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12 new type of Dipara Walker, 1833 (Hymenoptera, Chalcidoidea, Pteromalidae, Diparinae) via Nigeria, having a critical for the particular Afrotropical species.
Hydroxyapatite deposition disease is a spectrum of disorders including calcific tendinitis, calcific periarthritis, and hydroxyapatite-induced arthritis. These usually present with acute onset of pain, and clinically, may be confused with acute infection or adhesive capsulitis. Supraspinatus calcific tendinitis and its imaging appearance is well known; however, calcific deposits may occur less commonly in other structures in and around the shoulder joint. We describe nine cases of relatively uncommon locations of calcific deposits around the shoulder with their imaging appearances. The Council for the International Organizations of Medical Sciences (CIOMS) and WHO working group on pharmacovigilance defines five cause specific AEFI which includes an immunization anxiety-related reaction. Historically this term has been used to describe a range of symptoms and signs that may arise after immunization that are related to "anxiety" about the immunization. However, the term "anxiety" does not adequately capture all the elements of this cause specific AEFI. In 2015, the Global Advisory Committee for Vaccine Safety convened an expert working group with the purpose of redefining, preventing and managing this particular AEFI. The term "Immunization Stress-Related Response" is proposed to replace the former terminology. We present a manual that redefines this AEFI and present a framework for prevention, diagnosis and management in both an individual and also when such events occur as clusters and affect multiple individuals. Since such mass events can result in cessation of immunization programmes and/or a loss of public confidence, a communication response is essential. Recently, there has been an apparent increase in terrorism-related incidents. The security experts believe that the risk of terrorist attacks cannot be fully ruled out in the Czech Republic either. For this reason, it is appropriate to obtain information from regions with more experience with terrorism and to learn from their mistakes. Based on the analysis of terrorist attacks in Madrid (2004), Israel (2001-2012) and Paris (2015) and our own experience gained during the humanitarian missions in Libya, Syria, Iraq and Ukraine, adequate recommendations for crisis management are presented. An integral part of the preparedness is also a regular training of activation of disaster management plan and simulation of reaction to a mass casualty incident. Key words mass casualty incident, terrorist attack, disaster management plan.Congenital cleft foot is a deformity characterised by genetic heterogeneity and a high degree of phenotypic variability. This together with its very low incidence is the reason for rather controversial opinions on the treatment. selleck chemical The authors present a case study of a boy with unilateral cleft foot classified as type III by Blauth-Borisch and type II by Abraham et al., who underwent a surgery at the age of 12 months. The defect was closed by rectangular soft tissue flaps, the intermetatarsal ligament connecting the first metatarsal head and the third metatarsal head was reconstructed with local fibrous tissue flap. The present hypermobility with extension position of the first ray were stabilised by the Kirschner wire inserted along the axis of the first ray from the dorsum of the talus through the middle of its head to the medial chondrogenic tarsal bones and further through the first metatarsal bone and the corrected metatarsophalangeal joint of the hallux. At the age of 6 years and 7 months, due to dynamic abductovalgus foot deformity, lengthening calcaneal osteotomy was also performed. Favourable clinical and radiographic outcomes of the used surgical technique were observed by the authors. The cleft foot as such shall be treated after a thorough evaluation of the patient and his/her necessary monitoring during the childhood. Key words ectrodactyly, cleft foot, split hand/foot malformation.Hemicorporectomy or translumbar amputation is an extensive surgical procedure consisting in removing the lower portion of the body. Thakur et al. found a total of 71 hemicorporectomies described in literature before 2017. In the form of a case study we present the case of our patient with terminal pelvic osteomyelitis, in whom hemicorporectomy was subsequently performed, namely from the spine surgery perspective. The man, 19 years old, was exposed to high-voltage electricity and fell down from a height of 4 meters. He suffered an instable comminuted fracture of T10 (AO A3.3.) with paraplegia (Frankel A) and multiple third-degree burns affecting 25% of his total body surface area. Subsequently, the patient underwent a total of 16 surgical procedures performed by medical experts in various specialties (orthopaedic surgery, general surgery, plastic surgery, urology, vascular surgery), but in spite of that the extensive pelvic osteomyelitis has not been successfully managed. At first, urine and stool diversion we portion of the body. Now, 1 year after the surgery, the patient enjoys good physical as well as mental health. Hemicorporectomy is an extensive surgical technique, which can despite multiple complications be offered to patients with otherwise unmanageable condition. Terminal pelvic osteomyelitis is currently the most frequent diagnostic indication and the resulting condition makes possible a long-term survival of the patient in a satisfactory condition. The spinal surgeon is an irreplaceable member of the multidisciplinary team performing the surgical procedure, the primary treatment of the spinal