Supplementary orthopaedic screening for children and adolescents to prevent permanent skeletal deformities - protocol for the "OrthoKids" study.

BACKGROUND: Skeletal deformities (SD) in children and adolescents can lead to arthritic conditions, impairment of quality of life, and high treatment costs in the long term. However, comprehensive data on the prevalence of SDs in children and adolescents are limited and it remains therefore unclear whether there is a healthcare gap. "OrthoKids" is a project that addresses this evidence gap by implementing an orthopaedic screening for children and adolescents that supplements existing detection examinations within statutory standard care in Germany. OBJECTIVE: To detect SDs so that they can be treated as needed at an early stage. METHODS: The implementation of the supplementary orthopaedic screening will be evaluated through an exploratory cohort study that is set up in the German state Baden-Wuerttemberg. 20,000 children and adolescents aged 10 to 14 years will be recruited as a prospective cohort. A retrospective control cohort will be formed based on claims data provided by two cooperating statutory health insurances (SHIs). Participating children and adolescents receive a one-time orthopaedic screening. If at least one SD is diagnosed, treatment will be provided as part of the statutory standard care. Within the scope of the project, a follow-up examination will be performed after one year. An IT-platform will complement the study. The primary outcome measure is the point prevalence of scoliosis, genu varum/valgum, hip dysplasia, and flat feet. Secondary outcome measures are (i) the point prevalence of further less common SDs, (ii) health-related quality of life (HRQoL), (iii) sports ability based on activity (physical/athletic), physical constraints, and (sports) injuries, as well as (iv) monetary consequences of the orthopaedic screenings' implementation. Implementation determinants will be evaluated, too. DISCUSSION: If the supplementary orthopaedic screening proves to be viable, it could be considered as a supplementary examination for children and adolescents within the frame of SHI in Germany. This could relieve the burden of disease among children and adolescents with SDs. In addition, it could disburden SHIs in the medium to long term. TRIAL REGISTRATION: The OrthoKids study was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) on 26th July 2022 under the number 00029057.

[Immobilized forms of daunorubicin in patients with acute leukemia]. / Primenenie immobilizirovannykh form daunorubitsina u bol'nykh ostrymi leikozami.

AIM: To study pharmacokinetics of liposomal daunorubicine DaunoXome and daunorubicine (rubomycin) associated with red cells: to assess their effectiveness and toxicity in patients with acute leukemia. MATERIALS AND METHODS: 7 patients with resistant or recurrent acute leukemia entered the trial. Of them 2 patients had acute myeloid leukemia. They received DaunoXome in dose 100 mg in days 1, 2 and 3 of 7 + 3 program. 1 patient had pretreated acute promyelocytic leukemia. This patient received 5-day course of DaunoXome in a dose 100 mg in the presence of ATRA therapy. 4 patients were given single dose daunorubicin associated with autoerythrocytes in the courses RACOP and 7 + 3 in a dose 45 mg/m2. Concentrations of free, bound and liposomal daunorubicin were determined spectrofluorimetrically in chlorophorm extracts of plasm, blood, liquor and bone marrow specimens. RESULTS: Immobilization of daunorubicin on the red cells and liposomes changes pharmacokinetics of the drug: peak concentrations change and the area under the concentration curve increases. Tolerance of DaunoXome and daunorubicine associated with red cells was satisfactory in all the cases: clinical and echo-CG signs of cordiotoxicity were absent, myelotoxicity was similar to that of free daunorubicine. DaunoXome was effective in 2 of 3 patients with acute myeloblastic leukemia. CONCLUSION: The findings are of practical interest for physicians designing new programs of therapy of acute leukemia.

[Low doses of cytarabine in the treatment of acute non-lymphoblastic leukemia in adults]. / Malye dozy tsitozara v lechenii ostrykh nelimfoblastnykh leikozov vzroslykh.

Low doses of cytarabine were used in the therapy of 33 adult patients with non-lymphoblastic leukemia. A total of 37.5% of complete remissions were recorded in the group of primary patients, and 36% of complete remissions--in the group of resistant patients and in those with relapses. Indications have been determined, and an opinion on the mechanism of action of low doses of cytarabine has been expressed.

[Complex effect of surface-active substances on the process of microbiological hydrocarbon oxidation]. / Kompleksnoe vliianie poverkhnostno-aktivnykh veshchestv na protsess mikrobiologicheskogo okisleniia uglevodorodov.

The object of this work is to study the effect of various emulsifiers on microbiological oxidation of n-alkanes. The detergents improved permeability of cellular membranes and increased the activity of dehydrogenase. A considerable effect was observed in the presence of anionic (sodium laurylsulfate and ammonium alkylpyrophosphate) and nonionogenic (Tween 85, Syntanol DS-10) surfactants.

[Correlation of the basic growth parameters of microorganisms in the presence of surface-active substances]. / Korreliativnaia sviaz' osnovnykh parametrov rosta mikroorganizmov v prisutstvii poverkhnostno-aktivnykh veshchestv.

The object of this work was to study the effect of the nature of surfactants on the solubility of oxygen in the cultural broth. A correlation was established between the concentration of a surfactant and the concentration of dissolved oxygen, the specific rate of growth and the activity of dehydrogenases. Apparently, the biological action of surfactants on the parameters of growth of the yeast Candida tropicalis K-14 in the process of fermentation should be attributed to the formation of micelles.

[Yeast cultivation on the water-soluble oxidation products of brown coal]. / Kultivirovanie drozhzhei na vodorastvorimykh produktakh okisleniia burogo uglia.

The object of this work was to find out whether a mixture of organic acids produced at the first and second stages of lignite oxidation can be used as a substrate for cultivating six yeast cultures belonging to the Candida genus. Succinic acid has been shown to be the best accumulated component in the mixture. When C. guilliermondii VSB-249 was cultivated on succinic acid, its growth was inhibited by alpha-naphthoic acid, 1,2-naphthalene dicarboxylic acid and isophthalic acid. It might be concluded therefore that a mixture of acids produced at the first atage of oxidation can serve as the source of carbon for Candida since it contains less inhibitors than a mixture of acids produced at the second stage of lignite oxidation.

[Cultivation of Candida tropicalis yeasts on coal substrates]. / Kul'tivirovanie drozhzhei Candida tropicalis na ugol'nykh substratakh.

The optimum conditions have been established in order to obtain aquaeous extracts of oxidized coal. Coal substrates seem to consist of aromatic polycarboxylic acids and unsaturated aliphatic compounds. Candida tropicalis was adapted to coal extracts, and about 2 g of absolutely dry yeast biomass had been obtained from 600 ml of the substrate in the conditions of a laboratory fermenter. The amino acid composition of the biomass was determined.