'Bhim Kol (Musa Balbisiana)' Wine: Chemical Profiling and Antidiabetic Properties with MD Simulation Insights.

Musa balbisiana (Bhim Kol), an exotic fruit that offers numerous benefits can be fermented to obtain a unique indigenous wine. This study explores the fermentation of Musa balbisiana (Bhim Kol) fruit to produce a unique indigenous wine using strain of Saccharomyces cerevisiae and sugar over a 21-day period. Chemical profiling via GC-MS analysis revealed the presence of major volatile compounds such as butan-1-ol, propanoic acid, 2-phenylethanol, oxolane-2,5-dione etc.

The influence of lumbosacral transitional vertebrae on lumbar lordosis and the angle of pelvic incidence.

Pelvic incidence and lumbar lordosis have only normative values for spines comprising five lumbar and five sacral vertebrae. However, it is unclear how pelvic incidence and lumbar lordosis are affected by the common segmentation anomalies at the lumbo-sacral border leading to lumbosacral transitional vertebrae, including lumbarisations and sacralisations. In lumbosacral transitional vertebrae it is not trivial to identify the correct vertebral endplates to measure pelvic incidence and lumbar lordosis because ontogenetically the first sacral vertebra represents the first non-mobile sacral segment in lumbarisations, but the second segment in sacralisations.

Comparative Efficacy of Conservative Surgery vs Minor Amputation for Diabetic Foot Osteomyelitis.

Background: There is uncertainty regarding the optimal surgical intervention for diabetic foot osteomyelitis (DFO). Conservative surgery-amputation-free resection of infected bone and soft tissues-is gaining traction as an alternative to minor amputation. Our primary objective was to explore the comparative effectiveness of conservative surgery and minor amputations in clinical failure risk 1 year after index intervention.

No Difference in Risk of Amputation or Frequency of Surgical Interventions Between Patients With Diabetic and Nondiabetic Charcot Arthropathy.

Background: The cause of Charcot neuro-osteoarthropathy (CN) is diabetes in approximately 75% of patients. Most reports on the clinical course and complications of CN focus on diabetic CN, and reports on nondiabetic CN are scarce. No study, to our knowledge, has compared the clinical course of patients initially treated nonoperatively for diabetic and nondiabetic CN.

Endoscopic Treatment of Stump Infection of the Residual Synovial Cavity After Through-the-Knee Amputation: A Case Report.

Case: We report the case of a 35-year-old patient who presented with a septic residual synovial cavity infection 8 weeks after a through-the-knee amputation because of a parosteal sarcoma. An endoscopic evacuation of the turbid fluid and synovial debridement through parapatellar portals as in a standard knee arthroscopy was performed, in conjunction with appropriate antibiotic therapy. One year postoperatively, there were no signs of residual infection.

Nonoperative Treatment of Charcot Neuro-osteoarthropathy.

Conservative treatment of Charcot neuro-osteoarthropathy (CN) aims to retain a stable, plantigrade, and ulcer-free foot, or to prevent progression of an already existing deformity. CN is treated with offloading in a total contact cast as long as CN activity is present. Transition to inactive CN is monitored by the resolution of clinical activity signs and by resolution of bony edema in MRI.

Long-term outcome of patients with adolescent idiopathic scoliosis seeking nonoperative treatment after a mean follow-up of 42 years.

Purpose: Adolescent idiopathic scoliosis (AIS) affects up to 3% of otherwise healthy adolescents. The extreme long-term outcomes of nonoperative treatment are underreported. This study aimed to investigate the long-term outcome of nonoperative-treated AIS patients.

Salami-Tactics: when is it time for a major cut after multiple minor amputations?

Introduction: Repetitive minor amputations carry the concomitant risks of multiple surgical procedures, major amputations have physical and economical major drawbacks. The aim of this study was to evaluate whether there is a distinct number of minor amputations predicting a major amputation in the same leg and to determine risk factors for major amputation in multiple minor amputations.

