Pragmatic use of ultrasound in plaster room.

X-ray represent gold standard to check reduction of fractures and dislocations. Sometimes plaster room is not equipped with C-arm or similar devices. Practical and focused use of ultrasound in plaster room cannot replace X-ray but may be a useful tool especially in tricky situations.

Current Practice of Italian Association of Revision Surgery Members in the Treatment of Unified Classification System Type B Periprosthetic Femoral Fracture Around Hip Arthroplasty: A Cross-Sectional Survey.

Introduction: Periprosthetic femoral fracture around hip arthroplasty are growing in the world, nevertheless management and treatment options for fractures "around the stem" are still debated due to lack of high-level studies.

Materials And Method: A 85-item survey were fill out by 40 Italian Orthopedic Surgeon member of SIOT (Società Italiana di Ortopedia e Traumatologia) and AIR (Associazione Italiana Riprotesizzazione) to assess their current opinion in the management of type B periprosthetic femoral fractures. Responses were summarized using proportions, and further stratified by practice type, case volume, surgeon age, and fellowship training.

Combined Microwave Ablation and Osteosynthesis for Long Bone Metastases.

The purpose of this study was to evaluate the feasibility, safety and efficacy of microwave ablation (MWA) in combination with open surgery nail positioning for the treatment of fractures or impending fractures of long bone metastases. Eleven patients (four men, seven women) with painful bone metastases of the humerus, femur or tibia with non-displaced fractures (one case) or impending fractures (10 cases) underwent open MWA in combination with osteosynthesis by locked nail positioning. Pain intensity was measured using a VAS score before and after treatment.

Late onset periprosthetic joint infection of the knee caused by Streptococcus anginosus. Case presentation and literature review.

Periprosthetic joint infection (PJI) is one of the most dramatic complications of joint arthroplasty. Although streptococcal bone and joint infections are less common than staphylococcal cases, their role as causative agents of bone and joint remains significant accounting for at least 10% of PJIs. Streptococcus anginosus group (SAG) bacteria are usually found in the normal flora of the urogenital tract, intestinal tract and oropharynx and could cause pyogenic infections to affect brain, lungs and liver.

Reliability and reproducibility of the new AO/OTA 2018 classification system for proximal humeral fractures: a comparison of three different classification systems.

Background: The classification systems for proximal humeral fractures routinely used in clinical practice include the Neer and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 2007 systems. Currently used systems have low inter- and intraobserver reliability. In 2018, AO/OTA introduced a new classification system with the aim of simplifying the coding process, in which the Neer four-part classification was integrated into the fracture description.

Conservative treatment of early-onset tubercular periprosthetic joint infection following total knee arthroplasty.

Tubercular periprosthetic joint infections (PJI) are uncommon diseases in developed countries. Therefore, the systematic screening for Mycobacterium tuberculosis (TB) is not currently recommended before a total knee arthroplasty procedure. However, due to the new human migration flows and higher mycobacterial infection rates, tuberculosis could represent a rare but potential cause for PJI.

Is antegrade nailing a proper option in 2- and 3-part proximal humeral fractures?

Purpose: To report our experience with antegrade short locked intramedullary nail for treatment of proximal humeral fractures and to review the current literature.

Materials And Methods: From January 2012 to July 2013, 41 patients affected by two and three-part proximal humeral fractures were treated with surgical internal fixation with short locked intramedullary nails. Outcome analysis included standard clinical follow-up, Constant shoulder score and plain radiographs.

The impact of magnetic resonance imaging in the diagnostic and classification process of osteoporotic vertebral fractures.

Introduction: Standard radiographs are still considered as the gold standard for the early assessment of thoraco-lumbar osteoporotic vertebral fractures (OVFs), although several studies demonstrated superior accuracy of magnetic resonance imaging (MRI) in the diagnostic process of OVFs. The aim of this study was to quantify the misdiagnosis rate of OVFs and analyse the impact of MRI on early diagnosis and classification, compared to standard radiographs alone.

