Lembo di muscolo peroneo breve a peduncolo distale: valutazione anatomica preoperatoria con risonanza magnetica

Introduzione: Le perdite di sostanza dell’arto inferiore ad eziologia traumatica o di altra natura, con esposizione ossea o tendinea rappresentano una condizione estremamente comune, causa di considerevole morbidità e mortalità nella popolazione generale. Un’adeguata ricostruzione spesso richiede l’impiego di lembi locali o lembi liberi. Il lembo di muscolo peroneo breve a peduncolo distale (LMPB) si è dimostrato essere un’efficace e relativamente semplice opzione ricostruttiva per le perdite di sostanza di dimensioni piccolo-moderate localizzate nel terzo distale dell’arto inferiore. Obiettivi dello studio: Dato che uno dei principali fattori limitanti per l’impiego del LMPB è rappresentato dalla lunghezza del ventre muscolare disponibile per la copertura, in questo studio si valuta la capacità della Risonanza Magnetica 3D (3D-RM) dell’arto inferiore di misurare questo parametro preoperativamente al fine di agevolare la pianificazione chirurgica e la selezione dei candidati più adatti all’intervento. Pazienti e Metodi: Tra il 2008 e il 2014, 12 pazienti (10 Uomini e 2 Donne, Età μ=53.6±15.2) con perdite di sostanza a carico dei tessuti molli e/o ossei del terzo distale dell’arto inferiore sono stati sottoposti a 3D-RM della gamba e il ventre del muscolo peroneo breve (PB) è stato misurato a partire dall’origine prossimale sulla superfice laterale della fibula fino all’inizio della porzione tendinea distale. Le dimensioni delle perdite di sostanza erano piccolo-moderate, (diametro medio μ= 3 x 5 cm), localizzate sulla regione calcaneale e anteriore della caviglia, in prossimità dei malleoli laterale/mediale e lungo il tendine di Achille. Durante l’intervento, la dissezione del muscolo PB effettuata a partire dalla superficie laterale della fibula è stata condotta fino al terzo distale del muscolo, circa 6 cm prossimalmente al malleolo laterale (fra 5 e 8 cm), dove i rami segmentali, provenienti dall’arteria peroniera, costituiscono il peduncolo arterioso distale provvedendo alla vascolarizzazione retrograda del lembo. Prima di elevare completamente il lembo, il ventre muscolare del muscolo PB è stato misurato intraoperatoriamente dall’origine fibulare fino all’inizio della porzione tendinea. Le misure chirurgiche sono state, in seguito, confrontate con quelle ottenute tramite RM. Risultati: Le misure del ventre muscolare del peroneo breve ottenute tramite risonanza magnetica avevano una media di 14,6 cm con deviazione standard di 3,7 cm (range da 8 a 15 cm). Undici lunghezze chirurgiche su dodici corrispondevano a quelle radiologiche (con differenza ±1 cm, r=0.93 e p=0,002). In un solo paziente si è registrata una lunghezza fisica del ventre muscolare 4 cm inferiore a quella riscontrata in RM. Tutti i lembi scolpiti sono rimasti vitali e nessuna complicanza legata al lembo è stata registrata, con accettabile morbidità del sito donatore, ottimo esito funzionale e limitato discomfort postoperatorio dei pazienti. Discussione: Il LMPB a peduncolo distale si è dimostrato essere un’alternativa efficace, versatile e rapida rispetto alle più complesse procedure di trapianto tissutale tramite lembi liberi nelle perdite di sostanza del terzo distale della gamba di dimensioni piccolo-moderate. L’ampio arco di rotazione e il pattern vascolare relativamente costante rendono questo lembo adatto alla ricostruzione della regione malleolare e calcaneale con limitata morbidità del sito donatore e rare complicanze. La RM preoperatoria dell’arto inferiore si è dimostrata essere una tecnica accurata per valutare l’anatomia del muscolo PB se effettuata da un radiologo esperto in imaging dei tessuti molli e rappresenta un prezioso supporto alla pianificazione chirurgica e a una più efficiente selezione dei candidati più adatti all’intervento. Conclusioni: Il LMPB a peduncolo distale rappresenta una soluzione rapida e affidabile per la ricostruzione del terzo distale della gamba, in particolare quando sia richiesta la copertura con un lembo muscolare. Nella nostra esperienza, una valutazione anatomica radiologica con RM dovrebbe diventare parte integrante delle indagini preoperatorie quando il LMPB è considerato fra le opzioni ricostruttive, sebbene un'ulteriore standardizzazione del protocollo diagnostico sia necessaria

Annotating digital libraries and electronic editions in a collaborative and semantic perspective

