Cases Report: Clavicular Fractures after Hook-Plate Fixation Surgery

The clavicular hooked plate had been used worldwide for fixation the unstable fracture of the distal clavicle and displaced acromioclavicular joint dislocation.  Although it has been widely accepted as the new device used, some complications were still present. The reported complications include acromion fracture, clavicle fracture at the medial end of the hook plate, recurrent acromioclavicular joint subluxation, disengagement of plate as well as subacromial pain and impingement. There were few reports about complications after hook plate fixation surgery. The present study reported 2 cases of clavicle fracture at the medial end of the hook plate after the operation. The first case was diagnosed with displaced fracture at distal end of right clavicle (Neer type II) and the second case was diagnosed with displaced right acromioclavicular joint (Rockwood type IV).  All fracture lines were initiated beneath the medial end of hook plate and adjacent to medial screw which indicated a weak point. Additionally, the stress at the medial end of the hook plate was increased. Both patients were received conservative treatment and were not performed re-fixation surgery. They achieved clavicle union with a good functional result

Successful artificial insemination in the Asian elephant (Elephas maximus) using chilled and frozen-thawed semen

<p>Abstract</p> <p>Background</p> <p>Artificial insemination (AI) using frozen-thawed semen is well established and routinely used for breeding in various mammalian species. However, there is no report of the birth of elephant calves following AI with frozen-thawed semen. The objective of the present study was to investigate the fertilizing ability of chilled and frozen-thawed semen in the Asian elephant following artificial insemination (AI).</p> <p>Methods</p> <p>Semen samples were collected by from 8 bulls (age range, 12-to 42-years) by manual stimulation. Semen with high quality were either cooled to 4°C or frozen in liquid nitrogen (-196°C) before being used for AI. Blood samples collected from ten elephant females (age range, 12-to 52-years) were assessed for estrus cycle and elephants with normal cycling were used for AI. Artificial insemination series were conducted during 2003 to 2008; 55 and 2 AI trials were conducted using frozen-thawed and chilled semen, respectively. Pregnancy was detected using transrectal ultrasonography and serum progestagen measurement.</p> <p>Results</p> <p>One female (Khod) inseminated with chilled semen became pregnant and gave birth in 2007. The gestation length was 663 days and the sex of the elephant calf was male. One female (Sao) inseminated with frozen-thawed semen showed signs of pregnancy by increasing progestagen levels and a fetus was observed for 5 months by transrectal ultrasonography.</p> <p>Conclusion</p> <p>This is the first report showing pregnancy following AI with frozen-thawed semen in the Asian elephant. Successful AI in the Asian elephant using either chilled or frozen-thawed semen is a stepping stone towards applying this technology for genetic improvement of the elephant population.</p

Outcomes with a shorter multidrug-resistant tuberculosis regimen from Karakalpakstan, Uzbekistan

Background In 2016, WHO guidelines conditionally recommended standardised shorter 9–12 month regimens for multidrug-resistant tuberculosis (MDR-TB) treatment. We conducted a prospective study of a shorter standardised MDR-TB regimen in Karakalpakstan, Uzbekistan. Methods Consecutive adults and children with confirmed rifampicin-resistant pulmonary TB were enrolled between 1st September 2013 and 31st March 2015; exclusions included prior treatment with second-line anti-TB drugs, and documented resistance to ofloxacin or to two second-line injectable agents. The primary outcome was recurrence-free cure at 1 year following treatment completion. Results Of 146 enrolled, 128 patients were included: 67 female (52.3%), median age 30.1 (IQR 23.8–44.4) years. At the end of treatment, 71.9% (92/128) patients achieved treatment success, with 68% (87/128) achieving recurrence-free cure at 1 year following completion. Unsuccessful outcomes during treatment included 22 (17.2%) treatment failure with fluoroquinolone resistance amplification in 8 patients (8/22, 36.4%); 12 (9.4%) loss to follow-up; 2 (1.5%) deaths. Recurrence occurred in one patient. 14 patients (10.9%) experienced serious adverse events. Baseline resistance to both pyrazinamide and ethambutol (aOR 6.13, 95% CI 2.01;18.63) and adherence<95% (aOR 5.33, 95% CI 1.73;16.36) were associated with unsuccessful outcome in multivariable logistic regression. Conclusions Overall success with a standardised shorter MDR-TB regimen was moderate with considerable treatment failure and amplification of fluoroquinolone resistance. When introducing standardised shorter regimens, baseline drug susceptibility testing and minimising missed doses are critical. High rates globally of pyrazinamide, ethambutol and ethionamide resistance raise questions of continued inclusion of these drugs in shorter regimens in the absence of DST-confirmed susceptibility

