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Background: Distal humeral fractures are notorious injuries, and they require surgical fixation. The reliability of reconstruction devices has been a subject of debate. Our primary outcome was to detect differences, if any, between two different groups of patients using the patient-reported outcomes measurement information system (PROMIS) Global-10 form and to compare it with the Mayo elbow performance score (MEPS) results. Other secondary outcomes included the difference in union time between patients who received a reconstruction plate vs those who received a pre-contoured anatomical plate., Material and Methods: It is a prospective randomised study which included a total of 30 cases equally distributed into two groups., Results: The mean PROMIS and MEPS scores for group A were 31.5 SD 6.6 and 77.7, respectively, compared to 33.7 SD 6.66 and 73, respectively, for the other group. Time to union was 13.4 weeks for group A and 12.6 weeks for the other group. There was no statistically significant difference between the groups regarding union and function. However, reconstruction plates were more cost effective. The correlation between the MEPS and PROMIS G scores in both groups was statistically significant., Conclusion: 1. Recon plates continue to be a cost-effective method of treatment in simple intra-articular fractures. 2.PROMIS is a valuable tool to be used along with other scores in future studies.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and fibromyalgia (FM) are two chronic complex diseases with overlapping symptoms affecting multiple systems and organs over time. Due to the absence of validated biomarkers and similarity in symptoms, both disorders are misdiagnosed, and the comorbidity of the two is often unrecognized. Our study aimed to investigate the expression profiles of 11 circulating miRNAs previously associated with ME/CFS pathogenesis in FM patients and individuals with a comorbid diagnosis of FM associated with ME/CFS (ME/CFS + FM), and matched sedentary healthy controls. Whether these 11 circulating miRNAs expression can differentiate between the two disorders was also examined. Our results highlight differential circulating miRNAs expression signatures between ME/CFS, FM and ME/CFS + FM, which also correlate to symptom severity between ME/CFS and ME/CFS + FM groups. We provided a prediction model, by using a machine-learning approach based on 11 circulating miRNAs levels, which can be used to discriminate between patients suffering from ME/CFS, FM and ME/CFS + FM. These 11 miRNAs are proposed as potential biomarkers for discriminating ME/CFS from FM. The results of this study demonstrate that ME/CFS and FM are two distinct illnesses, and we highlight the comorbidity between the two conditions. Proper diagnosis of patients suffering from ME/CFS, FM or ME/CFS + FM is crucial to elucidate the pathophysiology of both diseases, determine preventive measures, and establish more effective treatments., (© 2023. The Author(s).)

Introduction: Neonatal Sepsis is a significant leading cause of infant death around the world, particularly in developing nations. The study aimed to identify maternal and neonatal risk factors linked to neonatal sepsis., Methods: A hospital-based case-control study was conducted in the ICU. Cases were neonates diagnosed as having sepsis by clinical criteria and laboratory findings. Controls were admitted neonates who were neither suspected nor diagnosed with sepsis. Data on mothers and babies, as well as laboratory findings, were gathered and analyzed., Results: A total of 174 cases and 348 controls were included in the study. Maternal age, parity, route of delivery, PROM, prematurity, birth weight, neonatal gender and age were significantly associated with the risk of sepsis ( p < 0.05). However, the bivariate logistic model revealed that the most influential predictors of neonatal sepsis were premature rupture of membranes, Gestational age, Neonatal age, birth weight, and mode of delivery., Conclusion: Both maternal and neonatal variables were found to have a significant association with the risk of neonatal sepsis; thus, empowering mothers to pursue antenatal care may allow the detection of risk factors for undesirable delivery consequences such as neonatal sepsis, as well as appropriate management to mitigate those risks., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

