Resurfacing Capitate Pyrocarbon Implant for the treatment of advanced wrist arthritis in the elderly: a retrospective study.

OBJECTIVE: Advanced forms of wrist osteoarthritis in the elderly are quite common and often under-treated, preferring a conservative management of the condition due to the age of the patient. However, in elderly people who are still active, sporty and physically demanding, surgical management of wrist osteoarthritis should be considered. Proximal Row Carpectomy associated with a Resurfacing Capitate Pyrocarbon Implant (RCPI), allows the management of a wide range of wrist arthrosis, involving both the radio-carpal and the mid-carpal joints. This treatment has been already reported as a solution in younger people affected by degenerative pathologies of the wrist, giving overall good results. Authors aimed at verifying how this technique could be useful in elderly patients, resolving the severe pain often related to this pathology and letting them recover strength and motion. PATIENTS AND METHODS: This is a retrospective analysis involving 7 cases of elderly men (mean age = 68 y.o.), suffering from severe wrist arthritis and treated with RCPI between 2016 and 2021. RESULTS: All patients reported a return to manual activities between 6 and 12 months after surgery, significantly improving pain. Two patients complained moderate pain under strain at follow-up, with residual difficulty in performing manual tasks. In all cases, an increase of strength and improvement in terms of stiffness was registered. No cases of infections or implant mobilization were reported. CONCLUSIONS: RCPI combined with proximal row carpectomy shows satisfying results in all published studies and it has been confirmed in our series as well. Indications for this procedure should be widened to elderly people, as useful alternatives to more aggressive salvage procedures, such as total prosthesis or arthrodesis.

DOES AN EARLY POST-OPERATIVE PAIN RELIEVE INFLUENCE THE FUNCTIONAL OUTCOME OF PATIENTS WITH COLLES FRACTURES TREATED WITH EG-BLOCK SYSTEM?

Distal Radius Fractures (DRFs) represent one of the most common elderly patient's fractures. Often DRFs required surgical treatment based on instability of the fragments and due to the high functional demand from patients. A general agreement on the best pharmacological treatment in the post-operative is still missing. The present study describes the clinical outcome in patients who underwent surgery for Colles fracture using ES fixation osteosynthesis. ; The present investigation represents a one center retrospective analysis. In this study, two different medical treatments were recognized, and groups consequently set (Group A: Ketoprofene 100 mg twice a day for 5 days, 59 patients; Group B: Tramadol 75 mg and Dexketoprofen 25 mg, 62 patients). Outcomes were the functionality of the affected wrist through AROM assessment and the evaluation of painkillers intake, pain itself and Quick-DASH.; 121 patients were included in the present study. The pharma blending of Tramadol 75 mg and Dexketoprofen 25 mg resulted effective for the rapid recovery of the treated wrist motion. In fact, in the group B motion was better compared to group A (p<0.05) for any movement examined (flexion, extension, pronation, supination) until the last follow-up (70 days).; Associations of different painkillers are common, even if a general agreement on the most effective combination is still missing. Tramadol and Dexketoprofen provide a good clinical result, less side effects and a better functional recovery of the wrist motion. This guarantees a fewer social cost and a best management of post-operative physiotherapy.

OUTCOMES OF A LONG-TERMS MICROVASCULAR TRAINING FOR RESIDENTS IN ORTHOPEDIC.

The acquisition of specific technical skills in the field of microsurgery like the use of operating microscope and microsurgical instruments, arterial and venous anastomosis, vascular grafts, nerve sutures and tenorrhaphies, is very important during the training in Orthopedics and in Hand Surgery in order to deal with management of complex and amputative traumas of the upper limb. The learning curve in microsurgical techniques is significantly shortened for surgeons who benefit from pre-clinical courses on an animal model. The aim of this study was to standardize a long-term microsurgical activity during the training in Orthopedics and Hand Surgery and to document the benefits that the residents of the School of Specialization got by chance of practicing weekly this discipline on in-vivo model. In 2016, a protocol for teaching in vivo microsurgery on Wistar rats for orthopedics and hand surgery residents was approved. In the first 3 years of graduation course, the students performed the training aimed at acquiring manual dexterity and confidence with the microsurgical instrumentations on nonliving models. Subsequent exercises were performed ex vivo on chicken leg models under the microscope or loupes. Finally, the in-vivo rat exercises were intended for residents in the last 2 years who required access to the supplementary diploma in hand surgery. Outcome evaluations consisted of the Global Rating Scale score and time to completion. Two-tailed Student t test was performed to compare initial and final outcome evaluations (p<0.05). Only 8 residents completed the microvascular training of almost thirty microsurgical teaching sessions administered on a weekly basis. The total mean GRS score (and standard deviation) improved from 15±2 points for the initial score to 21±6 points for the final score (p<0.005). Time to completion of the anastomosis also significantly improved (p<0.005), from a mean score of 31:18±9:21 minutes for the initial time to 21:15±6:10 minutes for the final time. A microvascular training curriculum utilizing a live rat model, preceded by a training on non-living models, provides a superior surgical simulation experience and is effective at improving resident microvascular surgical skills.

