Cannabinoids induce cell death in leukaemic cells through Parthanatos and PARP-related metabolic disruptions

BACKGROUND

Several studies have described a potential anti-tumour effect of cannabinoids (CNB). CNB receptor 2 (CB2) is mostly present in hematopoietic stem cells (HSC). The present study evaluates the anti-leukaemic effect of CNB.

METHODS

Cell lines and primary cells from acute myeloid leukaemia (AML) patients were used and the effect of the CNB derivative WIN-55 was evaluated in vitro, ex vivo and in vivo.

RESULTS

We demonstrate a potent antileukemic effect of WIN-55 which is abolished with CB antagonists. WIN-treated mice, xenografted with AML cells, had better survival as compared to vehicle or cytarabine. DNA damage-related genes were affected upon exposure to WIN. Co-incubation with the PARP inhibitor Olaparib prevented WIN-induced cell death, suggesting PARP-mediated apoptosis which was further confirmed with the translocation of AIF to the nucleus observed in WIN-treated cells. Nicotinamide prevented WIN-related apoptosis, indicating NAD+ depletion. Finally, WIN altered glycolytic enzymes levels as well as the activity of G6PDH. These effects are reversed through PARP1 inhibition.

CONCLUSIONS

WIN-55 exerts an antileukemic effect through Parthanatos, leading to translocation of AIF to the nucleus and depletion of NAD+, which are reversed through PARP1 inhibition. It also induces metabolic disruptions. These effects are not observed in normal HSC.

Comparison of complications and reoperations in AO/OTA 43.C3 pilon fractures treated with conventional ORIF versus minimally invasive hexapod ring fixation

INTRODUCTION

Controversy exists regarding the optimal management of AO/OTA 43. C3 pilon fractures. Open reduction and internal fixation (ORIF) is the gold standard treatment, but serious soft tissue and infectious complications have been previously reported. Minimally invasive strategies using hexapod ring fixation (HRF) with supplemental limited internal fixation have been used to reduce the incidence of complications. Previous studies have included heterogeneous types of pilon fractures, with non-comminuted injuries being more likely to be treated with ORIF and complex fractures receiving HRF treatment. To our knowledge, no studies have compared the complications and reoperation rates between ORIF and HRF exclusively for C3 fractures.

METHODS

Retrospective study comparing 53 patients treated for AO/OTA 43.C3 pilon fracture with ORIF or HRF in a trauma level I center with at least a two-year follow-up. Patients treated between January 2015 and January 2019 received ORIF and those treated between January 2019 and January 2021 received HRF. Complications were divided into two groups: minor (superficial infection and malalignment) and major (non-union, deep infection, and amputation). Reoperations, prevalence of ankle osteoarthritis, and requirement for ankle arthrodesis/total ankle replacement were registered.

RESULTS

We included 30 and 23 patients in the ORIF and HRF groups, respectively. The overall complication rate was similar in both groups, with 50% and 56,5% of the patients having complications in the ORIF and HRF groups, respectively (p:0,63). Minor complications were significantly more prevalent in the HRF group (p<0,001) whilst the ORIF group had a significantly higher rate of major complications (p<0,01). Superficial infections were highly prevalent in the HRF group (47,8%), as they were related to half-pin or K-wire infections. Deep infection was present only in the ORIF group, with 20% of the patients developing this major complication (p:0,03). Non-union rate, reoperations, ankle osteoarthritis, and the need for arthrodesis or ankle replacement showed no significant differences.

CONCLUSION

In AO/OTA 43.C3 fractures, HRF is safe and effective, achieving high union rates with a significantly lower rate of major complications compared to ORIF. According to our results, ORIF should be used cautiously for these types of fractures, considering the increased risk of deep infection.

