Peripheral Bones Research Articles

“Histopthological Spectrum Of Leprosy In A Tertiary Care Centre”

Background: Leprosy affects skin and peripheral nerves, muscles, eyes, bones, testis and internal organs. Histopathology and demonstration of lepra bacilli is a vital role to supplement clinical examination and diagnosis for correct classification and therefore for patients treatment. Aim- To study the Histopathology spectrum of Leprosy in a tertiary care centre. Materials &Methods: All the skin biopsy with clinically suscipious of leprosy and sent for histopathological examination during the year Jan 2020 to Dec 2024 were included in the study. Results: A total of 60 cases were studied out of them 61% are male and 39% are female. With M:F ratio1.56: 1, majority of them belongs to 41-50 age group. The commonest histological type was borderline TB leprosy followed by Borderline lepromatous leprosy, least common cases were of lepromatous leprosy and histoid leprosy. Conclusion: Histopathological examination is the important investigation for accurate diagnosing and typing of leprosy

Insights into the shell microstructure of Bauruemys elegans and other pelomedusoids from the Cretaceous and Paleogene of Brazil, including first Testudines material from Jangada Roncador Village, Paraná Basin

Pelomedusoides and Chelidae are groups of pleurodiran turtles that have evolved from the Cretaceous period to the present. In this study, we carried out thin sections in shell elements (including costal, neural, peripheral and xiphiplastron bones) from Bauruemys elegans, an undetermined Podocnemididae taxon, and shell fragments of other pelomedusoids from Upper Cretaceous and Paleogene sedimentary deposits. We explored and discussed shell microstructures and microanatomy data of these extinct pelomedusoids alongside two extant pleurodires, Podocnemis unifilis and Phrynops sp. Our study of costo-neural bones reinforces the hypothesis that the turtle carapace originated endoskeletally from ribs and vertebral arches. Our osteohistological examination of these shell bones suggests an aquatic to semi-aquatic lifestyle for the studied extinct Pelomedusoides. Notably, all examined bones show high bone compactness, a feature often associated with terrestrial life, although it is not exclusive to such a lifestyle. Additionally, our comparative analysis reveals greater shell compactness in Podocnemididae compared to the other specimens sampled. These findings contribute to our understanding of the environmental interactions of these pleurodires.

Detecting Associations Between Body Mass Index and Bone Mineral Density in Patients with Fractures of Different Localizations

Introduction . Osteoporosis is a multifactorial metabolic disease that increases the risk of bone fracture because of reduced bone mineral density. The International Osteoporosis Foundation estimates that about 200 million people are affected by osteoporosis. Therefore, it is relevant to develop clinical and diagnostic methods that would make it possible to effectively predict fracture risks in different parts of the skeleton and, based on population studies, to accurately predict the course of the disease. Aim . To study the levels of body mass index and bone mineral density in men and women with fractures of different localizations. Materials and methods . 828 postmenopausal women (61.94 ± 7.98 years) and 496 men over 50 years (62.03 ± 10.83 years) were examined. Bone mineral density (BMD) was measured by means of two-phase Dual-energy X-ray absorptiometry (DEXA) using QDR 4500A (Hologic, USA) in standard locations. Body mass index (BMI) was also assessed. Results and discussion . The study has revealed associations between BMI and peripheral bone fractures, BMD of the lumbar vertebrae and fractures of the peripheral bones and spine, BMD of the femoral neck and fractures of this localization in women. In men, associations were revealed between BMI, BMD of the lumbar spine and fractures of all localizations, as well as between BMD of the femoral neck and spinal fractures and concomitant fractures. Conclusion . In women, a decrease in BMD of the femoral neck enhances the risk of fractures in general, BMD of the lumbar spine — only the risk of fractures of this localization. In men, a decline in BMD of both the lumbar spine and the femoral neck increases the risk of fractures of various localizations. Reduced BMI enhances the risk of fractures in general in both men and women.

