The sales of foot-propelled scooters in the United States has skyrocketed with a concomitant increase in emergency department visits related to injuries. It is estimated that more than 60% of ...injuries could be prevented or reduced in severity if protective gear had been worn. Pediatric nurses should support efforts to decrease scooter-related injuries in children by advocating for the usage of protective gear. Further research is indicated to assess knowledge of potential dangers in those with reported scooter-related injuries, the extent of injuries, and protective gear worn prior to injury occurrence.
Iron-doped β-rhombohedral boron was synthesized by 28
GHz microwave irradiation on a powder mixture of iron and β-boron. β-Boron strongly absorbs 28
GHz microwaves, and this strong coupling with ...microwave energy can be used to promote a reaction with iron dopant. The powder mixture was heated to 1800°C within 2
min by microwave irradiation, resulting in the formation of β-rhombohedral boron interstitially doped with iron. The reaction proceeded rapidly without accompanying grain growth. The XRD analysis and the electrical conductivity measurements revealed successful incorporation of iron into two doping sites of β-boron.
Purpose
To evaluate the safety and efficacy of an at-home photobiomodulation (PBM) device for the treatment of diabetic foot ulcers (DFUs) in a frail population with severe comorbidities.
Methods
...Prospective, randomized, double-blind, sham-controlled pilot study. Patients (age = 63 ± 11 years, male:female 13:7) with insulin-dependent diabetes type 2, neuropathy, peripheral artery disease, significant co-morbidities, and large osteomyelitis-associated DFUs (University of Texas grade ≥ III) were randomized to receive active (
n
= 10) or sham (
n
= 10) at-home daily PBM treatments (pulsed near-infrared 808 nm Ga-Al-As laser, 250 mW, 8.8 J/cm
2
) for up to 12 weeks in addition to standard care. The primary outcome was the %wound size reduction. The secondary was adverse events.
Results
With the numbers available, PBM-treated group had significantly greater %reduction compared to sham (area cm
2
, baseline vs endpoint: PBM 1020.3 cm
2
vs 0.22.4 cm
2
; sham, 7.9 12.0 cm
2
vs 4.6 13.8 cm
2
,
p
= 0.018 by Mann–Whitney
U
test). Wound closure > 90% occurred in 7 of 10 PBM-treated patients but in only 1 of 10 sham patients (
p
= 0.006). No adverse device effects were observed.
Conclusions
Photobiomodulation at home, in addition to standard care, may be effective for the treatment of severe DFUs in frail patients with co-morbidities and is particularly relevant at these times of social distancing. Our preliminary results justify the conduction of a larger clinical trial. ClinicalTrials.gov: NCT01493895.
•The prevalence of extended-spectrum beta-lactamase (ESBL)-producing bacteria in patients with diabetic foot infection was 25%.•The annual rate of ESBL infection did not change over the ...years.•Patients with ESBL infection had higher SINBAD and Wagner scores upon admission.•They were more likely to have been hospitalized in the recent 6 months.
Objectives: The aim of this study was to describe the predictors and outcomes of infection with extended-spectrum beta-lactamase (ESBL)-producing bacteria in patients with an acute diabetic foot infection (DFI).
Methods: The records of patients admitted with acute DFI to a large tertiary hospital during the years 2014–2018 were reviewed. Demographic, clinical, and laboratory data were collected, as well as outcomes regarding amputations and mortality. Only cultures obtained during the first 2 weeks following admission were considered.
Results: Cultures were available for 493 patients; 121 (24.5%) included bacteria suspected of being ESBL producers. Patients infected with ESBL-producing bacteria were older, more likely to have peripheral vascular disease (PVD), and had higher SINBAD and Wagner scores upon admission. They were also more likely to have been hospitalized in the recent 6 months. Major amputations were more prevalent in patients with versus without an ESBL-producing bacterial infection (30.6% vs 19.4%; P = 0.010), yet overall amputations and mortality rates were similar.
Conclusions: ESBL-producing bacteria are common pathogens in DFI, more prevalent in older patients with PVD, advanced ulcers, and recent hospitalization. They are associated with higher rates of major amputation. These considerations may support the choice of empirical antibiotic therapy in patients admitted with an acute DFI.
Aims
Cartilage injuries rarely heal spontaneously and often require surgical intervention, leading to the formation of biomechanically inferior fibrous tissue. This study aimed to evaluate the ...possible effect of amelogenin on the healing process of a large osteochondral injury (OCI) in a rat model.
Methods
A reproducible large OCI was created in the right leg femoral trochlea of 93 rats. The OCIs were treated with 0.1, 0.5, 1.0, 2.5, or 5.0 μg/μl recombinant human amelogenin protein (rHAM
+
) dissolved in propylene glycol alginate (PGA) carrier, or with PGA carrier alone. The degree of healing was evaluated 12 weeks after treatment by morphometric analysis and histological evaluation. Cell recruitment to the site of injury as well as the origin of the migrating cells were assessed four days after treatment with 0.5 μg/μl rHAM
+
using immunohistochemistry and immunofluorescence.
Results
A total of 12 weeks after treatment, 0.5 μg/μl rHAM
+
brought about significant repair of the subchondral bone and cartilage. Increased expression of proteoglycan and type II collagen and decreased expression of type I collagen were revealed at the surface of the defect, and an elevated level of type X collagen at the newly developed tide mark region. Conversely, the control group showed osteoarthritic alterations. Recruitment of cells expressing the mesenchymal stem cell (MSC) markers CD105 and STRO-1, from adjacent bone marrow toward the OCI, was noted four days after treatment.
