Aim To report the results of a two-stage reconstruction of septic non-unions of the upper limb using the bone-and-strut technique with a follow-up of more than two years. Methods A total of 19 patients (12 males and seven females; age 27 to 85 years) were included in this cohort study. The evaluation endpoint was set at 24 months. Radiographic union, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores, pain and return to work were assessed. All patients were treated with debridement and antibiotic therapy. At a second stage, the nonunion focus was filled with a cancellous bone allograft. Stability was provided using a locking plate and a bone strut. Results After 24 months, the QuickDASH scores improved from a median of 28 (interquartile range, 13 - 35 points), to a median of 78 (interquartile range, 70 - 89 points). Mean pain scores improved from 8.1 (range, 0.3-10) to 0.6 (range 0-2). Radiographic and clinical union was seen in all patients. The majority of patients returned to work or previous activities when retired. A new neurological deficit, recurrence of infection, or other surgery-related adverse events were not observed. Conclusion The two-stage bone-and-strut technique is a safe and effective technique in the treatment of septic non-unions of the upper limb. The union rate is high, the complication rate is acceptable and return return-to-work is high. Recurrence of infectious sequelae during a follow-up period of at least two years was not seen. The patient-reported outcomes increased significantly.

Data on the immune response to West Nile virus (WNV) are limited. We analyzed the antiviral cytokine response in serum and cerebrospinal fluid (CSF) samples of patients with WNV fever and WNV neuroinvasive disease using a multiplex bead-based assay for the simultaneous quantification of 13 human cytokines. The panel included cytokines associated with innate and early pro-inflammatory immune responses (TNF-α/IL-6), Th1 (IL-2/IFN-γ), Th2 (IL-4/IL-5/IL-9/IL-13), Th17 immune response (IL-17A/IL-17F/IL-21/IL-22) and the key anti-inflammatory cytokine IL-10. Elevated levels of IFN-γ were detected in 71.7% of CSF and 22.7% of serum samples (p = 0.003). Expression of IL-2/IL-4/TNF-α and Th1 17 cytokines (IL-17A/IL-17F/IL-21) was detected in the serum but not in the CSF (except one positive CSF sample for IL-17F/IL-4). While IL-6 levels were markedly higher in the CSF compared to serum (CSF median 2036.71, IQR 213.82–6190.50; serum median 24.48, IQR 11.93–49.81; p < 0.001), no difference in the IL-13/IL-9/IL-10/IFN-γ/IL-22 levels in serum/CSF was found. In conclusion, increased concentrations of the key cytokines associated with innate and early acute phase responses (IL-6) and Th1 type immune responses (IFN-γ) were found in the CNS of patients with WNV infection. In contrast, expression of the key T-cell growth factor IL-2, Th17 cytokines, a Th2 cytokine IL-4 and the proinflammatory cytokine TNF-α appear to be concentrated mainly in the periphery.

Reduced maintenance costs of concrete structures can be ensured by efficient and comprehensive condition assessment. Ground-penetrating radar (GPR) has been widely used in the condition assessment of reinforced concrete structures and it provides completely non-destructive results in real-time. It is mainly used for locating reinforcement and determining concrete cover thickness. More recently, research has focused on the possibility of using GPR for reinforcement corrosion assessment. In this paper, an overview of the application of GPR in corrosion assessment of concrete is presented. A literature search and study selection methodology were used to identify the relevant studies. First, the laboratory studies are shown. After that, the studies for the application on real structures are presented. The results have shown that the laboratory studies have not fully illuminated the influence of the corrosion process on the GPR signal. Also, no clear relationship was reported between the results of the laboratory studies and the on-site inspection. Although the GPR has a long history in the condition assessment of structures, it needs more laboratory investigations to clarify the influence of the corrosion process on the GPR signal.

A R T I C L E I N F O A B S T R A C T Article history: Received: 14 December, 2020 Accepted: 19 January, 2021 Online: 05 February, 2021 A comparative analysis of formulas for blast wave overpressure is presented in the paper, and models were compared with available experimental data. The Kinney and Shin models show the best agreement with experimental data (Kingery-Bulmash) for free airburst, while for surface burst, Swisdak, Vanuci, and Jeon models predict test data most accurately. One of the novelties in the paper is introduction of new exponential and power functions for blast overpressure estimation, giving good agreement with experimental data. Also, several numerical simulations of free airburst explosions were performed to introduce methodology, and compare the data obtained with experimental data. A detailed description of the procedure for these simulations was provided – a contribution to numerical modeling of blast wave phenomena.

