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Objective: To determine the clinical effects of COVID-19 on patients and families after diagnosis at regular intervals of 30 days and 90 days respectively. Study Design: Prospective longitudinal Study. Place and Duration of Study: Combined Military Hospital, Hyderabad Pakistan, from Mar 2020 to Feb 2021. Methodology: Two hundred patients and their families who were symptomatic and RT-PCR positive for COVID-19 with mild and moderate disease were included in the study. The patients listed in our COVID-19 registry were called on Day 30 and Day 90 after the appearance of the first symptoms and were assessed on various parameters. Results: In our study, 200 patients were included and assessed on days 30 and 90. On day 90, the median number of symptoms per person was almost 3, reduced from a median of 7 on day 30. However, at the time of presentation, the median number of symptoms per person was 12. The patients had persistent symptoms that hindered their routine lives and reduced their working capacity. Conclusion: The persistence of clinical symptoms post-COVID-19 requires assessment and longitudinal monitoring. Persistence of symptoms reflects a worse clinical progression and delay in attaining 100% fitness.

Background: Mechanical augmentation upon implantation is essential for the long‐term success of tissue‐engineered intervertebral discs (TE‐IVDs). Previous studies utilized stiffer materials to fabricate TE‐IVD support structures. However, these materials undergo various failure modes in the mechanically challenging IVD microenvironment. FlexiFil (FPLA) is an elastomeric 3D printing filament that is amenable to the fabrication of support structures. However, no present study has evaluated the efficacy of a flexible support material to preserve disc height and support the formation of hydrated tissues in a large animal model. Methods: We leveraged results from our previously developed FE model of the minipig spine to design and test TE‐IVD support cages comprised of FPLA and PLA. Specifically, we performed indentation to assess implant mechanical response and scanning electron microscopy to visualize microscale damage. We then implanted FPLA and PLA support cages for 6 weeks in the minipig cervical spine and monitored disc height via weekly x‐rays. TE‐IVDs cultured in FPLA were also implanted for 6 weeks with weekly x‐rays and terminal T2 MRIs to quantify tissue hydration at study endpoint. Results: Results demonstrated that FPLA cages withstood nearly twice the deformation of PLA without detrimental changes in mechanical performance and minimal damage. In vivo, FPLA cages and stably implanted TE‐IVDs restored native disc height and supported the formation of hydrated tissues in the minipig spine. Displaced TE‐IVDs yielded disc heights that were superior to PLA or discectomy‐treated levels. Conclusions: FPLA holds great promise as a flexible and bioresorbable material for enhancing the long‐term success of TE‐IVD implants. [ABSTRACT FROM AUTHOR]

(1) Background: Our team has previously introduced the Single-Step Pedicle Screw System (SSPSS), which eliminates the need for K-wires, as a safe and effective method for percutaneous minimally invasive spine (MIS) pedicle screw placement. Despite this, there are ongoing concerns about the reliability and accuracy of screw placement in MIS procedures without traditional tools like K-wires and Jamshidi needles. To address these concerns, we evaluated the accuracy of the SSPSS workflow by comparing the planned intraoperative screw trajectories with the final screw positions. Traditionally, screw placement accuracy has been assessed by grading the final screw position using postoperative CT scans. (2) Methods: We conducted a retrospective review of patients who underwent lumbar interbody fusion, using intraoperative 3D navigation for screw placement. The planned screw trajectories were saved in the navigation system during each procedure, and postoperative CT scans were used to evaluate the implanted screws. Accuracy was assessed by comparing the Gertzbein and Robbins classification scores of the planned trajectories and the final screw positions. Accuracy was defined as a final screw position matching the classification of the planned trajectory. (3) Results: Out of 206 screws, 196 (95%) were accurately placed, with no recorded complications. (4) Conclusions: The SSPSS workflow, even without K-wires and other traditional instruments, facilitates accurate and reliable pedicle screw placement. [ABSTRACT FROM AUTHOR]

BackgroundInvasive mold infections (IMIs) are a leading cause of mortality in immunocompromised children, yet there has never been an international epidemiologic investigation of pediatric IMIs.MethodsThis international, prospective cohort study was performed to characterize the epidemiology, antifungal therapy, and outcomes of pediatric IMIs. Children (≤18 years) with proven or probable IMIs were enrolled between August 2007 and May 2011 at 22 sites. Risk factors, underlying diagnoses, and treatments were recorded. Outcomes were assessed at 12 weeks after diagnosis using European Organization for Research and Treatment of Cancer/Mycoses Study Group response criteria.ResultsOne hundred thirty-one pediatric patients with IMIs were enrolled; the most common IMI was invasive aspergillosis ([IA] 75%). Children with IA and those with other types of IMIs had similar underlying risk factors, except that children with IMIs caused by non-Aspergillus species were more likely to have received mold-active antifungal agents preceding diagnosis. The most commonly used antifungal classes after diagnosis were triazoles (82%) and polyenes (63%). Combination therapy was used in 53% of patients. Use of combination therapy was associated with an increased risk of adverse events (risk ratio, 1.98; 95% confidence interval, 1.06-3.68; P = .031), although there was no detectable difference in outcome.ConclusionsAlthough risk factors for IMIs are similar across specific subtypes, preceding antifungal therapy may be an important modifier. Combination antifungal therapy requires further study to determine its true risks and benefits.

Osteoporosis and low bone mineral density (BMD) pose significant challenges in adult spinal deformity surgery, increasing the risks of complications such as vertebral compression fractures, hardware failure, proximal junctional kyphosis/failure, and pseudoarthrosis. This narrative review examines the current evidence on bone health optimization strategies for spinal deformity patients. Preoperative screening and medical optimization are crucial, with vitamin D supplementation showing particular benefit. Among the pharmacologic agents, bisphosphonates demonstrate efficacy in improving fusion rates and reducing hardware-related complications, though the effects may be delayed. Teriparatide, a parathyroid hormone analog, shows promise in accelerating fusion and enhancing pedicle screw fixation. Newer anabolic agents like abaloparatide and romosozumab require further study but show potential. Romosozumab, in particular, has demonstrated significant improvements in lumbar spine BMD over a shorter duration compared to other treatments. Surgical techniques like cement augmentation and the use of larger interbody cages can mitigate the risks in osteoporotic patients. Overall, a multifaceted approach incorporating medical optimization, appropriate pharmacologic treatment, and tailored surgical techniques is recommended to improve outcomes in adult spinal deformity patients with compromised bone quality. Future research should focus on optimizing the treatment protocols, assessing the long-term outcomes of newer agents in the spine surgery population, and developing cost-effective strategies to improve access to these promising therapies. [ABSTRACT FROM AUTHOR]