Invasive bacterial disease in young infants in rural Gambia: Population-based surveillance.

Background: Invasive bacterial diseases (IBD) cause significant mortality in young infants. There are limited population-based data on IBD in young infants in Sub-Saharan Africa. Methods: We conducted population-based surveillance for IBD among infants aged 0-90 days in a demographic surveillance area in rural Gambia between 1 March 2011 and 31 December 2017. Infants admitted to health facilities within the study area had standardised clinical evaluation plus conventional microbiological investigation. We defined IBD as isolation of pathogenic bacteria from blood, cerebrospinal fluid, lung, or pleural aspirate. We determined incidence, aetiology and case-fatality of IBD. Results: A total of 3794 infants were admitted and 3605 (95%) had at least one sample collected for culture. We detected 254 (8.0%) episodes of IBD (bacteraemia 241; meningitis 14; pneumonia seven). The incidence of IBD in infants aged 0-90 days was 25 episodes/1000 person-years (95% confidence interval (CI) = 22-28), the incidence in neonates was 50 episodes/1000 person-years (95% CI = 43-58) and the incidence in infants aged 29-90 days was 12 episodes/1000 person-years (95% CI = 9-15). The most common pathogens causing IBD were Staphylococcus aureus (n = 102, 40%), Escherichia coli (n = 37, 15%), Streptococcus pneumoniae (n = 24, 9%) and Klebsiella pneumoniae (n = 12, 5%). Case-fatality was 29% (95% CI = 23-37) in neonates and 19% (95% CI = 11-29) in infants aged 29-90 days. A minimum of 7.3% of all young infant deaths in the population were caused by IBD. Conclusions: IBD are common in young infants in rural Gambia and have a high case-fatality. Strategies are needed to prevent IBD in young infants. Overcoming barriers to widespread implementation of existing vaccines and developing new vaccines against the most common pathogens causing IBD should be among top priorities for reducing the high mortality rate in young infants.

Liquid Phase Isolation of SnS Monolayers with Enhanced Optoelectronic Properties.

Recent advances in atomically thin two dimensional (2D) anisotropic group IVA -VI metal monochalcogenides (MMCs) and their fascinating intrinsic properties and potential applications are hampered due to an ongoing challenge of monolayer isolation. Among the most promising MMCs, tin (II) sulfide (SnS) is an earth-abundant layered material with tunable bandgap and anisotropic physical properties, which render it extraordinary for electronics and optoelectronics. To date, however, the successful isolation of atomically thin SnS single layers at large quantities has been challenging due to the presence of strong interlayer interactions, attributed to the lone-pair electrons of sulfur. Here, a novel liquid phase exfoliation approach is reported, which enables the overcome of such strong interlayer binding energy. Specifically, it demonstrates that the synergistic action of external thermal energy with the ultrasound energy-induced hydrodynamic force in solution gives rise to the systematic isolation of highly crystalline SnS monolayers (1L-SnS). It is shown that the exfoliated 1L-SnS crystals exhibit high carrier mobility and deep-UV spectral photodetection, featuring a fast carrier response time of 400 ms. At the same time, monolayer-based SnS transistor devices fabricated from solution present a high on/off ratio, complemented with a responsivity of 6.7 × 10-3 A W-1 and remarkable stability upon prolonged operation in ambient conditions. This study opens a new avenue for large-scale isolation of highly crystalline SnS and other MMC manolayers for a wide range of applications, including extended area nanoelectronic devices, printed from solution.

Pneumonia, Meningitis, and Septicemia in Adults and Older Children in Rural Gambia: 8 Years of Population-Based Surveillance.

BACKGROUND: Representative data describing serious infections in children aged ≥5 years and adults in Africa are limited. METHODS: We conducted population-based surveillance for pneumonia, meningitis, and septicemia in a demographic surveillance area in The Gambia between 12 May 2008 and 31 December 2015. We used standardized criteria to identify, diagnose, and investigate patients aged ≥5 years using conventional microbiology and radiology. RESULTS: We enrolled 1638 of 1657 eligible patients and investigated 1618. Suspected pneumonia, septicemia, or meningitis was diagnosed in 1392, 135, and 111 patients, respectively. Bacterial pathogens from sterile sites were isolated from 105 (7.5%) patients with suspected pneumonia, 11 (8.1%) with suspected septicemia, and 28 (25.2%) with suspected meningitis. Streptococcus pneumoniae (n = 84), Neisseria meningitidis (n = 16), and Staphylococcus aureus (n = 15) were the most common pathogens. Twenty-eight (1.7%) patients died in hospital and 40 (4.1%) died during the 4 months after discharge. Thirty postdischarge deaths occurred in patients aged ≥10 years with suspected pneumonia. The minimum annual incidence was 133 cases per 100 000 person-years for suspected pneumonia, 13 for meningitis, 11 for septicemia, 14 for culture-positive disease, and 46 for radiological pneumonia. At least 2.7% of all deaths in the surveillance area were due to suspected pneumonia, meningitis, or septicemia. CONCLUSIONS: Pneumonia, meningitis, and septicemia in children aged ≥5 years and adults in The Gambia are responsible for significant morbidity and mortality. Many deaths occur after hospital discharge and most cases are culture negative. Improvements in prevention, diagnosis, inpatient, and follow-up management are urgently needed.