Quantum dynamics of Mn2+ in dimethylammonium magnesium formate.

Dimethylammonium magnesium formate, [(CH3)2NH2][Mg(HCOO)3] or DMAMgF, is a model used to study high temperature hybrid perovskite-like dielectrics. This compound displays an order-disorder phase transition at about 260 K. Using multifrequency electron spin resonance in continuous wave and pulsed modes, we herein present the quantum dynamics of the Mn2+ ion probe in DMAMgF. In the high temperature paraelectric phase, we observe a large distribution of the zero field splitting that is attributed to the high local disorder and further supported by density functional theory computations. In the low temperature ferroelastic phase, a single structure phase is detected and shown to contain two magnetic structures. The complex electron paramagnetic resonance signals were identified by means of the Rabi oscillation method combined with the crystal field kernel density estimation.

Side-on cupric-superoxo triplet complexes as competent agents for H-abstraction relevant to the active site of PHM.

Copper complexes with N3S donors mimic the CuM site of copper monooxygenases and react with O2 affording side-on cupric-superoxo complexes capable of H-abstraction from dihydroanthracene and THF. Spectroscopic and DFT data of the Cu-superoxos support a spin triplet ground state for the side-on complexes, as well as a hemilabile thioether.

Lifestyle changes in the management of adulthood and childhood obesity.

Adulthood and childhood obesity is rapidly becoming an epidemic problem and it has a short and long term impact on health. Short term consequences are mostly represented by psychological effects, in fact obese children have more chances to develop psychological or psychiatric problems than non--obese children. The main long term effect is represented by the fact that childhood obesity continues into adulthood obesity and this results in negative effects in young adult life, since obesity increases the risk to develop morbidity and premature mortality. The obesity--related diseases are mostly represented by hypertension, type 2 diabetes, dyslipidaemia, cardiovascular diseases. Medical treatment should be discouraged in childhood because of the side effects and it should be only reserved for obese children with related medical complications. Lifestyle changes should be encouraged in both adulthood and childhood obesity. This review focuses on the management of obesity both in adulthood and in childhood, paying particular attention to lifestyle changes that should be recommended.

Spin interaction in octahedral zinc complexes of mono- and diradical Schiff and mannich bases.

