High Stability Rates Research Articles

High survival and stability rates ofEscherichia colidried in hydroxyectoine

High survival and stability rates of<i>Escherichia coli</i>dried in hydroxyectoine

High survival and stability rates of Escherichia coli dried in hydroxyectoine

The tetrahydropyramidine hydroxyectoine acts as an osmolyte in a range of bacterial species, but its use as a desiccation protectant is less well explored. Recently, it was demonstrated that hydroxyectoine provides effective stabilisation of the Gram-negative species Pseudomonas putida, which is only relatively poorly preserved by the better-characterised protectant, trehalose. It is now shown that hydroxyectoine also protects the paradigmatic bacterium, Escherichia coli: osmotically-preconditioned E. coli dried in hydroxyectoine exhibited a high degree of desiccation tolerance, similar to that achieved using trehalose in this species. Hydroxyectoine is apparently accumulated from hypersaline medium in preference to trehalose biosynthesis, but E. coli loaded with hydroxyectoine in this way showed reduced stability in the dry state. This suggests that, although both hydroxyectoine and trehalose perform equally well as extracellular protectants, trehalose is preferred for intracellular protection.

Maternal attachment style and depression associated with childbirth: preliminary results from a European and US cross-cultural study.

Insecure attachment style relates to major depression in women, but its relationship to depression associated with childbirth is largely unknown. A new UK-designed measure, the Attachment Style Interview (ASI), has potential for cross-cultural use as a risk marker for maternal disorder. To establish there liability of the ASI across centres, its stability over a 9-month period, and its associations with social context and major or minor depression. The ASI was used by nine centres antenatally on 204 women, with 174 followed up 6 months postnatally. Interrater reliability was tested and the ASI was repeated on a subset of 96 women. Affective disorder was assessed by means of the Structured Clinical Interview for DSM-IV. Satisfactory interrater reliability was achieved with relatively high stability rates at follow-up. Insecure attachment related to lower social class position and more negative social context. Specific associations of avoidant attachment style (angry-dismissive or withdrawn) with antenatal disorder, and anxious style (enmeshed or fearful) with postnatal disorder were found. The ASI can be used reliably in European and US centres as a measure for risk associated with childbirth. Its use will contribute to theoretically under pinned preventive action for disorders associated with childbirth.

Controversies in arthroscopic shoulder surgery: arthroscopic versus open bankart repair, thermal treatment of capsular tissue, acromioplasties—are they necessary?

A significant debate has involved in the last several years regarding the optimal surgical management of glenohumeral instability. The majority of patients with traumatic anterior-inferior instability sustain a capsulolabral detachment1,2 described by Perthes3 and Bankart.4 The open Bankart repair by Rowe5 has resulted in a high rate of shoulder stability, although the functional outcome has sometimes been suboptimal, especially for higher-caliber athletes. Although suture anchors have simplified the procedure when compared with bone tunnels,6 the technique has not changed substantially. In an effort to decrease the morbidity and improve the functional results, Caspari7,8 developed an arthroscopic capsular shift technique, which began a period of intense interest and study in arthroscopic techniques to stabilize the shoulder. As refinements have been made to the arthroscopic methods, the number of proponents has grown. Current arthroscopic techniques using suture anchors9 mimic the open Bankart repair and comparable results have been reported.10–13 Rather than attempt to defend a particular position as to whether an arthroscopic or an open approach to shoulder stabilization is best, the focus here is placed on what we have learned regarding the appropriate indications for each of these techniques.

Implantation of an empty carbon fiber composite frame cage after single-level anterior cervical discectomy in the treatment of cervical disc herniation: preliminary results.

The authors sought to evaluate retrospectively the radiological and clinical outcome of anterior cervical discectomy followed by implantation of an empty carbon fiber composite frame cage (CFCF) in the treatment of patients with cervical disc herniation and monoradiculopathy. Twenty-five consecutive patients (12 men, 13 women, mean age 45 years) with monoradiculopathy due to cervical disc herniation were treated by anterior cervical discectomy followed by implantation of an empty CFCF cage. On lateral flexion-extension radiographs segmental stability at a mean follow up of 14 months (range 5-31 months) was demonstrated in all 25 patients, and bone fusion was documented in 24 of 25 patients. The mean anterior intervertebral body height was 3.4 mm preoperatively and 3.8 mm at follow up in 20 patients. In these patients the mean segmental angle (angle between lower endplate of lower and upper vertebra) was 0.9 degrees preoperatively and 3.1 degrees at follow up. In the remaining five patients preoperative images were not retrievable. Self-scored neck pain based on a visual analog scale (1, minimum; 10, maximum) changed from a preoperative average of 5.6 to an average of 2 at follow up; radicular pain was reduced from 7.7 to 2.1 postoperatively. Analysis of the SF12 questionnaires showed a significant improvement in both the physical capacity score (preoperative mean 32.4 points; follow up 46 points) and the mental capacity score (preoperative mean 45.8 points; follow up 57.5 points). Implantation of an empty CFCF cage in the treatment of cervical disc herniation and monoradiculopathy avoids donor site morbidity associated with autologous bone grafting as well as the use of any supplementary material inside the cage. Restoration or maintenance of intervertebral height and thus segmental lordosis and a very high rate of segmental stability and fusion are achieved using this technique.

