Spinal Infections: An Update

Spinal infection poses a demanding diagnostic and treatment problem for which a multidisciplinary approach with spine surgeons, radiologists, and infectious disease specialists is required. Infections are usually caused by bacterial microorganisms, although fungal infections can also occur. The most common route for spinal infection is through hematogenous spread of the microorganism from a distant infected area. Most patients with spinal infections diagnosed in early stages can be successfully managed conservatively with antibiotics, bed rest, and spinal braces. In cases of gross or pending instability, progressive neurological deficits, failure of conservative treatment, spinal abscess formation, severe symptoms indicating sepsis, and failure of previous conservative treatment, surgical treatment is required. In either case, close monitoring of the patients with spinal infection with serial neurological examinations and imaging studies is necessary

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

CONTRIBUTION A L’ETUDE DE L’INHIBITION DE LA CORROSION DU FER PAR LE MONOFLUOROPHOSPHATE DE MANGANESE

The inhibiting effect of manganesemonofluorophosphate on the ironcorrosion in 3% NaCl solution wasinvestigated using electrochemicalimpedance spectroscopy. Anequivalent circuit is assumed in orderto characterize the film capacitance, the charge transfer resistance at the interface and the ionic flux across the film. The infrared reflection spectroscopy (IRRAS) revealed the presence of monofluorophosphate group on the electrode surface and other iron species.L'effet inhibiteur du monofluorophosphate de manganèse sur la corrosion du fer dans le milieu NaCl 3% a été étudié par spectroscopie d'impédance électrochimique. Un circuit équivalent est utilisé pour caractériser la capacité de film, la résistance de transfert de charge à l'interface et le flux ionique à travers le film. La spectroscopie infrarouge à transformée de Fourrier (IRRAS) a indiqué la présence du groupement monofluorophosphate à la surface de l’électrode de fer et d’autres espèces à base du fer

Etude de l’inhibition de la corrosion du fer en milieu sulfurique 1 M par l’acide hexa méthylène diamine tétra méthyle phosphonique

The efficiency of hexa methylene diamine tetra methyl-phosphonic acid (HMDTMP), as corrosion inhibitor for iron in 1M H2SO4, has been determined by gravimetric and electrochemical measurements. Polarization curves indicate that the compound is mixed inhibitor, affecting both cathodic and anodic corrosion currents. Adsorption of HMDTMP derivatives on iron surface is in agreement with the Langmuir adsorption isotherm model, and the calculated Gibbs free energy value confirms the chemical nature of the adsorption. EIS results show that the change in the impedance parameters (Rt and Cdl) with concentration of HMDTMP is indicative. The adsorption of this molecule leads to the formation of a protective layer on iron surface.L'effet inhibiteur de l’acide hexaméthylène diamine tétra méthylène phosphonique (HMDTMP) sur la corrosion du fer en milieu H2SO4 1M a été étudié à l'aide des méthodes électrochimiques et gravimétriques. Les courbes de polarisation indiquent que le composé est un inhibiteur mixte, réduisant à la fois les courants de corrosion cathodique et anodique. L’adsorption de HMDTMP à la surface du fer suit l’isotherme du modèle de Langmuir, et la valeur obtenue de l’énergie libre de Gibbs confirme la nature chimique de l'adsorption. Les mesures d’impédance électrochimiques montrent que la variation des paramètres d'impédance (Rt et Cdl) avec la concentration de HMDTMP est indicative. L'adsorption de cette molécule conduit à la formation d'une couche protectrice sur la surface du fer

Complications of spine surgery for metastasis

The spinal column represents the third most common site for metastases after the lungs and the liver, and the most common site for metastatic bone disease. With life-extending advances in the systemic treatment of cancer patients, the surgical proce-dures performed for spinal metastases will increase, and their related complications will increase unavoidably. Furthermore, considering the high complication rates reported in the spinal literature regarding spine surgery overall, it becomes clear that a better understanding of complications that the cancer patients with spinal metastases may experience is necessary. This article aims to summarize and critically examine the current evidence for complications after spine surgery for metastatic spinal disease, in both the perioperative and postoperative period. This paper would be useful for the treating physicians of these patients in their clinical practic

DFT, DFTB and TD-DFT theoretical investigations of π-conjugated molecules based on thieno[2,3-b] indole for dye-sensitized solar cell applications

In this study, the electrochemical, photovoltaic and absorption properties of the new designed organic sensitizers dyes: Dye-1, Dye-2, Dye-3 and Dye-4 based on Dye-R, of D-π-A architecture, before and after binding to the TiO2 cluster surface on the ability to inject electrons to the surface. The D donor is the thieno[2,3-b] indole, π-spacer is thiophene, A acceptor is cycnoacrylic acid (CA). The properties were calculated using functional density theory (DFT), time-dependent TD-DFT and the density-functional tight-binding (DFTB) approach. Our study also focused on the analysis of the effects of the introduction of the auxiliary donor (D′)/acceptor (A′) groups on the main photovoltaic properties of the reference molecule Dye-R and to study the relationship between the molecular structure and optoelectronic properties. The analysis of the calculated properties of the new designed compounds D-D′-π-A (Dye-1), D-π-D′-A (Dye-2), D-A′-π-A (Dye-3) and D-π-A′-A (Dye-4), where A′ is benzothiadiazole and D′ is 9,9-diethyl-9H-fluorene, indicate that the molecular architecture has a significant effect on various properties of the studied dyes and that nature (donor D ′or acceptor A′) of the introduced groups, as well as the choice of their locations with respect to the π bridge, is of great importance. Indeed, among the four designed compounds Dye-4 (D-π-A′-A) and Dye-3 (D-A′-π-A) display significantly better properties than those of the reference molecule Dye-R (D-π-A) and of the two other designed dyes Dye-1 (D-D′-π-A), Dye-2 (D-π-D′-A). © 2022 Elsevier B.V

High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-up

We reviewed 192 patients (224 knees) to assess the results of HTO in medial gonarthrosis during the period 1982–2008. Median follow-up was about 15 years for 134 females and 58 males. Among the knees, 118 had an average opening wedge for varus angle of 13° and 106 had closing wedges of 11°. Knee Society scoring before osteotomies was 68/200 for opening wedge and 81/200 for closing wedge. Modified Ahlback classification showed preoperative grades I (n = 44), II (78), III (83) and IV (19). Healing delay was 55 days for closing and 70 for opening osteotomy. Twenty-nine knees were still painful. Twenty-eight patients were revised and 19 others had complications. After opening wedge osteotomy, scoring was 101/200 and valgus angle was 2°. After closing wedge osteotomy, scoring was 94/200 and valgus angle was 4°. Global results were as follows: very good, 12%; good, 30%; fair, 31%; and poor, 27%. HTO decreases stresses on medial compartments and widens joint space. The average of 5° mechanical valgus at the time of osteotomy seems to be quite effective at the follow-up for at least ten years. Our indications are opening wedge for grades 1–3 and wide varus angle, until the age of between 65–70. Closing wedge is indicated for medium varus in younger patients