Lamberttorres1486

The European Leukemia Net (ELN) guidelines for treatment of myelodysplastic syndromes (MDS) connect heterogeneous MDS subgroups with a number of therapeutic options ranging from best supportive care to allogeneic stem cell transplantation (alloSCT). However, it is currently unknown whether adherence to guideline recommendations translates into improved survival. The sizeable database of the Duesseldorf MDS Registry allowed us to address this question. We first performed a retrospective analysis including 1698 patients (cohort 1) to whom we retrospectively applied the ELN guidelines. We compared patients treated according to the guidelines with patients who deviated from it, either because they received a certain treatment though it was not recommended or because they did not receive that treatment despite being eligible. We also performed a prospective study with 381 patients (cohort 2) who were seen in our department and received guideline-based expert advice. Again, we compared the impact of subsequent guideline-adherent versus non-adherent treatment. For the majority of treatment options (best supportive care, lenalidomide, hypomethylating agents, low-dose chemotherapy, and intensive chemotherapy), we found that adherence to the ELN guidelines did not improve survival in cohort 1. The same was true when patient management was prospectively enhanced through guideline-based treatment advice given by MDS experts (cohort 2). The only exceptions were alloSCT and iron chelation (ICT). find more Patients receiving ICT and alloSCT as recommended fared significantly better than those who were eligible but received other treatment. Our analysis underscores the limited survival impact of most MDS therapies and suggests to pursue alloSCT in all suitable candidates. Graphical abstract.

The aim of this study was to group the patients with total knee arthroplasty(TKA) surgery according to the World Health Organization (WHO) obesity classification and to evaluate the effects of body mass index (BMI) on complication rates, the functional and clinical outcomes of the patients after TKA.

Between 2011 and 2018, 588 patients who underwent TKA by a single surgeon were retrospectively evaluated. According to WHO's classification criteria, 588 patients were divided into 5 groups such as normal (< 25.0kg/m

, n 138, 23.4%), overweight (25.0-29.9kg/m

n 201, 34.1%), class I obese (30.0-34.9kg/m

n 124, 21%), class II obese (35-39.9kg/m

n 82, 13.9%) and class III obese (> 40kg/m

n 43 7.6%). Groups were compared in terms of age, sex, surgical side, follow-up period, case duration, prosthesis infection and aseptic prosthesis loosening rates, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm functional scores and knee flexion degrees.

There was a statistically significant difference between the groups in terms of prosthesis infection or aseptic prosthesis loosening following TKA. The incidence of these complications increased as BMI increased (X2 20,079, p 0.01). Postoperative knee flexion degrees, KOOS and Lysholm scores were significantly different between the groups (p 0.000). As BMI increased, clinical and functional outcomes deteriorated.

Obesity is one of the most important risk factors for prosthesis infection and aseptic prosthesis loosening which can be seen after TKA. High BMI values also adversely affect clinical and functional outcomes after TKA.

Obesity is one of the most important risk factors for prosthesis infection and aseptic prosthesis loosening which can be seen after TKA. High BMI values also adversely affect clinical and functional outcomes after TKA.

Medulloscopy refers to the visualization of the intramedullary canal with an arthroscope, providing access to the infection site without the need for an extensive approach therefore not compromising the surrounding soft tissue. It provides information regarding the extent of the infected endosteal surface of bone, and it allows a thorough debridement of the intramedullary canal in a controlled manner. Therefore, it can be used as an adjunct to traditional open surgical techniques, to perhaps help to visualize hard to see intramedullary areas.

This article reports a patient with chronic osteomyelitis of the distal metaphysis of the femur that was treated successfully with intramedullary debridement through medulloscopy. The sinus tract reaching down to the femoral bone and communicating with the intramedullary canal was excised, and a cortical window was formed through which the arthroscope was inserted and thorough irrigation of the intramedullary canal and excision of necrotic and infected bone was done. A second medulloscopy through the same approach was necessary 3months later because of persistent infection. RE SULTS At 3-year follow-up, the patient was well without any clinical or radiographic evidence of recurrent infection.

Medulloscopy can be very useful in localized osteomyelitis as an adjunct to traditional surgical techniques; it helps to visualize hard to see intramedullary areas and adequately addresses the infection, while the damage to surrounding soft-tissue is limited.

Medulloscopy can be very useful in localized osteomyelitis as an adjunct to traditional surgical techniques; it helps to visualize hard to see intramedullary areas and adequately addresses the infection, while the damage to surrounding soft-tissue is limited.Bioremediation of a petroleum contaminated seawater from Persian Gulf was investigated and efficiency of natural attenuation by native halotolerant bacterial consortium, biostimulation by addition of macro nutrients (nitrogen and phosphorus) and surfactant and bioaugmentation by application of halotolerant hydrocarbon degrading strains were evaluated. Biodegradation rates in defined conditions were studied for 30 days. Four pure isolates including Bacillus sp. PG-1, Pseudomonas aeruginosa PG-2, Paenibacillus lautus PG-3, and Pseudomonas putida PG-4 were used to preparation of bacterial consortium. Results indicated that the bioaugmentation yielded the best TPH removal efficiency of 56.24%, followed by biostimulation with surfactant addition (removal of 31.52%). The most bacterial density was also observed for bioaugmentation bioreactor. Toxicity of reaction medium was evaluated by oxygen consumption rate inhibition, dehydrogenase activity inhibition and growth rate inhibition methods in which, the least toxicity rates of 27%, 25% and 31% were observed for bioaugmentation based bioreactor, respectively.