Restablecimiento de una nueva normalidad biomecánica en las graves deformidades de la rodilla

En las graves alteraciones morfo-estructurales de la rodilla, con inestabilidad en varusvalgus, las prótesis vinculadas a bisagra simple, tendían a fallar. El presente trabajo se propone evidenciar que, en tales situaciones, la prótesis vinculada a rotación representa la solución más idónea para el restablecimiento de una nueva normalidad. 18 pacientes (13 mujeres y 5 hombres) con edad media de 68 años han sido sometidos a intervención para colocar prótesis de rodilla. Ha sido utilizado el implante Endo-Model® de Waldemar Link®, prótesis vinculada a rotación. El follow-up medio es de 19 meses con controles a 2, 3, 6 y 12 meses y después anuales. Los resultados han sido: óptimo para 17 pacientes y bueno para 1 paciente, en el cual se ha verificado la ruptura post-operatoria del tendón cuadricipital. Nuestra casuística muestra resultados comparables a los de otros autores. No hemos tenido movilizaciones asépticas o sépticas, ni complicaciones médicas intraoperatorias y post-operatorias. Consideramos que, en presencia de la correcta indicación clínica, la utilización de la prótesis vinculada a rotación es preferible a la de deslizamiento porque disminuye el riesgo de una movilización precoz del implante y del desgaste anormal de los componentes protésicos, restableciendo una nueva normalidad biomecánica.Peer Reviewe

The role of weighing-bathing sequence and postmenstrual age in eliciting adaptive/maladaptive responses in very low birth weight preterm infants

Purpose: In the neonatal intensive care unit, preterm infants are exposed to several stressful stimuli. Inappropriate stimulation led to high risk for short- and long-term neurocognitive disabilities. This study aimed to evaluate whether the sequence of execution of weighing/bathing nursing procedures and postmenstrual age (PMA) have any effect on preterm infants' stress responses. Design and Methods: Prospective cross-sectional study on a sample of 21 preterm infants. Responses to the procedures were assessed using an observational sheet based on Als's Synactive Theory of Development. Autonomic and motor responses were scored according to five-point Likert scales. The order of execution of weighing/bathing nursing procedures and PMA were documented. Effects of weighing/bathing execution sequence and PMA on autonomic and motor response scores were analyzed by linear multiple regression analysis. Results: The sequence of execution had a significant effect on the autonomic score during weighing (p =.035), evidencing more stress when weighing was executed first. A higher level of stress response on the autonomic score during both weighing (p =.015) and bathing (p =.018) procedure was independently associated with a lower infant PMA. Conclusions and Practice Implications: The real-time recognition of adaptive/maladaptive responses allows nurses to personalize their approach to preterm infants, taking into account PMA and adjusting the appropriate sequence of execution of weighing/bathing nursing procedures

Comparison of three domestications and wild-harvested plants for nutraceutical properties and sensory profiles in five wild edible herbs: Is domestication possible?

In this study, five wild edible herbs traditionally consumed in the Tuscany region (Italy) were evaluated for their potential in human nutrition. The nutraceutical characterization of Rumex acetosa, Cichorium intybus, Picris hieracioides, Sanguisorba minor, and Plantago coronopus, as well as their sensory profile were reported. Additionally, a preliminary assessment of completely different domestication of the wild species (named "soilless", pot, and open field) was conducted to verify the possibility of their marketability, which is impossible if the plants are only gathered as wild. The open field domestication allowed to obtain plants with nutraceutical and sensory profiles similar to those of the wild species, especially in C. intybus, P. hieracioides, and S. minor. The pot domestication allow to obtain plants with chlorophyll and carotenoid contents close to those of the wild species, as well as a lower total phenolic and flavonoid content and ascorbic acid content than wild species. In the "soilless"method, R. acetosa and P. coronopus exhibited a high quality in terms of phytochemicals and antioxidant activity. Afterward, the sensory profile was strongly affected by the domestication in terms of the palatability, except for R. acetosa and P. coronopus, which displayed Hedonic Index (HI) values close to the consumer acceptability limit (HI = 6). A sensory profile similar to that of wild species was reported in open field domestication, whereas a worse sensory profile was reported in P. hieracioides and C. intybus domesticated using the soilless method. Finally, according to the preliminary assessment carried out in this study through an analysis of the general nutraceutical properties, S. minor was shown to be the most promising species thanks to its intrinsically highest nutraceutical properties considering the marketability of wild edible herbs as "new"functional food. However, further research on the bioavailability and bioactivity tests of nutraceutical compounds present in this species are required to confirm the findings of this study

3-Tesla MR spectroscopy in patients subjected to bone marrow transplantation: clinical correlations.

