Single-stage medial plateau elevation and metaphyseal osteotomies in advanced-stage Blount’s disease: a new technique

PurposeSurgical treatment in advanced-stage infantile Blount’s disease with medial plateau (MP) depression is challenging. Several osteotomies and fixation methods have been described with no established benchmark. We conducted this study to evaluate the efficacy and safety of a new single-stage technique for acute medial condyle elevation and metaphyseal osteotomies with internal fixation.MethodsA prospective case series of 19 consecutive patients (21 knees) with severe infantile Blount’s disease underwent a single-stage MP elevation and metaphyseal osteotomies, with internal fixation. The mean age was 10.3 years (8.2 to 13.6) and the mean follow-up was 5.1 years (3.2 to 8.3). The outcome measures included clinical and radiological parameters and patient-reported pediatric outcomes data collection instrument (PODCI) score.ResultsThe mean PODCI score improved significantly from 50% to 88%. The mean internal tibial torsion improved from -27° to 11°. All cases maintained full knee extension, no limitation in flexion range of movement and no signs of instability or lateral thrust gait. All the radiographic parameters improved significantly; the mean tibiofemoral angle improved from -29° to 7°, the metaphyseal-diaphyseal angle improved from 33.4° to 4.7° and the angle of depressed MP improved from 38.3° to 2.4° (p < 0.001). At the latest follow-up, no cases of deformity recurrence were identified, the final limb-length discrepancy was < 1 cm in all patients.ConclusionSingle-stage MP elevation and metaphyseal osteotomies with internal fixation significantly improved the clinical and radiographic parameters and PODCI score in advanced infantile Blount’s disease and precluded the use of external immobilization, with no evidence of deformity recurrence.Level of evidenceIV     

Pelvic and lower extremity arterial imaging: diagnostic performance of three-dimensional contrast-enhanced MR angiography

OBJECTIVE: The diagnostic performance of a three-dimensional MR angiography-based strategy was assessed with regard to its ability to characterize the arterial vasculature from the aortic bifurcation to the lower extremity runoff vessels. A single-injection, two-station protocol in combination with a lower-extremity vascular coil was used. SUBJECTS AND METHODS: Both conventional digital subtraction angiography and three-dimensional contrast-enhanced MR angiography with a dedicated peripheral vascular coil were performed in 61 patients with suspected peripheral vascular disease. In a prospective analysis, one reviewer evaluated the digital subtraction angiographic images and a second reviewer evaluated the MR angiographic images; both were unaware of the results of the other imaging technique. Each vascular segment (29 segments per patient) was evaluated for the presence of occlusive vessel disease. The following grading system was applied: 0, normal; 1, vessel irregularity with a luminal reduction of less than 10%; 2, mild stenosis (lumen reduction, 10-49%); 3, severe stenosis (lumen reduction, 50-99%); and 4, occlusion (lumen reduction, 100%). In 11 patients surgical graft patency was assessed. RESULTS: MR angiography provided an image quality comparable with that of digital subtraction angiography. Overall sensitivity and specificity for MR angiography were 92% and 96.6%, respectively, for the detection of hemodynamically significant disease and 92.3% and 99.4%, respectively, for the detection of occlusions. CONCLUSION: Two-station contrast-enhanced three-dimensional MR angiography with a dedicated lower-extremity vascular coil proved effective enough to consider it as a noninvasive alternative to digital subtraction angiography in the assessment of the pelvic and lower extremity arterial vasculature.     

Physical activity combined with massage improves bone mineralization in premature infants: a randomized trial.