ZnO NPs immobilized by Alizarin as in vitro predictive and imaging biomarkers for protein amyloidosis.

Protein amyloidosis represents the main pathological hallmark of many incurable neurodegenerative disorders and protein misfolding diseases. Nanomaterials-based approaches give rise to diagnosis and/or prediction of these proteinopathies, with regards to the multifactorial nature of their pathogenesis. Herein, crystalline truncated hexagonal shaped naked ZnO nanoparticles (mean value 47.4 nm) have been solvothermally prepared and immobilized further with alizarin (Alzn) molecules (54%) to stand up to amyloidosis acting both as inhibitors and imaging agents, as well as antioxidants. Thioflavin-T (ThT) assay revealed that the resulted zinc oxide nanoparticles immobilized with alizarin (ZnO@Alzn NPs) inhibited in vitro insulin amyloids formation in a dose-dependent manner, while the kinetic mechanism of the phenomenon was recorded. In parallel, amyloid oligomers and plaques have been visualized by conventional optical microscopy upon protein co-incubation with ZnO@Alzn NPs, highlighting the imaging ability of the immobilized NPs. The antioxidant activity was monitored by 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, through which it was shown that alizarin incorporation onto the inorganic core leads to the reduction of IC50 values from 221 µg/mL to 167 µg/mL. The enhanced free radical scavenging effects of ZnO@Alzn compared to the naked-ZnO NPs, features their prospect to serve additional functions.

Patency of permanent vascular access creation in paediatric patients with end stage renal disease.

Renal transplant is the first-line therapy in paediatric patients with end-stage renal disease (ESRD). Wong HS and Goh BL reported up to 79% of 1061 paediatric patients still require long-term haemodialysis (HD).1 The lack of deceased and living donors is attributable to the poor awareness, cultural and religious grounds. Permanent vascular access (PVA) in paediatrics therefore, serves more as a long term treatment rather than a bridging therapy. We observed 5 children and an adolescent, all with previous indwelling catheters, who underwent arteriovenous fistula (AVF) creation and report the outcomes. The aim of this report is to determine the factors that influence the longterm patency of paediatric AVF. Factors such as body weight, vessel diameter, preoperative preparations, microsurgical technique and postoperative maintenance are discussed. In addition, considerations on the choice and timing of PVA is highlighted.

Effect of Sintering Temperature of Bioactive Glass Nanoceramics on the Hemolytic Activity and Oxidative Stress Biomarkers in Erythrocytes.

INTRODUCTION: The nature of the surface is critical in determining the biological activity of silica powders. A novel correlation between toxicity and surface properties of bioactive glass ceramics (BGCs) synthesized via the sol-gel method was attempted in this study. METHODS: The behavior of BGCs after their attachment to the surface of red blood cells (RBCs) was evaluated and their toxic effects were determined based on hemolysis, membrane injury via anti-phosphotyrosine immunoblot of Band 3, lipid peroxidation, potential to generate reactive oxygen species, and antioxidant enzyme production. In particular, three BGCs were synthesized and treated at three sintering temperatures (T1 = 835 °C, T2 = 1000 °C and T3 = 1100 °C) to investigate possible relation between surface charge or structure and hemolytic potential. RESULTS: Their toxicity based on hemolysis was dose dependent, while BGC-T2 had the best hemocompatibility in compare with the other BGCs.No BGCs in dosages lower than 0.125 mg/mL could damage erythrocytes. On the other hand, all BGCs promoted the production of reactive oxygen species in certain concentrations, with the BGC-T2 producing the lowest ROS and increasing the glutathione levels in RBCs protecting their damage. CONCLUSIONS: The results suggest that various factors such as size, a probable different proportion of surface silanols, a balanced mechanism between calcium and magnesium cellular uptake or the different crystalline nature may have contributed to this finding; however, future research is needed to clarify the underlying mechanisms.

