The impact of methoxypropylamino cyclohexenylidene ethoxyethylcyanoacetate (MCE) UVA1 filter on pigmentary and ageing signs: An outdoor prospective 8-week randomized, intra-individual comparative study in two populations of different genetic background.

BACKGROUND: Of all ultraviolet (UV) radiations reaching the earth, UVA1 rays have a higher potential of penetrating and producing clinically harmful consequences. While UV radiations up to 370 nm are well-blocked by current sunscreens, a photoprotection gap remains for the UVA1 wavelengths between 370 and 400 nm. OBJECTIVE: This study was to assess under outdoor summer conditions the impact on pigmentation and skin ageing signs of a protection against UVA1 using methoxypropylamino cyclohexenylidene ethoxyethylcyanoacetate (MCE) filter added to a reference SPF50 sunscreen, in comparison with the same sunscreen without the MCE filter. MATERIALS AND METHODS: This prospective randomized comparative intra-individual study was conducted in 113 women in Brazil and China. Subjects had their face and two forearms exposed twice-daily to a 1-h outdoor sunlight exposure over 8 weeks. Before exposure, the SPF50 sunscreen containing 3% MCE was applied on one half-face and one forearm and the same reference product without MCE on the other half-face and forearm. Primary study endpoint was skin colour changes (chromametry). Other endpoints included expert panel grading of pigmentation and facial skin ageing, and naïve panel assessment of facial skin radiance and homogeneity. RESULTS: After 8 weeks, the skin was darker on both forearms but the increase in sun-induced pigmentation was smaller with the SPF50/MCE sunscreen. Expert panel evaluations showed no change in severity scores for pigmentation and a decreased severity scores for facial skin ageing in areas protected with the SPF50/MCE product: severity scores in areas protected with the SPF50 alone were either increased (pigmentation) or unchanged (skin ageing). Naïve panel evaluations of skin radiance and homogeneity showed statistically significant superiority of the SPF50/MCE product. CONCLUSION: Overall, this study demonstrates that a protection with the SPF50/MCE sunscreen significantly reduces pigmentation and ageing signs compared to the same SPF50 sunscreen.

Maisonneuve fracture treated with suture-button system stabilization combined with plate and arthroscopic assistance (SBPAA): Clinical and radiological evaluation in short-medium period.

The aim of this study was to estimate the time needed for patients with Maisonneuve fractures to return to routine activities, after treatment with a suture-button system stabilization combined with plate and arthroscopic assistance (SBPAA). Methods: The study included 13 patients treated at our surgical department from January 2018 to June2022. Specific radiographical follow-up and periodic checks were performed in a short -to-medium term period, to evaluate syndesmosis evolution and tibiofibular overlap with medial clear space (MCS). Results: Progressive recovery and improvement were observed during follow-up from both radiographic and clinical perspective. Data showed that patients were able to return to full weight-bearing walking around the ninth week and to sport activities in 7.5 months. Long-term complications associated with residual joint stiffness, complex regional pain syndrome, or wound complications were observed in three patients. Conclusions: Intraoperative arthroscopy represent a valid diagnostic tool to better recognize and evaluate osteochondral lesions in case of syndesmosys. The study demonstrates the importance of intraoperative arthroscopy for recognizing and treating associated osteochondral lesions with proper syndesmosis evaluation. Plate associated to double TightRope represent valid solution to functionally fix and reduce fractures. Additionally, it imitates the normal syndesmosis's anatomy and provides elasticity and robustness, guaranteeing a rapid return to sporting activity. Data and casuistry support these findings.

Impact on facial skin aging signs of a 1-year standardized photoprotection over a classical skin care routine in skin phototypes II-VI individuals: A prospective randomized trial.

