Search

Accurate soft tissue balancing during total knee arthroplasty has a direct effect on patellofemoral tracking and knee range of motion. Numerous instruments and methods are available to balance knee prostheses. The eLIBRA Dynamic Knee Balancing System (Synvasive Technology, Inc, Reno, Nevada) is an electronic device that establishes femoral component rotation using ligamentous tone. The eLIBRA is an articulating spacer that emulates implant trials before anteroposterior femoral cuts are made to obtain a dynamic gap symmetry.

Premenstrual syndrome (PMS) affects most women during their reproductive life. Headache is regarded as a typical symptom of PMS and, close to menses, migrainous women could experience their worst migraine attacks. Vitex agnus-castus(VAC) is a phytopharmaceutical compound, considered worldwide to be a valid tool to treat PMS. Aim of this study is to explore if headache is ameliorate in migrainous women treated with VAC for PMS by an open-label clinical observation. Migrainous women with PMS were enrolled in the study and advised to assume a treatment with VAC (40 mg/day) for PMS for a 3-month period. Effects both on PMS and headache were assessed. Out of 107 women, 100 completed the 3-month treatment for PMS. Out of them, 66 women reported a dramatic reduction of PMS symptoms, 26 a mild reduction, and 8 no effect. Concerning migraine, 42 % of patients experienced a reduction higher than 50 % in frequency of monthly attacks, and 57 % of patients experienced a reduction higher than 50 % in monthly days with headache. No patients reported remarkable side effects. Pending a placebo-controlled trial to confirm our results, we observed that the use of VAC in migrainous women affected by PMS resulted to be safe and well tolerated, and may positively influence the frequency and duration of migraine attacks.Premenstrual syndrome (PMS) affects most women during their reproductive life. Headache is regarded as a typical symptom of PMS and, close to menses, migrainous women could experience their worst migraine attacks. Vitex agnus-castus(VAC) is a phytopharmaceutical compound, considered worldwide to be a valid tool to treat PMS. Aim of this study is to explore if headache is ameliorate in migrainous women treated with VAC for PMS by an open-label clinical observation. Migrainous women with PMS were enrolled in the study and advised to assume a treatment with VAC (40 mg/day) for PMS for a 3-month period. Effects both on PMS and headache were assessed. Out of 107 women, 100 completed the 3-month treatment for PMS. Out of them, 66 women reported a dramatic reduction of PMS symptoms, 26 a mild reduction, and 8 no effect. Concerning migraine, 42 % of patients experienced a reduction higher than 50 % in frequency of monthly attacks, and 57 % of patients experienced a reduction higher than 50 % in monthly days with headache. No patients reported remarkable side effects. Pending a placebo-controlled trial to confirm our results, we observed that the use of VAC in migrainous women affected by PMS resulted to be safe and well tolerated, and may positively influence the frequency and duration of migraine attacks.

The partial and complete cycle of the intestinal pH-dependent oligopeptide transporter PepT1 from three species (seabass, zebrafish and rabbit) were studied using an electrophysiological approach and a biophysical analysis, in order to identify similarities and differences. On the whole the presteady state currents of the fish transporters were similar to each other, while presenting some quantitative differences with respect to rabbit PepT1: this last form showed slower decaying currents and the charge vs. potential (Q/V) and time constant vs. potential (τ/V) curves shifted to more positive potentials. All isoforms were similarly affected by external pH, showing acidity-induced slowing of the transients and positive shifts in the Q/V and τ/V curves. Analysis of the pH dependence of the unidirectional rates of the intramembrane charge movement suggested that external protonation of the protein limits the speed of this process in both directions. The complete cycle of the transporter was studied using the neutral dipeptide Gly-Gln. Michaelis-Menten analysis confirmed that in all species the apparent affinity for the substrate is significantly increased by acidity, while the maximal transport current is not strongly affected. Simulations using a kinetic model incorporating the new findings show good agreement with experimental data for all three species both with respect to the presteady-state and transport currents.

