Combined Biologic Augmentation Strategies with Collagen Patch Graft, Microfractures, and Platelet Concentrate Injections Improve Functional and Structural Outcomes of Arthroscopic Revision Rotator Cuff Repair

Background: Arthroscopic revision rotator cuff repair (ARRCR) is challenging. Biologic strategies seem to be promising. The aim was to evaluate the effectiveness of the combination of microfractures of the greater tuberosity, augmentation with collagen patch graft, and platelet concentrate injections in ARRCR. Methods: A retrospective comparative study was conducted on patients that underwent ARRCR with a minimum follow-up of two years. Patients in the augmentation group underwent ARRCR combined with microfractures, collagen patch graft, and postoperative subacromial injections of platelet concentrate. A standard rotator cuff repair was performed in the control group. Primary outcome: Constant-Murley score (CMS). Secondary outcomes: disease-specific, health-related quality of life using the Disabilities of the Arm, Shoulder, and Hand (DASH) score; assessment of tendon integrity with magnetic resonance at least six months after surgery. Significance was set at p < 0.05. Results: Forty patients were included. Mean follow-up was 36.2 ± 8.7 months. The mean CMS was greater in the augmentation group (p = 0.022). No differences could be found for DASH score. Healing failure rate was higher in the control group (p = 0.002). Conclusion: Biologic augmentation of ARRCR using a combination of microfractures, collagen patch graft, and subacromial injections of platelet concentrate is an effective strategy in improving tendon healing rate. Level of evidence: retrospective cohort study, level III

Adolescents and primary herpetic gingivostomatitis: an Italian overview

Aim The aim of this study was to investigate the therapies administered to Italian adolescents with primary herpetic gingivostomatitis (PHGS) Methods The medical records of 74 adolescents with PHSG were reviewed. The following data were recorded: age, gender, day of onset, type of treatment, lesions' severity, pain scoring, eating, and drinking ability. The oral examination was performed at the first evaluation (T0) and after one week (T1). Results All patients showed up at the first visit at least 48 h after the onset of symptoms. No patient was prescribed an antiviral therapy. An antibiotic therapy was prescribed in order to prevent secondary bacterial infections. Fifteen patients had been treated with non alcoholic chlorhexidine rinses (group A), 29 patients with non alcoholic chlorhexidine rinses plus hyaluronic acid gel (group B); 30 patients with non alcoholic chlorhexidine rinses plus Mucosyte (R) (group C). A significant improvement of the pain scoring and lesions' severity was noted in group C. Conclusion In Italian adolescents, PHGS is diagnosed at least 48 h after onset and the antibiotic therapy is widely prescribed in order to prevent overinfections. Among topical therapies, an association of verbascoside and sodium hyaluronhate seems to favour a faster healing

Tongue carcinoma in young adults : a review of the literature

A recent reduction in the number of smoke-related tumours has been observed thanks to the diffusion of anti-tobacco campaigns carried out in the majority of developed countries. Nevertheless, as demonstrated by recent global epidemiologic studies, squamous cell carcinoma of the mobile tongue appears to be progressively increasing in incidence, particularly among young adults and especially in females. The driving mechanism responsible for such changes is still to be precisely defined. Several genetic studies have compared the mutational pattern of tongue squamous cell carcinoma in young adults to that of more elderly patients, without identifying significant differences that may help in better characterising this subgroup of subjects. Tongue squamous cell carcinomas in young adults have been historically considered as particularly aggressive clinical entities, with a high risk of loco-regional relapse, survival rates inferior to those of the general head and neck cancer group and need for a more aggressive therapy. However, considering the most recent studies, prognostic results in this patient group are heterogeneous and it is not possible to confirm this tendency. Thus, it is not justified to embrace different therapeutic approaches according to patient age. Eventually, an additional element to consider when examining young subjects affected by tongue cancer is the possibility of genetic predisposition. Alterations affecting pathways involved in DNA repair, surveillance of genetic stability or regulation of cellular growth may determine an increased likelihood of developing head and neck cancers

Investigating the possibility of leakage detection in water distribution networks using cosmic ray neutrons in the thermal region

Water distribution systems can experience high levels of leakage, originating from different sources, such as deterioration due to aging of pipes and fittings, material defects, and corrosion. In addition to causing financial losses and supply problems, leakages in treated water distribution also represent a risk for public health. Despite several techniques for leak detection are already available, there is still a lot of interest in new non-invasive approaches, especially for scenarios where acoustic techniques struggle, such as in noisy environmental conditions. In this work we investigated the possibility of using cosmic ray (CR) neutrons for the detection of underground leakages in water distribution networks, by exploiting the difference in the above ground thermal neutron flux between dry and wet soil conditions. The potential of the technique has been assessed by means of an extensive set of Monte Carlo simulations based on GEANT4, involving realistic scenarios based on the Italian aqueduct design guidelines. Simulation studies focused on sandy soils and results suggest that a significative signal, associated with a leakage, could be detected with a data-taking lasting from a few minutes to a half-hour, depending on the environmental soil moisture, the leaking water distribution in soil, and the soil chemical composition. Finally, a brief description of a new portable and low-cost detector for thermal neutrons, currently under commission, is also presented

Superconductivity mediated by a soft phonon mode: specific heat, resistivity, thermal expansion and magnetization of YB6

The superconductor YB6 has the second highest critical temperature Tc among the boride family MBn. We report measurements of the specific heat, resistivity, magnetic susceptibility and thermal expansion from 2 to 300 K, using a single crystal with Tc = 7.2 K. The superconducting gap is characteristic of medium-strong coupling. The specific heat, resistivity and expansivity curves are deconvolved to yield approximations of the phonon density of states, the spectral electron-phonon scattering function and the phonon density of states weighted by the frequency-dependent Grueneisen parameter respectively. Lattice vibrations extend to high frequencies >100 meV, but a dominant Einstein-like mode at ~8 meV, associated with the vibrations of yttrium ions in oversized boron cages, appears to provide most of the superconducting coupling and gives rise to an unusual temperature behavior of several observable quantities. A surface critical field Hc3 is also observed.Comment: 29 pages, 5 tables, 17 figures. Accepted for publication in Phys. Rev.