Assessing the general health, increase in mental and physical workload among administrative staff of the University of Nigeria due to the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has changed the global workloads and general well-being of employees, especially in the university system. The object of this study is to evaluate the mental health and effect of increase in workload on the general well-being of the administrative staff of the University of Nigeria, Nsukka, on the resumption of academic activities after the lockdown due to COVID-19. A total of 73 randomly selected administrative staff were involved in the study. Three sets of instruments, the demographic questionnaire, National Aeronautics and Space Administration-Task Load Index, and General Health Questionnaire, were used to obtain information on the demographic characteristics, workload, and level of mental disorder among the respondents due to COVID-19. The generalized linear regression model, 1-way analysis of variance, independent samples t test, and contingency coefficient were used to analyze the data. The results revealed that high workload is significantly associated with high risk of mental and general health disorders among the respondents. The married, divorced, widowed, older, and females staff with >2 children are the most vulnerable to mental disorder, physical workload, frustration, and general health challenges. The younger staff, those with at most 2 children, and those who are still single experience lower mental and general health disorder and are more resilient. Significant and comprehensive health and administrative support should be provided for the overall well-being of the staff.

Intestinal parasites in Przewalski's horses (Equus ferus przewalskii): a field survey at the Hortobágy National Park, Hungary.

The Pentezug Wildhorse Reserve, located in the Hortobágy National Park, Hungary, has one of the biggest ex situ populations of Przewalski's horses and aims to preserve its landscape and to study this subspecies. Between September and November 2018, 79 faecal samples were collected from Przewalski's horses. The McMaster, Willis flotation, natural sedimentation and coproculture methods were applied to all the samples. Results showed an average level of 1287 eggs per gram (EPG), which is a high faecal egg-shedding level. All the samples were positive for strongyle-type eggs (100%). There were no statistical differences regarding the EPG values between different harems of the population. The same happened when considering sexes, ages, lactating status or when bachelors are compared with harem members. Cyathostominae were dominant, when compared to Strongylinae and Tricostrongylidae, and 15 different morphological infective third-stage larvae types and/or species belonging to the order Strongylida were identified. The subfamily Cyathostominae was prevalent in 100% of the horses. Strongylus vulgaris was the most prevalent strongylin (40.5%). Additionally, 27.8% were positive for Parascaris sp. and 2.5% showed Oxyuris equi in their faeces. This study revealed that there is a higher prevalence of Triodontophorus serratus and Poteriostomum spp. in juveniles. Horses with S. vulgaris showed lower levels of EPG. This was the first study involving this population, showing 100% prevalence of intestinal parasites.

Analysis and forecasting of confirmed, death, and recovered cases of COVID-19 infections in Nigeria: Implications for university administrators.

ABSTRACT: The coronavirus (COVID-19) disease outbreak was a public health emergency of international concern which eventually evolved into a pandemic. Nigeria was locked down in March, 2020 as the country battled to contain the spread of the disease. By August 2020, phase-by-phase easing of the lockdown was commenced and university students will soon return for academic activities. This study undertakes some epidemiological analysis of the Nigerian COVID-19 data to help the government and university administrators make informed decisions on the safety of personnel and students.The COVID-19 data on confirmed cases, deaths, and recovered were obtained from the website of the Nigerian Centre for Disease Control (NCDC) from April 2, 2020 to August 24, 2020. The infection rate, prevalence, ratio, cause-specific death rate, and case recovery rate were used to evaluate the epidemiological characteristics of the pandemic in Nigeria. Exponential smoothing was adopted in modeling the time series data and forecasting the pandemic in Nigeria up to January 31, 2021.The results indicated that the pandemic had infection rate of at most 3 infections per 1 million per day from April to August 2020. The death rate was 5 persons per 1 million during the period of study while recovery rate was 747 persons per 1000 infections. Analysis of forecast data showed steady but gradual decrease in the daily infection rate and death rate and substantial increase in the recovery rate, 975 recoveries per 1000 infections.In general, the epidemiological attributes of the pandemic from the original data and the forecast data indicated optimism in the decrease in the rate of infection and death in the future. Moreover, the infection rate, prevalence and death rate in January 2021 coincided with the predictions based on the analysis. Therefore, the Nigerian government is encouraged to allow universities in the country to reopen while university administrators set up the necessary protocols for strict adherence to safety measures.