The distinction between digital libraries and electronic editions is becom-ing more and more subtle. The practice of annotation represents a point of conver-gence of two only apparently separated worlds. The aim of this paper is to present a model of collaborative semantic annotation of texts (SemLib project), suggesting a system that find in Semantic Web and Linked Data the solution technologies for en-abling structured semantic annotation, also in the field of electronic editions in Digi-tal Humanities domain. The main purpose of SemLib is to develop an application so to make easy for developers the integration of annotation software in digital librar-ies, which are different both for technical implementations and managed contents, and provide to users, indifferently from their cultural backgrounds, a simple system which could be used as a front-end. We present, for this purpose, a final example of semantic annotation in a specific context: a digital edition of a literary text and the issues that an annotation task involves

Clinical, microbiological and immunological short, medium and long-term effects of different strains of probiotics as an adjunct to non-surgical periodontal therapy in patients with periodontitis. Systematic review with meta-analysis

Introduction/objectives: Probiotics have been proposed as adjuncts to non-surgical periodontal therapy (NSPT), however, the effect of their use remains unclear. The aim of this systematic review and meta-analysis was to analyze the evidence regarding the use of probiotics as an adjunct to NSPT in patients with periodontitis at a clinical, microbiological and immunological level. Data/sources: A comprehensive search to identify clinical studies investigating the use of probiotics as an adjunct to NSPT in patients treated for periodontitis was performed. The data were grouped according to probiotic strain, frequency, form and duration of the probiotic intake. Study selection: A total of 25 articles were included, all articles analysed clinical parameters, 10 included also microbiological findings and only 4 had immunological findings. The difference in probing depth (PD) between the test and the control group was statistically significant in favour of the test group when the probiotics were in the form of lozenges, administered twice a day and when the strain was L. reuteri. In terms of Clinical Attachment Level (CAL) gain the difference was statistically significant in the short and in the medium term but not in the long term. Due to the heterogeneity of the data, it was not possible to compare trough a meta analysis the immunological and the microbiological findings that were therefore analysed only descriptively. Conclusions: The use of probiotics as an adjunct to NSPT in patients with periodontitis appears to provide additional clinical benefits that depend on the duration, the frequency, the form and the strain of probiotic used. Clinical significance: This review not only shows data on the efficacy of probiotics in non-surgical periodontal therapy, but provides important information on their effects over time and which forms of probiotic administration might be most clinically useful

Studio di fattibilità del progetto: Biennale del Design di Ascoli Piceno

Il rapporto raccoglie i principali risultati delle attività di ricerca e consulenza tecnicoscientifica per la redazione dello studio di fattibilità del progetto “Biennale del Design ad Ascoli Piceno”, condotte dal Dipartimento ProCAm, Progettazione e Costruzione dell’Ambiente, della Facoltà di Architettura dell’Università di Camerino, in collaborazione con il Consorzio Universitario Piceno (CUP). Obiettivo principale dello studio: delineare i fattori strutturali necessari e le condizioni contestuali più idonee per la realizzazione di una manifestazione biennale dedicata al design, cercando di evidenziarne le potenzialità e gli eventuali benefici, per quanto possibile, anche in termini socio-economici oltre che culturali

Dimerization of the C-type lectin-like receptor CD93 promotes its binding to Multimerin-2 in endothelial cells

Blocking the signaling activated by the plasma membrane receptor CD93 has recently been demonstrated a useful tool in antiangiogenic treatment and oncotherapy. In the proliferating endothelium, CD93 regulates cell adhesion, migration, and vascular maturation, yet it is unclear how CD93 interacts with the extracellular matrix activating signaling pathways involved in the vascular remodeling. Here for the first time we show that in endothelial cells CD93 is structured as a dimer and that this oligomeric form is physiologically instrumental for the binding of CD93 to its ligand Multimerin-2. Crystallographic X-ray analysis of recombinant CD93 reveals the crucial role played by the C-type lectin-like and sushi-like domains in arranging as an antiparallel dimer to achieve a functional binding state, providing key information for the future design of new drugs able to hamper CD93 function in neovascular pathologies

The evolution of breast prostheses.