Peculiarities of the detection and course of the pediatric extrapulmonary tuberculosis taking into account drug resistance

Abstract Pediatric tuberculosis is a health problem of special significance because it is a marker for current transmission of tuberculosis in society. The research aimed at analyzing the peculiarities of detection and course of pediatric extrapulmonary tuberculosis (EPTB) taking into account the profile of drug resistance. A retrospective study of medical charts of children with EPTB (n = 47; 1st group) and pulmonary tuberculosis (PTB) (n = 49; 2nd group) aged 0-15 for 2013-2020 has been conducted. 2 subgroups with EPTB were identified separately: resistant (EPRTB) (n = 23) and sensitive (EPSTB) (n = 24). Results and discussion. The frequency of EPTB was 9.8%. Tuberculosis of peripheral LN (40.5%), CNS (27.7%), bones and joints (23.4%) was significantly more often diagnosed, than other lesions. Almost half of children with EPTB had a miliary distribution. In 44.7% of children with EPTB contact with a patient with tuberculosis was not established. EPRTB was significantly more common among children under 1 and up to 3 years of age than EPSTB. The resistance to combination of HR (73.6%) was found more often than to HRES (10.5%), HRS, H and Z (5.3% each; p<0.01). In 73.9% of children with EPRTB was detected when seeking medical care, in 13.0% the time to diagnosing lasted 6 months. Among children with EPRTB, gradual course was more frequent and in 47.8% intoxication syndrome was dominating. 78.3% of children with EPRTB were not vaccinated. Conclusion. The above indicates the need to intensify preventive measures against tuberculosis among children, especially at risk groups, make monitoring of contacts and their treatment.

The skeletal taphonomy of anurans from the Eocene Geiseltal Konservat‐Lagerstätte, Germany: insights into the controls on fossil anuran preservation

AbstractThe Geiseltal biota is an Eocene lacustrine Konservat‐Lagerstätte in central Germany. Despite its rich fauna and flora (over 50 000 fossil vertebrates, insects and other invertebrates, plants and trace fossils) the taphonomy of the biota, and of the anurans in particular, is poorly understood. We analysed the skeletal taphonomy of 168 anurans, scoring each specimen for orientation, completeness and articulation. Most are partial skeletons, truncated during preparation. This process introduces measurable artefacts into the taphonomic data, which requires further study. We identified recurring taphonomic states, including disarticulation or loss of abdominal bones, loss of one or more limbs, extensive disarticulation, and extensive loss of elements across the body. Relatively rare states include: loss of distal limb elements only, scattered bones, and isolated, articulated limbs. These data inform a new taphonomic model for the Geiseltal anurans. Comparative analysis of patterns in completeness and articulation in these specimens and anurans from other Cenozoic Lagerstätten reveals repeated patterns in preservation in lacustrine‐hosted settings, such as proximal to distal trends in completeness, preferential loss of small peripheral bones, disarticulation of abdominal bones, and reorientation of major body regions. Taphonomic controls in lacustrine systems are surface water temperature, lake depth, vegetation, exposure to bottom currents, transport mechanisms, scavenging, decay regime, bone size and location in the skeleton; all ultimately controlled by palaeoclimate, lake physiography and hydrology, and anuran anatomy. A universal approach to quantitative analysis of skeletal taphonomy metrics will enable comparative testing of the relationship between preservation and palaeoenvironment for diverse fossil vertebrates.

Treatment of osteoporosis in clinical practice: first experience with the Russian generic drug of zoledronic acid

Objective: to evaluate the effect of the generic drug of zoledronic acid on bone mineral density (BMD) and markers of bone metabolism in patients with osteoporosis (OP), as well as possible long-term adverse reactions (AR) 12 months after drug administration.Patients and methods. The study included 30 postmenopausal women with OP (mean age 64±8 years) who signed an informed consent of participance in clinical observation. Patients received a single dose of generic zoledronic acid (5 mg) as a 15-minute infusion. All patients additionally took calcium and vitamin D. The dynamics of BMD and bone metabolism markers, as well as the safety and tolerability of the drug, were evaluated. Fractures that might have occurred during follow-up should have been reported as ARs.Results and discussion. During treatment with generic zoledronic acid, the increase in BMD in the lumbar region was 4.9% (p<0.0001), in the femoral neck –2.7% (p<0.01), and in the femur as a whole – 3.0% (p<0.0001). Positive dynamics (increase in BMD>2%) in the spine was detected in 26 (86.7%) patients, in the proximal femur – in 20 (66.7%) patients. There was a decrease in the intensity of pain in both the thoracic (by 62%; p=0.038) and lumbar (by 29%; p=0.022) spine. Three months after the administration of the drug, a decrease in the level of bone metabolism markers was revealed: CTX – by an average of 29.7%, and P1NP – by an average of 25.5%. ARs were post-dose reactions that occurred within the first 48 hours after drug infusion. Remote ARs, fractures of peripheral bones and vertebrae were not recorded.Conclusion. The use of the generic drug of zoledronic acid has demonstrated its positive effect on BMD and markers of bone metabolism, as well as safety.

