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A educação alimentar é um componente decisivo para a promoção de saúde, e seu efeito pode ser potencializado quando realizada durante a infância, pois é nessa faixa etária que os hábitos alimentares são formados e consolidados. Para que os resultados da educação alimentar sejam satisfatórios, as educadoras envolvidos precisam estar cientes de seu papel como facilitador desse processo. Esse estudo teve por objetivo avaliar o estado nutricional e de saúde das educadoras de uma creche do município de São Paulo. Foi realizado um estudo transversal descritivo com educadoras de uma creche do município de São Paulo. A coleta dos dados foi realizada por estagiárias de nutrição previamente treinadas. Foram coletadas informações sociodemográficas por meio de uma anamnese alimentar, a fim de avaliar os hábitos alimentares, assim como os dados antropométricos estatura (m), peso (kg) e circunferência da cintura -CC (cm). Participaram da pesquisa 31 educadoras, do gênero feminino, com média de idade 33 anos (± 6,18 dp), não fumantes, a maioria (71%) não consumia bebida alcoólica e não praticava nenhum tipo de atividade física (83,4%). Em relação ao estado nutricional, 51,6% apresentava sobrepeso ou algum grau de obesidade e 45,2% tinha risco para doenças metabólicas segundo a CC. Os resultados indicaram que a maioria das educadoras apresentaram sobrepeso/obesidade, o que reforça a necessidade de implementação de ações de educação nutricional.

Introduction: The optimal treatment approach for Bony Bankart remains a subject of considerable debate among shoulder surgeons. Existing literature highlights low recurrence rates and high patient satisfaction with nonoperative treatment, particularly in the middle-aged population. This study aimed to evaluate the recurrence rate of dislocation, as well as the clinical and functional outcomes in middle-aged individuals treated nonoperatively following an acute bony Bankart fracture. Additionally, the impact of glenoid rim size and fragmentation on the treatment outcome was investigated., Material and Methods: A prospective analysis was conducted on 20 patients aged over 50 with nonoperatively treated bony Bankart fractures, ensuring a minimum follow-up of 24 months. The study population was categorized based on fragment size (small and medium) according to Kim classification and glenoid rim fragmentation (type 1b and 1c) according to Scheibel classification. Data including UCLA score, Rowe score, recurrence rate, clinical instability, and range of motion (ROM) were collected and analyzed., Results: The average UCLA and Rowe scores were 32.15 ± 2.85 and 93.85 ± 2.19, respectively, with no instances of dislocation recurrence. The affected shoulder exhibited no significant reductions in ROM compared to the contralateral side, except for a loss of external rotation (ER) (13.08° ± 7.51; p = 0.005). No differences were observed based on fragment size, although patients with multifragmented glenoid rims showed a greater loss of ER compared to those with a solitary fragment, albeit not reaching statistical significance., Conclusion: Nonoperative treatment appears to be a viable and effective option for middle-aged individuals with bony Bankart fractures, resulting in favorable functional outcomes and a low risk of recurrence. Additionally, a notable loss of external rotation was observed in fractures with glenoid rim fragmentation., Level of Evidence: IV., (© 2024. The Author(s).)

Alzheimer's disease (AD) brains are histologically marked by the presence of intracellular and extracellular amyloid deposits, which characterize the onset of the disease pathogenesis. Increasing evidence suggests that certain nutrients exert a direct or indirect effect on amyloid β (Aβ)-peptide production and accumulation and, consequently, on AD pathogenesis. We exploited the fruit fly Drosophila melanogaster model of AD to evaluate in vivo the beneficial properties of Lisosan G, a fermented powder obtained from organic whole grains, on the intracellular Aβ-42 peptide accumulation and related pathological phenotypes of AD. Our data showed that the Lisosan G-enriched diet attenuates the production of neurotoxic Aβ peptides in fly brains and reduces neuronal apoptosis. Notably, Lisosan G exerted anti-oxidant effects, lowering brain levels of reactive oxygen species and enhancing mitochondrial activity. These aspects paralleled the increase in autophagy turnover and the inhibition of nucleolar stress. Our results give support to the use of the Drosophila model not only to investigate the molecular genetic bases of neurodegenerative disease but also to rapidly and reliably test the efficiency of potential therapeutic agents and diet regimens.

