Novel nano-composite multi-layered biomaterial for the treatment of multifocal degenerative cartilage lesions

We report on a 46-year-old athletic patient, previously treated with anterior cruciate ligament reconstruction, with large degenerative chondral lesions of the medial femoral condyle, trochlea and patella, which was successfully treated with a closing-wedge high tibial osteotomy and the implant of a newly developed biomimetic nanostructured osteochondral bioactive scaffold. After 1 year of follow-up the patient was pain-free, had full knee range of motion, and had returned to his pre-operation level of athletic activity. MRI evaluation at 6 months showed that the implant gave a hyaline-like signal as well as a good restoration of the articular surface, with minimal subchondral bone oedema. Subchondral oedema was almost non-visible at 12 months

Fibrin glue improves osteochondral scaffold fixation: study on the human cadaveric knee exposed to continuous passive motion

SummaryObjectiveTo evaluate stability and integrity of bi-layer and three-layer collagen-hydroxyapatite (C-HA) osteochondral scaffolds in a human cadaveric knee exposed to continuous passive motion (CPM) with and without loading and the role of added fibrin glue to improve the press-fit fixation of C-HA scaffolds.DesignOsteochondral lesions (2.0 × 1.5 cm) were chiseled out on both condyles and trochlea in eight human cadaveric knees. A total of 24 bi-layer (5 mm, four in each condyle) or three-layer C-HA scaffolds (8 mm, eight in the trochlea, four in each condyle) were first press-fit implanted and underwent testing with CPM, 90 cycles, 0°–90°. The second set of 24 scaffolds was implanted in cleaned lesions with the addition of fibrin glue. Two knees with fibrin glue fixation were additionally exposed to 15 kg loading, with 30 cycles of CPM, 0°–30°. Then, the knees were reopened and the scaffolds were evaluated using semi-quantitative Drobnic and modified Bekkers scores.ResultsAll but two scaffolds remained in the lesions site throughout CPM. Two implants failed: both were bi-layer osteochondral scaffolds, press-fit implanted at the lateral femoral condyle (LFC). A statistically significant difference was obtained between press-fit and fibrin glue implants with both Drobnic (2.9 ± 0.7 vs 4.3 ± 0.1, P < 0.0005) and Bekkers (3.3 ± 1.0 vs 5.0 ± 0.1, P < 0.0005) scores. Additional knee loading did not affect fibrin glue scaffold fixation or integrity.ConclusionThis cadaveric study showed fibrin glue notably improved bi-layer or three-layer C-HA scaffold press-fit fixation regardless of lesion location. It is therefore recommended that fibrin glue be used during surgery to improve early post-operative C-HA scaffold stability and integrity

EQUATION REGRESSION MODEL FOR THE 50 M FREESTYLE PERFORMANCE IN ELITE MASTER SWIMMERS

This study was conducted during the 10th World Masters Championships, held in Riccione, Italy, June 3-11, 2004. The aim was to investigate, in male and female elite master swimmers, the relationships between performance time and age, anthropometric characteristics (weight, stature, arm and forearm lengths and forearm volume) and muscle strength (hand grip). Performance times were recorded during 50 m freestyle events. Anthropometric values and hand grip were collected the same day the competition in a field laboratory organised beside the swimming pool. For this study we considered twenty eight volunteers: 15 men aged 42-81 years and 13 women aged 4173 years. Firstly, the anthropometrical characteristics. the hand grip strength and the performance time were used for a simple correlation analysis. Subsequently a multiple regression analysis was carried out to create a swimming time prediction model for the 50 freestyle performances. It revealed that in 50 m freestyle women race, age, weight and strength explained about 97% of the variance in performance. This study provided novel information which could be useful in designing training programs, optimizing swimmer's resources or capabilities

Rhodococcus equi Pneumonia in Kidney Transplant Recipient Affected by Acute Intermittent Porphyria: A Case Report

