L’eredità del Tenchini come punto di partenza per la ricostruzione della storia di un criminale del XIX secolo

Late in the 19th century, physician Lorenzo Tenchini undertook a study of criminal subjects and psy-chiatric patients. One of these was B.A., a 22-year-old soldier who committed suicide after attempting to kill his lover, a prostitute named G.I. The starting points of this study were the analysis of the subject's biography – data which resulted from the autopsy – and several observations on his brain and skull in accordance with the phrenological doctrine of that time. The goal of this work was to shed new light on an Italian criminal of the late 19th century and on Tenchini's work, combining the material collected by the doctor himself with sources of the period and modern medical knowledge.Alla fine del XIX secolo, il Dottor Lorenzo Tenchini intraprese uno studio su soggetti criminali e pazienti psichiatrici. Uno dei soggetti analizzati era B.A., un soldato di 22 anni che morì dopo aver tentato di uccidere la sua amante, una prostituta di nome G.I. I punti di partenza di questo studio sono stati l'analisi della biografia del soggetto, i dati emersi dall'autopsia e diverse osservazioni riguardanti il suo cervello e il cranio compiute secondo la dottrina frenologica dell'epoca. L'obiettivo di questo studio era di gettare nuova luce su un criminale italiano di fine '800 e sull'opera del Dottor Tenchini, unendo il materiale raccolto dal medico, con fonti dell'epoca e le moderne conoscenze mediche

Treatment of Stifle Joint Luxation in a Cat Using a Temporary Trans-Articular Locking Plate

AbstractThe aim of this study was to report the surgical treatment of stifle joint luxation through temporary immobilization of the joint with locking plates in a cat. Stifle joint was immobilized using a temporary trans-articular locking plate applied medially. Return to function was assessed by physical and radiographic follow-up examinations. The cat had good return to function despite a reduction in range of motion. Moderate chronic gonarthritis developed, as seen radiographically. Under the limitation of this single case, temporary trans-articular plating may be considered as useful method for the treatment of long-standing, severely displaced stifle joint luxations in cats

Treatment of Y-T Humeral Fractures with Polyaxial Locking Plate System (PAX) in 14 Dogs

The aim of this study is to report the results and to review the outcome of 14 cases of Y-T humeral fractures repair using paired polyaxial locking system (PAX) plates through a combined medial and lateral approach. Fourteen consecutive dogs, with traumatic humeral Y-T fractures, met the inclusion criteria. This study includes signalment, preoperative radiographs, type of implants, radiographic bone healing assessment, complications, range of motion (ROM) of the elbow and limb function evaluated at 120 days after surgery. Postoperative radiographs revealed adequate anatomic reconstruction, and in all cases, bone healing has been achieved. No implant failure was observed. Functional outcome was excellent in 7 dogs (no lameness and preserved ROM), good in 4 (slight lameness and moderate ROM reduction) and discrete in 2 (mild lameness and severe ROM reduction). Complications were encountered in 2/14 patients with implant-associated infection resolved after long-term antibiotic treatment and implant removal. The PAX system is shown to be a valid alternative for the treatment of Y-T humeral fractures, offering the benefit of polyaxial insertion of locking screws. The possibility of angle locking screws is helpful in the distal humeral bicondylar fractures, providing additional options for screw placement in juxtarticular fractures, avoiding fracture lines or other implants

Spontaneous Upbeat Nystagmus and Selective Anterior Semicircular Canal Hypofunction on Video Head Impulse Test: A New Variant of Canalith Jam?

: We describe a rare case of spontaneous upbeat nystagmus (UBN) attributable to a canalith jam involving the anterior semicircular canal (ASC) in a patient in whom comprehensive vestibular assessment was useful to identify the underlying pathomechanism. A 56-year-old woman with unsteadiness following repositioning procedures for left-sided benign paroxysmal positional vertigo (BPPV) presented with spontaneous UBN that showed slight right torsional components. A vestibular test battery detected isolated left ASC hypofunction on a video-head impulse test (Video-HIT). We postulated a persistent utriculopetal deflection of the left ASC cupula, which was attributable to entrapment of debris in a narrow canal tract, with consequent sustained inhibition of the ampullary afferents. Although spontaneous UBN receded after impulsive physical therapy, unsteadiness deteriorated into positional vertigo secondary to canalolithiasis involving the ipsilateral posterior canal. In our view, physical therapy possibly fragmented the canalith jam and released free-floating otoconia that eventually settled into the ipsilateral posterior canal. Video HIT revealed normalization of ASC hypofunction, and leftsided posterior canal canalolithiasis was successfully treated using appropriate repositioning procedures. We propose that a canalith jam involving the ASC should be considered in the differential diagnosis of spontaneous UBN, particularly in patients with a history of BPPV and isolated ASC hypofunction detected on video HIT

