ABSTRACT
The coronavirus disease (COVID-19) pandemic has influenced hospital visiting patterns. Although vaccination has decreased infection rates and disease severity, hospital visiting patterns and associated treatment changes related to orthopedics remain unexplored in the Middle East. Therefore, this study aimed to examine the impact of the COVID-19 pandemic and vaccination on individual departments dealing with musculoskeletal disorders in the United Arab Emirates. Relationships between publicly available national data on the number of COVID-19 polymerase chain reaction tests and confirmed and recovered cases during May 2020-July 2021 and hospital data on the number of outpatients, inpatients, operations, and physiotherapy consultations were analyzed. In January 2021, the relationship between vaccination rate and orthopedic unit utilization was evaluated after vaccination campaign initiation. Multifactorial analysis revealed that an increased number of COVID-19-related deaths correlated with a decreased number of joint operations. Negative linear relationships were observed among confirmed and death cases with inpatient treatment and joint operation as well as recovered cases with inpatient treatment. Recovered cases with inpatient treatment and joint operation showed a positive linear relationship. Inpatient spine treatment showed a positive relationship with vaccination rates. The COVID-19 pandemic influenced orthopedic treatment in the Middle East, and vaccination campaigns facilitated inpatient spine treatment.
ABSTRACT
Background: Extradural spinal tumors arise from soft or bony tissues in the spine and account for majority of spinal tumors. Interest in the unilateral biportal endoscopic (UBE) technique is rising, because it can easily decompress the bony spinal canal and accommodate all open surgical instruments under endoscopic guidance. However, reports of this technique have been limited to certain diseases. This study first demonstrates the UBE technique for extradural tumor biopsy and removal, and percutaneous stabilization in a 72-year-old female patient with dramatic symptom improvement. Methods: We used the UBE technique for decompression and the percutaneous screw fixation technique for stabilization in a patient with an extradural mass compressing the thecal sac and destroying the posterior element. Under endoscopic guidance, a unilateral approach was used, and decompression and flavectomy were performed bilaterally. After decompression, tumor removal and biopsy were performed using various forceps and biopsy needles. After confirming sufficient spinal canal decompression, the screw was placed percutaneously. We evaluated the technical process of the procedure, the patient's pre- and postoperative pain (using the visual analog scale), and operative radiology and pathologic results. Results: Postoperative pain and disability improved clinically, and spinal alignment stabilized radiologically. As the pathology findings confirmed an aneurysmal bone cyst, the treatment was completed without adjuvant therapy. Conclusions: We treated an unstable spine due to an extradural tumor with the UBE and percutaneous screw techniques.
ABSTRACT
Although global cheese manufacturers release a variety of products onto the market, research on the microbiological quality and safety of cheese has focused mainly on conventional cheeses made from milk. Here, this study aimed to investigate commercially processed cheese products produced by mixing conventional cheeses after melting. Two approaches were used: a summary and comparison of legal definitions and standards/regulations regarding the microbiological criteria used by major cheese traders in the global market (Australia/New Zealand, China, European Union, Japan, Mexico, Republic of Korea, and the United States) and a comprehensive microbiological analysis of commercial products (nâ¯=â¯800), along with an assessment of salinity, pH, water activity, and heating conditions. The results of the literature search showed that major importing countries (China, Japan, Mexico, and the Republic of Korea) have stricter microbiological criteria for commercially available cheese products than major exporters (Australia/New Zealand, EU, and the USA). The former set limits with respect to the number of total coliforms in the product. Microbiological analyses were designed according to global standards and recommendations. No test sample contained detectable levels of Clostridium perfringens, enterohemorrhagic Escherichia coli, Listeria monocytogenes, Salmonella, or Staphylococcus aureus. In addition, no coliform bacteria (including E. coli) were detected. Overall, 79.9% of the samples contained detectable aerobic plate counts (1.0-7.8â¯logâ¯CFU/g); these levels varied significantly according to product type (grated cheeseâ¯>â¯chunks; cream cheeseâ¯>â¯portions or sliced) (pâ¯<â¯.05). There was no significant association between microbe levels and salinity, water activity, pH, and heating conditions. The results can be used to develop a comprehensive database about commercially processed cheese products available in the global market and, as such, may be helpful for both national authorities and cheese manufacturers when considering novel strategic management plans for microbiological quality and safety.
