Can low-grade chondrosarcoma in flat bones be treated with intralesional curettage and cryotherapy?

BACKGROUND AND OBJECTIVES: Chondrosarcomas in flat bones are thought to be more aggressive in their behavior, and little is known about intralesional treatment outcomes of low-grade chondrosarcoma in these locations. We tried to find the differences between patients who had low-grade chondrosarcoma in their flat bones versus those with long bone involvement with regard to (1) disease outcome, (2) functional outcome, and (3) treatment complications. METHODS: We retrospectively reviewed 44 patients with primary low-grade chondrosarcoma who were treated with intralesional curettage and cryotherapy. The patients were divided by location of tumor, group I (flat bones, seven patients) and group II (long bones, 37 patients). RESULTS: The local recurrence rate was higher in group I with 5 years disease-free survival of 80.0% in group I and 97.0% in group II (p = 0.001). All recurrent cases were noted to have initially presented with soft tissue extension (Enneking stage IB). The mean Musculoskeletal Tumor Society score at the last follow-up was 21.7 in group I and 27.9 in group II (p = 0.045). CONCLUSIONS: Intralesional curettage and cryotherapy for low-grade chondrosarcoma appear to be a safe and reasonable surgical option for patients with lesions confined to bone (Enneking stage IA). LEVEL OF EVIDENCE: Level III, retrospective cohort study. See the Guidelines for Authors for a complete description of levels of evidence.

Combining Ability and Performance of Extra-Early Maturing Provitamin A Maize Inbreds and Derived Hybrids in Multiple Environments.

Availability of maize (Zea mays L.) hybrids with elevated provitamin A (PVA) levels and tolerance to contrasting stresses would improve food self-sufficiency and combat malnutrition in sub-Saharan Africa (SSA). This study was conducted to (i) analyze selected PVA inbreds of extra-early maturity for carotenoid content, (ii) estimate the combining abilities of the inbred lines for grain yield and other agronomic traits, (iii) assign inbred lines to distinct heterotic groups (HGs), (iv) identify testers among the inbred lines, and (v) determine grain yield and stability of the PVA hybrids across contrasting environments. Thirty-three extra-early maturing inbred lines selected for high carotenoid content were crossed with four inbred testers to obtain 132 testcrosses. The testcrosses, six tester × tester crosses and two hybrid checks, were evaluated across three Striga-infested, four drought and five optimal growing environments in Nigeria, 2014-2016. Results of the chemical analysis revealed that inbred lines TZEEIOR 109, TZEEIOR 30, TZEEIOR 41, TZEEIOR 97, TZEEIOR 42, and TZEEIOR 140 had intermediate PVA levels. Both additive and nonadditive gene actions were important in the inheritance of grain yield and other measured traits under stress and optimal environments. However, additive gene action was preponderant over the nonadditive gene action. The inbred lines were classified into three HGs across environments. Inbreds TZEEIOR 249 and TZEEIOR 30 were identified as testers for HGs I and II, respectively. The hybrid TZEEI 79 × TZEEIOR 30 was the most outstanding in terms of grain yield and was stable across environments. This hybrid should be tested extensively in on-farm trials for consistency in performance and commercialized to combat malnutrition and food insecurity in SSA.

Nigerian Surgical Trainees' Work Schedule: It is Time for a Change!

BACKGROUND: Unregulated work schedules have deleterious effects on trainees' productivity and patients' safety. For these reasons, duty hours have been capped in many developed countries. Such regulations, however, appear to be lacking in many parts of Africa, and the effects of unregulated work hours in this part of the world have only been scantily documented. This study evaluated the work schedule of Nigerian surgical trainees, and its impact on their wellbeing, as well as assessed the perception of trainees towards capped duty hours. METHODS: A cross-sectional survey of 650 Nigerian Resident Doctors in surgical specialties was conducted in November 2020. Enquiries were made about their work schedules using a purpose-designed questionnaire, developed using Google Forms®. The data were analysed using the IBM SPSS version 23. RESULTS: The mean weekly work hours of surgical residents was 122.72 ± 34.17 h. Majority (228, 40.4%) of the residents had cumulative call hours of ≥ 72 h per week. One-half (283, 50.1%) of them worked continuously for up to 48-72 h during calls, with mean daily sleep hours of 3.53 ± 1.42 h during calls. The majority (558, 98.8%) of respondents had post-call clinical responsibilities. Seventy-five percent of the respondents reported hazards from prolonged work hours, and an overwhelming majority (530, 93.8%) desire official limits on work hours. CONCLUSION: Prolonged, unregulated work schedules appear to be the norm among Nigerian surgical trainees. This trend calls for urgent measures, to avoid potentially catastrophic consequences on both physicians and patients.

Assessment of Korean rice lines for their reaction to rice yellow mottle virus in Ghana.

