Dermatological high-dose-rate brachytherapy for the treatment of basal and squamous cell carcinoma

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are among the most common cancers in humans. Various therapies are currently being used to treat these tumours including surgery, topical treatments and radiotherapy. We describe a new treatment for BCC and SCC. This consists of superficial radiotherapy, using synthetic resin containing a radioactive beta-emitting isotope. The resin is applied to the lesion to perform a selective beta-irradiation brachytherapy treatment

Tiered social distancing policies and epidemic control

Tiered social distancing policies have been adopted by many governments to mitigate the harmful consequences of COVID-19. Such policies have a number of well-established features, i.e. they are short-term, adaptive (to the changing epidemiological conditions), and based on a multiplicity of indicators of the prevailing epidemic activity. Here, we use ideas from Behavioural Epidemiology to represent tiered policies in an SEIRS model by using a composite information index including multiple indicators of current and past epidemic activity mimicking those used by governments during the COVID-19 pandemic, such as transmission intensity, infection incidence and hospitals’ occupancy. In its turn, the dynamics of the information index is assumed to endogenously inform the governmental social distancing interventions. The resulting model is described by a hereditary system showing a noteworthy property, i.e. a dependency of the endemic levels of epidemiological variables from initial conditions. This is a consequence of the need to normalize the different indicators to pool them into a single index. Simulations suggest a rich spectrum of possible results. These include policy suggestions and identify pitfalls and undesired outcomes, such as a worsening of epidemic control, that can arise following such types of approaches to epidemic responses

Long-term clinical and radiographic results of acl reconstruction. Retrospective comparison between three techniques (hamstrings autograft, hamstrings autograft with extra-articular reconstruction, bone patellar tendon autograft)

Background. There is no consensus in the current literature on which surgical options render the best long-term results after ACL reconstruction in terms of clinical outcomes and development of radiographic osteoarthritis (AO). The aim of this study is to investigate clinical and radiological results at long-term follow up after ACL reconstruction using hamstring tendons autograft (Group HT), hamstrings autograft with extra-articular reconstruction (Group HT-ER), and bone patellar tendon bone autograft (Group BPTB). Methods. All patients were evaluated at final follow-up using Lysholm, Internation- al Knee Documentation Committee (IKDC), and Tegner scores. An arthrometric KT-1000 evaluation was also done. Comparative weight bearing radiographs were taken, including a skyline view for patellofemoral joint and analyzed according to Fair- bank, Kellgren, and IKDC classification. Sixty patients were selected for this retrospective study, 20 for each group. The mini- mum final follow-up was 10 years for each group. All patients were male and involved in sport activities (Tegner pre-injury >7). Results. Subjective scores improved significantly in all groups, with no significative differences between groups (P<0,05). The number of patients classified as C or D at the IKDC objective activity score was higher in Group HT (2/20, 10%), than in Group BTB (1/20, 5%) and Group HT-E (0/20, 0%). In term of failure-rate, there were no difference between the three groups (P<0,05). Radiologic evaluation shoved more arthritic changes in Group-BT in the patello-fem- oral joint (PMJ). Conclusions. All the three techniques showed satisfactory results at long term follow up with no differences in term of subjective scores. Finally, there was a statistically significant higher incidence of arthritic changes in PFJ as evaluated with x-ray in the BPTP group respect to HT and HT + ER groups (p<0.05)

Fabrication and Characterization of Molybdenum Tips for Scanning Tunneling Microscopy and Spectroscopy

We present a method for the preparation of bulk molybdenum tips for scanning Tunneling Microscopy and Spectroscopy (STM - STS) and we assess their potential in performing high resolution imaging and local spectroscop by measurements on different single crystal surfaces in UHV, namely Au(111), Si(111)-7x7 and titanium oxide 2D ordered nanostructures supported on Au(111). The fabrication method is versatile and can be extended to other metals, e.g. cobalt

Griscelli syndrome type 2: long-term follow-up after unrelated donor bone marrow transplantation

Griscelli syndrome (GS) is a rare autosomal recessive disease characterized by silvery hair ('partial albinism'). Three forms exist; GS type 2 (GS2), the most common one, is characterized by severe primary immunodeficiency with acute episodes of hemophagocytic lymphohistiocytosis (HLH) which may be fatal in the absence of hematopoietic stem cell transplantation. A 5-year-old boy with HLH was referred to us because of silvery-gray hair present since birth. Abnormal pigment clumps were observed in the medulla of hair shafts on light microscopy. Electron microscopy of a skin biopsy revealed melanosomes in melanocytes, but not in keratinocytes. Leukocytes were devoid of intracytoplasmic granules on blood smear. Neurological signs were absent. Genotyping revealed a homozygous haplotype for polymorphic markers linked to the RAB27A locus, but no RAB27A mutation. A diagnosis of GS2 was established. The patient received bone marrow transplantation (BMT) from an unrelated donor, and after 72 months he did not show relapse of HLH. The long, uneventful follow-up supports the use of BMT from an unrelated donor if transplantation from a relative is not possible

Acute primary repair of the anterior cruciate ligament with anterolateral ligament augmentation

Acute injuries of the anterior cruciate ligament are often associated with concurrent injuries to the structures of the anterolateral complex, specifically the anterolateral ligament. Some injury patterns of the anterior cruciate ligament involve tearing of the majority of the ligament from the femoral origin, leaving a large, viable ligament remnant. In these patients, a repair of the anterior cruciate ligament back to the femoral origin can be undertaken. Subsequently, percutaneous repair of the anterolateral ligament can be performed through anatomical, percutaneous suture tape augmentation. The combined technique of anterior cruciate ligament repair with anterolateral ligament reinforcement is presented

Combined acl and segond repair in combined acute proximal acl tears and segond fracture

A renewed interest in anterior cruciate ligament preservation has been noted using arthroscopic primary repair in patients with proximal tears, but the main concern remained the control of the rotational instability. Segond fracture occurs in less than 10% of cases of acute anterolateral instability, but it can result in continued rotation instability. The aim of this study is to describe the surgical technique to acutely repair both the anterior cruciate ligament and Segond fracture in the acute setting

Non-invasive computer navigation can quantify the pivot shift maneuver with good to excellent reliability in healthy volunteers

Purpose: The aim of this study was to determine the inter- and intra-observer reliability of knee laxity assessment using a non-invasive navigation system in a population of healthy young athletes. It was hypothesized that knee laxity parameters recorded using non-invasive computer navigation would demonstrate good inter- and intra- observer reliability. Methods: Healthy volunteers aged between 18 to 30 years were recruited to the study. Static and dynamic knee laxity parameters including anterior tibial translation and tibial rotation during the pivot shift test were recorded on awake patients using non-invasive computer navigation by two independent observers: at the first visit each athlete was evaluated by the consultant and resident surgeons independently; 6 weeks after the first visit all the participants were re-tested only by the resident surgeon. Inter- and intra-observer reliability was calculated and then interpreted according to Cicchetti’s criteria. Results: One hundred healthy volunteers were recruited to the study, of these 38 were women (38%), and the average age was 25.5 ± 2.4 years. According to Cicchetti’s criteria the intra- and inter-observer reliability for static measurements were fair for anterior tibial translation (0.572 and 0.529, respectively) and excellent for total passive tibial rotation (0.859 and 0.883, respectively). For the dynamic measurements of translation and rotation during the pivot shift maneuver both measurements demonstrated good to excellent reliability with intra and inter observer reliability ranging from 0.684 to 0.936. Conclusion: Non-invasive navigation for the assessment of knee laxity is associated with fair to excellent inter- and intra-observer reliability in a population of healthy volunteers