In an effort to identify rare alleles associated with adolescent idiopathic scoliosis (AIS) whole-exome sequencing was performed on a discovery cohort of 73 unrelated patients and 70 age-and sex matched controls, all of French-Canadian ancestry. A collapsing gene burden test was performed to analyze rare protein-altering variants using case-control statistics. Since no single gene achieved statistical significance, targeted exon sequencing was performed for 24 genes with the smallest p values, in an independent replication cohort of unrelated severely affected females with AIS and sex-matched controls (N = 96 each). An excess of rare, potentially protein-altering variants was noted in one particular gene, FAT3, although it did not achieve statistical significance. Independently, we sequenced the exomes of all members of a rare multiplex family of three affected sisters and unaffected parents. All three sisters were compound heterozygous for two rare protein-altering variants in FAT3. The parents were single heterozygotes for each variant. The two variants in the family were also present in our discovery cohort. A second validation step was done, using another independent replication cohort of 258 unrelated AIS patients having reach their skeletal maturity and 143 healthy controls to genotype nine FAT3 gene variants, including the two variants previously identified in the multiplex family: p.L517S (rs139595720) and p.L4544F (rs187159256). Interestingly, two FAT3 variants, rs139595720 (genotype A/G) and rs80293525 (genotype C/T), were enriched in severe scoliosis cases (4.5% and 2.7% respectively) compared to milder cases (1.4% and 0.7%) and healthy controls (1.6% and 0.8%). Our results implicate FAT3 as a new candidate gene in the etiology of AIS., (© 2022. The Author(s).)

Adolescent idiopathic scoliosis (AIS) is the most prevalent pediatric spinal deformity. We previously demonstrated elongated cilia and an altered molecular mechanosensory response in AIS osteoblasts. The purpose of this exploratory study was to characterize the mechanosensory defect occurring in AIS osteoblasts. We found that cilia length dynamics in response to flow significantly differ in AIS osteoblasts compared to control cells. In addition, strain-induced rearrangement of actin filaments was compromised resulting in a failure of AIS osteoblasts to position or elongate in function of the bidirectional-applied flow. Contrary to control osteoblasts, fluid flow had an inhibitory effect on AIS cell migration. Moreover, flow induced an increase in secreted VEGF-A and PGE2 in control but not AIS cells. Collectively our data demonstrated that in addition to the observed primary cilium defects, there are cytoskeletal abnormalities correlated to impaired mechanotransduction in AIS. Thus, we propose that the AIS etiology could be a result of generalized defects in cellular mechanotransduction given that an adolescent growing spine is under constant stimulation for growth and bone remodeling in response to applied mechanical forces. Recognition of an altered mechanotransduction as part of the AIS pathomechanism must be considered in the conception and development of more effective bracing treatments., (© 2022. The Author(s).)

Heavy metals intoxication causes several health problems that necessitate finding new protective and therapeutic approaches. This study aimed to evaluate the impact of Musa sp. leaves extract (MLE) on hepato-renal toxicities induced by cadmium (Cd) in male mice. The phytochemical screening, metal chelating activity (MCA), and the median lethal dose (LD 50 ) of MLE were determined. Fifty CD-1 male mice were used and intraperitoneally (i.p.) injected with MLE (1000 to 5000 mg/kg b.wt) for MLE LD 50 determination. Another 50 mice were used for evaluating the effect of MLE on Cd toxicity. Blood samples were collected for hematological, liver, and kidney functions assessments. Liver tissue homogenates were used for determination of oxidant/antioxidant parameters. Liver and kidney tissues were harvested for histopathological and molecular investigations. MLE showed potent in vitro antioxidant activities. The MCA and LD 50 of the MLE were 75 µg/mL and 3000 mg/kg b.wt, respectively. MLE showed beneficial therapeutic activity against hepato-renal toxicities in Cd-intoxicated mice, evidenced by improving the hematological, biochemical, histopathological, and molecular alterations.

Competing Interests: Competing interests: None declared.

