Carbon vs. Titanium Nails in the Treatment of Impending and Pathological Fractures: A Literature Review.

Background: Long bones are commonly affected by musculoskeletal tumors, but they also represent one of the most frequent locations for metastases. The treatment is based on pain management and the prevention or stabilization of pathological fractures by intramedullary nailing. While titanium nails are probably the most used, carbon-fiber-reinforced (CFR) nails have emerged as a new option for oncological patients. The aim of this review is to compare titanium and CFR nails according to current findings. Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards were followed: a total of 1004 articles were identified and 10 were included. Results: Traditionally, titanium implants are highly valued for their optimal biomechanical properties and ease of insertion, facilitated by their radiopacity. However, the use of titanium poses challenges in radiotherapy due to interference with radiation dosage and the creation of ferromagnetic artifacts. Conversely, CFR implants have emerged as a recommended option for intramedullary fixation, due to their biomechanical and structural properties and their benefits during radiotherapy and follow-up monitoring X-ray. Conclusions: CFR nailing represents a promising advancement in the surgical management of oncological patients with long bone metastases. However, further studies are needed to increase surgeons' confidence in their use.

Pharyngeal Residue Scoring in Fiberoptic Endoscopic Evaluation of Swallowing: Reliability Comparison and Applicability Among Different Scales.

Several scales to assess pharyngeal residue in Fiberoptic Endoscopic Evaluation of Swallowing (FEES) are currently available. The study aimed to compare the reliability and the applicability in real clinical practice among four rating scales: the Pooling Score (P-SCORE), the Boston Residue and Clearance Scale (BRACS), the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), and the Residue Ordinal Rating Scale (RORS). Twenty-five FEES videos were evaluated four times, once for each scale, by four speech and language pathologists. To test intra-rater reliability, the same raters re-assessed the videos two weeks apart. To test the applicability, raters recorded the time required to complete each assessment and the perceived difficulty/ease on a visual-analog scale (VAS). The intra-rater and the inter-rater reliability were calculated with Cohen's weighted Kappa and the Fleiss weighted Kappa, respectively. Time and perceived difficulty/ease scores were compared. The intra-rater reliability analysis showed almost perfect agreement for YPRSRS (k = 0.91) and RORS (k = 0.83) and substantial agreement for P-SCORE (k = 0.76) and BRACS (k = 0.74). Pairwise comparison showed no significant differences among the scales. The inter-rater reliability for the YPRSRS (k = 0.78) was significantly higher than P-SCORE (k = 0.52, p < 0.001), BRACS (k = 0.56, p < 0.001), and RORS (k = 0.65, p = 0.005). The BRACS required the longest time (p < 0.001) and was perceived as the most difficult scale (p < 0.001). The RORS was perceived as the easiest scale (p < 0.05). In conclusion, the YPRSRS showed the highest reliability, while raters perceived the RORS as the easiest to score. These results will allow clinicians to consciously choose which scale to use in clinical practice.

Machine Learning Assessment of Spasmodic Dysphonia Based on Acoustical and Perceptual Parameters.

Adductor spasmodic dysphonia is a type of adult-onset focal dystonia characterized by involuntary spasms of laryngeal muscles. This paper applied machine learning techniques for the severity assessment of spasmodic dysphonia. To this aim, 7 perceptual indices and 48 acoustical parameters were estimated from the Italian word /a'jwɔle/ emitted by 28 female patients, manually segmented from a standardized sentence and used as features in two classification experiments. Subjects were divided into three severity classes (mild, moderate, severe) on the basis of the G (grade) score of the GRB scale. The first aim was that of finding relationships between perceptual and objective measures with the Local Interpretable Model-Agnostic Explanations method. Then, the development of a diagnostic tool for adductor spasmodic dysphonia severity assessment was investigated. Reliable relationships between G; R (Roughness); B (Breathiness); Spasmodicity; and the acoustical parameters: voiced percentage, F2 median, and F1 median were found. After data scaling, Bayesian hyperparameter optimization, and leave-one-out cross-validation, a k-nearest neighbors model provided 89% accuracy in distinguishing patients among the three severity classes. The proposed methods highlighted the best acoustical parameters that could be used jointly with GRB indices to support the perceptual evaluation of spasmodic dysphonia and provide a tool to help severity assessment of spasmodic dysphonia.

Poly-D,L-lactic acid polymer and cochlear implantation.

This case report describes a peculiar and innovative fixing procedure with a Poly-D,L-lactic acid (PDLLA) polymer in the unusual case of magnet dislodgment and rupture of the cochlear implant (CI) silicone sheath holding the magnet.

Periprosthetic knee fractures in an elderly population: open reduction and internal fixation vs distal femur megaprostheses.

