The effectiveness of the two different devices in the management of developmental dysplasia of the hip

118 DDH was detected by US and classified following Graf\u2019s criteria. A blinded randomized study was effected using Teuffel-Mignon (59) and Coxa-Flex (59) devices, to evaluate effectiveness of both harnesses in management. Type C recovered in 60,09 days, D in 100, IIIA in 103,60, IIIB in 108,66 days. Statistical model shows associations between outcome and pathological type (P<0.001), age at diagnosis (P<0.001) and device (P<0.02). Model shows that on average for each day of delay in diagnosis needed more than half a day for the patient to recover. Model confirmed that patients with serious pathologies need more time to recover. The treatment of DDH is based on the device, on the correct diagnosis with Graf\u2019s method and on the early treatment, when the hip is more mouldable. Our opinion is that one device instead of another isn\u2019t what\u2019s important. What\u2019s fundamental is the choice of the device based on long experience

Madura's foot in native of the Philippines immigrant in northern Italy

Clinical case about a man, emigrated from Philippines. The patient presented a single cutaneous lesion on a foot that was thick, swollen and blackish. There were no fistulas. He remenbers a traumatic implantation of wood splinters on the sole foot 10 years ago. Radiography, Magnetic Resonance, tomographic investigation were performed. The exceptional occurrence of the mycetoma in our countries and absence of clear infectious picture were the reason for an initial clinical misinterpretation as a benign neoplasm of soft tissues.We performed surgical removal of neoplasm, with histological examination.Histopathologic exam revealed an unexpected mass of fungal hyphae; diagnosis of Madura’s foot was confirmed. We started pharmacological therapy with “itracozanole”.Our case offers opportunity to stress need for clinical suspicion of fungal infection, considering increase of immigration by the countries with endemic mycetoma, and we must prepare to observe and treat many pathologies now unknown in our practice

Ischemia with endovascular balloon during disarticulations and amputations of limbs

Objective Limb disarticulation has been widely performed since the 18th century, especially in war surgery. Actually is infrequently done in orthopaedic and vascular surgery, and it is associated with a high mortality rate because of frequent comorbidities. Disarticulation usually is reserved for patients with malignant tumours or gangrene from severe artherosclerosis. During disarticulation, hemodynamic stability can be altered by hemorrhagic events in the femoral or humeral arteries. We propose an endovascular technique for proximal control of the artery to reduce blood loss during disarticulation. Our experience today is limited at hip disarticulation. Material and methods The vascular access was percutaneous at the common femoral artery of the healthy limb. A 6 French (Fr) introducer sheath was placed using the Seldinger technique. Under fluoroscopic control, with a portable vascular C-arm capable of digitally subtracter angiogram and roadmap angiography, a 0.035 inch hydrophilic guide wire was crossed aver into the opposite side iliac artery through a 5F contra angiographic catheter placed at the aortic bifurcation. After a diagnostic angiography the guide wire was replaced with an Amplatz 0.0035 inch, 260 cm long, super stiff guide wire. Then, a 7 9 20 mm Ultra-thinTM SDS balloon catheter was placed in the external iliac artery and systemic heparinization with 2500 UI was performed. The balloon catheter was inflated and femoral pulsation ceased immediately. After proximal, endovascular occlusion, hip disarticulation was accomplished without any hemorrhagic complication. At the end of procedure, the balloon was deflated and removed. Hemostasis of the surgical field completed the procedure. The femoral access in the healthy common femoral artery was controlled with a 6 Fr Angio-seal percutaneous hemostatic system. Results and discussion In hip disarticulation, hemostatic tourniquets cannot be used of the location of the operating field. Therefore, control of bleeding is a major issue in this procedure. Various techniques have been proposed, femoral vessels and nerves were attached before the disarticulation. The use of semi-compliant balloon catheters for endovascular occlusion avoids injury to the endothelium of the vessel wall during balloon inflation. However preoperative assessment, with color-duplex scanning and plain abdominal radiographs, is mandatory; coexisting atherosclerosis often is present especially in elderly patients, and severe wall calcification can lead to vessel rupture and retroperitoneal hematoma, or even balloon catheter rupture. Moreover, color-duplex scanning and radiographs will help in choosing the landing-zone for balloon inflation. Conclusions Endovascular balloon assistance is a simple, safe and effective technique in preventing major arterial bleeding during amputation or disarticulation and can be routinely used

Oxygen content variation and cation doping dependence of (La)1.4(Sr1-yCay)1.6Mn2O7 (y = 0, 0.25, 0.5) bilayered manganites properties

The results of the synthesis and characterization of the optimally doped (La)1.4(Sr1-yCay)1.6Mn2O7 solid solution with y=0, 0.25 and 0.5 are reported. By progressively replacing the Sr with the smaller Ca, while keeping fixed the hole-concentration due to the divalent dopant, the 'size effect' of the cation itself on the structural, transport and magnetic properties of the bilayered manganite has been analysed. Two different annealing treatments of the solid solution, in pure oxygen and in pure argon, allowed also to study the effect of the oxygen content variation. Structure and electronic properties of the samples have been investigated by means of X-ray powder diffraction and X-ray absorption spectroscopy measurements. Magnetoresistivity and static magnetization measurements have been carried out to complete the samples characterization. Oxygen annealing of the solid solution, that showed a limit for about y=0.5, induces an increase of the Mn average valence state and a transition of the crystal structure from tetragonal to orthorhombic while the argon annealing induces an oxygen under-stoichiometry and, in turn, a reduction of the Mn average valence state. Along with the Ca substitution, the Jahn-Teller distortion of the MnO6 octahedra is reduced. This has been directly connected to a general enhancement of the transport properties induced by the Ca-doping. For the same cation composition, oxygen over-stoichiometry leads to higher metal-insulator transition temperatures and lower resistivity values. Curie temperatures (TC) reduce by increasing the Ca-doping. The lower TC for all the annealed samples with respect to the 'as prepared' ones are connected to the strong influence on the magnetic interaction of the point defects due to the oxygen content variation.Comment: 49 pages, 13 figure