A retrospective review was conducted to evaluate the mid-term results (8.5 years follow-up) of the Versys ET stem (Zimmer, Warsaw, Indiana, USA). From 1995 to 2000, 225 total hip arthroplasties (THA) were performed using this device. All patients were evaluated clinically by the Harris Hip Score, and radiographically. The Hip Score increased from 54 preoperatively to 97 points postoperatively. The stem displayed a varus alignment between 5° and 10° in 17 cases without any clinical consequences (HHS 96.8). We recorded one case of septic loosening and one case of aseptic loosening. The stability of the stem was radiographically evaluated according to Engh's criteria, confirming bone ongrowth in all other cases.

Introduction:Aplasia cutis congenita (ACC) is a rare congenital disease, characterised by absence of skin, that can affect different parts of the body. ACC is more frequent on the scalp, but can involve limbs, with partial-or total-thickness loss of skin, with a functional impairment of the joint affected. There is no clear indication for surgical or conservative treatment, therefore, it would be helpful to find scientific support for the optimal treatment strategies.Clinical presentation:We present a case of a newborn female, with six wounds on the inferior limbs, treated with conservative therapy. To prevent infection and promote healing, the defects were kept moist and covered with non-adherent/antimicrobical dressings. Complete wound healing occurred in eight weeks. The duration of follow-up was three years.Results:In this kind of ACC with superficial partial-thickness wounds of the lower limbs, conservative treatment was successful. The same conservative treatment can be proposed for larger or deeper wounds of lower limbs with no involvement of underlying structures, with delayed scar excision after the complete growth of the patient. ACC scar excision could require complex tissue rearrangement, tissue expansion, or skin grafting.Conclusion:In the evaluation for treatment of ACC of inferior limbs, even in cases of total-thickness skin loss, even on joints, the conservative approach could be considered as the first choice.Declaration of interest:None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

L’obiettivo qualità rappresenta sicuramente uno dei cardini attorno cui ruota la produzione ortofrutticola moderna, che si mostra sempre più incline a produrre secondo elevati standard qualitativi. Alle caratteristiche qualitative “tradizionali” oggi, se ne affiancano altre, legate a nuove esigenze da parte dei consumatori che sono sempre più interessati ad una dieta basata sul consumo di ortofrutta senza residui di pesticidi e con un alto valore nutrizionale. Nell’ambito di un possibile programma di qualificazione delle produzioni ortofrutticole, risulta quindi fondamentale uno studio dei determinanti della qualità secondo un approccio euristico, idoneo ad individuare il contributo dei singoli fattori nel determinare la qualità del prodotto. Le conoscenze genetiche applicate a diverse tecniche di costituzione varietale rappresentano sicuramente la base per la creazione di variabilità utile al miglioramento della qualità senza però limitare la produttività colturale. Sotto il profilo agronomico, le opportunità offerte da una gestione sostenibile dei fattori della produzione, orientata verso il miglioramento di uno o più parametri di qualità, sono senz’altro numerose e riconducibili, ora al miglioramento della interazione pianta-ambiente, ora ad un più mirato input dei mezzi di produzione, ora alla induzione di condizioni di stress di natura diversa. Anche le tecniche del post-raccolta risultano ora sempre più importanti per garantire che la qualità ottenuta in campo sia garantita fino al consumatore. In considerazione di tale articolazione e facendo riferimento ad alcune colture modello si cercherà di delineare un quadro volto ad evidenziare, con riferimento ai principali determinanti, le potenzialità in tema di qualificazione delle corrispondenti produzioni.

The purpose of this study was to evaluate 115 “Conus” uncemented stems at an average follow-up of 6 years (2–9 years). Seventeen patients were lost at follow-up for a final number of 98 stems in 75 patients. The clinical outcome of 71 hips (72%) was graded excellent, 25 (25%) were good, one (2%) fair and one (2%) poor. The average Harris Hip Score increased from 49.35 before operation to 96.30 at the time of the last follow-up.None of the stems implanted required a revision for aseptic or septic loosening. Cortical hypertrophy or radiolucencies were never seen in any of the stems evaluated. Heterotopic ossification was seen in one hip (1%). Modification of the calcar was observed in 29 hips (30%) and they consisted in a slight rounding off of the proximal medial edge of the cut femoral neck.These results encourage the use of this versatile stem which showed a good primary and secondary stability, with a good load distribution along the femur.

