Precision and safety of Multilevel Cervical Transpedicular Screw Fixation with 3D Patient-Specific Guides; A Cadaveric Study

The aim is to design a patient-specific instrument (PSI) for multilevel cervical pedicle screw placement from C2 to C7, as well as verifying reliability and reproducibility. Computed tomography (CT) scans were obtained from 7 cadaveric cervical spines. Using Mimics software, semiautomatic segmentation was performed for each cervical spine, designing a 3D cervical spine bone model in order to plan transpedicular screw fixation. A PSI was designed according to the previously cited with two cannulated chimneys to guide the drill. The guides were 3D printed and surgeries performed at the laboratory. Postoperative scans were obtained to study screw placement. Sixty-eight transpedicular screws were available for study. 61.8% of all screws were within the pedicle or partially breached <4 mm. No differences were observed between cervical levels. None of these screws had neurovascular injury. Of the 27 screws with a grade 3 (screw outside the pedicle; 39.7%), only 2 had perforation of the transverse foramen and none of them would have caused a neural injury. In conclusion, multilevel PSI for cervical pedicle screw is a promising technology that despite showing improvements regarding free-hand technique requires further studies to improve the positioning of the PSI and their accuracy

Determination of diquat by flow injection-chemiluminescence

A simple, economic, sensitive and rapid method for the determination of the pesticide diquat was described. This new method was based on the coupling of flow injection analysis methodology and direct chemiluminescent detection; to the authors' knowledge, this approach had not been used up to now with this pesticide. It was based on its oxidation with ferricyanide in alkaline medium; significant improvements in the analytical signal were achieved by using high temperatures and quinine as sensitiser. Its high throughput (144 h(-1)), together with its low limit of detection (2 ng mL(-1)), achieved without need of preconcentration steps, permitted the reliable quantification of diquat over the linear range of (0.01-0.6) mu g mL(-1) in samples from different origins (river, tap, mineral and ground waters), even in the presence of a 40-fold concentration of paraquat, a pesticide commonly present in the commercial formulations of diquat.López-Paz, JL.; Catalá-Icardo, M.; Antón Garrido, B. (2009). Determination of diquat by flow injection-chemiluminescence. Analytical and Bioanalytical Chemistry. 394(4):1073-1079. doi:10.1007/s00216-009-2609-zS107310793944Hayes WJ Jr, Laws ER Jr (1991) Handbook of pesticide toxicology, Academic Press, San DiegoUS Environmental Protection Agency. http://www.epa.gov/06WDW/contaminants/dw_contamfs/diquat.html (accessed in August 2008)Horwitz W (2000) Official methods of analysis of AOAC International 17th edition. AOAC International, Gaithersburg, MD, USAHara S, Sasaki N, Takase D, Shiotsuka S, Ogata K, Futagami K, Tamura K (2007) Anal Sci 23(5):523–531Rial Otero R, Cancho Grande B, Pérez Lamela C, Simal Gandara J, Aria Estevez M (2006) J Chromatogr Sci 44(9):539–542Aramendia MA, Borau V, Lafont F, Marinas JM, Moreno JM, Porras JM, Urbano FJ (2006) Food Chem 97(1):181–188Nuñez O, Moyano E, Galceran MT (2004) Anal Chim Acta 525(2):183–190Martinez Vidal JL, Belmonte Vega A, Sanchez Lopez FJ, Garrido Frenich AJ (2004) Chromatogr A 1050(2):179–184Lee XP, Kumazawa T, Fujishiro M, Hasegawa C, Arinobu T, Seno H, Sato K (2004) J Mass Spectrom 39(10):1147–1152De Almeida RM, Yonamine M (2007) J Chromatogr B 853(1–2):260–264De Souza D, Machado SAS (2006) Electroanalysis 18(9):862–872De Souza D, Da Silva MRC, Machado SAS (2006) Electroanalysis 18(23):2305–2313Picó Y, Rodriguez R, Manes J (2003) Trends Anal Chem 22(3):133–151Ishiwata T (2004) Bunseki Kagaku 53(8):863–864Carneiro MC, Puignou L, Galcerán MT (2000) Anal Chim Acta 408:263Luque M, Rios A, Valcarcel M (1998) Analyst 123(11):2383–2387Perez Ruiz T, Martínez Lozano C, Tomas V (1991) Int J Environ Anal Chem 44(4):243–252Perez Ruiz T, Martínez Lozano C, Tomas V (1991) Anal Chim Acta 244(1):99–104Townshend A (1990) Analyst 115:495–500López Paz JL, Catalá Icardo M (2008) Anal Chim Acta 625:173–179Pawlicová Z, Sahuquillo I, Catalá Icardo M, García Mateo JV, Martínez Calatayud J (2006) Anal Sci 22:29–34Albert García JR, Catalá Icardo M, Martínez Calatayud J (2006) Talanta 69:608–614Tomlin CDS (1997) The pesticide manual, 11th edn.The British Crop Protection CouncilUKCatalá-Icardo M, Martínez-Calatayud J (2008) Crit Rev Anal Chem 38:118–130Ministerio de Medio Ambiente y Medio Rural y Marino. http://www.marm.es/ (accessed in September 2008)US Environmental Protection Agency. http://www.epa.gov/OGWWDW/contaminants (accessed in October 2008

