Surgical site infections after distal radius fracture surgery:

xlomafota.13 shared this article with you from Inoreader Surgical site infections after distal radius fracture surgery: a nation-wide cohort study of 31,807 adult patients Via Latest Results for BMC Musculoskeletal Disorders Abstract Background Surgical site infections (SSI) after distal radius fracture (DRF) surgery have not previously been studied as the primary outcome in a large population with comparative data for different surgical methods. The aims of this study were 1) to compare SSI rates between plate fixation, percutaneous pinning and external fixation, and 2) to study factors associated with SSI. Methods We performed a nation-wide cohort study linking data from the Swedish national patient register (NPR) with the Swedish prescribed drug register (SPDR). We included all patients ≥18 years with a registration of a surgically treated DRF in the NPR between 2006 and 2013. The primary outcome was a registration in the SPDR of a dispensed prescription of peroral Flucloxacillin and/or Clindamycin within the first 8 weeks following surgery, which was used as a proxy for an SSI. The SSI rates for the three main surgical methods were calculated. Logistic regression was used to study the association between surgical method and the primary outcome, adjusted for potential confounders including age, sex, fracture type (closed/open), and a dispensed prescription of Flucloxacillin and/or Clindamycin 0–8 weeks prior to DRF surgery. A classification tree analysis was performed to study which factors were associated with SSI. Results A total of 31,807 patients with a surgically treated DRF were included. The proportion of patients with an SSI was 5% (n = 1110/21,348) among patients treated with plate fixation, 12% (n = 754/6198) among patients treated with percutaneous pinning, and 28% (n = 1180/4261) among patients treated with external fixation. After adjustment for potential confounders, the surgical method most strongly associated with SSI was external fixation (aOR 6.9 (95% CI 6.2–7.5, p < 0.001)), followed by percutaneous pinning (aOR 2.7 (95% CI 2.4–3.0, p < 0.001)) (reference: plate fixation). The classification tree analysis showed that surgical method, fracture type (closed/open), age and sex were factors associated with SSI. Conclusions The SSI rate was highest after external fixation and lowest after plate fixation. The results may be useful for estimation of SSI burdens after DRF surgery on a population basis. For the physician, they may be useful for  estimating the likelihood of SSI in individual patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The faster the better? Time to first CT scan after admission in moderate-to-severe traumatic brain injury and its association with mortality

xlomafota.13 shared this article with you from Inoreader The faster the better? Time to first CT scan after admission in moderate-to-severe traumatic brain injury and its association with mortality Via Latest Results for Neurosurgical Review Abstract Fast acquisition of a first computed tomography (CT) scan after traumatic brain injury (TBI) is recommended. This study is aimed at investigating whether the length of the period preceding initial CT scan influences mortality in patients with leading TBI. A retrospective cohort analysis of patients registered in the TraumaRegister DGU® was conducted including adult patients with TBI, defined as Abbreviated Injury ScaleHead ≥ 3 and GCS ≤ 13 who had been treated in level 1 or 2 trauma centers from 2007–2016. Patients were grouped according to time intervals either from trauma or from admission to CT. A total of 6904 patients met the inclusion criteria. Mean time period from trauma to hospital admission was 68.8 min. From admission to first CT, a mean of 19.0 min elapsed. Trauma severity was higher in groups with a longer duration from trauma to CT as represented by a mean (± standard deviation) Injury Severity Score (ISS) of 19.8 ± 9.0, 20.7 ± 9.3, and 21.4 ± 7.5 and similar distribution of mortality of 24.9%, 29.9%, and 36.3% in the ≤ 60-min, 61–120-min, and ≥ 121-min groups, respectively. An adjusted multivariable logistic regression model showed a significant influence of the level of the trauma center (p = 0.037) but not for interval from admission to CT (p = 0.528). TBI patients with a longer time span from trauma to first CT were more severely injured and demonstrated a worse prognosis, but received a CT scan faster when duration from admission is observed. The duration until the CT scan was obtained showed no significant impact on the mortality. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Influence of Biochar Particle Size and Concentration on Pb and As Availability in Contaminated Mining Soil and Phytoremediation Potential of Poplar Assessed in a Mesocosm Experiment

xlomafota.13 shared this article with you from Inoreader Influence of Biochar Particle Size and Concentration on Pb and As Availability in Contaminated Mining Soil and Phytoremediation Potential of Poplar Assessed in a Mesocosm Experiment Via Latest Results for Water, Air, & Soil Pollution Abstract Metal(loid)s found at many sites as a result of human activities induce contamination of ecosystems, which threatens the environment and public health. Several approaches can be used in order to reduce such negative impacts of pollutants, and among them, phytoremediation has gained attractive attention. The objective of the present study was to assess the capacity of Populus euramericana, Dorskamp cultivar, for the phytoremediation of metal(loid)s on a technosol (former mining site) highly contaminated mainly with Pb and As, and amended with biochars having different particle sizes. In a 46-day mesocosm glasshouse pot experiment, technosol was mixed at three ratios (0, 2, or 5% w/w) with four different hardwood-derived biochars (with various particle sizes) in order to study the biochar application rate and particle size effects on soil pore water (SPW) characteristics, on poplar growth, and on metal(loid) distribution and concentrati ons in the plant organs. The results showed that all biochars tested had a significant impact on several SPW physico-chemical parameters. Especially, biochar additions reduced available Pb concentrations but with no effect on As. In such conditions, Populus growth in amended technosol increased whatever rate and particle size of biochar used. Metal(loid) concentrations and repartition in plant organs showed the following: (1) for Pb, a higher root concentration with low aerial part translocation, which depended on biochar used, and (2) for As, mainly a root sequestration. We identified biochar with the finest particle size and combined with P. euramericana, Dorskamp, was the most suitable as remediation tools for Pb stabilization in post-mining contaminated soils. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Critical Ischemia