Post-Kidney-Transplant Diabetes: Evaluation of Risk Factors.

INTRODUCTION: Post-transplant diabetes mellitus is a complication of kidney transplantation with deleterious effects on graft and patient survival and is associated with higher mortality. The goal of this paper is to identify risk factors that contribute to its development so that it can be avoided. METHODS: We performed a retrospective analysis of 659 kidney transplants performed in adult patients between January 2013 and December 2017. We excluded patients with a previous diagnosis of diabetes mellitus and identified 61 patients with post-transplant diabetes mellitus (10.6%), then compared them to a control group of 61 patients who did not suffer from the disease, namely the kidney transplant pair or the patient submitted for transplant immediately after. DISCUSSION: A comparative analysis of the 2 groups revealed significant differences regarding the use of ß-blockers, fasting glucose on the fifth day post-transplant, kidney recipient age, and body mass index. Using multivariate logistic regression methods, 2 variables with an impact on post-transplant diabetes development were found: fasting glucose on the fifth day post-transplant (odds ratio 1.044, 95% confidence interval 1.010-1.079, P = .010) and body mass index (odds ratio 1.130, 95% confidence interval 1.009-1.264, P = .034). We did not find any differences for other potential risk factors. CONCLUSION: A high plasma glucose level on the fifth day after the transplant and a high body mass index in the setting of the transplant can potentially impact the transplant's outcomes, so it is important to identify these levels as soon as possible to take measures to prevent this disease.

A 1-Year Follow-Up of Post-operative Scars After the Use of a 1210-nm Laser-Assisted Skin Healing (LASH) Technology: A Randomized Controlled Trial.

BACKGROUND: Laser therapies are used prophylactically for excessive scar formation. The Laser-Assisted Skin Healing treatment induces a controlled heat stress that promotes tissue regeneration. This comparative trial is the first to evaluate the performance of a new automated 1210-nm laser system, compatible with all Fitzpatrick scale phototypes. METHODS: Forty women undergoing bilateral breast reduction were enrolled in this double-blinded randomized controlled trial. The horizontal sutured incision of one breast was treated with the portable 1210-nm laser while in the operating theatre. The other breast was used as the study control. Objective measurements, subjective clinical assessments and safety evaluation were carried out over 1 year by both clinicians and patients. RESULTS: Six weeks following surgery, better overall appearance and modified OSAS scores were reported for the laser-treated scars when compared to the control group (p = 0.024 and p = 0.079). This supports an early effect of the laser treatment during the inflammatory stage of the healing process. After a post-treatment period of 6 months, there continued to be a strong tendency in favour of the laser treatment based on the subjective scores and corroborated by the objective improvement of the treated scar volume (p = 0.038). At 1 year, the laser-treated scars continued to improve compared to the control ones in terms of volume (p = 0.004), surface (p = 0.017) and roughness (p = 0.002), and these comparatively better results were strengthened with the blind expression of patients' preference for their laser-treated scar (p = 0.025). CONCLUSIONS: This new 1210-nm laser treatment, used as a single session performed immediately after surgery, provides significant objective and subjective improvements in scar appearance. These data can be useful when preparing patients to undergo their surgical procedure. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

[Autologous fat grafting in children]. / Les particularités du lipofilling chez l'enfant.

Lipofilling or fat grafting transfer is defined as a technique of filling soft tissue by autologous fat grafting. The basic principle of lipofilling is based on a harvest of adipose tissue, followed by a reinjection after treatment. Lipofilling main objective is a volume defect filling, but also improving cutaneous trophicity. Lipofilling specificities among children is mainly based on these indications. Complications of autologous fat grafting among children are the same as those in adults: we distinguish short-term complications (intraoperative and perioperative) and the medium and long-term complications. The harvesting of fat tissue is the main limiting factor of the technique, due to low percentage of body fat of children. Indications of lipofilling among children may be specific or similar to those in adults. There are two types of indications: cosmetic, in which the aim of lipofilling is correcting a defect density, acquired (iatrogenic, post-traumatic scar) or malformation (otomandibular dysplasia, craniosynostosis, Parry Romberg syndrom, Poland syndrom, pectus excavatum…). The aim of functional indications is correcting a velar insufficiency or lagophthalmos. In the paediatric sector, lipofilling has become an alternative to the conventional techniques, by its reliability, safety, reproducibility, and good results.

