Diversity in orthopaedic surgery for pacific islanders: the battle continues

It’s no secret that orthopaedic surgery is the specialty with the least diversity when it comes to race and gender. More than likely, patients from different ethnic backgrounds desire to be treated by physicians ethnic backgrounds desire to be treated by physicians who look like them but due to the lack of diversity in the field of orthopaedic surgery, it makes it difficult to find physicians who fully understand the cultural barriers to medicine. A systemic review was completed by reviewing research from The American Journal of Surgery, the Journal of the AAOS, and The Journal of Bone and Joint Surgery, among others. Since the rapid immigration into the United States in the early 2000s, Pacific Islanders have begun to make up an increasing portion of the US population, yet a significant increase in the representation of Pacific Islanders in orthopaedic surgery has not reflected this. This acute problem can cause long-term negative effects on the community of Pacific islanders as they continue to be treated by physicians who do not look like them and who do not completely understand the cultural barriers faced by their communities

Contaminated bone grafts and tuberculosis in three spine surgery patients: a case series

Tuberculosis (TB) is a global health issue affecting millions of people every year. Previous articles displayed cases of TB resulting from contaminated bone grafts used in spinal surgeries. However, deeper understanding about the serious health consequences for patients affected by TB-infected bone grafts is lacking. Here, we discuss three unique patients who contracted TB after undergoing lumbar spinal surgery. We describe three patient cases in which individuals initially presented with back pain, underwent required lumbar spinal fusion surgery with bone graft implants, and, afterwards, contracted TB. All patients were given RIPE therapy, had additional surgery to remove the faulty hardware, and lived with significant and prolonged pain. In addition, patient X experienced night sweats, patient Y had a subcutaneous abscess positive for TB, and patient Z had severe burning pain, rash, and sweats. Altogether, we emphasize the importance of increasing our awareness about the potential risks and complications associated with utilizing contaminated surgical products. We encourage healthcare professionals to take necessary precautions to ensure the safety of their patients by screening bone grafts for potential pathogens and practicing proper sterilization techniques.

Effects of patient education on knee joint injections and the impact on patient care and satisfaction in rural Guatemala

Background: As the rates of osteoarthritis increase among the elderly population across the world, the number of intra-articular corticosteroid injections has also steadily increased. The objective of this research study was to compare the ratings of anxiety level, pain level, and education about glucocorticoid injections between the group who received expansive education about joint injections and the group who received minimal education about joint injections. Methods: Each participant was given a pre-injection survey allowing them to rate their anxiety level, pain level, prior education level on knee injections, and duration and severity of symptoms. Each participant completed a post-injection survey following the procedure. Rating data were analyzed using a paired t-test to compare each of the groups to themselves and unpaired t-tests were used to compare the two groups. Demographic and survey data were analyzed using Fisher’s exact test. Results: Statistical significance was noted when a paired t-test was run between pain levels before and after the knee injection was administered in group A and between pain levels before and after the knee injection was administered in group B (p<0.001). A paired t-test also showed statistical significance when comparing the educational levels before and after the knee injection was administered in group A (p=0.04). Conclusions: This research study showed that increased education on corticosteroid knee injections prior to the procedure demonstrated increased education on corticosteroid knee injections after the injection and decreased pain levels following the injection in participants with osteoarthritis in rural Guatemala

SMALL AND BEYOND : SUPPLENESS + PROTOTYPE FOR A WAY OF LIVING SMALL

Master'sMASTER OF ARCHITECTURE (M.ARCH

BOAT SHELTER AND FISHERY IN HAI DUONG COMMUNE : PROTOTYPE INTEGRATING COASTAL PROTECTION AND WAVE ENERGY INFRASTRUCTURE IN CENTRAL VIETNAM

