Solitary Tibial Osteolytic Lesion

We report an unusual case of solitary osteolytic tibial metastasis from a primary endometrial cancer in a 62-year-old woman. The primary cancer was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy combined with postoperative external beam radiotherapy, while the tibial metastasis was treated with an above knee amputation. The rarity of the case lies on the fact that metastases distally to the elbow and knee are uncommon and endometrial cancer rarely gives distal bone metastases and particularly solitary to the extremities

Olive oil microemulsions as a biomimetic medium for enzymatic studies: Oxidation of oleuropein

Journal URL: http://www.springerlink.com/content/120382

Natural Antioxidant-Loaded Nanoemulsions for Sun Protection Enhancement

The aim of this study was to formulate nanodispersions to encapsulate antioxidants extracted from olive mill wastewater (OMW) and phycocyanin extracted from Spirulina maxima to act as enhancers for the skin’s protection against UV radiation. For this purpose, two water-in-oil nanoemulsions were prepared using a low-energy homogenization method. Both systems were based on isopropyl myristate as the continuous phase, while water or a mixture of glycerol and water was used as the dispersed phase. Then, antioxidants extracted from OMW and phycocyanin from Spirulina maxima were encapsulated in the water core of the nanoemulsions. The empty and antioxidant-loaded systems were then structurally studied using dynamic light scattering for the detection of their droplet size and stability over time. Electron paramagnetic resonance (EPR) spectroscopy using adequate probes was applied for the characterization of the surfactants’ monolayer in the presence and absence of antioxidants. It was found that the mean droplet diameter of the emulsions was 200 nm. The nanoemulsions remained stable for over 2 months. The encapsulated antioxidants were assessed for their scavenging activity of a model stable radical by applying EPR spectroscopy. It was found that the loaded systems exhibited an increased antioxidant capacity compared with the empty ones. Finally, the most stable system was added to commercial sunscreen lotions and the overall sun protection factor (SPF) was assessed. The sunscreen lotions that contained the nanoemulsions loaded with OMW extracts or phycocyanin showed an increase in their SPF value

Brain abscess and generalized seizure caused by halo pin intracranial penetration: case report and review of the literature

The objective of our study is to report a rare complication of halo pin insertion associated with an epileptic seizure and brain abscess, and to discuss the diagnostic and therapeutic approach to its management. The treatment of unstable cervical spine injuries with a halo vest is an established procedure. Complications of pin penetration such as brain abscess and seizure are rare, and need to be urgently treated. Intracranial abscess and seizure associated with the use of the halo device is an unusual complication, and only a few cases have been reported in the literature. A 21-year-old male had a halo vest placed for the management of an odontoid type II fracture, which he sustained from a motor vehicle accident. Ten weeks after halo ring placement he complained of headaches which relieved by analgesics. After 2 weeks he was admitted at the emergency unit in an unconscious condition after a generalized tonic-clonic seizure. The halo pins were displaced during the seizure and were removed at his admission. No drainage was noted from the pin sites, and a Philadelphia cervical collar was applied. A brain CT and MRI revealed intracranial penetration of both posterior pins and a brain abscess in the right parietal lobe. Computed tomography of the cervical spine revealed stable fusion of the odontoid fracture. Cultures from the pin sites were negative; however, intravenous wide spectrum antibiotic treatment was administered to the patient immediately for 4 weeks followed by oral antibiotics for additional 2 weeks. Anti-epileptic medication was also started at his admission. The patient was discharged from the hospital in 6 weeks without symptoms, continuing anti-epileptic medication. On the follow-up visits he had fully recovered without any neurologic sequelae. In conclusion, complications of halo pin penetration are rare which need immediate intervention. Any neurologic or infectious, local or generalized, symptom need to be investigated urgently with available imaging techniques and treated promptly. Pin over-tightening may cause bone penetration and possible deep cranial infection with serious complications

Prevention of heterotopic ossification in high-risk patients with total hip arthroplasty: the experience of a combined therapeutic protocol

The combination of radiotherapy and indomethacin for the prevention of heterotopic ossification (HO) in high-risk patients undergoing total hip arthroplasty (THA) has not been reported. The aim of the present study was to present the experience of our department with this combined therapeutic protocol. Fifty-four patients who underwent THA received a single dose of 7 Gy of postoperative radiotherapy and 75 mg of indomethacin for 15 days. Patients were analyzed for clinical and radiographical evidence of HO development at 1 year postoperatively. The overall radiographical incidence of HO was 20.4% (95% CI 10.6–33.5%), while only 1 patient with clinically significant HO was seen. Patients with secondary arthritis due to congenital hip disease had a statistically significantly higher incidence of HO compared with those with osteoarthrosis. The clinical assessment with the Merle d’Aubigné score showed that patients with radiographic documentation of HO had a lower mean score compared with those with no evidence of HO. No treatment-related side effects were seen. Combined radiotherapy and indomethacin was effective in preventing heterotopic ossification after total hip arthroplasty. The evaluation of this efficacy compared with radiotherapy or NSAIDs alone should be the future target of larger randomized designs