BACKGROUND: Osteopenia of prematurity is a known source for morbidity in preterm infants. Premature infants have shown favorable outcomes in response to massage and physical activity. Whether such intervention can stimulate bone formation or decrease bone resorption is yet to be determined. OBJECTIVE: To test the hypothesis that massage combined with physical activity can stimulate bone formation and ameliorate bone resorption in premature infants. DESIGN/METHODS: A prospective double-blinded randomized trial was conducted at the Neonatal Intensive Care Unit of Ain Shams University in Cairo, Egypt. Thirty preterm infants (28 to 35 weeks' gestation) were randomly assigned to either control group (Group I, n=15) or intervention group (Group II, n=15). Infants in the intervention group received a daily protocol of combined massage and physical activity. Serum type I collagen C-terminal propeptide (PICP) and urinary pyridinoline crosslinks of collagen (Pyd) were used as indices for bone formation and resorption, respectively. PICP and Pyd were measured at enrollment and at discharge for all subjects. t-Test, ANOVA and linear regression analysis were used for statistical analyses. RESULTS: There was no difference between groups I and II in gestational age (32.1+/-1.8 vs 31.5+/-1.4 weeks) or birth weight (1.429+/-0.148 vs 1.467+/-0.132 g). In the control group, serum PICP decreased over time from 82.3+/-8.5 to 68.78+/-14.6 (p<0.01), while urinary Pyd increased from 447.7+/-282.8 to 744.9+/-373.6 (p<0.01) indicating decreased bone formation and increased bone resorption, respectively. In the intervention group, serum PICP increased over time from 62.5+/-13.8 to 73.84+/-12.9 (p<0.01). Urinary Pyd also increased over time from 445.7+/-266.5 to 716.8+/-301.8 (p<0.01). In a linear regression model including gestational age and intervention, serum PICP increased significantly in the intervention group (regression coefficient 18.8+/-4.6, p=0.0001) while urinary Pyd did not differ between groups (regression coefficient=5.6+/-114.3, p=0.961). CONCLUSIONS: A combined massage and physical activity protocol improved bone formation (PICP) but did not affect bone resorption (Pyd). Pyd increased over time in both groups, possibly due to continuous bone resorption and Ca mobilization.     

Electrochemical Impedance Investigation of Dye-Sensitized Solar Cells Based on Electrospun TiO2 Nanofibers Photoanodes

This work investigates an electrochemical impedance analysis based on synthesized TiO₂ nanofibers (NFs) photoanodes, which were fabricated via electrospinning and calcination. The investigated photoanode substrate NFs were studied in terms of physicochemical tools to investigate their morphological character, crystallinity, and chemical contents via scanning electron microscope (SEM), X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD) analyses. As a result, the studied photoanode substrate NFs were applied to fabricate dye-sensitized solar cells (DSCs), and the electrochemical impedance analysis (EIS) was studied in terms of equivalent circuit fitting and impacts of N-doping, the latter of which was approved via XPS analysis. N-doping has a considerable role in the enhancement of charge transfers, which could be due to the strong interactions between active-site N atoms and the used photosensitizer.     

Synthesis and Characterization of the Mixed Metal Oxide of ZnO-TiO2 Decorated by Polyaniline as a Protective Film for Acidic Steel Corrosion: Experimental,and Computational Inspections

In this work, the preparation, characterization, and evaluation of a novel nanocomposite using polyaniline (PANi) functionalized bi-metal oxide ZnO-TiO₂ (ZnTiO@PANi) as shielding film for carbon steel (CS)-alloy in acidic chloride solution at 298 K was studied. Different spectroscopic characterization techniques, such as UV-visible spectroscopy, dynamic light scattering (DLS), X-ray photoelectron spectroscopy (XPS), and Fourier transform infrared spectroscopy (FTIR) approaches, as well as other physicochemical methods, such as X-ray diffraction (XRD), high-resolution transmission electron microscopy (HR-TEM), and field emission scanning electron microscope (FESEM), were used to describe the produced nanocomposites. The significance of these films lies in the ZnO-TiO₂ nanoparticle’s functionalization by polyaniline, a material with high conductivity and electrochemical stability in acidic solutions. The mechanistic findings of the corrosion inhibition method were obtained by the use of electrochemical methods including open-circuit potentials (OCP) vs. time, potentiodynamic polarization (PDP), and electrochemical impedance spectroscopy (EIS). The results indicate that the synthesized ZnTiO@PANi is a powerful acidic corrosion inhibitor, and its inhibition effectiveness is 98.86% in the presence of 100 ppm. Additionally, the charge transfer resistance (R_p) value augmented from 51.8 to 432.7, and 963.7 Ω cm² when the dose of PANi, and ZnTiO@PANi reached 100 ppm, respectively. The improvement in R_p and inhibition capacity values with an increase in nanocomposite dose is produced by the nanocomposite additives covering a larger portion of the surface, resulting in a decrease in alloy corrosion. By identifying the probable regions for molecule adsorption on the steel substrate, theoretical and computational studies provided significant details regarding the corrosion mitigation mechanism. The possibility of substituting old poisonous small substances with inexpensive and non-hazardous polymeric materials as shielding layers for utilization in the oilfield sectors is an important suggestion made by this research.     