Every year approximately 1.5 million prostheses are implanted worldwide for breast augmentation and reconstructive indications. The modern breast implant as we know was released to the open market in 1963. It has gone through intense phases of development which have improved the initially primitive and limited devices to current-day devices, which exhibit a tremendous range of surface textures, sizes, gel consistencies, and anatomical shapes. This article explores the evolution of breast implants providing historical facts and technical details

A Nine-Strain Bacterial Consortium Improves Portal Hypertension and Insulin Signaling and Delays NAFLD Progression In Vivo

Bacterial consortium; Gut microbiome; Portal hypertensionConsorcio bacteriano; Microbioma intestinal; Hipertensión portalConsorci bacterià; Microbioma intestinal; Hipertensió portalThe gut microbiome has a recognized role in Non-alcoholic fatty liver disease (NAFLD) and associated comorbidities such as Type-2 diabetes and obesity. Stool transplantation has been shown to improve disease by restoring endothelial function and insulin signaling. However, more patient-friendly treatments are required. The present study aimed to test the effect of a defined bacterial consortium of nine gut commensal strains in two in vivo rodent models of Non-alcoholic steatohepatitis (NASH): a rat model of NASH and portal hypertension (PHT), and the Stelic animal (mouse) model (STAM™). In both studies the consortium was administered orally q.d. after disease induction. In the NASH rats, the consortium was administered for 2 weeks and compared to stool transplant. In the STAM™ study administration was performed for 4 weeks, and the effects compared to vehicle or Telmisartan at the stage of NASH/early fibrosis. A second group of animals was followed for another 3 weeks to assess later-stage fibrosis. In the NASH rats, an improvement in PHT and endothelial function was observed. Gut microbial compositional changes also revealed that the consortium achieved a more defined and richer replacement of the gut microbiome than stool transplantation. Moreover, liver transcriptomics suggested a beneficial modulation of pro-fibrogenic pathways. An improvement in liver fibrosis was then confirmed in the STAM™ study. In this study, the bacterial consortium improved the NAFLD activity score, consistent with a decrease in steatosis and ballooning. Serum cytokeratin-18 levels were also reduced. Therefore, administration of a specific bacterial consortium of defined composition can ameliorate NASH, PHT, and fibrosis, and delay disease progression

Virtual Non-Contrast Spectral CT in Renal Masses:Is It Time to Discard Conventional Unenhanced Phase?

Dual-layer Dual-Energy CT (dl-DECT) allows one to create virtual non-contrast (VNC) reconstructions from contrast-enhanced CT scans, with a consequent decrease of the radiation dose. This study aims to assess the reliability of VNC for the diagnostic evaluation of renal masses in comparison with true non-contrast (TNC) images. The study cohort included 100 renal masses in 40 patients who underwent dl-DECT between June and December 2021. Attenuation values and standard deviations were assessed through the drawing of regions of interest on TNC and VNC images reconstructed from corticomedullary and nephrographic phases. A Wilcoxon signed-rank test was performed in order to assess equivalence of data and Spearman’s Rho correlation coefficient to evaluate correlations between each parameter. The diagnostic accuracy of VNC was estimated through the performance of receiver operating characteristic (ROC) curve analysis. Differences between attenuation values were, respectively, 74%, 18%, 5% and 3% (TNC-VNCcort), and 74%, 15%, 9% and 2% (TNC-VNCneph). The Wilcoxon signed-rank test demonstrated the equivalence of attenuation values between the TNC and VNC images. The diagnostic performance of VNC images in the depiction of kidney simple cysts remains high compared to TNC (VNCcort-AUC: 0.896; VNCneph-AUC: 0.901, TNC-AUC: 0.903). In conclusion, quantitative analysis of attenuation values showed a strong agreement between VNC and TNC images in the evaluation of renal masses.</p

Seguimiento de verdeos de raigrás anual en establecimientos ganaderos del sur de Corrientes

La provincia de Corrientes cuenta con ambientes aptos para la implantación de verdeos de invierno, especialmente el centro sur sobre campos de altura y monte de ñandubay. Los verdeos son una alternativa tecnológica válida que permite cubrir el bache forrajero del periodo invernal, y mejorar los resultados productivos y económicos del sistema ganadero.EEA MercedesFil: Preisz, Víctor Hernán. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Mercedes. Agencia de Extensión Rural Curuzú Cuatiá; Argentina.Fil: Barbera, Pablo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Mercedes; Argentina.Fil: Rivero, Luis Domingo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Mercedes; Argentina.Fil: Beccaria, Mauricio Daniel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Mercedes. Agencia de Extensión Rural Curuzú Cuatiá; Argentina.Fil: Sosa Leguizamón, Gustavo Andrés. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Mercedes. Agencia de Extensión Rural Curuzú Cuatiá; Argentina.Fil: Castro, Federico. Actividad privada; Argentina.Fil: Vallejo, Fernando. Actividad privada; Argentina.Fil: Sirtori, Oscar. Actividad privada; Argentina.Fil: France, Federico. Actividad privada; Argentina.Fil: Guenaga, Miguel. Actividad privada; Argentin