Purpose: The aim of this study was to evaluate the relationship between the Löwenstein Lateral view and the True Lateral view for the positioning of the cephalic hip screw, through a cadaveric study., Materials and Methods: We placed two Kirschner wires in eight femur specimens using an Antero-Posterior view, Löwenstein Lateral view and True Lateral view. The distances between the Kirschner wires and the anterior, posterior, superior and inferior cortex were measured in all projections. The head of the femur was then sectioned, and the same macroscopic distances were measured. Finally, we could calculate the accuracy of the two radiographic lateral projections., Results: When the Kirschner wire was placed in the center of the head using the Antero-Posterior and the True Lateral view, the accuracy of Antero-Posterior view was 0.9705 while the accuracy of True Lateral view and Löwenstein Lateral view was 1.1479 and 1.1584, respectively. When the Kirschner wire was placed superior on the Antero-Posterior and centrally on the True Lateral view, the accuracy of Antero-Posterior view was 0.9930 while the accuracy of True Lateral view and Löwenstein Lateral view was 1.1159 and 0.7224, respectively., Conclusion: When the Kirschner wire was positioned proximal in Antero-Posterior view and central in True Lateral view, only the True Lateral view showed high accuracy., (© 2023. The Author(s).)

Objectives: Proximal humerus fractures account for four-five % of all fractures. Shoulder hemiarthroplasty is indicated for complex fractures with high complication rates when treated with ORIF. This study aims to evaluate the correlation between the proper intraoperative tuberosity reduction, and the mid-to-long-term clinical outcome in a series of patients treated with hemiarthroplasty after proximal humerus fracture., Methods: Forty-one patients with proximal humerus fractures who underwent hemiarthroplasty surgery between July 2009 and December 2019 were retrospectively reviewed. Quantitative analysis of the reduction of the tuberosities was performed on postoperative X-rays focusing on the distance between reconstructed greater tuberosity and the apex of the head of the prosthesis, (head-tuberosity distance), and contact between tuberosity and humerus diaphysis. The University of California Los Angeles Score (UCLA) was calculated for each patient., Results: The mean time to surgery was 6.29 ± 2.8 days (range 2-18 days). Nine patients out of 41 (22%) had non anatomic tuberosity, and 32 (78%) were anatomic reduced. The UCLA score at the final follow-up was good and excellent (≥27) in 27 patients (66%), and poor (<27) in 14 (34%). A significant correlation was observed between proper tuberosity reduction and good/excellent UCLA scores (P<0.001)., Conclusion: Hemiarthroplasty is a valid and reliable technique for the treatment of proximal humerus fracture not eligible for internal fixation, with high risk of failure. The proper tuberosity reconstruction, paying special attention to the HTD and the contact between the cortical of the humeral diaphysis and the reconstructed tuberosity, is essential to reach a good clinical outcome., Competing Interests: None, (2024 © BY THE ARCHIVES OF BONE AND JOINT SURGERY.)

Nowadays, chronic disease management is the primary challenge of the healthcare system. From 2015, in the Veneto region (Italy), patients with a diagnosis of type 2 diabetes mellitus (T2DM) have been included in the diagnostic-therapeutic pathway (PDTA) program, and their clinical condition has been continuously monitored. The aim of this retrospective study is to determine the effectiveness of PDTA intervention, alone or in combination with a specialized one, in subjects with diagnosis of T2DM. Clinical and behavioral characteristics were collected at baseline and after 1 year of follow-up. Two subgroups were considered: subjects enrolled in PDTA only and subjects enrolled in both the PDTA program and in the care plan proposed by the specialized medical center (CAD group). Longitudinal analysis showed a relevant positive effect of time on diastolic blood pressure, while CAD enrollment appears to be related to higher levels of glycated hemoglobin. When included together in the same model, interaction between time and CAD covariates results in completely nonsignificant effects. As long-term management of chronic disorders, such as T2DM, is often difficult due to disease characteristics and problems in healthcare organization, monitoring programs, such as PDTA, and specialized care programs, such as CAD, do not show a clinically relevant effect in the first year of follow-up. Therefore, they should be analyzed over a longer period. However, they should also carefully consider the need for adequate tools for data collection and sharing, in addition to the context of application, patient expectations and the need for a long-term educational program.