Restoration of Anatomic Parameters and Syndesmotic Reduction After Intramedullary Nailing of Distal Fibular Fractures

Background:

Intramedullary nailing of the fibula (FN) is a method of fixation that has proven to be useful for treating distal fibular fractures (DFs). FN minimizes soft tissue complications and provides similar stability to plating, with fewer hardware-related symptoms. Nevertheless, FN has been associated with syndesmotic malreduction and the incapacity of restoring length and rotation of the fibula. We aimed to evaluate the fibular position and syndesmotic reduction after fixation with FN compared with the uninjured ankle in the immediate postoperative period.

Methods:

Prospective cohort study. Patients with DF fractures treated with IN between January 2017 and January 2020 were included. Immediate postoperative bilateral ankle CT was obtained in all cases. Fibular rotation, length, and translation as well as syndesmotic diastasis were measured on both ankles and compared by 3 independent observers.

Results:

Twenty-eight patients were included (16 women). The mean age was 46 years (range 16-91). Fracture type distribution according to AO/ASIF classification included 19 patients with 44.B (67.9%), 8 patients with 44.C (28.6%), and 1 patient with a 44.A fracture (3.6%). No significant differences were identified considering fibular rotation (P = .661), syndesmotic diastasis (P = .147), and fibular length (P = .115) between the injured and uninjured ankle. Fibular translation had statistical differences (P = .01) compared with the uninjured ankle. The intraclass correlation coefficient showed an excellent concordance between observers except for fibular translation on the injured ankle.

Conclusion:

In this cohort, fixation of DF fractures with FN allows restoration of anatomical parameters of the ankle in terms of fibular rotation, length, and syndesmotic diastasis. However, fibular translation had significant differences compared with the uninjured ankle based on bilateral CT scan evaluation.

Level of Evidence:

Level II, prospective cohort study.

Quality of Reduction of Posterior Malleolar Fractures: A CT-Based Case-Control Study Comparing APPA Screw Fixation vs Posterolateral Approach

Category:

Trauma; Ankle

Introduction/Purpose:

Classically, the standard of care in posterior malleolar fracture consisted in indirect reduction and percutaneous anteroposterior (AP) or posteroanterior (PA) fixation. There is a current trend to use a posterolateral approach (PL) for direct visualization of the fragment to obtain superior anatomical reduction. Comparative studies between both strategies of management have usually benefit the PL approach for obtaining superior articular reduction. Nonetheless, most of these studies are retrospective and tend to compare different group of fractures since percutaneous AP or PA groups are usually used for smaller fragments and PL for bigger PM fractures. There are no radiologic studies comparing the quality of reduction of AP-PA screws versus direct PL fixation on similar fracture-specific morphology and size patterns.

Methods:

A retrospective case-control study was performed including 228 trimalleolar ankle fractures treated in a level 1 trauma center between 2012 and 2021. Demographic and clinical data was obtained. Fractures were classified using the Bartonicek and Rammelt classification. The study group was conformed by 27 patients with PM fractures fixed with percutaneous AP-PA screws (PER). The control group was conformed by 27 patients matching the study group in terms of type of fracture morphology and age treated using a posterolateral approach (PL). Post operative ankle CT images were analyzed and quality of reduction was evaluated in both groups. Quality of reduction was defined according to the articular step-off, graded as excellent (less than 1 mm), satisfactory (1 to 2 mm) or poor (more than 2 mm) in sagittal and axial planes. Differences between groups was evaluated using Fisher's test with statistical significance defined as p <0.05 using SPSS V24.0 analysis software.

Results:

The average age of both groups was 44.4 years old with 53% of patients being females. According to Bartonicek and Rammelt classification, 2 patients were graded as type 1, 21 as type 2, 3 as type 3 and 1 as type 4. In the PL approach group, the tibio talar reduction was described as excellent in 19 patients, satisfactory in 7 and poor in 1 patient, while the fibular notch reduction was described as excellent in 20 patients, satisfactory in 6 and poor in 1 patient. In the PER group, the tibiotalar reduction was described as excellent in 22 patients and satisfactory in 5, with no patients with poor reduction. The fibular notch reduction was described as excellent in 25 patients, with 1 patient each with satisfactory and poor reduction. No significant difference (p= 0.52) in the articular reduction quality was detected considering the classification mentioned and the demographics variables.

