The use of knee mega-prosthesis for the management of distal femoral fractures: A systematic review

Introduction: Distal femur fractures (DFFs) are unusual and difficult to deal, especially in elderly patients. A consensus about a gold-standard treatment has not been reached yet. Available options include both conservative and surgical management. In elderly patients a prosthetic replacement could be a valid treatment option. Literature is lacking about the use of mega-prosthesis in this type of fractures. The purpose of the present systematic review is to examine which fracture, both acute and chronic, involving distal femur should be treated by using a mega-prosthesis. Materials and Methods: Studies were identified by searching electronic databases. All studies that enrolled people of any age affected by a DFFs treated by using a megaprosthesis were included. Primary outcomes of the present reviews were: ROM, functional assessment and complications. Two review authors independently selected eligible trials. Disagreements at any stage were resolved by consensus or a third party adjudication. Descriptive statics was used to summarize the data. Results: Thirteen article were finally included in the review. One hundred-four patients were treated with knee megaprosthesis. Three categories of patients were identified: 29 patients were affected by supracondylar femur fracture; 51 patients occurred with a periprosthetic fracture; 24 patients suffered a non-union of a previous supracondylar fracture. The follow-up varied between 6 months to 58 months. All studies showed good results in terms of improving quality of life, resuming activities of daily living (ADLs), early mobilization, ROM, shorter hospital stay. Although not frequent, the only reported complications were infection and aseptic loosening. Discussion: The present review showed that the use of knee megaprosthetic implants could represent a valid treatment option aiming to reduce patients’ immobilitazion and hospital stay. Good clinical outcomes with low rate of complications were reported by all included studies. Literature is lacking about long-term outcomes and complications. Moreover studies comparing knee prostheses and other types of surgical treatment (intramedullary nails, plate fixation system) are needed. Conclusions: Megaprosthesis represent a viable treatment option in patients affected by DFFs (either acute, periprostethic or non-union) because they allow immediate weight-bearing, shorter hospital stay, a fast recovery of knee function and ADLs

New national and regional Annex I Habitat records: from #102 to #122*

New Italian data on the distribution of the Annex I Habitats are reported in this contribution. Specifically, 9 new occurrences in Natura 2000 sites are presented and 34 new cells are added in the EEA 10 km × 10 km reference grid. The new data refer to the Italian administrative regions of Abruzzo, Apulia, Calabria, Latium, Lombardy, Marche, Sardinia, Sicily, Tuscany and Umbria

New national and regional Annex I Habitat records: From #45 to #59

New Italian data on the distribution of Annex I Habitats are reported in this contribution. Specifically, 8 new occurrences in Natura 2000 sites are presented and 27 new cells are added in the EEA 10 km × 10 km reference grid. The new data refer to the Italian administrative regions of Apulia, Campania, Calabria, Lazio, Tuscany, Umbria, Sardinia, and Sicily

Improvement of a real-time lamp protocol for the detection of Xylella fastidiosa in Philaenus spumarius and Neophilaenus campestris

Trabajo presentado en la 2nd European conference on Xylella fastidiosa (how research can support solutions), celebrada en Ajaccio el 29 y 30 de octubre de 2019.The epidemic spread of Xylella fastidiosa (Xf) in southern Italy, with very important economic repercussions for the olive tree industry, makes it advisable to use methodologies for early monitoring of potential tree infection before symptom development in host plants, such as the use of spy insects. This approach is based on the use of molecular tests to detect the presence of Xf, among which the real-time LAMP. In this work, a commercial kit (Enbiotech, Italy) based on this technique, was assayed for detection of Xf in Philaenus spumarius and Neophilaenus campestris specimens in different demarcated areas in Europe. Spiked samples were tested using the entire insect and bulk insect heads artificially inoculated with serial dilutions (from 106 to 100 CFU) of a strain of X. fastidiosa subsp. pauca ST53, isolated from an olive tree in Apulia. In order to exclude the loss of sensitivity due to the presence of inhibitors in the reaction, spiked samples were also tested using the insect heads macerated in the extraction buffer provided by the kit. The lowest bacterial dilution was always detected. Approximately 525 individuals of P. spumarius were sampled in late summer in an infected olive grove in Lecce (Italy) and tested by this assay. The total incidence of infection ranged from 13% to 16%, using single entire insects or single heads, respectively. This incidence was confirmed with bulk heads to assess the diagnostic sensitivity of the real-time LAMP test; with a progressive increase in bacterial detection observed by analysing a higher number of heads. Finally, heads of approximately 280 P. spumarius and N. campestris, collected in an infected almond grove in Alicante (Spain), are being analysed to determine the infection prevalence using the commercial kit and the real-time-PCR of Harper et al. (2010, erratum 2013), to compare the sensitivity of both techniques

Small business ownership and mental health

Small businesses contribute greatly to economic activity and provide employment for large proportions of people worldwide. While the definition of a small business, or a small to medium enterprise (SME), varies across countries, the significant economic contribution made by entrepreneurial activity is consistent. In Australia, businesses with less than 20 workers employed approximately 4.8 million people in 2017, comprising 44% of the workforce (Gilfillan, 2018). Similarly, there are over 4.5 million such business in the USA employing over 20 million people (United States Census Bureau, 2019)

The issue of psychotropic drug monitoring in sexual assault victims

Drug-facilitated sexual assault (DFSA) is a sexual act in which the victim is unable to give or deny consent due unconsciousness caused by intoxication with alcohol and/or psychoactive drugs that have been self-administered (opportunistic DFSA) or surreptitiously administered by the offender (predatory DFSA). . The characteristics of drugs used in DFSA include: being tasteless and odourless and readily soluble in beverages of any type; ability to cause sedation and/or anterograde amnesia; rapidly absorbable after oral administration, and with a most possible rapid clearance from the body (e.g. within 24 h). In DFSA, the victim is unconscious, unable to reject the abuser and unable to clearly remember the circumstances surrounding the intercourse. The consequence is the delay in requiring and carrying out toxicological analysis on the biological matrices of the victim or even the reluctance of the victim to disclose the crime. Moreover, since the so-called “date rape drugs” are often consumed with ethanol and show similar toxicodynamic effects, the diagnosis can be wrongly considered as classical ethanol intoxication