Comparative study of polycyclic aromatic hydrocarbons (PAHs) in salt gland and liver of loggerhead turtle Caretta caretta (Linnaeus, Cheloniidae) stranded along the Mediterranean coast, Southern Italy.

The levels of polycyclic aromatic hydrocarbons, PAHs, were determined in the liver and salt gland of 19 loggerhead turtles (Caretta caretta Linnaeus, Cheloniidae) stranded along the coasts of the south Tyrrhenian Sea, Italy, from 2019 to 2021. The 16 EPA's priority PAHs were determined by gas chromatography coupled with mass spectrometry (GC-MS). The average values of ΣPAHs in liver, 139 ± 55.0, were exceptionally high and up to one hundred times those of literature and appeared even more worrying in salt gland, 320 ± 97.6 ng/g, w.w. Naphthalene was the predominant contributor to PAHs richness and accounted for 90.0% and 93.7% of ΣPAHs in the two matrices, highlighting the petrogenic source of exposure. An overall higher bioaccumulation of NAP, more than two-fold, was detected in salt gland and especially in female and adults. Data of PAHs richness highlighted a potential risk of neoplastic disease development and that anthropogenic activities may seriously impair healthy state conditions of C. caretta. populations in south Tyrrhenian Sea.

Levels of non-dioxin-like PCBs (NDL-PCBs) in liver of loggerhead turtles (Caretta caretta) from the Tyrrhenian Sea (Southern Italy).

The levels of six non-dioxin-like polychlorinated biphenyls (PCBs 28, 52, 101, 138, 153, and 180) were determined in the liver of 84 loggerhead turtles (Caretta caretta) stranded along the coasts of the Tyrrhenian Sea in Campania Region (Southern Italy), from 2017 to 2021. The average value of the sum (∑6PCBIND) was 28.0 ± 52.2 ng/g (w.w.). The hexachlorobiphenyls PCB 153 and PCB 138 and the heptachlorobiphenyl PCB 180 were the main contributors to the ∑6PCBIND. A weak positive correlation was found between CCL and highly chlorinated PCBs, with adult females having lower PCB concentrations than juvenile females and adult males. This study provides more comprehensive information on the levels of NDL-PCB in Mediterranean loggerhead turtles and sets the basis for assessing anthropogenic impacts on this species.

Peri-Implant Distal Radius Fracture: Proposal of a New Classification.

A peri-implant fracture near the volar plate of the distal radius represents a rarity and can be associated with a mechanical failure of the devices. A literature review was conducted including all fractures that occurred around a volar wrist plate, which could be associated with an ulna fracture. All articles published until December 2021 were considered according to the guidelines presented in the PRISMA Statement. The search was conducted with the PubMed electronic database, Cochrane Database of Systematic Reviews, Medline, Embase, and Google Scholar. Only nine cases of these fractures were reported in the literature. The causes could be due to delayed union/non-union of the old fracture after low energy traumas, high energy trauma in patients with poor bone quality, or hardware mechanical failure. Furthermore, the literature review of peri-implant radius fracture shows different level of radius fracture and types of implant failure. In accordance with these different cases, a new classification of peri-implant fracture of the distal radius is proposed.

Spatial distribution of trace elements in surface sediments of Hooghly (Ganges) river estuary in West Bengal, India.

The spatial distribution of trace elements in surface sediments of the Hooghly estuary was studied over the monsoons in 2014-2017. As, Cd, Ni, Pb and U were two- to sixteen-fold the crust means with increasing levels toward the estuary, with Ni peak during the post-monsoon. Pearson's correlation matrix, cluster analysis, enrichment factors and pollution index revealed the anthropic source and association of trace elements with Fe, Mn and Al and of Pb with U. Geoaccumulation index revealed for Ni an extremely contaminated situation at the estuary water during monsoon and for Cd a heavily contaminated situation at freshwater location. The potential contamination index was >6; thus, sediments were very severely contaminated by As, Cd and Ni with worst situation for As and Cd at fresh and brackish water and during post-monsoon. The overall ecological risk was severe, 300≤RI<600 at all sites and seasons, especially after the monsoon, at fluvial and brackish locations.

A rare case of peri-implant distal radius fracture.

A peri-implant fracture near the volar plate of distal radius represent a very rare injury. The main factor of this lesion is high energy trauma on the wrist. We report a case of a 61-year-old woman with a peri-implant fracture located just proximally to the plate and a fracture of the ulnar head that occurred after a simple fall. The patient was surgically treated by plate and screws removal. The fracture was fixed using a longer volar plate for the radial fracture and a plate for the head ulnar fracture. Different factors such as osteoporosis, BMI and screw position could influence the fracture pattern. However, considering growing use of plates for distal radius fracture fixation, the frequency of these kind of fracture will probably increase.