Photocurable bioadhesive based on lactic acid.

Novel photocurable and low molecular weight oligomers based on l-lactic acid with proven interest to be used as bioadhesive were successfully manufactured. Preparation of lactic acid oligomers with methacrylic end functionalizations was carried out in the absence of catalyst or solvents by self-esterification in two reaction steps: telechelic lactic acid oligomerization with OH end groups and further functionalization with methacrylic anhydride. The final adhesive composition was achieved by the addition of a reported biocompatible photoinitiator (Irgacure® 2959). Preliminary in vitro biodegradability was investigated by hydrolytic degradation in PBS (pH=7.4) at 37 °C. The adhesion performance was evaluated using glued aminated substrates (gelatine pieces) subjected to pull-to-break test. Surface energy measured by contact angles is lower than the reported values of the skin and blood. The absence of cytoxicity was evaluated using human fibroblasts. A notable antimicrobial behaviour was observed using two bacterial models (Staphylococcus aureus and Escherichia coli). The cured material exhibited a strong thrombogenic character when placed in contact with blood, which can be predicted as a haemostatic effect for bleeding control. This novel material was subjected to an extensive characterization showing great potential for bioadhesive or other biomedical applications where biodegradable and biocompatible photocurable materials are required.

[Median congenital fistula of the upper lip associated with Goldenhar syndrome: Report of a case]. / Fistule congénitale médiane de la lèvre supérieure associée à un syndrome de Goldenhar : à propos d'un cas.

AIM OF THE STUDY: We present the case of a patient with Goldenhar syndrome associated with congenital fistula in the middle of philtrum at the upper lip. PATIENTS AND METHODS: The patient was supported from birth for Goldenhar syndrome. Several procedures were performed in childhood to correct a macrostomia and mandibular hypoplasia right. At 14 years old, she has a rhinoplasty to correct a complex nasal malformation. During the procedure, a hole in the upper central incisor inter-space is found. It is extended by a fistula which runs through the front palate towards the vomer rail at the base of the partition. This fistula is blind behind the vomer and can be completely resected. Pathological examination of the resection reveals a squamous lining. RESULTS: The median fistula of the upper lip are extremely rare : less than 30 cases reported in the literature. The unusual run of the fistula and the recent appearance of a pituitary syndrome in this patient makes us look for a continuity between it and Rathke's pocket by computed tomography imaging type. CONCLUSION: The association of Goldenhar syndrome and median congenital fistula of the upper lip was never yet described in the literature. The association with hypopituitarism was suspected with the posterior extension of the malformation, not confirmed by the scanner, but strongly suspected jointly by the neurosurgical and plastic surgery team.

[Mycetoma of the foot: a case report]. / Mycétome actino-mycosique du pied, à propos d'un cas.

Mycetoma is a chronic inflammatory cutaneous and subcutaneous pathology caused by either a fongic (eumycetoma) or bacterial (actinomycetoma) infection, which lead to a granulomatous tumefaction with multiple sinuses. When localized in the foot this infection is named "Madura foot". This infection is endemic to tropical and subtropical regions and rarely occurs in western countries. A historical case in Europe of a foot mycetoma evolving since 20 years without any treatment is presented. A histopathologic diagnosis of actinomycetoma has been done in 1987. The patient presented a severe Staphylococcus aureus chronic osteitis leading to a trans-tibial amputation. This case allows to present this infection which, even if rarely presented in France, can be meet especially among a migrant's population.

Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction / Validação da Classificação de Killip e Kimball e Mortalidade Tardia Após Infarto Agudo do Miocárdio

Background: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) during the decade of 60. Objective: To validate the risk stratification of Killip classification in the long-term mortality and compare the prognostic value in patients with non-ST-segment elevation MI (NSTEMI) relative to patients with ST-segment elevation MI (STEMI), in the era of reperfusion and modern antithrombotic therapies. Methods: We evaluated 1906 patients with documented AMI and admitted to the CCU, from 1995 to 2011, with a mean follow-up of 05 years to assess total mortality. Kaplan-Meier (KM) curves were developed for comparison between survival distributions according to Killip class and NSTEMI versus STEMI. Cox proportional regression models were developed to determine the independent association between Killip class and mortality, with sensitivity analyses based on type of AMI. Results: The proportions of deaths and the KM survival distributions were significantly different across Killip class >1 (p <0.001) and with a similar pattern between patients with NSTEMI and STEMI. Cox models identified the Killip classification as a significant, sustained, consistent predictor and independent of relevant covariables (Wald χ2 16.5 [p = 0.001], NSTEMI) and (Wald χ2 11.9 [p = 0.008], STEMI). Conclusion: The Killip and Kimball classification performs relevant prognostic role in mortality at mean follow-up of 05 years post-AMI, with a similar pattern between NSTEMI and STEMI patients. .

Fundamento: A classificação ou índice de gravidade de insuficiência cardíaca em pacientes com infarto agudo do miocárdio (IAM) foi proposta por Killip e Kimball com o objetivo de avaliar o risco de mortalidade hospitalar e o potencial benefício do tratamento especializado em unidades coronárias (UCO) na década de 1960. Objetivos: Validar a classificação de Killip para mortalidade total em longo prazo e comparar o valor prognóstico em pacientes com IAM sem elevação do segmento ST (IAMSEST) em relação àqueles com elevação do segmento ST (IAMCEST), na era pós-reperfusão e de terapia antitrombótica moderna. Métodos: Foram avaliados 1906 pacientes com IAM confirmado, admitidos em UCO entre 1995 e 2011, com seguimento médio de cinco anos, para avaliação da mortalidade total. Curvas de Kaplan-Meier foram construídas para comparação da sobrevida por classe Killip e IAMSEST versus IAMCEST. Modelos de regressão de risco proporcional de Cox foram construídos para determinar a associação independente entre a classe Killip e a mortalidade, com análises de sensibilidade por tipo de IAM. Resultados: As proporções de óbitos e as distribuições das curvas de sobrevida foram diferentes conforme a classe Killip >1 (p <0,001) e similares entre IAMSEST e IAMCEST. Os modelos de risco identificaram a classificação de Killip como preditor significante, sustentado, consistente e independente de covariáveis relevantes (Wald χ2 16,5 [p = 0,001], IAMSEST) e (Wald χ2 11,9 [p = 0,008], IAMCEST). Conclusão: A classificação de Killip e Kimball desempenha papel prognóstico relevante na mortalidade em seguimento médio de cinco anos pós-IAM e, de modo similar, entre pacientes com IAMSEST e IAMCEST. .

Investigation of a fatigue failure in a stainless steel femoral plate.

Surgical implants are exposed to severe working conditions and therefore a wide range of failure mechanisms may occur, including fatigue, corrosion, wear, fretting and combinations of them. The mechanical failures of metallic implants may also be influenced by several other factors, including the design, material, manufacturing, installation, postoperative complications and misuse. An 83-year-old patient suffered an oblique femoral shaft fracture due to a fall at home. A stainless steel locking compression plate (LCP) employed in the fracture reduction failed after four months and was sent back to the producer. A second LCP of the same type was implanted and also failed after six months. A failure analysis of the second femoral LCP is performed in this paper. The results demonstrate that poor material quality was decisive to the failure. The chemical analysis revealed a high P content in the steel, which is not in accordance to the standards. A combination of factors lead to LCP fracture and these include: brittle crack initiation due to phosphorus, segregation at grain boundaries, crack propagation due to cyclic loading and final fast fracture favored by the loss of ductility due to cold work.

[Autologous fat grafting and rhinoplasty]. / Rhinoplastie et injection de tissu adipeux autologue.