Materials And Methods: A retrospective chart review including 429 patients with 534 index minor amputations between 07/1984 and 06/2019 was conducted.

How good are clinicians in predicting the presence of spp. in diabetic foot infections? A prospective clinical evaluation.

Introduction: The most frequently prescribed empirical antibiotic agents for mild and moderate diabetic foot infections (DFIs) are amino-penicillins and second-generation cephalosporins that do not cover spp. Many clinicians believe they can predict the involvement of in a DFI by visual and/or olfactory clues, but no data support this assertion.

Methods: In this prospective observational study, we separately asked 13 experienced (median 11 years) healthcare workers whether they thought the spp.

Long-term follow-up of conservative treatment of Charcot feet.

Background: Charcot arthropathy (CN) can ultimately lead to limb loss despite appropriate treatment. Initial conservative treatment is the accepted treatment in case of a plantigrade foot. The aim of this retrospective study was to investigate the mid- to long-term clinical course of CN initially being treated conservatively, and to identify risk factors for reactivation and contralateral development of CN as well as common complications in CN.

Resting TcPO2 levels decrease during liner wear in persons with a transtibial amputation.

Background: In our clinic, a substantial number of patients present with transtibial residual limb pain of no specific somatic origin. Silicone liner induced tissue compression may reduce blood flow, possibly causing residual limb pain. Thus, as a first step we investigated if the liner itself has an effect on transcutaneous oxygen pressure (TcPO2).

Extreme long-term outcome of operatively versus conservatively treated patients with adolescent idiopathic scoliosis.

Purpose: We report on outcomes of surgically versus (vs) non-surgically treated patients with moderate adolescent idiopathic scoliosis (AIS) after minimum of 29 years.

Methods: AIS patients with a follow-up of  ≥ 41 years in the surgical group and  ≥ 29 years in the non-surgical group were included. Patients were treated surgically for primary curves  ≥ 45° vs non-surgically for curves  < 45° or refusal of surgery.

Long-term results after internal partial forefoot amputation (resection): a retrospective analysis.

Introduction: Internal partial forefoot amputation (IPFA) is a treatment option for osteomyelitis and refractory and recurrent chronic ulcers of the forefoot. The aim of our study was to assess the healing rate of chronic ulcers, risk of ulcer recurrence at the same area or re-ulceration at a different area and revision rate in patients treated with IPFA.

Materials And Methods: All patients who underwent IPFA of a phalanx and/or metatarsal head and/or sesamoids at our institution because of chronic ulceration of the forefoot and/or osteomyelitis from 2004 to 2014 were included.

Mid-term walking ability after Charcot foot reconstruction using the Ilizarov ring fixator.

Background: Failed conservative treatment and complications are indications for foot reconstruction in Charcot arthropathy. External fixation using the Ilizarov principles offers a one-stage procedure for deformity correction and resection of osteomyelitic bone. The aim of this study was to determine whether external fixation with an Ilizarov ring fixator leads reliably to walking ability.

Optimization of the antibiotic management of diabetic foot infections: protocol for two randomized controlled trials.

Background: Few studies have addressed the appropriate duration of antibiotic therapy for diabetic foot infections (DFI) with or without amputation. We will perform two randomized clinical trials (RCTs) to reduce the antibiotic use and associated adverse events in DFI.

Methods: We hypothesize that shorter durations of postdebridement systemic antibiotic therapy are noninferior (10% margin, 80% power, alpha 5%) to existing (long) durations and we will perform two unblinded RCTs with a total of 400 DFI episodes (randomization 1:1) from 2019 to 2022.

Molecular characterization and genetic relationships of seven piranha species of the genera Serrasalmus and Pygocentrus (Characiformes: Serrasalmidae) from Paraná-Paraguay, São Francisco and Tocantins River basins in Brazil.

