A synopsis of current practices in minimally invasive surgery for adult spinal deformity

To provide a comprehensive summary of the status, indications and developments in the use of minimally invasive surgery in the field of adult spinal deformity. This study was performed by expert review of literature which has been published and is indexed on PubMed. The most appropriate and recent articles were selected to obtain a consolidation of information and knowledge on use and benefits of minimally invasive surgery in adult spinal deformity. Various MIS techniques have been developed to perform the complex ASD surgeries. These include the transforaminal lateral interbody fusion (TLIF), percutaneous segmental fixation as well as the lateral body interbody fusion (LLIF). It is important for a surgeon to obtain a holistic view of current literature and recommended guidelines on the procedures available for ASD surgeries. Overall, minimally invasive spine surgery has resulted in less use of pain medicine, less blood loss, lower infection rates, less requirement for intensive care, less hospitalization, reduction in physiologic stress, reduction in complication rates, reduction in muscle atrophy and preservation of normal motion with fusion rates being as high as 80-95%. More articles consolidating the vast literature on minimally invasive spine surgery need to be published to allow a surgeon to effectively weight the benefits and drawbacks of it. More research needs to be performed to compare the efficacy of sub-types of minimally invasive spine surgery

Seasonal fluctuations of phlebotomines sand fly populations (Diptera: Psychodidae) in the Moulay Yacoub province, centre Morocco: Effect of ecological factors

An entomological survey of phlebotomine sand flies was conducted in the Moulay Yacoub province, central Morocco. An anthropic niche (Ouled Aid) and a wild niche (Zliligh) were selected. Sand flies were collected twice a month between April 2011 and March 2012, using sticky traps and CDC light traps. 3675 specimens were collected (78.3% males/21.7% females) which composed of eight species divided into two genera: Phlebotomus (90.34%), wide Phlebotomus papatasi (49.78%), Phlebotomus sergenti (27.17%), Phlebotomus longicuspis (13.69%), Phlebotomus pernicuosis (9.36%) and Sergentomyia (9.66%) composed of Sergentomyia fallax (52.36%), Sergentomyia minuta (34.26%) Sergentomyia antennata (11.16%) and Sergentomyia dreyfussi (2.22%). P. papatasi is dominant in the anthropic niche and P. longicuspis is dominant in the wild niche. The population dynamics showed a bimodal pattern with a first peak in June for both studied stations and a second one in September for Ouled Aid and in August for Zliligh. A significant positive correlation between the density and the temperature(r = 0.64, r = 0.66) and a significant negative correlation with humidity (r = -0.64, r = -0.62) are shown. Density (119 specimens/m2/night) of sand flies showed that Moulay Yacoub’s province presents a risk for the inhabitants in the vicinity of Fez. This situation requires continuous monitoring to prevent and reduce the leishmania risk.Key words: Sand flies, leishmaniasis, seasonality; risk period, Moulay Yacoub, Morocco

Separation of variables in perturbed cylinders

We study the Laplace operator subject to Dirichlet boundary conditions in a two-dimensional domain that is one-to-one mapped onto a cylinder (rectangle or infinite strip). As a result of this transformation the original eigenvalue problem is reduced to an equivalent problem for an operator with variable coefficients. Taking advantage of the simple geometry we separate variables by means of the Fourier decomposition method. The ODE system obtained in this way is then solved numerically yielding the eigenvalues of the operator. The same approach allows us to find complex resonances arising in some non-compact domains. We discuss numerical examples related to quantum waveguide problems.Comment: LaTeX 2e, 18 pages, 6 figure

Muscle force contributions to anterior cruciate ligament loading

Anterior cruciate ligament (ACL) injuries are one of the most common knee pathologies sustained during athletic participation and are characterised by long convalescence periods and associated financial burden. Muscles have the ability to increase or decrease the mechanical loads on the ACL, and thus are viable targets for preventative interventions. However, the relationship between muscle forces and ACL loading has been investigated by many different studies, often with differing methods and conclusions. Subsequently, this review aimed to summarise the evidence of the relationship between muscle force and ACL loading. A range of studies were found that investigated muscle and ACL loading during controlled knee flexion, as well as a range of weightbearing tasks such as walking, lunging, sidestep cutting, landing and jumping. The quadriceps and the gastrocnemius were found to increase load on the ACL by inducing anterior shear forces at the tibia, particularly when the knee is extended. The hamstrings and soleus appeared to unload the ACL by generating posterior tibial shear force; however, for the hamstrings, this effect was contingent on the knee being flexed greater than ~ 20° to 30°. The gluteus medius was consistently shown to oppose the knee valgus moment (thus unloading the ACL) to a magnitude greater than any other muscle. Very little evidence was found for other muscle groups with respect to their contribution to the loading or unloading of the ACL. It is recommended that interventions aiming to reduce the risk of ACL injury consider specifically targeting the function of the hamstrings, soleus and gluteus medius

