Staged Custom, Intramedullary Antibiotic Spacers for Severe Segmental Bone Loss in Infected Total Hip Arthroplasty

Introduction. Total hip arthroplasty (THA) infections with severe bone loss pose significant reconstructive challenges. We present our experience with two-stage hip reimplantation using an intramedullary, antibiotic-impregnated nail. Methods. Three patients with infected THA with severe proximal femoral bone loss (Mallory type IIIB or greater) were treated using a custom antibiotic spacer. Clinical outcomes and any complications were recorded. Average followup was 49 months from final reimplantation. Results. Mean age at spacer placement (stage 1) was 53 years. The mean Harris Hip Score at final followup was 80. Two patients had asymptomatic heterotopic ossification, and one patient had a 2 cm leg-length discrepancy. Conclusions. A custom intramedullary nail antibiotic spacer is a reliable option in the staged management of the infected THA with severe proximal femoral bone loss. Benefits of this technique include limb salvage with maintenance of leg length, soft tissue tension, and functional status

Perspectives of Zambian Clinical Oncology Trainees in the MD Anderson and Zambia Virtual Clinical Research Training Program (MOZART)

Published in The Oncologist, 2022;, oyac110, https://doi.org/10.1093/oncolo/oyac110 PMID 35689473https://openworks.mdanderson.org/mozart/1025/thumbnail.jp

Lysine Production of Microbacterium lacticum by Submerged Fermentation Using Various Hydrocarbon, Sugar and Nitrogen Sources

Abstract Bacterial isolation from oil-contaminated and uncontaminated soil was screened for hydrocarbon utilizer which was also capable of producing lysine. Microbial production of lysine by Microbacterium lacticum was investigated in submerged fermentations using various concentrations of hydrocarbon, sugar sources and nitrogen. Of the nine sugar and five nitrogen sources tested, glucose/ammonium sulphate proved optimum for lysine production. Effect of varying concentration of carbon and nitrogen sources on lysine accumulation showed that glucose (4%) ammonium sulphate (1%) respectively increased lysine production. A gram positive rod bacterium identified as Microbacterium lacticum was identified. Optimizing the cultural conditions of Microbacterium lacticum in submerged medium gave a methionine yield of 2.99 mg/ml lysine in the broth culture after 96 h

OPTIMIZED PRODIGIOSIN PRODUCTION BY SERRATIA MARCESCENS AND ITS ANTIMICROBIAL EFFECT

Serratia marcescens commonly synthesize a red pigment known as prodigiosin. Prodigiosin is considered a promising pharmaceutical due to its documented properties of having antimicrobial, anticancer, and immunosuppressive effects. This investigation involved the isolation of Serratia marcescens, a bacterium capable of producing prodigiosin, from grey water samples collected in Nnamdi Azikiwe University Awka campus, Nigeria. The central composite design (CCD) of the experiment was applied to generate a set of 31 experimental combinations to study the optimal conditions for pigment production using nutrient broth supplemented with glucose as a fermentation medium. A regression model that described the relationship between the test variables for optimum prodigiosin yield was developed. The regression coefficient (R2) value of 72.48% implied adequate model fitness. The optimal conditions identified were 24 g/L glucose concentration, pH 7.2, 2.4 mL inoculum size, and 180 rpm agitation speed. A 4.25-fold increase in prodigiosin yield was recorded in optimized condition than in unoptimized condition. Antimicrobial activity against E. coli and Candida albicans shows that prodigiosin has significantly higher activity than the conventional antibiotics tested. Our results indicate that prodigiosin production by Serratia marcescens can be enhanced using statistical models, and the pigment can be an alternative to conventional antibiotics for treating microbial infections

The Impact of Mental Illness Stigma on People Diagnosed With Schizophrenia: An Analysis of Factors Contributing to Black-White Disparities in Schizophrenia Outcomes