Synaptotagmins at the endoplasmic reticulum-plasma membrane contact sites maintain diacylglycerol homeostasis during abiotic stress

Endoplasmic Reticulum-Plasma Membrane contact sites (ER-PM CS) play fundamental roles in all eukaryotic cells. Arabidopsis mutants lacking the ER-PM protein tether synaptotagmin1 (SYT1) exhibit decreased plasma membrane (PM) integrity under multiple abiotic stresses such as freezing, high salt, osmotic stress and mechanical damage. Here, we show that, together with SYT1, the stress-induced SYT3 is an ER-PM tether that also functions in maintaining PM integrity. The ER-PM CS localization of SYT1 and SYT3 is dependent on PM phosphatidylinositol-4-phosphate and is regulated by abiotic stress. Lipidomic analysis revealed that cold stress increased the accumulation of diacylglycerol at the PM in a syt1/3 double mutant relative to WT while the levels of most glycerolipid species remain unchanged. Additionally, SYT1-GFP preferentially binds diacylglycerol in vivo with little affinity for polar glycerolipids. Our work uncovers a SYT-dependent mechanism of stress adaptation counteracting the detrimental accumulation of diacylglycerol at the PM produced during episodes of abiotic stress

Clinical case of plantar verrucous carcinoma versus diabetic foot.

Caso Clínico: Se presenta un caso de un carcinoma verrucoso en el hallux del pie derecho, que inicialmente fue extirpado completamente, evolucionando de forma tórpida hasta una posterior amputación transmetatarsiana sin evidencia de recidiva tumoral, durante su seguimiento en un periodo de 3 años, para evolucionar a otra entidad patológica como es el Pie Diabético. Discusión: Este carcinoma se caracteriza clínicamente por un lento crecimiento de aspecto similar a la verruga plantar, siendo su histología típica la invasión local mínima con algo de displasia y baja incidencia de metástasis y presenta buen pronóstico. Para el diagnóstico correcto, es imprescindible la biopsia quirúrgica. La resección radical es el tratamiento de elección con confirmación histológica de los márgenes de resección libres del tumor. Conclusiones: El carcinoma verrucoso plantar presenta una evidente dificultad diagnóstica, constituyendo la resección quirúrgica completa de la lesión el tratamiento de elección. Posee un buen pronóstico y mejor resolución. Excepcionalmente hay pacientes que presentan complicaciones a este tratamiento.Case report: A case of a verrucous carcinoma in the hallux of the right foot is presented, which was initially completely removed, evolving torpidly until a subsequent transmetatarsal amputation without evidence of tumor recurrence, during its follow-up over a period of 3 years, to evolve to another pathological entity such as the Diabetic Foot. Discussion: Verrucous carcinoma is clinically characterized by a slow growth similar in appearance to the plantar wart. The typical histology is a minimal local invasion with low incidence of metastasis and a good prognosis. Surgical biopsy is essential for correct diagnosis. Radical resection is the treatment of choice with histological confirmation of free resection margins of the tumor. Conclusions: The plantar verrucous carcinoma usually presents diagnostic difficulty. The complete surgical resection of the lesion is the treatment of choice presenting a good prognosis and prompt healing. As an exception, there are patients who present complications to this treatment.Medicin

