Stability and Clinical Outcomes of Angle Fracture Fixation Using Sagittal Split Plate (SSOP) Versus Two Miniplates: Randomized Clinical Trial.

The aim of this study was to compare the stability and clinical outcomes between the two miniplates and sagittal split plate (SSOP) in angle fracture fixation. Thirty-eight patients with a mandibular angle fracture were selected and divided randomly into two groups. Intervention was treated with SSOP, and the control group was treated with conventional two miniplates. Clinical evaluation included occlusion, edema, nerve affection, wound dehiscence and mouth opening. Radiographic parameters included the measurement of inter-ramus distance, inter-mental distance and bone density. All clinical parameters were evaluated at one week, one month and three months intervals. Radiographic parameters were evaluated immediately postoperative, and after three months. Results showed that SSOP had less postoperative complications (10.50%) than the two miniplates (31.60%). It can be concluded that both methods offered high performance in management of mandibular angle fractures. However, SSOP group had a significantly shorter operating time, increased bone density and less edema. Clinical trial registration number: NCT03839368.

P. falciparum genetic markers associated with drug resistance from patients with treatment failure in the Southern part of Senegal in 2017.

Artemisinin Combination Therapies (ACT) stand as the most potent antimalarial treatments. In response to the emergence of ACT-resistant malaria parasites in Southeast Asia, the World Health Organization (WHO) has recommended continuous monitoring of the effectiveness of ACT and other antimalarials. To address this need, we collected dried blood spots from malaria patients during a 42-days drug efficacy trial evaluating the efficacy of Artesunate plus Amodiaquine (ASAQ), Artemether Plus Lumefantrine (AL) and Dihydroarthemisinine plus Piperaquine (DHAPQ) on simple P. falciparum malaria in 2017. Blood samples were collected on Day 0, prior to the patients' initial ACT dose, and on any days of recurrent parasitemia. Genetic markers such as Merozoite Surface Protein 1 (MSP1) and Merozoite Surface Protein 2 (MSP2) were genotyped to differentiate between recrudescence and re-infestation cases. Furthermore, PCR Single Specific Oligonucleotide Probes combined with-ELISA platform (PCR-SSOP-ELISA) and PCR-RFLP techniques were used to identify Pfcrt 72-76 mutant haplotype and Pfmdr1_86Y allele associated with chloroquine and amodiaquine resistance, respectively. Out of the 320 patients enrolled in the study, only 43 (13.43%) experienced relapses. Upon PCR correction, our analysis revealed that recrudescent infections affected 13 patients, with 8 in the ASAQ group, 5 in the AL group, and none in the DHAPQ group. Notably, no early treatment failures (within the first 3 days of treatment) were observed, and all recurrences occurred between Day 21 and Day 42. The prevalence of the Pfcrt wild-type haplotype CVMNK and Pfmdr N86 allele was 67.03% and 97.70%, respectively. In contrast, the mutant types CVIET and 86Y were found at 32.97% and 2.3%, respectively. The high prevalence of the CVMNK wild haplotype suggests that the parasites remain sensitive to chloroquine, while the low prevalence of the 86Y mutants indicates continued effectiveness of amodiaquine. Furthermore, the low prevalence of strains exhibiting the combination of CVIET and 86Y suggests that the use of multiple antimalarials is valuable for resistance control. Notably, none of the relapse cases carried the 86Y mutation or the combination of 86Y and CVIET.

Single Snapshot Imaging of Optical Properties (SSOP) for Perfusion Assessment during Gastric Conduit Creation for Esophagectomy: An Experimental Study on Pigs.