Methodology of surface electromyography in gait analysis: review of the literature.

Gait analysis is a significant diagnostic procedure for the clinicians who manage musculoskeletal disorders. Surface electromyography (sEMG) combined with kinematic and kinetic data is a useful tool for decision making of the appropriate method needed to treat such patients. sEMG has been used for decades to evaluate neuromuscular responses during a range of activities and develop rehabilitation protocols. The sEMG methodology followed by researchers assessed the issues of noise control, wave frequency, cross talk, low signal reception, muscle co-contraction, electrode placement protocol and procedure as well as EMG signal timing, intensity and normalisation so as to collect accurate, adequate and meaningful data. Further research should be done to provide more information related to the muscle activity recorded by sEMG and the force produced by the corresponding muscle during gait analysis.

Carbonyl compounds of Tc, Re, and Bh: Electronic structure, bonding, and volatility.

Calculations of molecular properties of M(CO)5 and MH(CO)5, where M = Tc, Re, and Bh, and of the products of their decomposition, M(CO)4 and MH(CO)4, were performed using density functional theory and coupled-cluster methods implemented in the relativistic program suits such as ADF, DIRAC, and ReSpect. The calculated first M-CO bond dissociation energies (FBDEs) of Bh(CO)5 and BhH(CO)5 turned out to be significantly weaker than those of the corresponding Re homologs. The reason for that is the relativistic destabilization and expansion of the 6d AOs, responsible for weaker σ-forth and π-back donations in the Bh compounds. The relativistic FBDEs of M(CO)5 have, therefore, a Λ-shape behavior in the row Tc-Re-Bh, while the non-relativistic values increase toward Bh. Using the results of the molecular calculations and a molecule-slab interaction model, adsorption enthalpies, ΔH ads, of group-7 carbonyl hydrides on quartz and Teflon were estimated for future gas-phase chromatography experiments. It was found that BhH(CO)5 should be almost as volatile as the homologs, although its interaction with the surfaces should be somewhat stronger than that of MH(CO)5 (M = Tc and Re), while the M(CO)4 (M = Tc, Re, and Bh) molecules should be non-volatile. It will, therefore, be difficult to distinguish between the group-7 MH(CO)5 species by measuring their ΔH ads on surfaces of Teflon and quartz with an error bar of ±4 kJ/mol. The trends in properties and ΔH ads of group-7 carbonyl hydrides are similar to those of group-8 carbonyls of Ru, Os, and Hs.

Gait analysis methodology for the measurement of biomechanical parameters in total knee arthroplasties. A literature review.

Gait analysis using external skin markers provides scope for the study of kinematic and kinetic parameters shown on different total knee arthroplasties (TKA). Thus an appropriate methodology is of great importance for the collection and correlation of valid data. Calibration of equipment is of great importance before measurements, to assure accuracy. Force plates should be calibrated to 1080 Hz and optoelectronic cameras should use 120 Hz frequency, because of the nature of gait activity. Davis model which accurately defines the position of the markers is widely accepted and cited, for the gait analysis of TKA's. To ensure the reproducibility of the measurement, a static trial at the anatomical position must be captured. Following, all acquisitions of dynamic data must be checked for consistency in walking speed, and abnormal gait style because of fatigue or distraction. To establish the repeatability of the measurement, this procedure must be repeated at a pre-defined number of 3-5 gait cycles. Anthropometric measurements should be combined with three-dimensional marker data from the static trial to provide positions of the joint's center and define anatomical axes of total knee arthroplasty. Kinetic data should be normalized to bodyweight (BW) and percentage of BW and height depending on the study. External moments should also be calculated by using inverse dynamics and amplitude-normalized to body mass (Nm/kg). Gait analysis using external skin markers provides scope for the study of biomechanical parameters shown on different TKAs. Thus a standard gait analysis methodology when measuring TKA biomechanical parameters is necessary for the collection and correlation of accurate, adequate, valid and reproducible data. Further research should be done to clarify if the development of a specific kinematic model is appropriate for a more accurate definition of total knee implant joint center in measurements concerning 3D gait analysis.

Intrapericardial Development of a Bronchogenic Cyst - Case Report.