Shape analysis is an important and powerful tool in a wide variety of medical applications. Many shape analysis techniques require shape representations which are in correspondence. Unfortunately, popular techniques for generating shape representations do not handle objects with complex geometry or topology well, and those that do are not typically readily available for non-expert users. We describe a method for generating correspondences across a population of objects using a given template. We also describe its implementation and distribution via SlicerSALT, an open-source platform for making powerful shape analysis techniques more widely available and usable. Finally, we show results of this implementation on mouse femur data.

Based on the computed tomography (CT) images it is not possible to see all the lymph nodes that belong to the stomach. In radiotherapy, for a clinical target volume (CTV) delineation based on CT images, it is necessary to determine the appropriate margin around the corresponding blood vessels to make sure that all the required lymph nodes will be irradiated. The larger margin will certainly cover all the lymph nodes but it can also produce an increase of the received dose in the normal tissues. While a smaller margin can eventually spare the normal structures as a consequence it brings a higher risk of missing the suspected lymph nodes. The aim of this study was to analyse the radiation doses received by some organs at risk (OARs) in the case of the three-dimensional conformal radiotherapy (3DCRT) treatment of the gastric cancer, for lymph node CTV margin sizes 5 mm, 7 mm and 10 mm. The study included 40 patients undergo the external beam radiotherapy (EBRT) treatment of gastric cancer. The one-way analysis of variance (ANOVA) with repeated measures test and Friedman’s nonparametric test have been used for testing the statistical significance of differences among the examined groups. The difference between the examined groups has been considered significant if p < 0.05. The statistically significant differences in the dose contributions to the observed OARs (spinal cord, heart, small bowel and colon), among the examined CTVs, were found.

Balneo-gynaecological treatment methods include external bath hydrotherapy, sedentary baths and topical dressings/cataplasm, and internal (intravaginal or intrarectal use of peloids and mineral water). Hyperosmolar thermal spas have been very popular in the treatment of infertility due to the improvement of symptoms of chronic pelvic pain, endometriosis, chronic vascular and inflammatory pelvic diseases. Acute pelvic inflammatory syndrome is a contraindication for balneo-hydrotherapy while hyperthermal hydrotherapy is contraindicated in endometriosis and neurovegetative dystonia due to the stimulation of hyperemia, which worsens the clinical picture. Balneo-hydrotherapy is not recommended in metrorrhagia and malignancies. Balneogynaecological treatment certainly has its own primary but also complementary role in the treatment of chronic gynaecological diseases and is increasingly recommended today.

ABSTRACT Six blood groups (Rh, MN, Duffy, Kidd, Kell, and Lutheran) were investigated among three major ethnic groups (Bosniaks, Bosnian Croats, and Bosnian Serbs), as well as 10 regional subpopulations across Bosnia and Herzegovina (B&H): Krajina; Posavina; northeastern, eastern, middle, and central Bosnia; Sarajevo region; eastern, central, and western Herzegovina. This is the first study that introduces the molecular genetic typing of five blood groups within the B&H population, with the exception of the RhD blood group. The sample consisted of 450 buccal swabs from unrelated individuals. Five blood group systems (RhD, RhC, RhE, Kidd, MN) were genotyped by PCR with sequence specific primers, while three blood group systems (Kell, Duffy, Lutheran) were genotyped by the PCR-restriction-fragment-length polymorphism method. Minor variation of genetic diversity was observed within the three major B&H ethnic groups, as well as within the 10 subpopulations stratified according to geographical criteria. No genetic differentiation among ethnic groups was noticed. These results are in agreement with the results of previous studies based on different molecular genetics markers, which indicate that the three B&H ethnic groups belong to the same gene pool. A similar level of genetic variance was observed within regional subpopulations, with no significant genetic differentiation among them. Comparison of intrapopulation genetic diversity of the B&H population with other European and non-European populations, based on three loci (RHD, MN, and KEL), clearly show that the level of genetic diversity of the B&H population is within the European range.