Unilateral microscopic approach for lumbar spinal stenosis decompression: a scoping review.

BACKGROUND: Microscopic unilateral laminotomy for bilateral decompression (ULBD) is a minimally invasive technique used in the treatment of lumbar spinal stenosis and could limit spinal instability and be associated with better clinical outcomes. However, there is ongoing debate regarding its utility compared to conventional laminectomy (CL). The primary objective was to collate and describe the current evidence base for ULBD, including perioperative parameters, functional outcomes, and complications. The secondary objective was to identify operative techniques. METHODS: A scoping review was conducted between January 1990 and August 2022 according to the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. Major databases were searched for full text English articles reporting on outcomes following microscopic unilateral laminotomy in patients with lumbar spinal stenosis. RESULTS: Seventeen articles met the inclusion criteria. Two studies were randomised controlled trials. Two studies were prospective data collection and the rest were retrospective analysis. Three studies compared ULBD with CL. ULBD preserves the osteoligamentous complex and may be associated with shorter operative time, less blood loss, and similar clinical outcomes when compared to CL. CONCLUSION: This review highlights that ULBD aims to minimise disruption to the normal posterior spinal anatomy and may have acceptable clinical outcomes. It also highlights that it is difficult to draw valid conclusions given there are limited data available as most studies identified were retrospective or did not have a comparator group.

Resolving solitary osteolytic lumbar tuberculosis in young adult.

Lumbar vertebral tuberculosis presenting with a focal solitary osteolytic lesion is rare in spinal tuberculosis (TB) and the English literature describing this entity is scant. The differential diagnosis includes primary and secondary malignancies. In this report, we describe a case of 35-year-old woman who presented with low back pain and was found to have a focal L4 vertebral lytic lesion on MRI and CT. Whole body CT was carried out as a potential malignancy staging procedure and demonstrated lung lesions suggestive of TB. Her neurological and general examination were entirely normal. Her blood test was positive for QuantiFERON Gold. She was managed conservatively with anti-TB medications and serial imaging which showed evidence of resolution of the osteolytic lesion. Although it is unusual for TB to present as an isolated osteolytic vertebral body lesion, the possibility should always be considered in the differential diagnosis, along with neoplastic processes. Conservative medical management, in the absence of neurological deficits and deformity, is the main stay of management with a very good outlook.

Could a Legume-Switchgrass Sod-Seeding System Increase Forage Productivity?

Nowadays, the lack of cattle feed, particularly green fodder, has become a key limiting factor in the agricultural economy. Switchgrass appears to offer a viable solution to the feed shortage. An improved cultivation practice might be needed to boost switchgrass forage production all season long. This study was conducted to quantify the positive effects of introducing different legume crops (vetch and pea), optimally fertilized, on the production and quality of mixed harvested switchgrass-legumes hay in late spring (May) and switchgrass hay harvested once more in early fall (September). The studied intercropping systems, independently of the legume species used, increased forage productivity (almost threefold), reaching 7.5 t ha-1 and quality characteristics, with protein content almost rising threefold, reaching 12.5%. The aforementioned practice can assist the perennial crop (switchgrass) in providing a high hay production during the early fall harvest, even without fertilization. The overall annual economic benefit for the farmers may be increased by 90-720 € per ha, depending on the prevailing weather conditions. Overall, it may be concluded that the suggested cropping system produces a significantly higher yield of cattle feed compared to traditional monocultures, improving the agricultural economy while reducing the negative effects of modern agriculture on the environment.

Presentation, Management, and Outcome of Primary Leiomyosarcoma of the Spine: A Systematic Review.

