Mediterranean Diet conceptual model and future trends of its use in Portugal.

The aim of this study was to present a new model for the Mediterranean Diet definition and to identify the major trends for the use of the Mediterranean Diet concept by 2028, in Portugal. A Delphi panel was implemented with 28 experts with solid knowledge and understanding of the Mediterranean Diet concept. The first round evaluated the degree of expert self-knowledge, which also contributed to the final questionnaire building. It was answered in 2 successive rounds with 21 statements, divided into 2 dimensions: Mediterranean Diet concept and use. A Mediterranean Diet model definition was produced with 73.8% of agreement. Culture, education, environment, health, food industry/distribution and tourism were identified as the future trends of Mediterranean Diet use areas. The model presented can be used as a pedagogical tool. For the first time, it was possible to explore the future trends of Mediterranean Diet use, which can help with the initiatives to safeguard the Mediterranean Diet concept.

Stable fixation of a madreporic Lord femoral prosthesis at 31-year follow-up in a total hip arthroplasty: A case report.

INTRODUCTION: Lord total hip prosthesis was discontinued due to high revision rates of the smooth threaded acetabular component and negative effects of stress shielding in the proximal femur. PRESENTATION OF CASE: We report the outcome of a Lord cementless femoral stem, in a 55-year-old woman. In 1984, the patient underwent a Lord total hip arthroplasty for the treatment of advanced dysplastic osteoarthritis of the left hip. After 12 years, the cementless acetabular component of the prosthesis had been revised due to aseptic loosening. An acetabular metallic support ring and a cemented polyethylene cup were implanted, the femoral stem was not changed. The acetabular bone loss was reconstructed with morsellised cancellous bone allografts by the impacting technique. No complications were reported during the period of 19 years of the postoperative course. At the last clinical and radiological evaluations, the patient presented an asymptomatic hip and expressed high degree of satisfaction with the surgery result. The femoral stem was stable, with no measurable subsidence or radiolucent lines around the stem. DISCUSSION: Several reports have presented a high clinical success rate with the fully-porous-coated Lord femoral stem in both primary and revision cases. However, the long-term results showed a substantial rate of proximal femoral bone loss and thigh pain. CONCLUSION: In our case, the Lord stem showed an excellent long-term result at the 31-year follow-up. To our knowledge, there is no published report with results of the Lord stem longer than 26-year's follow-up.

Potential behavioral and pro-oxidant effects of Petiveria alliacea L. extract in adult rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Petiveria alliacea (Phytolaccaceae) is a perennial shrub indigenous to the Amazon Rainforest and tropical areas of Central and South America, the Caribbean, and sub-Saharan Africa. In folk medicine, Petiveria alliacea has a broad range of therapeutic properties; however, it is also associated with toxic effects. AIM OF THE STUDY: The present study evaluated the putative effects of Petiveria alliacea on the central nervous system, including locomotor activity, anxiety, depression-like behavior, and memory, and oxidative stress. MATERIALS AND METHODS: Two-month-old male and female Wistar rats (n=7-10 rats/group) were administered with 900 mg/kg of hydroalcoholic extracts of Petiveria alliacea L. The behavioral assays included open-field, forced swimming, and elevated T-maze tests. The oxidative stress levels were measured in rat blood samples after behavioral assays and methemoglobin levels were measured in vitro. RESULTS: Consistent with previous reports, Petiveria alliacea increased locomotor activity. It also exerted previously unreported anxiolytic and antidepressant effects in behavioral tests. In the oxidative stress assays, the Petiveria alliacea extract decreased Trolox equivalent antioxidant capacity levels and increased methemoglobin levels, which was related to the toxic effects. CONCLUSIONS: The Petiveria alliacea extract exerted motor stimulatory and anxiolytic effects in the OF test, antidepressant effects in the FS test, and elicited memory improvement in ETM. Furthermore, the Petiveria alliacea extract also exerted pro-oxidant effects in vitro and in vivo, inhibiting the antioxidant status and increasing MetHb levels in human plasma, respectively.

A technique to remove a well-fixed titanium-coated RM acetabular cup in revision hip arthroplasty.

A major concern during revision hip arthroplasty is acetabular bone loss and bleeding during the extraction of well-fixed cementless acetabular cup, because no interface exists between the host bone and the cup. Forceful removal of such component using curved gouges and osteotomes often leads to extended bone loss and compromises reimplantation of a new socket. In the following case report, we removed a well-fixed polyethylene titanium-coated RM acetabular cup with 20 years of follow-up, by significant wear of the polyethylene layer. The isoelastic femoral stem was also removed by mechanical failure. We report a technique for removal of the cementless acetabular cup using powered acetabular reamers. The RM cup was sequentially reamed and when the polyethylene layer was thin enough, the remaining cup was removed easily by hand tools. The acetabular bone stock is preserved and the risks of bone fractures and bleeding are minimized. To our knowledge, these principles were applied only in cemented cups. We have used this technique in 10 cases with excellent results and no complications were noted. This is a simple, reproducible, non-costly, non-timing consuming, safe and successful technique to remove well-fixed titanium-coated RM acetabular cups.