A retrospective study was conducted to correlate the clinical result of joint replacement in dysplastic hips with the obtained modifications of the rotation centre.Sixty primary total hip arthroplasties were performed on 46 patients suffering from hip dysplasia at our institution. The radiographic evaluation of the hip rotation centre was performed using the method proposed by Pierchon. The clinical assessment was by Harris Hip Score. Our results revealed that it was possible to modify the position of the pathological rotational centre with a statistically significant difference (p<0.05) for both coordinates. The general clinical evaluation relates well to the radiological evaluation as the average HHS increased to 92.683 (p<0.05). The data from our study are in accordance with the most recent literature and confirm the importance of a suitable biomechanical position of the hip rotation centre in a distal and medial sense.

Purpose. To present preliminary clinical experience with Matrix-induced autologous chondrocyte implantation, a new tissue-engineering technique for treatment of deep cartilage defects, in which autologous chondrocytes are seeded on a tridimensional scaffold provided by a bilayer type I–III collagen membrane.Methods. From December 1999 to January 2001, 13 patients underwent implantation procedure for deep cartilage defects. Age of patients ranged from 18 to 49 years (mean age, 35 years). The mean defect size was 3.5 cm2(range, 2.0–4.5 cm2). Clinical and functional evaluation were performed using various score systems for the ankle and the knee, and magnetic resonance imaging was performed at 6 and 12 months postoperatively. Membrane structure and cellular population were investigated by light microscopy, scanning electron microscopy, and electrophoresis before implantation.Results. The mean follow-up was 6.5 months (range, 2–15 months). No complications were observed in the postoperative period. The 6 patients with a minimum follow-up of 6 months showed an improvement in clinical and functional status after surgery. Magnetic resonance images showed the presence of hyaline-like cartilage at the site of implantation; there was evidence of chondroblasts and type II collagen inside the seeded membrane.Conclusion. Matrix-induced autologous chondrocyte implantation offers several advantages with respect to the traditional cultured cell procedure. These include technical simplicity, short operating time, minimal invasiveness, and easier access to difficult sites. It appears to be a reliable method for the repair of deep cartilage defects.

This review is about the involvement of the water and carbon fluxes in the formation of tomato fruit quality. This approach has provided new insights that help in understanding and controlling some of the major variables of fruit quality. Variations in the concentration of dry matter and sugars have been coupled with the conditions of climate and root medium: these concentrations increase under high radiation, high vapour pressure deficit (VPD) or high nutrient concentration. Dry matter and sugar concentrations would not be affected by the availability of assimilates (CO$_2$ concentration or fruit load). Such increases in dry matter or sugar concentration could be associated with variations in the balance between water and assimilate influx to the fruit i.e. between the fluxes of the phloem and xylem saps and of fruit transpiration. Similarly, the observed relation between the occurrence of blossom-end rot (BER) and conditions of osmotic or water stress can be explained by variations of Ca transport to the fruit by the xylem influx. Fruit cracking could be related to high variations in fruit growth and water influx under changing conditions of temperature or VPD. In contrast, acids and products of the secondary metabolism that are synthesised during the maturation stages could not be linked to the water and carbon fluxes between the plant and the fruit.

AbstractAn epidemiological survey of the use of antimicrobial prophylaxis in Italian hospitals was carried out under the auspices of the Journal of Chemotherapy. Out of 500 Italian orthopedic centers queried, 225 agreed to participate in this study. A total of 136,321 surgical procedures were reported in the 166 centers reporting complete answers on type of surgery. They comprised hip and knee prosthesis (13.9%), spine surgery (4%), hip endoprosthesis (5.2%), osteosynthesis (26.9%), arthroscopy (24.4%), and others (25.5%). Perioperative antimicrobial prophylaxis was used in 75% of operations (ranging from 57.1% to 99.4% in arthroscopy and joint prosthesis, respectively). Short term (<24 h) antimicrobial prophylaxis was performed in 38.4% of the 206 centers answering this question correctly. 61.1% of centers employed single agent prophylaxis and 70.8% of these prescriptions were betalactam antibiotics. Bacteriological analysis revealed Gram-positive isolates in 73.3% of cases. Methicillin resistance was present in 45% of 915 tested strains. Out of 4221 patients with high risk of infectious complications (joint prosthesis surgery) given antimicrobial prophylaxis in 46 centers, the percentage of surgical wound infections was overall 2.1%, while that of non-surgical wound infections was 3.6%. The total infection rate was decreased by about half in association with long-term (>24 h) as compared to short-term (<24 h) antibiotic treatment (3.7% vs7.6%, respectively), and with use of antibiotic drug combinations vssingle antibiotic drugs (3.9 vs6.6%, respectively). The incidence of surgical-site infection was not decreased by extending the chemoprophylaxis for more than the first 24 h after surgery, while it was reduced from 2.5 to 1.4% by use of combination antibiotic therapy.

