Results Of Various Treatments Research Articles

A Neglected Fracture: Treatment and Infection of Seymour Fractures of the Hallux in the Pediatric Population.

Seymour physeal fractures of the distal phalanx of the Hallux in children are common but rarely described in the literature. There is limited literature investigating how these fractures should be specifically treated. Generally, good results are reported when open fractures are treated with debridement and antibiotics. This large retrospective review evaluates incidence of infection and compares outcomes of various treatments for Seymour physeal fractures of the distal phalanx of the Hallux in children. This study included patients ≤18 years of age treated for Seymour fractures of the Hallux between January 1, 2007, and November 20, 2018, at a single tertiary-care urban children's hospital. Demographic, injury, and treatment data were obtained via a retrospective review of electronic medical records, including closed versus open fracture status, time to treatment, and whether antibiotics were prescribed and taken. Initial radiographic imaging was examined by a single attending surgeon for angulation (degrees) and widening (mm). Outcome variables included the development of infection and the rate and success of healing. One hundred thirty-eight patients were included in our analysis. Most (84/138, 61%) fractures were closed and treated successfully without antibiotics. Treatment for open fractures varied greatly, with many of these fractures undergoing an incision and drainage procedure (I&D) (33/54, 61%) and antibiotic prescription (43/54, 76%). Most (47/54, 87%) open fractures did not develop infection. However, 7/54 open fractures presented with an active infection. Four out of seven (29%) of these fractures did not receive any treatment before infection presentation. Two others who presented with infection both had delayed antibiotics and neither underwent I&D. Fractures that either presented with or developed an infection presented significantly later than those fractures that did not develop infection (P<0.001). Neither angulation nor displacement correlated to the time of healing or development of infection. In our large cohort, the majority of open Seymour fractures of the Hallux treated in a timely manner did not develop infection, regardless of treatment. However, open fractures that presented multiple days after injury had an increased incidence of infection. Thus, for open fractures, we recommend timely antibiotics and I&D. Closed fractures may be treated conservatively, with no indication for reduction or use of antibiotics.

Challenges in the Treatment of Psychotic Bipolar Depression.

Psychotic bipolar depression (PBD) is a prevalent yet understudied psychiatric illness, and there are no specific guidelines or Food and Drug Administration-approved medications for its treatment. Recent studies suggest that some antipsychotics and mood stabilizers may be effective in managing bipolar depression; however, their effectiveness for PBD remains unclear. Given the urgent need for more focused research for managing PBD, we conducted a literature review to summarize the existing literature on PBD. We conducted an electronic literature search from the 1960s to 2023, utilizing PubMed, MEDLINE, EMBASE, and Google, and selected studies based on their relevance to PBD. PBD is a complex disorder, with 50%-75% of patients with bipolar disorder exhibiting psychotic features. This likelihood increases among those with a history of psychotic mania. Treatment guidelines often recommend a combination of mood stabilizers, antipsychotics, or electroconvulsive therapy, but they do not specify a first-line treatment. PBD symptoms can be masked by mixed high mood and energy feelings, potentially delaying diagnosis and treatment while increasing suicide risk. Limited research has evaluated outcomes of various treatments for PBD, and despite the lack of evidence for superior efficacy, in clinical practice, antipsychotics are frequently prescribed. Notably, combining an antipsychotic with selective noradrenaline reuptake inhibitors or tricyclic antidepressants may be effective, but including a mood stabilizer is necessary. PBD poses a significant challenge in mental health due to its severity and the lack of consensus on optimal treatment approaches. There is a critical need for more dedicated clinical trials and research to answer key questions about the effective treatment of acute PBD, ideal follow-up care, traits of responders to different therapies, and decision models for subsequent treatments.

Minimum Clinically Important Difference of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire for Patients with Lumbar Spine Disease Undergoing Posterior Surgery by Generation.