OBJECTIVE: Primary spinal leiomyosarcoma (PSL) is extremely rare. A case is presented, followed by a systematic review establishing the consensus on presentation, diagnosis, management, and outcomes. Comparison is made with metastatic spinal leiomyosarcoma (MSL). METHODS: A systematic review was conducted in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Eligibility criteria were decided before the literature search was conducted. Data were extracted and analyzed. RESULTS: A total of 397 articles were identified, 25 of which conformed to the eligibility criteria. Thirty-four cases were included in the analysis. PSL had a female preponderance (69.2%), with back pain being the most common presenting symptom (60.9%). Neurologic signs were present in most (69.6%), with tumors typically in the thoracic spine (46.9%). Diagnosis was primarily made using magnetic resonance imaging (64.7%) and computed tomography (55.9%), with a histologic sample being obtained in all cases. Most patients underwent operative management (91.2%), with variable use of neoadjuvant and adjuvant therapies. Operative approach differed greatly and outcome after surgical management was stated in 48.4% of patients, all noting an improvement from presentation. Patient follow-up was limited (median, 7 months), with most patients being free of disease (43.8%). CONCLUSIONS: PSL diagnosis is challenging, with positron emission tomography-computed tomography and histopathologic sampling playing an important role. There is a limited evidence base for the treatment strategies used but surgical management is key, with generally good outcomes. Prognosis for PSL seems to be better than for MSL. There is scope for more dedicated research in PSL and MSL.

Chemical composition and biological activity of cardoon (Cynara cardunculus L. var. altilis) seeds harvested at different maturity stages.

Cardoon seeds collected in Greece at four different maturity stages (samples S1 to S4) were analysed in terms of chemical composition and in vitro bioactivities. The content of phenolic compounds (six compounds in total) increased with increasing maturity, and 3,5-O-dicaffeyolquinic (14.8-33.8 mg/g extract) acid was the compound detected in higher abundance. Mature seeds (sample S4) also revealed the highest content in lipids (23 g/100 g extract) and tocopherols (29.62 mg/100 g dw) and demonstrated the highest cytotoxic (GI50 of 97-216 µg/mL) and anti-inflammatory (IC50 = 148 µg/mL) activities, and capacity to inhibit the formation of thiobarbituric acid reactive substances (TBARS) (IC50 = 5 µg/mL). Cardoon seed hydroethanolic extracts also revealed high antibacterial and antifungal potential, particularly samples S3 and S1, respectively. This study proved the multifaceted potential associated with valorisation of cardoon seeds, while their biological and chemical composition can be influenced by the maturity stage.

Determination of heavy metals in the territory of contaminated areas of Greece and their restoration through hyperaccumulators.

Phytoremediation is an effective technique for the processing of contaminated soil and for sequestering environmental contaminants such as heavy metals. This kind of pollution is ubiquitous in mines and similar excavation sites. This mini-review aims to provide an overview of the alternative forms of restoring contaminated soils (phytoremediation) highlighting the areas of Kozani (Agios Dimitrios) and Chalkidiki (Stratoni) in Greece characterized by exorbitant metallurgical activities. Firstly, a literature search in databases such as ScienceDirect, SciFinder, PubMed, Google Scholar, and Scopus was conducted, using the following keywords to identify relevant articles: "utilization", "plants", "phytoremediation", "sustainability", "environment", and "restoration". Two case studies have subsequently been chosen in Northern Greece, one characterized by metal mining (Pb, Zn, Ag) and hot summer Mediterranean climate and another one involving lignite mining and concomitant Cr, Zn, Cu, and Ni pollution under subtropical climate. Based on the literature search some possible, non-invasive plant species were proposed, focusing on the most efficient hyperaccumulators.

Seasonal variation of bioactive properties and phenolic composition of Cynara cardunculus var. altilis.

Cynara cardunculus L. (cardoon) has several health benefits mainly attributed to its abundance in polyphenols. In this study, cardoon heads (capitula) were harvested in Greece during the flowering stage, and the hydroethanolic extracts were assessed in terms of phenolic compounds composition and antioxidant, cytotoxic, anti-inflammatory, and antimicrobial activities. The phenolic profile was evaluated by HPLC-DAD-ESI/MS to better understand the seasonal changes in the individual compound levels and how these changes correlate with bioactive properties. The main phenolic compounds identified were caffeoylquinic and dicaffeoylquinic acid derivatives. Immature heads (Car A: principal growth stage (PGS) 5) had the highest phenolic content (34.3 mg/g) and cytotoxic (GI50 of 69-268 µg/mL) and anti-inflammatory (IC50 of 183 µg/mL) activities. Sample Car D (PGS 6/7) revealed the highest antioxidant (IC50 of 23-227 µg/mL) and antifungal (MIC of 0.26-0.51 mg/mL) potential. Regarding the antibacterial activity, Car E (PGS 7) revealed the best results (MIC of 0.59-1.18 mg/mL). This study suggests that the maturity stage of the plant influences the phenolic composition and bioactivity.