DUPLICATE: Osteoplasty, fixation, and ablations in peripheral bones: It is time for interventional radiologists to move forward

Bone metastases occur in about 40% of all patients with cancer. This substantial proportion reflects the significant challenge faced by patients and clinicians as well as the need for treatment advancements, particularly since life expectancy has increased due to the introduction of precision medicine. The primary goal of treatment of these patients is to alleviate symptoms while the secondary goal is to maintain or restore patient function. As patients often experience pain with conservative management of this condition, which impacts quality of life and can lead to reduced mobility, depression, and anxiety, interventional radiologists (IRs) have recently been successfully integrated into the standard treatment team alongside surgeons and radiation oncologists.

Coexistence of Sjögren syndrome in patients with synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: A retrospective observational study.

To identify the prevalence and clinical characteristics of Sjögren syndrome (SS) in a Chinese single-center cohort of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome.Patients diagnosed with SS were screened out from a cohort of 164 cases of SAHPO syndrome. Information regarding the patients’ gender, age at onset, clinical features, laboratory tests, bone scintigraphy, and treatment was reviewed.Five patients were screened out. The prevalence of SS in SAPHO patients was 3.05% The mean onset age of SS was 48.0 ± 12.0 years old and no apparent time order in the occurrence of SAPHO and SS was observed. Compared with the general SAPHO cohort, the 5 SS patients exhibited no significant difference in the SAPHO related clinical features or inflammatory markers, except for a higher prevalence of peripheral joints and bones involvement in bone scintigraphy. Objective evidence of dryness and positive salivary gland biopsy were found in all the patients. However, the positive rates of SSA and SSB antibody were only 20%. Anti-inflammatory treatment for SS was recorded in 3 patients (ESSDAI score: 3 in 2 patients; 12 in 1 patient) with extra-glandular manifestations, severe complications or poor response to the basic treatment.The prevalence of SS is higher in the SAPHO cohort than in the general Chinese population. Objective tests or biopsy might be more indicative than the antibody detection for SS diagnosis. Anti-inflammatory treatment should be prescribed in consideration of both the severity of SS and the demand for disease activity control of SAPHO.

Clinical features of the disease course in patients with solitary plasmacytoma and extramedullary multiple myeloma

Objective: to study the clinical laboratory features of the course of solitary plasmacytoma (SP) and extramedullary multiple myeloma (EMM).Material and methods. The study included 42 people (22 patients newly diagnosed with EMM and 20 patients diagnosed with SP of various localization). The results were evaluated after 3 years of the study. The median age in the SP group was 61.5 years, in the EMM group — 65 years.Results. A comparative analysis of the SP and EMM groups in terms of the clinical and laboratory parameters has found no statistical differences in the distribution of immunochemical variants. Significant differences were found in the frequency of determination of the abnormal ratio of immunoglobulin light chains (p = 0.046).In EMM, extramedullary lesions were the most common for patients with multiple lytic bone lesions of the skeleton. SP was the most frequently detected in lesions of the peripheral skeletal bones and vertebral bodies.Clinically, EMM was characterized by a more aggressive course if additional factors of an unfavorable prognosis (translocations, mutations) or unfavorable immunophenotypic markers (a combination of signs — expression of markers CD56 > 20 % and CD95 < 20 %) were identified or if the disease had been diagnosed at a young age.The presence of even a minimal number of tumor or aberrant plasma cells in the bone marrow of SP patients, an abnormal ratio of immunoglobulin light chains, paraprotein detected in blood serum or urine were all poor prognostic factors.Conclusion. The clinical course of SP and EMM combined with a young age, the presence of translocations or mutations, unfavorable immunophenotypic markers, is characterized by an increased frequency of progression or the development of resistance to the performed therapy.