Anastomotic leakage (AL) is a serious complication occurring after esophagectomy. The current knowledge suggests that inadequate intraoperative perfusion in the anastomotic site contributes to an increase in the AL rate. Presently, clinical estimation undertaken by surgeons is not accurate and new technology is necessary to improve the intraoperative assessment of tissue oxygenation. In the present study, we demonstrate the application of a novel optical technology, namely Single Snapshot imaging of Optical Properties (SSOP), used to quantify StO2% in an open surgery experimental gastric conduit (GC) model. After the creation of a gastric conduit, local StO2% was measured with a preclinical SSOP system for 60 min in the antrum (ROI-A), corpus (ROI-C), and fundus (ROI-F). The removed region (ROI-R) acted as ischemic control. ROI-R had statistically significant lower StO2% when compared to all other ROIs at T15, T30, T45, and T60 (p < 0.0001). Local capillary lactates (LCLs) and StO2% correlation was statistically significant (R = -0.8439, 95% CI -0.9367 to -0.6407, p < 0.0001). Finally, SSOP could discriminate resected from perfused regions and ROI-A from ROI-F (the future anastomotic site). In conclusion, SSOP could well be a suitable technology to assess intraoperative perfusion of GC, providing consistent StO2% quantification and ROIs discrimination.

The associations of HLA-A, -B, DRB1 alleles and haplotypes in Turkish lymphoma patients.

A significant association between lymphomas and HLA alleles has been shown in previous studies. However, the frequency of HLA alleles and haplotypes has not been studied in Turkish lymphoma patients. We studied HLA-A, -B, -DRB1 alleles and haplotypes in 80 adult lymphomas and 360 unrelated normal subjects by PCR-SSOP method using Luminex technology. The allele frequencies of HLA-A*29, B*07, and DRB1*11 were higher in patients with Hodgkin's lymphoma (HL) compared with the controls [OR; 5.65 (95%CI; 2.16-14.81), P=0.001], [OR; 3.00 (95%CI; 1.50-5.99), P=0.003)], and [OR; 1.80 (95%CI; 1.08-3.01), P=0.002); respectively]. In patients with non-Hodgkin's lymphoma (NHL) HLA-B*51 and DRB1*04 allele frequencies were higher than controls [OR; 2.25 (95%CI; 1.27-4.00), P=0.007] and [OR; 2.14 (95%CI; 1.20-3.78), P=0.01]. The most frequently observed haplotypes were A*02 B*35 DRB1*11 (7.50% vs. 1.89%) in HL patients, A*02 B*51 DRB1*11 (5.00% vs. 1.96%) in NHL patients, and A*02 B*35 DRB1*13 (2.19%) in the controls. We detected four haplotypes specific to NHL, five haplotypes to HL patients. Seven haplotypes were unique to controls. Our findings suggest that in HL patients, HLA-A*29, B*07, and DRB1*11 alleles, and in NHL patients, HLA-B*51 and DRB1*04 alleles might be presumptive predisposing factors.

Relationships of Human Leukocyte Antigen-A, -B, -DRB1 Alleles, and Haplotypes in 129 Ethnic Turkish Patients With Acute Myeloblastic Leukemia.

OBJECTIVE: To evaluate the frequencies of HLA class I (A, B) and class II (DRB1) alleles in acute myeloblastic leukemia (AML) and to compare them with the frequencies of those alleles in unrelated, healthy ethnic Turkish control subjects. METHOD: We investigated the relationship of HLA alleles in 129 ethnic Turkish patients with AML and 126 unrelated, healthy, ethnic Turkish controls using the polymerase chain reaction with sequence-specific oligonucleotide probes (PCR-SSOP) method via Luminex technology. RESULTS: Allele frequencies of HLA-A*23, HLA-A*68, HLA-B*13, HLA-B*40, and HLA-DRB1*01 were lower in patients with AML compared with control individuals (P =.04, P =.02, P =.005, P = 02, and P =.02, respectively). In contrast, the HLA-DRB1*15 allele frequency was higher than in the controls (P =.01). The most commonly observed haplotype was A*01/B*08/DRB1*03 (5.4% vs 0.8%; P =.03) in patients with AML. In contrast, the most commonly observed haplotype was A*02/B*35/DRB1*04 (2.3% vs 3.2%) in controls. We could not find any haplotypes negatively associated with AML. Also, the homozygosity of HLA-A*01 and HLA-A*02 alleles were higher in patients with AML compared with controls (P =.046; P =.001, respectively). CONCLUSIONS: The HLA-DRB1*15 allele, the A*01/B*08/DRB1*03 haplotypes, and the homozygosity of HLA-A*01 and HLA-A*02 may play a presumptive predisposing factor in AML. Also, the HLA-A*23, HLA-A*68, HLA-B*13, HLA-B*40, and HLA-DRB1*01 alleles have been found to be negatively associated with AML.

