Eradication Of Infection Research Articles

Application of furazolidone in Helicobacter pylori infection eradication.

Increasing antibiotic resistance is the primary reason for treatment failure of Helicobacter pylori (H. pylori) infection. To enhance the eradication rate, minimize the development of secondary resistance, and alleviate the socioeconomic burden, it is crucial to select H. pylori-sensitive antibiotics carefully. Furazolidone has been used for H. pylori eradication in developing countries for decades due to its affordability and low resistance rate. Numerous studies have demonstrated that furazolidone-containing regimens are more efficacious than those containing other antibiotics, as both first- and second-line therapies, and are also well tolerated. However, utility of furazolidone is restricted or not optimal in certain countries due to its infrequent but potentially severe adverse effects. The decision to discontinue usage of furazolidone because of concerns regarding adverse effects may be misguided. Here we comprehensively reviewed the studies on furazolidone at different dosages and treatment durations for H. pylori eradication. Further research on the mechanisms of action and clinical trials of furazolidone are of great practical importance.

Non-alcoholic fatty liver disease and Helicobacter pylori infection: is there a relationship? Review

The article outlines the relevance of finding a connection between non‑alcoholic fatty liver disease (NAFLD) and Helicobacter pylori infection. The presented data of the majority of studies indicate the presence of Helicobacter pylori infection as a risk factor for the development of NAFLD. In addition, a number of researchers point to the possibility of the influence of Helicobacter pylori on important pathogenetic chains of NAFLD: insulin resistance, the state of the intestinal microbiota, the level of such hormones as ghrelin, leptin, adiponectin, and also that the effect of Helicobacter pylori (H. pylori) toxins can cause direct damage to the liver and that Helicobacter pylori invasion of the small intestine mucosa can increase the permeability of the latter, disrupting the functioning of the gut—liver axis. The article emphasizes the relationship between H. pylori infection and an unfavorable metabolic profile: dyslipidemia, body mass index, blood pressure, fasting blood glucose, and insulin resistance. In addition, research data on the novelty of higher levels of aspartate and alanine aminotransferase in Helicobacter‑positive patients compared to Helicobacter‑negative patients, in the absence of differences in liver fibrosis, are given. Separately, the research data are given, which indicate that the successful eradication of Helicobacter infection does not have a significant effect on liver steatosis, but probably reduces the severity of insulin resistance. Also, the authors draw attention to the fact that in a number of studies, the connection of H. pylori with NAFLD was not found, and no significant differences were found in the levels of high and low‑density lipoprotein cholesterol in people with Helicobacter infection compared to Helicobacter‑negative ones. The authors conclude that today there is no clear understanding of the role of Helicobacter pylori infection in the NAFLD pathogenesis, which requires further research because, after all, most researchers testify in favor of the fact that H. pylori infection can be one of the risk factors, contributing to the emergence and progression of NAFLD, and eradication of H. pylori may be important in the treatment of this disease.

High failure rate of 2-stage revision for the infected total elbow arthroplasty: a single institution’s experience

Despite 2 stage revision being a common treatment for elbow prosthetic joint infection (PJI), failure rates are high. The purpose of this study was to report on a single institution's experience with two stage revisions for elbow PJI and determine risk factors for failed eradication of infection. The secondary purpose was to determine risk factors for needing allograft bone at the second stage of revision in the setting of compromised bone stock. We retrospectively analyzed all two stage revision TEAs performed for infection at a single institution between 2006 and 2020. Data collected included demographics, and treatment course prior to, during and after 2 stage revision. Radiographs obtained after explantation and operative reports were reviewed to evaluate for partial component retention and incomplete cement removal. The primary outcome was failed eradication of infection, defined as the need for repeat surgery to treat infection after the second stage revision. The secondary outcome was the use of allograft for compromised bone stock during the second stage revision. Risk factors for both outcomes were determined. Nineteen patients were included. Seven (37%) patients had either the humeral or ulnar component retained during the 1st stage and ten (53%) had incomplete removal of cement in either the humerus or ulna. Nine (47%) patients had allograft strut used during reimplantation and reconstruction. Nine (47%) patients failed to eradicate the infection after 2 stage revision. Demographic data was similar between the repeat infection and non-repeat infection groups. Six patients (60%) with retained cement failed compared to three patients (33%) with full cement removal (p=0.370). Two patients (29%) with a retained component failed compared to seven patients (58%) with full component removal (p=0.350). Allograft was used less frequently when a well-fixed component or cement was retained, with no patients with a retained component needing allograft compared to nine with complete component removal (p=0.003). Three (30%) patients with retained cement needed allograft, compared to six (67%) patients who had complete cement removal (p=0.179). Nearly half of the patients failed to eradicate infection after 2 stage revision. The data did not demonstrate a clear association between retained cement or implants and risk of recurrent infection. Allograft was used less frequently when a component and cement were retained, possibly serving as a proxy for decreased bone loss during the first stage of revision. Therefore, the unclear benefit of removing well-fixed components and cement need to be carefully considered as it likely leads to compromised bone stock that complicates the second stage of revision.