Few studies have assessed the minimum clinically important difference (MCID) of each Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) domain. This study assessed MCIDs of JOABPEQ in patients with lumbar spine disease by generation. We evaluated the JOABPEQ score of 805 consecutive patients with lumbar spine disease undergoing posterior surgery preoperatively and 1 year postoperatively. MCIDs of each JOABPEQ domain were determined using anchor- and distribution-based methods according to age. A question based on the concept of a health transition item was used as the anchor for the MCID decision. Overall, MCIDs of the JOABPEQ were 28.6 and 27.3 points for pain-related disorder and gait disturbance, respectively. The MCID for the lumbar spine dysfunction domain did not reach 0.6 over the area under the curve. Regarding the differences among generations, MCIDs of pain-related disorder and gait disturbance domains differed slightly between the elderly and middle-aged. The psychological disorder domain did not reflect clinically meaningful changes in the elderly. MCIDs of the social life disturbance domain decreased with age. Focusing on achieving the ideal responsiveness of patient-reported outcomes across generations, MCIDs of the pain-related disorder and gait disturbance domains may be valuable for patients, regardless of age, when adopting the JOABPEQ for patients with lumbar spine disease undergoing surgery. This study only evaluated cases that underwent posterior lumbar surgery. Future research will necessitate conducting surveys concerning the outcomes of various treatments for lumbar spine disease.

The 50 most influential publications in clavicle fractures.

Clavicle fractures are among the most common orthopedic fractures, and treatment methods, operative versus nonoperative, have been a point of contention. The purpose of this study was to evaluate the 50 most influential articles regarding clavicle fractures to better understand past focuses of research and to identify any gaps in knowledge. A review of the most cited articles related to clavicle fractures was conducted using Web of Science database. A search was conducted in April 2022 by one trained researcher. Two independent researchers evaluated each article based on relevance to clavicle fracture. The mean number of citations was 179.1, ranging from 576 to 81 citations, and collectively cited 8954 times. The decade from 2000 to 2009 contributed the greatest portion of articles, with only a small portion coming from before 1980. The Journal of Bone and Joint Surgery-American Volume contributed the greatest number of articles (20%). The majority of the articles were therapeutic (n = 37) and focused on treatment and outcome (n = 32). Most of the clinically focused articles had a level of evidence of IV (n = 26). There is an increased influence of recent articles focused on clavicle fracture and management, due to the idea that conventional nonoperative treatment has a high rate of nonunion. Many of the most influential studies evaluate the outcomes of various treatments. Many of these studies, however, are lower levels of evidence, leaving a paucity of high level of evidence articles to support these conclusions. V.

A Retrospective Observational Study to Compare the Outcome of Various Treatment Modalities of Idiopathic Avascular Necrosis of Hip.

Avascular necrosis (AVN) of hip of the femoral head is increasingly seen in young age, disabling them in their productive years of life. Available treatment options need to be evaluated. The aim was to compare the outcome of various treatments at different stages of AVN hip. A retrospective observational study was done in patients with idiopathic AVN hip, who had undergone different treatment modalities. The data of the included patients at different time intervals were compared. All patients were graded with the help of Harris Hip Score (HHS), and their outcome was evaluated. The age distribution of patients showed that nearly 80% of them were below the age of 50 years. The patients were presenting more often in Ficat and Arlet stage 4 compared to earlier stages. The patients in stage 1 were treated by core decompression alone, which produced good-to-excellent results in 4 of 7 (57.1%) patients. Patients in stage 2 and 3 were treated by core decompression with fibular bone grafting and had good-to-excellent results in 6 of 8 (75%) patients. In stage 4 of disease, cemented total hip replacement (THR) was done, and it produced good-to-excellent results in 13 of 15 (86.6%) patients. In the early stage of disease, core decompression with and without bone grafting produced satisfactory results. In an advanced stage of AVN, THR is an excellent treatment option.

Impact of Treatment Modalities upon Survival Outcomes in Skull Base and Clival Chordoma: An NCDB Analysis.

