NCTC12662 is sensitive to infection by many
bacteriophages. Here we used this strain to investigate the molecular mechanism behind phage resistance development when exposed to a single phage and ...demonstrate how phase variable expression of one surface component influences phage sensitivity against many diverse
phages. When
NCTC12662 was exposed to phage F207 overnight, 25% of the bacterial cells were able to grow on a lawn of phage F207, suggesting that resistance develops at a high frequency. One resistant variant, 12662R, was further characterized and shown to be an adsorption mutant. Plaque assays using our large phage collection showed that seven out of 36 diverse capsular polysaccharide (CPS)-dependent phages could not infect 12662R, whereas the remaining phages formed plaques on 12662R with reduced efficiencies. Analysis of the CPS composition of 12662R by high-resolution magic angle spinning nuclear magnetic resonance (HR-MAS NMR) showed a diminished signal for
-methyl phosphoramidate (MeO
N), a phase variable modification of the CPS. This suggested that the majority of the 12662R population did not express this phase variable modification in the CPS, indicating that MeO
N serves as a phage receptor in NCTC12662. Whole genome analysis of 12662R showed a switch in the length of the phase variable homopolymeric G tract of gene
, encoding a putative MeO
N-transferase located in the CPS locus, resulting in a non-functional protein. To confirm the role of
in phage resistance development of NCTC12662, a
knockout mutant in NCTC12662 was constructed and analyzed by HR-MAS NMR demonstrating the absence of MeO
N in the CPS of the mutant. Plaque assays using NCTC12662Δ
demonstrated that seven of our CPS-dependent
phages are dependent on the presence of MeO
N for successful infection of
, whereas the remaining 29 phages infect independently of MeO
N, although with reduced efficiencies. Our data indicate that CPS-dependent phages uses diverse mechanisms for their initial interaction with their
host.
In recent years robotic devices became part of rehabilitation offers for patients suffering from Spinal Cord Injury (SCI) and other diseases. Most scientific publications about such devices focus on ...functional outcome. The aim of this study was to verify whether an improvement in physiological gait can be demonstrated in addition to the functional parameters after treatment with neurological controlled HAL® Robot Suit. Fifteen subjects with acute (<12 months since injury,
n
= 5) or chronic (>12 months since injury,
n
= 10) incomplete paraplegia (AIS B,
n
= 0/AIS C,
n
= 2/AIS D,
n
= 8) or complete paraplegia (AIS A,
n
= 5) with zones of partial preservation participated. Subjects underwent a body weight supported treadmill training for five times a week over 12 weeks using HAL®. At baseline and at the end of the study a gait analysis was performed and additional functional parameters such as 10-Meter-Walk-Test, Timed-Up-and-Go-Test, 6-Minutes-Walk-Test, and WISCI II score were collected. Results were evaluated for whole group and individually for acute and chronic subgroups. All functional parameters improved. Differences were also found in physiological parameters such as phases of gait cycle and accompanied by significant improvement in all spatiotemporal and gait phase parameters. The presented study shows signs that an improvement in physiological gait can be achieved in addition to improved functional parameters in patients with SCI after completing 12-week training with HAL®.
Trial Registration:
DRKS, DRKS00020805. Registered 12 February 2020—Retrospectively registered,
https://www.drks.de/DRKS00020805
.
Study Design:
Retrospective, monocentric, observational study in a tertiary health care center.
Objectives:
To analyze prehospital and clinical findings, complications, neurological improvement and ...follow-up in a young person cohort with spinal cord injury (SCI) and tetraplegia according to the American Spinal Injury Association (ASIA) Impairment Scale (AIS) A to D after diving into shallow water.
Methods:
Included were all persons younger than 50 years with SCI after head-first diving into shallow water between June 2001 and June 2019. All persons with SCI were divided into complete tetraplegia (AIS A) and incomplete tetraplegia (AIS B, C, and D) to test differences.