INTRODUCTION: Bronchogenic cysts, commonly located in the mediastinum or lung parenchyma, arise from abnormal budding of the tracheobronchial tree. Since an unknown percentage of asymptomatic adult patients with bronchogenic cysts remain undiagnosed, the true natural history ofthese cysts in adults is uncertain and the available series reflect a significant selection bias in favor of the symptomatic individual. CASE REPORT: We present the case of a 42-year-old female who presented with adull central chest pain, which gradually worsened overseveral weeks. After several tests performed (standard blood tests, standard X-Ray, ECG, angio-CT scan), we identified a mediastinal mass inferior to the carina and adjacent tothe left pleura, left atrium, pulmonary artery and esophagus. Considering the size of this mass and the possible complications, surgery was proposed and preformed. We were able to completely remove the cyst and the patient had no complications after surgery. DISCUSSIONS: It may be difficult to differentiate a bronchogenic cyst from other lesions (acquired cystic lesions, mediastinal masses). Serious complications from bronchogenic cysts are rare, but can include SVC syndrome, tracheal compression, pneumothorax, pleurisy and pneumonia. Surgical excision is recommended even for asymptomatic cysts, to prevent complications and operative difficulties. CONCLUSIONS: Bronchogenic cysts are rare and usually asymptomatic. Asymptomatic patients with bronchogenic cysts may become symptomatic cases, and in time may develop lifethreating complications. Definitive tissue diagnosis is usually available only after surgical excision. Based on our experience and after studying data from literature, we can conclude that bronchogenic cysts should be treated surgically and that a conservative approach is not recommended.

No Differences Identified in Transverse Plane Biomechanics Between Medial Pivot and Rotating Platform Total Knee Implant Designs.

BACKGROUND: Total knee arthroplasties (TKAs) using well-designed, fixed bearing prostheses, such as medial pivot (MP), have produced good long-term results. Rotating-platform, posterior-stabilized (RP-PS) mobile bearing implants were designed to decrease polyethylene wear. Sagittal and coronal plane TKA biomechanics are well examined and correlated to polyethylene wear. However, limited research findings describe this relationship in transverse plane. We assumed that although axial plane biomechanics might not be the most destructive parameters on polyethylene wear, it is important to clarify their role because both joint kinematics and kinetics in all 3 planes are important input parameters for TKA wear testing (International Organization for Standardization 14243-1 and 14343-3). Our hypothesis was that transverse plane overall range of motion (ROM) and/or peak moment show differences that reflect on wear advantages when compared RP-PS implants to MP designs. METHODS: Two groups (MPs = 24 and RP-PSs = 22 subjects) were examined by using 3D gait analysis. The variables were total internal-external rotation (IER) ROM and peak IER moments. RESULTS: No statistically significant difference was demonstrated between the 2 groups in kinetics (P = .389) or kinematics (P = .275). CONCLUSION: In the present study, no wear advantages were found between 2 TKAs. Both designs showed identical kinetics at the transverse plane in level-ground walking. Kinematic analysis could not illustrate any statistically significant difference in terms of overall IER ROM. Nevertheless, kinematic gait pattern differences observed possibly reflect different patterns of joint surface motion or abnormal gait patterns. Thus, wear testing with various input waveforms combined with functional data analysis will be necessary to identify the actual effects of gait variability on polyethylene wear.

Cervico-mediastinal Esophageal Duplication Cyst - Case Presentation.

INTRODUCTION: esophageal cysts can be divided into 2 categories: simple epithelial-lined cysts and esophageal duplication, which is an embryologic duplication of a portion of the muscle and submucosa of the esophagus without epithelial duplication. CASE PRESENTATION: 48 year-old male, with no relevant history, was transferred in our department with vomiting, dysphagia, anorexia, and weight loss. The CT scan highlights a tumor mass, well defined, with maximum size of 6.5 cm, developed in the left upper mediastinum and lower left cervical region. We decided to perform surgery in order to remove the mass completely. The approach was through a cervical incision, allowing access to the upper mediastinum, as well as for the anterior cervical region. DISCUSSION: Complete surgical excision is recommended for all foregut cyst malformations. Considering the localization of the esophageal cyst in our patient, we decided cervico-sternotomy will be the best approach, giving a wide exposure of the mediastinum and of the lower cervical region if necessary. The lesion was carefully dissected from the surrounding structures and completely removed. CONCLUSION: All esophageal cysts should be evaluated and, eventually, resected. Most patients with esophageal cysts eventually become symptomatic; therefore, cysts should be resected when they are diagnosed.

