[Acceptability criteria of spirometry in young workers]. / I criteri di accettabilità delle spirometrie nei giovani lavoratori.

It is uncertain the Forced Expiratory Time (FET) acceptable during spirometry of young people (16-20 years old) because they are not children nor adults. We studied 235 boys and 187 girls of this age and, comparing spirometries with FET > 3 s and > 6 s, we found no significative difference (t test) between Vext, DtPEF, FVC and FEV1 repeatibility, while for wheight in males (p =0.0022) and plateau time (p < 0.00001) in males and females. We conclude that blows with FET < 6s but > 3s can be acceptable in young people when other criteria are respected.

Relationship of the biceps-brachialis complex to the medial coronoid process of the canine ulna.

OBJECTIVE: To describe the anatomic relationship of the biceps brachii-brachialis muscle complex and the medial compartment of the canine elbow. STUDY DESIGN: Anatomical cadaveric study. METHODS: Cadaveric forelimbs, and radius and ulna bones were examined to study the anatomy of the biceps brachii-brachialis complex and its relationship to the medial compartment of the elbow. RESULTS: The biceps brachii and brachialis muscles comprise a large muscular complex. The biceps brachii is a pennate fibred muscle which plays a major role in stabilising the elbow joint during the stance phase and facilitating limb acceleration during the swing phase. Additionally, the insertion of the muscular complex onto the ulnar tuberosity is such that a moment is generated which the authors hypothesise rotates the medial coronoid process against the radial head. The result is a compressive force which generates internal shear stress oblique to the long axis of the medial coronoid process. The authors further hypothesise that this may result in the microdamage or fragmentation of the medial coronoid process. CONCLUSION: The authors' conclude that contraction of the biceps brachii and brachialis complex may explain an aetiopathogenesis for fragmented medial coronoid process not associated with elbow dysplasia.

Ground reaction force profiles after partial and pancarpal arthrodesis in dogs.

OBJECTIVES: To evaluate and compare long-term functional outcome after partial carpal arthrodesis and pancarpal arthrodesis in dogs using kinetic gait analysis. METHODS: Fourteen dogs with 19 partial carpal or pancarpal arthrodeses were retrospectively examined and underwent force-plate gait analysis. Mean times since surgery were 29.4 and 24.4 months for pancarpal and partial carpal arthrodesis respectively. Vertical and braking-propulsive ground reaction force profiles were compared between treatment groups, and to those of normal dogs (control group) using Kruskal-Wallis one-way analysis of variance. RESULTS: With the exception of time to vertical peak that occurred earlier in dogs with pancarpal than in dogs with partial carpal arthrodesis (p <0.01), there was no difference between the two treatment groups. Several parameters differed significantly between operated and healthy dogs (p <0.01): vertical impulses were significantly lower in both treatment groups, braking forces and impulses were also reduced after both techniques. Propulsive forces and impulses were only reduced in dogs with pancarpal arthrodesis. When comparing gait parameters of sound limbs of unilateral operated dogs to those of control dogs, braking forces and impulses (p <0.01; p <0.05) were significantly higher in the sound legs of unilateral operated dogs. CLINICAL SIGNIFICANCE: Long-term outcome after partial carpal and pancarpal arthrodesis is good and comparable to each other. Propulsive action may be altered more in dogs with pancarpal arthrodesis.

Evaluation of an occupational therapy program for patients with spinal cord injury.

STUDY DESIGN: Clinical controlled trial. OBJECTIVES: To evaluate the effectiveness of an occupational therapy (OT) program combined with neuromotor rehabilitation, by assessing the degree of functional independence reached by patients with spinal cord injuries at first hospitalization. SETTINGS: Subjects selected from the Spinal Cord Unit of the Rehabilitation Institute of Montecatone (Imola, Italy). PARTICIPANTS: Thirty-six male patients below age 60, with complete paraplegia (ASIA-A) in thoracic-lumbar level, at first hospitalization. METHODS: Patients were divided into experimental and control groups. Subjects in the experimental group underwent neuromotor rehabilitation coupled with an OT program, whereas those in the control group followed neuromotor rehabilitation only. Increase in functional independence at discharge was evaluated by the Valutazione Funzionale Mielolesi (VFM) assessment scale. RESULTS: Patients in the experimental group showed a significant increase in the total VFM score, and in domains concerning transfers and wheelchair use. A significant improvement was observed in unmarried patients as compared to married ones. CONCLUSION: An OT service within a Spinal Cord Unit allows us to achieve a higher level of functional independence.

[Gunshot wounds--ballistics, physiopathology, surgical treatment]. / Schussverletzungen--Ballistik, Pathophysiologie, chirurgisches Behandlungsprinzip.

The form and size of gunshot wounds depend on the projectile type (bird shot, deforming projectiles, non-deforming projectiles), its velocity at impact (high or low velocity projectiles) and the type of tissue affected by the projectile (soft tissues, bones). Gunshot wounds are always contaminated. While low velocity projectiles usually cause minimal wounds, high velocity projectiles can cause large, devastating wounds. All projectiles fired from firearms have a high velocity on impact and may cause death by traumatic shock instantaneously. Ballistics, pathophysiology and clinical findings of gunshot wounds are discussed, forensic aspects are mentioned. Gunshot wounds are often emergencies. Lifesaving and -stabilizing treatment is most important. A treatment plan aiming at preventing possible complications such as infections and functional disturbances is given for different types of gunshot wounds. Systemic lead poisoning has not been investigated sufficiently. Projectiles usually become encapsulated. The search for projectiles is associated with an additional surgical trauma and usually indicated only for joint wounds (lead arthropathy).

Short cycles of very low calorie diet in the therapy of obese type II diabetes mellitus.

Very Low Calorie Diet (VLCD) is known to induce not only weight loss, but also an improvement of metabolic control, in obese type II diabetics. In order to evaluate the therapeutical efficacy of cycles of VLCD shorter than those previously described, 29 obese type II diabetics and 31 obese nondiabetic subjects were entered as inpatients and prescribed a 450 kcal/day diet for 15 days. Metabolic results obtained were similar to those achieved with longer cycles of VLCD, showing that 15 days are sufficient to induce a BMI decrease in diabetic (BMI from 35.3 +/- 4.8 to 33.3 +/- 4.6 after VLCD) and nondiabetic patients (BMI from 40.5 +/- 7.4 to 38.1 +/- 7.2 after VLCD), a desired fall of blood glucose levels and the decrease of daily insulin needs in insulin-treated patients. Glucagon tests were performed before and after VLCD in order to study possible modifications of insulin secretion. Although we did not observe any significant increase of C-peptide basal or peak levels (nM/ml) either in diabetic (basal levels before VLDC: 1.2 +/- 0.4 and peak levels 2.4 +/- 0.7; basal after VLCD 1.23 +/- 0.6 and peak 2.6 +/- 0.7) and nondiabetic patients (basal levels before VLDC 1.0 +/- 0.3 and peak levels 2.5 +/- 0.4; basal after VLCD 0.9 +/- 0.3 and peak 2.4 +/- 0.6). The rise of the C-peptide/glycemia ratio is an index of an improvement of insulin biological activity, which could be partly responsible for the therapeutical effects of VLCD.(ABSTRACT TRUNCATED AT 250 WORDS)