Objectives Skull base chordomas are locally aggressive malignant tumors derived from the notochord remnant. There are limited large-scale studies examining the role and extent of surgery and radiation therapy. Design Analysis of the National Cancer Database (NCDB) was performed to evaluate the survival outcomes of various treatments, and to assess for predictors of overall survival (OS). Participants This is a retrospective, population-based cohort study of patients diagnosed with a clival/skull base chordoma between 2004 and 2015 in the NCDB. Main Outcome Measures The primary outcome was overall survival (OS). Results In all, 468 cases were identified. Forty-nine percent of patients received surgery and 20.7% had positive margins. Mean age at diagnosis was 48.4 years in the surgical cohort, and 55% were males. Of the surgical cohort, 33.8% had negative margins, 20.7% had positive margins, and 45.5% had unknown margin status. Age ≥ 65 (hazard ratio [HR]: 3.07; 95% confidence interval [CI]: 1.63-5.76; p < 0.001), diagnosis between 2010 and 2015 (HR: 0.49; 95% CI: 0.26-0.90; p = 0.022), tumor size >5 cm (HR: 2.29; 95% CI: 1.26-4.15; p = 0.007), and government insurance (HR: 2.28; 95% CI: 1.24-4.2; p = 0.008) were independent predictors of OS. When comparing surgery with or without adjuvant radiation, no survival differences were found, regardless of margin status ( p = 0.66). Conclusion Surgery remains the mainstay of therapy. Advanced age (>65 years), large tumor size, and government insurance were predictors of worse OS. Whereas negative margins and the use of adjuvant radiation did not appear to impact OS, these may very well reduce local recurrences. A multidisciplinary approach is critical in achieving optimal outcomes in this challenging disease.

Effects of Different Treatment Regimens on Primary Spontaneous Pneumothorax: A Systematic Review and Network Meta-Analysis.

The best treatment strategy for primary spontaneous pneumothorax is controversial and varies widely in practice. Literatures were searched from databases till 24 August 2021. A Bayesian network meta-analysis was conducted to compare the outcomes of various treatments with the following endpoints: recurrence rate, postoperative chest tube duration, postoperative air leakage duration, length of hospital stay, and complications rate. In all, 7210 patients of 20 randomized controlled trials and 17 cohort studies were included. Surgery had a significantly lower recurrence rate compared to other treatments. Besides, bullectomy (BT) combined with chemical pleurodesis (CP), mechanical pleurodesis, or staple line coverage (SLC) can reduce the recurrence rate compared to BT alone, but none of them were statistically significant. In terms of reducing chest tube duration, BT with tubular Neoveil outperformed BT + pleural abrasion (mean difference [MD], 95% confidence interval [CI]: -2.5 [-4.63, -0.35]) and BT + apical pleurectomy (MD, 95% CI: -2.72 [-5.16, -0.27]). Surgical methods were superior to manual aspiration (MA), chest tube drainage (CTD), and conservative treatment in terms of recurrence reduction. There was no significant difference between MA and CTD in reducing the recurrence rate. Among surgical methods, CP is more effective than mechanical pleurodesis and SLC among the additional procedures based on BT.

The Treatment Results in Patients with Aluminum Phosphide Toxicity Admitted to Razi Hospital in Ahvaz