Isolated osteoblastoma of the cuboid bone: A case report and review of the literature.

Osteoblastoma is a relatively rare, benign, bone-forming tumor, commonly observed in the second and third decades of life. Spine and the long tubular bones are the most common sites of involvement. Osteoblastoma is infrequently seen in other sites, including the bones of hand and foot. A rare case of a 35-year-old man that presented an osteoblastoma of the cuboid bone is reported. The patient was treated with surgical resection and grafting. After the intervention, the patient recovered with no clinical and radiological evidence of recurrence after one year of follow-up. Several cases of osteoblastoma-like variant of osteosarcoma of the cuboid have been previously reported, but, to our knowledge, this is the first case of conventional and isolated osteoblastoma involving the cuboid bone reported in the literature.

Sediment contamination by heavy metals and ecological risk assessment: The case of Gulf of Pozzuoli, Naples, Italy.

Heavy metal concentrations in sediments of the Gulf of Pozzuoli, GoP, and northwest of the Gulf beyond Monte di Procida, MdP, were determined. The enrichment factor, EF, revealed in GoP strong pollution with peaks for Cr and Cu of 61.1 and 96.9. High EF Cr, Cu, and Ni values were observed for MDP. Geoaccumulation index, Igeo, rates GoP extremely polluted by Cr and Cu, Igeo > 5, and MdP heavily polluted by Cr, moderately to heavily polluted by Cu, and heavily to extremely polluted by Ni. Contamination factor, Cf, was high in GoP and varied: Cu > Cr > Ni > Cd > Hg > Zn > Pb > As, and those of Cr, Cu and Ni largely surpassed the thresholds in MdP. The ecological and comprehensive ecological risk placed Cr, Cu, Hg and Ni at high or serious risk level in the Gulf, with a peak of 465 for Cu and at a moderate level in MdP except for a very high risk for Ni.

What's the resolutive surgery for pseudo-ainhum in Vohwinkel syndrome? A case report and review of the literature.

Vohwinkel Syndrome, also known as Keratoderma Hereditarium Mutilans, is an extremely rare dominant autosomal keratosis. It typically presents with "starfish" keratoses on the knuckles, palmoplantar keratoderma (PPK), hearing impairment and mutilating digital constriction bands (pseudoainhum) that cause strangulation, often leading to autoamputation of the affected digit. Both medical and surgical treatment haven't shown to date consistent results, in the treatment of pseudoainhum. In this study we present the case of a woman with Vohwinkel syndrome who showed constriction bands causing ischemic changes of the 5th digit of the right hand for which she was treated with surgery. We also present a review of the literature for the management of this disease.

Acromion Clavicular Joint Reconstruction with LARS Ligament in Acute Dislocation.

BACKGROUND: The acromion clavicular joint dislocations are common injuries of the shoulder. The severity is dependent upon the degree of ligamentous injury. Surgical treatment is typically performed in higher grade acromioclavicular separation with several static and dynamic operative procedures with or without primary ligament replacement. METHODS: 47 patients with acute Rockwood type III, IV, and V injuries were treated surgically with LARS reconstruction. The success of technique was evaluated by radiographic outcomes for each patient at every follow-up visit (one, three, 12 months), while to assess pain reduction and clinical evaluation Visual Analogue scale score (VAS) and Constant-Murley score (CMA) was performed, respectively. An One Way Analysis of Variance (Kruskal-Wallis test), a multiple comparison Turket test, or a t-test (Mann-Whitney Rank Sum Test) were used when required. RESULTS: Follow-up radiographs revealed maintenance of anatomical reduction in 41 patients, and no bone erosions has been identified. In short-term joint functional recovery has been observed. Indeed, after 12 months pain on the VAS-scale in all groups decreased significantly (P < 0.05), and the CMS revealed a significant overall improvement (P < 0.05). CONCLUSION: These data demonstrate that the use of the LARS allows to provide stability to the joint and especially to ensure its natural elasticity, relieving pain and improving joint function already one month post-surgery.

Contaminants bioaccumulation and pathological assessment in Mytilus galloprovincialis in coastal waters facing the brownfield site of Bagnoli, Italy.

We studied the bioaccumulation of metals and PAHs, the pathological conditions, regressive phenomena and pathogens in wild Mytilus galloprovincialis taken along the North Pier facing the former second Italian largest steelworks of Bagnoli. There was no Cd and Pb bioaccumulation with respect to the EU role 221/2002. Metal shell index decreased as follows: Pb > Ni > Zn > Cu and correlates with the pollution state. The level of BaP was up to thirtysixfold higher the EU rule 835/2011. The sum of 4 hydrocarbons, PAH4, were up to seventeen-fold the rule. PAH levels increased toward the coast. Prevalence values of tissue necrosis and inflammatory lesions were between 50 and 100%. In May animals showed lesion like granulocytomas and inflammatory capsules. Signs of atresia, necrotic oocytes and diffused cases of hermaphroditism were detected. An appropriate localization of farming to avoid contamination from sediment turbulence and risks for consumer health is needed.