Breaking Iron Homeostasis: Iron Capturing Nanocomposites for Combating Bacterial Biofilm.

Given the scarcity of novel antibiotics, the eradication of bacterial biofilm infections poses formidable challenges. Upon bacterial infection, the host restricts Fe ions, which are crucial for bacterial growth and maintenance. Having coevolved with the host, bacteria developed adaptive pathways like the hemin-uptake system to avoid iron deficiency. Inspired by this, we propose a novel strategy, termed iron nutritional immunity therapy (INIT), utilizing Ga-CT@P nanocomposites constructed with gallium, copper-doped tetrakis (4-carboxyphenyl) porphyrin (TCPP) metal-organic framework, and polyamine-amine polymer dots, to target bacterial iron intakes and starve them. Owing to the similarity between iron/hemin and gallium/TCPP, gallium-incorporated porphyrin potentially deceives bacteria into uptaking gallium ions and concurrently extracts iron ions from the surrounding bacteria milieu through the porphyrin ring. This strategy orchestrates a "give and take" approach for Ga3+/Fe3+ exchange. Simultaneously, polymer dots can impede bacterial iron metabolism and serve as real-time fluorescent iron-sensing probes to continuously monitor dynamic iron restriction status. INIT based on Ga-CT@P nanocomposites induced long-term iron starvation, which affected iron-sulfur cluster biogenesis and carbohydrate metabolism, ultimately facilitating biofilm eradication and tissue regeneration. Therefore, this study presents an innovative antibacterial strategy from a nutritional perspective that sheds light on refractory bacterial infection treatment and its future clinical application.

Breaking Iron Homeostasis: Iron Capturing Nanocomposites for Combating Bacterial Biofilm

AbstractGiven the scarcity of novel antibiotics, the eradication of bacterial biofilm infections poses formidable challenges. Upon bacterial infection, the host restricts Fe ions, which are crucial for bacterial growth and maintenance. Having coevolved with the host, bacteria developed adaptive pathways like the hemin‐uptake system to avoid iron deficiency. Inspired by this, we propose a novel strategy, termed iron nutritional immunity therapy (INIT), utilizing Ga‐CT@P nanocomposites constructed with gallium, copper‐doped tetrakis (4‐carboxyphenyl) porphyrin (TCPP) metal–organic framework, and polyamine‐amine polymer dots, to target bacterial iron intakes and starve them. Owing to the similarity between iron/hemin and gallium/TCPP, gallium‐incorporated porphyrin potentially deceives bacteria into uptaking gallium ions and concurrently extracts iron ions from the surrounding bacteria milieu through the porphyrin ring. This strategy orchestrates a “give and take” approach for Ga3+/Fe3+ exchange. Simultaneously, polymer dots can impede bacterial iron metabolism and serve as real‐time fluorescent iron‐sensing probes to continuously monitor dynamic iron restriction status. INIT based on Ga‐CT@P nanocomposites induced long‐term iron starvation, which affected iron‐sulfur cluster biogenesis and carbohydrate metabolism, ultimately facilitating biofilm eradication and tissue regeneration. Therefore, this study presents an innovative antibacterial strategy from a nutritional perspective that sheds light on refractory bacterial infection treatment and its future clinical application.

Vonoprazan: A Review in Helicobacter pylori Infection.