Improving nursing assistant turnover and stability rates in a long-term care facility.

In this study, we developed formulas to calculate nursing assistant turnover and stability rates, identified reasons for termination and facility-specific strategies to reduce turnover, and evaluated the effectiveness of implemented strategies. Although turnover remained relatively unchanged (23% in year 1, 28% in year 2), the stability rate remained high (76% in year 1, 75% in year 2). Tracking turnover rates without tracking stability yields an incomplete picture of a facility's efforts to attract and retain qualified employees. Achieving high stability rates in addition to low turnover rates are important goals, and we have included some recommendations.

Surface Replacement: The Hip Replacement of the Future?

Surface replacement is a significant development in the evolution of hip arthroplasty. Unlike conventional total hip arthroplasty, surface replacement does not require resection of the femoral head; thus, it presents a potentially effective, bone-conserving alternative to conventional replacements. Moreover, conversion to total hip replacement can be made readily, if necessary, with fewer complicating factors than with total hip revision surgery. It offers the greatest potential benefit to patients who are young and physically active. Previous surface replacement used metal-on-polyethylene devices; however, the large ball size of the femoral component contributed to high volumes of polyethylene wear. For some patients, osteolysis occurred due to tissue reaction to polyethylene debris, resulting in aseptic component loosening. Recent advances in technology have allowed metal-on-metal implants to be manufactured with great precision. Hybrid and all cementless fixation, have both shown good early results without the prevalence of loosening seen with polyethylene bearings. Metal-on-metal surface replacement has proved to be quite successful. Results from patients with metal-on-metal devices, especially those with ConservePlus™ implants, show no complications; moreover, there has been an absence of pain and a return to high functional levels, including participation in sports. Due to the large ball size, metal-on-metal devices offer high stability and low dislocation rates. Hemisurface replacement of the femoral head has also proved to be successful in patients with osteonecrosis with or without collapse of the femoral head, when the acetabulum remains relatively normal. For this type of surgery, some acetabular articular cartilage must be preserved. With high survivorship over time, it has emerged as the treatment of choice for this patient group.

Is the technique of posterior transarticular screw fixation suitable for rheumatoid atlanto-axial subluxation?

The rheumatoid patient with atlanto-axial subluxation presents a major challenge to the spinal surgeon, owing to the poor wound healing and bone quality. Traditional wiring techniques are associated with a high complication and failure rate. Posterior transarticular screw fixation of the atlanto-axial joint offers a credible alternative and when combined with a Gallie construct offers immediate true 3-point stability. It is, however, a difficult and demanding technique which carries a risk of vertebral artery, cranial nerve and spinal cord damage. The question that arises therefore is "Do the improved stability rates afforded by this technique really justify the risks of arterial and neurological damage?" To date there have been no studies of this technique dealing solely with the rheumatoid patient, with most reports dealing with a heterogeneous patient population, mainly trauma-related cases. The purpose of this report is to analyse critically our results with particular reference to the complications that we have encountered and the technical reasons for their occurrence. We analysed the clinical and radiological data of 38 rheumatoid patients (six males: 32 females, mean age of 54 years) with atlanto-axial subluxation who underwent transarticular screw fixation. Our analysis centred on screw malposition and complications. Parametric and non parametric statistical analysis was performed. Significance was accepted at the 5% level ( p 0.05). Our analysis revealed that three vertebral arteries were damaged. Two of these were recognized at the time of surgery, with the remaining case only suspected following postoperative CT to assess screw positioning. Vertebral artery occlusion was subsequently confirmed by angiography. All three patients were asymptomatic from their arterial injury. There was only one neurological complication in this series, and this was caused by a high screw, which damaged the hypoglossal nerve with a temporary nerve palsy ensuing. Four screws broke, all were made of titanium, but more importantly, all were also associated with contralateral screw malposition. Stability was achieved in 95% of cases overall. The high stability rates afforded by this technique do appear to justify the inherent risks of this procedure. If unilateral screw fixation only is achieved, we would recommend a period of halo immobilization until osseous union occurs.

The reliability and consistency of self-reports on substance use in a longitudinal study.

SummaryThe paper presents an evaluation of the stability and consistency of self‐reported adolescent drug use. The data were collected from 1900 high‐school students. Analyses included estimates of alternate forms reliability, non‐response rates, logical consistency in the responses, test‐retest reliability as well as estimates of exaggerated reports. The findings indicate a high rate of stability in self‐reporting of substance use, both cross‐sectionally and longitudinally. These results are in agreement with other studies of self‐reported drug use and suggest that questionnaire may provide highly reliable data for research.