Introduction: Aluminum phosphide (ALP), locally known as "Rice Tablet", is a cheap and powerful pesticide used frequently to protect cereals. Cases of ALP toxicity have grown dramatically in recent decades by using it for suicide purposes. Treatment of ALP toxicity is largely supported by various remedies as there is no specific antidote. This study deals with the epidemiology of ALP toxicity in Khuzestan (Iran) and assesses the clinical and paraclinical manifestations, as well as the results of various treatments during the last 12 years. The study further examines the next suicidal intentions and subsequent complications of poisoning with ALP. Methodology: The records of all patients with ALP toxicity admitted to Razi Hospital in Ahvaz from 2006 to 2017 were reviewed within a retrospective study. Epidemiological and demographic information, clinical and paraclinical manifestations, and the results of various treatments were extracted. Data on the subsequent complications and the next suicidal intentions in those who have survived a suicide attempt were gathered and analyzed. Results: Of the 48 patients studied, 50% were male and the mean age was 29.33±10.45. Most of the toxicities were orally and with the intention of suicide in Ahvaz and Andimeshk. A total of 71.42% of the dead have been carried to this center. The majority of cases were reported from urban areas and in August and during summer. The most prevalent clinical signs were loss of consciousness, nausea, and vomiting. There were some differences in the experimental and EKG results. A meaningful correlation was observed between the administration and/or consumption of ranitidine, NAC, and intravenous sodium bicarbonate with treatment outcomes. Only one case of reattempt to suicide has been reported, and hematuria, ascites, and pleural effusion were widely visible in survivors. Conclusion: On-call counseling may decrease the rate of mortality in dispatching patients. Clinical and paraclinical manifestations can be useful in the diagnosis or prognosis. Patients' follow-up, actions to enhance public awareness, restrictions on the distribution of ALP, and availability of alternative substances can be helpful to diminish cases of ALP toxicity and/or death. Keywords: Aluminum phosphide (ALP), Rice tablets, Poisoning, Khuzestan

Complete Responses of Myeloid/Lymphoid Neoplasms with Rearrangement of Pdgfra Presenting As AML/ALL/Myeloid Sarcoma to Imatinib Monotherapy

Background Patients with eosinophilia and FIP1L1-PDGFRA fusion protein accounted for approximately 23% (range, 3%-56%) of hyper-eosinophilias. In the 2008 and 2016 WHO classification of myeloid neoplasms, myeloid/lymphoid neoplasms with rearrangement of PDGFRA have been categorized as a distinct type of hematopoietic disorders. Reported cases mostly exhibit normal or mildly elevated bone marrow blasts at diagnosis and imatinib monotherapy is sufficient to induce rapid and complete hematopoietic responses. Patients with rearrangement of PDGFRA but presenting as AML/ALL or myeloid sarcomas are rare and the efficacy of imatinib monotherapy in these patients remains undefined.Methods Two male patients were diagnosed as myeloid neoplasms with rearrangement of PDGFRA in our hospital in 2016. Patient One (aged 31) was presenting as myeloid sarcoma with a 6.9×3.3cm mass on his chest wall and was treated with chemotherapy plus imatinib. Patient Two (aged 25) was presenting as AML with a bone marrow blasts of 27% and was treated with imatinib monotherapy. A literature review searching for patients with PDGFRA rearrangement but presented as AML/ALL/myeloid sarcoma was performed and efficacy of imatinib monotherapy was explored.Results Both of the cases from our hospital survived. Patient One received two cycles of standard chemotherapy (MA and IA) but failed to reduce the tumor size. Imatinib (400mg/d) was initiated immediately. His tumor shrunk dramatically in one week and he achieved complete molecular remission (CMR) in 4 weeks. Patient Two receiving imatinib monotherapy achieved complete hematopoietic remission (CHR) in 1 month and CMR in 3 months after initiation of imatinib (400mg/d). Both patients remain CHR and CMR till now (8 months and 18 months, respectively). We combined our data with 24 cases found in literature that presented as AML/ALL/myeloid sarcoma at diagnosis. All 26 patients were male, and the median age was 40 years (range, 21 to 46). We further compared outcomes of patients treated with imatinib monotherapy or with chemotherapy/HSCT plus imatinib. Most cases in the latter group were given imatinib after chemotherapy induction due to persistent eosinophilia, unsatisfied regress of tumor mass, continued positivity of PDGFRA fusion gene, or disease relapse. The 3-year probabilities of overall survival (OS) were 87.5% for the monotherapy group and 80% for the plus chemotherapy/HSCT group, which were of no statistical significance (p=0.919). In each group there was one patient died from imatinib resistance caused by a mutation in the fusion gene.Conclusions We reported two rare cases of myeloid neoplasms with rearrangement of PDGFRA but presenting as AML/myeloid sarcoma at diagnosis and showed their excellent responses to imatinib. By pooling data in literature we suggest imatinib monotherapy was comparable to combination of chemotherapy/HSCT and imatinib in overall survival rate. To our knowledge, this is the first study to specifically explore outcomes of various treatments for this disease. The efficacy of imatinib monotherapy emphasized importance of FIP1L1-PDGFRA detection at diagnosis of hematopoietic malignancies with eosinophilias. DisclosuresNo relevant conflicts of interest to declare.