Ligand-free gold nanoparticles as colorimetric probes for the non-destructive determination of total dithiocarbamate pesticides after solid phase extraction.

In this work, we describe a simple and sensitive non-destructive method for the determination of the total concentration of dithiocarbamate fungicides (DTCs) in real samples. The proposed method combines for the first time the benefits of an extraction method for sample clean-up and preconcentration with a sensitive colorimetric assay based on gold nanoparticle probes. In this two-step procedure, the target DTCs are isolated from the matrix and preconcentrated by solid phase extraction onto commercially available C18 sorbents. Following elution, the extract containing the target dithiocarbamates, free from most interferences and matrix components, is delivered into an aqueous dispersion of plain citrate-capped gold nanoparticles (AuNPs) which aggregate in response to DTCs coordination on AuNPs surface through multiple gold thiolate bonds. This aggregation is evidenced by changes in the spectral properties of the solution involving a decrease in the original absorbance of Au nanoparticles at 522 nm and the appearance of a new absorption band above 700 nm. An ensuing chromatic shift of the solution from wine-red to purple-blue is observed which is visual by naked eye at concentrations as low as 50 µg L(-1). Further improvement in the detection limits can be accomplished by scaling-down the method to micro-volume conditions alleviating the need to preconcentrate larger sample volumes. Overall, by combining sample clean-up and preconcentration with the strong affinity of DTC thiol group for the gold surface, the total concentration of dithiocarbamate pesticides was successfully determined in various water samples at the low and ultra-low µg L(-1) levels without resorting to destructive techniques, sophisticated instrumentation or post-synthetic modification of gold nanoparticles. Method application in real samples showed good analytical features in terms of recoveries (81.0-94.0%), precision (5.6-8.9%) and reproducibility (~9%) rendering the method as an attractive alternative to current methodologies for the determination of DTC fungicide residues in samples of environmental interest.

Management of metastatic sacral tumours.

PURPOSE: Metastatic involvement of the sacrum is rare and there is a paucity of studies which deal with the management of these tumours since most papers refer to primary sacral tumours. This study aims to review the available literature in the management of sacral metastatic tumours as reflected in the current literature. METHODS: A systematic review of the English language literature was undertaken for relevant articles published over the last 11 years (1999-2010). The PubMed electronic database and reference lists of key articles were searched to identify relevant studies using the terms "sacral metastases" and "metastatic sacral tumours". Studies involving primary sacral tumours only were excluded. For the assessment of the level of evidence quality, the CEBM (Oxford Centre of Evidence Based Medicine) grading system was utilised. RESULTS: The initial search revealed 479 articles. After screening, 16 articles identified meeting our inclusion criteria [1 prospective cohort study on radiosurgery (level II); 2 case series (level III); 4 retrospective case series (level IV) and 9 case reports (level IV)]. CONCLUSION: The mainstay of management for sacral metastatic tumours is palliation. Preoperative angioembolisation is shown to be of value in cases of highly vascularised tumours. Radiotherapy is used as the primary treatment in cases of inoperable tumours without spinal instability where pain relief and neurological improvement are attainable. Minimal invasive procedures such as sacroplasties were shown to offer immediate pain relief and improvement with ambulation, whereas more aggressive surgery, involving decompression and sacral reconstruction, is utilised mainly for the treatment of local advanced tumours which compromise the stability of the spine or threaten neurological status. Adjuvant cryosurgery and radiosurgery have demonstrated promising results (if no neurological compromise or instability) with local disease control.