Posterior Tibial Tendon Rupture Associated With Anterolateral Distal Tibial and Medial Malleolar Fracture and a Novel Pattern of Tibiofibular Syndesmotic Injury: A Case Report and Review of the Literature.

A posterior tibial tendon (PTT) rupture associated with ankle fractures is a very rare condition. Ankle pronation and external rotation (PER) movement are the typical traumatic mechanism. This injury is frequently overlooked preoperatively. Early diagnosis and treatment are very important to prevent the serious consequences related to functional PTT insufficiency on biomechanics of the foot. Few cases have been described in the literature that highlight the relationship between PTT rupture and PER type ankle fracture with a medial malleolar fracture. We present a case of a complete PTT rupture in a closed atypical ankle fracture in which a medial malleolar fracture was associated with a very large fragment from the anterolateral distal tibia (Tillaux-Chaput fragment) and a concomitant avulsion fracture from the anteromedial portion of the fibula (Lefort-Wagstaffe fragment), with a novel pattern never described before

Inferior peroneal retinaculum tear with isolated peroneus longus tendon dislocation: A case report of an extremely rare injury, with the proposal of an innovative repair technique

Peroneus longus tendon (PLT) dislocation associated with inferior peroneal retinaculum (IPR) tear is an extremely rare injury. Only 6 cases are described in English literature to date, and its diagnosis is always delayed from the initial trauma. Swelling at the lateral face of the heel and a snapping during the movement of the foot and ankle are typical signs that can induce the suspect of this injury. Operative treatment is required as it typically affects young adults with high functional demands and tendon instability causes pain and functional limitation; also, a neglected dislocated or instable PTL may eventually end up with a rupture. In the few cases reported in literature, different operative techniques have been described, all with excellent results. A case of an initially overlooked dynamic dislocation of the PLT due to IPR tear in a young professional soccer player is described. The lesion was treated with a not yet described operative technique that consists in groove deepening and subsequent IPR repair through transosseous sutures, instead of peroneal tubercle resection as mostly advocated. Final follow up at 15 months showed complete recovery, with a Foot and Ankle Outcome Score of 100%

Prevention and Preparedness of the Messina-Reggio Calabria Strait: An Earthquake Forecasting and Didactic Project

This contribution is addressed to an introductive university course on the correlation existing between radon emission and earthquakes processes held following a flipped-class approach where students receive didactic materials prior to face-to-face lessons. This research was initially started to investigate the real correlation between Radon emission from the Earth and the occurrence of strong earthquakes by using measurements of hourly Radon flow variation. During quiet seismogenic conditions, we observe an unvarying level of Radon emission in the air. Before a strong earthquake, substantial variations of Radon (222Rn) concentration have been observed in the air, probably because of the increase of thermodynamic energy inside the Earth. The physical processes affecting earthquakes are still not fully understood; therefore, we are interested in investigating a wide variety of signals observed before an earthquake, ranging from chemical, electric, and magnetic variations. The goal is to be able to estimate the earthquake magnitude, timing also location in advance with a good approximation. The experimental observation and research studies were carried out by G. Giuliani Permanent Foundation since 2002 in Abruzzo. The innovative methodology of observations with Gamma detectors allowed us to reveal a close correlation between the different physical phenomena during the preparation phase of strong earthquakes. We master the methodology of measuring the hourly flow of 222Rn gas decay, which provides a good correlation with the occurrence of strong earthquakes. To advance the reliability of our assessment, we added more parameters to our observations, such as magnetic and RF. The joint analysis advances our understanding of the processes underlying the earthquake occurrence. The experimental observation of Radon has been tested for more than a decade in the Abruzzo region. The initial results provided the baseline of reliable correlation between radon variations and earthquakes that could be used as an alert mechanism for the forthcoming seismic events. The multiparametric approach of detecting pre-earthquakes signals provided the robustness in detecting the earthquake preparation phase. There are no doubts that by expanding the network of gamma sensors, we achieve much better signal detection, which is critical for the better spatial correlation of Radon variations with the earthquake processes