Background: Schizophrenia spectrum and other psychotic disorders pose significant challenges and impairments, with Black individuals disproportionately affected by these conditions. Racial disparities in schizophrenia diagnosis, treatment, and outcomes are well-documented, yet the underlying mechanisms remain poorly understood. This study addresses the potential contribution of mental illness stigma to these disparities by examining its impact on treatment-seeking behavior, substance use as a means of aversive coping, and overall psychological wellbeing among Black people diagnosed with schizophrenia spectrum and other psychotic disorders (PDWS).Methods: Data from the Recovery After Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP), a cluster randomized control trial conducted from 2009 to 2012, were utilized. A total of 404 participants were enrolled from 34 outpatient community mental health centers across the United States. Mental illness stigma was assessed using the Stigma Self-Report Scale (SSRS), depressive symptoms were measured with the Calgary Depression Scale for Schizophrenia (CDSS), psychological wellbeing was evaluated using an abbreviated version of the Scales of Psychological Wellbeing (SPWB), and social support was assessed using the interpersonal relations subscale of the Heinrichs-Carpenter Quality of Life Scale (QLS). Frequency of outpatient service use, psychiatric hospitalizations, and substance use types were also documented. T-tests and longitudinal path analysis was employed to explore the relationships among variables, the potential role of social support in buffering the impact of stigma, and Black-White racial differences in support for the proposed model.Results: While some racial differences emerged, including more outpatient visits by Black PDWS and less substance use, stigma did not directly predict wellbeing in the overall sample. Surprisingly, there was support for a relationship between stigma and depression symptom severity among White participants but not among Black participants. Social support did not significantly moderate the relationship between stigma and depression, although the moderation effect approached significance among Black participants. Model fit was equivalent across racial groups.Conclusion: This study underscores the importance of addressing stigma in interventions for PDWS, emphasizing its association with depression and substance use. It highlights the need for culturally sensitive, stigma-focused interventions tailored to the diverse experiences and needs of PDWS. Future research should further explore the complex interplay of stigma, depression, service utilization, substance use, social support, and race in shaping mental health outcomes among PDWS, with a focus on understanding and addressing racial disparities in schizophrenia diagnosis and treatment

The Aversive Impact of Stigma on Black People Diagnosed with Schizophrenia

Compared to their White counterparts, Black people diagnosed with schizophrenia (PDWS) are at elevated risk for poor outcomes (e.g., greater likelihood of misdiagnosis, poorer treatment engagement, higher suicide rates). Although it is well known that there are racial disparities in schizophrenia treatment and service utilization, little is known about the mechanisms driving these disparities. Studies have found that Black Americans hold more negative attitudes towards mental illness than White Americans and that the impact of such stigmatizing attitudes on help-seeking for mental health problems is detrimental. Mental illness stigma may generate disparities in schizophrenia by delaying or preventing treatment seeking among Blacks. This study sought to identify the mechanisms by which mental illness stigma, a racialized and politicized construct historically used to push Black Americans to the margins, acts as a barrier to care for Black PDWS and generates worse overall outcomes. It was hypothesized that Black PDWS who access routine outpatient care less frequently would be more likely to experience deterioration in their conditions and enter the mental health care system through less favorable inpatient access points. Depressive symptoms caused by stigma were thought to promote suboptimal patterns of service utilization, thereby resulting in increased substance use. Social support was expected to serve as a buffer against the harmful effects of stigma. The hypotheses of this study were partially supported. Findings were consistent with prior research indicating that stigma is a determinant of psychological wellbeing in individuals with serious mental illness and that depression is one pathway by which the effect occurs. Stigma was found to be less detrimental at higher levels of social support. Additionally, this study provides some evidence that stigma generates negative outcomes by reducing use of outpatient mental health services in Black PDWS. This finding, which must be taken with caution, comes alongside the finding that usage of outpatient mental health visits is negatively associated with misuse of various substances. Integrating perspectives from other disciplines, this study adds to the modest literature in psychology that either centers the experiences of Black Americans or examines stigma in relation to race. Its results have major public health implications. Indeed, this study was the first to examine the relationships among stigma, depression, service utilization, substance use, and overall behavioral health. Future research directions include examining whether there are differential levels of support for the proposed structural model across racial groups, whether Black men are more vulnerable to the disadvantages of mental illness stigma, replicating these findings with theory-driven covariates and in larger samples, conducting qualitative analyses to inform conceptualization of service use variables, and testing these research questions longitudinally