Morphological and molecular characterisation of Aporcelaimellus nigeriensis sp. n. (Dorylaimida: Aporcelaimidae), a remarkable dorylaim from Nigeria

Published online: 08 Sep 2020A new species of Aporcelaimellus, collected in a watermelon field in Nigeria, is described, including its morphological and molecular (D2-D3 28S-rDNA, 18r-DNA) characterisation. Aporcelaimellus nigeriensis sp. n. is distinguishable by its 2.76-3.55 mm length, very coarse ventral body pores, lip region offset by deep constriction and 24-27 μm broad odontostyle 30-36 μm long at its dorsal and 28-31 μm at its ventral side, neck 648-779 μm long, pharyngeal expansion occupying 54-60% of total neck length, uterus 300-473 μm or 2.1-3.2 body diam. long and tripartite, V = 49-54, tail short and convex conoid (27-41 μm, c = 72-115, c′ = 0.5-0.7), spicules 108-137 μm long, and 9-10 spaced ventromedian supplements with hiatus. LSU analysis revealed a close relationship of A. nigeriensis sp. n. with other Aporcelaimellus species and questioned, once more, the monophyly of Aporcelaimidae. SSU phylogenetic tree was not able to resolve the relationship between the new species and other closely related species

Palliative Management of Nonoperative Femoral Neck Fractures With Continuous Peripheral Pain Catheters

Introduction: To identify the success of pain catheters in the management of pain in nonoperatively treated femoral neck fractures (FNFs) in supplement to current multimodal protocols for end-of-life pain management. Methods: Twenty patients aged older than 50 years with FNFs were selected in a retrospective fashion at a level 1 trauma center. These patients were treated nonoperatively with indwelling continuous peripheral pain catheters to palliate pain. Adjunctive pain control for patients undergoing nonoperative management of FNFs was provided with an indwelling continuous intra-articular/peripheral nerve ropivacaine pain catheters. Pain scores 24 hours before/after continuous pain catheter placement, ambulation status before/after continuous pain catheter placement, mortality at 30 days/1 year, and length of hospital stay were measured. Results: Twenty patients were identified with an average age of 84.55 years. The average length of stay was 4.85 days with a decrease of 4.45 points on the visual analog scale and an improvement of 90% in ambulation status. Thirty-day and one-year mortality were 65% and 95%, respectively. Conclusion: This case series provides orthopedic surgeons with an option for and data on the success of this adjunct to palliate patients who elect to undergo nonoperative management of FNFs. This study also helps define which patients may be candidates for nonoperative management of geriatric hip fractures

Palliative Management of Nonoperative Femoral Neck Fractures With Continuous Peripheral Indwelling Catheters: Case–Control Series

Introduction: This case–control study evaluates the success of indwelling pain catheters in nonoperatively treated femoral neck fractures (FNFs) for end-of-life pain management. Methods: Patients older than 65 years with nonoperatively treated FNFs were retrospectively identified at a level 1 trauma center between March 2012 and September 2015. Twenty-three received indwelling continuous peripheral pain catheters (experimental) and 10 received traditional pain control modalities (control). Pain scores 24 hours before/after pain management interventions, ambulation status at admission and discharge, mortality at 30 days/1 year, and length of hospital stay (LOS) were compared between treatment groups. Results: The experimental and control groups were similar with respect to demographics, differing only in pre-fracture ambulatory status ( P = .03). The 30-day mortality was 52% versus 50% (odds ratio, OR: 1.1 [95% confidence interval, CI: 0.25-4.82], P = .99) and 1-year mortality was 87% versus 80% (OR: 1.67 [95% CI: 0.23-11.9], P = .63) for experimental and control groups, respectively. The LOS did not statistically significantly differ for experimental and control groups (5.3 ± 3.56 days vs 3.8 ± 1.81 days, P = .15), respectively. The experimental group experienced twice the improvement in ambulation status (1.0 ± 0.56 vs 0.5 ± 0.71, P = 0.03) and greater improvement in pain scores (4.5 ± 2.19 vs 1.2 ± 2.72, P = .002). Discussion: Operative management of FNFs may not be indicated in patients with advanced age and comorbidities. Regardless, these patients require pain palliation and early mobilization while minimizing hospital LOS and opiate consumption. Conclusion: This case–control study demonstrates significant improvement in both pain level and ambulatory status for patients treated with indwelling continuous peripheral catheters. Future studies should further evaluate with a larger sample size; however, this study provides an excellent launching point for palliative management of this complex population