Ibuprofen and Lipoic Acid Diamide as Co-Drug with Neuroprotective Activity: Pharmacological Properties and Effects in β-Amyloid (1–40) Infused Alzheimer's Disease Rat Model

Both oxidative stress and inflammation are elevated in brains of Alzheimer's disease patients, but their pathogenic significance still remains unclear. Current evidence support the hypothesis that non-steroidal anti-inflammatory drugs (NSAIDs) and antioxidant therapy might protect against the development of Alzheimer's disease, and ibuprofen has the strongest epidemiological support. In the present work our attention was focused on (R)-α-lipoic acid considered as a potential neuroprotective agent in Alzheimer's disease therapy. In particular, we investigated a new co-drug (1) obtained by joining (R)-α-lipoic acid and ibuprofen via a diamide bond, for evaluating its potential to antagonize the deleterious structural and cognitive effects of β-amyloid (1–40) in an infused Alzheimer's disease rat model. Our results indicated that infusion of β-amyloid (1–40) impairs memory performance through a progressive cognitive deterioration; however, ibuprofen and co-drug 1 seemed to protect against behavioural detriment induced by simultaneous administration of β-amyloid (1–40) protein. The obtained data were supported by the histochemical findings of the present study: β-amyloid protein was less expressed in 1-treated than in ibuprofen and (R)-α-lipoic acid alone-treated cerebral cortex. Taken together, the present findings suggest that co-drug 1 treatment may protect against the cognitive dysfunction induced by intracerebroventricular infusion of β-amyloid (1–40) in rats. Thus, co-drug 1 could prove useful as a tool for controlling Alzheimer's disease-induced cerebral amyloid deposits and behavioural deterioration

Impatto dell'epidemia di COVID-19 sulla salute mentale degli infermieri di Terapia Intensiva. Uno studio multicentrico Italiano

Aim: The aim of this study was to evaluate variations in ICU nurses ' mental health status over the COVID-19 outbreak by quantifying the extent of symptoms of depression, anxiety and PTSD over time. Methods: This study was an Italian multicenter prospective cohort study assessing caseness of anxiety, depression and PTSD at 6 and 12 months from the beginning of the COVID-19 outbreak in Italy. Results: A total of 359 nurses, 233 (64.9%) were males and 126 (35.1%) were females were enrolled. At 6 months the caseness prevalence for anxiety, depression and PTSD were 31.3%, 32.1% and 18.7% respectively. At 12 months the caseness prevalence for anxiety, depression and PTSD were 34.8%, 36.4% and 24.1 % respectively. No statistically significant increase between 6 and 12 months was recorded for the caseness prevalence anxiety (p= .29) and depression (p= .19). However, an increase for the caseness prevalence PTSD at 12 months was observed (p= .049). The significant risk factors for the 221 patients with at least one disorders were age 31-40 (RR= 1.44, IC= 1.25-1.89; p < .001), female gender (RR= 1.31, IC= 1.02-1.51; p=. 042) and had 0-5 years of professional experience (RR= 1.36, IC= 1.02-1.63; p = .031). Conclusion: The results of our study may provide support for the implementation of some interventions for well-being in COVID-19 outbreak condition. Key words: Anxiety, Depression, Post-Traumatic stress disorder, Covid-19, Nurses, Mental health.Scopo: Lo scopo di questo studio era valutare le variazioni dello stato di salute mentale degli infermieri in terapia intensiva durante l'epidemia di COVID-19 quantificando l'entità dei sintomi di depressione, ansia e PTSD nel tempo. Metodi: Si tratta di uno studio di coorte prospettico multicentrico italiano che ha valutato la presenza di di ansia, depressione e PTSD a 6 e 12 mesi dall'inizio dell'epidemia di COVID-19. Risultati: Sono stati arruolati un totale di 359 infermieri, 233 (64.9%) uomini e 126 (35.1%) donne. A 6 mesi dall’inizio della pandemia, la prevalenza di disturbi di ansia, depressione e disturbo da stress post-traumatico era rispettivamente del 31.3%, 32.1% e 18.7%. A 12 mesi la prevalenza per ansia, depressione e PTSD era rispettivamente del 34.8%, 36.4% e 24.1%. Nessun aumento statisticamente significativo tra 6 e 12 mesi è stato registrato per l’ansia (p = .29) o la depressione (p = .19). Tuttavia, è stato osservato un aumento del disturbo da stress post-traumatico a 12 mesi (p = .049). I fattori di rischio significativi per i 221 pazienti con almeno un disturbo, erano un età di 31-40 (RR = 1.44, IC = 1.25-1.89; p < .001), sesso femminile (RR = 1.31, IC = 1.02-1.51; p = .042) e avere un esperienza professionale di 0-5 anni (RR = 1.36, IC = 1.02-1.63; p = .031). Conclusioni: I risultati del nostro studio possono fornire supporto per l'implementazione di alcuni interventi per il benessere lavorativo nella condizione di epidemia di COVID-19. Parole chiave: Ansia, depressione, disturbo da stress post-traumatico, Coronavirus, Infermieri, salute mentale