Conclusion:

In this case-control study there were no significant differences regarding quality of reduction in morphologically matched displaced PM fractures fixed with AP-PA screws versus a PL approach. Further clinical prospective studies are needed to define the clinical relevance of these results and define the optimal strategy of fixation.

Indocyanine green fluorescence: A surgeon's tool for the surgical approach of gallstone ileus

Fluorescence cholangiography has been shown to improve biliary anatomy identification. A case of 60-year-old man with intestinal obstruction is reported, an entero-biliary fistula is suspected, and intravenous application of indocyanine green is decided, despite the great inflammatory process and fibrotic tissues found during the procedure, safe open cholecystectomy was achieved.

Cystic adventitial disease of popliteal artery, the both sides of the coin: Arterial resection vs cyst excision

Adventitial cystic disease (ACD) is a rare form of non‐atherosclerotic arterial stenosis. This entity accounts only for 0.1% of all vascular diseases and affects the popliteal artery unilaterally in 85% of the cases. The options for treatment ACD include excision of cysts, removal of the affected arterial segment with vein graft reconstruction or radiological aspiration. We present two cases of ACD of the popliteal artery and its subsequent management and discuss the pros and cons of the treatment's strategies.

In patients with cystic adventitial disease of popliteal artery, surgical conservative treatment with cyst excision can be performed if no complete arterial wall alteration and no presence of arterial thrombosis, compared with arterial resection.

Treatment of Patellofemoral Chondral Lesions Using Microfractures Associated with a Chitosan Scaffold: Mid-Term Clinical and Radiological Results

OBJECTIVE

To assess the clinical and radiological results of patellofemoral osteochondral lesions treated with microfractures associated with a chitosan scaffold.

DESIGN

A retrospective observational analytical study was performed. Fifteen patients with full-thickness patellofemoral osteochondral lesions were included. Quantity and quality of the reparation cartilage was assessed with the MOCART 2.0 score on a postoperative magnetic resonance imaging (MRI), and clinical outcomes were evaluated with pre- and postoperative Kujala score tests. Shapiro-Wilk test for normality was applied as well as Wilcoxon's signed rank test and Kruskal-Wallis H test for clinical scores within subjects and patella versus trochlea subgroups comparisons. Analysis of variance test was used for imaging subgroups comparison, with P < 0.05 defined as statistical significance.

RESULTS

Mean follow-up was 33.36 months (range 24-60 months). Postoperative Kujala scores improved an average of 19 points compared with the preoperative state (SE = 17.6; P < 0.001). No statistical difference was found through the clinical location assessment (P = 0.756), as well as the cartilage imaging assessment (P = 0.756). The mean MOCART 2.0 scale was 67.67 (range 50-85).

CONCLUSIONS

Treating full-thickness patellofemoral osteochondral lesions with microfractures associated with a chitosan scaffold proved to be effective regarding defect filling and symptomatic improvement.

Phosphate-Arsenic Interactions in Halophilic Microorganisms of the Microbial Mat from Laguna Tebenquiche: from the Microenvironment to the Genomes