Clinico-epidemiological characteristics of hidradenitis suppurativa: A retrospective cohort study from a tertiary care centre in Northern India

Background:Hidradenitis suppurativa (HS) is a chronic debilitating disease with a relapsing and remitting course. Due to delay in diagnosis, patients are often referred when the disease is very severe. Management strategies vary across multiple guidelines.Aims:The aim of this study was to analyze the demographic and clinical characteristics of patients with HS among our outpatient attendees and to study the outcomes of various treatments offered.Methodology:This was a retrospective cohort study analyzing case files and photographic records of all patients diagnosed with HS, presenting to our tertiary care institute over 18 months.Results:A total of 22 patients (10 males and 12 females) of HS were studied with majority having Hurley stage 2 and 3 diseases. The most common site affected was axilla. Overweight and obese patients were 45.4% and 18.1%, respectively. Rifampicin–clindamycin combination or doxycycline was the first line therapy offered. Adalimumab was given in only two patients but could not be continued for long term due to financial issues. Surgery was performed in six patients. Procedures included wide local excision and deroofing which is left to heal by secondary intention. Least number of remissions and most satisfactory improvement was seen with a combination of antibiotics and surgery compared to medical treatment alone.Limitations:Retrospective nature and a single center study were the major drawbacks.Conclusion:Patients undergoing procedural intervention in addition to pharmacotherapy have best overall outcomes and involvement of a multidisciplinary team plays a key role, however a larger follow-up study is required.

GINGIVAL BIOTYPE- AN APPRAISAL IN THE ESTHETIC ZONE

The interface between the restoration and the gingival tissue seems to have a great influence on the final outcome of various treatments. Therefore, the aim of this study was to evaluate the correlation between different morphometric parameters with the thickness of buccal gingiva at the cemento- enamel junction. In 60 periodontally healthy subjects, the six maxillary anterior teeth were examined. Clinical parameters included the gingival thickness, crown width/crown length ratio (CW/ CL), gingival width (GW), papillary height and transparency of the periodontal probe through the gingival sulcus (TRAN). A positive correlation was found between the gingival thickness (GT) and the crown width/ crown length (CW/CL) ratio as well as the papillary height (PH). A weak negative correlation was found between the transparency of probe TRAN and gingival width (GW) with the gingival thickness (GT). Thus, crown form (CW/CL) and papillary height are helpful indicators to determine the gingival thickness at the cemento- enamel junction. The transparency of probe method is subjective and cannot be relied upon for clinical application.

Update on long-term outcomes for chronic rhinosinusitis in cystic fibrosis.

This article reviews the existing body of literature regarding long-term outcomes of various treatments for chronic rhinosinusitis (CRS) in the cystic fibrosis population. The management of CRS in cystic fibrosis involves a multitude of medical and surgical therapies. Despite their high usage amongst clinicians, corticosteroids and antibiotics currently have little outcome data supporting their use. There is emerging evidence demonstrating beneficial outcomes for DNAse mucolytics and molecular modulators of cystic fibrosis transmembrane conductor regulator (CFTR). Endoscopic sinus surgery (ESS) improves sinonasal outcomes in cystic fibrosis CRS; however, the benefit on pulmonary outcomes remains unclear. Successful management of CRS in cystic fibrosis requires multimodal and multidisciplinary care. The long-term outcome data is variable for different treatment modalities. There is recent evidence supporting the role of DNAse mucolytics, CFTR-targeting therapies, and ESS in management of cystic fibrosis CRS.