Dietary Intake as a Link between Obesity, Systemic Inflammation, and the Assumption of Multiple Cardiovascular and Antidiabetic Drugs in Renal Transplant Recipients.

Abstract We evaluated dietary intake and nutritional-inflammation status in ninety-six renal transplant recipients, 7.2±5.0 years after transplantation. Patients were classified as normoweight (NW), overweight (OW), and obese (OB), if their body mass index was between 18.5 and 24.9, 25.0 and 29.9, and ≥30 kg/m2, respectively. Food composition tables were used to estimate nutrient intakes. The values obtained were compared with those recommended in current nutritional guidelines. 52% of the patients were NW, 29% were OW, and 19% were OB. Total energy, fat, and dietary n-6 PUFAs intake was higher in OB than in NW. IL-6 and hs-CRP were higher in OB than in NW. The prevalence of multidrug regimen was higher in OB. In all patients, total energy, protein, saturated fatty acids, and sodium intake were higher than guideline recommendations. On the contrary, the intake of unsaturated and n-6 and n-3 polyunsaturated fatty acids and fiber was lower than recommended. In conclusion, the prevalence of obesity was high in our patients, and it was associated with inflammation and the assumption of multiple cardiovascular and antidiabetic drugs. Dietary intake did not meet nutritional recommendations in all patients, especially in obese ones, highlighting the need of a long-term nutritional support in renal transplant recipients

Near-Real-Time Strong Motion Acquisition at National Scale and Automatic Analysis

A strong motion monitoring network records data that provide an excellent way to study how source, path, and site effects influence the ground motion, specifically in the near-source area. Such data are essential for updating seismic hazard maps and consequently building codes and earthquake-resistant design. This paper aims to present the Italian Strong Motion Network (RAN), describing its current status, employment, and further developments. It has 648 stations and is the result of a fruitful co-operation between the Italian government, regions, and local authorities. In fact, the network can be divided into three sub-networks: the Friuli Venezia Giulia Accelerometric Network, the Irpinia Seismic Network, and all the other stations. The Antelope software automatically collects, processes, and archives data in the data acquisition centre in Rome (Italy). The efficiency of the network on a daily basis is today more than 97%. The automatic and fast procedures that run in Antelope for the real-time strong motion data analysis are continuously improved at the University of Trieste: a large set of strong motion parameters and correspondent Ground Motion Prediction Equations allow ground shaking intensity maps to be provided for moderate to strong earthquakes occurring within the Italian territory. These maps and strong motion parameters are included in automatic reports generated for civil protection purposes