Postharvest Aloe vera gel coating application maintains the quality of harvested green chilies during cold storage.

The effect of Aloe vera (ALV) coating was studied on chillies at 10 ± 1°C for 28 days. ALV gel-coated chillies showed reduced weight loss, disease incidence, red chili percentage, respiration rate, electrolyte leakage, hydrogen peroxide, and superoxide anion contents. The ALV coating maintained general acceptance in terms of visual quality and marketability index with higher chlorophyll contents, ascorbic acid contents, total phenolic contents, and total antioxidants. In addition, ascorbate peroxidase, catalase, superoxide dismutase, and peroxidase activities were markedly higher in coated chillies compared to control. The biochemical attributes such as soluble solids content, acidity, sugar: acid ratio, and juice pH were non-significantly affected by ALV application; however, the said attributes were comparatively higher in contrast to control. In conclusion, ALV edible coating could be used as an eco-friendly approach for delaying senescence and maintaining the postharvest quality of green chillies up to 28 days. PRACTICAL APPLICATIONS: Green chilies being highly perishable exhibit limited postharvest life with rapid loss of water, shrivelling, wilting, disease incidence, and reduced consumer acceptability. ALV gel coating significantly delayed postharvest senescence, reduced disease spread, maintained higher antioxidant activities of green chilies during cold storage. Therefore, ALV coating [50%] would be the suitable alternative to synthetic preservatives for extending the storage life and conserving the quality of green chilies.

Potential of Aloe vera gel coating for storage life extension and quality conservation of fruits and vegetables: An overview.

Aloe vera (ALV) with its unique nutritional profile is being used for food, health, and nutraceutical industries globally. Due to its organic nature, ALV gel coating has created lot of interest for exploring its potential in extending the shelf and storage life of fresh produce. ALV gel coating plays imperative role in delaying fruit ripening by lowering ethylene biosynthesis, respiration rate, and internal metabolic activities associated with fruit softening, color development, enzymatic browning, and decay. ALV gel coating reduces the microbial spoilage due to its antifungal properties and maintains visual appearance, firmness, sugar: acid ratio, total antioxidants, and phenolic contents with conserved eating quality. ALV coated fruits and vegetables showed reduced weight loss, superoxide ion ( O2-∙ ), hydrogen peroxide (H2 O2 ), ion leakage, and soluble solids content and exhibited higher acidity, anthocyanins, ascorbic acid, catalase (CAT), superoxide dismutase (SOD), and ascorbate peroxidase (APX) activities. It also delayed the enzymatic browning by inducing peroxidase (POD) activity during storage. Recent local studies also revealed that ALV gel coating markedly conserved higher consuming quality and extended storage period (>1.34-fold) of different fruits and vegetables. Overall, Aloe vera gel coating alone or in combination with other organic compounds has shown great potential as a food-safe and eco-friendly coating for maintaining the quality of fruits and vegetables over extended period and reducing postharvest losses in the supply chain. PRACTICAL APPLICATIONS: ALV gel is a plant-based natural coating of eco-friendly nature. The present review summarizes the updated information of ALV gel coating application, methods of extraction, combinations with other postharvest coatings, and its impact on quality of various fruits and vegetables. It also provides future insights for the development of commercially applicable ALV gel coating protocols through simulation studies. So, being a natural coating, ALV gel has tremendous potential to be used in fruit and vegetable industries around the globe.

Determination of Positivity of Computed Tomographic Angiography in Poorly Visualized Left Anterior Descending Artery on Conventional Angiography.

OBJECTIVE: To determine the positivity of CT angiography in visualization of poorly visualized left anterior descending artery (LAD) on conventional angiography for decision of its surgical revascularization. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Cardiac Surgery, Faisalabad Institute of Cardiology, Faisalabad, from July 2014 to March 2015. METHODOLOGY: This study involved 55 patients who had non-graftable LAD on conventional coronary angiography (CCA). All patients underwent computed tomography angiography (CTA). Patients having graftable LAD on CTA then underwent coronary artery bypass grafting (CABG). Peroperatively, the characteristics of LAD such as diameter, calcification and graftability were also recorded. RESULTS: The mean age of the patients was 52.76 ±8.52 years. There were 45 (81.8%) male and 10 (18.2%) female patients. Out of 55 patients, CTA revealed graftable LAD in 33 (60%) cases while LAD was non-graftable in 22 (40%) cases. Out of 33 patients having graftable LAD, 26 (78.79%) patients underwent CABG; whereas, remaining 7 (21.21%) patients had different reasons like other associated diseases and refusal from surgery. Among those who underwent surgery, LAD was graftable in all the patients (100%) peroperatively. Peroperatively 11 (42.3%) patients had mild calcification followed by severe calcification in 9 (34.6%) and moderate calcification in 6 (23.1%) cases. Fifteen (57.7%) patients had LAD caliber >1.5 mm while 11 (42.3%) patients had LAD caliber between 1.25 - 1.5 mm peroperatively. CONCLUSION: Positivity of the CT angiography for poorly visualized LAD on conventional angiography was 60% in the present study.