Clinical Results of Various Treatments for Retinal Capillary Hemangioma.

PurposeWe report the clinical outcomes of retinal capillary hemangioma (RCH) after the application of various treatments.MethodsWe performed a retrospective chart analysis of eight eyes treated for RCH between August 2009 and January 2018. During the follow-up period, the status and progression of the RCHs were checked by fundus photography, fluorescein angiography, and optical coherence tomography, and additional treatments were applied when necessary.ResultsThree of the five patients had bilateral RCH, and two had unilateral RCH. Six eyes received laser photocoagulation; two eyes received cryotherapy, and one eye received intravitreal Avastin injection. Three eyes each had intravitreal triamcinolone injection, subtenon triamcinolone injection, and intravitreal dexamethasone injection to control inflammation. Also, two patients took oral prednisolone, and one patient used prednisolone eye drops to control inflammation. Two eyes underwent vitrectomy and scleral buckling due to deterioration of the epiretinal membrane and vitreal traction, respectively. As a result of those treatments, the tumors were stable in five of the eight eyes. However, one eye is now in a pre-phthisis state, and one patient who refused treatment showed progression of the tumor, epiretinal membrane, and traction.ConclusionsBecause RCHs vary in size, the degree of inflammation, and symptoms, this disorder should be actively treated on a case-by-case basis. Fluorescein angiography should be used periodically to determine recurrence of the tumor or inflammation, and the appropriate treatment should be repeated as necessary. Moreover, regular systemic screening tests for von Hippel-Lindau disease should be performed in RCH patients to ensure that they have no abnormalities other than in the eye.

Surgical treatment of pulmonary oligorecurrence after curative resection for non-small-cell lung cancer.

The most appropriate therapeutic strategy for patients with pulmonary oligorecurrence after curative resection of non-small-cell lung cancer (NSCLC) is unclear; therefore, characterizing the results of various treatments for pulmonary oligorecurrence would be valuable. This study compared the prognosis of operative and non-operative treatment for pulmonary oligorecurrence after complete resection of NSCLC. Among 2230 patients from a prospective lung cancer database who underwent surgical resection between 2004 and 2014, 486 patients (22%) experienced recurrence, including 254 with pulmonary recurrence and 102 with pulmonary oligorecurrence (5 or fewer metastatic lesions). Post-recurrence survival (PRS) rates were compared between those who received operative or non-operative treatment, including chemotherapy, radiotherapy, chemoradiotherapy and best supportive care. Among 102 patients with pulmonary oligorecurrence, 41 patients received operative treatment and 61 received non-operative treatment (34 chemotherapy, 15 radiotherapy, 9 chemoradiotherapy and 3 best supportive care). The patients who received operative treatment were significantly younger at the first operation than those in the non-operative group and had better performance status, lower pathological T stage at the first operation, younger age at recurrence and fewer metastatic lesions. The median PRS was 46.4 months, and the 5-year PRS rates were 67% and 26% in the operative and non-operative groups, respectively. The multivariable analysis revealed that undergoing video-assisted thoracoscopic surgery at the first operation and receiving operative treatment for recurrence were independent prognostic factors for more favourable PRS. Operative treatment of pulmonary oligorecurrence after curative resection significantly prolonged the PRS in patients who underwent curative resection for NSCLC.