Treatment for the eradication of Helicobacter pylori infection, a leading cause of peptic ulcer disease and an important risk factor for gastric cancer and mucosa-associated lymphoid tissue lymphoma, is indicated whenever infection is identified. However, treatment success rates with current guideline-recommended proton-pump inhibitor (PPI)-based regimens remain suboptimal, with one potential factor associated with treatment failure being inadequate acid suppression. Vonoprazan (Voquezna®) is a first-in-class potassium-competitive acid blocker with the potential to provide potent and sustained acid suppression. Following clinical trials conducted mainly in Asia (supported by post-marketing experience from Asia) and the phaseIII PHALCON-HP trial conducted in the USA and Europe, vonoprazan is now approved in the USA for use in combination with amoxicillin (dual therapy) or amoxicillin and clarithromycin (triple therapy) for the treatment of H.pylori infection in adults. The vonoprazan-based dual and triple therapy regimens were generally well tolerated in PHALCON-HP. In addition, vonoprazan has advantages including a rapid onset of action and no food effect, making vonoprazan-based dual and triple therapy regimens valuable alternatives to standard PPI-based triple therapy in the treatment of H.pylori infection.

Synergistic quorum sensing inhibition and mild-temperature photothermal therapy of integrated nanoplatform for implant-associated biofilm infections

In current clinical practice, the presence of biofilms poses a significant challenge in the effective elimination of bacterial infections because of the physical and chemical barriers formed by biofilms, which offer persistent protection to bacteria. Here, we developed hollow mesoporous polydopamine (hMP) nanoparticles (NPs) loaded with luteolin (Lu) as a quorum sensing inhibitor, which were further coated with hyaluronic acid (HA) shells to create hMP-Lu@HA NPs. We observed that upon reaching the infection site, the HA shells underwent initial degradation by the hyaluronidase enzyme present in the bacterial infection's microenvironment to expose the hMP-Lu NPs. Subsequently, Lu was released in response to the acidic conditions characteristic of bacterial infections, which effectively hindered and dispersed the biofilm. Moreover, when subjected to near-infrared irradiation, the robust photothermal conversion effect of hMP NPs accelerated the release of Lu and disrupted the integrity of the biofilms by localized heating. This dual action enhanced the eradication of the biofilm infection. Importantly, hMP-Lu@HA NPs also promoted tissue regeneration and healing at the implantation site, concurrently addressing biofilm infection. Taken together, this nanosystem, combined with mild-temperature photothermal therapy and quorum sensing inhibition strategy, holds significant potential for applications in the treatment of implantation-associated infections.

Nitric oxide-releasing multifunctional catechol-modified chitosan/oxidized dextran hydrogel with antibacterial, antioxidant, and pro-angiogenic properties for MRSA-infected diabetic wound healing

The study presents a multifunctional catechol-modified chitosan (Chi-Ca)/oxidized dextran (Dex-CHO) hydrogel (CDP-PB) that possesses antibacterial, antioxidant, and pro-angiogenic properties, aimed at improving the healing of diabetic wounds. The achievement of the as-prepared CDP-PB hydrogel with superb antibacterial property (99.9 %) can be realized through the synergistic effect of phenylboronic acid-modified polyethyleneimine (PEI-PBA) and photothermal therapy (PTT) of polydopamine nanoparticles loaded with the nitric oxide (NO) donor BNN6 (PDA@BNN6). Notably, CDP-PB hydrogel achieves ∼3.6 log10 CFU/mL MRSA of inactivation efficiency under 808 nm NIR laser irradiation. In order to mitigate oxidative stress, the Chi-Ca was synthesized and afterward subjected to a reaction with Dex-CHO via a Schiff-base reaction. The catechol-containing hydrogel demonstrated its effectiveness in scavenging DPPH, •OH, and ABTS radicals (> 85 %). In addition, the cellular experiment illustrates the increased migration and proliferation of cells by the treatment of CDP-PB hydrogel in the presence of oxidative stress conditions. Moreover, the findings from the animal model experiments provide evidence that the CDP-PB hydrogel exhibited efficacy in the eradication of wound infection, facilitation of angiogenesis, stimulation of granulation, and augmentation of collagen deposition. These results indicate the potential of the CDP-PB hydrogel for use in clinical applications.

