Results of closed subtalar dislocations.

BACKGROUND: The subtalar dislocation (SD) of the foot is an uncommon injury characterized by a simultaneous dislocation of talocalcaneal and talonavicular joints without involvement of the tibiotalar and calcaneocuboid joints. PURPOSES: The purpose of this study was to evaluate the clinical and radiological outcome in a consecutive series of close SD. METHODS: We retrospectively evaluated a case series of patients who presented a close SD. Thirteen patients were selected for this study. There were 9 patients with a medial SD, 3 patients with a lateral dislocation and 1 patient with a posterior subtalar dislocation. RESULTS: The most frequent symptoms observed in our study included transient mild pain, swelling and decreased ankle ROM, which did not restrict patients' daily activities. However, lower AOFAS scores were observed on patients with associate peritalar osseous injuries. CONCLUSION: The results of the present study suggest that detecting and treating any associate peritalar fractures are the keys to a successful long-term outcome.

Patient-specific instrumentation for total knee arthroplasty: a literature review.

During the past decade, total knee arthroplasty (TKA) has been markedly increased. Recently, patient-specific custom cutting guides have been commercially introduced in order to achieve an accurate component alignment during TKA. In fact, these cutting blocks are specific to a patient's knee anatomy and should help the surgeons to perform bone cuts, reducing the complexity of conventional alignment and sizing tools. Nevertheless, there are critical arguments against patient-specific cutting guides for routine use, such as poor evidence and higher costs. Additionally, there are still no mild and long-term results available that describe the clinical outcomes following patient-specific instrumentation of TKR, cost-effectiveness and lower revision rates. Aim of the current manuscript was to describe the recent improvements of the surgical technique and instrumentation of TKA, reviewing the recent literature concerning the PSI technology.

In vitro anti-biofilm activity of Boswellia spp. oleogum resin essential oils.

AIMS: To evaluate the anti-biofilm activity of the commercially available essential oils from two Boswellia species. METHODS AND RESULTS: The susceptibility of staphylococcal and Candida albicans biofilms was determined by methyltiazotetrazolium (MTT) staining. At concentrations ranging from 217.3 microg ml(-1) (25% v/v) to 6.8 microg ml(-1) (0.75% v/v), the essential oil of Boswellia papyrifera showed considerable activity against both Staphylococcus epidermidis DSM 3269 and Staphylococcus aureus ATCC 29213 biofilms. The anti-microbial efficacy of this oil against S. epidermidis RP62A biofilms was also tested using live/dead staining in combination with fluorescence microscopy, and we observed that the essential oil of B. papyrifera showed an evident anti-biofilm effect and a prevention of adhesion at sub-MIC concentrations. Boswellia rivae essential oil was very active against preformed C. albicans ATCC 10231 biofilms and inhibited the formation of C. albicans biofilms at a sub-MIC concentration. CONCLUSIONS: Essential oils of Boswellia spp. could effectively inhibit the growth of biofilms of medical relevance. SIGNIFICANCE AND IMPACT OF THE STUDY: Boswellia spp. essential oils represent an interesting source of anti-microbial agents in the development of new strategies to prevent and treat biofilms.

Effects of levodopa oral bolus on the kinematics of the pointing movements in Parkinson's disease patients.

We studied the time-course of a levodopa oral bolus effects on the kinematics of patients affected by a mild akinetic-rigid form of idiopathic Parkinson's disease (PD). Eleven PD patients were evaluated: a) in OFF-state, that is before their first medication or after its withdrawal, b) in ON-state, that is at 1/2, 1, 2, 3, 4, 5, 6, 24, 30 and 48 hours after the administration of 250 mg of levodopa plus 25mg of carbidopa. The main kinematics (i. e.movement time, peak of velocity, peak of acceleration and peak of deceleration) of pointing movements to six target-stimuli placed on the horizontal plane of a table were recorded. Clinical conditions were assessed according to the Motor Examination section of the Unified Parkinson's Disease Rating Scale. The levopoda bolus had stable clinical effects only within the first six hours from its administration. The decline of the clinical response was marked by the changes of peak acceleration whereas other kinematics (i. e. movement time and the peak of velocity) changed also in the late observations (24, 30 and 48 hours after drug intake). The dissociation between the persistent improvement on movement time on peak velocity and the rapid deterioration of levodopa effects on early kinematics (i. e. peak acceleration) could be accounted for by a progressive decline in movement programming.

Prevalence of headache in patients with Behçet's disease without overt neurological involvement.

The aims of the present study were to evaluate the prevalence of headache and the frequency of different headache syndromes in patients with Behçet's Disease (BD) without neurological involvement and to investigate the relationship with other clinical, and behavioural variables. Twenty-seven BD patients and 27 control subjects underwent a validated semistructured questionnaire based on the International Headache Society criteria. Levels of anxiety and depression, disease activity, and current medication were collected. Headache occurred in 88.9% of BD patients. There was no difference in the prevalence of the different headache syndromes between BD patients and controls. Only migraine without aura (MwA) was significantly more frequent in BD patients than controls (44.4% vs. 11.1%, respectively, P= 0.013). No relationship was found between MwA and clinical, and behavioural variables. Among headache syndromes, MwA showed the highest frequency in BD. A vascular or neuronal subclinical dysfunction could justify this association. A careful interview for migraine might be included in the diagnostic work-up of BD.

Atractyligenine chemistry, Part VI: Synthesis and biological activities of atractyligenine derivatives.

Derivatives of atractyligenine, the aglycone of atractyloside, were tested in vitro for their antimicrobial and antiproliferative activity against K-562 (human chronic myelogeneous leukemia), HL-60 (human leukemia) and MCF-7 (human breast adenocarcinoma) cell lines. The most active compound showed IC50 values in the range 0.8-6.9 microM.

Traditional medicine as a source of new therapeutic agents against psoriasis.

In the frame of traditional medicine, the use in the treatment of psoriasis of some plants typical of the flora of Sicily is reported. A preliminary search on some plants used for the treatment of psoriasis in Asia, South America and Africa is also reported.

The structure and the stereochemistry of atractyliretin.

The nor-kaurane diterpene Atractyliretin was obtained by acid hydrolysis of Atractyloside, a toxic substance isolated from ATRACTYLIS GUMMIFERA L (Compositae). On the basis of spectral (IR, (1)H-NMR, (13)C-NMR and MS) analysis and chemical degradation its structure and stereochemistry was identified as 4.

New secondary metabolites of Aspergillus wentii Wehmer. The positive and negative ion mass spectra produced by electron impact.

The positive and negative ion mass spectra of three secondary metabolites of Aspergillus Wentii Wehmer, namely 15-acetoxyhexadecyl-, 15-oxohexadecyl- and 15-hydroxyhexadecylcitraconic anhydrides are reported and discussed. The positive ion mass spectra, which have been studied in detail by exact mass measurements and metastable ion detection using a defocusing method, show very weak molecular ions and complex fragmentation pathways, strongly influenced by the group on C-15. However, the negative ion mass spectra show very abundant molecular ions and little fragmentation, with the negative charge mainly retained by the anhydride moiety. The behavior of both positive and negative ions is in agreement with the charge localization concept, on the grounds of ionization energy and electron affinity considerations. positive and negative ion mass spectra are largely complementary, thus increasing their analytical value.