Long-term outcome of Rockwood capsular shift for recurrent shoulder dislocation

Purpose. To review the long-term outcome of Rockwood capsular shift for recurrent shoulder dislocation secondary to trauma. Methods. Records of 30 males and 4 females who underwent Rockwood capsular shift for recurrent (≥2 episodes) anterior shoulder dislocation were reviewed. An additional Bankart repair with different techniques was performed in 24 of the patients by 2 different surgeons. The outcome was assessed using the Western Ontario Shoulder Instability Index (WOSI) and the Western Ontario Osteoarthritis of the Shoulder (WOOS) index questionnaires, the modified Rowe score, and the Constant-Murley score. Shoulder range of motion (ROM) was measured. Degenerative joint changes were evaluated on radiographs. Results. During a mean follow-up of 13 (range, 10–16) years, 6 (18%) patients had a mean of 1.2 recurrent dislocations. Four of the patients reported a traumatic event during recurrent dislocation. Of the 6 patients, 3 had undergone a Bankart lesion repair. Better Rowe and adjusted Constant scores were associated with lower age at first dislocation, at the index surgical procedure, and at follow-up. Four patients developed glenohumeral osteoarthritis: 2 were mild or moderate and 2 were severe and symptomatic. Glenohumeral osteoarthritis was associated with follow-up duration (p=0.03) and poorer Rowe score (p=0.012), adjusted Constant score (p=0.001), and WOOS score (p=0.006). Conclusion. Rockwood capsular shift can preserve shoulder ROM, with rates of recurrent dislocation and degenerative joint changes comparable with other techniques

Efficacy of modified atkins ketogenic diet in chronic cluster headache. An open-label, single-arm, clinical trial

Introduction: Drug-resistant cluster headache (CH) is still an open clinical challenge. Recently, our group observed the clinical efficacy of a ketogenic diet (KD), usually adopted to treat drug-resistant epilepsies, on migraine. Aim: Here, we aim to detect the effect of KD in a group of drug-resistant chronic CH (CCH) patients. Materials and methods: Eighteen drug-resistant CCH patients underwent a 12-week KD (Modified Atkins Diet, MAD), and the clinical response was evaluated in terms of response (>= 50% attack reduction). Results: Of the 18 CCH patients, 15 were considered responders to the diet (11 experienced a full resolution of headache, and 4 had a headache reduction of at least 50% in terms of mean monthly number of attacks during the diet). The mean monthly number of attacks for each patient at the baseline was 108.71 (SD = 81.71); at the end of the third month of diet, it was reduced to 31.44 (SD = 84.61). Conclusion: We observed for the first time that a 3-month ketogenesis ameliorates clinical features of CCH

Treatment of Severe Post-traumatic Bone Defects With Autologous Stem Cells Loaded on Allogeneic Scaffolds.

Mesenchymal stem cells may differentiate into angiogenic and osteoprogenitor cells. The effectiveness of autologous pluripotent mesenchymal cells for treating bone defects has not been investigated in humans. We present a case series to evaluate the rationale of using nucleated cells from autologous bone marrow aspirates in the treatment of severe bone defects that failed to respond to traditional treatments. Ten adult patients (mean age, 49.6-years-old) with severe bone defects were included in this study. Lower limb bone defects were >or=5 cm3 in size, and upper limb defects .or=2 cm3. Before surgery, patients were tested for antibodies to common pathogens. Treatment consisted of bone allogeneic scaffold enriched with bone marrow nucleated cells harvested from the iliac crest and concentrated using an FDA-approved device. Postsurgery clinical and radiographic follow-up was performed at 1, 3, 6, and 12 months. To assess viability, morphology, and immunophenotype, bone marrow nucleated cells were cultured in vitro, tested for sterility, and assayed for the possible replication of adventitious (contaminating) viruses. In 9 of 10 patients, both clinical and radiographic healing of the bone defect along with bone graft integration were observed (mean time, 5.6 months); one patient failed to respond. No post-operative complications were observed. Bone marrow nucleated cells were enriched 4.49-fold by a single concentration step, and these enriched cells were free of microbial contamination. The immunophenotype of adherent cells was compatible with that of mesenchymal stem cells. We detected the replication of Epstein-Barr virus in 2/10 bone marrow cell cultures tested. Hepatitis B virus, cytomegalovirus, parvovirus B19, and endogenous retrovirus HERV-K replication were not detected. Overall, 470 to 1,150 million nucleated cells were grafted into each patient. This case series, with a mean follow-up of almost 2 years, demonstrates that an allogeneic bone scaffold enriched with concentrated autologous bone marrow cells obtained from the iliac crest provides orthopedic surgeons a novel option for treating important bone defects that are unresponsive to traditional therapies

