Good sterilization practices include discarding items containing residual moisture after steam sterilization. In this small laboratory study, however, the presence of residual water did not appear to ...compromise the sterility of surgical instruments in 2 commonly used types of packaging during routine storage after steam sterilization.
Intensive production of TiO2 nanoparticles (TiO2-NPs) would lead to their release in the environment. Their ecotoxicological impact is still poorly documented, while their use in commercial goods is ...constantly increasing. In this study we compare root accumulation and root-to-shoot translocation in wheat of anatase and rutile TiO2-NPs with diameters ranging from 14nm to 655nm, prepared in water. NP distribution in plant tissues was mapped by synchrotron-radiation micro-X-ray fluorescence, observed by transmission electron microscopy and quantified in the different compartments of plant roots by micro-particle-induced X-ray emission. Our results provide evidence that the smallest TiO2-NPs accumulate in roots and distribute through whole plant tissues without dissolution or crystal phase modification. We suggest a threshold diameter, 140nm, above which NPs are no longer accumulated in wheat roots, as well as a threshold diameter, 36nm, above which NPs are accumulated in wheat root parenchyma but do not reach the stele and consequently do not translocate to the shoot. This accumulation does not impact wheat seed germination, biomass and transpiration. It does not induce any modification of photosynthesis nor induce oxidative stress. However exposure of wheat plantlets to the smallest NPs during the first stages of development causes an increase of root elongation. Collectively, these data suggest that only the smallest TiO2-NPs may be accumulated in wheat plants, although in limited amounts and that their impact is moderate.
► TiO2-NP diameter, but not crystallinity, influences their transfer in plant tissues. ► Wheat roots accumulate TiO2-NPs with diameter up to 36nm but not 140nm TiO2-NPs. ► TiO2-NPs with diameter lower than 36 nm are translocated from wheat root to shoot. ► A 100 mg/L TiO2-NP wheat root exposure leads to Ti root content up to 110μg/gd.wt. ► Exposure of wheat to the smallest TiO2-NP induces increased root elongation.
Preoperative planning in high tibial osteotomy (HTO) is a critical step for achieving the desired correction and a clinically satisfactory outcome. Conventional radiography, navigation assistance and ...patient-specific instrumentation (PSI) are the 3 means of planning, but no prospective studies have compared precision between the 3. The aims of the present study were: (1) to analyze and compare correction precision between the 3 planning approaches at 1 year's follow-up; (2) to compare results to those reported in the literature; and (3) to analyze factors influencing the achievement of planned correction.
The study hypothesis was that PSI provides more precise and reproducible planned correction than conventional methods or navigation.
Between June 2017 and June 2018, a multicenter non-randomized prospective observational study was conducted in 11 centers. One hundred and twenty-six patients with Ahlbäck grade I, II or III idiopathic medial tibiofemoral osteoarthritis with stable knee were included and allocated to 3 preoperative planning groups: conventional (group 1), navigation (group 2) and PSI (group 3). Mean age at surgery was 51.2 years (range, 19-69 years; median, 53.2 years); 100 male, 26 female. Complete weight-bearing radiographic work-up was performed preoperatively and at 1 year's follow-up. The PSI group also underwent CT as part of guide production. Target angular correction and mechanical Hip-Knee-Ankle (HKA) axis were set preoperatively. The main endpoint was the difference between planned HKA and HKA at a minimum 12 months.
Mean HKA difference was 1.1±3 in group 1, 2.1±2.6 in group 2 and 0.3±3.1 in group 3. Precision was better with PSI, but not significantly when comparing all 3 groups together. On pairwise intergroup comparison, there was a significant difference only between groups 2 and 3, in favor of PSI (P=0.011).
None of the 3 techniques demonstrated superiority in achieving target correction at 1 year. The study hypothesis was thus not confirmed. All 3 techniques proved reliable and precise in HTO planning.
III, prospective non-randomized comparative study.
The primary objective of this study was to determine the time to and level of return to sports after anterior cruciate ligament (ACL) reconstruction in children and adolescents. The secondary ...objectives were to evaluate the risk of early ACL re-tear after return to sports and the risk of ACL tear in the contralateral knee.
The time to return to sports in young patients is considerably longer than in adults.
A prospective multicentre study was conducted at 12 centres specialised in knee ligament surgery, in children and adolescents younger than 18 years, between 1 January 2015 and 31 October 2015. The patients were divided into a paediatric group with open physes and a skeletally mature group with closed physes. We recorded the time to return to sport, the type of sport resumed, and the occurrence of early re-tears on the same side. A poor outcome was defined as a re-tear or an objective IKDC score of C or D. A contralateral ACL tear was not considered a poor outcome.