Theoretical predictions of properties and volatility of chlorides and oxychlorides of group-4 elements. I. Electronic structures and properties of MCl4 and MOCl2 (M = Ti, Zr, Hf, and Rf).

Relativistic, infinite order exact two-component, density functional theory electronic structure calculations were performed for MCl4 and MOCl2 of group-4 elements Ti, Zr, Hf, and element 104, Rf, with the aim to predict their behaviour in gas-phase chromatography experiments. RfCl4 and RfOCl2 were shown to be less stable than their lighter homologs in the group, tetrachlorides and oxychlorides of Zr and Hf, respectively. The oxychlorides turned out to be stable as a bent structure, though the stabilization energy with respect to the flat one (C(2v)) is very small. The trend in the formation of the tetrachlorides from the oxychlorides in group 4 is shown to be Zr < Hf < Rf, while the one in the formation of the oxychlorides from the chlorides is opposite. All the calculated properties are used to estimate adsorption energy of these species on various surfaces in order to interpret results of gas-phase chromatography experiments, as is shown in Paper II.

Theoretical predictions of properties and volatility of chlorides and oxychlorides of group-4 elements. II. Adsorption of tetrachlorides and oxydichlorides of Zr, Hf, and Rf on neutral and modified surfaces.

With the aim to interpret results of gas-phase chromatography experiments on volatility of group-4 tetrachlorides and oxychlorides including those of Rf, adsorption enthalpies of these species on neutral, and modified quartz surfaces were estimated on the basis of relativistic, two-component Density Functional Theory calculations of MCl4, MOCl2, MCl6(-), and MOCl4(2) with the use of adsorption models. Several mechanisms of adsorption were considered. In the case of physisorption of MCl4, the trend in the adsorption energy in the group should be Zr > Hf > Rf, so that the volatility should change in the opposite direction. The latter trend complies with the one in the sublimation enthalpies, ΔH(sub), of the Zr and Hf tetrachlorides, i.e., Zr < Hf. On the basis of a correlation between these quantities, ΔH(sub)(RfCl4) was predicted as 104.2 kJ/mol. The energy of physisorption of MOCl2 on quartz should increase in the group, Zr < Hf < Rf, as defined by increasing dipole moments of these molecules along the series. In the case of adsorption of MCl4 on quartz by chemical forces, formation of the MOCl2 or MOCl4(2-) complexes on the surface can take place, so that the sequence in the adsorption energy should be Zr > Hf > Rf, as defined by the complex formation energies. In the case of adsorption of MCl4 on a chlorinated quartz surface, formation of the MCl6(2-) surface complexes can occur, so that the trend in the adsorption strength should be Zr ≤ Hf < Rf. All the predicted sequences, showing a smooth change of the adsorption energy in the group, are in disagreement with the reversed trend Zr ≈ Rf < Hf, observed in the "one-atom-at-a-time" gas-phase chromatography experiments. Thus, currently no theoretical explanation can be found for the experimental observations.

Giant thoraco-abdominal tumor -- a surgical challenge. Case report.

BACKGROUND: During the last three decades, several improvements in surgical and anesthetic techniques have allowed a better management of primary and secondary tumors of the chest wall. OBJECTIVES: Chest wall tumors, regardless of their location,anterior, posterior or lateral, have always been a challenge for the thoracic surgeon through technical and tactical problems they entail. The most common techniques to reconstruct a full thickness defect are by the use of alloplastic material and filling the soft tissue defect with myocutaneous flap. METHOD: We present the unusual case of a 45 years old patient with a giant right thoraco-abdominal tumor, developing for the last 22 years. The tumor occupied the lower half of the right hemithorax and the right hemi abdomen, down to the right iliac crest. The tumor also developed inside the thoracic cavity, with the invasion of the last 3 ribs, of the diaphragm(partial) and with intra-abdominal invasion of a liver section and the right kidney. RESULTS: The surgery team had special problems related to:providing training and logistics, in-block tumor resection in oncological limits, followed by complex thoraco-abdominal reconstruction. The results were very good, with a favorable postoperative evolution, without any complications, the patient being discharged with the recommendation to come for follow-up on his condition. CONCLUSIONS: A complex surgical intervention proved to be the only solution for saving the patient, for which the life due to the tumor's size became almost unbearable.

Multivisceral echinococcosis: concept, diagnosis, management.