Design,Structural Inspection and Bio-Medicinal Applications of Some Novel Imine Metal Complexes Based on Acetylferrocene

Some novel imine metal chelates with Cr³⁺, Mn²⁺, Fe³⁺, Co²⁺, Ni²⁺, Cu²⁺, Zn²⁺, and Cd²⁺ cations were produced from 2-acetylferrocene and 3-aminophenol. The new acetylferrocene azomethine ligand ((Z)-cyclopenta-1,3-dien-1-yl(2-(1-((3-hydroxyphenyl)imino)ethyl)cyclopenta-2,4-dien-1-yl)iron) and its metal ion chelates were constructed and elucidated using FT-IR, UV/Vis, ¹HNMR, DTA/TGA, CHNClM studies, mass spectrometry and SEM analysis. According to the TGA/DTG investigation, the ferrocene moiety spontaneously disintegrates to liberate FeO. The morphology of the free acetylferrocene azomethine via SEM analysis was net-shaped with a size of 64.73 nm, which differed in Cd(II) complex to be a spongy shape with a size of 42.43 nm. The quantum chemical features of the azomethine ligand (HL) were computed, and its electronic and molecular structure was refined theoretically. The investigated acetylferrocene imine ligand behaves as bidinetate ligand towards the cations under study to form octahedral geometries in case of all complexes except in case of Zn²⁺ is tetrahedral. Various microorganisms were used to investigate the anti-pathogenic effects of the free acetylferrocene azomethine ligand and its metal chelates. Moreover, the prepared ligand and its metal complexes were tested for anticancer activity utilizing four different concentrations against the human breast cancer cell line (MCF7) and the normal melanocyte cell line (HBF4). Furthermore, the binding of 3-aminophenol, 2-acetylferrocene, HL, Mn²⁺, Cu²⁺, and Cd²⁺ metal chelates to the receptor of breast cancer mutant oxidoreductase was discovered using molecular docking (PDB ID: 3HB5).     

Sutureless Scleral Tunnel Trabeculectomy: Evaluation of Feasibility and Effectiveness versus Conventional Trabeculectomy for Management of Primary Open Angle Glaucoma

Purpose: To evaluate the intraocular pressure-lowering effect of sutureless scleral tunnel trabeculectomy with Mitomycin-C (MMC) compared to the standard trabeculectomy with MMC in patients with primary open angle glaucoma (POAG). Methods: This was a masked, randomized, controlled comparison trial involving 34 eyes of 34 patients with bilateral POAG. Patients were randomized to receive sutureless sclera flap trabeculectomy with MMC or conventional trabeculectomy with MMC. The main outcome for comparison was the IOP-lowering effect of both procedures. Complete surgical success was considered if the patient’s IOP was <22 mmHg and the IOP were lowered by more than 20% with the use of maximum two anti-glaucoma medications. Results: All surgeries passed uneventfully without intraoperative complications and all patients showed significantly (p<0.05) lower IOP on the first postoperative day compared to their respective preoperative IOP with non-significant (p>0.05) difference between both study groups. All patients, irrespective of operative procedure, maintained significantly (p<0.05) lower IOP compared to their respective preoperative IOP until the end of 12 months’ follow-up. There were no recorded serious postoperative complications in either groups, like wound leaks or endophthalmitis. Conclusion: Sutureless scleral tunnel trabeculectomy exhibits potential as an alternative to conventional trabeculectomy surgery. Over 12 months of follow-up, sutureless sclera flap trabeculectomy was safe and effective with an IOP-lowering effect comparable to that achieved with the conventional technique, but with increased rate of postoperative transient hypotony.     

Enhanced Nitrate Ions Remediation Using Fe0 Nanoparticles from Underground Water: Synthesis,Characterizations, and Performance under Optimizing Conditions

The presence of nitrates in water in large amounts is one of the most dangerous health issues. The greatest risk posed by nitrates is hemoglobin oxidation, which results in Methemoglobin in the human body, resulting in Methemoglobinemia. There are many ways to eliminate nitrates from underground water. One of the most effective and selective methods is using zero-valent iron (ZVI) nanoparticles. ZVI nanoparticles can be easily synthesized by reducing ferric or ferrous ions using sodium borohydride. The prepared ZVI nanoparticles were examined by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), electron microscopy (TEM), X-ray diffraction (XRD), Brunauer–Emmett–Teller (BET) surface area, and zeta potential. We aim to eliminate or reduce the nitrates in water to be at the acceptable range, according to the world health organization (WHO), of 10.0 mg/L. Nitrate concentration in water after and before treatment is measured using the UV scanning method at 220 nm wavelength for the synthetic contaminated water and electrochemical method for the naturally contaminated water. The conditions were optimized for obtaining an efficient removing process. The removal efficiency reaches about 91% at the optimized conditions.