The incidence of periprosthetic fractures of distal femur (PPDFFx) after primary total knee arthroplasties is described around 0.3% and 2.5% and it is increasing as the number of patients with total knee arthroplasty continues to arise. surgical options treatments for PPDFFx include fixation in the form of eather Open reduction and internal fixation (ORIF), or retrograde intramedullary nailing (RIMN), or conventional (non locked) plating, or locked plating such as the Less Invasive Stabilization System (LISS), or dynamic condylar screws. In recent years, however, the use of megaprostheses has been increasing. Patients with periprosthetic fractures of distal femur after primary total knee arthroplasties treated with ORIF or with the use of Distal femur replacement (DFR) were retrospectively analyzed in this to evaluate differences in intra-operative blood loss, need of blood trasfusion, weight bearing, range of motion, rate of complications, rate of revision surgery and functional outcome according Oxford Knee Score between two groups. Treatment of Periprosthetic distal femur fracture remains controversial. While ORIF seems to guarantee less percentage of complications and reoperation rate, those treated with megaprosthesis seem to gain better range of motion in a very short post-operative time. In the future it will be necessary to investigate with greater numbers possible advantages and disadvantages of the various treatments in periprosthetic distal femur fractures.

Effect of substituted stilbenes on platelet function.

Stilbenes, including resveratrol, are polyphenols provided with protective actions on the cardiovascular system. Some natural derivatives of resveratrol, like pterostilbene, have a better bioavailability than the parent compound. The aim of the present study was to prepare different substituted stilbenes (dimethylallyloxy-stilbene, dimethylallyloxy-pterostilbene) and compare them with resveratrol, p-hydroxy-stilbene and pterostilbene for their biologic activities on platelet aggregation, platelet radical oxygen species (ROS) production, and platelet nitric oxide (NO) synthesis. The results show that the increase of stilbene derivative lipophilicity enhances their biologic activities.

Diterpenoids and Triterpenoids from the Resin of Bursera microphylla and Their Cytotoxic Activity.

A chemical study of the nonpolar fraction of a methanol-soluble extract of Bursera microphylla resin yielded a variety of di- and triterpenoids. In total, 15 compounds were isolated, of which three are new, namely, malabaricatrienone (1), malabaricatrienol (2), and microphyllanin (3). The antiproliferative activity of the major compounds was evaluated in different murine cancer cell lines (M12.C3.F6 and RAW264.7) and human cancer cells (A549, HeLa, and PC-3). The new compounds (1-3) did not show significant antiproliferative activity. The known compounds ariensin (4), burseran (5), and dihydroclusin diacetate (6) were effective against the RAW264.7 cell line, with IC50 values in the micromolar range.

Organoselenium Compounds as Phytochemicals from the Natural Kingdom.

Selenium is naturally present in soils but it is also produced by pollution from human activities into the environment. Its incorporation into plants affords organoselenium metabolites that, depending on the nature of the molecules and the plant species, can be incorporated into proteins, stored or eliminated by volatilization. The possibility to use the selenium metabolism of some plants as a method for bioremediation and, at the main time, as a source of selenated phytochemicals is here discussed taking into consideration the growing interest in organic selenium derivatives as new potential therapeutic agents.

Antioxidant and antifungal activity of different extracts obtained from aerial parts of Inula crithmoides L.

The total phenolic content, antioxidant and antifungal activities of three Inula crithmoides extracts (n-hexane, methylene chloride and MeOH) were investigated. The methanolic extract showed the highest total phenolic content. In the DPPH assay, the methanolic and hexane extracts exhibited the highest DPPH-radical scavenging activity; in the 5-lipoxygenase assay, the hexane extract showed greater inhibitory effect with an IC50 similar to that of Trolox and ascorbic acid. The antifungal activity of the methanolic extract revealed a higher activity against Phytophtora cryptogea and Alternaria solani.

One-pot heterogeneous synthesis of Δ(3)-tetrahydrocannabinol analogues and xanthenes showing differential binding to CB(1) and CB(2) receptors.

Δ(9)-tetrahydrocannabinol (Δ(9)-THC) is the major psychoactive cannabinoid in hemp (Cannabis sativa L.) and responsible for many of the pharmacological effects mediated via cannabinoid receptors. Despite being the major cannabinoid scaffold in nature, Δ(9)-THC double bond isomers remain poorly studied. The chemical scaffold of tetrahydrocannabinol can be assembled from the condensation of distinctly substituted phenols and monoterpenes. Here we explored a microwave-assisted one pot heterogeneous synthesis of Δ(3)-THC from orcinol (1a) and pulegone (2). Four Δ(3)-THC analogues and corresponding Δ(4a)-tetrahydroxanthenes (Δ(4a)-THXs) were synthesized regioselectively and showed differential binding affinities for CB1 and CB2 cannabinoid receptors. Here we report for the first time the CB1 receptor binding of Δ(3)-THC, revealing a more potent receptor binding affinity for the (S)-(-) isomer (hCB1Ki = 5 nM) compared to the (R)-(+) isomer (hCB1Ki = 29 nM). Like Δ(9)-THC, also Δ(3)-THC analogues are partial agonists at CB receptors as indicated by [(35)S]GTPγS binding assays. Interestingly, the THC structural isomers Δ(4a)-THXs showed selective binding and partial agonism at CB2 receptors, revealing a simple non-natural natural product-derived scaffold for novel CB2 ligands.

Agarsenone, a Cadinane Sesquiterpenoid from Commiphora erythraea.