Pilot study of bone tissue reparative regeneration of the young Trachemys scripta shell

The turtles skeleton plan is an evolutionary developmental novelty in connection with the formation of a tortoise-specific carapacial ridge, which induces the growth of ribs in the dorsal direction and the subsequent formation of several carapace plates. The bone plates of these reptiles have different histogenesis: the neural and costal plates develop according to the mechanism of indirect osteogenesis by perichondral ossification of the axial skeleton elements (vertebrae and ribs), the peripheral and plastron bones develop according to the mechanism of direct osteogenesis in the dermis of the skin - these are the so-called «skin bones», which are derived from individual osteogenic cells outside the axial skeleton and develop by intramembranous osteogenesis. An experiment was carried out to study the post-traumatic osteogenesis of the carapace bone plates on a freshwater turtles Trachemys scripta at the age of 3 months. Two defects of carapace costal plates with a diameter of 4 mm and a depth to the fascia were performed with further routine histological examination. It was found that already on the 90th day the turtles carapace bones were restored with the formation of a full-fledged bone regenerate by the mechanism of indirect osteogenesis.

Computed tomography characteristics of multiple myeloma and other osteolytic metastatic bone lesions.

Differentiation of multiple myeloma (MM) from osteolytic metastatic (OM) bone lesions may be critical in patients with lytic bone lesions but can be challenging for radiologists. To determine whether computed tomography (CT) can be used to distinguish between MM and other OM bone lesions. In this retrospective study, 320 lesions of 207 patients diagnosed with MM or OM, based on biopsy or clinical examination, were evaluated. Eight qualitative features were evaluated by two radiologists blinded to the diagnoses. The chi-square and Fisher exact tests, and logistic regression analysis, were used to evaluate the relationships between the CT findings and diagnoses. High-density areas were more common in OM than MM lesions (85.2% and 19%, P < 0.001), as were perilesional sclerosis (38.9% vs. 13.2%, P < 0.001), heterogeneity (on non-contrast CT images, 60% vs. 19.1%, P < 0.001; on contrast enhanced CT images, 80.6% vs. 28.2%, P < 0.001), and ill-defined margins (34.6% vs. 9.1%, P < 0.001). Similarly, OM lesions showed high-density areas more than MM in evaluation of skeletal system subgroups (vertebrae, 93.8% vs. 29.8%, P < 0.0001; thoracic cage bones, 69.6% vs. 19.2%, P < 0.001; pelvic bones and sacrum, 84.8% vs. 7.7%, P < 0.001; peripheral skeletal bones, 81.5% vs. 8.3%, P < 0.001). Logistic regression analysis revealed that the presence of a high-density area in the lesion increased the probability of a metastasis 25.88-fold (R2 = 0.516, P < 0.001). MM and OM lesions can be differentiated by CT; OM lesions exhibit high- density areas.

Clinical characteristics of pediatric synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome: the first Chinese case series from a single center.

Pediatric SAPHO syndrome is regarded as the equivalent of chronic recurrent multifocal osteomyelitis or chronic non-bacterial osteomyelitis. This study aimed to evaluate the clinical features and treatment options for Chinese pediatric patients with SAPHO syndrome. We conducted a single-center, retrospective study on a sample of 24 pediatric patients with SAPHO syndrome who were diagnosed at Peking Union Medical College Hospital from April 2014 to August 2018. The demographic, clinical, laboratory, imaging, histological, and therapeutic data were collected and analyzed. A total of 15 boys and 9 girls were included. The mean age of onset of bone and skin symptoms was 11.7 ± 3.8 and 14.4 ± 2.7years, respectively. The mean follow-up period was 39.2months. Seventeen patients had skin manifestations (46% had severe acne, 100% were boys; 21% had palmoplantar pustulosis, 100% were girls). Bone lesions were localized in four of the following major regions: anterior chest wall (42%), mandible (29%), peripheral bones (50%), and spine and sacroiliac joints (21%). Six patients had been treated with non-steroidal anti-inflammatory drugs, 10 with bisphosphonate, 10 with a tumor necrosis factor-α antagonist, and 1 with glucocorticoids, with variable responses. A total of 70% of the patients had complete remission after bisphosphonate or TNF-α antagonist therapy. Pediatric patients with SAPHO syndrome have different characteristics from other cohorts in the sex ratio, frequency of mandibular involvement, and sex distribution of skin lesions. Bisphosphonate and TNF-α antagonists show a favorable response in pediatric SAPHO syndrome treatment. Key points •Being the first study that describes an Asian pediatric SAPHO case series. •Chinese pediatric patients with SAPHO syndrome have different characteristics from Chinese adult patients and Caucasian pediatric patients.