Materials And Methods: A total of 173 patients were enrolled in this study.

Functional outcomes and clinical strength assessment after infraspinatus-sparing surgical approach to scapular fracture: Does it really make a difference?

Background: Surgical treatment of scapular fractures with posterior approach is frequently associated with postoperative infraspinatus hypotrophy and weakness. The aim of this retrospective study is to compare infraspinatus strength and functional outcomes in patients treated with the classic Judet versus modified Judet approach for scapular fracture.

Patients And Methods: 20 cases with scapular neck and body fracture treated with posterior approach for lateral border plate fixation were reviewed.

Periprosthetic fractures: epidemiology and current treatment.

Periprosthetic fractures are becoming increasingly frequent due to aging population and growing number of total joint replacements involving joints different from hip and knee, such as shoulder and elbow. The treatment of these fractures still represents one of the major challenges for the orthopedic surgeon. Despite all efforts to understand and treat these patients, high rate of failure and mortality are still reported.

VNS induced desynchronization in gamma bands correlates with positive clinical outcome in temporal lobe pharmacoresistant epilepsy.

The vagus nerve stimulation (VNS) represents a diffuse non-pharmacological low-risk surgical option for epilepsy treatment. The aim of this study is to investigate the correlation between variations of global EEG synchronization and the clinical outcome in pharmacoresistant epileptic subjects implanted with VNS. Ten subjects affected by pharmacoresistant epilepsy were recruited on the basis of a clear-cut successful or unsuccessful outcome of the VNS add-on treatment.

Amyotrophic lateral sclerosis in Sardinia (Italy): epidemiologic features from 1957 to 2000.

Objectives: To evaluate epidemiological variables of amyotrophic lateral sclerosis (ALS) in Sardinia (Italy) in the 1991-2000 periods and compare them with the preceding decades.

Material And Methods: Survey, critical reappraisal or clinical re-evaluation of all ALS cases with onset in the decade 1991-2000; calculation of crude and age-adjusted incidence, duration of disease, survival rates and the latency between onset of symptoms and diagnosis.

Results: A significant increase in the mean annual incidence was observed in comparison with the values found in the two previous decades, 1971-1980 and 1981-1990.

SYN1 loss-of-function mutations in autism and partial epilepsy cause impaired synaptic function.

Several genes predisposing to autism spectrum disorders (ASDs) with or without epilepsy have been identified, many of which are implicated in synaptic function. Here we report a Q555X mutation in synapsin 1 (SYN1), an X-linked gene encoding for a neuron-specific phosphoprotein implicated in the regulation of neurotransmitter release and synaptogenesis. This nonsense mutation was found in all affected individuals from a large French-Canadian family segregating epilepsy and ASDs.

Ligand migration in the apolar tunnel of Cerebratulus lacteus mini-hemoglobin.

The large apolar tunnel traversing the mini-hemoglobin from Cerebratulus lacteus (CerHb) has been examined by x-ray crystallography, ligand binding kinetics, and molecular dynamic simulations. The addition of 10 atm of xenon causes loss of diffraction in wild-type (wt) CerHbO(2) crystals, but Leu-86(G12)Ala CerHbO(2), which has an increased tunnel volume, stably accommodates two discrete xenon atoms: one adjacent to Leu-86(G12) and another near Ala-55(E18). Molecular dynamics simulations of ligand migration in wt CerHb show a low energy pathway through the apolar tunnel when Leu or Ala, but not Phe or Trp, is present at the 86(G12) position.

Tyrosine phosphorylation of synapsin I by Src regulates synaptic-vesicle trafficking.

Synapsins are synaptic vesicle (SV)-associated phosphoproteins involved in the regulation of neurotransmitter release. Synapsins reversibly tether SVs to the cytoskeleton and their phosphorylation by serine/threonine kinases increases SV availability for exocytosis by impairing their association with SVs and/or actin. We recently showed that synapsin I, through SH3- or SH2-mediated interactions, activates Src and is phosphorylated by the same kinase at Tyr301.