Results:
A total of 59 males (98.7%) and 1 female with a mean age of 27.7 years suffered an SCI. Alcohol use was documented in 25 cases (41.7%). At the time of admission, 33 people (55%) showed a complete tetraplegia (AIS A) and 27 showed an incomplete tetraplegia with 8 AIS B (13.3%), 15 AIS C (25%), and 4 AIS D (6.7%). At the time of discharge, people with initially complete tetraplegia showed a significant improvement from admission to discharge (P ≤ .004). Persons with incomplete tetraplegia were more likely to improve their neurological status compared with complete tetraplegia patients (P ≤ .001). Especially persons with complete tetraplegia suffered from typical SCI-related problems and complications.
Conclusions:
People with SCI and tetraplegia at the time admission show neurological improvement in 50% of the cases with an overall better outcome in persons with incomplete tetraplegia. The surgical treatment of SCI within 24 hours seems to be associated with a better neurological outcome and a lower level of tetraplegia. The incidence of SCI caused by diving into shallow water remains stable without a significant change, especially in high-risk groups. More education and prevention programs are necessary to avoid these injuries.
Lumbar spinal stenosis is defined as narrowing of the lumbar spinal canal, which causes compression of the spinal cord and nerves. Spinal stenosis can cause leg pain and potentially back pain that ...can affect the quality of life. Ultimately, surgical decompression is required to alleviate the symptoms. In this review, we first utilize several important studies to compare lumbar laminectomy alone versus lumbar laminectomy and fusion. We also compare the effectiveness of more novel surgical approaches, stand-alone anterior lumbar interbody fusion (ALIF), and stand-alone lateral lumbar interbody fusion (LLIF). These techniques have their own advantages and disadvantages in which many factors must be taken into account before choosing a surgical approach. In addition, the patient’s anatomy and pathology, lifestyle, and desires should be analyzed to help determine the ideal surgical strategy
This study was conducted on 600 one-day-old male broiler chicks, using a 2 × 6 factorial design (ambient temperature, A x feed additive, F), for a period of 42 days. The chicks assigned to different ...groups were exposed to thermoneutral (TN, 24 ± 1 °C) and constant heat stress (HT, 36 ± 1 °C) conditions, and were only fed on a basal diet, and a basal diet supplemented with either 100 mg/kg chloramphenicol, 50 IU/kg α-tocopherol, or 200, 400, and 600 mg/kg of cumin essential oil (CEO). The results showed that heat stress adversely affected performance and carcass characteristics, and increased both the mortality rate and footpad lesions. Moreover, constant chronic heat stress showed negative effects on serum biochemistry and the intestinal microbiota, increased antioxidant activity in both the plasma and breast meat, and increased counts of the pathogenic microorganisms in the small intestine. On the other hand, dietary CEO supplementation positively affected these parameters. CEO had a slight effect on performance, carcass characteristics, mortality rate and the incidence of footpad lesions. When compared to the control group, it was determined that CEO generally had a positive effect on lipid peroxidation in the plasma and tissues and decreased antioxidant enzyme activity. Furthermore, CEO positively affected serum biochemistry and counts of beneficial microorganisms in the small intestine.
Study Design:
Retrospective cohort study.
Objective:
The purpose of the study was to compare early complication, morbidity and mortality risks associated with fusion surgery crossing the ...cervico-thoracic junction in patients aged over 80 years undergoing combined anterior and posterior approach versus a posterior-only approach.
Methods:
We retrospectively identified octogenarian patients with myelopathy who underwent fusion crossing the cervico-thoracic junction. Patient demographics, Nurick score, surgical characteristics, complications, hospital course, early outcome and 90-day mortality were collected. Comorbidities were classified using the age-adjusted Charlson Comorbidity Index (AACCI). Radiographic measurements for deformity correction included the C2-C7 sagittal Cobb angle, C2-7 sagittal vertical axis and T1 slope pre- and postoperatively.
Results:
Out of 8,521 surgically treated patients, 12 octogenarian patients had a combined anterior and posterior approach (AP group) and 14 were treated from posterior-only (P group). Mean age was 81.4 ± 1.2 and 82.5 ± 2.7 years, respectively. There was no significant difference in Nurick scores between the groups (P > 0.05). The major complication risk in the AP group was significantly higher, requiring PEG tube placement due to severe dysphagia in 4 patients (33%) compared to none in the P group. A greater improvement in cervical lordosis could be achieved through a combined approach. The 90-day mortality risk was 8% for the AP group and 0% for the P group.
