Pubo-femoral distance in selective ultrasound screening of developmental dysplasia of the hip.

BACKGROUND: Developmental dysplasia of the hip (DDH) incidence is already debated due to different types of screening techniques. Despite of that, timely treatment of this pathology is necessary to reduce complications on the hip joint. METHODS: A retrospective study has been performed on the incidence of DDH in Marche region (Italy) in 2017. Epidemiological data have been collected and evaluated. 302 ultrasound images stored in the hospital archives were selected to measure pubo-femoral distance (PFD) and bony rim percentage (BRP). PFD and BRP values were compared with α and ß angles measured by Graf method. RESULTS: DDH incidence was 12%. Girls were more affected than males (ratio 3:1). Right side was more involved, 20% of patient had familiarity with DDH, 7% were breech babies and 15% suffered from other congenital orthopedic diseases. PFD in pathological hips was 3.21 mm (0.60-7 mm) and 2.47 mm (0.80-5.30 mm) in normal hips (P<0.005). Dispersion of PFD with respect to α and ß angles showed that PFD grows with increasing ß angle values and decreasing α angles. BRP in pathological hips was 47.29%, while in normal hips was 49.53% (<3 months). BRP was 49.71% in normal hips and 45.83% in pathological ones (>3 months). BRP measurement did not match the expected results, requiring more studies before its adoption in clinical practice. CONCLUSIONS: Our study evidenced the DDH incidence in Marche region and helped to validate a new screening technique consisting in measuring of PFD. For a full BRP validation, future studies will still be required.

Remodeling of distal radius fractures in children: preliminary retrospective cost/analysis in level II pediatric trauma center.

BACKGROUND AND AIM: Children displaced distal radius fractures (DRFs) are commonly treated by reduction. Yet, their excellent remodeling ability provides good clinical-radiographic outcomes even in case of non-anatomical reduction. The reduction under analgesia or sedation involves hospitalizations, greater risks, and higher hospital costs. The aim of this preliminary study is to demonstrate the accountability and conveniency of non-anatomical reduction. METHODS: The study involved all 0-8 years-old children who were affected by a closed overriding DRF from February 2017 to December 2018 and were managed non-operatively by a long arm cast without reduction, analgesia, or sedation treatments. We retrospectively evaluated their clinical-radiographic outcomes and healing time. The costs of no-reduction treatments were compared with those of the two main approaches to DRFs, that is: closed reduction under sedation and application of a long arm cast; closed reduction under anesthesia, percutaneous pinning, and application of a long arm cast. The comparison was based on the Diagnosis Related Group system. RESULTS: We treated 11 children with an average initial radial shortening of 5±3 mm and average initial sagittal and coronal angulations of 4.0° and 3.5°, respectively. Average casting duration was 40 days. All patients achieved a full range of wrist motion without deformities. The procedure was respectively 7 times less expensive than closed reduction in emergency room under sedation and application of a long arm cast, and 64 times less expensive than closed reduction in the operating room under anesthesia, percutaneous pinning, and application of a long arm cast. CONCLUSIONS: In children aged 0-8 years, non-operative treatment of closed overriding DRFs with a long arm cast without reduction is a simple and cost-effective procedure with both clinical and radiographic medium-term excellent outcomes.

Quinazoline based α1-adrenoreceptor antagonists with potent antiproliferative activity in human prostate cancer cell lines.

New α1-adrenoreceptor (α1-AR) antagonists related to prazosin and doxazosin were synthesized by replacing piperazine ring with (S)- or (R)-3-aminopiperidine. Binding studies indicated that the S configuration at the 3-C position of the piperidine ring is crucial for an optimal interaction of the compounds at all three α1-AR subtypes. Quinazolines 9 and 10, bearing a quinone ring on the lateral chain, exhibited also potent antiproliferative activity in LNCaP androgen-sensitive prostate cancer cell lines, higher than that of doxazosin. Compound 10 increased apoptosis, in terms of DNA fragmentation, without triggering cell necrosis. The prooxidant activity found in compound 10 may underlie its ability to inhibit cell proliferation in synergy with the effect mediated by α1-AR antagonism. Due to its better biological profile compared to doxazosin for LNCaP cell line, compound 10 might be a valuable lead compound for the design of new prostate antitumor agents.

Synthesis of monomeric derivatives to probe memoquin's bivalent interactions.

Eight monomeric congeners, related to the multitarget lead candidate memoquin, were prepared and evaluated at multiple targets to determine their profile against Alzheimer's disease. 2-4 bind to AChE with similar low nanomolar affinities and function as effective inhibitors of amyloid aggregation. The most potent monovalent ligand 2 also inhibits BACE-1 in vitro and APP metabolism in primary chicken telencephalic neurons.