Background: In nursing homes, most of the patients with dementia are affected by severe cognitive disorder. Care interventions follow an accurate and recurring multidimensional assessment, including cognitive status. There is still a need to develop new performance-based scales for moderate-to-advanced dementia., Objectives: The development of the Residual Cognition Assessment (RCA) responds to the need to create new scales for global cognitive screening in advanced dementia, with some peculiar features: performance based, brief (<5 m), available without specific training, and suitable for nonverbal patients with minimal distress., Methods: Two raters have administered the RCA and the Severe Impairment Battery-short version (SIB-S) to 84 participants with MMSE = 0. After 2-3 weeks, the same sample has been retested. The RCA has been also administered to 40 participants with MMSE 1-10 for a comparison., Results: The RCA has exhibited excellent values for test-retest reliability (intraclass correlation [ICC] = 0.956) as well as for inter-rater reliability (ICC = 0.997). The concurrent validity analyzes have shown strong correlations between the RCA and the SIB-S with ρ = 0.807 (p < 0.01), and the RCA and the Clinical Dementia Rating (CDR) with ρ = -0.663 (p < 0.01). Moderate correlation has been found between the RCA and the Functional Assessment Staging Scale with ρ = -0.435 (p < 0.01). The instrument has showed high internal reliability, too (total: α = 0.899). The RCA has low floor effect (2%) with respect to the SIB-S (58%) but shows ceiling effect in the MMSE 1-10 sample (50%). The ROC curve analyses demonstrate that the RCA is acceptably able to discriminate between subjects with CDR 4/5 with an AUC of 0.92. Exploratory factor analysis shows 3 factors, defined as three major degrees of cognitive performance in advanced dementia, indeed hierarchically structured in three possible levels of decline., Conclusions: The RCA has showed excellent validity and reliability as well as good sensitivity to identify advanced cognitive impairment in dementia, without floor effect. The RCA seems complementary to the MMSE, so advisable when the latter reaches 0. Administration and scoring are simple, and only few minutes are required to assess the patient. The RCA can discriminate at least 3 different major stages in advanced dementias: severe, profound, and late., (© 2021 S. Karger AG, Basel.)

Bone turnover is a complex set of different molecules pathways and it is strictly connected with bone vasculature. It includes every bone process concerning bone modelling and remodelling such us skeletal growth and healing process. A fundamental component of this bone architecture is played by the endothelium, that acts in a paracrine fashion on other bone stromal cells via humoral factors, growth factors and chemokines/cytokines. The alteration of those biochemical interactions between endothelium, vasculature and bone tissue may cause various pathological manifestations. Understanding the bases of the interaction between those different pathways could provide novel therapeutic strate¬gies for bone disease. The Authors present an updated overview of the most common communication biomolecules between bone cells and endothelium and their interactions both in healthy and pathological conditions. Furthermore, focusing on gene and related therapies, possible future therapeutic strategies for bone vasculature/metabolic diseases are presented.

Background: The self-monitoring of caloric intake is becoming necessary as the number of pathologies related to eating increases. New wearable devices may help people to automatically record energy assumed in their meals., Objective: The present review collects the released articles about wearable devices or method for automatic caloric assessments., Method: A literature research has been performed with PubMed, Google Scholar, Scopus and ClinicalTrials.gov search engines, considering released articles regarding applications of wearable devices in eating environment, from 2005 onwards., Results: Several tools allow caloric assessment and food registration: wearable devices counting the number of bites ingested by the user, instruments detecting swallows and chewings, methods that analyse food with digital photography. All of them still require more validation and improvement., Conclusion: Automatic recording of caloric intake through wearable devices is a promising method to monitor body weight and eating habits in clinical and non-clinical settings, and the research is still going on.

A new Italian earthworm morphologically close to the similarly large and anecic Eophila tellinii (Rosa, 1888) is described. Distribution of Eophila crodabepis sp. nov. extends over 750 km2 from East to West on the Asiago Plateau and Vittorio Veneto Hills, from North to South on mounts Belluno Prealps (Praderadego and Cesen), Asiago, Grappa and onto the Montello foothills. This range abuts that of Eophila tellinii in northern Friuli Venezia Giulia region. Known localities of both E. tellinii and E. crodabepis sp. nov. are mapped. mtDNA barcoding definitively separates the new western species from classical Eophila tellinii (Rosa, 1888).