Revision rhinoplasty can be very challenging especially in cases of thin skin. Autologous fat graft is utilized in numerous applications in plastic surgery; however, its use relative to the nasal region remains uncommon. Adipose tissue, by virtue of its volumetric qualities and its action on skin trophicity, can be considered to be a gold standard implant. From 2006 until 2012, we have treated patients by lipofilling in order to correct sequelae of rhinoplasty. The mean quantity of adipose tissue injected was 2.1cm(3) depending on the importance of the deformity and the area of injection: irregularity of the nasal dorsum, visible lateral osteotomies, saddle nose. Following the course of our practice, we conceived micro-cannulas that allow a much greater accuracy in the placement of the graft and enable to perform interventions under local anesthesia. These non-traumatic micro-cannulas do not cause post-operative ecchymosis and swelling which shorten the recovery time for the patient. On patients who have undergone multiple operations, lipofilling can be a simple and reliable alternative to correct imperfections that may take place after a rhinoplasty.

Validation of the Killip-Kimball classification and late mortality after acute myocardial infarction.

BACKGROUND: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) during the decade of 60. OBJECTIVE: To validate the risk stratification of Killip classification in the long-term mortality and compare the prognostic value in patients with non-ST-segment elevation MI (NSTEMI) relative to patients with ST-segment elevation MI (STEMI), in the era of reperfusion and modern antithrombotic therapies. METHODS: We evaluated 1906 patients with documented AMI and admitted to the CCU, from 1995 to 2011, with a mean follow-up of 05 years to assess total mortality. Kaplan-Meier (KM) curves were developed for comparison between survival distributions according to Killip class and NSTEMI versus STEMI. Cox proportional regression models were developed to determine the independent association between Killip class and mortality, with sensitivity analyses based on type of AMI. RESULTS: The proportions of deaths and the KM survival distributions were significantly different across Killip class >1 (p <0.001) and with a similar pattern between patients with NSTEMI and STEMI. Cox models identified the Killip classification as a significant, sustained, consistent predictor and independent of relevant covariables (Wald χ2 16.5 [p = 0.001], NSTEMI) and (Wald χ2 11.9 [p = 0.008], STEMI). CONCLUSION: The Killip and Kimball classification performs relevant prognostic role in mortality at mean follow-up of 05 years post-AMI, with a similar pattern between NSTEMI and STEMI patients.

Congenital esophageal stenosis owing to tracheobronchial remnants.

OBJECTIVE To emphasize the need of an accurate diagnosis of congenital esophageal stenosis due to tracheobronchial remnants, since its treatment differs from other types of congenital narrowing. CASE DESCRIPTION Four cases of lower congenital esophageal stenosis due to tracheobronchial remnants, whose definitive diagnosis was made by histopathology. Except for the last case, in which a concomitant anti-reflux surgery was not performed, all had a favorable outcome after resection and anastomosis of the esophagus. COMMENTS The congenital esophageal stenosis is an intrinsic narrowing of the organ's wall associated with its structural malformation. The condition can be caused by tracheobronchial remnants, fibromuscular stenosis or membranous diaphragm and the first symptom is dysphagia after the introduction of solid food in the diet. The first-choice treatment to tracheobronchial remnants cases is the surgical resection and end-to-end anastomosis of the esophagus.

[Rupture by attrition of the median nerve found during a carpal tunnel release procedure]. / Découverte inédite d'une rupture par usure du nerf médian lors d'une reprise de canal carpien.

We report the finding of a subtotal rupture of the median nerve caused by a "bridge" or"easel" erosion due to a sequela of childhood wrist fracture. This unpublished observation was made during a carpal tunnel release procedure on an 80-year-old patient who was operated on for recurrence of a severe carpal tunnel syndrome 30 years after a previous neurolysis. If the flexor tendon ruptures are widely described, as well as nerve sections following high energy trauma, the median nerve rupture caused by its erosion over a bony projection has never been published at the best of our knowledge.

[Autologous fat grafting in the surgical management of painful scar: preliminary results]. / Greffe de tissu adipeux autologue dans la prise en charge chirurgicale des cicatrices douloureuses : résultats préliminaires.