The four Schiff bases 2-tert-butyl-4-methoxy-6-[(pyridin-2-ylmethylimino)methyl]phenol, 2,4-di-tert-butyl-6-[(pyridin-2-ylmethylimino)methyl]phenol, 2-tert-butyl-4-methoxy-6-(quinolin-8-yliminomethyl)phenol, and 2,4-di-tert-butyl-6-(quinolin-8-yliminomethyl)phenol) as well as one Mannich base, N,N',N,N'-bis[(2-hydroxy-3,5-di-tert-butylbenzyl)(2-pyridylmethyl)]ethylenediamine, and their zinc bis-phenolate complexes 1-5, respectively, have been prepared. The complexes 4 and 5 have been characterized by X-ray diffraction crystallography, showing a zinc ion within an octahedral environment, with a cis orientation of the phenolate moieties. 1-5 exhibit in their cyclic voltammetry curves two anodic reversible waves attributable to the successive oxidation of the phenolates into phenoxyl radicals. Bulk electrolysis at ca. +0.1 V affords the zinc-coordinated monophenoxyl radical species (1(*))(+)-(5(*))(+) characterized by UV-vis absorption bands at 400-440 nm. The more stable radicals are (3(*))(+) and (4(*))(+) (half-life higher than 90 min at 298 K), likely due to the increased charge delocalization within the quinoline moieties. These species exhibit a significant additional near-IR band (epsilon > 1650 M(-1) cm(-1)) attributed to a CT transition. In the two-electron-oxidized species (1(**))(2+)-(5(**))(2+) the radical spins present a weak magnetic coupling. EPR reveals an antiferromagnetic exchange interaction for (1(**))(2+)-(4(**))(2+), whereas an unusual ferromagnetic exchange coupling is operative in (5(**))(2+). The weak magnitude of experimental |J| values (within the 1-5 cm(-1) range) as well as their sign could be well reproduced by DFT calculations at the B3LYP level. The small energy gap between the ground and the first excited spin states allows us to investigate the zero-field splitting (ZFS) of the triplet by EPR spectroscopy. This parameter is found to be axial for all systems, with |D| values of 0.0163 cm(-1) for (1(**))(2+), 0.0182 cm(-1) for (2(**))(2+), 0.0144 cm(-1) for (3(**))(2+), 0.0160 cm(-1) for (4(**))(2+), and 0.0115 cm(-1) for (5(**))(2+). The trend between experimental ZFS is confirmed by DFT calculations, which give further insight regarding its sign (negative for all the compounds). Lower ZFS values are obtained for (2(**))(2+) compared to (1(**))(2+) (and also for (4(**))(2+) compared to (3(**))(2+)), which can be interpreted by an increased delocalization of the spin density over the methoxy para substituent. Significant spin population on the quinoline also contributes to a lowering of the |D| value, as observed when (3(**))(2+) is compared to (1(**))(2+) (and also when (4(**))(2+) is compared to (2(**))(2+)).

Spectroscopic description of an unusual protonated ferryl species in the catalase from Proteus mirabilis and density functional theory calculations on related models. Consequences for the ferryl protonation state in catalase, peroxidase and chloroperoxidase.

The catalase from Proteus mirabilis peroxide-resistant bacteria is one of the most efficient heme-containing catalases. It forms a relatively stable compound II. We were able to prepare samples of compound II from P. mirabilis catalase enriched in (57)Fe and to study them by spectroscopic methods. Two different forms of compound II, namely, low-pH compound II (LpH II) and high-pH compound II (HpH II), have been characterized by Mössbauer, extended X-ray absorption fine structure (EXAFS) and UV-vis absorption spectroscopies. The proportions of the two forms are pH-dependent and the pH conversion between HpH II and LpH II is irreversible. Considering (1) the Mössbauer parameters evaluated for four related models by density functional theory methods, (2) the existence of two different Fe-O(ferryl) bond lengths (1.80 and 1.66 A) compatible with our EXAFS data and (3) the pH dependence of the alpha band to beta band intensity ratio in the absorption spectra, we attribute the LpH II compound to a protonated ferryl Fe(IV)-OH complex (Fe-O approximately 1.80 A), whereas the HpH II compound corresponds to the classic ferryl Fe(IV)=O complex (Fe=O approximately 1.66 A). The large quadrupole splitting value of LpH II (measured 2.29 mm s(-1) vs. computed 2.15 mm s(-1)) compared with that of HpH II (measured 1.47 mm s(-1) vs. computed 1.46 mm s(-1)) reflects the protonation of the ferryl group. The relevancy and involvement of such (Fe(IV)=O/Fe(IV)-OH) species in the reactivity of catalase, peroxidase and chloroperoxidase are discussed.

A novel mutation in SACS gene in a family from southern Italy.

A form of autosomal recessive spastic ataxia (ARSACS) has been described in the Charlevoix and Saguenay regions of Quebec. So far a frameshift and a nonsense mutation have been identified in the SACS gene. The authors report a new mutation (1859insC), leading to a frameshift with a premature termination of the gene product sacsin, in two sisters from consanguineous parents. The phenotype is similar to previously described patients with ARSACS.

Dementia, ataxia, extrapyramidal features, and epilepsy: phenotype spectrum in two Italian families with spinocerebellar ataxia type 17.