Influence of sutures configuration on the strength of tendon-patch joints for rotator cuff tears treatment.

PURPOSE: Massive rotator cuff tears are common in the aging population. The incidence of failed rotator cuff repairs is still quite high, especially in the treatment of full-thickness tears or revision repairs. In this context, natural and synthetic meshes can be used as augmentation scaffolds or as devices to close the gap between a retracted tendon and the bone. The purpose of this work is to evaluate the ultimate tensile strength of different tendon-patch joints in order to consider their use in the treatment of massive cuff tears. MATERIALS AND METHODS: Porcine tendons and a synthetic low-density polypropylene mesh have been used. A preliminary study on the tensile strength of tendons and patches has been performed. Different patch-tendon joints have been studied by modifying the number and the layout of the sutures. For every joint, the tensile test, performed through an electromechanical machine, has been repeated at least twice to obtain reliable data. RESULTS: Experimental tensile tests on tendons and patches have given good results with very low dispersion data. Mean values of the calculated ultimate tensile stresses are, respectively, about 34 MPa and 16 MPa for tendons and patches. As regards the sutures arrangement, the staggered layout gave, for all joints, a higher tensile strength than the regular (aligned) one. Different ultimate tensile stress values, depending on the sutures number and layout, have been calculated for the joints. CONCLUSION: Synthetic patches could be an interesting option to repair massive cuff tears and to improve, in a significant way, pain, range of motion and strength at time 0, so reducing the rehabilitation time. Obtained results demonstrated that joints with a suitable number and layout of sutures could ensure very good mechanical performances. The failure load of the tendon-patch joint, in fact, is higher than the working load on a healthy tendon.

Self-inflicted long bone fractures for insurance fraud.

Self-inflicted fractures simulating traffic accident represent a new social fraud opportunity for criminality. Recognising scams through an increase of awareness of existence of self-inflicted arm fractures for insurance fraud could help community health workers to report these injuries to the competent authorities. In this article, authors have recognised an unusual but consistent pattern of upper and lower limb fractures whose incidence does not coincide in numerical terms with what is reported in literature. The aim of the present study is to describe fracture patterns observed over the past 2 years. Further, authors describe clinical presentations of these fractures and attempt to define a possible mechanism of these types of injuries.

Levels of pollution of rare earth elements in the surface sediments from the Gulf of Pozzuoli (Campania, Italy).

The Gulf of Pozzuoli includes the former second largest Italian steelworks of Bagnoli. The REE, Y, Th and Sc pollution in sediments of the Gulf of Pozzuoli was determined. Ce, La, Nd and Pr had the highest percentage distribution of rare earth elements normalized respect to chondrite with 31.19, 28.35, 19.51 and 8.41% individually. It was observed a marked enrichment of these elements, from west to the east from 26.39 to 111.04 mg/kg and from onshore to offshore from 31.67 to 217.74 mg/kg. The output of the principal component analysis revealed that the REE were mainly of anthropic origin being clearly linked to that of PAHs, metals and organic matter. This, together with their distribution patterns, highlighted the role of the former Bagnoli metallurgical plant in the pollution of the gulf.

Electromagnetic distal targeting system does not reduce the overall operative time of the intramedullary nailing for humeral shaft fractures.

INTRODUCTION: We aimed to evaluate the efficacy of the use of the electromagnetic distal targeting system in treating humeral shaft fracture. METHODS: Patients were divided in: Group 1) patients that received a distal locking screw placement following the free-hand technique; Group 2) patients in which the distal locking screw was performed using the SURESHOT device. RESULTS: No differences were noted comparing Group 1 (freehand) [71,9 range 40-135 min] to Group 2 (SURESHOT)[70, range 25-125 min]. CONCLUSION: The use of the EM distal targeting system doesn't reduce the overall operative time of the humeral shaft fracture fixation using IMN.

Can Clinical and Surgical Parameters Be Combined to Predict How Long It Will Take a Tibia Fracture to Heal? A Prospective Multicentre Observational Study: The FRACTING Study.

BACKGROUND: Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days) score, calculated soon after tibia fracture treatment, to predict healing time. METHODS: The study included 363 patients. Information on patient health, fracture morphology, and surgical treatment adopted were combined to calculate the FRACTING score. Fractures were considered healed when the patient was able to fully weight-bear without pain. RESULTS: 319 fractures (88%) healed within 12 months from treatment. Forty-four fractures healed after 12 months or underwent a second surgery. FRACTING score positively correlated with days to healing: r = 0.63 (p < 0.0001). Average score value was 7.3 ± 2.5; ROC analysis showed strong reliability of the score in separating patients healing before versus after 6 months: AUC = 0.823. CONCLUSIONS: This study shows that the FRACTING score can be employed both to predict months needed for fracture healing and to identify immediately after treatment patients at risk of prolonged healing. In patients with high score values, new pharmacological and nonpharmacological treatments to enhance osteogenesis could be tested selectively, which may finally result in reduced disability time and health cost savings.