The possible renal and hepatic toxicities of ethylenediaminetetraacetic acid (EDTA) in bean cooking media were studied using 100 male albino mice. Two sublethal doses of EDTA were used to explore their toxic effects; 20 mg/kg and 200 mg/kg, which corresponded to 1/100th and 1/10th of LD 50 , respectively. Accordingly, the toxicity study was performed using 50 mice, divided into five groups ( n = 10/group) as follows: group 1 (Gp1) served as a negative control and was orally administered normal saline; group 2 (Gp2) was administered the bean cooking medium; group 3 (Gp3) was administered EDTA (200 mg/kg); group 4 (Gp4) was administered bean cooking medium containing 20 mg/kg of EDTA; and group 5 (Gp5) was administered bean cooking medium containing 200 mg/kg of EDTA. The results showed no significant changes in liver and kidney functions in Gp2 while Gp3, Gp4, and Gp5 exhibited significant increases in adverse liver and kidney function markers. Hematocrit values were significantly decreased in Gp3 and Gp5, while the total white blood cells counts were significantly decreased in Gp3 and significantly increased in Gp5. The number of platelets was decreased in Gp3, Gp4, and Gp5. The blood levels of sodium (Na + ), iron (Fe 2+ ), and calcium (Ca 2+ ) were decreased in Gp3, Gp4, and Gp5 due to the chelating effects of EDTA. The hepatic and renal architectures were disorganized in Gp3, Gp4, and Gp5 with some hemorrhagic manifestations in livers and kidneys of mice. These results demonstrate that EDTA in bean cooking is harmful in mice under the conditions of this study, and the potentially harmful effects in humans supports restricting its use.

Adolescent idiopathic scoliosis is the most prevalent spine deformity and the molecular mechanisms underlying its pathophysiology remain poorly understood. We have previously found a differential impairment of melatonin receptor signaling in AIS osteoblasts allowing the classification of patients into three biological endophenotypes or functional groups (FG1, FG2 and FG3). Here, we provide evidence that the defect characterizing each endophenotype lies at the level of Gαi proteins leading to a systemic and generalized differential impairment of Gi-coupled receptor signaling. The three Gαi isoforms exhibited a selective serine phosphorylation patterns for each AIS endophenotype resulting in a differential reduction in Gαi protein activity as determined by cellular dielectric spectroscopy and small interfering RNA methods. We found that one endophenotype (FG2) with phosphorylated Gαi 1 and Gαi 2 was consistently associated with a significantly high risk of spinal deformity progression when compared to the other two endophenotypes (FG1 and FG3). We further demonstrated that each endophenotype is conserved among affected family members. This study expands our understanding of the mechanism underlying the Gi-coupled receptor signaling dysfunction occurring in AIS and provides the first evidence for its hereditary nature. Collectively, our findings offers a new perspective on Gαi hypofunctionality in a human disease by revealing specific serine phosphorylation signatures of Gαi isoforms that may facilitate the identification of AIS patients at risk of spinal deformity progression.

A flexible, hollow fiber measuring 1.5 mm diameter was used in conjunction with the laparoscope to deliver a CO2 laser beam to the rabbit uterine horn. The fibers tested consistently transmitted 5 to 15 W of laser power without loss of input mode. Several fiber-to-target distances were evaluated from the standpoint of crater characteristics. Microscopic sections were studied, and crater heights and widths were quantified. All lesions produced by the CO2 laser fiber closely mimicked those delivered by the free-hand piece or micromanipulator. In two chronic experiments, rapid fibrosis and "filling in" of the craters was evident at 5 days. No adhesions were observed. The CO2 laser fiber has several advantages over current techniques for the performance of laser laparoscopy as well as over alternative systems, e.g., neodymium:yttrium-aluminum-garnet(ND:YAG) and argon-coupled fibers. The CO2 laser fiber will further increase the options available to the gynecologist for operative endoscopy.

