2D-fluoroscopic navigated percutaneous screw fixation of pelvic ring injuries - a case series

<p>Abstract</p> <p>Background</p> <p>Screw fixation of pelvic ring fractures is a common, but demanding procedure and navigation techniques were introduced to increase the precision of screw placement. The purpose of this case series was the evaluation of screw misplacement rate and functional outcome of percutaneous screw fixation of pelvic ring disruptions using a 2D navigation system.</p> <p>Methods</p> <p>Between August 2004 and December 2007, 44 of 442 patients with pelvic injuries were included for closed reduction and percutaneous screw fixation of disrupted pelvic ring lesions using an optoelectronic 2D-fluoroscopic based navigation system. Operating and fluoroscopy time were measured, as well as peri- and postoperative complications documented. Screw position was assessed by postoperative CT scans. Quality of live was evaluated by SF 36-questionnaire in 40 of 44 patients at mean follow up 15.5 ± 1.2 month.</p> <p>Results</p> <p>56 iliosacral- and 29 ramus pubic-screws were inserted (mean operation time per screw 62 ± 4 minutes, mean fluoroscopy time per screw 123 ± 12 seconds). In post-operative CT-scans the screw position was assessed and graded as follows: I. secure positioning, completely in the cancellous bone (80%); II. secure positioning, but contacting cortical bone structures (14%); III. malplaced positioning, penetrating the cortical bone (6%). The malplacements predominantly occurred in bilateral overlapping screw fixation. No wound infection or iatrogenic neurovascular damage were observed. Four re-operations were performed, two of them due to implant-misplacement and two of them due to implant-failure.</p> <p>Conclusion</p> <p>2D-fluoroscopic navigation is a safe tool providing high accuracy of percutaneous screw placement for pelvic ring fractures, but in cases of a bilateral iliosacral screw fixation an increased risk for screw misplacement was observed. If additional ramus pubic screw fixations are performed, the retrograde inserted screws have to pass the iliopubic eminence to prevent an axial screw loosening.</p

Habitat structure mediates top-down effects of spiders and ants on herbivores

Sanders D, Nickel H, Grutzner T, Platner C. Habitat structure mediates top-down effects of spiders and ants on herbivores. BASIC AND APPLIED ECOLOGY. 2008;9(2):152-160.Differences in structural complexity of habitats have been suggested to modify the extent of top-down forces in terrestrial food webs. In order to test this hypothesis, we manipulated densities of generalist invertebrate predators and the complexity of habitat structure in a two-factorial design. We conducted two field experiments in order to study predation effects of ants and spiders and, in particular, of the wasp spider Argiope bruennichi on herbivorous arthropods such as grasshoppers, plant- and leafhoppers in a grassland. Predator densities were manipulated by removal in habitats of higher and lower structural diversity, and the effects on herbivore densities were assessed by suction sampling. Habitat structure was changed by cutting the vegetation to half its height and removing leaf litter.We found a significant negative effect of this assemblage of generalist predators on plant- and leafhoppers, which were 1.6 times more abundant in predator removal plots. This effect was stronger in low-structured (cut) than in uncut vegetation. Densities of the most abundant planthopper Ribautodelphax pungens (Delphacidae) were 2.2 times higher in predator removal plots. Furthermore, adult plant- and leafboppers responded more strongly than juveniles and epigeic species more strongly than hypergeic species. The presence of predators had a positive effect on plant- and leafhopper species diversity. In a second field experiment, we tested the exclusive impact of Argiope bruennichi on its prey, and found that its effect was also significant, although weaker than the effect of the predator assemblage. This effect was stronger in grass-dominated vegetation compared to structurally more complex mixed vegetation of grasses and herbs. We conclude that habitat structure and in particular vegetation height and architectural complexity strongly modify the strength of top-down forces and indirectly affect the diversity of herbivorous arthropods. (c) 2007 Gesellschaft fur Okologie. Published by Elsevier GmbH. All rights reserved

Influence of Turkish origin on hematology reference intervals in the German population