Conclusion
We found that 0.5 μg/μl rHAM
+
induced in vivo healing of injured articular cartilage and subchondral bone in a rat model, preventing the destructive post-traumatic osteoarthritic changes seen in control OCIs, through paracrine recruitment of cells a few days after treatment.
Cite this article:
Bone Joint Res
2023;12(10):615–623.
OBJECTIVES
To determine the clinical features of a novel heart syndrome with transient left ventricular (LV) apical ballooning, but without coronary artery stenosis, that mimics acute myocardial ...infarction, we performed a multicenter retrospective enrollment study.
BACKGROUND
Only several case presentations have been reported with regard to this syndrome.
METHODS
We analyzed 88 patients (12 men and 76 women), aged 67 ± 13 years, who fulfilled the following criteria: 1) transient LV apical ballooning, 2) no significant angiographic stenosis, and 3) no known cardiomyopathies.
RESULTS
Thirty-eight (43%) patients had preceding aggravation of underlying disorders (cerebrovascular accident n = 3, epilepsy n = 3, exacerbated bronchial asthma n = 3, acute abdomen n = 7) and noncardiac surgery or medical procedure (n = 11) at the onset. Twenty-four (27%) patients had emotional and physical problems (sudden accident n = 2, death/funeral of a family member n = 7, inexperience with exercise n = 6, quarreling or excessive alcohol consumption n = 5 and vigorous excitation n = 4). Chest symptoms (67%), electrocardiographic changes (ST elevation 90%, Q-wave formation 27% and T-wave inversion 97%) and elevated creatine kinase (56%) were found. After treatment of pulmonary edema (22%), cardiogenic shock (15%) and ventricular tachycardia/fibrillation (9%), 85 patients had class I New York Heart Association function on discharge. The LV ejection fraction improved from 41 ± 11% to 64 ± 10%. Transient intraventricular pressure gradient and provocative vasospasm were documented in 13/72 (18%) and 10/48 (21%) of the patients, respectively. During follow-up for 13 ± 14 months, two patients showed recurrence, and one died suddenly.
CONCLUSIONS
A novel cardiomyopathy with transient apical ballooning was reported. Emotional or physical stress might play a key role in this cardiomyopathy, but the precise etiologic basis still remains unclear.
Mesenchymal stem cells (MSCs) are a potential source of angiogenic factors which may promote wound healing in poorly vascularized diabetic foot ulcers. We demonstrate that MSCs of patients with ...diabetic foot ulcers seeded on decellularized micro-fragments transcribe and secrete angiogenic factors in amounts comparable to MSCs derived from healthy individuals.
•MSCs from Diabetic Patients Have Similar Angiogenic Potential as MSCs from Healthy Donors Once seeded on Decellularized Micro Fragments.•The Resulting Vascular Inducing Device (VID) Transcribes and Secretes A Whole Repertoire of Angiogenic Factors.•A Novel Approach for Induce Angiogenesis, Using Only 10 ML of Bone Marrow, Without the Need for Expansion or Enrichment of MSCs.
Intra-articular fractures can produce degenerative changes causing continued pain and disability, therefore optimal surgical care might be indicated. Metatarsal (MT) intra-articular are no exception. ...While prior literature described mainly intra-articular fractures of the first MT and lateral toes, there is scarce literature addressing fractures of the second MT head, which is the longest and most robust MT bone. In this case series, we report three cases of second MT head fracture-dislocation and their clinical outcomes. We also review the literature addressing this pathology.
Mammalian cells express several transcription factors embedded in the endoplasmic reticulum (ER) as transmembrane proteins that are activated by proteolysis, and two types of these proteins have been ...extensively investigated. One type comprises the sterol regulatory element-binding proteins (SREBP-1 and SREBP-2). The other type comprises the activating transcription factors 6 (ATF6α and ATF6β), which are activated in response to ER stress. It was shown previously that both SREBP and ATF6 are cleaved sequentially first by the Site-1 protease (serine protease) and then by the Site-2 protease (metalloprotease) (Ye, J., Rawson, R. B., Komuro, R., Chen, X., Dave, U. P., Prywes, R., Brown, M. S., and Goldstein, J. L. (2000) Mol. Cell 6, 1355–1364). In this study, we examined various protease inhibitors and found that 4-(2-aminoethyl)benzenesulfonyl fluoride (AEBSF), a serine protease inhibitor, prevented ER stress-induced cleavage of ATF6α and ATF6β, resulting in inhibition of transcriptional induction of ATF6-target genes. AEBSF also inhibited production of the mature form of SREBP-2 that was induced in response to sterol depletion, and appeared to directly prevent cleavage of ATF6α and ATF6β by inhibiting Site-1 protease. As the Site-1 protease is localized in the Golgi apparatus, both SREBP and ATF6 must relocate to the Golgi apparatus to be cleaved. We showed here that AEBSF treatment had little effect on ER stress-induced translocation of ATF6 from the ER to the Golgi apparatus, but blocked nuclear localization of ATF6. These results indicate that the transport of ATF6 from the ER to the Golgi apparatus and that from the Golgi apparatus to the nucleus are distinct steps that can be distinguished by treatment with AEBSF.
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