Bilateral ruptures of the extensor mechanism of the knee: A systematic review.

INTRODUCTION: We conduct a systematic and qualitative review of the current literature to evaluate studies that described bilateral ruptures of the extensor mechanism of the knee. METHODS: A comprehensive literature search was performed to evaluate all studies included in the literature until September 2016. RESULTS: Fourteen studies with a total of 44 patients met the inclusion criteria. There were 14 patients with CRF (61%), 6 patients were affected by diabetes mellitus (14%) while other 6 patients were obese patients (14%). CONCLUSION: CRF represents the most frequent comorbidity in patients with bilateral quadriceps/patellar tendon ruptures.

Distribution and enrichment of trace metals in surface marine sediments in the Gulf of Pozzuoli and off the coast of the brownfield metallurgical site of Ilva of Bagnoli (Campania, Italy).

The distribution of metals in surface sediments of Gulf of Pozzuoli (GoP), embedding the former second Italian largest integrated steelworks of Bagnoli, was studied based on sediment dispersal, quality guidelines (SQGs) and quantitative pollution indices of the respective metals. As, Cd, Hg, Pb, Zn largely exceeded the limits. Hg had a mean of 5.8mg/kg, twentyfold higher the rule, accumulating primarily near Bagnoli site. The mean effective range quotient, m-ERM-Q, revealed a high potential for negative biological effects especially in the area nearby the Bagnoli site. The enrichment factor (EF) values were outstandingly high, >1.5 with values which were often ≥100. The geoaccumulation index, Igeo, was very critical for Cr, Cu, Hg and Ni, showing an Igeo in the range of strongly polluted (45). The principal component analysis (PCA) and Pearson's correlation matrix (CM), excluded significant contribution from weathering products.

Three single loops enhance the biomechanical behavior of the transtibial pull-out technique for posterior meniscal root repair.

PURPOSE: To investigate the effect of applying an additional suture to enhance the biomechanical behavior of the suture-meniscus construct used during the transtibial pull-out repair technique. METHODS: A total of 20 fresh-frozen porcine tibiae with intact medial menisci were used. In one half of all specimens (N = 10), two non-absorbable sutures were passed directly over the meniscal root from the tibia side of the meniscus to the femoral side (2SS). In other ten specimens, three sutures were passed over the meniscal root (3SS). All specimens were subjected to cyclic loading followed by load-to-failure testing. Displacement of the construct was recorded at 100, 500, and 1000 cycles. Further, stiffness (500-1000 cycles) and ultimate load and modes of failure of the suture-meniscus construct were also recorded. RESULTS: There was no statistically significant difference between the Group 2SS and Group 3SS at the 1st (1.6 ± 0.7 vs 1.4 ± 0.4 mm) and the 100th cycle (2 ± 0.7 vs 1.8 ± 0.4 mm). At 500 and 1000 cycles, the 2SS fixation technique resulted in significantly more displacement than the 3SS fixation technique (2.8 ± 0.6 vs 2.3 ± 0.5 mm; 3.1 ± 0.7 vs 2.5 ± 0.5 mm) (p < 0.05). No differences between two groups were noted concerning ultimate load to failure and stiffness (500-1000 cycles). CONCLUSION: Three single sutures technique provided superior biomechanical properties compared with the two single sutures technique during the conducted fatigue tests. CLINICAL RELEVANCE: Applying three simple stitches during meniscal root repair might be beneficial for healing of the posterior meniscal root, potentially reducing the post-operative immobilization time.

Characterization and source apportionment of polycyclic aromatic hydrocarbons (pahs) in the sediments of gulf of Pozzuoli (Campania, Italy).

Most of the literature reports on the impact of the former Bagnoli brownfield on the pollution of Bagnoli Bay, embedded in the Gulf of Pozzuoli (GoP). Thus, we studied concentrations, types and sources of sixteen PAHs (EPA) in sediments at 22 sites along 5 transects covering the entire area of GoP. Outstanding levels of PAHs were found, varying from 7.1µgg-1 to 2.5 E+3µgg-1. Sediments collected at sites far away from Bagnoli were found to be polluted to a similar extent than those facing the brownfield site, with values>100µgg-1. Total PAHs levels in the sediments of GoP were higher by thirty-eleven thousand fold than those reported by other studies from various marine sites in the world. Transit axes of fine and very fine sands and diagnostic indexes revealed a common pyrolytic PAHs pollution spreading from the Bagnoli plant to all GoP.