Next-generation sequencing in bone marrow failure syndromes and isolated cytopenias: experience of the spanish network on bone marrow failure sundromes

© 2021 the Author(s).Inherited bone marrow failure syndromes (IBMFSs) are a group of congenital rare diseases characterized by bone marrow failure, congenital anomalies, high genetic heterogeneity, and predisposition to cancer. Appropriate treatment and cancer surveillance ideally depend on the identification of the mutated gene. A next-generation sequencing (NGS) panel of genes could be 1 initial genetic screening test to be carried out in a comprehensive study of IBMFSs, allowing molecular detection in affected patients. We designed 2 NGS panels of IBMFS genes: version 1 included 129 genes and version 2 involved 145 genes. The cohort included a total of 204 patients with suspected IBMFSs without molecular diagnosis. Capture-based targeted sequencing covered > 99% of the target regions of 145 genes, with more than 20 independent reads. No differences were seen between the 2 versions of the panel. The NGS tool allowed a total of 91 patients to be diagnosed, with an overall molecular diagnostic rate of 44%. Among the 167 patients with classified IBMFSs, 81 patients (48%) were diagnosed. Unclassified IBMFSs involved a total of 37 patients, of whom 9 patients (24%) were diagnosed. The preexisting diagnosis of 6 clinically classified patients (6%) was amended, implying a change of therapy for some of them. Our NGS IBMFS gene panel assay is a useful tool in the molecular diagnosis of IBMFSs and a reasonable option as the first tier genetic test in these disorders

Next-generation Sequencing in Bone Marrow Failure Syndromes and Isolated Cytopenias : Experience of the Spanish Network on Bone Marrow Failure Syndromes

Inherited bone marrow failure syndromes (IBMFSs) are a group of congenital rare diseases characterized by bone marrow failure, congenital anomalies, high genetic heterogeneity, and predisposition to cancer. Appropriate treatment and cancer surveillance ideally depend on the identification of the mutated gene. A next-generation sequencing (NGS) panel of genes could be 1 initial genetic screening test to be carried out in a comprehensive study of IBMFSs, allowing molecular detection in affected patients. We designed 2 NGS panels of IBMFS genes: version 1 included 129 genes and version 2 involved 145 genes. The cohort included a total of 204 patients with suspected IBMFSs without molecular diagnosis. Capture-based targeted sequencing covered > 99% of the target regions of 145 genes, with more than 20 independent reads. No differences were seen between the 2 versions of the panel. The NGS tool allowed a total of 91 patients to be diagnosed, with an overall molecular diagnostic rate of 44%. Among the 167 patients with classified IBMFSs, 81 patients (48%) were diagnosed. Unclassified IBMFSs involved a total of 37 patients, of whom 9 patients (24%) were diagnosed. The preexisting diagnosis of 6 clinically classified patients (6%) was amended, implying a change of therapy for some of them. Our NGS IBMFS gene panel assay is a useful tool in the molecular diagnosis of IBMFSs and a reasonable option as the first tier genetic test in these disorders

Genetic analyses of aplastic anemia and idiopathic pulmonary fibrosis patients with short telomeres, possible implication of DNA-repair genes

