilateral breast and high-resolution axillary MRI of patients with breast cancer: preliminary results

OBJECTIVE: The aims of this study were to develop a standardized one-step procedure for simultaneous high-resolution MRI of the axilla and bilateral breast MRI and to identify nodal features suggestive of metastatic involvement. SUBJECTS AND METHODS. We studied 16 women undergoing axillary lymph node dissection after combined bilateral breast MRI and high-resolution MRI of the axilla with a maximum in-plane resolution of 0.6 x 0.4 mm. MRI was performed using a standard double breast coil and a 15-cm round flexible surface coil adapted to the axilla. High-resolution axillary sequences, including inversion recovery T2- and spin-echo T1-weighted sequences, were performed before and after gadolinium chelates bolus injection. Axillary image analysis focused on nodal morphology including size, contour regularity, cortex and hilar appearance, signal intensity, and enhancement parameters. Axillary MRI findings were compared with the final pathogic results from axillary lymph node dissection in all patients. Patients were divided into groups according to the final pathologic axillary status. Differences in MRI lymph node features across the groups were tested using a t test for quantitative data and the chisquare test or Fisher's exact test for binary data. RESULTS: The features of the axilla on high-resolution MRI that best discriminated between patients with positive pathologic findings and those with negative pathologic findings were the presence of nodes with irregular contours (p < 10(-4)), high signal intensity on T2 sequences (p < 10(-3)), marked gadolinium enhancement (p < 10(-3)), and round hila and abnormal cortexes (p < 0.05). CONCLUSION: Breast tissue and axillary lymph nodes both can be analyzed on MRI in a one-step process using a bilateral breast coil combined with a surface coil. Morphologic features observed on high-resolution MRI of the axilla can improve the identification of metastatic nodes.     

Revisional versus primary Roux-en-Y gastric bypass: a case-matched analysis

Background

Laparoscopic adjustable gastric banding (LAGB) has been a widely performed bariatric procedure. Unfortunately, revisional surgery is required in 20–30 % of cases. Data comparing revisional and primary gastric bypass procedures are scarce. This study compared revisional malabsorptive laparoscopic very very long limb (VVLL) Roux-en-Y gastric bypass (RYGB) with primary VVLL RYGB and tested the hypothesis that one-stage revisional laparoscopic VVLL RYGB is an effective procedure after failed LAGB.

Methods

In this study, 48 revisional VVLL RYGBs were matched one-to-one with 48 primary VVLL RYGBs. The outcome measures were operating time, conversion to open surgery, excess weight loss (EWL), and early and late morbidity.

Results

Surgical and medical morbidities did not differ significantly. No conversions occurred. The revisional group showed an EWL of 41.8 % after 12 months of follow-up evaluation and 45.1 % after 24 months based on the pre-revisional weight. The total EWL based on the weight before the LAGB was calculated to be 54.3 % after 12 months and 57.2 % after 24 months. The EWL in the primary RYGB group was significantly higher for both types of calculation: 41.8 %/54.3 % versus 64.1 % (p < 0.001 and <0.01) after 12 months and 45.1 %/57.2 % versus 70.4 % (p < 0.001 and <0.002) after 24 months.

Conclusions

Revisional laproscopic VVLL RYGB can be performed as a one-stage procedure by experienced bariatric surgeons but shows less effective EWL than primary RYGB procedures.     

Psychotropic Drug Use in a Cohort of Workers 4 Years After an Industrial Disaster in France

Two years after the 2001 Toulouse industrial disaster, a longitudinal study was set up to evaluate the impact of the disaster. The current substudy examines the medium‐term impact (5 years) the incident had on the mental health of 3,004 participants. As part of the monitoring, data relating to the psychotropic drug use of 2,494 participants were collected from administrative databases 4 years after the disaster. Use of psychotropics was higher among women for anxiolytics (10.4% for men and 15.0% for women), hypnotics (10.5% and 17.0%), and antidepressants (7.6% and 11.2%). Exposure to the disaster, especially proximity to the exposure, was significantly associated with the use of antidepressants in men, OR = 3.22, 95% CI[1.57, 6.61]. This was also the case for other exposure factors (saw dead or injury, injured, home damage, death or injury loved one, psychological disorders, exposure toxic fumes): range of OR 1.75 to 2.52 in men, 1.48 to 1.62 in women. In conclusion, this study highlights the medium‐term psychological impact of an industrial disaster on psychotropic drug use and the potential for using medical records data as a means for tracking postdisaster mental health.