HLA Genotyping: Methods for the Identification of the HLA-DQ2,-DQ8 Heterodimers Implicated in Celiac Disease (CD) Susceptibility.

In this chapter we will present the principal technical methods to genotype the HLA-DQA1* and -DQB1* alleles associated with celiac disease (CD), corresponding to the serological heterodimers HLA-DQ2 and -DQ8. We will present the methods specific for the genotyping of these heterodimers, which represents a common request from consultant doctors. Because these alleles are also common in healthy subjects, their presence is not diagnostic for CD. Conversely, their absence is more important because it excludes the disease, since CD patients negative for these heterodimers are very rare. Accordingly, HLA typing has been included as a useful test to exclude celiac disease in the ESPGHAN guidelines for diagnosis of celiac disease. The methods for HLA typing described in the present chapter are based on the following techniques: PCR-SSP (Polymerase Chain Reaction-Sequence Specific Primers): PCR with primers specific for HLA alleles encoding the CD risk heterodimers, whose presence is revealed through the electrophoresis of PCR products. Reverse PCR-SSOP (PCR-Sequence Specific Oligonucleotide Probes): PCR with primers specific for a single locus or a large group of alleles followed by hybridization with enzyme-conjugated probes specific for a single allele, immobilized on different supports (i.e., nitrocellulose strips), in which DNA-probes binding is revealed by the production of a colored precipitate derived from the enzymatic modification of a specific substrate. Real-Time PCR (RT-PCR): PCR with locus or allelic specific primers whose amplification is revealed by particular probes (i.e., Taqman probes) hybridizing the DNA template within the two PCR primers and emitting fluorescent while the PCR reaction occurs.

HLA-B allele and haplotype diversity among Thai patients identified by PCR-SSOP: evidence for high risk of drug-induced hypersensitivity.

BACKGROUND: There are 3 classes of HLA molecules; HLA class I, II and III, of which different classes have different functions. HLA-B gene which belongs to HLA class I play an important role predicting drug hypersensitivity. MATERIALS AND METHODS: Nine hundred and eighty-six Thai subjects who registered at a pharmacogenomics laboratory were determined for HLA-B genotype using a two-stage sequence-specific oligonucleotide probe system (PCR-SSOP). RESULTS: In this study, HLA-B alleles did not deviate from Hardy-Weinberg equilibrium (P > 0.05). The most common HLA-B alleles observed in this population were HLA-B (*) 46:01 (11.51%), HLA-B (*) 58:01 (8.62%), HLA-B (*) 40:01 (8.22%), HLA-B (*) 15:02 (8.16%) and HLA-B (*) 13:01 (6.95%). This finding revealed that HLA-B allele frequency in the Thai population was consistent with the Chinese population (p > 0.05), however, differed from the Malaysian population (p < 0.05). The top five HLA-B genotypes were HLA-B (*) 40:01/46:01 (2.13%), HLA-B (*) 46:01/46:01 (2.03%), HLA-B (*) 40:01/58:01 (2.03%), HLA-B (*) 46:01/58:01 (1.93%) and HLA-B (*) 15:02/46:01 (1.83%). This study found that 15.92% of Thai subjects carry HLA-B (*) 15:02, which has been associated with carbamazepine-induced severe cutaneous adverse drug reactions (SCARs). Moreover, 16.33% of Thai subjects carry the HLA-B (*) 58:01 allele, which has been associated with allopurinol-induced SCARs. CONCLUSION: This study demonstrates a high diversity of HLA-B polymorphisms in this Thai population. The high frequency of HLA-B pharmacogenomic markers in the population emphasizes the importance of such screening to predict/avoid drug hypersensitivity.

