Priorities in Chronic nonbacterial osteomyelitis (CNO) - results from an international survey and roundtable discussions.

OBJECTIVE: Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disorder that predominantly affects children and young people. The pathophysiology and molecular mechanisms of CNO remain poorly understood, and diagnostic criteria and biomarkers are lacking. As a result, treatment is empiric and follows personal experience, case series and expert consensus plans. METHODS: A survey was designed to gain insight on clinician and patient experiences of diagnosing and treating CNO and to collate opinions on research priorities. A version containing 24 questions was circulated among international expert clinicians and clinical academics (27 contacted, 21 responses). An equivalent questionnaire containing 20 questions was shared to explore the experience and priorities of CNO patients and family members (93 responses). RESULTS: Responses were used to select topics for four moderated roundtable discussions at the "International Conference on CNO and autoinflammatory bone disease" (Liverpool, United Kingdom, May 25-26th, 2022). The group identified deciphering the pathophysiology of CNO to be the highest priority, followed by clinical trials, necessary outcome measures and classification criteria. Surprisingly, mental wellbeing scored behind these items. CONCLUSIONS: Agreement exists among clinicians, academics, patients and families that deciphering the pathophysiology of CNO is of highest priority to inform clinical trials that will allow for the approval of medications for the treatment of CNO by regulatory agencies.

[COMBINED SPINAL-PARAVERTEBRAL ANESTHESIA IN TOTAL HIP ARTHROPLASTY.]

BACKGROUND: Optimizing analgesia in total hip arthroplasty contributed to the idea of combined use of spinal and paravertebral anesthesia. THE AIM: the clinical evaluation of combined spinal-paravertebral anesthesia in patients undergoing total hip ar- throplasty. MATERIALS AND METHODS: 67 patients were divided into groups: at the first a combined spinal-paravertebral anesthesia (KSPA) was used, the second - a combined spinal-epidural anesthesia (CSEA). The location of the lumbar plexus was determined by ultrasound scan. Spinal component was provided 0.5% ropivacaine solution. In the perioperative period propofol infusionfor sedation was used. After operation infusion of 0.2% ropivacaine solution at a rate of5-6 ml/hour was started through the catheter for 48 hours. The postoperative period was assessed pain intensity on a 10-point visual analog scale (VAS), the needfor analgesics, incidence of complications and patient satisfaction with the quality of anesthesia. RESULTS: The lumbar plexus at the L2-3 level was in 29,9%- immediately after the release ofthe intervertebral holes, in 67.2%- in the psoas major muscle at L4-5 level of 80.1% in the psoas major muscle. In both groups postoperative pain intensity within 48 hours does not exceed 3, VAS scores. The frequency of complications in the postoperative period was against the background of paravertebral blockade of 18.2%, against the backdrop of epidural analgesia - 26 5%. 90.1% ofpatients in the first group and 82.4% ofpatients in the second group were fully satisfied with the chosen method of anesthesia (p> 0.05). CONCLUSIONS: Combined spinal-paravertebral block for total hip arthroplasty is an effective and safe method of pain relief.

Malaria signs and infection rate among asymptomatic schoolchildren in Hajr Valley, Yemen.

This study recorded malaria signs and the rate of parasitaemia among asymptomatic schoolchildren in Hajr valley, Hadhramout governorate, Yemen. Tests were made for malaria parasites and anaemia in 469 randomly selected primary-school children aged 6-11 years, together with clinical examination to determine spleen size, and interviews to study sociodemographic factors. Of the children, 12.8% had positive malaria blood films and 11.3% had spleen enlargement. There were significant associations between malaria infection, anaemia and splenomegaly and fever. Children with malaria parasitaemia were more often absent from school.

Malaria signs and infection rate among asymptomatic schoolchildren in Hajr valley, Yemen

This study recorded malaria signs and the rate of parasitaemia among asymptomatic schoolchildren in Hajr valley, Hadhramout governorate, Yemen. Tests were made for malaria parasites and anaemia in 469 randomly selected primary-school children aged 6-11 years, together with clinical examination to determine spleen size, and interviews to study sociodemographic factors. Of the children, 12.8% had positive malaria blood films and 11.3% had spleen enlargement. There were significant associations between malaria infection, anaemia and splenomegaly and fever. Children with malaria parasitaemia were more often absent from school

p53 is dispensable for UV-induced cell cycle arrest at late G(1) in mammalian cells.

Genotoxic agents, including gamma-rays and UV light, induce transient arrest at different phases of the cell cycle. These arrests are required for efficient repair of DNA lesions, and employ several factors, including the product of the tumor suppressor gene p53 that plays a central role in the cellular response to DNA damage. p53 protein has a major function in the gamma-ray-induced cell cycle delay in G(1) phase. However, it remains uncertain as to whether p53 is also involved in the UV-mediated G(1) delay. This report provides evidence that p53 is not involved in UV-induced cellular growth arrest in late G(1) phase. This has been demonstrated in HeLa cells synchronized at the G(1)/S border by aphidicolin, followed by UV exposure. Interestingly, the length of this p53-independent G(1) arrest has been shown to be UV dose-dependent. Similar results were also obtained with other p53-deficient cell lines, including human promyelocytic leukemia HL-60 and mouse p53 knock-out cells. As expected, all of these cell lines were defective in gamma-ray-induced cell growth arrest at late G(1). Moreover, it is shown that in addition to cell cycle arrest, HL-60 cells undergo apoptosis in G(1) phase in response to UV light but not to gamma-rays. Together, these findings indicate that p53- compromised cells have a differential response following exposure to ionizing radiation or UV light.

Drug-induced arterial spasm relieved by lidocaine. Case report.

Following major intracranial surgery in a 35-year-old man, sodium pentothal was intravenously infused to minimize cerebral ischaemia. Intense vasospasm with threatened gangrene arose in the arm used for the infusion. Since the cranial condition precluded use of more usual methods, lidocaine was given intra-arterially, with careful cardiovascular monitoring, to counteract the vasospasm. The treatment was rapidly successful.