Pelvic limb alignment measured by computed tomography in purebred English Bulldogs with medial patellar luxation

Objectives: The aim of the study was to describe the differences in pelvic limb alignment between healthy purebred English Bulldogs and those with medial patellar luxation through the measurement of femoral and tibial angles on computed tomography images in multiplanar reconstruction modality (MPRCT). Methods: Twenty-one purebred English Bulldogs were included and divided into two groups: one including healthy dogs (15 limbs) and the other including those with medial patellar luxation (24 limbs). Three different observers used MPR-CT to measure the following angles: anatomical lateral proximal femoral angle (aLPFA), anatomical lateral distal femoral angle (aLDFA), mechanical lateral proximal femoral angle (mLPFA), mechanical lateral distal femoral angle (mLDFA), angle of inclination of the femoral neck (AI), angle of anteversion (AA), mechanical medial proximal tibial angle (mMPTA), mechanical medial distal tibial angle (mMDTA), mechanical caudal distal tibial angle (mCdDTA), mechanical caudal proximal tibial angle (mCdPTA), and the tibial torsion angle (TTA). A Mann-Whitney U test was used to compare each variable in both groups. Results: The values for aLDFA and mLDFA in the medial patellar luxation population were significantly increased compared to healthy subjects (p <0.05). No significant differences were observed for the other variables. Clinical significance: In our population, an increased distal femoral varus was associated with medial patellar luxation. Our results could be useful to determine whether or not angular deformity of the femur is present and help determine the degree of correction necessary to restore alignment

Single cycle to failure in bending of three titanium polyaxial locking plates

Objective: Evaluation of the bending properties in one direction of three titanium polyaxial locking plate systems. Materials and methods: The Polyaxial Advanced Locking System (PAX®) straight plate (PAX SP), the PAX® reconstruction plate (PAX RP), and the VetLOX reconstruction plates (VetLOX) were evaluated individually and as constructs applied to a bone model simulating a fracture gap and compared using a two-way analysis of variance and Tukey posthoc analysis. Results: The PAX SP had the highest values of bending stiffness, bending structural stiffness and bending strength. When tested as plates alone, the PAX RP and VetLOX showed no differences with regard to bending stiffness and bending structural stiffness, whilst the PAX RP had significantly higher strength. The PAX RP construct had significantly higher bending stiffness, bending structural stiffness and bending strength than the VetLOX construct. Clinical relevance: The PAX RP and VetLOX reconstruction plates are much more likely to fail when used as bridging implants, thus adjunct support is needed. The lower bending strength of the VetLOX reconstruction plates suggests it should not be used in fractures under high loads

The Role of Cholangioscopy in Biliary Diseases

Endoscopy plays a central role in diagnostic and therapeutic approaches to biliary disease in both benign and malignant conditions. A cholangioscope is an endoscopic instrument that allows for the direct exploration of the biliary tree. Over the years, technology has improved endoscopic image quality and allowed for the development of an operative procedure that can be performed during cholangioscopy. Different types of instruments are available in this context, and they can be used in different anatomical access points according to the most appropriate clinical indication. The direct visualization of biliary mucosa is essential in the presence of biliary strictures of unknown significance, allowing for the appropriate allocation of patients to surgery or conservative treatments. Cholangioscopy has demonstrated excellent performance in discriminating malignant conditions (such as colangiocarcinoma) from benign inflammatory strictures, and more recent advances (e.g., artificial intelligence and confocal laser endomicroscopy) could further increase its diagnostic accuracy. Cholangioscopy also plays a primary role in the treatment of benign conditions such as difficult bile stones (DBSs). In this case, it may not be possible to achieve complete biliary drainage using standard ERCP. Therapeutic cholangioscopy-guided lithotripsy allows for stone fragmentation and complete biliary drainage. Indeed, other complex clinical situations, such as patients with intra-hepatic lithiasis and patients with an altered anatomy, could benefit from the therapeutic role of cholangioscopy. The aim of the present review is to explore the most recent diagnostic and therapeutic advances in the roles of cholangioscopy in the management of biliary diseases