Culture of skeletal myoblasts from human donors aged over 40 years: dynamics of cell growth and expression of differentiation markers

BACKGROUND: Local myogenesis, neoangiogenesis and homing of progenitor cells from the bone marrow appear to contribute to repair of the infarcted myocardium. Implantation into heart tissues of autologous skeletal myoblasts has been associated with improved contractile function in animal models and in humans with acute myocardial ischemia. Since heart infarction is most prevalent in individuals of over 40 years of age, we tested whether culture methods available in our laboratory were adequate to obtain sufficient numbers of differentiated skeletal myoblasts from muscle biopsy specimens obtained from patients aged 41 to 91. METHODS AND RESULTS: No matter of donor age, differentiated skeletal muscle cells could be produced in vitro in amounts adequate for cellular therapy (≥300 millions). Using desmin as a cytoplasmic marker, about 50% cultured cells were differentiated along myogenic lineages and expressed proteins proper of skeletal muscle (myosin type I and II, actin, actinin, spectrin and dystrophin). Cytogenetic alterations were not detected in cultured muscle cells that had undergone at least 10 population doublings. Molecular methods employed for the screening of persistent viral infections evidenced that HCV failed to replicate in muscle cells cultured from one patient with chronic HCV infection. CONCLUSION: The proposed culture methods appear to hold promise for aged patients not only in the field of cardiovascular medicine, but also in the urologic and orthopedic fields

Iron Biofortification of Greenhouse Soilless Lettuce: An Effective Agronomic Tool to Improve the Dietary Mineral Intake

The present experiment addressed the effects of different iron (Fe) concentrations in the nutrient solution supplied as Fe-HBED, i.e., 0.02 (Fe0, control), 1.02 (Fe1), and 2.02 mmol L-1 (Fe2) on lettuce ('Nauplus' and 'Romana') yield and compositional traits. This experiment was carried out in a greenhouse using an open soilless cultivation system, at the experimental farm of the University of Catania (Sicily, Italy: 37 degrees 24'31.5 '' N, 15 degrees 03'32.8 '' E, 6 m a.s.l.). The addition of Fe-HBED reduced the plants' aboveground biomass (-18%, averaged over Fe1 and Fe2), but promoted their dry matter content (+16% in Fe2). The concentration of chlorophylls, carotenoids, anthocyanins, and antioxidants peaked at Fe2, along with the antioxidant capacity and concentration of stress indicators in leaves. The Fe content in leaves was promoted in the Fe-treated plants (+187% averaged over Fe1 and Fe2). 'Romana' showed the highest Fe accumulation (reaching 29.8 mg kg(-1) FW in Fe1), but 'Nauplus' proved a higher tolerance to the Fe-derived oxidative stress. The Fe2 treatment maximized leaf N, P, K, S, and Zn contents, while those of Ca, Mg, Mn, and B peaked at Fe1. Overall, our study revealed the effectiveness of Fe-HBED in increasing the Fe content and improving the nutritional quality of lettuce grown in soilless cultivation systems