Of 278 included patients, 100 had open physes and 178 closed physes. In the open physes group, return to running occurred after 10.4±4.7 months, return to pivoting/contact sport training after 13.1±3.9 months, and return to pivoting/contact sport competitions after 13.8±3.8 months. Of the 100 patients, 80% returned to the same sport and 63.5% to pivoting/contact sport competitions. Re-tears occurred in 9% of patients, after 11.8±4.1 months, and contralateral tears in 6% of patients, after 17.2±4.4 months. In all, 19.4% of patients had a poor outcome, including 10.4% with an IKDC score of C or D and 9% with re-tears. In the group with closed physes, return to running occurred after 8.8±5.1 months, return to pivoting/contact sport training after 11.7±4.7 months, and return to pivoting/contact sport competitions after 12.3±4.2 months. Of the 178 patients, 76.9% returned to the same sport and 55.6% to pivoting/contact sport competitions. The re-tear rate was only 2.8% and the contralateral tear rate 5%. In all, 14.7% of patients had poor outcome, including 11.9% with an IKDC score of C or D and 2.8% with re-tears. No risk factors for re-tears were identified; the quadruple-bundle semitendinosus technique showed a non-significant association with re-tears.
In young children, the return to sport time after ACL reconstruction is considerably longer than 1 year and the return to competitions occurs later and is more difficult. The results of this study indicate that reservations are in order when informing the family about return to sports prospects after ACL reconstruction. The return to pivoting/contact sport competitions should not be allowed until 14 months after surgery in young skeletally immature patients, and the risk of re-injury is high within the first 2 years.
IV, retrospective study.
Little is known about the prevalence and factors associated with long-term remission in cutaneous lupus erythematosus (CLE).
To assess the prevalence, the factors associated with remission, and the ...long-term remission with and without treatment during CLE.
Longitudinal cohort study including biopsy-proven patients with CLE seen between November 1, 2019 and April 30, 2021, with at least 6 months of follow-up after diagnosis. Demographic data, CLE subtypes, remission status, and treatments were recorded. Remission was defined by a Cutaneous Lupus Erythematosus Disease Area and Severity Index activity score of 0. Long-term remission was defined by remission >3 years.
Among 141 patients included (81% of women), 93 (66%) were in remission at last follow-up with a median duration since diagnosis of 11.4 years (interquartile range, 4.2-24.7). Long-term remission was observed in 22 (19%) of 114 patients with at least 3 years of follow-up, including 5 (4.4%) with no systemic treatment. Active smoking (odds ratio, 0.22 95%CI: 0.05-0.97; P = .04) and discoid CLE lesions (odds ratio, 0.14 95%CI, 0.04-0.48; P = .004) were associated with a lower risk of long-term remission.
Partial retrospective data collection and tertiary center population.
Long-term remission is rare in CLE and negatively associated with active smoking and discoid CLE.
Reply to the Letter from Grégoire Micicoi et al Tardy, Nicolas; Steltzlen, Camille; Bouguennec, Nicolas ...
Orthopaedics & traumatology, surgery & research,
April 2021, 2021-Apr, 2021-04-00, 20210401, Letnik:
107, Številka:
2
Journal Article
Rituximab (RTX) resistance or early B-cells repopulation were observed in children but only few publications reported the use of Obinutuzumab and no recommendations were made concerning the dosage ...for children.
This study was a single-center retrospective cohort study of all the children followed-up in the Pediatric Neurology Department of Necker-Enfants malades Hospital in Paris, France, and treated with obinutuzumab, between November 1, 2019, and November 1, 2021.
A total of eight children (three females, median age 4.5 years) were treated. Seven patients presented with autoimmune encephalitis and one with myeloradiculitis. The median delay of B-cell repopulation after a course of RTX was 87 days (range 41 to 160). A switch to obinutuzumab (anti-CD20) was performed for eight children. The median duration between the first RTX infusion and obinutuzumab administration was 6.6 months. The dosage regimen for obinutuzumab was one infusion of 1000 mg/1.73 m2, that is to say 580 mg/m2 (maximum 1000 mg/infusion), by extrapolation from the adult dosage. The median delay of B-cell repopulation after one course of obinutuzumab was 230 days (range 66 to 303 days) vs 87 days after one course of RTX (P < 0.01). None of the patients presented side effects with obinutuzumab treatment. All patients had a favorable evolution at the last-follow up. Median follow-up was 1.6 years.
This study reports the use of obinutuzumab in neurological inflammatory diseases in a pediatric population. Obinutuzumab seems to have a better biological efficacy than RTX with a longer time of B-cell repopulation.
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