column considerably limits blood losses. Key words hemicorporectomy, en bloc sacrectomy, terminal pelvic osteomyelitis, sacral tumors.PURPOSE OF THE STUDY Our experimental study presents a set of bone grafts harvested by a minimally invasive procedure from selected deceased donors. Our objective was to compare the concentration of red bone marrow in the cancellous bone harvested in this way from selected regions with the reference harvesting from the iliac crest. Thus, the potential of grafts to heal complicated fractures or non-unions is assessed. MATERIAL AND METHODS The Hospital Department of Pathology provided 10 cadaver preparations - 7 male and 3 female for the experiment. In the process of selection, the age limit was 18-50 years, the other exclusion criteria were severe injuries and burning to death as mechanisms affecting the condition of the skeletal system, bone diseases except for osteoporosis, and malignant diseases. From each preparation, a total of 12 samples of cancellous bone tissue were harvested from pre-defined 6 harvest sites bilaterally - proximal humerus, proximal ulna, greater trochanter of proximal femur, distal femn practice just as the material from greater trochanter of the femur, distal femur or proximal humerus, which is of equal quality. The other regions, proximal tibia and ulna, contain only minimum concentration of red bone marrow. CONCLUSIONS The experimental study comparing the concentration of red bone marrow in grafts harvested using a minimally invasive procedure from the region of greater trochanter, distal femur and proximal humerus concluded that these samples are comparable with the grafts from the iliac wing. The grafts harvested from proximal tibia and proximal ulna show only negligible concentration of red bone marrow and their use in clinical practice is disputable. The benefits of our experimental study for treatment shall be further evaluated in a clinical study. Key words bone marrow, stem cells, bone healing/orthobiologics, new technology assessment, autograft harvesting.PURPOSE OF THE STUDY This retrospective study investigated the significance of a combination of peak latency of waveform amplitude and waveform amplitude in association with spinal deformities. The correlation with postoperative neurologic deficit was evaluated too. MATERIAL AND METHODS Between January 2007 and January 2018, a group of 113 patients was evaluated in the study who underwent spine surgery using intraoperative neurophysiological monitoring (IONM) focusing on transcranial motor evoked potential (tc-MEP) monitoring. The average age of the patients was 30 years. Tc-MEPs were recorded bilaterally from tibialis anterior muscle and the abductor hallucis muscle in 88 patients without neurological deficit and in 25 patients with neurological deficit. The peak latency of waveform amplitude was defined as the period from stimulation until the waveform amplitude reached its peak. The correlation with postoperative neurological deficit was examined separately for latency delays of 5% and 10% or more and in cith the decrease of waveform amplitude. Another study found similarities in the decrease of amplitude of 70 % or more from baseline and the delay in amplitude latency of 10% or more from baseline; with 86% sensitivity, 98% specificity, 2% FPR and 86% PPV (1). CONCLUSIONS In conclusion, we investigated the efficacy of a change of peak latency delay of waveform amplitude in tc-MEP monitoring. The utilizing of the peak latency delay of waveform amplitude value resulted in high sensitivity up to 100 % and allows reduction of the FPR and an increase of the PPV. Further studies should set the alarm criteria more precisely for the waveform amplitude latency peak delay to achieve more effective spinal cord tc-MEP monitoring. Our concept of findings supports the neurophysiological monitoring findings in other studies. Key words monitoring, IONM, intraoperative neurophysiological monitoring, tc-MEP, motor evoked potential, transcranial, amplitude, latency, peak.PURPOSE OF THE STUDY The prevalence of complications in surgical units is available in the literature. The aim of this study was to compare the "rotational" (more than one surgeon) and "full-time single surgeon" use of the orthopedic theater. MATERIAL AND METHODS We retrospectively evaluated patients who underwent orthopedic surgery in 2016 in different theaters. A total of 604 of 1973 patients were excluded from the study, and 1369 patients were analyzed. The follow-up period was 1 year. While evaluating the cases, the duration and order of each case, the total operation time on the table, the number of surgeons, the total number of cases, the number of residents, and the experiences of the surgeons were investigated, and the effects of these parameters on the complication rates were analyzed. The Dindo-Clavien system was used to classify the complications. RESULTS When comparing the methods, the complication rate of the full-time single-surgeon method (12.9%) was less than that of the rotational method (21.7%) (p 0.022). A higher rate of complications (8.5%) was observed in operations with a duration of 115 minutes or more compared to other operations (p less then 0.001). A higher complication rate (23.7%) was observed in cases lasting more than 345 minutes (p = 0.002). CONCLUSIONS According to our study, full-time use of the orthopedic theater by a single surgeon was found to be safer than rotational use. In addition, the duration of surgeries lasting longer than 115 minutes or longer than 345 minutes during the day increased the rate of surgical complications. Key words patient safety, surgical planning, operation time, operation order, orthopedic complication.
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