Agarsenone (1), a new cadinane sesquiterpenoid, was isolated from the resin of Commiphora erythraea. The structures of 1 and its decomposition products agarsenolides (2a and 2b) and myrrhone (3) were established by extensive NMR spectroscopic analysis. The absolute configuration of 3 and the relative and absolute configurations of 1 were assigned by comparison of experimental and calculated optical rotatory dispersion and electronic circular dichroism spectra.

Antigenotoxic effect, composition and antioxidant activity of Dendrobium speciosum.

The chemical composition, the antiradical properties of Dendrobium speciosum (Orchidaceae) leaves and stem extracts have been studied. Furthermore, in view of the use of this orchid as "bush foods", the genotoxic/antigenotoxic effects of the extracts have been evaluated.

Furanodien-6-one from Commiphora erythraea inhibits the NF-κB signalling and attenuates LPS-induced neuroinflammation.

We investigated the in vitro anti-inflammatory activity of 1(10),4-furanodien-6-one, one the most active compounds of the hexane extract of Commiphora erythraea (Ehrenb.) Engl., by exposing microglial BV-2 cells to lipopolysaccharide. We showed that furanodien-6-one pre-treatment restored cell viability and ROS to control levels while halving NO generation. Production of pro-inflammatory IL-6, IL-23, IL-17, TGF-ß, and INF-γ, significantly induced by LPS, was also markedly reduced by furanodien-6-one treatment. We further showed that furanodien-6-one protects primary neuronal cultures against the inflammatory/toxic insults of LPS-treated BV-2 conditioned media, indicating that furanodien-6-one exerts anti-inflammatory/cytoprotective effects in neuronal cells. We then investigated whether furanodien-6-one exerts anti-inflammatory properties in an in vivo model of microglial activation. In adult mice ip-injected with LPS we found that furanodien-6-one had strong cerebral anti-inflammatory properties by inhibiting liver and brain TNFα as well as IL-1ß expression. Results were not unexpected since FTIR-metabolomic analyses showed that furanodien-6-one-treated mice had a reduced dissimilarity to control animals and that the response to LPS treatment was markedly modified by furanodien-6-one. In conclusion our data provide strong evidence of the anti-inflammatory properties of furanodien-6-one that could be exploited to counteract degenerative pathologies based on neuroinflammation.

Antiviral furanosesquiterpenes from Commiphora erythraea.

The crude methanolic extract obtained from C. erythraea resin was chromatographed on silica gel with solvent of increasing polarity. The extract and fractions were evaluated for cytotoxicity and antiviral activity [parainfluenza type 3 virus (PIV3)] by plaque forming units (PFU) reduction assay using HEp-2 cells (human larynx epidermoid carcinoma cell line). From the active fraction, five compounds were isolated and tested. Only two of these showed anti-PIV3 activity with a selectivity index (SI) of 66.6 and 17.5, respectively. Both the compounds are furanosesquiterpenoids.

Antibacterial properties of auraptene and oxyprenylated naturally occurring benzoic and cinnamic acids / Propiedades antibacterianas del auraptene y acidos benzoicos y cinámicos oxi-prenilados naturales

The in vitro anti-bacterial activity of auraptene and four prenyloxycinnamic and benzoic acids was evaluated against a panel of three bacterial strain. All compounds were shown to be active as inhibitory agents of the growth of Staphylococcus aureus.

La actividad antibacteriana in vitro del auraptene y de cuatro ácidos preniloxycinámicos y benzoicos ha sido evaluada sobre un grupo de tres distintas cepas bacterianas. Todos los compuestos mostraron ser activos como agentes inhibitorios del crecimiento del Staphylococcus Aureus.

Protective effects of Commiphora erythraea resin constituents against cellular oxidative damage.

By bioguided fractionation of the hexane extract of Commiphora erythraea resin we isolated four furanosesquiterpenoids that were tested for their protective activity against oxidative stress. Furanodienone and 1,10(15)-furanogermacra-dien-6-ones showed to be potent inhibitors of lipid peroxidation (IC(50) of -0.087 µM), being more active than the methoxylated analogues. Furthermore, using BV2 microglial cells, we found that furanodienone from C. erythraea is able to counteract LPS-induced cell death and decrease LPS-induced NO generation thus protecting microglial cells from LPS-induced cytotoxicity. Finally, docking studies were undertaken to gain insight into the possible binding mode of the isolated compounds at 5-LOX binding site.

Anti-inflammatory, antioxidant and antifungal furanosesquiterpenoids isolated from Commiphora erythraea (Ehrenb.) Engl. resin.

The topical anti-inflammatory, free radical scavenging and antifungal activities of essential oils and extracts of Commiphora erythraea (Ehrenb.) Engl. resin were investigated. The hexane extract significantly inhibited oedema when applied topically in Croton oil-induced ear oedema assay in mice. The same extract showed antioxidant activity in DPPH radical scavenging assay. A bioguided separation of the hexane extract led to the isolation of furanosesquiterpenoids 1 and 2 that showed a weak antifungal activity, while compounds 3-5 resulted to be antioxidant (EC(50) 4.28, 2.56 and 1.08 mg/mL, respectively) and anti-inflammatory (30, 26 and 32% oedema reduction, respectively).