xlomafota.13 shared this article with you from Inoreader Critical Ischemia Via Latest Results Abstract Critical ischemia is defined as the presence of ischemic symptoms at rest. It identifies patients with high risk of imminent tissue loss. Critical ischemia in SSc results from progressive microvascular insufficiency but occasionally it may result from macrovascular compromise by emboli, thrombosis or vasculitis. Outcome of critical ischemia is contingent on the duration of ischemia, presences of comorbidities, prompt institution of appropriate workup and therapy. Timely and comprehensive therapy is key to prevent loss of threatened tissues. Therapies vary based on location of ischemia and the severity of symptoms. Primary prevention and control of modifiable risk factors remain paramount in the ongoing care of patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

How to Assess a Patient for HSCT

xlomafota.13 shared this article with you from Inoreader How to Assess a Patient for HSCT Via Latest Results Abstract Treatment of early diffuse cutaneous systemic sclerosis (dcSSc) patients can be challenging especially when organ involvement is present. Comprehensive screening is therefore necessary to determine the nature and extent of heart, lung and kidney involvement. This should include ECG, cardiac MRI, thoracic HRCT, lung function testing, right heart catheterisation and laboratory tests including NT-proBNP and hs-cTnI. Such patients may be considered for autologous hematopoietic stem cell transplantation (HSCT) if they do not respond to conventional immunosuppressive medication and have other features of poor prognosis. Clinical decision making may be difficult however in those patients with cardiac involvement who are deemed at risk of serious adverse events from HSCT including treatment-related death from heart/lung failure due to cardiotoxicity of high dose cyclophosphamide, cytokine-release syndrome from ATG and/or fluid overload. We describe two cases of poor prognosis dcSSc with subclinical myocardial involvement who underwent autologous stem cell transplantation with favourable outcomes. These cases demonstrate that HSCT may be considered even in dcSSc patients with cardiac involvement but are probably best managed in tertiary referral centers. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Ncoa7 locus regulates V-ATPase formation and function, neurodevelopment and behaviour

xlomafota.13 shared this article with you from Inoreader The Ncoa7 locus regulates V-ATPase formation and function, neurodevelopment and behaviour Via Latest Results for Cellular and Molecular Life Sciences Abstract Members of the Tre2/Bub2/Cdc16 (TBC), lysin motif (LysM), domain catalytic (TLDc) protein family are associated with multiple neurodevelopmental disorders, although their exact roles in disease remain unclear. For example, nuclear receptor coactivator 7 (NCOA7) has been associated with autism, although almost nothing is known regarding the mode-of-action of this TLDc protein in the nervous system. Here we investigated the molecular function of NCOA7 in neurons and generated a novel mouse model to determine the consequences of deleting this locus in vivo. We show that NCOA7 interacts with the cytoplasmic domain of the vacuolar (V)-ATPase in the brain and demonstrate that this protein is required for normal assembly and activity of this critical proton pump. Neurons lacking Ncoa7 exhibit altered development alongside defective lysosomal formation and function; accordingly, Ncoa7 deletion animals exhibited abnormal neuronal patterning defects and a reduced expression of lysosomal markers. Furthermore, behavioural assessment revealed anxiety and social defects in mice lacking Ncoa7. In summary, we demonstrate that NCOA7 is an important V-ATPase regulatory protein in the brain, modulating lysosomal function, neuronal connectivity and behaviour; thus our study reveals a molecular mechanism controlling endolysosomal homeostasis that is essential for neurodevelopment. Graphic abstract View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Autophagy and the endolysosomal system in presynaptic function

xlomafota.13 shared this article with you from Inoreader Autophagy and the endolysosomal system in presynaptic function Via Latest Results for Cellular and Molecular Life Sciences Abstract The complex morphology of neurons, the specific requirements of synaptic neurotransmission and the accompanying metabolic demands create a unique challenge for proteostasis. The main machineries for neuronal protein synthesis and degradation are localized in the soma, while synaptic junctions are found at vast distances from the cell body. Sophisticated mechanisms must, therefore, ensure efficient delivery of newly synthesized proteins and removal of faulty proteins. These requirements are exacerbated at presynaptic sites, where the demands for protein turnover are especially high due to synaptic vesicle release and recycling that induces protein damage in an intricate molecular machinery, and where replacement of material is hampered by the extreme length of the axon. In this review, we will discuss the contribution of the two major pathways in place, autophagy and the endolysosomal system, to presynaptic protein turnover and presynaptic function. Although clear ly different in their biogenesis, both pathways are characterized by cargo collection and transport into distinct membrane-bound organelles that eventually fuse with lysosomes for cargo degradation. We summarize the available evidence with regard to their degradative function, their regulation by presynaptic machinery and the cargo for each pathway. Finally, we will discuss the interplay of both pathways in neurons and very recent findings that suggest non-canonical functions of degradative organelles in synaptic signalling and plasticity. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.