Full-thickness bilateral rotator cuff tears as a result of a bench-pressing accident: case report and literature review of treatment of bilateral rotator cuff tears

Rotator cuff injuries are frequent pathologies presenting to orthopedic surgeons. These injuries especially occur among older adults due to intrinsic or extrinsic degeneration. They can however present in young athletes, but as result of different etiologies. Overhead athletes may incur rotator cuff injuries due to repetitive trauma. Bilateral simultaneous traumatic shoulder dislocations have been reported in the literature following acute trauma or weight-lifting activity, but bilateral traumatic rotator cuff tears following bench pressing is an unusual presentation in a young individual. To our knowledge, there has been no previous report describing this injury. This article presents a case of a young male athlete who had bilateral rotator cuff tears after a barbell bench press. Both shoulders were treated operatively in a sequential manner, three months apart, and the patient regained excellent functional status 24 months postoperatively

Dynamics of Anti-S IgG Antibodies Titers after the Second Dose of COVID-19 Vaccines in the Manual and Craft Worker Population of Qatar

There is limited seroepidemiological evidence on the magnitude and long-term durability of antibody titers of mRNA and non-mRNA vaccines in the Qatari population. This study was conducted to generate evidence on long-term anti-S IgG antibody titers and their dynamics in individuals who have completed a primary COVID-19 vaccination schedule. A total of 300 male participants who received any of the following vaccines BNT162b2/Comirnaty, mRNA-1273, ChAdOx1-S/Covishield, COVID-19 Vaccine Janssen/Johnson, or BBIBP-CorV or Covaxin were enrolled in our study. All sera samples were tested by chemiluminescent microparticle immunoassay (CMIA) for the quantitative determination of IgG antibodies to SARS-CoV-2, receptor-binding domain (RBD) of the S1 subunit of the spike protein of SARS-CoV-2. Antibodies against SARS-CoV-2 nucleocapsid (SARS-CoV-2 N-protein IgG) were also determined. Kaplan–Meier survival curves were used to compare the time from the last dose of the primary vaccination schedule to the time by which anti-S IgG antibody titers fell into the lowest quartile (range of values collected) for the mRNA and non-mRNA vaccines. Participants vaccinated with mRNA vaccines had higher median anti-S IgG antibody titers. Participants vaccinated with the mRNA-1273 vaccine had the highest median anti-S-antibody level of 13,720.9 AU/mL (IQR 6426.5 to 30,185.6 AU/mL) followed by BNT162b2 (median, 7570.9 AU/mL; IQR, 3757.9 to 16,577.4 AU/mL); while the median anti-S antibody titer for non-mRNA vaccinated participants was 3759.7 AU/mL (IQR, 2059.7–5693.5 AU/mL). The median time to reach the lowest quartile was 3.53 months (IQR, 2.2–4.5 months) and 7.63 months (IQR, 6.3–8.4 months) for the non-mRNA vaccine recipients and Pfizer vaccine recipients, respectively. However, more than 50% of the Moderna vaccine recipients did not reach the lowest quartile by the end of the follow-up period. This evidence on anti-S IgG antibody titers should be considered for informing decisions on the durability of the neutralizing activity and thus protection against infection after the full course of primary vaccination in individuals receiving different type (mRNA verus non-mRNA) vaccines and those with natural infection.The World Health Organization (WHO) - grant number [2021/1183356-0]

Innate immune humoral factors, C1q and factor H, with differential pattern recognition properties, alter macrophage response to carbon nanotubes