Fermented milk product “Narineh” with Lactobacillus acidophilus in sequential and classical therapy for Helicobacter pylori-associated peptic ulcers

Background: In recent years, there has been a growing dissatisfaction with the classical schemes of the eradication of Helicobacter pylori in ulcerative disease among physicians due to frequent failures in eradication therapy, mostly due to antibiotic resistance. It is a known fact that the Lactobacillus acidophilus inhibits the growth of Helicobacter pylori. Objective: Our main goal was to investigate the ability of the fermented milk product "Narineh,” as a functional food, containing Lactobacillus acidophilus to evaluate the efficiency and incidence of adverse effects in addition to the standard triple scheme of eradication therapy with colloidal bismuth substrate. Methods: The patients with peptic ulcer were divided into 2 groups: control (42 patients) received traditional treatment regimens, including 7 days proton pump inhibitor (PPI) + amoxicillin (A) and clarithromycin (C) in the standard doses and subsequent 14 day De-nol (colloidal bismuth subcitrate); experimental (44 patients) received in addition to this standard conventional scheme "Narineh" - 200g, containing 2x109 Lactobacillus acidophilus one time a day starting from the 8-th day for 4 weeks. The results of the eradication in patients were evaluated after 4 -5 weeks, 6 months, and 12 months after completion of treatment using the C13 respiratory urea test (RUT). Repeated endoscopy with histological biopsies was carried out together with RUT in 4-5 weeks after the completion of treatment, and later (6-12 months) for the identification of recurrent ulcer. Results: The treatment with “Narineh” added to the standard regimen significantly reduces the percentage of reinfection and relapse of the disease with a statistical difference (P<0,05). The combination of fermentation milk product “Narineh”, containing Lactobacillus acidophilus with bismuth subcitrate, doesn’t cause a violation of biocenosis of the large intestine, in contrast to the PPI and antibiotics with a statistical difference (P<0,05). In addition, it provides the normalization of gut biocenosis and reduces the frequency of antibiotic-associated diarrhea and other side effects. Conclusion: The treatment with “Narineh” added to the standard scheme is more effective for eradication of Helicobacter pylori infection and significantly reduces the percentage of reinfection and relapse of the disease and lessens the side effects of medications. Keywords: peptic ulcer, eradication Helicobacter pylori, side effects reinfection, fermented milk product “Narineh”, Lactobacillus acidophilus, functional foods

Pharmacokinetics and bioavailability of ceftiofur following intravenous and intramuscular administrations in broiler chickens

The study focussed on pharmacokinetics and bioavailability of ceftiofur (CFT) after receiving a single dose (2 mg/kg BW) through either intravenous (IV) or intramuscular (IM) injection. Eight broiler chickens, were used in a crossover design with a washout period of two weeks to analyze the behaviour of CFT. Ceftiofur concentrations in the plasma were determined by HPLC with UV detector. The pharmacokinetics of CFT was analyzed using non- compartmental analysis. Following IV injection, CFT elimination half-life (t1/2β) was 2.43 h, volume of distribution at steady state (Vdss) was 0.63 L/kg, and total body clearance (Cl) was 0.24 L/h/kg. Following a single intramuscular (IM) injection of CFT at the same dose, the drug was quickly absorbed into the bloodstream with an absorption half- life (t1/2ab) of 0.31 h. The maximum concentration of the drug in the plasma (Cmax) was 2.85 μg/mL and reached at a time (Tmax) of 0.57 h after injection and the bioavailability (F) of CFT was 96.25%. The results of the study revealed that CFT was absorbed rapidly and showed high bioavailability when administered by IM route. This suggests that CFT has a promising disposition in chickens, and its use could help determine the best dosage regimens for effective eradication of various infections in chickens.

