The arthroereisis procedure in adult flexible flatfoot grade IIA due to insufficiency of posterior tibial tendon.

BACKGROUND: To report on the functional, biomechanical, and radiographic results of patients who had undergone arthroereisis plus tensioning of the posterior tibial tendon for flexible flatfoot. The hypothesis is that arthroereisis associated to a tensioning of the posterior tibial tendon give a good correction with great satisfaction in patients with flexible flatfoot in grade IIA. METHODS: We evaluated 29 patients (31 feet), mean age of 46.4 years, who had been surgically treated for adult flatfoot grade IIA according to Myerson. Mean follow-up was 34.15 months. For clinical evaluation, the AOFAS hindfoot and VAS-FA scores were used. RESULTS: Postoperative results showed significant increases in both AOFAS and VAS-FA scores: 54.2-81.9 and 61.5-83.2 points, respectively. For the X-ray parameters, we observed a significant variation in the talo-first metatarsal angle, from 13.8° in pre-op to 7.4° in post-op. In lateral view, Djian Annonier angle was improved from 146.6° to 134.1°. The Meary's angle, compared to an average of 8.8° in pre-operative stage improved to 4.3° in the post-operative stage. Postoperative satisfaction was excellent-good according to 23 patients (79.4%). Pain in the tarsal sinus was reported in 5 out of 31 feet (16.1%) for the first three months after surgery. CONCLUSIONS: Arthroereisis and tensioning of the posterior tibial tendon provided good functional outcomes for patients under 60 years of age having stage IIA flexible flatfoot without arthritic manifestations.

Hazardous waste and health impact: a systematic review of the scientific literature.

Waste is part of the agenda of the European Environment and Health Process and included among the topics of the Sixth Ministerial Conference on Environment and Health. Disposal and management of hazardous waste are worldwide challenges. We performed a systematic review to evaluate the evidence of the health impact of hazardous waste exposure, applying transparent and a priori defined methods. The following five steps, based on pre-defined systematic criteria, were applied. 1. Specify the research question, in terms of "Population-Exposure-Comparators-Outcomes" (PECO). POPULATION: people living near hazardous waste sites; Exposure: exposure to hazardous waste; Comparators: all comparators; Outcomes: all diseases/health disorders. 2. Carry out the literature search, in Medline and EMBASE. 3. Select studies for inclusion: original epidemiological studies, published between 1999 and 2015, on populations residentially exposed to hazardous waste. 4. Assess the quality of selected studies, taking into account study design, exposure and outcome assessment, confounding control. 5. Rate the confidence in the body of evidence for each outcome taking into account the reliability of each study, the strength of the association and concordance of results.Fifty-seven papers of epidemiological investigations on the health status of populations living near hazardous waste sites were selected for the evidence evaluation. The association between 95 health outcomes (diseases and disorders) and residential exposure to hazardous waste sites was evaluated. Health effects of residential hazardous waste exposure, previously partially unrecognized, were highlighted. Sufficient evidence was found of association between exposure to oil industry waste that releases high concentrations of hydrogen sulphide and acute symptoms. The evidence of causal relationship with hazardous waste was defined as limited for: liver, bladder, breast and testis cancers, non-Hodgkin lymphoma, asthma, congenital anomalies overall and anomalies of the neural tube, urogenital, connective and musculoskeletal systems, low birth weight and pre-term birth; evidence was defined as inadequate for the other health outcomes. The results, although not conclusive, provide indications that more effective public health policies on hazardous waste management are urgently needed. International, national and local authorities should oppose and eliminate poor, outdated and illegal practices of waste disposal, including illegal transboundary trade, and increase support regulation and its enforcement.

Comparison of sampling bags for the analysis of volatile organic compounds in breath.

Nalophan, Tedlar and Cali-5-Bond polymeric bags were compared to determine the most suitable type for breath sampling and storage when volatile organic compounds are to be determined. Analyses were performed by thermal desorption gas chromatography mass spectrometry. For each bag, the release of contaminants and the chemical stability of a gaseous standard mixture containing eighteen organic compounds, as well as the CO2 partial pressure were assessed. The selected compounds were representative of breath constituents and belonged to different chemical classes (i.e. hydrocarbons, ketones, aldehydes, aromatics, sulfurs and esters). In the case of Nalophan, the influence of the surface-to-volume ratio, related to the bag's filling degree, on the chemical stability was also evaluated. Nalophan bags were found to be the most suitable in terms of contaminants released during storage (only 2-methyl-1,3-dioxalane), good sample stability (up to 24 h for both dry and humid samples), and very limited costs (about 1 € for a 20 liter bag). The (film) surface-to-(sample) volume ratio was found to be an important factor affecting the stability of selected compounds, and therefore we recommended to fill the bag completely.

Oral clearance of NaF from chewing gum and tablets in children and adults.

AIM: Aim of the present study was to evaluate the salivary clearance of Fluoride following administration of tablets and chewing gums containing 0.50 mg of Fluoride in the form of NaF. MATERIALS AND METHODS: Ten children (age 10-13 years) and a control group of 10 adults (age 22-27 years) were recruited and selected for the study. The experiment consisted of saliva samples collection from each participant at fixed time intervals. Whole saliva was sampled from ten 10-13 years-old children to assess the baseline fluoride concentration, then participants received one piece of chewing-gum and were asked to chew for 15 minutes. Whole saliva samples were collected 5, 10, 20, 30, 45 and 60 minutes after the chewing period. The day after once again we administered a chewing-gum to each child, instructing them to continuously chew it for 15 minutes; subsequently we collected saliva samples at the same intervals previously fixed. The following day the experiment was repeated, this time requesting the patient to chew as slow as possible for 15 minutes and then news samples were collected. Saliva samples were collected at the same intervals previously fixed from control group of 10 adults. After a week, children's group received one tablet and new saliva samples were collected at the same intervals. The collected samples were analysed by a potentiometric method, assessing the Fluoride concentration by means of a Fluoride ion-selective electrode. RESULTS: The clearance of Fluoride is similar for both the administration methods used. CONCLUSION: Both chewing gum and tablets are valid methods of Fluoride administration and they can be considered useful aids in dental caries prevention (when used in addition to adequate oral hygiene).