The results of modeling the physical processes of interaction of a pneumatic tire with a supporting surface to determine the forces acting in the contact patch

The article presents the results of modeling the physical processes of the interaction of a pneumatic tire with a supporting surface in order to determine the forces acting in the contact spot. This justifies and develops a diagram of a generalized model of a Simulink car wheel, presents a Simulink circuit block for a mathematical model of a car wheel. Simulink circuit blocks are used for calculating displacements of the reaction application point for calculating the reaction point, the absolute speed and angle of rotation of the wheel, the force, angular and peripheral wheel rotation bones and rolling resistance forces.

Клинико-функциональные особенности и проблемы реабилитации больных остеопорозом пожилого возраста в сочетании с сопутствующей патологией

Osteoporosis is one of the most common metabolic diseases of the skeleton that develops with age. Close attention to osteoporosis is explained by its high pre-valence, as well as often severe medical, social and economic consequences, in the form of fractures of the vertebrae and peripheral bones, which lead not only to disability, but also high mortality, especially among elderly patients. To date, there is no unified and clear method of treatment and rehabilitation of patients of older age groups, taking into account their clinical and functional characteristics against the background of concomitant diseases. As a result, many patients do not receive the treatment they need, or the effect of treatment is often lower than expected. Aim. To analyse of clinical and functional characteristics, quality of life and the main directions of rehabilitation of elderly patients with osteoporosis in combination with concomitant pathology in the form of impaired carbohydrate metabolism. Materials and methods. The study included 188 elderly patients diagnosed with osteoporosis. The control methods were general clinical examination, ECG and 24-hour ECG monitoring, ECHO CG, analysis of BMD using dual-energy X-ray absorptiometry – densitometry (dualenergy X-ray absorbtiometry – DXA). Assessment of the degree of development of the atherosclerotic process by ultrasonic duplex scanning (USDS). In order to determine the structural and functional state of the abdominal organs, all patients underwent ultrasound examination. All patients were examined by related specialists: an ophthalmologist, neurologist, cardiologist. To diagnose diabetic neuropathy, the following diagnostic scales were used: the Neuropathy Symptom Score (NSS). The quality of life (QOL) of pa-tients was assessed using the MOS SF-36 questionnaire (modified version for Russia). Results. The features of the clinical picture of osteoporosis, complicated and not complicated by pathological fractures of various localization, are highlighted, taking into account the age characteristics of patients and the influence of concomitant pathology. Difficulties in the treatment and rehabilitation of patients with osteoprosis and its consequences, accompanied by limitation of physical activity, pain syndrome, psychoemotional disorders, resulting in a decrease in the quality of life, are described. Conclusion. Modern methods of treatment and rehabilitation provide great opportunities for restoring working capacity and significantly improving the quality of life in patients with osteoporosis and its consequences. However, existing programs of treatment and rehabilitation should be developed individually, taking into account age, severity of structural and functional disorders, as well as the presence and severity of concomitant diseases.

Characterized Organic Pollutants and Their Health Effects in Sampled Groundwater Around Ilorin Metropolis