Interim Use of Antibiotic-Loaded Cement Spacer for Patients with Infected Cervical Fusion

The management of postoperative deep infection after anterior cervical discectomy and fusion (ACDF) remains challenging for spine surgeons. Our institution uses handmade antibiotic-loaded cement spacers to treat these complex cases. This study aimed to determine the efficacy and feasibility of this treatment. This study included 4 patients with deep cervical spine infections after ACDF who underwent our treatment between March 2012 and January 2022. Patients' laboratory data, visual analog scale scores, comorbidities, complications, and neurological status were recorded. Their clinical conditions were also evaluated based on the Neck Disability Index, Japanese Orthopaedic Association score, and Odom criteria. Infection eradication was achieved in all patients after treatment. The average preoperative visual analog scale score was 7.5 (range: 7-8); this decreased to 1.25 (range: 1-2) at 1year postoperatively. None of the patients experienced severe complications, such as neurological deterioration or bone graft dislodgement. The Neck Disability Index improved from a preoperative value of 54% (range: 48-60%) to 6% (range: 4-8%) at 1year postoperatively. The Japanese Orthopaedic Association score improved from a preoperative score of 10.25 (range: 10-11)-14.75 (range: 14-16) at 1year postoperatively. All patients achieved excellent outcomes based on Odom criteria at 1year postoperatively. Good clinical outcomes were achieved in this study. Although 2-stage surgery is required, this technique could be an alternative for patients with postoperative deep infection after ACDF.

Availability of Mean Platelet Volume and Neutrophil/Lymphocyte Ratio in Control of Helicobacter Pylori Eradication

Aim: The most common chronic bacterial infection in humans is Helicobacter pylori (HP) and has been proven to cause gastritis, recurrent peptic ulcers, duodenal ulcers, and gastric cancer. We investigated the neutrophil-lymphocyte ratio (NLR) and the mean platelet volume (MPV) in the control of HP infection eradication success.
 Material and Method: Patients with HP infection in endoscopic biopsy performed due to dyspeptic complaints were included in this retrospective analysis. Quadruple antibiotic eradication therapy was given to the patients for 14 days. Pre- and post-treatment complete blood count parameters of 217 patients whose eradication treatment was successful were evaluated.
 Results: There was a statistically significant decrease in the neutrophil count after treatment compared to before treatment (p

Smart Nanofibrous Hydrogel Wound Dressings for Dynamic Infection Diagnosis and Control: Soft but Functionally Rigid.

Chronic wounds, such as burns and diabetic foot ulcers, pose significant challenges to global healthcare systems due to prolonged hospitalization and increased costs attributed to susceptibility to bacterial infections. The conventional use of antibiotic-loaded and metal-impregnated dressings exacerbates concerns related to multidrug resistance and skin argyrosis. In response to these challenges, our research introduces a unique approach utilizing antibiotic-free smart hydrogel wound dressings with integrated infection eradication and diagnostic capabilities. Electrospinning stands out as a method capable of producing hydrogel nanofibrous materials possessing favorable characteristics for treating wounds and detecting infections under conditions utilizing sustainable materials. In this study, innovative dressings are fabricated through electrospinning polycaprolactone (PCL)/gelatin (GEL) hybrid hydrogel nanofibers, incorporating pDA as a cross-linker, εPL as a broad-spectrum antimicrobial agent, and anthocyanin as a pH-responsive probe. The developed dressings demonstrate exceptional antioxidant (>90% radical scavenging) and antimicrobial properties (95-100% killing). The inclusion of polyphenols/flavonoids and εPL leads to absolute bacterial eradication, and in vitro assessments using HaCaT cells indicate increased cell proliferation, decreased reactive oxygen species (ROS) production, and enhanced cell viability (100% Cell viability). The dressings display notable alterations in color that correspond to different wound conditions. Specifically, they exhibit a red/violet hue under healthy wound conditions (pH 4-6.5) and a green/blue color under unhealthy wound conditions (pH > 6.5). These distinctive color changes provide valuable insights into the versatile applications of the dressings in the care and management of wounds. Our findings suggest that these antibiotic-free smart hydrogel wound dressings hold promise as an effective and sustainable solution for chronic wounds, providing simultaneous infection control and diagnostic monitoring. This research contributes to advancing the field of wound care, offering a potential paradigm shift in the development of next-generation wound dressings.

Antibiotic-Coated Intramedullary Nailing Managing Long Bone Infected Non-Unions: A Meta-Analysis of Comparative Studies.

