Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To characterize methicillin-resistant S. aureus (MRSA) strains phenotypically and genotypically and to determine their clonal affiliation, representation and antibiotic resistance profile. Methods A total of 62 randomly selected MRSA isolates of different clinical samples collected from 2009 to 2017 were phenotypically and genotypically analysed. Phenotypic analyses were performed by standard microbiological procedures, and using VITEK 2/AES instrument as well as MALDI-TOF (matrix-assisted laser desorption/ionization) technology. ⋯ During 2009 and 2010 the most frequent MRSA strain was South German clone, ST228-MRSA-I (80% and 90%, respectively), while in later years it was replaced with Brazilian-Hungarian clone ST239-MRSA-III (75% in 2015 and 2016). The South German clone, spa type t041 in 90.48% of cases was resistant to clindamycin, ciprofloxacin, erythromycin, cefoxitin, gentamicin, kanamycin, tobramycin and penicillin, while 70.58% samples of the Brazilian-Hungarian clone spa type t037 were additionally resistant to tetracycline and rifampicin. Conclusion This research can supplement the existing knowledge about the clonal distribution of MRSA in Bosnia and Herzegovina and their sensitivity to antibiotics in order to improve the national control of these infections.
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Rotator cuff tears (RCT) are a common problem encountered by orthopaedic surgeons. The incidence of re-tears (up to 94%) following surgical repair of RCTs renders the management of RCTs challenging. This higher re-tear rate has been attributed to the failure of healing at the tendon-bone junction. ⋯ However, these newly generated biological augmentation strategies are mostly studied in animal models. The efficacy and safety of the biological augmentation methods in humans need further investigation. In this review, we aimed to highlight the most recent advancements in RCT surgical repair with biological augmentation.
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Randomized Controlled Trial
The challenge of the surgical treatment of paediatric distal radius/ forearm fracture: K wire vs plate fixation - outcomes assessment.
Aim Distal radius/forearm fractures in adolescent patients remain challenging injuries to treat. Distal radius/forearm bony anatomy is not completely restored with intramedullary K wire fixation. The aim of this study was to compare radiographic and functional outcomes obtained using intramedullary K wire fixation and open reduction and internal fixation in the treatment of distal radius/ forearm fracture. ⋯ Conclusion The treatment of adolescent distal radius or forearm fractures remains challenging. One challenge facing the physician is the choice of surgical technique and fixation method, which will be influenced by individual experience and preference. The question of distal radius or forearm fractures in adolescents would be best answered with a prospective randomized study.
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Randomized Controlled Trial
Does low intensity direct current affect open fracture wound healing?
Aim To explore the effects of a molecular pathway from the application of low-intensity direct current (LIDC) for wound healing through the pathway signalling growth factor and initiation of fibroblast activation. Methods This randomized clinical trial included 32 patients with open fracture wounds who came to Hasan Sadikin Hospital in Bandung, Indonesia. The patients were divided in the control and the treatment group. ⋯ Results This study showed a better wound area repair in the treatment group than the standard group, 3.17±0.11 and 0.78±0.07, respectively. The increase of FGF-2 level (42.69±3.5 and 15.09±1.8, respectively), FGF-7 level (42.99±3.55 and 14.67±1.9, respectively), and fibroblast group expression (7.62±0.79 and 3.54±0.6, respectively) were found to be higher in the treatment group (p <0.05). Conclusion Low-intensity direct current accelerates wound healing through the increase of growth factor and fibroblast activation.
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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. ⋯ 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.