We observed two families with a dominantly inherited complex neurological syndrome with onset in adulthood. Family F included 9 affected in four generations. One patient showed prominent anticipation of onset age. Onset was with cerebellar signs followed by dementia, psychiatric symptoms, seizures, and extrapyramidal features. Family M included 14 affected individuals in five generations. Presenting symptoms were either psychiatric and cognitive impairment or a cerebellar syndrome. Extrapyramidal features, dysphagia, incontinence, seizures, and myoclonus may occur. In both families magnetic resonance imaging showed marked atrophy of the brain and cerebellum. Molecular analyses demonstrated an expanded CAG/CAA repeat in the in the TATA box-binding protein (TBP) gene (SCA17).

[Does extracorporeal lithotripsy causes hearing loss?]. / Produce sordera la litotricia extracorpórea?

INTRODUCTION: The electrohydraulic lithotripter has revolutiomised the treatment of urolithiasis. It produces shock waves by electrical discharge in water associated at a noise. We know that the hearing damage is above 85 decibels. Our goal is determine if the Econolith 2000 lithotriptor produce hearing damage. PATIENTS AND METHODS: 10 patients were treated. They had audiometry prior to a single exposure to lithotripsy and twenty four hours after treatment. All our patients wore protective ear. The intensity of the sound was measured. RESULTS: Inside of the operated room the intensity of the sound was 96 decibels, outside was 70. There weren't hearing damage in the patients. CONCLUSIONS: The lithotriptor Econolith 2000 doesn't produce hearing damage in patients with protective ear.

[Our experience with 1 mg BCG vaccine instillation in T1 stage cancer of the bladder]. / Nuestra experiencia con instilaciones de 1 mg de vacuna BCG en cáncer vesical etapa T1.

UNLABELLED: We studied 67 patients with bladder cancer in stage T1, with terminated BCG treatment and in pursuit. No stage Ta neither carcinoma in situ was included. The protocol was: beginning of treatment upon retiring vesical catheter, instilation of 1 mg of liofilized BCG vaccine (16 x 10(6) bacilles) in 40-50 ml of intravesical saline solution. A weekly instilation during the first month. An instilation each 15 days during the second and third month and one monthly until complete 12 months of treatment. Also was carried out an study of T lymphocites and cytokines. RESULTS: The average followup of the 67 patients treated was 51.3 months. 17 patients relapses (25.4%). A 33% were grade 3 and 27% grade 2. Like complications there was a case of inguinal TBC adenititis, 2 TBC prostatitis, 2 TBC cistitis and 5 cases of slight disuric syndrome. The study of subpopulations of lymphocites in peripheral blood demonstrated a significant increase of CD3 and CD4/CD8 ratio. The interleukin 2 measurement in serum also increased significantly after the BCG instilations. CONCLUSIONS: Our protocol gets similar results to the higher doses, but with minimal complications diminishing the relapses of the tumors in stage T1. A monthly maintenance dose would help to maintain immunity.

[Cancer of the prostate: evaluation of the expression of the mutated protein of the 53 tumor suppressor gene]. / Cáncer de la próstata: evaluación de la expresión de la proteína mutada del gen supresor de tumores p53.

UNLABELLED: Prostate cancer is the most common tumour in men, and is most frequently established late in life. The objective of the article is to determine the protein expression of gene p53 in prostate cancer and to correlate the findings with clinical, morphological and epidemiological parameters. MATERIAL AND METHODS: Immunohistochemical techniques with monoclonal antibody used to study the gene p53 expression. The study included 35 prostate carcinoma: 4 cases in stage A; 5 cases in stage B; 12 in stage C and 14 in stage D. The control group consisted in 10 benign prostate hyperplasia. Average age was 66.8 (SD +/- 6.7 years). RESULTS: Positive staining for gene p53 protein was seen in 11 of the 35 cases (31.4%). All stage A and B tumours were negative; however, stage C and D tumours were positive in 16 and 64% cases respectively. In the control group all cases were gene p53 negative. No statistical relationship was seen between Gleason Index and positive results for p53. There was a significant difference between gene 53 expression and clinical stage. CONCLUSIONS: Results show that the immunohistochemical expression of gen p53 mutated protein keeps no relation to Gleason's rating index and is seen with significantly higher frequency in advanced, primarily stage D tumours.