Plants were grown in two glasshouse compartments under two vapour pressure deficit (vpd) levels: low vpd was obtained by increasing air humidity with a fogging system, and high vpd was obtained during sunny hours in a greenhouse where air humidity was not controlled. The mean value, of the six driest hours of the day concerning the growing period of the fruits considered, was 1.6 kPa under low vpd and 2.2 kPa under high vpd conditions. Over the whole experimental period, the difference in mean hourly temperature never exceeded 0.8°C. The oldest leaves were removed to different extents in different plots to analyse whether a different leaf/fruit ratio could modify the effect of high vpd.

SummaryAn epidemiological survey of the use of antimicrobial prophylaxis in Italian hospitals was carried out under the auspices of the Journal of Chemotherapy. Out of 500 Italian orthopedic centers requested, 225 have participated in this study. A total of 136,321 surgical procedures were reported in the 166 centers reporting complete answers on type of surgery. They comprised hip and knee prosthesis (13.9%), spine surgery (4%), hip endoprosthesis (5.2%), osteosynthesis (26.9%), arthroscopy (24.4%), and others (25.5%). Perioperative antimicrobial prophylaxis was used in 75% of operations (ranging from 57.1% to 99.4% in arthroscopy and joint prosthesis, respectively). Short term (<24 h) antimicrobial prophylaxis was performed in 38.4% of the 206 Centers answering this question correctly. 61.1% of Centers employed single agent prophylaxis. 70.8% of these prescriptions were betalactam antibiotics. Bacteriological analysis of the wound in 86 Centers (total number of isolates 2013) revealed the presence of Gram-positive isolates in 73.7% of cases. Methicillin resistance was expressed in 45% of 915 tested strains. Out of 4221 patients with high risk of infectious complications (joint prosthesis surgery) given antimicrobial prophylaxis in 46 Centers, the percentage of surgical wound infections was overall 2.1%, while that of non-surgical wound infections was 3.6%. A decrease in the total infection rate by about half was associated with long-term (>24 h) as compared to short-term (<24h) antibiotic treatment (3.7 vs 7.6%, respectively), and with the use of antibiotic drug combinations vs single antibiotic drugs (3.9 vs 6.6%, respectively). The incidence of surgicalsite infection is not decreased by extending the chemoprophylaxis for more than the first 24 h after surgery, while it is reduced from 2.5 to 1.4% by use of combination antibiotic therapy.

The purpose of this study was to evaluate 54 “Conus” uncemented stems both clinically and radiologically. The radiological evaluation was carried out to verify the stability of this rounded cross-section stem in terms of bone ingrowth and axial subsidence. Clinically, 39 hips (72%) were rated excellent, 13 (24%) were rated good, 2 (4%) were rated fair or poor. The average Harris Hip Score increased from 53 before operation to 93 at the time of the last follow-up (average FU 22.5 months). None was reoperated. Radiologically, 13 stems (24%) were judged to have subsided using a method described by Loudon and Charnley (6). Calcar modification, observed in 22 hips (41%), consisted of a slight rounding off of the proximal medial edge at the cut femoral neck. These results encourage the use of this versatile stem which revealed good primary and secondary stability, with good load distribution along the femur.

Two cases of unusual valgus and lateral stem displacement in cementless total hip replacement are reported. A certain number of mechanical conditions must have been present to cause this unusual prosthesis displacement. The Authors suggest that the stem's design was one of these factors.

A case of intratendinous chondroma of a finger flexor tendon is described. To our knowledge, such a location has never been reported before.

The article focuses on the Via Krupp road in Capri, Italy designed by Emilio Mayer in 1900 and completed in 1902. The road was constructed to connect the gardens of San Giacomo Chartreuse to the Marina Piccola. It notes that the road's pedestrian walk fosters the relationship between the man made environment and the landscape. It mentions that roads have been experiencing degradation due to the suspension of the maintenance jobs for the route.