Rice yellow mottle virus (RYMV) is the most damaging viral disease of rice in Africa and can cause yield losses of up to 100%. The objective of this study was to characterize newly introduced rice lines from Korea into Ghana for their reaction to RYMV infection. One hundred and seventy-two rice lines from Korea were screened for their level of resistance RYMV in a screen house at Fumesua, Ghana. Four checks consisting of two highly resistant lines (Tog7291 and Gigante with rymv1-2 (resistant gene1-allele2) and rymv2 (resistant gene2) respectively), a moderately resistant line (CRI-Amankwatia) and a susceptible cultivar Jasmine 85 were used. The experiment was carried out in a 4 x 44 lattice design with four replicates. Screening for RYMV resistance was conducted by visual symptom scoring and virus-assessment through serology using enzyme linked immunosorbent assay (ELISA) test. Disease incidence and severity were assessed from 2 to 42 dpi. Data for disease severity and incidence were transformed (Log x+1) for ANOVA. Five lines (8261112, 8261119, 8261133, 8261588, and 8261634) were identified to be highly resistant to the disease just like Tog7291 and Gigante. The study also revealed 24 lines that were resistant but not grouping with Tog7291 and Gigante, whereas 100 moderately resistant lines clustered with the moderately resistance check CRI-Amankwatia in a distinct group. Forty-three (43) susceptible lines were identified with the susceptible check Jasmine 85 falling in this group. No highly susceptible line was identified. The newly idenfied resistant genotypes can be used by breeders to develop RYMV resistant varieties.

30-Day Outcomes of Operative Versus Nonoperative Management for Humeral Diaphyseal Fractures in Patients with Concomitant Hip Fractures.

Every year over 330,000 people are hospitalized for hip fractures in the US. Of those patients, approximately 4-5% of patients with hip fractures present with a concomitant upper extremity fracture. Upper extremity (UE) fractures account for an estimated 2 million fractures a year. The number of hip fractures is projected to double by 2050. There is evidence that the presence of a concomitant upper extremity fracture results in an increased hospital length of stay (LOS), lower functional capacity upon discharge and higher mortality rates than seen with hip fractures in isolation. Additionally, hip fractures pose a significant economic burden and are expected to increase to over $62 billion in 2040. As such, hip fractures are a public health crisis. This study seeks to evaluate the differences in perioperative outcomes between nonoperative and operative management of humeral diaphyseal fractures in patients with concomitant hip fractures. (Journal of Surgical Orthopaedic Advances 29(2):99-102, 2020).

A predictive model for increased hospital length of stay following geriatric hip fracture.

BACKGROUND: The purpose of this study was to identify the risk factors that are significantly associated with hospital length of stay (LOS) following geriatric hip fracture and to use these significant variables to develop a LOS calculator. MATERIALS AND METHODS: This was a retrospective study examining 614 patients treated for geriatric hip fracture between January 2000 and December 2009 at an urban, Level 1 trauma center. A negative binomial regression analysis was used to identify perioperative variables associated with hospital LOS. RESULTS: 614 patients met the inclusion criteria, presenting with a mean age of 78 (±10) years. The most common pre-operative comorbidity was hypertension, followed by diabetes and COPD. After controlling for all collected comorbidities as well as demographics and operative variables, hypertension (IRR: 1.10, p = 0.029) and disseminated cancer (IRR: 1.24, p = 0.007) were found to be significantly associated with LOS. In addition, two demographic/presenting variables, admission to the medicine service (IRR: 1.48, p < 0.001) and male sex (IRR: 1.09, p = 0.034), were shown to be independent risk factors for prolonged LOS. These variables were synthesized into a LOS formula, which estimated LOS to within 3 days of the true length of stay for 0.758 of the series (95% confidence interval: 0.661 to 0.855). CONCLUSIONS: This study identified several comorbidity and perioperative variables that were significantly associated with LOS following geriatric hip fracture surgery. The resulting LOS model may have utility in the risk stratification of orthopaedic trauma patients presenting with hip fracture.

Microwave ablation of ex vivo bovine tissues using a dual slot antenna with a floating metallic sleeve.

PURPOSE: To study the efficiency of a dual slot antenna with a floating metallic sleeve on the ablation of different ex vivo bovine tissues. MATERIALS AND METHODS: COMSOL Multiphysics® version 4.4 (Stockholm, Sweden), which is based on finite element methods (FEM), was used to design and simulate monopole and dual slot with sleeve antennas. Power, specific absorption rate (SAR), temperature and necrosis distributions in the selected tissues were determined using these antennas. Monopole and dual slot with sleeve antennas were designed, simulated, constructed and applied in this study based on a semi-rigid coaxial cable. Ex vivo experiments were performed on liver, lung, muscle and heart of bovine obtained from a public animal slaughter house. The microwave energy was delivered using a 2.45 GHz solid-state microwave generator at 40 W for 3, 5 and 10 min. Aspect ratio, ablation length and ablation diameter were also determined on ablated tissues and compared with simulated results. Student's t-test was used to compare the statistically significant difference between the performance of the two antennas. RESULTS: The dual slot antenna with sleeve produces localised microwave energy better than the monopole antenna in all ablated tissues using simulation and experimental validation methods. There were significant differences in ablation diameter and aspect ratio between the sleeve antenna and monopole antenna. Additionally, there were no significant differences between the simulation and experimental results. CONCLUSIONS: This study demonstrated that the dual slot antenna with sleeve produced larger ablation zones and higher sphericity index in ex vivo bovine tissues with minimal backward heating when compared with the monopole antenna.