Clear cell acanthoma (CCA)-like lesions of the nipple/areola: A clinicopathological study of 12 cases supporting a nonneoplastic eczematous disease

Clear cell acanthoma (CCA) of the nipple/areola has been reported. The CCA-like histology more likely represents a feature of eczematous dermatitis of the nipple/areola. We reviewed cases of CCA-like lesions of the nipple/areola and compared them with classic CCA to clarify their relationship. The clinicopathological features of 12 cases of CCA-like lesions of the nipple/areola were compared with classic CCA. The literature on this condition was reviewed, and the results of various treatments were analyzed. CCA-like lesions of the nipple/areola were clinically different from those of classic CCA. Although they shared the glycogen-rich clear epidermal cells with neutrophilic exocytosis, dermal eosinophils appeared to be a distinctive feature. The anatomic site and association with atopic dermatitis suggested that CCA-like lesions of nipple/areola might represent a manifestation of atopic eczema involving nipple/areola. Topical steroids could be effective. This was a retrospective study with limited cases. Although CCA-like lesions of the nipple/areola shared histopathological features with classicCCA, their clinical changes were consistent with dermatitis. We propose to namethis condition CCA-like eczematous dermatitis of the nipple/areola.

The Need of Validated Disease-Specific Outcome Instruments for Spine Trauma.

This article focuses on patient-reported and clinician-reported outcome measures in spine trauma care. The measurement of the quality of care and functional and health-related quality of life outcomes of spine trauma patients has become increasingly important. However, no outcome instrument is specifically designed, validated, or universally adapted for this specific patient population. Issues specific to spinal trauma patients may not be adequately addressed by the instruments that are currently used in the literature and the daily clinical practice. The AOSpine Knowledge Forum Trauma initiated a project to develop and validate such instruments for spine trauma patients. To reflect the different perspectives of patients and the treating surgeons, 2 separate tools are being developed: the Patient Reported Outcome Spine Trauma (AOSpine PROST) and Clinician Reported Outcome Spine Trauma (AOSpine CROST). These tools hold promise, as useful instruments to measure the outcomes of spine trauma patients with and without neurological deficit, making it more feasible for clinical use as well. Treating surgeons around the world are encouraged to use the AOSpine PROST and AOSpine CROST in daily clinical practice and for research purposes to create and contribute to evidence-based and patient-centered care. Using the same outcome measures that are specifically developed and validated for traumatic spine injuries will allow us to compare the outcomes of various treatments in a valid and reproducible fashion. This contributes to a reduction of the ongoing controversies and providing the best treatments for our patients.

Starch Flocculation by the Sweet Potato Sour Liquid Is Mediated by the Adhesion of Lactic Acid Bacteria to Starch.

In the current study, we focused on the mechanism underlying starch flocculation by the sweet potato sour liquid. The traditional microbial techniques and 16S rDNA sequencing revealed that Lactobacillus was dominant flocculating microorganism in sour liquid. In total, 86 bacteria, 20 yeasts, and 10 molds were isolated from the sour liquid and only eight Lactobacillus species exhibited flocculating activity. Lactobacillus paracasei subsp. paracasei L1 strain with a high flocculating activity was isolated and identified, and the mechanism of starch flocculation was examined. L. paracasei subsp. paracasei L1 cells formed chain-like structures on starch granules. Consequently, these cells connected the starch granules to one another, leading to formation of large flocs. The results of various treatments of L1 cells indicated that bacterial surface proteins play a role in flocculation and L1 cells adhered to the surface of starch granules via specific surface proteins. These surface starch-binding proteins were extracted using the guanidine hydrochloride method; 10 proteins were identified by mass spectrometry: three of these proteins were glycolytic enzymes; two were identified as the translation elongation factor Tu; one was a cell wall hydrolase; one was a surface antigen; one was lyzozyme M1; one was a glycoside hydrolase; and one was an uncharacterized proteins. This study will paves the way for future industrial application of the L1 isolate in starch processing and food manufacturing.

Tratamientos para la remoción de antibacteriales y agentes antimicrobiales presentes en aguas residuales

The abundant use of emerging micro-pollutants and their inadequate final disposal have focused the attention of environmental authorities on the effects on the environment of antibacterial and antimicrobial agents discharged into bodies of water. Currently, several researches have focused their objectives on determining the efficiencies that different physical, chemical and biological treatments present to remove different pharmaceutical products including those mentioned above. This review includes results of various treatments at the microcosm, mesocosm and real scale level, which include the main experimental conditions in which the measurements are developed.