INTRODUCTION: Hydatid disease is in a come-back period. In Romania the incidence is cited at 5-6 cases per 100,000 inhabitants. MATERIAL AND METHOD: In this study we define the concept of multivisceral echinococcosis, which is a more serious form of the hydatid disease with implications of diagnosis, treatment,morbidity and mortality. Multivisceral echinococcosis must be differentiated from multiple echinococcosis. The latter is defined as the localization of multiple hydatid cysts in the same organ. In case of multiple echinococcosis, we can describe double echinococcosis (two hydatid cysts located in the same organ), triple, etc. The etiology of multivisceral echinococcosis is similar to mono-visceral echinococcosis.Regarding the pathogenic mechanism, we appreciate that there are two distinct mechanisms: primary infection (most of them) and secondary infection. DISCUSSION: We propose a classification of multivisceral echinococcosis based on the anatomical compartment involved.The diagnosis of this condition is easy to establish using classicor more recent investigations (CT, MRI). Compared to monovisceral echinococcosis, the symptomatology is louder because of the involvement of several organs and its association with different other conditions. CONCLUSIONS: We wish this study to bring more information about hydatid disease, but especially about multivisceral echinococcosis.

Minimally invasive repair for pectus excavatum -- aesthetic and/or functional?

INTRODUCTION: Pectus excavatum is the most frequent anterior thoracic wall congenital malformation. This malformation is increasing its effects with the aging process and has its peak during teenage, when the clinical symptoms become more acute and psychological effects are really important. Across the course of time many treatment techniques have been proposed, among which conservative or surgical correction techniques. The minimally invasive repair of pectus excavatum, "Nuss technique", developed after 1987, is the most frequently performed technique world wide. MATERIAL AND METHOD: This article analyzes 52 patients, admitted to the University Emergency Military Hospital "Carol Davila" - Thoracic Surgery Department, diagnosed, investigated and surgically treated according to Nuss procedure. Therapeutic and diagnostic protocols will be presented and analyzed: clinical and paraclinical evaluation, indications and contraindications of Nuss procedure, as well as possible intraoperative and postoperative complications. RESULTS AND CONCLUSIONS: Nuss procedure's benefits will be presented, as well as improvements of functional and aesthetic parameters. Nuss procedure has a series of advantages: minimally invasive surgical procedure reduced operative time, minimal blood loss and fast socio-professional reinstatement.

Anterior thoracic wall giant tumor--special surgical procedure.

We describe the case of a 39 years old male known with an anterior thoracic traumatism in 1993 who observed ananterior thoracic wall tumor since 2000. After one and half year of empiric treatment the tumor starts growing very fast, reaching 30/40/35 cm by the date of his hospital admission (march 2003). Due to this accelerate growth and the size of the tumor the patient is proposed for a particular surgical procedure removing the tumor along with the anterior thoracic wall and the reconstruction using "spider web" technique, Thoratex reinforced mesh and muscle flaps. Thisprocedure had agood result, the patient returned to his anterior lifestyle few months after. The patient did not come for follow-up, although he was recommended to come every tree months. Four years after surgery (2007) the patient came back with local recurrence of the tumor. In 2007 the patient underwent another surgical intervention, removing the tumor recurrence. Chest wall tumors are complex surgical conditions requiring complex treatment. The empiric treatment and the fact that the patient did not come as planned for follow-up, prolonged his sufferance, leading to a second surgical intervention.

Covering materials incorporating radiation-preventing techniques to meet greenhouse cooling challenges in arid regions: a review.

Cooling greenhouses is essential to provide a suitable environment for plant growth in arid regions characterized by brackish water resources. However, using conventional cooling methods are facing many challenges. Filtering out near infra-red radiation (NIR) at the greenhouse cover can significantly reduce the heating load and can solve the overheating problem of the greenhouse air. This paper is to review (i) the problems of using conventional cooling methods and (ii) the advantages of greenhouse covers that incorporate NIR reflectors. This survey focuses on how the cover type affects the transmittance of photosynthetically active radiation (PAR), the reflectance or absorptance of NIR and the greenhouse air temperature. NIR-reflecting plastic films seem to be the most suitable, low cost and simple cover for greenhouses under arid conditions. Therefore, this review discusses how various additives should be incorporated in plastic film to increase its mechanical properties, durability and ability to stand up to extremely harsh weather. Presently, NIR-reflecting covers are able to reduce greenhouse air temperature by no more than 5 °C. This reduction is not enough in regions where the ambient temperature may exceed 45 °C in summer. There is a need to develop improved NIR-reflecting plastic film covers.