The study was aimed at determining the possible volatile organic compounds present in groundwater from hand-dug wells within and around filling stations across Ilorin metropolis as well as to ascertain the possible sources of the contaminants and their health effects. Water samples were obtained from twenty-six (26) wells that were found within the scope of stations above the age of 15 years and functioning with underground storage tank capacities of over 33,000 L each for different petroleum products stored above the water level. Laboratory analysis to determine volatile organic compounds and their concentrations were carried out using the gas chromatography- mass spectrophotometer (GC-MS) after prior extraction of hydrocarbon from the water samples by the Liquid-Liquid Extraction (LLE) method. The result revealed a total of fifty-three (53) VOCs across samples where nonanal, dodecane, methyl palmitate, heptanophenone, 13, hexyloxacyclotridec – 10 – en – 2 – one, cyclohexane, octyl, decahydro- 4, 4, 8, 9, 10 – pentamethyl naphthalene, (z) – 3 – heptene, were the most frequently occurring compounds, which could be traced to anthropogenic activities involving the use of paints, detergents, stain removers, leaking underground storage tanks, piped networks containing petroleum products as the possible sources of release into the environmental media. Related health impacts from exposure to these contaminants includes brain damage, cancer, tumours, anaemia, central and peripheral nervous system breakdown, liver, bones, autism, Skin, eye, and nose irritation, headache, dizziness, narcosis, and death at high levels of exposure. The study concluded that groundwater sources at close proximity to filling stations are susceptible to contamination through activities in the stations and such water resource should be treated before consumption and use to avoid negative health effects.

MDCT-QCT, QUS, and DXA in healthy adults: An intermodality comparison.

Background: Cortical deceleration is the main reason for bone loss at peripheral sites. It was suggested that when peripheral bones were assessed for osteoporosis, management and therapy can be administered early. The main aim of this study was to assess the relationships between the central and peripheral measurements at different skeleton bone sites (spine, femur, forearm, tibia, and calcaneus) with available modalities: DXA, QUS, and MDCT-QCT. Methods: The volunteers recruited in this study did not have any history or evidence of metabolic bone disease. Blood test and DXA measurements were used as inclusion criteria to select 40 healthy participants. The selected volunteers underwent 3 imaging modalities: QCT, DXA, and QUS. DXA-based measurements were made on 3 sites, including spine, femur, and forearm. QCT and QUS measurements were done for distal of tibia and calcaneus bones, respectively. The extracted parameters from the 3 modalities were analyzed using a bivariate (Pearson) correlation (r) in statistical software. Results: The results showed moderate to good correlations between spongy bones in central and peripheral sites from all the modalities. However, there was no correlation between MDCT measures and central bone values. According to correlations between different peripheral sits, aBMD of 33% radius and trabecular vBMD in 38% distal tibia showed weak but significant relationship between peripheral bones (r=-0.342, p=0.044). Conclusion: The findings demonstrated how bones in central and peripheral sites were correlated. Multimodality imaging was used in this group of healthy volunteers. Also, it was found that QCT-based MDCT needs more optimization and requires further investigations.

Marrow adipose tissue gradient is preserved through high protein diet and bed rest. A randomized crossover study

ContextMarrow adipose tissue (MAT) has a peripheral to central distribution in adults, higher in peripheral bones. Similarly, the spine has a caudal to cephalad MAT distribution, higher in lumbar vertebras. Diet and the level of physical activities are known modulators of MAT with significant impact on bone; however, whether these can modulate the MAT gradient is unknown. ObjectiveTo measure the effect of high protein diet and bed rest interventions on the lumbar MAT gradient. Design, participants, interventionIn a prospective randomized crossover trial, 10 healthy men participated in 2 consecutive campaigns of 21days head-down-tilt-bed-rest (HDTBR). They received either whey protein and potassium bicarbonate-supplemented or control diet separated by a 4-month washout period. Main outcome measure(s)Ten serial MRI measures of lumbar vertebral fat fraction (VFF) were performed at baseline, 10days and 20days of HDTBR and 3 and 28days after HDTBR of each bed rest campaign. ResultsThe mean L5-L1 VFF difference of 4.2±1.2 percentage point higher at L5 (p=0.008) constituted a caudal to cephalad lumbar MAT gradient. High protein diet did not alter the lumbar VFF differences during both HDTBR campaigns (all time points p>0.05). Similarly, 2 campaigns of 21days of HDTBR did not change the lumbar VFF differences (all time points p>0.05). ConclusionsThis pilot study established that the lumbar vertebral MAT gradient was not altered by a high protein nor by 2×21days bed rest interventions. These findings demonstrated that this lack of mechanical stimulus was not an important modulator of the lumbar MAT gradient. The highly preserved MAT gradient needs to be measured in more situations of health and disease and may potentially serve to detect pathological situations.