Analysis of fracture patterns from experimentally marrow-cracked frozen and thawed cattle bones

Pre-breakage treatment of bones affects fracture mechanics and bone-breakage patterns. Understanding the results of various treatments leads to a more objective interpretation of archaeological faunal assemblages. Little is known about the specifics of fracture pattern differences between frozen and thawed bone, which is important in the context of studying potential frozen meat caches. This study reports the results of experiments performing hammerstone bone-breakage on frozen and thawed cattle femora and humeri with the periosteum and a thin layer of muscle meat left intact. Results indicate that the frozen or thawed state of the bone influenced the extent and type of fracture and resulting fragments. These differences potentially allow for the macroscopic identification of frozen and thawed marrow-cracked bones from an archaeological assemblage or scavenging site.

THE EXPERIENCE OF TREATMENT OF MULTIPLE BASALIOMA IN GORLIN-GOLTZ SYNDROME

Цель – оценка клинической эффективности методов лечения множественной базалиомы при синдроме Горлина – Гольтца. Материал и методы. Проведен ретроспективный анализ результатов лечения различными методами у 23 больных с синдромом Горлина – Гольтца, наблюдательный период составил 25 лет. В зависимости от метода терапии были выделены 4 группы. В 1-й группе 18 пациентов получали лечение криодеструкцией, удалено 158 по- верхностных и язвенных базалиом T₁N₀M₀, T₂N₀M₀, T₃N₀M₀; во 2-й группе 5 пациентов получали фотодинамическую терапию, удалено 78 поверхностных, нодулярных и язвенных базалиом T₁N₀M₀, T₂N₀M₀, T₃N₀M₀; в 3-й группе 3 пациента получали лазероиндуцированную термотерапию, удалено 16 поверхностных базалиом T₁N₀M₀; в 4-й группе 5 пациентов получали наружную химиотерапию Мардил Селеном, удалено 18 поверхностных и язвенных базалиом T₁N₀M₀. В качестве источников излучения для проведения фотодинамической терапии и лазероиндуцированной термотерапии использовали лазерные установки с накачкой на парах меди и перестраиваемой длиной волны Металаз М1 и полу- проводниковый инфракрасный лазер ЛАМИ. Фотодинамическую терапию проводили с фотосенсибилизаторами Фотогем и Радахлорин. Pезультаты лечения и безрецидивный период оценивали ежегодно у всех больных в сроки до 5 лет после лечения. Результаты. После проведения криодеструкции выздоровление наступило у 83,3%, улучшение – у 16,7% больных с синдромом Горлина – Гольтца, излечены 153 базалиомы. Рецидивы в сроки от 1 до 3 лет отмечены у 16,7% пациентов, рецидивировали 9 базалиом. После фотодинамической терапии выздоровление наступило у 80%, улучшение – у 20% пациентов, излечены 73 базалиомы. Рецидивы в сроки от 1 до 3 лет отмечены у 20% больных, рецидивировали 2 базалиомы. После лазероиндуцированной термотерапии выздоровление наступило в 100% наблюдений, излечены 16 базалиом. Рецидивы в сроки от 1 до 2 лет зарегистрированы у 33% пациентов, рецидивировали 4 базалиомы. После наружной химиотерапии Мардил Селеном выздоровление наступило в 80%, улучшение – в 20% случаев, излечены 12 базалиом. Рецидивы в сроки от 1 до 3 лет отмечены у 20% больных с синдромом Горлина – Гольтца, рецидивировали 3 базалиомы. Заключение. Учитывая особенности заболевания и значительный арсенал средств и неинвазивных способов, ни один из предлагаемых методов лечения множественной базалиомы, ассоциированной с синдромом Горлина – Гольтца, не способен надежно предотвращать рецидивы болезни. Помимо радикального лечения необходимо проведение превентивной терапии ароматическими ретиноидами.