Long bone infected non-unions are such an orthopedic challenge that antibiotic-coated intramedullary nailing (ACIN) has become a viable therapeutic option for their management. This study aims to provide a comprehensive assessment of the available data about the use of antibiotic-coated nailing in the treatment of long bone infected non-unions. Following the PRISMA guideline in this meta-analysis, a systematic literature search was conducted across major databases for studies evaluating ACIN in long bone infected non-unions. The primary outcome measures included union rates, infection control, complications and functional status. Five eligible studies encompassing 183 patients in total met the inclusion criteria. The meta-analysis revealed no difference in the union rate in the antibiotic-coated intramedullary nailing group compared to that of the control group (OR = 1.73 [0.75-4.02]). Antibiotic-coated intramedullary nailing demonstrated no association with higher infection eradication (OR = 2.10 [0.97-4.54]). Also, functional outcome measure was mostly not significantly different between ACIN and control interventions. According to this meta-analysis, compared to the management of controls, ACIN is neither linked to increased union rates nor decreased infection rates. The paucity of research on this topic emphasizes the continuous need for additional well-designed randomized controlled trials for the application of antibiotics-coated intramedullary nailing in long bone non-unions.

Clinical outcomes and complications of S53P4 bioactive glass in chronic osteomyelitis and septic non-unions: a retrospective single-center study.

Dead space management following debridement surgery in chronic osteomyelitis or septic non-unions is one of the most crucial and discussed steps for the success of the surgical treatment of these conditions. In this retrospective clinical study, we described the efficacy and safety profile of surgical debridement and local application of S53P4 bioactive glass (S53P4 BAG) in the treatment of bone infections. A consecutive single-center series of 38 patients with chronic osteomyelitis (24) and septic non-unions (14), treated with bioactive glass S53P4 as dead space management following surgical debridement between May 2015 and November 2020, were identified and evaluated retrospectively. Infection eradication was reached in 22 out of 24 patients (91.7%) with chronic osteomyelitis. Eleven out of 14 patients (78.6%) with septic non-union achieved both fracture healing and infection healing in 9.1 ± 4.9 months. Three patients (7.9%) developed prolonged serous discharge with wound dehiscence but healed within 2 months with no further surgical intervention. Average patient follow-up time was 19.8 months ± 7.6 months. S53P4 bioactive glass is an effective and safe therapeutic option in the treatment of chronic osteomyelitis and septic non-unions because of its unique antibacterial properties, but also for its ability to generate a growth response in the remaining healthy bone at the bone-glass interface.

Validation of a Classification System for Optimal Application of Debridement, Antibiotics, and Implant Retention in Prosthetic Joint Infections following Total Knee Arthroplasty: A Retrospective Review.

Periprosthetic joint infection (PJI) remains a serious complication after total knee arthroplasty (TKA). While debridement, antibiotics, and implant retention (DAIR) are considered for acute PJI, success rates vary. This study aims to assess a new scoring system's accuracy in predicting DAIR success. 119 TKA patients (2008-2019) diagnosed with PJI who underwent DAIR were included for analysis. Data were collected on demographics, laboratory values, and clinical outcomes. This was used for validation of the novel classification system consisting of PJI acuteness, microorganism classification, and host health for DAIR indication. Statistical analysis was carried out using SPSS programming. Mean follow-up was 2.5 years with an average age of 65.5 ± 9.1 years, BMI of 31.9 ± 6.2 kg/m2, and CCI of 3.04 ± 1.8. Successful infection eradication occurred in 75.6% of patients. The classification system demonstrated 61.1% sensitivity, 72.4% specificity, and 87.3% positive predictive value (PPV) when the DAIR cutoff was a score less than 6. For a cutoff of less than 8, sensitivity was 100%, specificity was 37.9%, and PPV was 83.3%. To date, no consensus exists on a classification system predicting DAIR success. This novel scoring system, with high PPV, shows promise. Further refinement is essential for enhanced predictive accuracy.

Treatment of Infected Nonunion of Fracture of the Proximal Third of Tibia Using Ilizarov Ring Fixator: A Case Series