Levodopa/carbidopa/entacapone-induced acute Pisa syndrome in a Parkinson's disease patient.

Pisa syndrome (PS) is a dystonic lateroflexion of the trunk with a postural disturbance resembling the leaning tower of Pisa. Initially reported as a side effect related to antipsychotic therapy, this original dystonic posture is also manifested in neurodegenerative disorders such as Alzheimer's disease and multiple system atrophy, or in rare idiopathic cases. Recent observations have described the onset of PS with subchronic course in patients affected by Parkinson's disease (PD).

Increased natural cytotoxicity receptor expression and relevant IL-10 production in NK cells from chronically infected viremic HCV patients.

Hepatitis C virus (HCV) readily establishes high-level lifelong persistent infection in the majority of immunocompetent adults with failure of HCV-specific CD8+ CTL to clear viral replication. Virus-induced conditioning of innate immune responses is a possible mechanism that may contribute to the impairment of virus-specific CD8+ CTL responses. Here, we analyzed whether triggering of NK cell receptor expression and function is affected during chronic viremic HCV infection.

Description (reporting the actual words used in written letters) of the neuropsychological and psychopathological modifications produced by dopaminergic treatment in a young patient with Parkinson's disease.

Although it is an undeniable fact that dopaminergic therapy has greatly improved the quality of life and prognosis of patients with Parkinson's disease, various and serious adverse events correlated to dopaminergic drugs are not uncommon. Among these, those of neuropsychological and psychopathological nature are of particular importance, being capable of causing an upheaval in the basic personality of the patient. To this regard, the authors report the actual words of a patient himself that are far more convincing that any considerations we may express.

Low androgenization index in elderly women and elderly men with Alzheimer's disease.

The authors investigated whether testosterone levels and testosterone availability differ between older lean subjects with and without Alzheimer's disease (AD). Sex hormone binding globulin (SHBG) and estradiol levels were higher, whereas the free androgenization index (FAI) was lower, in lean subjects with AD than in lean subjects without AD. Factors involved in the increase of SHBG secretion could have an important role in the lower testosterone availability of subjects with AD.

Gabapentin in antipsychotic-induced tardive dyskinesia: results of 1-year follow-up.

Background: In a previous study, improvement of antipsychotic-induced blefarospasm and involuntary oral-mandibulo movements were observed with the use of the anticonvulsant drug gabapentin among affectively ill patients who had been exposed to maintenance neuroleptics. The results reported in the present paper represent the sequel to the previous study.

Methods: The purported efficacy of gabapentin in the treatment of tardive dyskinesia has been assessed in an open design 1-year follow-up study, in which 30 schizoaffective, bipolar I and schizophrenic patients from seven Italian centres were evaluated by means of AIMS.

Bipolar affective disorder and Parkinson's disease: a rare, insidious and often unrecognized association.

Five patients (4 women) with Parkinson's disease (PD) and primary major psychiatric disorder (PMPD) meeting DSM-IV criteria for the diagnosis of bipolar affective disorder (BAD) were studied. Four patients had early onset PD. Four developed a severe psychiatric disorder a few years after starting dopaminergic therapy in presence of a mild motor disability and a mild cognitive impairment, with no evidence of cerebral atrophy at CT or MRI.

Sensitivity and specificity of the EEG versus CT in acute cortical and subcortical stroke.

122 patients with acute stroke were examined in order to demonstrate the sensitivity and the specificity of EEG versus CT findings, in distinguishing cortical from subcortical lesions. To do this the electroencephalographic diagnosis performed by two different electroencephalographers was compared with the neuroimaging diagnosis. The results showed a sensitivity of 77% and a specificity of 75%.

Subarachnoid hemorrhage of unknown origin. A 44 cases study.

44 cases (20 men and 24 women) of subarachnoid hemorrhage (SAH) of unknown origin were studied: the mean age was 54.1 yrs. Highest frequency of the disease was observed in 51-70 years old patients.