BACKGROUND: Data reflecting the impact of photoprotection on cutaneous aging are scarce and mostly limited to fair skin. OBJECTIVE: To assess the effectiveness of a photoprotective product in counteracting the photoaging process in different skin phototypes over 1 year compared against a classical routine. MATERIALS AND METHODS: Two hundred and ninety Brazilian women aged 30-65 years, with skin phototype II-VI were equally randomized in two groups. Group 1 kept on their routine whereas Group 2 applied, twice daily, a photoprotective product (SPF 60, PPD = 24.1) replacing the one they routinely used. Volunteers reported the duration of their daily sun-exposure. Standardized photographs taken at D0 and D365 were analysed by 15 dermatologists to assess eight wrinkles and pigmentation signs. RESULTS: A global increase in severity was reported which was significant for Group 1. This increase was lower in Group 2 where only half the signs showed significant worsening. In Group 2 versus Group 1, the increase in forehead wrinkles, marionette lines, wrinkles created by ptosis and size of dark spot was significantly (p < 0.05) decreased by 30%-50%. CONCLUSION: Daily application of a high photoprotective product significantly decreases the progression of skin aging signs after 1 year in skin phototypes II-VI.

Subtalar dislocation: a narrative review.

BACKGROUND: Subtalar joint dislocation (1% of all dislocations) is the permanent loss of articular relationships in the talonavicular and talocalcaneal joints, without other involvement of the foot. Dislocation can occur medially (85%), laterally (15%), posteriorly (2.5%) and anteriorly (1%). Reduction can be performed by closed or open technique; lateral dislocations often require open reduction because of inclusion of soft tissues or bone fragments. Lateral dislocations are frequently complicated by bone exposure, risk of infection and associated soft tissues injuries. AIM OF THE STUDY: The aim of this study is to explain main characteristics and to clarify the most important pitfalls of subtalar dislocations. MATERIALS AND METHODS: We examined 47 articles published in the last thirty years (389 cases). For each dislocation we reviewed its main characteristics: direction, bone exposure, need for open reduction and for surgical stabilisation, associated injuries and method used for diagnosis. RESULTS: Medial dislocations (68.1%) has greater incidence compared to lateral ones (27.7%). Bone exposure (44.5%), associated lesions (44.5%) and need for surgical reduction (48.2%) are much more represented in lateral dislocation than in the others. CONCLUSIONS: Subtalar dislocations, especially the lateral one, represent a challenge for surgeons. Lateral subtalar dislocation occurs following high-energy trauma often involving associated injuries. Closed reduction could be unsuccessful and patients must undergo surgical reduction. After reduction CT scan is recommended. Our narrative review confirms these findings.

Targeted deletions of complement lectin pathway genes improve outcome in traumatic brain injury, with MASP-2 playing a major role.

The lectin pathway (LP) of complement activation is believed to contribute to brain inflammation. The study aims to identify the key components of the LP contributing to TBI outcome as possible novel pharmacological targets. We compared the long-term neurological deficits and neuropathology of wild-type mice (WT) to that of mice carrying gene deletions of key LP components after experimental TBI. WT or MASP-2 (Masp2-/-), ficolin-A (Fcna-/-), CL-11 (Colec11-/-), MASP-1/3 (Masp1-/-), MBL-C (Mbl2-/-), MBL-A (Mbl1-/-) or MBL-/- (Mbl1-/-/Mbl2-/-) deficient male C57BL/6J mice were used. Mice underwent sham surgery or TBI by controlled cortical impact. The sensorimotor response was evaluated by neuroscore and beam walk tests weekly for 4 weeks. To obtain a comparative analysis of the functional outcome each transgenic line was rated according to a health score calculated on sensorimotor performance. For selected genotypes, brains were harvested 6 weeks after injury for histopathological analysis. MASP-2-/-, MBL-/- and FCN-A-/- mice had better outcome scores compared to WT. Of these, MASP-2-/- mice had the best recovery after TBI, showing reduced sensorimotor deficits (by 33% at 3 weeks and by 36% at 4 weeks). They also showed higher neuronal density in the lesioned cortex with a 31.5% increase compared to WT. Measurement of LP functional activity in plasma from MASP-2-/- mice revealed the absence of LP functional activity using a C4b deposition assay. The LP critically contributes to the post-traumatic inflammatory pathology following TBI with the highest degree of protection achieved through the absence of the LP key enzyme MASP-2, underlining a therapeutic utility of MASP-2 targeting in TBI.