Water bears dominated cryoconite hole ecosystems : densities, habitat preferences and physiological adaptations of Tardigrada on an alpine glacier

We investigated the Forni Glacier and the surrounding area in the Alps in terms of habitat preferences, densities, dispersal and desiccation tolerance of glacier tardigrades, which are one of the most common faunal representatives and top consumers in supraglacial ecosystems. To do so, we sampled supraglacial environments (cryoconite holes, debris from ice surface, dirt cones and moraine, mosses from supraglacial stones) and non-glacial habitats (mosses, freshwater sediments and algae), and we installed air traps on the glacier and the nearby area. We found that cryoconite holes on the Forni Glacier are exclusively dominated by one metazoan group of tardigrades, representing one species, Hypsibius klebelsbergi (identified by morphological and molecular approaches). Tardigrades were found in 100% of cryoconite holes and wet supraglacial sediment samples and reached up to 172&nbsp;ind./ml. Additionally, we found glacier tardigrades in debris from dirt cones and sparsely in supraglacial mosses. Glacier tardigrades were absent from freshwater and terrestrial samples collected from non-glacial habitats. Despite the fact that H. klebelsbergi is a typical aquatic species, we showed it withstands desiccation in sediments, but in low temperatures only. Treatments conducted in higher temperatures and water only showed low or no recovery. We suspect successful dispersal with wind might have taken place only when tardigrades desiccated in sediments and were passively transported by cold wind. Limited ability to withstand high temperatures and desiccation may be potential barriers preventing glacier tardigrades inhabiting new, even apparently suitable high mountain water bodies like temporary rock pools

Sonography in the diagnosis of tear of the knee menisci

Goal of the study. The purpose of this study is to compare the accuracy of sonographic to radiographic measurements of subacromial space, and verify its variations in relation to acromial morphology, age, sex and rotator cuff pathologies. Materials and methods. As a result, we have compared a radiographic examination to sonographic examination, each measuring the subacromial space in 200 random shoulders, with a personal method. The sonographic examination was performed by using a HDI 5000 ultrasound scanner Sono-CT with 7.5 MHz linear array transducer. No stand-off pad was utilized. Results. The statistical analysis of the data derived from the two measurements was not sufficient to conclude that the two techniques are different (p>0.8). They also correspond with the radiographic morphology of the acromion. The size of subacromial space was related to the acromial morphology, female gender, and rotator cuff pathology, however, it was not related to age. Discussion and conclusions. Our results clearly show that sonographic measurements are very close to those obtained by X-ray (p>0.8). The Bland\u2013Altman analysis showed that for all groups, the were small enough to give us confidence that the sonographic technique may be used in place of the radiographic one for clinical purposes. One-way ANOVA showed that sonographic measurements were statistically different among the four groups (p<0.05). The sonography demonstrated precision, accuracy and carefulness in the measurement of the subacromial space

Sonographic evaluation of subacromial space

Goal of the study. The purpose of this study is to compare the accuracy of sonographic to radiographic measurements of subacromial space, and verify its variations in relation to acromial morphology, age, sex and rotator cuff pathologies. Materials and methods. As a result, we have compared a radiographic examination to sonographic examination, each measuring the subacromial space in 200 random shoulders, with a personal method. The sonographic examination was performed by using a HDI 5000 ultrasound scanner Sono-CT with 7.5 MHz linear array transducer. No stand-off pad was utilized. Results. The statistical analysis of the data derived from the two measurements was not sufficient to conclude that the two techniques are different (p>0.8). They also correspond with the radiographic morphology of the acromion. The size of subacromial space was related to the acromial morphology, female gender, and rotator cuff pathology, however, it was not related to age. Discussion and conclusions. Our results clearly show that sonographic measurements are very close to those obtained by X-ray (p>0.8). The Bland\u2013Altman analysis showed that for all groups, the were small enough to give us confidence that the sonographic technique may be used in place of the radiographic one for clinical purposes. One-way ANOVA showed that sonographic measurements were statistically different among the four groups (p<0.05). The sonography demonstrated precision, accuracy and carefulness in the measurement of the subacromial space

Post-Depositional Biodegradation Processes of Pollutants on Glacier Surfaces

Glaciers are important fresh-water reservoirs for our planet. Although they are often located at high elevations or in remote areas, glacial ecosystems are not pristine, as many pollutants can undergo long-range atmospheric transport and be deposited on glacier surface, where they can be stored for long periods of time, and then be released into the down-valley ecosystems. Understanding the dynamics of these pollutants in glaciers is therefore important for assessing their environmental fate. To this aim, it is important to study cryoconite holes, small ponds filled with water and with a layer of sediment, the cryoconite, at the bottom, which occur on the surface of most glaciers. Indeed, these environments are hotspots of biodiversity on glacier surface as they host metabolically active bacterial communities that include generalist taxa able to degrade pollutants. In this work, we aim to review the studies that have already investigated pollutant (e.g., chlorpyrifos and polychlorinated-biphenyls (PCBs)) degradation in cryoconite holes and other supraglacial environmental matrices. These studies have revealed that bacteria play a significant role in pollutant degradation in these habitats and can be positively selected in contaminated environments. We will also provide indication for future research in this field