PURPOSE: This study evaluated the usefulness of 3-Tesla magnetic resonance (MR) spectroscopy in patients with non-Hodgkin's lymphoma (NHL) undergoing bone marrow transplantation (BMT). MATERIALS AND METHODS: Twelve NHL patients who were candidates for BMT underwent three MR examinations of the lumbosacral spine: before ablative therapy for BMT, 15±4 days and 54±24 days after BMT. The MR study was supplemented by spectroscopic analysis. The lipid content was calculated and expressed as a percentage of lipid signal intensity relative to total signal intensity [fat fraction (FF)]. RESULTS: In the first MR study, the FF was 62.5±7%, in the second it was 70.75±5% and in the third it was 75±1%. We observed a statistically significant difference between FF values calculated at the various MR studies (p=0.02) and between red blood cell count (p=0.017), platelet count (p=0.003) and haematocrit (p<0.001) at the three MR studies. FF had a statistically significant correlation with the number of circulating platelets (p<0.01) CONCLUSIONS: MR spectroscopy of the bone marrow of NHL patients undergoing BMT is noninvasive and highly sensitive for characterising and monitoring bone marrow after BMT

The residues of fruit and vegetable pro-cessing: From “waste” to “resource” of natural phytochemical compounds

The project of Sant’Anna School, in line with the Italian legislation on limiting waste and promoting the redistribution of surpluses and unused goods, aimed to study the potential healthy value of residues obtained from the trans-formation of fruit and vegetable products that represent a cost, as they must be handled, stored and disposed according to stringent actual regulations. Two “model” species (potato and apple) were considered to test the possibility of using industrial processing waste for food applications. The extracts, obtained with “green” methods from potato and apple peels, were evaluated as natural antioxidants in the preparation of minimally processed fresh­cut apple. Results suggest the possibility to use these novel byproduct extracts as valuable alter-native treatments to traditional chemical additives employed for minimally processed apples

By-products from winemaking and olive mill value chains for the enrichment of refined olive oil: Technological challenges and nutraceutical features

A growing body of literature is available about the valorization of food by-products to produce functional foods that combine the basic nutritional impact with the improvement of the health status of consumers. In this context, this study had two main objectives: (i) An innovative multistep extraction process for the production of a refined olive oil enriched with phenolic compounds (PE-ROO) extracted from olive pomace, olive leaves, or grape marc was presented and discussed. (ii) The most promising PE-ROOs were selected and utilized in in vitro and in vivo trials in order to determine their effectiveness in the management of high fat diet-induced-metabolic syndrome and oxidative stress in rats. The best results were obtained when olive leaves were used as source of phenols, regardless of the chemical composition of the solvent utilized for the extraction. Furthermore, while ethanol/hexane mixture was confirmed as a good solvent for the extraction of phenols compounds soluble in oil, the mix ROO/ethanol also showed a good extracting power from olive leaves. Besides, the ROO enriched with phenols extracted from olive leaves revealed an interesting beneficial effect to counteract high fat diet-induced-metabolic disorder and oxidative stress in rats, closely followed by ROO enriched by utilizing grape marc

A kinetic approach to describe the time evolution of red wine as a function of packaging and storage conditions

With the aim to determine the influence of packaging in preserving the quality of wine, in this research project the chemical and sensorial evolution of a red wine stored in different packaging materials (glass bottles vs multilayer Tetrabriks®) has been evaluated over a period of 12 months. Furthermore, two different temperature levels (4 and 20 °C) for each packaging solution were maintained throughout the storage period. The results show how the characteristics of packaging could deeply affect wine quality as a function of the storage conditions used, and suggest that with their rational optimization the quality of red wine during storage can be kept and its shelf life extended. In this context, the kinetic characterization of the time evolution of some chemical compounds that can be assumed as indexes of wine oxidation rate could enhance the consumer’s enjoyment during tasting. Under the adopted experimental conditions, the rate of wine aging was higher when the storage temperature increased. Furthermore, after 12 months of storage at room temperature, the glass bottles generally better preserved red wine from oxidation than multilayer Tetrabriks®

Essential oils as post-harvest crop protectants against the fruit fly drosophila suzukii: Bioactivity and organoleptic profile

The essential oils extracted from mandarin (Citrus reticulata Blanco) fruits, and from tea tree (Maleleuca alternifolia (Maiden and Betche) Cheel) leaves have been chemically analyzed and tested for their bioactivity against D. suzukii. Besides, to estimate consumers’ acceptability of the essential oil (EO) treatments, we evaluated their impact on the organoleptic characteristics of the EO-treated fruits. The main chemical constituents of the two EOs were 1,8-cineole and 4-terpineol for M. alternifolia (22.4% and 17.6% of the total components, respectively), and limonene (83.6% of the total components) for C. reticulata. The behavioral tests indicate that the two EOs are able to deter D. suzukii oviposition and that D. suzukii shows positive chemotaxis to low concentrations of the EOs and negative chemotaxis when the EO concentration increases. While no negative effects on the organoleptic profiles were detected for fruits treated with C. reticulata EO, the olfactory profile of fruits treated with M. alternifolia EO was so negative that they were defined as “not suitable for consumption” by panellists. Overall, our findings indicate that the use of EOs for the post-harvest protection of small fruits is feasible, provided that the essential oils are selected not only for their bioactivity against the insect pest but also for their affinity with the consumers’ sensorial system

Secondary prevention medical therapy and outcomes in patients with myocardial infarction with non-obstructive coronary artery disease

Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous entity with relevant long-term major cardiovascular events. Several trials have demonstrated that dual antiplatelet therapy (DAPT), b-blocker, renin-angiotensin-aldosterone system (RAAS) inhibitor and statin therapy improve the prognosis in patients with obstructive myocardial infarction (ob-MI). However, evidence on the best medical therapy for secondary prevention in MINOCA patients is lacking. Purpose: To investigate the effects of secondary prevention treatments at discharge on mid-term outcomes in MINOCA. Methods: Patients with acute myocardial infarction (MI) undergoing early coronary angiography between 2016 and 2018 were extracted from a clinical database. The diagnosis of MINOCA was made according to 2016 ESC MINOCA Position Paper criteria. Second-level diagnostic work-up including cardiac magnetic resonance was performed to exclude non-ischemic troponin elevation cause. The relationship between treatments and outcomes was evaluated by using Kaplan-Meier survival analysis and Cox regression models. All confirmed MINOCA were followed in our outpatient clinics. The primary endpoints were all-cause mortality, re-hospitalization for MI and a composite outcome including all-cause mortality, hospitalization for MI and ischemic stroke (MACE). Results: Out of 1,141 AMI who underwent coronary angiography, 134 were initially diagnosed as MINOCA. Patients with MINOCA were less likely to receive secondary prevention treatments than patients with obstructive coronary artery disease (CAD) MI (respectively, 42.1% vs 81.8% for DAPT; 75.5% vs 89.6% for b-blockers; 64.7% vs 80.3% for RAAS inhibitor and 63.9% vs 83% for statins). Based on the diagnostic work-up completed during the first month after discharge, a final sample of 88 patients had confirmed MINOCA. During an average follow-up of 19.35 ± 10.65 months, all-cause mortality occurred in 11 (12.5%) patients, recurrence of MI in 4 (4.5%), and MACE in 15 (17.0%) patients. Patients treated with RAAS inhibitors and statins had a significantly longer survival. On the contrary, no increase in survival was found in patients treated with b-blockers or DAPT. Cox multivariable analysis, including all secondary prevention drugs, showed that only RAAS inhibitors were associated with reduced all cause-mortality and MACE. Conclusion: This prospective study suggests that RAAS inhibitor therapy provides midterm beneficial effects on outcomes in MINOCA patients; in contrast, dual antiplatelet, b-blocker and statin therapy had no effects on mortality and MACE. These results should be considered preliminary and warrant confirmation from larger studies

Secondary prevention medical therapy and outcomes in patients with myocardial infarction with non-obstructive coronary artery disease

Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous entity with relevant long-term major cardiovascular events. Several trials have demonstrated that dual antiplatelet therapy (DAPT), b-blocker, renin-angiotensin-aldosterone system (RAAS) inhibitor and statin therapy improve the prognosis in patients with obstructive myocardial infarction (ob-MI). However, evidence on the best medical therapy for secondary prevention in MINOCA patients is lacking. Purpose: To investigate the effects of secondary prevention treatments at discharge on mid-term outcomes in MINOCA. Methods: Patients with acute myocardial infarction (MI) undergoing early coronary angiography between 2016 and 2018 were extracted from a clinical database. The diagnosis of MINOCA was made according to 2016 ESC MINOCA Position Paper criteria. Second-level diagnostic work-up including cardiac magnetic resonance was performed to exclude non-ischemic troponin elevation cause. The relationship between treatments and outcomes was evaluated by using Kaplan-Meier survival analysis and Cox regression models. All confirmed MINOCA were followed in our outpatient clinics. The primary endpoints were all-cause mortality, re-hospitalization for MI and a composite outcome including all-cause mortality, hospitalization for MI and ischemic stroke (MACE). Results: Out of 1,141 AMI who underwent coronary angiography, 134 were initially diagnosed as MINOCA. Patients with MINOCA were less likely to receive secondary prevention treatments than patients with obstructive coronary artery disease (CAD) MI (respectively, 42.1% vs 81.8% for DAPT; 75.5% vs 89.6% for b-blockers; 64.7% vs 80.3% for RAAS inhibitor and 63.9% vs 83% for statins). Based on the diagnostic work-up completed during the first month after discharge, a final sample of 88 patients had confirmed MINOCA. During an average follow-up of 19.35 \ub1 10.65 months, all-cause mortality occurred in 11 (12.5%) patients, recurrence of MI in 4 (4.5%), and MACE in 15 (17.0%) patients. Patients treated with RAAS inhibitors and statins had a significantly longer survival. On the contrary, no increase in survival was found in patients treated with b-blockers or DAPT. Cox multivariable analysis, including all secondary prevention drugs, showed that only RAAS inhibitors were associated with reduced all cause-mortality and MACE. Conclusion: This prospective study suggests that RAAS inhibitor therapy provides midterm beneficial effects on outcomes in MINOCA patients; in contrast, dual antiplatelet, b-blocker and statin therapy had no effects on mortality and MACE. These results should be considered preliminary and warrant confirmation from larger studies