The effect of pulsed CO2 laser treatment on tissue reaction and fertility was evaluated. The left uterine horn was cut with a pulsed CO2 laser in 16 rats. In eight other rats, the left uterine horn was cut with microscissors. The anastomosis in both groups was accomplished by microsurgical techniques. The adhesions were mostly filmy after laser treatment, as compared with thick adhesions in the conventional group. Absence of adhesions was found in 62.5% and 50% of the laser and conventional surgery group, respectively. Histologically, some degree of fibrosis in the muscularis layer of the uterine horn was seen in the conventional group, whereas proper muscle continuity was seen in the laser-treated group. The pregnancy rates were 81% and 87.5% in the laser and conventional groups, respectively.

The sequelae of long-term inhalation of carbon dioxide laser smoke on 10 white rats were studied in a three-phase experiment. The fine particulate matter resulting from tissue vaporization was deposited in the animals' alveoli, which produced congestive interstitial pneumonia, bronchiolitis, and emphysema. The pathologic findings induced by laser plume are not dissimilar to those resulting from the long-term inhalation of other types of particulate matter. Use of an efficient smoke evacuator should offer substantial protection against these normal effects.

Forty-three rats underwent a series of operations with the CO2 laser to incise the uterine horn. Electronically pulsed laser light was compared with the continuous-wave (CW) mode on alternative horns, with each animal serving as its own control. Five variations of the superpulsed mode were compared with the same number of CW settings. Three experiments were performed: acute evaluation after partial uterine horn transection, acute observation after complete transection, and chronic studies after partial transection. The sectioned uterine horns were grossly observed and photographed, then sampled, histologically fixed, and studied by light and scanning electron microscopy. Zones of thermal necrosis were measured by an imaging tube and quantified by a computer-linked digitizing tablet. The results of this study demonstrated 2.5 times less thermal necrosis by electronically pulsed, versus the CW, laser beam. Four-and-one-half times less necrosis was also observed when the pulsed laser was employed for complete transection experiments. Adhesions were provoked in every animal that underwent chronic investigation. Inflammatory response, adhesion progression, and hydrosalpinx formation were significantly diminished in the pulsed-treated group. Qualitatively, wounds inflicted by pulsing showed different geometric patterns, compared with CW incisions. Electronic pulsing offers the surgeon the combined advantages of knife-like incisions and the precision and hemostatic properties of the CO2 laser.

Continuous wave (CW) CO2 laser using a power of 20 W and a spot size of 0.2 mm was used to cut the left uterine horn in 15 rats. Pulsed CO2 laser using a power of 14 W, pulse repetition rate of 400 pps, and a spot size of 0.2 mm was used to cut the left uterine horn in 16 rats. The right uterine horn was sham-operated and used as a control in each group. Microsurgical anastomosis of the cut horn was performed. The effect on fertility showed a pregnancy rate of 66.6% and 81.25% for the CW and pulsed CO2 laser, respectively. Histopathology studies of the anastomotic site revealed thinning of muscularis with fibrosis of both muscularis and subserosal layers in the CW CO2 laser-treated group. There was no thinning, disruption, or fibrosis of muscularis in pulsed laser-treated group. Adhesion score was not different in the two groups.

The amniotic membrane was used as a graft intraabdominally in the rat to study the healing process and the graft's efficacy in preventing postoperative adhesions. We observed the gradual invasion of the graft with fibroblasts and plasma cells and increased vascularity. By the tenth postoperative day the graft had taken completely. There was no evidence of infection at the graft site or rejection of the graft. Application of the graft after lysis of adhesions was followed by adhesion formation at the graft site. The graft did not show evidence of necrosis but failed to prevent adhesion formation.

We compared the effects of expectant and medical treatment on the fertility outcome in women with mild endometriosis. The five-year cumulative percentage of pregnancy with expectant treatment was 90%. In cases treated with 800 mg danazol a day for six months, the five-year cumulative percentage of pregnancy was 55.2. There was no statistical difference between the two groups. In surgically treated severe endometriosis the five-year cumulative percentage of pregnancy was 89.4. Patients with minimal or mild endometriosis should be offered expectant management for at least six months after all the associated factors are treated. Microsurgery is acceptable management for severe stages of the disease.