Abstract Introduction: Nonunions (NUs) of the fractured proximal third of the tibia are challenging to manage owing to a capacious canal and scarce anterior soft-tissue cover. Infection further complicates the use of internal fixators in such patients. We present a study of 25 cases of infected NU of the proximal third of the tibia that we treated using the Ilizarov ring fixator over 10 years. Materials and Methods: Twenty-three men and two women with infected NU of the proximal tibial meta-diaphyseal junction were studied. The mean age of the patients was 39.2 years. Treatment involved thorough debridement of the NU site with freshening of the bone ends followed by the application of a 3-ring hybrid Ilizarov construct. The patients were followed at regular intervals to assess the infection control, union, limb function, and complications. Results: Successful union and eradication of infection were achieved in 21 patients. Union was not satisfactory in four cases. The average fixator time was 7.12 months. Average knee flexion of 99.2° was observed. The Association for the Study and Application of the Methods of Ilizarov score was excellent in 56% of cases and good in 28%. Six patients required soft-tissue reconstruction. One patient suffered a fracture at the distal pin site while one had a refracture 4 months after treatment completion. Three patients developed a discharging sinus which required debridement and oral antibiotics. Conclusion: The Ilizarov construct provides multilevel, multidirectional, and multiplanar stability, aiding early mobility. Appropriate case selection, sound soft-tissue reconstruction, robust infection control, and good patient compliance are important for the success of the treatment.

The relation between hepatitis C viral infection and follicular lymphoma clinical course and outcome in a single-center study

Background Hepatitis C virus (HCV) infection has been related in the etiology of many lymphomas. Follicular lymphoma (FL) is the most common subtype of indolent non-Hodgkin lymphoma. This comparative retrospective study aimed to identify a relationship between HCV and FL clinicopathologic features and neoplasm outcome. Patients and methods This study was conducted on 103 patients with FL who attended our institution during 2008–2019. Results The prevalence of patients with HCV FL was 49.5% and showed significant B symptoms (P=0.023), advanced stages (P=0.016) with higher Follicular Lymphoma International Prognostic Index scores (P=0.042). Progression-free survival showed no differences regarding the viral infection or histological grades. Median overall survival showed significant improvement with histological grades 1–2 (P<0.0001), low Follicular Lymphoma International Prognostic Index, and HCV negative patients with FL, especially in the younger subgroup. Conclusion HCV positive patients with FL had a significantly more aggressive clinicopathological presentation and shorter overall survival. Thus, early virology screening and eradication of HCV infection in FL patients may improve the neoplasm course.

New Results on the Asymptotic Behaviour of a Stochastic SEI Model of Lymphatic Filariasis

The goal of this article is to examine a new stochastic epidemic model for lymphatic filariasis, susceptible‐exposed‐infected (SEI). Like other diseases, the spread of lymphatic filariasis is subject to a degree of randomness due to fluctuations in the natural environment. This provides us with the opportunity to formulate a mathematical model of lymphatic filariasis that comprehensively considers external stochastic influences. By using carefully designed stochastic Lyapunov functions, we establish sufficient conditions for the eradication of lymphatic filariasis infections. Moreover, under specific conditions regarding the intensity of white noise, we also demonstrate the existence of a unique ergodic stationary distribution and the persistence of the mean for the model. Numerical simulations are conducted to substantiate the validity of our findings.

Modulating the photodynamic modality of Au22 nanoclusters through surface conjugation of arginine for promoted healing of bacteria-infected wounds.

Developing novel antibacterial agents without drug resistance is highly desired but challenging. In this study, an Au nanocluster (NC)-based photodynamic antibacterial agent with aggregation-induced emission (AIE) has been designed to promote the healing of bacteria-infected wounds by conjugating arginine (Arg) on the surface of Au22 NCs. The conjugation of Arg not only endows the NCs with enhanced visible light absorption, increased photoluminescence (PL) intensity, and prolonged PL lifetime, but it also enables switching the photodynamic production mode of reactive oxygen species (ROS) and extra production of reactive nitrogen species (RNS). These enhancements allow the Arg-Au22 NCs to combine ROS/RNS-mediated antibacterial action with the enhanced inherent antibacterial properties of Au NCs, resulting in outstanding antibacterial efficacy against both Gram-negative and Gram-positive bacteria. In vivo experiments demonstrate the effective treatment of bacteria-infected wounds by the Arg-Au22 NCs, leading to the photodynamic eradication of bacterial infections and reduced inflammation in the wound area without causing systemic harm or impairing blood and liver functions. This study introduces a novel approach to designing metal NC-based photodynamic antibacterials with multiple antibacterial actions, contributing to deeper understanding of ROS/RNS-mediated antibacterial mechanisms, and future utilization of metal NCs in antibacterial therapies.