Background: Laparoscopic adrenalectomy is now used worlwide and is a great advance in laparoscopic technology. The reported benefits of this approach include decreased blood loss, better intraoperative haemodynamic control and shorter hospital stay, however some doubts on its indication for adrenal secreting tumors are still present. The aim of this retrospective study is to compare the physiologic alterations on blood pressure during laparoscopic and laparotomic adrenalectomy in patients with adrenal secreting adenoma, the intraoperative blood loss and mean hospital stay in the 2 groups of patients. A review of the literature is included., Methods: Laparoscopic adrenalectomy was performed in 13 patients (Conn's syndrome with adrenal adenoma in 10, pheochromocytoma in 3). Laparotomy was used for adrenalectomy in 9 patients: 4 with pheochromocytoma and 5 with Conn's adenoma. All the selected patients in the 2 groups had benign adenoma with tumor size less than 6 cm. During surgery the following data were determined: blood pressure before inducing anaesthesia, pressure peaks, episodes of hypertension and of hypotension, blood loss and operating times. The mean hospital stay was also recorded., Results: No differences were found in the blood-pressure values of the 2 groups of patients. The blood loss was minimal in all but 2 patients. The mean hospital stay was significantly longer in those patients who underwent laparotomy. No significant differences were recorded in the mean operating time., Conclusions: The 2 techniques seem to have the same physiological consequences in the cardiovascular system, and the operating times for laparoscopic and laparotomic adrenalectomy are not so different. Laparoscopic adrenalectomy is a safe technique to treat small benign adrenal secreting adenomas.

This study aimed at reporting the incidence of the hepatitis C virus as well as the prevention and control measures adopted in an hemodialysis unit. It is a prospective study developed with patients attended from September 1996 to December 1998 in an hemodialysis unit. The consultations from September 1996 to December 1996 were considered the control group and the ones from January 1997 to December 1998 the intervention group. Regarding the period of the control group, the routine of the unit was organized based on the regulation 2042 that systematizes the services of renal therapy. In the subsequent period, complementary measures were implemented. From 1997 to 1998, authors observed the reduction in the number of cases of hepatitis C.

Background: The more wide spread laparoscopic technique to operate on the adrenal gland is transabdominal approach with a lateral flank adrenalectomy. However, the transabdominal anterior approach can be a sure and safe alternative in selected patients., Methods: From 1997 to 1999, 18 selected patients underwent laparoscopic anterior adrenalectomy. Mean age was 43 years (range 25-63) with a male/female ratio of 1:1. Indications were Conn's adenoma in 10 patients, pheochromocytoma in 3 cases, Cushing syndrome in 1 and incidentaloma in 4. All the procedures were carried out laparoscopically and only one patient required conversion to an open adrenalectomy for clear signs of malignancy. The mean time for adrenalectomy was 140 minutes and the shorter times were recorded in the right-sided procedures (mean time 84 minute). Estimated blood loss was minimal and no transfusion was done. There were no postoperative complications related to the surgical technique and the hospital stay was 4 days in average., Results: Our data confirm, according with other authors, that this method is feasible in selected patients. Longer times recorded for the left-sided lesions were due to the more difficult dissection required to gain the left adrenal gland., Conclusions: Transabdominal adrenalectomy with patient in the supine position is feasible, but its use is restricted to the cases with suspect bilateral or multifocal pheochromocytoma, to patients with concomitant abdominal pathologies that can be operated on laparoscopically, to surgeons who prefer to have a frontal view of the operative field.

Background: In laparoscopic surgery, pneumoperitoneum may be obtained either by a blind or an open access technique. These two techniques and the advantages of Hasson technique are compared., Methods: Through January 1998 and May 1999, 262 unselected patients underwent laparoscopic surgery; pneumoperitoneum was obtained with a random technique, while in the patients previously operated on the open technique was always performed. In 161 cases (61.5%) pneumoperitoneum was obtained with Hasson technique and in 101 (38.5%) with Veress technique. All the patients were clinically evaluated after surgery and then after 30-40 days. The complications encountered were always associated with the Veress needle blind access: peritoneal space insufflation in 3 cases, greater omentum insufflation in 3 cases, 4 cases of difficult management and only one case of incisional hernia on the umbilical wound., Results: Our data confirm that Hasson open technique is safer than Veress blind technique as the risk of severe early and late complications is lower., Conclusions: The open laparoscopic technique with the Hasson trocar is recommended as it showed to be a quicker, safer and superior technique for obtaining pneumoperitoneum.