Cichorium intybus root extract: A "vitamin D-like" active ingredient to improve skin barrier function.

During the aging process, the human skin suffers many alterations including dryness, skin barrier function damage. The skin barrier function is important to the prevention of skin alterations and maintenance of homeostasis. So, the objective of this study was to assess the clinical efficacy on skin barrier function of Cichorium intybus root extract in cosmetic formulations with or without UV filters. Fifty women, aged between 45 and 60 years, were divided into two groups. One group received vehicle formulations containing UV filters, and the other group received formulations without UV filters. Both groups received a formulation containing the extract and the vehicle. The formulations were applied twice daily to the upper arms after washing with sodium lauryl sulphate. Transepidermal water loss (TEWL) and skin microrelief were evaluated before and after a 14- and 28-day period of treatment. The control regions and regions where the vehicles were applied showed an increase in the TEWL. For the formulations containing the extract, decreased TEWL and improved microrelief were observed when compared to the vehicle and control areas after a 28-day period. In conclusion, Cichorium intybus root extract showed protective and restructuring effects on the skin and stands out as an innovative ingredient to improve skin barrier function.

Morphological, structural and biophysical properties of French and Brazilian photoaged skin.

BACKGROUND: Knowledge of skin biology and its alterations in different populations is very important for the development of appropriate skincare strategies. OBJECTIVES: To evaluate and compare morphological, structural and biophysical properties of photoaged skin in French and Brazilian populations, using biophysical and skin-imaging techniques. METHODS: Forty-one French and 41 Brazilian healthy, female volunteers aged between 40 and 65 years were enrolled. Each participant completed a questionnaire concerning habits related to cosmetic use, sun exposure and sun protection during different life periods. Skin on the face and volar forearm was evaluated using noninvasive techniques, to determine skin colour, transepidermal water loss (TEWL), stratum corneum water content, skin microrelief, skin viscoelasticity and dermis structure. Reflectance confocal microscopy was used to measure epidermal layer thickness and epidermal morphological and structural characteristics. RESULTS: Compared with Brazilian skin, French skin was more hydrated, had a lower TEWL and presented a distinct viscoelastic profile on the forearms and face. Brazilian facial skin was more wrinkled, and the dermis was less echogenic on the forearms and face. The French participants had thicker stratum corneum. Brazilian facial skin presented a higher prevalence of rete ridge effacement, low interkeratinocyte reflectance, huddled collagen and solar elastosis. CONCLUSIONS: Morphological, structural and biophysical differences were found when assessing the skin of the Brazilian and French participants, who were exposed to different environmental factors.

In vivo photoprotective effects of cosmetic formulations containing UV filters, vitamins, Ginkgo biloba and red algae extracts.

The aim of this study was to assess the photoprotective effects of cosmetic formulations containing UV filters, red algae, Porphyra umbilicalis, extracts and combinations of the extract with vitamins and Ginkgo biloba through the use of in vivo preclinical studies. For this study, 4 groups of 4 hairless mice each were treated with topical formulations applied on the dorsum for 5 days as follows: group 1 - control (no treatment); group 2 - application of the formulation F (sunscreen formulation containing only UV filters); group 3 - application of the formulation FA (sunscreen formulation with red algae extract); and group 4 - application of the formulation FVGA (sunscreen formulation with red algae extract, G. biloba and vitamins A, C and E). The effects of these formulations were evaluated by determining the transepidermal water loss (TEWL) and erythema index. Apoptosis was detected by immunohistochemical staining with anti-p53 and anti-caspase-3 antibodies. The results showed that the formulations protected the skin from erythema when exposed to UV radiation. The group that received the formulation FVGA presented a greater TEWL than did the other groups, suggesting that this formulation was involved in cell renewal. Immunohistochemical analysis showed that UV radiation caused an increase in the expression of p53 and active caspase-3, confirming that the damage caused by UV radiation exposure led to apoptosis. The application of all formulations studied resulted in a statistically significant reduction in the expression of p53 and caspase-3, with a more pronounced effect observed following treatment with FA. In conclusion, extracts from the red algae P. umbilicalis could be considered effective ingredients to be used in sunscreen formulations. The combination of vitamins A, E, C and G. biloba along with red algae extracts can improve significantly the performance of the sunscreens, preventing UV-induced DNA damage and inflammation. Thus, they should be considered an interesting combination for an effective photoprotective formulation with anti-aging properties.