Arsenic (As) is a metalloid present in the earth's crust and widely distributed in the environment. Due to its high concentrations in the Andean valleys and its chemical similarity with phosphorus (P), its biological role in Andean Microbial Ecosystems (AMEs) has begun to be studied. The AMEs are home to extremophilic microbial communities that form microbial mats, evaporites, and microbialites inhabiting Andean lakes, puquios, or salt flats. In this work, we characterize the biological role of As and the effect of phosphate in AMEs from the Laguna Tebenquiche (Atacama Desert, Chile). Using micro X-ray fluorescence, the distribution of As in microbial mat samples was mapped. Taxonomic and inferred functional profiles were obtained from enriched cultures of microbial mats incubated under As stress and different phosphate conditions. Additionally, representative microorganisms highly resistant to As and able to grow under low phosphate concentration were isolated and studied physiologically. Finally, the genomes of the isolated Salicola sp. and Halorubrum sp. were sequenced to analyze genes related to both phosphate metabolism and As resistance. The results revealed As as a key component of the microbial mat ecosystem: (i) As was distributed across all sections of the microbial mat and represented a significant weight percentage of the mat (0.17 %) in comparison with P (0.40%); (ii) Low phosphate concentration drastically changed the microbial community in microbial mat samples incubated under high salinity and high As concentrations; (iii) Archaea and Bacteria isolated from the microbial mat were highly resistant to arsenate (up to 500 mM), even under low phosphate concentration; (iv) The genomes of the two isolates were predicted to contain key genes in As metabolism (aioAB and arsC/acr3) and the genes predicted to encode the phosphate-specific transport operon (pstSCAB-phoU) are next to the arsC gene, suggesting a functional relationship between these two elements.

Ultrasonic characterization of salt, moisture and texture modifications in dry-cured ham during post-salting

For the first time, this study addresses the use of non-destructive ultrasound to monitor ham post-salting. For that purpose, the ultrasonic velocity (1 MHz) and the weight loss of hams were measured regularly every 2 days up to 8 weeks after salting. Additionally, for different post-salting times, internal salt and moisture content and hardness were measured at different locations from the ham surface. The experimental results reflected that the ultrasonic velocity increased as the ham weight decreased (26.1 m/s per kg), showing a satisfactory correlation between both variables (r = 0.95). The ultrasonic velocity was also correlated with the salt and moisture content. However, ham hardness remained fairly constant during post-salting, which confirmed that characteristic textural changes mainly occur during the salting and drying-maturation stages. Thus, the ultrasonic velocity could be a reliable parameter with which to monitor not only overall modifications in ham weight, but also internal changes of moisture and salt content during post-salting in a non-destructive way.

Squamous cell carcinoma related with dental implants. A clinical cases report

One third of all cases of head and neck carcinoma (CA) concern the oral mucosa. The use of dental implants (DI) for dental rehabilitation is widely extended. However, a few studies have reported some cases with neoplasic alterations, among the tissue surrounding implants. Our aim was to analyze possible alterations at the bone-implant interface in patients with oral squamous cell carcinoma (SCC), providing new evidence that could relate or discard a possible link between these factors. We used, for the first time, different techniques, including electron microscopy and histology, to analyze the implant ´s surface and the surrounding tissue from four clinical cases with neoplasic alterations surrounding DI. Histologically, ample inflammatory tissue was found in direct contact with the implant surface. Surface analysis of this tissue, revealed titanium percentages. According to our study, no oncological relation with deterioration of the implant surface was found, although DI were constantly related with peri-implantitis, a chronic trauma of the oral mucosa that could involve a neoplastic factor.

Key words:Dental implants, carcinoma, peri-implantitis.

Predicting poverty. Data mining approaches to the health and demographic surveillance system in Cuatro Santos, Nicaragua

Background

In order to further identify the needed interventions for continued poverty reduction in our study area Cuatro Santos, northern Nicaragua, we aimed to elucidate what predicts poverty, measured by the Unsatisfied Basic Need index. This analysis was done by using decision tree methodology applied to the Cuatro Santos health and demographic surveillance databases.

Methods

Using variables derived from the health and demographic surveillance update 2014, transferring individual data to the household level we used the decision tree framework Conditional Inference trees to predict the outcome “poverty” defined as two to four unsatisfied basic needs using the Unsatisfied Basic Need Index. We further validated the trees by applying Conditional random forest analyses in order to assess and rank the importance of predictors about their ability to explain the variation of the outcome “poverty.” The majority of the Cuatro Santos households provided information and the included variables measured housing conditions, assets, and demographic experiences since the last update (5 yrs), earlier participation in interventions and food security during the last 4 weeks.