Genetic and phylogenetic relationships among seven piranha species of the genera Serrasalmus and Pygocentrus from the Paraná-Paraguay, São Francisco and Tocantins River basins were evaluated in the present study by partial sequences of two mitochondrial genes, Cytochrome b and Cytochrome c Oxidase I. Phylogenetic analysis of Maximum-Likelihood and Bayesian inference were performed. Results indicated, in general, greater genetic similarity between the two species of Pygocentrus (P.

Revision After Total Transmetatarsal Amputation.

Total transmetatarsal amputation (TMA) can be an option for foot salvage in gangrene, sepsis, or infected necrosis. However, the literature concerning predictive outcome factors and bacterial sampling is scarce. To identify potential associations between revision surgery and underlying bacteria or other preoperative selection criteria, we reviewed all patients with TMA who were treated at our institution.

Molecular characterization of the invasive aquatic macrophyte Hydrilla verticillata (Hydrocharitaceae) in Brazil.

Invasive populations of macrophytes are widely distributed and have been successfully introduced and established in freshwater habitats. Hydrilla verticillata was first recorded in 2005 in the Upper Paraná River floodplain and in 2007 at the Itaipu Reservoir (Brazil-Paraguay border, ca. 300 km downstream from its first record).

Diabetic calcaneal osteomyelitis.

Diabetic foot infection (DFI), a multi-facetted disease requiring a multidisciplinary approach for successful treatment, mostly affects the forefoot. Calcaneal osteomyelitis (CO) is an uncommon presentation of DFI with a somewhat different epidemiology, clinical features, and approach to management. These patients, compared to those with non-calcaneal DFI, more often require special surgical techniques and off-loading approaches.

The Charcot foot: a pictorial review.

Charcot foot refers to an inflammatory pedal disease based on polyneuropathy; the detailed pathomechanism of the disease is still unclear. Since the most common cause of polyneuropathy in industrialized countries is diabetes mellitus, the prevalence in this risk group is very high, up to 35%. Patients with Charcot foot typically present in their fifties or sixties and most of them have had diabetes mellitus for at least 10 years.

A Clinical Decision Support System for Assessing the Risk of Cardiovascular Diseases in Diabetic Hemodialysis Patients.

Background: One of the greatest challenges in the field of medicine is the increasing burden of chronic diseases, such as diabetes. Diabetes may cause several complications, such as kidney failure which is followed by hemodialysis and an increasing risk of cardiovascular diseases.

Objective: The purpose of this research was to develop a clinical decision support system for assessing the risk of cardiovascular diseases in diabetic patients undergoing hemodialysis by using a fuzzy logic approach.

Predictors for reoperation after lower limb amputation in patients with peripheral arterial disease.

Major amputations in patients with peripheral arterial disease (PAD) carry a high risk for complications, including revision of the amputation, sometimes to a higher level. Determining a safe level for amputation with good wound healing potential depends largely on vascular measurements. This study evaluated potential predictive factors for revision of major lower extremity amputations in patients with PAD.

Outcome After Surgical Treatment of Calcaneal Osteomyelitis.

Background: Surgical procedures for calcaneal osteomyelitis are partial calcanectomy (PC), total calcanectomy (TC), and below-knee amputation (BKA). With calcaneal osteomyelitis, limb-saving surgery was described to have secondary BKA rates of 4% to 20%, while secondary amputation rates after BKA are unknown. The aim of this study was to describe and compare overall revision and secondary amputation rates for each surgical option in our institution's cohort and to identify risk factors for secondary amputation.

[Leg ulcers (ulcus cruris): The frequent macrovascular causes].

Leg ulcers (ulcus cruris): The frequent macrovascular causes Four pathologies make up the macrovascular etiologies of leg uclers: Venous leg ulcers (50 %), mixed venous-arterial leg ulcers (20 %), arterial leg ulcers (5 %), and Martorell hypertensive ischemic leg ulcer (5 %). The remaining 20 % concern a large array of other etiologies. Every leg ulcer requires vascular (arterial and venous) work-up, that can be completed with microbiology, biopsy, and more in-depth internal diagnostics, as indicated.