Eficiência do programa de higienização de uniformes em frigorífico / Efficiency of the hygiene program in a refrigerator

A qualidade da higienização industrial deve ser avaliada considerando- -se, entre outros aspectos, o risco que a contaminação alimentar representa para a saúde pública. Este trabalho buscou avaliar as condições higienicossanitárias de superfícies de 25 uniformes de frigorífico, por meio de análise microbiológica para micro-organismos mesófilos aeróbios (UFC/ cm²), conforme a técnica recomendada swab test, avaliando a eficiência do processo de lavagem dos uniformes. Observou-se que 4% das superfícies dos uniformes apresentaram contagens abaixo ou igual 4,0 x100 UFC/ cm², demonstrando condições higiênicas satisfatórias e indicando eficiência nas técnicas de higienização dos uniformes, portanto, não representando riscos de contaminação cruzada através dos uniformes. Tais achados demonstraram que o processo de higienização dos uniformes realizado pelo frigorífico é eficiente e eficaz na redução da carga microbiana, comprovando as boas condições higienicossanitárias dos mesmos.

Evaluación de los programas pre-requisitos del plan HACCP en una planta de sardinas congeladas

Las buenas prácticas de fabricación (BPF) y los procedimientos operativos estándares de saneamiento (POES) en planta son considerados los pre-requisitos esenciales para la implementación del sistema de análisis de peligros y puntos de control crítico (HACCP) como una herramienta para la inocuidad de alimentos durante su procesamiento. El objetivo de esta investigación fue la evaluación de las BPF/POES en una línea de sardina (Sardinella aurita) entera congelada. Se verificó el cumplimiento de las BPF mediante la planilla de evaluación del MSAS (Ministerio de Salud) de Venezuela y de los POES a través de un cuestionario propuesto por la FDA. Las BPF y los POES fueron evaluados en base a deméritos, se obtuvo un valor en porcentaje por cada pre-requisito y fue referido como efectividad higiénica. Los resultados obtenidos de la evaluación de las BPF indicaron que la planta cumple con la mayoría de las condiciones de edificaciones e instalaciones, equipos y utensilios, requisitos higiénicos de la producción, aseguramiento de la calidad higiénica, almacenamiento y transporte, obteniendo una efectividad higiénica satisfactoria de un 84%. El nivel de cumplimiento de los POES fue de un 53,12% con deméritos en todos los aspectos evaluados, debido a la inexistencia de un documento guía, carencia de controles en el plan de saneamiento y de liderazgo en ejecutar acciones correctivas. Por lo tanto, se diseñó un programa de control sanitario basado en los POES.

Evaluation of prerequisites programs for a HACCP plan for frozen sardine plant. Good manufacturing practices (GMP) and sanitation standard operating procedures (SSOP) are prerequisites programs for the application of the Hazard Analysis and Critical Control Point (HACCP) system as a food safety approach during processing. The aim of this study was to evaluate GMP/SSOP prerequisites in processing line of frozen whole sardine (Sardinella aurita). The GMP compliance was verified according to a standard procedure of the Ministry for the Health of Venezuela, and the SSOP were assessed according to a checklist proposed by the FDA. GMP and SSOP were evaluated following a demerit-based approach. A percentage value was calculated and referred to as sanitary effectiveness. Results indicated that the plant had a good level of compliance with GMP from assessment of buildings and facilities, equipment and tools, hygienic requisites of the production, assurance of the hygiene quality, storage and transportation, and the percentage of sanitary effectiveness was 84%. The level of compliance for SSOP was 53,12 % with demerits found in all assessed aspects consisting of inexistent guidelines, lack of control in the sanitary plan and lack of leadership in applying corrective actions. Thus, an improvement in the plant sanitation program was designed targeting SSOP.