Results

Poverty was rare in households that have some assets and someone in the household that has a higher education than primary school. For these households participating in the intervention that installed piped water with water meter was most important, but also when excluding this variable, the resulting tree showed the same results. When assets were not taken into consideration, the importance of education was pronounced as a predictor for welfare. The results were further strengthened by the validation using Conditional random forest modeling showing the same variables being important as predicting the outcome in the CI tree analysis. As assets can be a result, rather than a predictor of more affluence our results in summary point specifically to the importance of education and participation in the water installation intervention as predictors for more affluence.

Conclusion

Predictors of poverty are useful for directing interventions and in the Cuatro Santos area education seems most important to prioritize. Hopefully, the lessons learned can continue to develop the Cuatro Santos communities as well as development in similar poor rural settings around the world.

Long-lasting, reversible and non-neurotoxic inactivation of hippocampus activity induced by neosaxitoxin

BACKGROUND

Neosaxitoxin (NeoSTX) and related paralytics shellfish toxins has been successfully used as local anesthetic and muscle relaxants to treat a variety of ailments. The primary mechanism of action of these toxins occurs by blocking voltage-gated sodium channels with compounds such as TTX, lidocaine, or derivatives. However, most of these non-classical sodium channel blockers act with a reduced time effect as well as ensuing neurotoxicity.

NEW METHOD

In this report, we show that the use of local NeoSTX injections inactivates the hippocampal neuronal activity reversibly with a by long-term dynamics, without neuronal damage.

RESULTS

A single 10 ng/μl injection of NeoSTX in the dorsal CA1 region abolished for up to 48 h memory capacities and neuronal activity measured by the neuronal marker c-fos. After 72 h of toxin injection, the animals fully recover their memory capacities and hippocampal neuronal activity. The histological inspection of NeoSTX injected brain regions revealed no damage to the tissue or reactive gliosis, similar to vehicle injection. Acute electrophysiological recording in vivo shows, also, minimal spreading of the NeoSTX in the cerebral tissue.

COMPARISON WITH EXISTING METHODS

Intracerebral NeoSTX injection showed longer effects than other voltage sodium channel blocker, with minimal spreading and no neuronal damage.

CONCLUSION

NeoSTX is a new useful tool that reversibly inactivates different brains region for a long time, with minimal diffusion and without neuronal damage. Moreover, NeoSTX can be used as a valuable sodium channel blocker for many studies in vivo and with potential therapeutic uses.

Intensification of heat transfer during mild thermal treatment of dry-cured ham by using airborne ultrasound

The application of power ultrasound (PuS) could be used as a novel technology with which to intensify thermal treatments using hot air. Mild thermal treatments have been applied to improve the soft texture of dry-cured ham caused by defective processing. In this regard, the aim of this study was to assess the kinetic intensification linked to the application of airborne PuS in the mild thermal treatment using hot air of dry-cured ham. For this purpose, vacuum packed cylindrical samples (2.52±0.11cm in diameter and 1.90±0.14cm in height) of dry-cured ham were heated using hot air at different temperatures (40, 45, 50°C) and air velocities (1, 2, 3, 4, 6m/s) with (22.3kHz, 50W) and without PuS application. Heat transfer was analyzed by considering that it was entirely controlled by conduction and the apparent thermal diffusivity was identified by fitting the model to the heating kinetics. The obtained results revealed that PuS application sped up the heat transfer, showing an increase in the apparent thermal diffusivity (up to 37%). The improvement in the apparent thermal diffusivity produced by PuS application was greater at high temperatures (50°C) but negligible at high air velocities (6m/s). Heating caused an increase in the hardness and elasticity of dry-cured ham, which would correct ham pastiness defects, while the influence of PuS on such textural parameters was negligible.