[Response of lymphocytes and cytokines in patients with superficial bladder cancer treated with 1 mg of BCG vaccine instillations]. / Respuesta de linfocitos y citokinas en pacientes portadores de cáncer vesical superficial tratados con instilaciones de 1 mg de vacuna BCG.

It was carried out a study of lymphocytes CD3, CD8 and cytokines in the blood of 13 patients, with superficial bladder cancer, and treated by instillations with BCG vaccine, with a dose of 1 mg. in an annual scheme, being related them before and after treatment. A control group of 10 patients without bladder cancer and without vaccine instillations were compared. The measurings took place in a blind way, previous to BCG treatment, 15 days, 3 days, 3 months, 6 months and 12 months of treatment. It was observed in postBCG treatment, a significative increase in the count of CD3 lymphocytes and the CD4/CD8 cociente (both, P < 0.05). Concerned to cytokines, a significative increase was only demonstrated by interleukin-2 in the post BCG group (P < 0.05). In both (lymphocytes and cytokines) the control groups didn't demonstrate statistics signification. The studies where analysed by means of ANDEVA test, under 2 x 2 cross over design, student t and no parametric tests. In conclusion, bladder instillations of 1 mg. of BCG vaccine as prophylactic treatment of superficial bladder cancer, it's capable of developing lymphocytic answer and stimulate the increase of interleukin-2 in the serum.

Inmunoterapia BCG en cáncer vesical superficial. Respuesta de linfocitos y citokinas a la minidosis / BCG immunotherapy in surface vesical cancer: lymphocyt and cytokin response to a little dosage

Se realizó estudio serológico de linfocitos CD3, CD4, CD8 y citokinas, en 13 pacientes portadores de cáncer vesical superficial, tratados con vacuna BCG en dosis de 1 mg en instilaciones intravesicales con un esquema anual, relacionándolos antes y después de tratamiento. Además de un grupo control de 10 pacientes sin cáncer vesical y sin instilaciones de vacuna. Las mediciones se realizaron en forma ciega, previo a tratamiento BCG, a los 15 días, 30 días, 3 meses, 6 meses y 12 meses de iniciado dicho tratamiento. Se observó un aumento significativo post BCG en el recuento de linfocitos CD3 y el cuociente CD4/CD8 (P menor 0,005 y p menor 0,05 respectivamente). Con respecto a las citokinas, se demostró un aumento significativo sólo en Interleukina 2 en el grupo postBCG (p menor 0.05). En ambos grupos, (linfocitos y citokinas) los resultados de los grupos controles y grupo preBCG con ellos, no demostraron significación estadística. Los estudios fueron analizados mediante test de ANDEVA, bajo un diseño cross-over 2x2, t de student pareada de un extremo y pruebas no paramétricas. En conclusión, la dosis de 1 mg de vacuna BCG como tratamiento profiláctico del cáncer vesical superficial, en instilaciones vesicales, es capaz de desarrollar respuesta linfocitaria y estimular el aumento de interleukina 2 a nivel serológico

Oncocitoma renal, casos clínicos y revisión de la literatura / Renal oncocitoma, clinical cases and review of literature

Se presentan 3 casos de pacientes portadores de oncocitoma renal operados durante los últimos 10 años (1,8 por ciento). En todos se realizó nefrectomía radical con buena evolución durante 17 meses de seguimiento. Se revisa la literatura

Divergence thresholds as functions of temporal separation, spatial separation, and retinal locus.

Human thresholds were measured for the detection of angular divergence between straight lines using pairs of line segments. The dependence of these thresholds on temporal separation between the two lines, spatial separation, and retinal locus was assessed. Results were comparable to prior divergence thresholds obtained by Harrington and Harrington in their study of "blur patterns." In blur patterns motion parameters may be processed partly or wholly as form information rather than as motion information per se. Harrington and Harrington had used moderate blurring velocities, for which information on both motion and form were present. Observers may have been responding either to motion or to form. The study reported here used briefly presented two-line "blur patterns" with only form information. Analysis suggested that the form components of fast motion-produced blur patterns could be processed by the human visual system. Neither temporal nor spatial separation was a significant determiner of thresholds in accordance with Harrington and Harrington who found no effect of blur-line density in the range studied. Retinal locus was a factor as it was with blur patterns. Some possible mechanisms for the detection of divergence indicated by these results are discussed.