Master'sMASTER OF ARCHITECTURE (M.ARCH

Case report: Tuberculosis recall on bone graft patient

Background: Bone grafting is commonly used in spine surgery to supplement or replace the need for autografts. This is harvested, prepared, and utilized predominantly for osteoconductive properties. Anterior cervical discectomy and fusion, a procedure to decompress and fuse the spine which treats herniated discs and compressed nerves, commonly uses Polyetheretherketone (PEEK) interbody filled with allograft bone matrices to reconstruct the disc space after a discectomy is performed. Case Description: The presented case is one of a 57-year-old male patient who underwent an uneventful cervical 5–6 and cervical 6–7 discectomy and fusion using a PEEK interbody and bone allograft. The allograft had been prepared using cancellous bone particles with preserved living cells and demineralized cortical bone fibers to facilitate bone repair and healing, which is a common technique. The allograft was aseptically processed to preserve native factors that can support bone repair and prevent contamination and cross-contamination of the product. Additionally, the product was sterilized using gamma irradiation to further prevent contamination. Outcome: Unfortunately, with the presented case, the State's Department of Health and The Center for Diseases Control and Prevention identified that the graft was from a source contaminated with tuberculosis. The patient being reported went on to develop disseminated tuberculosis, including lung abscesses and osteomyelitis. Conclusions: The current case highlights that there was contamination of the donor bone sources. Tuberculosis was not screened in the tissue donor even though he had risk factors, symptoms, and signs consistent with tuberculosis. Although there are methods to screen potential organ donors for tuberculosis, there is currently no approved standard laboratory tuberculosis screening tool for bone grafts. Thus, this emphasizes the importance of proper screening among individual institutions for even the most uncommon diseases in all donated bone grafts

Correlations between physical and chemical defences in plants: tradeoffs, syndromes, or just many different ways to skin a herbivorous cat?

� Most plant species have a range of traits that deter herbivores. However, understanding of how different defences are related to one another is surprisingly weak. Many authors argue that defence traits trade off against one another, while others argue that they form coordinated defence syndromes. � We collected a dataset of unprecedented taxonomic and geographic scope (261 species spanning 80 families, from 75 sites across the globe) to investigate relationships among four chemical and six physical defences. � Five of the 45 pairwise correlations between defence traits were significant and three of these were tradeoffs. The relationship between species’ overall chemical and physical defence levels was marginally nonsignificant (P = 0.08), and remained nonsignificant after accounting for phylogeny, growth form and abundance. Neither categorical principal component analysis (PCA) nor hierarchical cluster analysis supported the idea that species displayed defence syndromes. � Our results do not support arguments for tradeoffs or for coordinated defence syndromes. Rather, plants display a range of combinations of defence traits. We suggest this lack of consistent defence syndromes may be adaptive, resulting from selective pressure to deploy a different combination of defences to coexisting species

Additional file 1: Table S1. of Combinatorial epigenetic therapy in diffuse large B cell lymphoma pre-clinical models and patients

Toxicity. Highest grade of treatment-emergent adverse events encountered at the four different dose levels. (DLs). DL1: azacitidine (AZA) 55 mg/m2 days 1–5 and vorinostat (VST) 300 mg BID days 1–7. DL2: AZA 75 mg/m2 days 1–5 and VST 200 mg BID days 1–7. DL3: AZA 55 mg/m2 days 1–5 and VST 300 mg BID days 1–14. DL4: AZA 75 mg/m2 days 1–5 and VST 200 mg BID days 1–14. (DOC 57.0 kb

Additional file 2: Table S2. of Combinatorial epigenetic therapy in diffuse large B cell lymphoma pre-clinical models and patients

Treatment response at the four different dose levels (DLs). DL1: Azacitidine (AZA) 55 mg/m2 days 1–5 and vorinostat (VST) 300 mg BID days 1–7. DL2: AZA 75 mg/m2 days 1–5 and VST 200 mg BID days 1–7. DL3: AZA 55 mg/m2 days 1–5 and VST 300 mg BID days 1–14. DL4: AZA 75 mg/m2 days 1–5 and VST 200 mg BID days 1–14. (DOC 39 kb