Construct Validity of Assessing Interest in STEM Content Scale

The purpose of this research was to validate the assessing interest in STEM content scale. The sample in this research was 552 students in upper secondary school at Fangchanupathum School, Chiang Mai, Thailand, who validated the assessing interest in STEM content scale, which used a rating scale of four factors consisting of (1) science, (2) mathematics, (3) laboratorial skills, and (4) technology and 20 items. Confirmatory factor analysis was used to confirm the construct validity of the assessing interest in STEM content scale adapted from the study by Tyler-Wood, Knezek, and Christensen. The results confirmed that the construct validity of this assessing interest in STEM content scale had an excellent fit. They showed that the fitness index of validating the assessing interest in STEM content scale was X2 statistic of 163.679 (degree of freedom = 141, P value = 0.0928) and the X2/df ratio having a value of 1.160 indicating a good fit. The comparative fit index (CFI) was 0.991, and Tucker–Lewis coefficient (TLI) was 0.988. The root mean square error approximation (RMSEA) was 0.017. The standardized root mean residual (SRMR) was 0.047. All the indicators indicated that there was a good fit between the empirical data and the hypothetical measurement model

Outcomes with a shorter multidrug-resistant tuberculosis regimen from Karakalpakstan, Uzbekistan

Background: In 2016, World Health Organization guidelines conditionally recommended standardised shorter 9-12-month regimens for multidrug-resistant (MDR) tuberculosis (TB) treatment. We conducted a prospective study of a shorter standardised MDR-TB regimen in Karakalpakstan, Uzbekistan. Methods: Consecutive adults and children with confirmed rifampicin-resistant pulmonary TB were enrolled between September 1, 2013 and March 31, 2015; exclusions included prior treatment with second-line anti-TB drugs, and documented resistance to ofloxacin or to two second-line injectable agents. The primary outcome was recurrence-free cure at 1 year following treatment completion. Results: Of 146 enrolled patients, 128 were included: 67 female (52.3%), median age 30.1 (interquartile range 23.8-44.4) years. At the end of treatment, 71.9% (92 out of 128) of patients achieved treatment success, with 68% (87 out of 128) achieving recurrence-free cure at 1 year following completion. Unsuccessful outcomes during treatment included 22 (17.2%) treatment failures with fluoroquinolone-resistance amplification in 8 patients (8 out of 22, 36.4%); 12 (9.4%) lost to follow-up; and 2 (1.5%) deaths. Recurrence occurred in one patient. Fourteen patients (10.9%) experienced serious adverse events. Baseline resistance to both pyrazinamide and ethambutol (adjusted OR 6.13, 95% CI 2.01; 18.63) and adherence <95% (adjusted OR 5.33, 95% CI 1.73; 16.36) were associated with unsuccessful outcome in multivariable logistic regression. Conclusions: Overall success with a standardised shorter MDR-TB regimen was moderate with considerable treatment failure and amplification of fluoroquinolone resistance. When introducing standardised shorter regimens, baseline drug susceptibility testing and minimising missed doses are critical. High rates globally of pyrazinamide, ethambutol and ethionamide resistance raise questions of continued inclusion of these drugs in shorter regimens in the absence of drug susceptibility testing-confirmed susceptibility

Genetic assessment of captive elephant (Elephas maximus) populations in Thailand

The genetic diversity and population structure of 136 captive Thai elephants (Elephas maximus) with known region of origin were investigated by analysis of 14 highly polymorphic microsatellite loci. We did not detect significant indications of inbreeding and only a low differentiation of elephants from different regions. This is probably explained by the combined effects of isolation by distance and exchange between different regions or between captive and wild elephant populations. Estimates of effective population sizes were in the range of 90-240 individuals, which emphasizes the necessity to guard against inbreeding as caused by the current use of a restricted number of breeding bulls. © Springer Science+Business Media B.V. 2009

Genetic assessment of captive elephant (Elephas maximus) populations in Thailand

The genetic diversity and population structure of 136 captive Thai elephants (Elephas maximus) with known region of origin were investigated by analysis of 14 highly polymorphic microsatellite loci. We did not detect significant indications of inbreeding and only a low differentiation of elephants from different regions. This is probably explained by the combined effects of isolation by distance and exchange between different regions or between captive and wild elephant populations. Estimates of effective population sizes were in the range of 90-240 individuals, which emphasizes the necessity to guard against inbreeding as caused by the current use of a restricted number of breeding bulls. © Springer Science+Business Media B.V. 2009

Clinical and Public Health Implications of Human T-Lymphotropic Virus Type 1 Infection

International audienceHuman T-lymphotropic virus type 1 (HTLV-1) is estimated to affect 5 to 10 million people globally and can cause severe and potentially fatal disease, including adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The burden of HTLV-1 infection appears to be geographically concentrated, with high prevalence in discrete regions and populations. While most high-income countries have introduced HTLV-1 screening of blood donations, few other public health measures have been implemented to prevent infection or its consequences. Recent advocacy from concerned researchers, clinicians, and community members has emphasized the potential for improved prevention and management of HTLV-1 infection. Despite all that has been learned in the 4 decades following the discovery of HTLV-1, gaps in knowledge across clinical and public health aspects persist, impeding optimal control and prevention, as well as the development of policies and guidelines. Awareness of HTLV-1 among health care providers, communities, and affected individuals remains limited, even in countries of endemicity. This review provides a comprehensive overview on HTLV-1 epidemiology and on clinical and public health and highlights key areas for further research and collaboration to advance the health of people with and at risk of HTLV-1 infection