Background: Telomeres are nucleoprotein structures present at the terminal region of the chromosomes. Mutations in genes coding for proteins involved in telomere maintenance are causative of a number of disorders known as telomeropathies. The genetic origin of these diseases is heterogeneous and has not been determined for a significant proportion of patients. Methods: This article describes the genetic characterization of a cohort of patients. Telomere length was determined by Southern blot and quantitative PCR. Nucleotide variants were analyzed either by high-resolution melting analysis and Sanger sequencing of selected exons or by massive sequencing of a panel of genes. Results: Forty-seven patients with telomere length below the 10% of normal population, affected with three telomeropathies: dyskeratosis congenita (4), aplastic anemia (22) or pulmonary fibrosis (21) were analyzed. Eighteen of these patients presented known pathogenic or novel possibly pathogenic variants in the telomere-related genes TERT, TERC, RTEL1, CTC1 and ACD. In addition, the analyses of a panel of 188 genes related to haematological disorders indicated that a relevant proportion of the patients (up to 35%) presented rare variants in genes related to DNA repair or in genes coding for proteins involved in the resolution of complex DNA structures, that participate in telomere replication. Mutations in some of these genes are causative of several syndromes previously associated to telomere shortening

Prevention of skin lesions after the use of personal protective equipment against infection.

Una de las grandes preocupaciones actuales que padecen los profesionales sanitarios que precisan del uso continuado de equipos de protección individual (EPI), sobre todo para el manejo del paciente con enfermedad COVID, es la protección y prevención de las lesiones en piel que dichos equipos producen como evento adverso. El presente artículo revisa esta afectación y sus causas: oclusión de la piel, evaporación del agua intradérmica, fricción, presión, humedad y reacciones químicas. Como conclusiones, la estrategia de prevención incluye abordar aspectos como el lavado e hidratación de la piel, prevención de la presión local y prevención de la humedad.One of the major concerns of today's healthcare professionals who require the continued use of personal protective equipment (PPE), especially for the management of patients with COVID disease, is the protection and prevention of skin injuries that such equipment produces as an ad-verse event. This article reviews this affectation and its causes: skin occlusion, intra-dermal water evaporation, friction, pressure, humidity and chemical reactions. As conclusions, the prevention strategy includes addressing aspects such as washing and moisturizing the skin, preventing local pressure and preventing moisture.Medicin

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Analytical strategy photodegradation/chemiluminescence/continuous-flow multicommutation methodology for the determination of the herbicide Propanil

The present paper is dealing with an analytical strategy based on coupling photodegradation, chemiluminescence and multicommutation continuous-flow methodology for the determination of the pesticide Propanil, a common herbicide. The pesticide solution is inserted as small segments sequentially alternated with segments of the solution for adjusting the suitable medium for the photodegradation. Both flow-rates (sample and medium) are adjusted to required time for photodegradation, 2.0 min; and then, the resulting solution is also sequentially inserted as segments alternated with segments of the oxidizing solutions system, 1.00 x 10(-4) mol 1(-1) potassium permanganate in 2.00 mol 1(-1) sulphuric acid medium. The calibration range, from 10 mu g 1(-1) to 25 mg 1(-1), resulted in a linear behaviour over the range 10 mu g 1(-1)-5 mg 1(-1) and fitting the linear equation: I = 780.30C + 95.28; correlation coefficient 0.9999. The limit of detection was 8 mu g 1(-1) and the sample throughput 20 h(-1). After testing the influence of a large series of potential interferents the method is applied to water samples obtained from different places and to one formulation. The method is valid for the determination of other pesticides from the same chemical family, namely: alachlor, flumetsulam, furalaxyl and ofurace. Calibration graphs, limits of detection, repeatability and determination in water samples are obtained for each reported pesticide. (c) 2005 Elsevier B.V. All rights reserved.Albert-Garcia, JR.; Catalá Icardo, M.; Martínez Calatayud, J. (2006). Analytical strategy photodegradation/chemiluminescence/continuous-flow multicommutation methodology for the determination of the herbicide Propanil. Talanta. 69(3):608-614. doi:10.1016/j.talanta.2005.10.044S60861469