Rhodococcus equi is a gram-positive coccobacillus responsible for severe infections in patients with weakened immune systems. R equi generally causes pnumonia that may evolve into fatal systemic infection if left untreated. Here, we present a case of a 67-year-old woman affected by acute intermittent porphyria (AIP) who developed R equi pneumonia 7 months after kidney transplant. Although clinical features at presentation were nonspecific, lung computed tomography showed right perihilar consolidation with a mass-like appearance causing bronchial obstruction. Appropriate antibiotic including intravenous meropenem and oral azithromycin that was then switched to oral levofloxacin and oral azithromycin along with reduction of immunosuppressive therapy resolved pneumonia without provoking an acute attack of porphyria. AIP limited the choice of antibiotics for the treatment of R equi infection because some potentially porphyrinogenic antibacterial agents were avoided. Based on this experience, azithromycin and meropenem can be safely administered for the treatment of R Equi infection in patients with AIP

INFLUENCE OF AGE AND HAND GRIP STRENGTH ON FREESTYLE PERFORMANCES IN MASTER SWIMMERS

The aim of our work was to examine whether age and hand grip strength are correlated with 50m, 100m, 200m, 400m, 800m swimming performance times in Master swimmers and how correlation varies considering short, middle or long distances. The main finding of this work was that hand grip strength and age correlated significantly at each distance. Hand grip strength showed a relevant influence on performance time and explained 52% of variance of performance time in 50m race freestyle and only 15% in 800m race. Increasing age was a disadvantageous factor for performance time, and explained 45% of variance of performance time in 800m race freestyle and only 20% in 50 m race

Wet snow hazard for power lines: a forecast and alert system applied in Italy

Wet snow icing accretion on power lines is a real problem in Italy, causing failures on high and medium voltage power supplies during the cold season. The phenomenon is a process in which many large and local scale variables contribute in a complex way and not completely understood. A numerical weather forecast can be used to select areas where wet snow accretion has an high probability of occurring, but a specific accretion model must also be used to estimate the load of an ice sleeve and its hazard. All the information must be carefully selected and shown to the electric grid operator in order to warn him promptly. &lt;br&gt;&lt;br&gt; The authors describe a prototype of forecast and alert system, WOLF (&lt;b&gt;W&lt;/b&gt;et snow &lt;b&gt;O&lt;/b&gt;verload a&lt;b&gt;L&lt;/b&gt;ert and &lt;b&gt;F&lt;/b&gt;orecast), developed and applied in Italy. The prototype elaborates the output of a numerical weather prediction model, as temperature, precipitation, wind intensity and direction, to determine the areas of potential risk for the power lines. Then an accretion model computes the ice sleeves' load for different conductor diameters. The highest values are selected and displayed on a WEB-GIS application principally devoted to the electric operator, but also to more expert users. Some experimental field campaigns have been conducted to better parameterize the accretion model. Comparisons between real accidents and forecasted icing conditions are presented and discussed

Satisfactory clinical results and low failure rate of medial collagen meniscus implant (CMI) at a minimum 20 years of follow-up

Purpose: The aim of the study was to evaluate the long-term clinical results, reoperations, surgical failure and complications at a minimum of 20&nbsp;year of follow-up of the first 8 medial CMI scaffolds implanted by a single surgeon during a pilot European Prospective study. Methods: Seven (88%) out of 8 patients were contacted. The Cincinnati Score, VAS, and Lysholm score were collected. Moreover, magnetic resonance imaging (MRI) was performed on 4 patients at the last follow-up. Complications, reoperations and failures were also investigated. Results: The average follow-up was 21.5 ± 0.5&nbsp;years. One patient underwent TKA after 13&nbsp;years from CMI implantation; a second patient underwent valgus high tibial osteotomy 8&nbsp;years after the index surgery and another patient underwent anterior cruciate ligament hardware removal at 21&nbsp;years of follow-up. At the final follow-up, 3 patients were rated as “Excellent”, 1 as “Good” and 2 as “Fair” according to the Lysholm score. The Cincinnati score and the VAS were substantially stable over time. The MRI showed a mild osteoarthritis progression in 3 out of 4 patients according to the Yulish score, and the CMI signal was similar to the mid-term follow-up revealing 3 cases of myxoid degeneration and 1 case of normal signal with reduced scaffold size. Conclusion: The medial CMI is a safe procedure: satisfactory clinical results and a low failure rate could be expected even at a long-term follow-up. For this purpose, the correct indication as well as correcting axial malalignment and addressing knee instability at the time of the index surgery is mandatory. On the other hand, a mild osteoarthritis progression could be expected even after meniscus replacement. Level of evidence: IV