Multidetector CT imaging of bariatric surgical complications: a pictorial review.

The prevalence of obesity is increasing, along with the number of bariatric surgical procedures performed to treat obesity. Laparoscopic sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and laparoscopic gastric banding (GB) comprise the vast majority of procedures with SG now the dominant procedure in the USA. Although multidetector computed tomography (MDCT) is not always the examination of choice for a particular suspected complication, many of these patients present with non-specific abdominal symptoms and undergo MDCT evaluation as an initial diagnostic test. This pictorial essay will review and discuss the normal post-surgical bariatric appearance on MDCT, and the appearance of common and uncommon complications associated with the common bariatric procedures on MDCT with correlative imaging. SG complications include leak/abscess, hemorrhage, splenic injury, and portomesenteric thrombosis. RYGB complications include leak/abscess, gastrogastric fistula, small bowel obstruction, internal hernia, and intussusception. Although GB is waning in popularity, radiologists continue to see the legacy of these patients and complications include gastric prolapse, band erosion, and port/tubing mechanical failures. Awareness of the characteristic findings of bariatric complications on MDCT is critical, allowing for earlier recognition and prompt intervention.

Cesarean scar ectopic pregnancy: imaging features, current treatment options, and clinical outcomes.

PURPOSE: Cesarean scar ectopic pregnancy (CSEP) is considered to be quite rare, but the frequency is increasing given the increasing number of cesarean sections being performed, along with increased detection due to widespread use of early endovaginal sonography. The normal sonographic and magnetic resonance findings of this phenomenon will be discussed, including the appearance of complications associated with abnormal placentation, such as the placenta accreta spectrum. Cases of CSEP at our institution will be illustrated, along with clinical presentations and treatment outcomes. METHODS: The study included women who were diagnosed with a CSEP in the first trimester, which was confirmed by ultrasound. The clinical presentations, imaging findings, and treatment outcomes of these pregnancies were recorded. RESULTS: In our series, treatment ranged from no intervention with fetal demise on short-term follow-up ultrasound to viable near-term deliveries requiring cesarean section, urgent blood products, and emergent surgery. The majority of our cases 75% (15 of 20) underwent successful early first trimester termination by a combination of systemic methotrexate administration, ultrasound-guided injection of embryocidal agents, and/or surgery. CONCLUSION: Early imaging recognition and diagnosis of CSEP is critically important to minimize maternal complications, maintain treatment options, and potentially preserve future fertility.

Gel scaffolds of BMP-2-binding peptide amphiphile nanofibers for spinal arthrodesis.

Peptide amphiphile (PA) nanofibers formed by self-assembly can be customized for specific applications in regenerative medicine through the use of molecules that display bioactive signals on their surfaces. Here, the use of PA nanofibers with binding affinity for the bone promoting growth factor BMP-2 to create a gel scaffold for osteogenesis is reported. With the objective of reducing the amount of BMP-2 used clinically for successful arthrodesis in the spine, amounts of growth factor incorporated in the scaffolds that are 10 to 100 times lower than that those used clinically in collagen scaffolds are used. The efficacy of the bioactive PA system to promote BMP-2-induced osteogenesis in vivo is investigated in a rat posterolateral lumbar intertransverse spinal fusion model. PA nanofiber gels displaying BMP-2-binding segments exhibit superior spinal fusion rates relative to controls, effectively decreasing the required therapeutic dose of BMP-2 by 10-fold. Interestingly, a 42% fusion rate is observed for gels containing the bioactive nanofibers without the use of exogenous BMP-2, suggesting the ability of the nanofiber to recruit endogenous growth factor. Results obtained here demonstrate that bioactive biomaterials with capacity to bind specific growth factors by design are great targets for regenerative medicine.

Severe hypocalcaemia following coronary artery bypass grafting due to hypoparathyroidism.

A 55 years old man was extubated on first postoperative day following coronary artery bypass grafting at 7:30 am. The same day at 5 pm, he became drowsy but arousable only on painful stimuli with severe generalized hypertonia and bilateral upgoing plantars. He was reventilated and a provisional diagnosis of cerebrovascular accident was made. CT scan of brain was normal except for bilateral basal ganglia calcification. On further investigations, he was found to be severely hypocalcaemic due to hypoparathyroidism. All symptoms resolved on the treatment of his hypocalcaemia. There was no history of neck surgery in this patient and the case additionally highlights important interaction between parathyroid hormone (PTH) in calcium metabolism.

Characterizing the host response to rhBMP-2 in a rat spinal arthrodesis model.