Neurophysiological Responses to Different Product Experiences

It is well known that the evaluation of a product from the shelf considers the simultaneous cerebral and emotional evaluation of the different qualities of the product such as its colour, the eventual images shown, and the envelope’s texture (hereafter all included in the term “product experience”). However, the measurement of cerebral and emotional reactions during the interaction with food products has not been investigated in depth in specialized literature. (e aim of this paper was to investigate such reactions by the EEG and the autonomic activities, as elicited by the cross-sensory interaction (sight and touch) across several different products. In addition, we investigated whether (i) the brand (Major Brand or Private Label), (ii) the familiarity (Foreign or Local Brand), and (iii) the hedonic value of products (Comfort Food or Daily Food) influenced the reaction of a group of volunteers during their interaction with the products. Results showed statistically significantly higher tendency of cerebral approach (as indexed by EEG frontal alpha asymmetry) in response to comfort food during the visual exploration and the visual and tactile exploration phases. Furthermore, for the same index, a higher tendency of approach has been found toward foreign food products in comparison with local food products during the visual and tactile exploration phase. Finally, the same comparison performed on a different index (EEG frontal theta) showed higher mental effort during the interaction with foreign products during the visual exploration and the visual and tactile exploration phases. Results from the present study could deepen the knowledge on the neurophysiological response to food products characterized by different nature in terms of hedonic value familiarity; moreover, they could have implications for food marketers and finally lead to further study on how people make food choices through the interactions with their commercial envelope

Efficacy of transdermal rotigotine in chronic cluster headache: A case series:

Cluster headache (CH) is one of the most severe forms of headache, but the number of effective treatments is still limited. Recently, we reported the case of a drug-resistant CH patient responsive ..

Social Perception of Reconstruction following Orbital Exenteration

Background: Orbital exenteration, the removal of the entire globe, eyelids, and orbital content, is indicated in extensive neoplastic disease involving the orbital region. Although a functional reconstruction of orbital exenteration defects is mandatory, aesthetic concerns need to be considered. Facial disfigurement following reconstructive surgery often leads to great discomfort and social retirement, which can limit social interaction. The aim of this study was to explore how the society perceives the aspect of patients who underwent orbital exenteration and subsequent reconstruction, comparing two different types of reconstruction: standard anterolateral thigh (ALT) or "sandwich" fascial ALT (SALT) free flap. Methods: An online survey was created based on four questions regarding the perception of reconstruction (discomfort at looking at that patient, perception of unhealthiness, hypothesis of social life impairment, etc); five possible answers were provided, ranging from "completely" to "not at all." The survey was administered to the general population and to medical students. Results: In total, 255 people participated to the survey (130 medical students and 125 people of the general population); a total of 245 surveys were considered eligible (10 were incomplete and then discharged). Statistical significance was found (P < 0.001) regarding the better overall appearance of the SALT group over the ALT one. Conclusions: After analysis, the surgical outcome after SALT reconstruction has been found to be less disruptive in both groups, due to a reduced scar burden and a more pleasant orbital pocket. Our results encourage more research in the field of postexenteration reconstruction to achieve more aesthetic and social acceptability

NeuroDante: Poetry Mentally Engages More Experts but Moves More Non-Experts, and for Both the Cerebral Approach Tendency Goes Hand in Hand with the Cerebral Effort

Neuroaesthetics, the science studying the biological underpinnings of aesthetic experience, recently extended its area of investigation to literary art; this was the humus where neurocognitive poetics blossomed. Divina Commedia represents one of the most important, famous and studied poems worldwide. Poetry stimuli are characterized by elements (meter and rhyme) promoting the processing fluency, a core aspect of neuroaesthetics theories. In addition, given the evidence of different neurophysiological reactions between experts and non-experts in response to artistic stimuli, the aim of the present study was to investigate, in poetry, a different neurophysiological cognitive and emotional reaction between Literature (L) and Non-Literature (NL) students. A further aim was to investigate whether neurophysiological underpinnings would support explanation of behavioral data. Investigation methods employed: self-report assessments (recognition, appreciation, content recall) and neurophysiological indexes (approach/withdrawal (AW), cerebral effort (CE) and galvanic skin response (GSR)). The main behavioral results, according to fluency theories in aesthetics, suggested in the NL but not in the L group that the appreciation/liking went hand by hand with the self-declared recognition and with the content recall. The main neurophysiological results were: (i) higher galvanic skin response in NL, whilst higher CE values in L; (ii) a positive correlation between AW and CE indexes in both groups. The present results extended previous evidence relative to figurative art also to auditory poetry stimuli, suggesting an emotional attenuation “expertise-specific” showed by experts, but increased cognitive processing in response to the stimuli