•A mangled extremity is the most devastating limb injury and presents a challenge•Two main treatment options, reconstruction or amputation•Early extremity reconstruction should be the treatment of ...choice where possible•In this paper the authors describe and suggest treatment approaches in patients with a severely mangled extremity
A mangled extremity is the most devastating limb injury and presents a challenge for the orthopedic surgeon. There are two main treatment options, reconstruction or amputation, but sometimes indications for either are not clear. There are many pro and contra arguments for both options. To make the decision easier numerous score systems have been introduced, but the final decision is based on the judgment and experience of the treating surgeon. Early extremity reconstruction appears to give better results than delayed or late reconstruction and should be the treatment of choice where possible. The goal in reconstruction of a lower extremity is to restore and maintain balance and ambulation, while restoration of an upper extremity's numerous functions is more demanding. In this paper the authors describe and suggest treatment approaches in patients with a severely mangled extremity, including assessment and treatment of all injured tissues, using defined protocols, with special attention to bone stabilization, revascularization, soft-tissue coverage and nerve reconstruction. These have a great impact on the outcome and function of the injured extremity. Rehabilitation and return to the preinjury level is slow and sometimes uncertain.
Purple urine bag syndrome (PUBS) is an uncommon, but usually benign, underrecognized clinical condition with the distressing presentation of purple, blue or reddish discoloration of a patient’s ...catheter bag and tubing in the setting of catheter-associated urinary tract infections (UTIs). PUBS is the result of the complex metabolic pathway of the dietary essential amino acid tryptophan. Its urinary metabolite, indoxyl sulfate, is converted into red and blue byproducts (indirubin and indigo) in the presence of the bacterial enzymes indoxyl sulfatase and phosphatase. The typical predisposing factors are numerous and include the following: female gender, advanced age, long-term catheterization and immobilization, constipation, institutionalization, dementia, increased dietary intake of tryptophan, chronic kidney disease, alkaline urine, and spinal cord injury (SCI). Here, we present a case of PUBS in a home-dwelling elderly female patient with a history of long-term immobility after a pathological spinal fracture, long-term catheterization, constipation, and malignant disease in remission. Urine culture was positive for Proteus mirabilis. This state can be alarming to both patients and physicians, even if the patient is asymptomatic. Healthcare professionals and caregivers need to be aware of this unusual syndrome as an indicator of bacteriuria in order to initiate proper diagnostics and treatment.
Introduction
Fractures of the scaphoid account for 60–70% of all wrist bone fractures. The results of treatment in terms of bone healing vary depending on the type and location of the fracture, the ...time elapsed since the injury, the type of surgical treatment. Nonunion occurs in 5–15% of the cases on average. The purpose of this paper is to compare the surgical techniques and results of treating scaphoid nonunion (SNU) with osteoplastic xenografts of bovine origin or a vascularized autograft of the distal part of the dorsal radius.
Methods
We compare two groups of patients with symptomatic SNU, treated surgically with either a vascularized graft (
n
= 15) or a xenograft of bovine origin (
n
= 15). In the presurgical stage, the demographic characteristics of the patients, the time elapsed between injury and surgery, and classification of the injury (Schonberg, Herbert–Fisher, and Geissler–Slade) were recorded. One year following surgery, bone healing, total duration of the treatment, complications, the Mayo wrist score, and answers to the DASH questionnaire were analyzed.
Results
No statistically significant differences between the two groups of patients were observed for bone healing (86.7% vs 80%) or functional results. A highly significant difference was observed with respect to duration of the surgical intervention in favor of xenografts.
Conclusion
The xenograft method is simple and relatively acceptable, providing good results in terms of healing and functionality.
•The cyclic voltammetry has been successfully used for the determination of SRSA of flavonoids.•Correlation between structure and SRSA has been established.•The reaction mechanism involved in ...superoxide radical scavenging by flavonoids has been proposed.
The reactivities of a set of 18 diverse flavonoids against electrochemically generated superoxide anion radical were studied by monitoring changes in O2/O2·− cyclic voltammetry response upon addition of increasing concentrations of flavonoids. In the presence of flavonoids, the O2·- anodic peak current decreased, while the cathodic peak of O2 remained almost unchanged. Concomitantly with an O2·- anodic peak current decrease, a new irreversible cathodic pre-peak before the O2 reduction peak appeared on the CVs of O2/O2·− upon adding flavonoids. This phenomenon is described in detail for the first time on the basis of experimental measurements and model calculations. Based on the changes in O2/O2·− cyclic voltammetry response upon adding flavonoids, we could draw conclusions about the mechanism of superoxide radical scavenging by flavonoids. The superoxide radical scavenging activities of flavonoids, determined by measuring the anodic current decay of the radical in the presence of increasing concentrations of flavonoids, were expressed in terms of EC60 values, i.e. the concentration of flavonoid needed to consume 40% of a superoxide radical. All of the studied flavonoids showed a more or less pronounced superoxide radical scavenging activity, depending on their structural features. The structure-activity relationship was discussed. Superoxide radical scavenging activities of flavonoids correlated well with their electrochemical oxidation potentials, implying that the scavenging activity of flavonoids is mainly governed by their redox properties.
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The electrochemical behaviour of potential antitumor benzimidazole derivatives (benzobthieno2,3-bpyrido1,2-abenzimidazoles and benzimidazo1,2-aquinolines) bearing one or two piperazine substituents ...was studied at a glassy carbon electrode (GCE) using cyclic and square-wave voltammetry in a wide range of pH values and potential scan rates. The electrochemical oxidation of the studied benzimidazoles proceeded via one or two electrode reactions assigned to the oxidation of one or two piperazine substituents, respectively. The oxidation of piperazine ring involved the transfer of two electrons and one proton in a pH-dependent, kinetically controlled electrode reaction, followed by a homogenous chemical reaction (EC mechanism). Both the reactants and the products of EC reactions were strongly adsorbed on the GCE surface. The electrochemical reduction occurred in one quasireversible, pH-dependent step, followed by a chemical transformation of the electrochemically formed product. The proposed reduction mechanism was related to the cyano moiety. The assignment of electroactive sites in molecules of interest was confirmed by theoretically calculated, using the PM6 method, differences of Net atomic charges between the cation (or anion) and neutral molecule.
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