Clinical scoring and instrumental analysis to evaluate skin types.

BACKGROUND: The biology of the skin is very complex, and there are a number of methods used to classify the different skin types. It is possible to measure or quantify the characteristics of the specific skin types, using a variety of techniques that can objectively evaluate the properties of the skin in a noninvasive manner. AIM: To clinically characterize different skin types by dermatological evaluation and biophysical and skin imaging techniques, and to evaluate the relationship between the different characteristics. METHODS: The study recruited 26 volunteers. Clinical scoring was performed by a dermatologist who classified the volunteers' skin as normal or dry (group 1) and combination or oily (group 2). Objective measurements included skin microrelief, pH, oiliness, water content of the stratum corneum and transepidermal water loss (TEWL). RESULTS: Positive correlations were found between the level of skin oiliness and skin texture obtained from both instrumental analysis and clinical scoring. The combination and oily skin types had higher clinical scores for shine intensity, oiliness and tendency to pigmentation, and also had higher objective scores for sebum secretion, TEWL and roughness. CONCLUSIONS: Biophysical and skin imaging techniques are effective tools to help characterize skin type and assist in clinical dermatology. We found that different skin types had different characteristics related to skin microrelief, oiliness and TEWL, and therefore require specific dermatological treatments.

Identification and classification of dynamic event tree scenarios via possibilistic clustering: application to a steam generator tube rupture event.

This paper illustrates a method to identify and classify scenarios generated in a dynamic event tree (DET) analysis. Identification and classification are carried out by means of an evolutionary possibilistic fuzzy C-means clustering algorithm which takes into account not only the final system states but also the timing of the events and the process evolution. An application is considered with regards to the scenarios generated following a steam generator tube rupture in a nuclear power plant. The scenarios are generated by the accident dynamic simulator (ADS), coupled to a RELAP code that simulates the thermo-hydraulic behavior of the plant and to an operators' crew model, which simulates their cognitive and procedures-guided responses. A set of 60 scenarios has been generated by the ADS DET tool. The classification approach has grouped the 60 scenarios into 4 classes of dominant scenarios, one of which was not anticipated a priori but was "discovered" by the classifier. The proposed approach may be considered as a first effort towards the application of identification and classification approaches to scenarios post-processing for real-scale dynamic safety assessments.

Serum lipoprotein profile and APOE genotype in Alzheimer's disease.

Alterations in cholesterol homeostasis are associated with Alzheimer's disease (AD). The role played by specific fractions of serum lipoproteins in modifying the risk of AD, and the interaction with APOE genotype has not yet been investigated. We studied serum lipoprotein profiles using a gradient-density ultracentrifugation method in a cohort of late-onset sporadic AD patients without cerebrovascular lesions and in healthy elderly subjects. In the AD group the lipoprotein cholesterol distribution showed an increase in LDL cholesterol, reaching a significant difference with respect to controls in the LDL sub-fractions representing the transition between small dense-LDL (fraction 11, p = 0.04) and normal-density LDL particles (fraction 12, p = 0.03). APOE genotype and LDL cholesterol were independently associated with AD. The mean concentration of LDL in fractions 11 and 12 increased the risk of developing AD (p = 0.01 and p = 0.025, respectively). These results confirm that an alteration of cholesterol homeostasis is associated with AD and that serum concentrations of LDL cholesterol are higher in AD patients without cerebrovascular pathology than in elderly normal subjects. The presence of the APOE epsilon4+ allele is a risk factor for AD independent of increased serum cholesterol or a modification of other vascular risk factors. Increased levels of specific sub-fractions of LDL cholesterol may be associated with increased risk of AD.