New species of the long-necked chelid Yaminuechelys from the Upper Cretaceous (Campanian–Maastrichtian) of Chubut, Argentina

A new species of a long-necked chelid from the uppermost Cretaceous (Campanian–Maastrichtian) is presented in this contribution. Yaminuechelys sulcipeculiaris sp. nov. is found in outcrops of the La Colonia Formation in the northeast part of Chubut province, Argentina. This new species is mainly represented by carapacial, plastral, and postcranial remains (vertebrae and long bones). It was assigned to Yaminuechelys because it presents characters shared with the species Yaminuechelys gasparinii de la Fuente, Lapparent de Broin, and Manera de Bianco, 2001 and Yaminuechelys maior (Staesche, 1929). Those characters are a large shell with irregular polygons distributed on the external surface, the difference in length between the anterior and posterior peripheral bones, and the neural series separated from the suprapygal bones. Other characters, like the position of the sulcus between vertebral 5 and marginal 12 crossing the suprapygal and the location of the sulcus between the vertebral 5 and the marginal 11 crossing the costal 8 and suprapygal, suggest it is a new species. According to the phylogenetic analysis performed, the new species forms a monophyletic group together with Y. maior, and Y. gasparinii. The survival of Yaminuechelys to the K/Pg extinction event is also discussed.

A prospective study on management of polytrauma with early appropriate care

Introduction: The definition of polytrauma varies among different specialty and different countries, polytrauma patients are the subgroup of severely injured patients who have sustained injuries to more than one body region and organ with any one of the injury being life threatening. Early appropriate care (EAC), is an immediate resuscitative treatment protocol in orthopaedic trauma management in which we aim to feature any major trauma and address the most time critical injuries of body without adding to their physiological overload to the system. The aim of early appropriate care is to fix and stabilize the central skeletal system along with peripheral long bones of the skeletal system to reduce the risk of complications. Materials and Methods: It is a prospective observational study conducted from October 2016 to November 2017 and 29 patients in the study with a mean age of 35years. All patients were managed by Early Appropriate Care. The average time taken to resuscitate the patients was 8 hrs. Following surgery patients were followed up for one month to observe post operative complications. Results: In our series 3 patients developed pulmonary embolism, patients who developed complications were managed successfully without any mortality. Thus, a low incidence of mortality seems to be associated with EAC protocol in our series as well as in the existing literature. Conclusion: Following adequate resuscitation and correction of acidosis early definitive fixation is possible for bony injuries of polytrauma patients which avoids the need of second surgery, also reduces the hospital stay duration, reduces post operative complications and early rehabilitation protocols can be made. Keywords: Early appropriate care, EAC, Polytrauma management.

An untapped potential for imaging of peripheral osteomyelitis in paediatrics using [18F]FDG PET/CT\xa0\u2014the inference from a juvenile porcine model

PurposeTo examine parameters affecting the detection of osteomyelitis (OM) by [18F]FDG PET/CT and to reduce tracer activity in a pig model.Background[18F]FDG PET/CT is recommended for the diagnosis of OM in the axial skeleton of adults. In children, OM has a tendency to become chronic or recurrent, especially in low-income countries. Early diagnosis and initiation of therapy are therefore essential. We have previously demonstrated that [18F]FDG PET/CT is promising in juvenile Staphylococcus aureus (S. aureus) OM of peripheral bones in a pig model, not failing even small lesions. When using imaging in children, radiation exposure should be balanced against fast diagnostics in the individual case.MethodsTwenty juvenile pigs were inoculated with S. aureus. One week after inoculation, the pigs were [18F]FDG PET/CT scanned. PET list-mode acquired data of a subgroup were retrospectively processed in order to simulate and examine the image quality obtainable with an injected activity of 132 MBq, 44 MBq, 13.2 MBq, and 4.4 MBq, respectively.ResultsAll lesions were detected by [18F]FDG PET and CT. Some lesions were very small (0.01 cm3), and others were larger (4.18 cm3). SUVmax was higher when sequesters (p = 0.023) and fistulas were formed (p < 0.0001). The simulated data demonstrated that it was possible to reduce the activity to 4.4 MBq without compromising image quality in pigs.Conclusions[18F]FDG PET/CT localized even small OM lesions in peripheral bones. It was possible to reduce the injected activity considerably without compromising image quality, impacting the applicability of PET/CT in peripheral OM in children.