The purpose of this study was to report our experience about the effectiveness of autologous fat injections in the management of painful scars. Between 2010 and 2012, all patients with persistent incisional pain despite a well-conduced 6 months medical treatment received an autologous fat graft according to the technique originally described by Coleman. Results interpretation was based on pain improvement thanks to a Visual Analogic Scale (VAS), postoperative patient satisfaction, reduction on analgesics intake and quality of life improvement. Eleven patients were included, the mean quantity of fat injected was 11cm(3). Nine patients (1.5%) benefited from a complete or significant pain decrease, 74.5% reported being very satisfied or satisfied with the result. The mean reduction of VAS was 3.5 points. We did not observe any complication. Autologous fat grafting is an innovative therapeutic approach and appears to be an attractive concept in the management of scar neuromas resistant to drug treatment, by providing an easy effective and safe surgical treatment.

Congenital esophageal stenosis owing to tracheobronchial remnants / Estenosis congenita del esofago por remanecientes traqueobronquicos: relato de cuatro casos / Estenose congenita do esofago por remanescentes traqueobronquicos

OBJECTIVE To emphasize the need of an accurate diagnosis of congenital esophageal stenosis due to tracheobronchial remnants, since its treatment differs from other types of congenital narrowing. CASE DESCRIPTION Four cases of lower congenital esophageal stenosis due to tracheobronchial remnants, whose definitive diagnosis was made by histopathology. Except for the last case, in which a concomitant anti-reflux surgery was not performed, all had a favorable outcome after resection and anastomosis of the esophagus. COMMENTS The congenital esophageal stenosis is an intrinsic narrowing of the organâ€(tm)s wall associated with its structural malformation. The condition can be caused by tracheobronchial remnants, fibromuscular stenosis or membranous diaphragm and the first symptom is dysphagia after the introduction of solid food in the diet. The first-choice treatment to tracheobronchial remnants cases is the surgical resection and end-to-end anastomosis of the esophagus. .

OBJETIVO Enfatizar la necesidad de un diagnóstico preciso de estenosis congénita del esófago por remanecientes traqueobrónquicos, una vez que su tratamiento difiere de los otros tipos de estrechamiento congénito. DESCRIPCIÓN DEL CASO Cuatro casos de estenosis congénita del esófago inferior causada por remanecientes traqueobrónquicos, cuyo diagnóstico definitivo fue obtenido por examen histopatológico. Excepto por el último caso, en el que no se utilizó cirugía antirreflujo concomitante, todos presentaron evolución satisfactoria después de resección y anastomosis del esófago. COMENTARIOS La estenosis congénita del esófago consiste en el estrechamiento intrínseco de la pared del órgano asociado a la malformación de su estructura. Puede ser causada por restos traqueobrónquicos, espesamiento fibromuscular o diafragma membranoso y tiene como primera manifestación clínica disfagia después de la introducción de alimentos sólidos en la dieta. El tratamiento de elección para los casos de remanecientes traqueobrónquicos es la resección del segmento estenosado con anastomosis término-terminal. .

OBJETIVO Enfatizar a necessidade de um diagnóstico preciso de estenose congênita do esôfago por remanescentes traqueobrônquicos, já que seu tratamento difere dos outros tipos de estreitamento congênito. DESCRIÇÃO DO CASO Quatro casos de estenose congênita do esôfago inferior causada por remanescentes traqueobrônquicos, cujo diagnóstico definitivo foi obtido por exame histopatológico. À exceção do último caso, em que não se realizou cirurgia antirrefluxo concomitante, todos apresentaram evolução satisfatória após ressecção e anastomose do esôfago. COMENTÁRIOS A estenose congênita do esôfago consiste no estreitamento intrínseco da parede do órgão associada à malformação de sua estrutura. Pode ser causada por restos traqueobrônquicos, espessamento fibromuscular ou diafragma membranoso e tem como primeira manifestação clínica disfagia após introdução de alimentos sólidos na dieta. O tratamento de escolha para os casos de remanescentes traqueobrônquicos é a ressecção do segmento estenosado com anastomose término-terminal. .

Correction of sequelae of rhinoplasty by lipofilling.