1. Dissection of the vertebral artery during a basketball game: a case report.

Dissection of the vertebral artery represents a significant potential cause of strokes among young and middle-aged people. We present a case of dissection of the vertebral artery observed at the forensic autopsy of a professional basketball player who was suddenly taken ill during a practice game and died seven days after the event. A medico-legal autopsy was performed in order to establish an essential causal relationship between arterial dissection and basketball activity. No preceding trauma possibly contributing to the dissection was discovered. The histology of the arterial wall did not show specific alterations in the adventitia, the muscular layer, or the intima. In addition, the toxicological examination excluded any effects of drugs of abuse. We describe macroscopic and microscopic findings in the autopsy, and discuss possible mechanisms of the arterial rupture as well as the autopsy procedure in similar cases.

Carotid endarterectomy without angiography: a prospective randomised pilot study.

OBJECTIVES: to determine whether duplex ultrasonography alone is an adequate examination prior to carotid endarterectomy. DESIGN: prospective, randomised, single centre study. MATERIAL AND METHODS: all patients with carotid bifurcation stenosis greater than 70% - based on duplex scanning - were randomised to arteriography followed by carotid surgery (Group A n=96) or carotid surgery alone (Group B n=90). Study endpoints were neurological complications or death occurring between the day of randomisation and until 30 days after surgery. RESULTS: major neurological complications of death in 1 (1%) vs 3 (3.3%) patients in group A and B, respectively (n.s.). Minor neurological complications (only TIA) were observed in 0 and 3 (3.3%) patients, respectively. CONCLUSIONS: complication rates were low in both groups and within the generally accepted rate after carotid surgery in asymptomatic and symptomatic patients.

Myotonic dystrophy and chromosome translocation segregating in the same family.

We report on a family segregating the myotonic dystrophy (DM) gene and a t(5;8) reciprocal translocation. The DM presented the characteristics typically seen in this disease, i.e. full penetrance, broad expressivity, apparent anticipation in successive generations, presence of a congenital form transmitted by a carrier mother. The family was uninformative for linkage studies with the Lutheran and Secretor loci. The concordance between DM and chromosome translocation in 8 out of 9 individuals at risk was apparently due to chance.

The ABO(H) paradoxical and aberrant secretion in human saliva.

The paradoxical secretion and aberrant secretion of the ABH substances have been studied in the saliva of 251 and 283 subjects, respectively. A standardized hemagglutination-inhibition method was used and the results were scored by an Inhibition Index. Frequencies of 4.3% for paradoxical secretion and of 5.3% for aberrant secretion were observed. Gel chromatography on Sephadex G-25 showed that only the paradoxical secretors have in their saliva the oligosaccharides which inhibit nonspecifically the anti-A, anti-B and anti-H reagents.

Lethal orphenadrine intoxication: report of a case.

A case of lethal orphenadrine intoxication is reported. Included are the anatomical and toxicological findings. Most conspicuous histologically was the centrilobular necrosis of the liver.

Polymorphism of A, B and H substances in human urine.

The gel-chromatographic behavior of A, B and H substances from urine was examined and compared with that of previously described AHB salivary fractions. Urinary fractions 1 and 2 exhibited a molecular size smaller than those of salivary fractions 1 and 2. In the urine of 52 subjects a polymorphism of A, B and H substances, with four main types, was observed which is independent of the salivary one and of the so-called secretor and nonsecretor status.