Conclusions:
A combined anterior and posterior approach is associated with a significantly higher major complication rate and can result in severe dysphagia requiring PEG tube placement in one-third of patients over 80 years of age.
Study Design:
Retrospective case series analysis.
Objective:
To identify relevant clinical and radiographic markers for patients presenting with infectious spondylo-discitis associated with spinal ...instability directly related to the infectious process.
Methods:
We evaluated patients presenting with de-novo intervertebral discitis or vertebral osteomyelitis /discitis (VOD) who initiated non-surgical treatment. Patients who failed conservative treatment and required stabilization surgery within 90 days were defined as “failed treatment group” (FTG). Patients who experienced an uneventful course served as controls and were labeled as “nonsurgical group” (NSG). A wide array of baseline clinical and radiographic parameters was retrieved and compared between 2 groups.
Results:
Overall 35 patients had initiated non-surgical treatment for VOD. 25 patients had an uneventful course (NSG), while 10 patients failed conservative treatment (“FTG”) within 90 days. Factors found to be associated with poorer outcome were intra-venous drug abuse (IVDA) as well as the presence of fever upon initial presentation. Radiographically, involvement of the same-level facets and the extent of caudal and rostral VB involvement in both MRI and CT were found to be significantly associated with poorer clinical and radiographic outcome.
Conclusions:
We show that clinical factors such as IVDA status and fever as well as the extent of osseous and posterior element involvement may prove to be helpful in favoring surgical treatment early on in the management of spinal infections.
History of Bone Grafts in Spine Surgery Hampel, Gilad A; Yilmaz, Emre; Massrey, Chrissie ...
Curēus (Palo Alto, CA),
05/2022, Letnik:
14, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Bone grafting replaces damaged or missing bone with new bone and is used for surgical arthrodesis. Patients benefit from a huge variety of bone graft techniques and options for spinal fusions. This ...article reviews the rich history of bone grafts in surgery with particular emphasis on spinal fusion. During the early years of bone grafting in spine surgery, bone grafts were used on tuberculosis patients, and the structural support of the graft was most the important consideration. Between 1960 and 2000, many advances were made, specifically in the use of bone graft substitutes. The field of bone grafts in spine surgery has evolved rapidly since first described.
Background
The aim of this study was to investigate the relationship between QT (QTc) interval, Tp‐e interval, Tp‐e/QTc ratio, 5‐year sudden cardiac death (SCD) risk score, and late gadolinium ...enhancement (LGE) detected by CMR in hypertrophic cardiomyopathy (HCM) patients.
Method
A total of 74 consecutive patients who underwent CMR with HCM diagnosis were included in the study. These patients were divided into two groups according to the presence of LGE on CMR. All patients underwent detailed echocardiography and QTc interval, Tp‐e interval, and Tp‐e/QTc ratios and 5‐year SCD risk scores were calculated. These parameters were compared for two groups.
Results
CMR revealed LGE in 32 (43.2%) of 74 HCM patients. In the group with LGE, significantly higher QTc interval (p = 0.002), Tp‐e interval (p < 0.001), Tp‐e/QTc ratio (p = 0.004), and 5‐year SCD risk score were detected. In addition, QTc interval, Tp‐e interval, Tp‐e/QTc ratio, maximum wall thickness, left ventricular mass index, 5‐year SCD risk score, and cardiac fibrosis index were found to be correlated with various degrees in correlation analysis. Also, Tp‐e interval is found to be an independent predictor of LGE detected by CMR in HCM patients (p = 0.017, OR %95 CI = 1.017 1.001–1.034). In addition, the Tp‐e interval can detect the LGE with a sensitivity of 64.3% and a specificity of 84.2% at 99.4 ms. (p < 0.001, AUC 95% CI = 0.790 0.676–0.905).
Conclusion
The Tp‐e interval can be used to optimize SCD risk stratification in HCM patients and determine which patients will benefit from implantable cardioverter‐defibrillator (ICD) treatment.
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