STUDY DESIGN: Prospective, randomized, controlled preclinical trial. OBJECTIVE: This study seeks to characterize the localized and systemic host response to recombinant human bone morphogenetic protein-2 (rhBMP-2) in a well established rodent spine arthrodesis model utilizing cytokine analysis and magnetic resonance imaging (MRI). SUMMARY OF BACKGROUND DATA: Although high fusion rates are achieved with rhBMP-2 in the spine, several complications have also been reported, including a localized response leading to radiculitis and seroma formation. The mechanism in which this occurs clinically is yet unknown. METHODS: One hundred female Fischer rats underwent a posterolateral intertransverse lumbar spinal fusion, with paraspinal muscle tissue resection, using iliac crest autograft, type I absorbable collagen sponge (ACS), 10- or 100-µg rhBMP-2/ACS. The animals underwent magnetic resonance imaging evaluation, serum cytokine analysis, manual palpation, and gross tissue inspection at 2, 4, 7, 10, and 21 days, postoperatively. RESULTS: Qualitative evaluation of MR images demonstrated a transient fluid collection at the surgery site in the rhBMP-2 animals as early as 4 and 7 days that was greater than the autograft or ACS groups. Quantitative analysis on T2-weighted axial images demonstrated greater signal intensity in the rhBMP-2 animals compared with the ACS and autograft groups in a time-dependent fashion. Higher concentrations of several cytokines were also detected at 2, 4, and 7 days, including interleukin 1ß, interleukin 18, tumor necrosis factor α, macrophage inflammatory protein 1α, and monocyte chemotactic protein 1 in animals treated with rhBMP-2/ACS relative to ACS alone. CONCLUSION: Our data suggest that the in vivo host response to rhBMP-2 in an animal model may be associated with circulating proinflammatory and osteoclastic cytokines.

Functional and radiographic outcomes of juvenile osteochondritis dissecans of the knee treated with extra-articular retrograde drilling.

BACKGROUND: Osteochondritis dissecans (OCD) lesions of the medial femoral condyle in the adolescent population can cause significant impairment and restriction in physical activity. Studies have established the efficacy of transarticular antegrade drilling for juvenile OCD lesions of the knee, although concerns of consequences from drilling through the articular cartilage remain. Alternatively, retrograde extra-articular drilling avoids drilling the cartilage while ensuring adequate channels for revascularization and healing. PURPOSE: The authors present the results of 31 skeletally immature patients who underwent retrograde drilling of OCD lesions of the knee with an average follow-up of 4 years. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The procedure consisted of a standard arthroscopic evaluation of the knee and subsequent percutaneous retrograde drilling obliquely through the condylar epiphysis starting distal to the physis and ending in the center-center of the OCD lesion. Outcome measures included radiographic signs of healing, Lysholm scoring and the Tegner activity scale to measure performance and activity restriction, and visual analog scale (VAS) pain scores. RESULTS: Average follow-up for the 31 patients was 4 years (range, 1.5-7 years). Sixteen of the 34 lesions were grade I or II based on radiographic findings with signs and symptoms greater than 6 months. The remaining 18 were grade III secondary to a sclerotic rim surrounding the defect. Overall, improvement in Lysholm scores (70 to 95; standard deviation [SD] ± 14.95), Tegner scores (4 to 7; SD ± 2.31), and VAS pain scores (6.9 to 1.3; SD ± 2.16) were found to be statistically significant. Radiographs showed stable or improved lesions in all cases. CONCLUSION: Retrograde extra-articular drilling provided clinical and radiographic improvement in most juveniles with OCD lesions who failed nonoperative management. This method serves to decompress the lesion and allow revascularization without disrupting the articular cartilage surface in stable OCD lesions.

Nanocomposite therapy as a more efficacious and less inflammatory alternative to bone morphogenetic protein-2 in a rodent arthrodesis model.

The use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in spine fusion has led to concerns regarding a potential accompanying inflammatory response. This study evaluates a combination therapy (TrioMatrix®; Pioneer Surgical, Inc., Marquette, MI) comprised of a demineralized bone matrix (DBM), hydroxyapatite, and a nanofiber-based collagen scaffold in a rodent spine fusion model. Thirty-six athymic rats that underwent a posterolateral intertransverse spinal fusion were randomly assigned to 1 of 5 treatment groups: absorbable collagen sponge alone (ACS, negative control), 10 µg rhBMP-2 on ACS (positive control), TrioMatrix®, Grafton® (Osteotech, Inc., Eatontown, NJ), and DBX® (Synthes, Inc., West Chester, PA). Both TrioMatrix® and rhBMP-2-treated animals demonstrated 100% fusion rates as graded by manual palpation scores 8 weeks after implantation. This rate was significantly greater than those of the ACS, Grafton®, and DBX® groups. Notably, the use of TrioMatrix® as evaluated by microCT quantification led to a greater fusion mass volume when compared to all other groups, including the rhBMP-2 group. T2-weighted axial MRI images of the fusion bed demonstrated a significant host response associated with a large fluid collection with the use of rhBMP-2; this response was significantly reduced with the use of TrioMatrix®. Our results therefore demonstrate that a nanocomposite therapy represents a promising, cost-effective bone graft substitute that could be useful in spine fusions where BMP-2 is contraindicated.