Histoplasmosis in an immunocompetent host: a rare case report

Histoplasmosis, a systemic mycosis caused by Histoplasma capsulatum manifests clinically in immunocompromised patients as acute or chronic pulmonary infection or as a progressive disseminated disease. In immunocompetent hosts, the disease is usually self-limited or presents as flu-like symptoms. It is endemic in North, Central and South America as well as parts of Europe and Africa. We report a case of a 76-year-old diabetic, HIV negative patient who presented with white nodular patches on the tongue and gingiva which were reported as histoplasmosis on histopathology. He also had idiopathic CD4 lymphocytopenia and thrombocytopenia

Non-autonomous stochastic evolution equations and applications to stochastic partial differential equations

In this paper we study the following non-autonomous stochastic evolution equation on a UMD Banach space $E$ with type 2, {equation}\label{eq:SEab}\tag{SE} {{aligned} dU(t) & = (A(t)U(t) + F(t,U(t))) dt + B(t,U(t)) dW_H(t), \quad t\in [0,T], U(0) & = u_0. {aligned}. {equation} Here $(A(t))_{t\in [0,T]}$ are unbounded operators with domains $(D(A(t)))_{t\in [0,T]}$ which may be time dependent. We assume that $(A(t))_{t\in [0,T]}$ satisfies the conditions of Acquistapace and Terreni. The functions $F$ and $B$ are nonlinear functions defined on certain interpolation spaces and $u_0\in E$ is the initial value. $W_H$ is a cylindrical Brownian motion on a separable Hilbert space $H$. Under Lipschitz and linear growth conditions we show that there exists a unique mild solution of \eqref{eq:SEab}. Under assumptions on the interpolation spaces we extend the factorization method of Da Prato, Kwapie\'n, and Zabczyk, to obtain space-time regularity results for the solution $U$ of \eqref{eq:SEab}. For Hilbert spaces $E$ we obtain a maximal regularity result. The results improve several previous results from the literature. The theory is applied to a second order stochastic partial differential equation which has been studied by Sanz-Sol\'e and Vuillermot. This leads to several improvements of their result.Comment: Accepted for publication in Journal of Evolution Equation

An in vitro-identified high-affinity nucleosome-positioning signal is capable of transiently positioning a nucleosome in vivo

<p>Abstract</p> <p>Background</p> <p>The physiological function of eukaryotic DNA occurs in the context of nucleosomal arrays that can expose or obscure defined segments of the genome. Certain DNA sequences are capable of strongly positioning a nucleosome <it>in vitro</it>, suggesting the possibility that favorable intrinsic signals might reproducibly structure chromatin segments. As high-throughput sequencing analyses of nucleosome coverage <it>in vitro </it>and <it>in vivo </it>have become possible, a vigorous debate has arisen over the degree to which intrinsic DNA:nucleosome affinities orchestrate the <it>in vivo </it>positions of nucleosomes, thereby controlling physical accessibility of specific sequences in DNA.</p> <p>Results</p> <p>We describe here the <it>in vivo </it>consequences of placing a synthetic high-affinity nucleosome-positioning signal, the 601 sequence, into a DNA plasmid vector in mice. Strikingly, the 601 sequence was sufficient to position nucleosomes during an early phase after introduction of the DNA into the mice (when the plasmid vector transgene was active). This positioning capability was transient, with a loss of strong positioning at a later time point when the transgenes had become silent.</p> <p>Conclusions</p> <p>These results demonstrate an ability of DNA sequences selected solely for nucleosome affinity to organize chromatin <it>in vivo</it>, and the ability of other mechanisms to overcome these interactions in a dynamic nuclear environment.</p