There are few studies on incidence rates, treatment and outcomes for peri-implant femoral fractures (PIFF) in the proximity of osteosynthesis. The purpose of this study was to investigate the incidence of PIFF following osteosynthesis of proximal femoral fractures.

This retrospective cohort study comprised a consecutive series of hip fracture patients aged 50years or older and operated with osteosynthesis between 2003 and 2015. Patients were followed-up until 2018, removal of implants or death, for a mean of 4years (range 0-15). Data on age, sex, housing, hip complications, and reoperations were recorded. The risk of PIFFs was assessed using Cox proportional hazards regression analysis. In patients with two fractures during the study period, only the first fracture was included.

A total of 1965 osteosynthesis procedures were performed, of which 382 were cephalomedullary nails (CMN), 933 sliding hip devices (SHD) and 650 pins. Mean age was 80years (range 50-104), 65% of patients were women. A total of 41sty for femoral neck fracture.

To evaluate the effectiveness of routine repeat computed tomography (CT) for nonoperative management (NOM) of adults with blunt liver and/or spleen injury.

We conducted a systematic review of randomized and non-randomized controlled trials (RCTs), quasi-experimental and observational studies of repeat CT in adult patients with blunt abdominal injury. We searched Medline, Embase, Web of Science, and Cochrane Central from their inception to October 2020 using Cochrane guidelines. Primary outcomes were change in clinical management (e.g., emergency surgery, embolization, blood transfusion, clinical surveillance), mortality, and complications. Secondary outcomes were hospital readmission and length of stay.

Search results yielded 1611 studies of which 28 studies including 2646 patients met our inclusion criteria. The majority reported on liver (n = 9) or spleen injury (n = 16) or both (n = 3). No RCTs were identified. Selleck BYL719 Meta-analyses were not possible because no study performed direct comparisons of study outcomes across intervention groups. Only seven of the twenty-eight studies reported whether repeat CT was routine or prompted by clinical indication. In these 7 studies, among the 254 repeat CT performed, 188 (74%) were routine and 8 (4%) of these led to a change in clinical management. Of the 66 (26%)repeated CT prompted by clinical indication, 31 (47%) led to a change in management. We found no data allowing comparison of any other outcomes across intervention groups.

Routine repeat CT without clinical indication is not usefulin the management of patients with liver and/or spleen injury. However, effect estimates were imprecise and included studies were of low methodological quality. Given the risks of unnecessary radiation and costs associated with repeat CT, future research should aim to estimate the frequency of such practices and assess practice variation.

Systematic reviews and meta-analyses, Level II.

Systematic reviews and meta-analyses, Level II.

To identify the risk factors of calcineurin inhibitor (CNI)-associated new-onset diabetes mellitus (NODM) in chronic kidney disease (CKD) treatment.

We retrospectively screened patients treated with CNIs in our hospital from January 2015 to December 2018. The inclusion criteria were as follows a clear diagnosis of CKD and patients receiving CNI treatment. We compared patients with and without CNI-associated NODM.

Ninety-eight of the 336 assessed patients met the inclusion criteria, 15 (15.3% [15/98]) of whom developed CNI-associated NODM. Multiple logistic regression analysis revealed that baseline glycosylated hemoglobin (OR=4.141; 1.024-16.743; p=0.046) and CNI trough concentration (1 year) (OR=1.028; 1.009-1.047, p=0.004) were independent risk factors for NODM. In contrast, glucocorticoid type (prednisone) (OR=0.075; 0.011-0.526, p=0.009) was identified as an independent protective factor for NODM. Using a receiver operating characteristic curve, a cutoff cyclosporin A trough concentration of 102.1 ng/mL was identified as a predictive factor of NODM. Univariate logistic regression showed that the incidence of diabetes was significantly higher in patients with baseline glycosylated hemoglobin in non-diabetic range but higher than 5.65% (10.2% vs. 29.2%, p=0.038). One NODM patient (6.7% [1/15]) recovered at 12.7 months after the onset of diabetes mellitus.

We recommend that more attention be paid to patients with baseline glycosylated hemoglobin in non-diabetic range but higher than 5.65% during CKD treatment with CNIs. High trough concentrations of cyclosporin A, particularly those >102.1 ng/mL, contribute to NODM. CNI-associated NODM may be reversible in the treatment of CKD.

102.1 ng/mL, contribute to NODM. CNI-associated NODM may be reversible in the treatment of CKD.An actinomycete strain, designated YIM 98757T, was isolated from the hypersaline sediment of Aiding Lake in Xinjiang province, north-west China. The strain grew well on most media tested and no diffusible pigment was produced. The substrate mycelium was well developed and fragmented. No spores were formed. The whole-cell hydrolysates contained meso-diaminopimelic acid as the cell-wall diamino acid. Xylose, galactose, ribose were the major whole-cell sugars. The phospholipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylinositol, phosphatidylinositol mannosides and an unknown phospholipid. The predominant menaquinone was MK-8(H4). The major fatty acid was iso-C160. The DNA G + C content was 69.1 mol%. Phylogenetic analysis indicated that the isolate belongs to the genus Haloechinothrix. However, it differed from its closest relative, H. alba YIM 98757 T in many phenotypic and chemotaxonomic characteristics. Moreover, the DNA-DNA and ANI relatedness values between the novel isolate and H. alba YIM 93221 T were 53.3% and 92.5%, respectively. Based on comparative analysis of polyphasic taxonomic data, strain YIM 98757 T represents a novel species of the genus Haloechinothrix, for which the name Haloechinothrix aidingensis sp. nov. is proposed. The type strain is YIM 98757T (= CGMCC 4.7627T = CCTCC AA 2020012).