An assessment of the clinical relevance of coracoid graft osteolysis following the Latarjet procedure: a clinical and radiological review.

Background: The Latarjet procedure was developed for the treatment of anterior shoulder instability in young, high-demand patients with attritional glenoid bone loss, whose risk of redislocation following primary dislocation may exceed 90%. Coracoid graft osteolysis and prominent screws are commonly observed in late computed tomography (CT) scans of patients who re-present following the procedure, but the clinical relevance of osteolysis in the overall Latarjet cohort is undetermined. We aimed to evaluate clinical and radiological outcomes in patients who underwent the Latarjet procedure, and to determine if severe coracoid graft osteolysis compromised clinical outcomes. Methods: This was a retrospective analysis of patients who underwent the open Latarjet procedure. Patients were invited via an e-questionnaire that contained a Western Ontario Shoulder Instability Index (WOSI), and queried about redislocation and reoperation since index surgery. Preoperative glenoid bone loss was calculated on CT using the best-fit circle method. Osteolysis was graded (0, screw head buried in graft; 1, screw head exposed; 2, threads exposed; 3, complete resorption/severe osteolysis) at the level of the proximal and distal screws respectively, on axial CT scans performed ≥ 12 months postoperatively. Results: Between 2011 and 2022, a single surgeon performed 442 Latarjet procedures. One hundred fifty eight patients responded to the questionnaire at median (interquartile range [IQR]) 44 (27-70) months postoperatively, among whom the median (IQR) WOSI score was 352 (142-666) points (0 = best, 2100 = worst). Recurrent anterior instability occurred in 3/158 (2%) patients. One patient required reoperation for this indication. Among patients who had CT scans ≥ 12 months postoperatively (median [IQR] 40 [29-69] months), 1 patient developed severe osteolysis around both screws (WOSI = 90), 17/62 (27%) patients developed severe osteolysis around 1 screw, all of which were proximal (median [IQR] WOSI = 235 [135-644]), and 44/62 (71%) patients did not develop severe osteolysis around either screw (median [IQR] WOSI = 487 [177-815]). There were no statistically significant differences in WOSI scores between groups based on the presence of severe osteolysis. Conclusion: The Latarjet is reliable procedure that has a low rate of redislocation and reoperation. Severe coracoid graft osteolysis occurs with time, and always affects the proximal graft first. The presence of severe osteolysis did not compromise clinical outcomes.

Incidence of multiple organ failure in adult polytrauma patients: A systematic review and meta-analysis.

BACKGROUND: Postinjury multiple organ failure (MOF) is the leading cause of late death in trauma patients. Although MOF was first described 50 years ago, its definition, epidemiology, and change in incidence over time are poorly understood. We aimed to describe the incidence of MOF in the context of different MOF definitions, study inclusion criteria, and its change over time. METHODS: Cochrane Library, EMBASE, MEDLINE, PubMed, and Web of Science databases were searched for articles published between 1977 and 2022 in English and German. Random-effects meta-analysis was performed when applicable. RESULTS: The search returned 11,440 results, of which 842 full-text articles were screened. Multiple organ failure incidence was reported in 284 studies that used 11 unique inclusion criteria and 40 MOF definitions. One hundred six studies published from 1992 to 2022 were included. Weighted MOF incidence by publication year fluctuated from 11% to 56% without significant decrease over time. Multiple organ failure was defined using four scoring systems (Denver, Goris, Marshall, Sequential Organ Failure Assessment [SOFA]) and 10 different cutoff values. Overall, 351,942 trauma patients were included, of whom 82,971 (24%) developed MOF. The weighted incidences of MOF from meta-analysis of 30 eligible studies were as follows: 14.7% (95% confidence interval [CI], 12.1-17.2%) in Denver score >3, 12.7% (95% CI, 9.3-16.1%) in Denver score >3 with blunt injuries only, 28.6% (95% CI, 12-45.1%) in Denver score >8, 25.6% (95% CI, 10.4-40.7%) in Goris score >4, 29.9% (95% CI, 14.9-45%) in Marshall score >5, 20.3% (95% CI, 9.4-31.2%) in Marshall score >5 with blunt injuries only, 38.6% (95% CI, 33-44.3%) in SOFA score >3, 55.1% (95% CI, 49.7-60.5%) in SOFA score >3 with blunt injuries only, and 34.8% (95% CI, 28.7-40.8%) in SOFA score >5. CONCLUSION: The incidence of postinjury MOF varies largely because of lack of a consensus definition and study population. Until an international consensus is reached, further research will be hindered. LEVEL OF EVIDENCE: Systematic Review and Meta-analysis; Level III.

Amoxicillin degradation ability of Bacillus cereus C1 isolated from catfish pond sludge in Vietnam.

The biological removal of antibiotic residue in the environment has earned great interest. This study presented the biodegradation of amoxicillin (AMX) using B. cereus C1 isolated from the catfish pond sludge in Vietnam. This AMX-degrading bacterial strain grew well in the range of temperatures between 25ΟC and 40ΟC under aerobic condition. In a culture medium containing nitrogen source of NH4Cl (1 g.L-1) alone, the bacterium showed a AMX degradation ability of 54%. The AMX degradation ability of this bacterial strain was the highest level of 94% in the culture medium with 1.5 g.L-1 of NH4Cl and 3 g.L-1 of glucose. B. cereus C1 exhibited a great antibiotic degradation capability on high AMX concentration of 250 µg.mL-1 of AMX with AMX removal efficiency of 84% in 16 h of cultivation.

Pretreatment of rice straw with ammonia and ionic liquid for lignocellulose conversion to fermentable sugars.

Pretreatment technology is a prerequisite to facilitate the release of sugars from a lignocellulosic biomass prior to fermentation. Recently, some pretreatment methods have been tried with ionic liquids, but they were still expensive and unpractical. In this study, an efficient pretreatment method using ammonia and ionic liquid was developed for the recovery of bio-digestible cellulose from a lignocellulosic byproduct, rice straw, and the increase of ionic liquid utilization. The combined use of ammonia and ionic liquid ([Emim]Ac) treatment exhibited a synergy effect for rice straw with 82% of the cellulose recovery and 97% of the enzymatic glucose conversion. This cooperative effect showed over 90% of the glucose conversion even with a reduced enzyme usage and incubation time. The ionic liquid was successfully recycled more than 20 times. The 20th-recycled ([Emim]Ac) showed 74% of the cellulose recovery and 78% of the glucose conversion to rice straw. Compared with the conventional pretreatment, our combined method for lignocellulosic biomass pretreatment was an economical and eco-friendly.

Hydrogen production of the hyperthermophilic eubacterium, Thermotoga neapolitana under N2 sparging condition.

Gas sparging was found to be a useful technique to reduce hydrogen partial pressure in the liquid phase to enhance the hydrogen yields of strictly anaerobically fermentative bacteria. The effect of nitrogen (N(2)) sparging on hydrogen yield was investigated in sterile and non-sterile conditions using a pure strain of the hyperthermophilic eubacteria, Thermotoga neapolitana with glucose or xylose as a carbon source. The maximum hydrogen accumulations reached 41% of the gaseous mixtures after 30-40 h. Two applications of N(2) sparging after the H(2) content in the headspace reached the maximum levels gave an increase of H(2) production by 78% from 1.82 to 3.24 mol H(2)/mol glucose and by 56% from 1.41 to 2.20 mol H(2)/mol xylose. This result suggested that the removal of the produced H(2) from the gas headspace of the limited-volume, closed culture vial when it achieves the maximum level of H(2) tolerance of the bacterium is a necessary technique to improve its H(2) yield.