Interaction between the complement system and carbon nanotubes (CNTs) can modify their intended biomedical applications. Pristine and derivatised CNTs can activate complement primarily via the classical pathway which enhances uptake of CNTs and suppresses pro-inflammatory response by immune cells. Here, we report that the interaction of C1q, the classical pathway recognition molecule, with CNTs involves charge pattern and classical pathway activation that is partly inhibited by factor H, a complement regulator. C1q and its globular modules, but not factor H, enhanced uptake of CNTs by macrophages and modulated the pro-inflammatory immune response. Thus, soluble complement factors can interact differentially with CNTs and alter the immune response even without complement activation. Coating CNTs with recombinant C1q globular heads offers a novel way of controlling classical pathway activation in nanotherapeutics. Surprisingly, the globular heads also enhance clearance by phagocytes and down-regulate inflammation, suggesting unexpected complexity in receptor interaction. From the Clinical Editor: Carbon nanotubes (CNTs) maybe useful in the clinical setting as targeting drug carriers. However, it is also well known that they can interact and activate the complement system, which may have a negative impact on the applicability of CNTs. In this study, the authors functionalized multi-walled CNT (MWNT), and investigated the interaction with the complement pathway. These studies are important so as to gain further understanding of the underlying mechanism in preparation for future use of CNTs in the clinical setting.L.P., A.G.T., L.K., G.S. and U.K. thank Brunel University London for strategic Infrastructure funding. H.A.K. acknowledges the Deanship of Scientific Research at King Saud University for funding via Group No. RGP-009

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Background Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. Methods We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. Results Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). Some findings differed by sex and gross national income. Conclusion At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio

How do we forecast tomorrow's transfusion:The future of hematopoietic stem cell donation

Over the past three decades, the field of stem cell research and development (R&D) has witnessed extraordinary progress, allowing us to envisage a future where cell therapies can be used for the treatment of diseases currently considered incurable. Contemplating such a future also requires reflecting on donors and exploring their readiness to donate hematopoietic stem cells (HSCs) for these purposes. In 2019, seven focus groups took place with members of the public, prospective donors, and donors as part of a project launched by Anthony Nolan (AN), a UK not-for-profit organization and stem cell donor registry. The aim of the project was to assess prospective donors’ and donors’ attitudes towards donating cells for novel treatments R&D. Participants were asked about their donation being used for the treatment of multiple recipients and quality-of-life (QoL) conditions. Some participants viewed donating for multiple recipients as beneficial and could act as a “pull factor” to encourage more donors. Others were keen to position the idea of helping multiple recipients as an “added bonus”. Some expressed worry that such donations might diminish the connection between donors and recipients and drew upon the influential power of “success stories” to encourage and motivate future donors. Most participants considered it acceptable to donate HSCs for QoL conditions. A hierarchy of illnesses formed during the focus groups, as some donors were concerned they might be asked to donate stem cells to enhance and improve the lives of ‘healthy’ people. Responses suggest that the donor-recipient relationship plays a significant role in influencing donation decisions, and that underlying the portrayal of this relationship is a power dynamic. Donors’ agreeableness to donate for QoL conditions is crucial to expand our understanding of stem cell-based therapies. Nevertheless, we must also consider how such donations might impact donor recruitment for transplant patients

Migration and chronic noncommunicable diseases: Is the paradigm shifting?

In their commentary, the Authors comment upon the increasing incidence of non-communicable diseases in migrants from low income countries travelling to affluent western industrialized countrie

Bilateral basal ganglia calcifications and Graves' disease in a young patient: A very rare association (case report)

Abstract Basal ganglia calcifications have been linked to a wide range of conditions. Mostly it is an idiopathic finding, especially in the elderly. Endocrinological and neurological disorders are two significant entities causing this radiological finding. Here, we report the first case that suggests a possible correlation between Graves' disease and basal ganglia calcifications

Prospective donors’ perspectives on hematopoietic cell donation for cell and gene therapy research and development

Aims: To explore prospective donors’ attitudes and perceptions towards donating hematopoietic stem cells (HSCs) for novel treatments research and development (R&D). Methods: A survey was launched by Anthony Nolan (AN) to assess prospective donors’ willingness to donate HSCs for novel therapies R&D, and their degree of comfort with the AN collaborating with and receiving payment from external organizations. Results: Most participants (87%) were willing to donate for novel treatment R&D and were comfortable with AN collaborating with external organizations and receiving payment (91% and 80%, respectively). Conclusion: Results reveal an overall positive response towards donating HSCs for R&D. These findings can support stakeholders and policymakers in outlining donation practices that uphold donors’ safety and welfare