BACKGROUND: Rhinoplasty sequelae can be difficult to treat, especially in patients with thin skin. Autologous fat grafting is already used in numerous applications in plastic surgery. However, its use in the nasal region remains relatively uncommon. Given its volumetric qualities and its action on cutaneous trophicity, adipose tissue can be considered the reference product for filling. METHODS: From 2006 to 2012, 20 patients were treated by autologous fat injections according to the Coleman technique in order to correct rhinoplasty sequelae. The procedures were performed under local or general anaesthesia. The quantity of adipose tissue injected ranged from 1 to 6 cc depending on the size of the deformation and the zone being injected: dorsum irregularities, inverted V deformations, visible lateral osteotomies and saddle nose deformity. RESULTS: Of the 20 patients followed up for 18-24 months, 18 had satisfactory aesthetic results after one procedure and two required a second session. Our experience gradually led us to design micro-cannulae for greater injection precision and enabled us to perform these procedures under local anaesthesia. The reduction in ecchymoses and postoperative oedema through the use of these cannulae has significantly reduced convalescence time. CONCLUSION: In patients who undergo multiple procedures, lipofilling can be a simple and reliable alternative to correct imperfections following rhinoplasty.

New-onset diabetes after transplantation: assessment of risk factors and clinical outcomes.

BACKGROUND: New-onset diabetes after transplantation (NODAT) is a serious complicatin of kidney transplantation (KT) with adverse impacts on graft and patient survivals. This study aims assess potential risk factors for development of NODAT and compare clinical outcomes of KT recipients with versus without NODAT. METHODS: We retrospectively evaluated 648 patients who underwent KT between 2005 and 2009. From the 83 (12.8%) subjects who developed NODAT, we selected 47 for comparison with controls free of diabetes. RESULTS: The diagnosis of NODAT was made at 4.3 ± 8.5 months after transplantation in 47 patients, including 76.6% males, with an overall mean age of 54.5 ± 10.8 years. Patients with NODAT presented higher pretransplantation fasting plasma glucose levels (P < .001) as well as cyclosporine and tacrolimus trough levels (P = .003 and P < .001, respectively). On multivariate analysis, higher pretransplantation fasting plasma glucose and higher tacrolimus, but not cyclosporine concentrations were independent predictors of NODAT. No differences were found for other potential risk factors. Upon follow-up at 6, 12, 24, 36, 48, and 60 months, renal function (estimated Glomerular Filtration Rate using Modification of Diet in Renal Disease), 24 hour proteinuria and proportions of patients with hypertension were similar between groups. Patients with NODAT showed comparable numbers of hospitalizations and infections, as well as acute rejection episodes and acute cardiovascular events as their counterparts. Event-free survival (loss of graft function/death with functioning graft) was similar between the groups (P = .418; K-M). DISCUSSION: In our population, higher pretransplantation fasting plasma glucose levels and higher tacrolimus concentrations were independent predictors of NODAT. During a mean follow-up of 3 years, NODAT was not associated with worse clinical outcomes.

Interleukin-6 gene -174G>C and -636G>C promoter polymorphisms and prostate cancer risk.

Prostate cancer (PCa) is one of the most commonly diagnosed internal malignancies affecting men. Due to the important roles of IL-6 in different physiological and pathophysiological processes, IL-6 polymorphisms may modulate PCa risk. IL-6 -174 G>C (rs 1800795, also designated -236 G>C) and -636 G>C (rs 1800796, also designated -572 G>C) promoter polymorphisms have been implicated in PCa susceptibility, albeit still controversial. A literature search using PubMed and Highwire databases was conducted, resulting in eight case-control studies concerning the IL-6 -174 G>C polymorphism (11,613 PCa cases and 13,992 controls) and four case-control publications regarding the IL-6 -636 G>C polymorphism (1,941 PCa cases and 3,357 controls). In order to derive a more precise estimation, a meta-analysis based upon these selected case-control studies was performed. There was no significant association between IL-6 -174 G>C polymorphism and PCa increased risk. Nevertheless, the presence of allele C and the CC genotype were statistically significantly associated with decreased PCa risk in the overall analysis for IL-6 -636 G>C polymorphism. Additional studies in larger samples and analyses of functional repercussions of these SNPs in prostate tumor cells are necessary to validate these findings.