Development of an SdFFF-ETAAS hyphenated technique for dimensional and elemental characterization of colloids.

Direct hyphenation of electrothermal atomic-absorption spectroscopy (ETAAS) to sedimentation field-flow fractionation (SdFFF) has been developed to enable elemental characterization of submicron particles as a function of size. This hyphenation is particularly suitable for characterizing colloidal particles of environmental interest, for example water-borne particles. The interface is an automatic capillary injection device (CID) which enables direct introduction of large and variable volumes of colloidal particle suspensions into a hot graphite furnace, thus preconcentrating the colloidal particles on the furnace walls. The method was validated by determination of Fe in certified submicron Fe2O3. The procedure was set up by first optimizing the SdFFF fractionation under programmed field conditions, thus enabling optimum fractionation of particle size. The ETAAS procedure was then tested to determine whether it could be used for direct analysis of Fe2O3 slurries without the need for a mineralization step. CID coupled to ETAAS was subsequently exploited for its ability to enhance the sensitivity, because of the increased injection volume. Statistical tests and data handling were conducted to prove the suitability of the ETAAS-CID module. Finally, off-line and on-line ETAAS-CID-SdFFF hyphenation were investigated. These experiments emphasized the advantages of the on-line coupling, because it enables synchronized sampling, enrichment, and elemental analysis of the flowing eluate. The benefits of the proposed hyphenation are the high specificity of analytical detection, increased sensitivity, reduction of analysis time, and minimum sample handling and contamination.

cAMP phosphodiesterase activity in diabetic rats eyes in normoxic, hypoxic and hyperoxic conditions.

Phosphodiesterase activity was tested on homogenized eyes of pre-diabetic rats kept in normoxic, hypoxic and hyperoxic conditions, with the aim of correlating any difference in PDE activity with variations in atmospheric oxygen contents. The activity of the cAMP phosphodiesterase (cAMP-PDE) was tested. Phosphodiesterases seem to be particularly susceptible to variations in oxygen tension, suggesting an important role of cyclic nucleotides in adaptive processes of the cell. cAMP-PDE activity increases slightly in normoxic, hypoxic and hyperoxic conditions in pre-diabetic rats. The second messenger, cAMP, plays important roles in mediating the biological effects of a wide variety of first messengers. The intracellular levels of cyclic nucleotides depend upon rates of synthesis and degradation, of cyclases and phosphodiesterase (PDEs), respectively. Therefore, PDEs seem to play an important role in a wide variety of physiological processes.

Polychlorobiphenyls in Antarctica

The presence and the distribution of polychlorobiphenyls (PCBs) in Antarctic environmental components and the effect of the seasonal formation/melting process of pack ice on the pollution level of seawater were investigated. Seawater, marine, and lake sediment and soil samples were collected in a large area of the Ross Sea and Victoria Land during the 1988-1989, 1989-1990, 1990-1991, and 1991-1992 Italian expeditions. The results obtained highlighted a low and quite homogeneous PCB contamination of the studied area. Surface seawater samples from Gerlache Inlet and Wood Bay showed a typical PCB concentration of 130 pg/liter, and an increase after pack ice melting of about 30-40%. Marine sediment, lake sediment, and soil samples showed normalized mean PCB contents of 150, 240, and 130 (pg/g)/(m2/cm3), respectively.

[Surgical treatment of fractures of the neck of the radius in children and adolescents. Review of 24 cases]. / Il trattamento cruento delle fratture del collo del radio nel bambino e nell'adolescente. Revisione di 24 casi.

At the Orthopaedic Clinic of the University of Perugia from 1973 to 1984, 28 fractures of the neck of the radius were treated with open reduction in children aged between 4 and 15. Follow-up evaluation showed a high percentage of poor results (33.3%) frequently associated with a deficit of pronation and supination. Clinical results were related both to the severity of the displacement and to the radiographic results at follow-up. Open reduction is essential in highly displaced fractures, but it can be avoided in those with minor displacement.

Congenital hip dysplasia treated by the Salter osteotomy. Long-term review of 18 patients.

Between 1965 and 1974 at the Orthopaedic Clinic of the University of Perugia, 20 osteotomies of the innominate bone were performed on 18 patients aged between 18 months and 10 years. All the patients were followed up for 10 to 19 years (average 15 years) after operation. The results were evaluated both clinically and radiographically (according to the Severin and MacFarland methods). The data were later submitted to computer analysis, using a semiautomatic aquisition programme which allowed for evaluation of the geometry of the hip. The most important parameters for evaluation of the results were the Wiberg CE angle, the acetabular angle, the minimum joint space, and the horizontal component of the resultant force. Clinically and radiographically there was an 80% success rate according to Severin's method of evaluation. There was also good correlation with the computerized analysis. Biomechanically, there was almost normal recovery of the load distribution. The clinical, radiographic and biomechanical parameters worsened slightly with age, particularly during puberty.