Mayr FX, Bertram A, Cario H, et al. Influence of Turkish origin on hematology reference intervals in the German population. Scientific Reports . 2021;11(1): 21074.Reference intervals for laboratory test results have to be appropriate for the population in which they are used to be clinically useful. While sex and age are established partitioning criteria, patients' origin also influences laboratory test results, but is not commonly considered when creating or applying reference intervals. In the German population, stratification for ethnicity is rarely performed, and no ethnicity-specific hematology reference intervals have been reported yet. In this retrospective study, we investigated whether specific reference intervals are warranted for the numerically largest group of non-German descent, individuals originating from Turkey. To this end, we analyzed 1,314,754 test results from 167,294 patients from six German centers. Using a name-based algorithm, 1.9% of patients were identified as originating from Turkey, in line with census data and the algorithm's sensitivity. Reference intervals and their confidence intervals were calculated using an indirect data mining approach, and Turkish and non-Turkish reference limits overlapped completely or partially in nearly all analytes, regardless of age and sex, and only 5/144 (3.5%) subgroups' reference limits showed no overlap. We therefore conclude that the current practice of using common reference intervals is appropriate and allows correct clinical decision-making in patients originating from Turkey. © 2021. The Author(s)

DMRT gene cluster analysis in the platypus: New insights into genomic organization and regulatory regions

We isolated and characterized a cluster of platypus DMRT genes and compared their arrangement, location, and sequence across vertebrates. The DMRT gene cluster on human 9p24.3 harbors, in order, DMRT1, DMRT3, and DMRT2, which share a DM domain. DMRT1 is highly conserved and involved in sexual development in vertebrates, and deletions in this region cause sex reversal in humans. Sequence comparisons of DMRT genes between species have been valuable in identifying exons, control regions, and conserved nongenic regions (CNGs). The addition of platypus sequences is expected to be particularly valuable, since monotremes fill a gap in the vertebrate genome coverage. We therefore isolated and fully sequenced platypus BAC clones containing DMRT3 and DMRT2 as well as DMRT1 and then generated multispecies alignments and ran prediction programs followed by experimental verification to annotate this gene cluster. We found that the three genes have 58-66% identity to their human orthologues, lie in the same order as in other vertebrates, and colocate on 1 of the 10 platypus sex chromosomes, X5. We also predict that optimal annotation of the newly sequenced platypus genome will be challenging. The analysis of platypus sequence revealed differences in structure and sequence of the DMRT gene cluster. Multispecies comparison was particularly effective for detecting CNGs, revealing several novel potential regulatory regions within DMRT3 and DMRT2 as well as DMRT1. RT-PCR indicated that platypus DMRT1 and DMRT3 are expressed specifically in the adult testis (and not ovary), but DMRT2 has a wider expression profile, as it does for other mammals. The platypus DMRT1 expression pattern, and its location on an X chromosome, suggests an involvement in monotreme sexual development.El-Mogharbel N, Wakefield M, Deakin JE, Tsend-Ayush E, Grützner F, Alsop A, Ezaz T, Marshall Graves JA.http://www.ncbi.nlm.nih.gov/pubmed/1696273

Next-generation reference intervals for pediatric hematology.

Zierk J, Hirschmann J, Toddenroth D, et al. Next-generation reference intervals for pediatric hematology. Clinical chemistry and laboratory medicine. 2019;57(10):1595-1607.Background Interpreting hematology analytes in children is challenging due to the extensive changes in hematopoiesis that accompany physiological development and lead to pronounced sex- and age-specific dynamics. Continuous percentile charts from birth to adulthood allow accurate consideration of these dynamics. However, the ethical and practical challenges unique to pediatric reference intervals have restricted the creation of such percentile charts, and limitations in current approaches to laboratory test result displays restrict their use when guiding clinical decisions. Methods We employed an improved data-driven approach to create percentile charts from laboratory data collected during patient care in 10 German centers (9,576,910 samples from 358,292 patients, 412,905-1,278,987 samples per analyte). We demonstrate visualization of hematology test results using percentile charts and z-scores (www.pedref.org/hematology) and assess the potential of percentiles and z-scores to support diagnosis of different hematological diseases. Results We created percentile charts for hemoglobin, hematocrit, red cell indices, red cell count, red cell distribution width, white cell count and platelet count in girls and boys from birth to 18 years of age. Comparison of pediatricians evaluating complex clinical scenarios using percentile charts versus conventional/tabular representations shows that percentile charts can enhance physician assessment in selected example cases. Age-specific percentiles and z-scores, compared with absolute test results, improve the identification of children with blood count abnormalities and the discrimination between different hematological diseases. Conclusions The provided reference intervals enable precise assessment of pediatric hematology test results. Representation of test results using percentiles and z-scores facilitates their interpretation and demonstrates the potential of digital approaches to improve clinical decision-making