Immunological changes in patients with primary osteoarthritis of the hip after total joint replacement

We aimed to assess whether the immunological abnormalities which have been observed in patients with loose total hip replacements (THRs) are present in patients with a well-fixed prosthesis. We examined blood samples from 39 healthy donors, 22 patients before THR and 41 with well-fixed THRs of different types (15 metal-on-metal, 13 metal-on-polyethylene, 13 ceramic-on-ceramic). Before THR, the patients showed a decrease in leukocytes and myeloid cells in comparison with healthy donors, and a prevalence of type-1 T lymphocytes, which was confirmed by the increase in ratio of interferon-γ to interleukin 4. Moreover, patients with metal-on-metal or metal-on-polyethylene implants showed a significant decrease in the number of T lymphocytes and a significant increase in the serum level of chromium and cobalt, although no significant correlation was observed with the immunological changes. In the ceramic-on-ceramic group, leukocytes and lymphocyte subsets were not significantly changed, but a significant increase in type-2 cytokines restored the ratio of interferon-γ to interleukin 4 to normal values. We conclude that abnormalities of the cell-mediated immune response may be present in patients with a well-fixed THR, and that the immunological changes are more evident in those who have at least one metal component in the articular coupling

Gokyo Khumbu/Ama Dablam Trek 2012

In the expedition Gokyo Khumbu/Ama Dablam Trek 2012, we studied the effects of two 12-day training periods performed both at sea level and at high altitude. The main results on adult women have been published in six original articles. In women, high altitude trekking induced CD69 T cell activation and promoted anti-stress effects of the immune responses and the oxidative balance (1). Low-to-moderate exercise training at s.l. improves the regenerative capacity of skeletal muscle and depicted the epigenetic signature of satellite cells. The cell differentiation was favored by increased [Ca2+]i and fusion index (2). On the contrary, the training in hypobaric-hypoxia induced oxidative stress and impaired the regenerative capacity of satellite cells (6). Although training did not significantly modify muscle phenotype , it induced beneficial adaptations of the oxygen transport-utilization systems witnessed by faster VO2 kinetics at exercise onset (3). The two training periods did not influence the postural stability (4). In young adult women, micturition physiological parameters were affected during adaptation to hypoxia; the correlation with SpO2 strongly suggests a role of hypoxia in these changes (5

Application of systematic design methods to cultural heritage preservation

The preservation of cultural heritage often involves the design of systems with different purposes, as for example the devices for extraction of data from inaccessible locations and/or demonstrative models. For the latter, when the starting information about the model to be designed is incomplete, the task is not trivial, and different interpretations of the system can lead to different design outcomes. Moreover, other requirements concerning size, materials and interactivity, make this a real engineering design task, where actors with conflicting needs can be involved. Accordingly, to ensure a comprehensive fulfilment of the task, it is possible to follow engineering systematic design approaches that, even if originally developed for the development of industrial systems, can be conveniently used for different fields of application. More specifically, these design methods ensure the design of cost-effective solutions by reducing the useless and costly design iterations that often characterize non-structured procedures. In particular, the present paper shows the application of systematic methods for the interpretation, the design and the development of realistic physical models from some of the Leonardo da Vinci’s machines, for the Museo Leonardiano of Vinci (Italy). The followed approach allowed to efficiently gather the starting list of design requirements, and to engage a successful interaction among the designers, the historians, the museum staff and the architect involved in the showroom design. The key points of the systematic design methodology are presented in this paper, together with some applicative examples from the Da Vinci’s models. Other possible application of systematic design approaches are also presented, with the aim of showing some representative examples were the Engineering design and problem-solving methods can support the preservation of cultural heritage

Elbow arthroplasty: current techniques and complications

This handbook provides detailed, state-of-the-art information on total elbow replacement, covering all relevant aspects, from basic science and pathogenesis to clinical and instrumental evaluation, and treatment techniques. Elbow arthroplasties have undergone a considerable evolution in recent decades due to better anatomical and biomechanical knowledge, continuous development of biomaterials, improvement of operative techniques and better definition of the surgical indications. This book enables readers to better understand the main indications, the outcomes and the complications following total elbow arthroplasty, radial head arthroplasty, radiocapitellar arthroplasty and distal humerus hemiarthroplasty. The closing section addressing the post-operative management of the patients who have undergone elbow replacement is provided in order to optimize the relationship between the orthopedic surgeon and the rehabilitation physician. Written by leading experts in the field, the book is an invaluable tool for experienced surgeons, orthopedic residents and shoulder fellows

Antibiotic resistance of gram-negative bacteria from wild captured loggerhead sea turtles

Sea turtles have been proposed as health indicators of marine habitats and carriers of antibiotic-resistant bacterial strains, for their longevity and migratory lifestyle. Up to now, a few studies evaluated the antibacterial resistant flora of Mediterranean loggerhead sea turtles (Caretta caretta) and most of them were carried out on stranded or recovered animals. In this study, the isolation and the antibiotic resistance profile of 90 Gram negative bacteria from cloacal swabs of 33 Mediterranean wild captured loggerhead sea turtles are described. Among sea turtles found in their foraging sites, 23 were in good health and 10 needed recovery for different health problems (hereafter named weak). Isolated cloacal bacteria belonged mainly to Enterobacteriaceae (59%), Shewanellaceae (31%) and Vibrionaceae families (5%). Although slight differences in the bacterial composition, healthy and weak sea turtles shared antibiotic-resistant strains. In total, 74 strains were endowed with one or multi resistance (up to five different drugs) phenotypes, mainly towards ampicillin (~70%) or sulfamethoxazole/trimethoprim (more than 30%). Hence, our results confirmed the presence of antibiotic-resistant strains also in healthy marine animals and the role of the loggerhead sea turtles in spreading antibiotic-resistant bacteria