Two different approaches for novel extracapsular cranial cruciate ligament reconstruction: an in vitro kinematics study.

OBJECTIVE: To analyse the best combination of isometric points with the best kinematic results between two different approaches of TightRope® cranial cruciate ligament reconstruction. MATERIALS AND METHODS: Cranial drawer, cranial tibial thrust, internal/external, range of motion and varus/valgus tests were passively performed in different stifle conditions: cranial cruciate ligament-intact/deficient, after F2-T2/F2-T3 TR reconstruction at 22-44-99 N of tension. Data were acquired by a custom-made navigation system. RESULTS: The cranial drawer test showed recovery of laxity only at 99 N in both approaches. Significant laxity reduction (cranial tibial thrust) was present at only the F2-T2 point. Differences were noted in internal/external and varus/valgus rotation between the cranial cruciate ligament-intact and TightRope® stifles at all of the implant tensions. The range of motion underlined significantly lower laxity values following the F2-T2/F2-T3 reconstruction at all of the evaluated implant tensions. CLINICAL SIGNIFICANCE: The best isometric site was at the F2-T2 point, however significant differences in the amount of laxity between the two techniques were limited to the cranial tibial thrust and internal/external test. The F2-T2 technique was the best consideration for clinical application because it is relatively easy to perform, repeatable and results in good stifle stability with low morbidity and complications.

[Results of a screening project for congenital hypothyroidism in 4 years of experience]. / Risultati di un progetto di screening per l'ipotiroidismo congenito in 4 anni di esperienza.

A screening program for congenital hypothyroidism has been starting in Siena since November, 1977 with the Guthrie's test for PKU. According to the recommendations of the Committee of the European Thyroid Association the program were performed on capillary blood samples collected between the fourth and sixth days after birth on an adsorbent paper. The screening began with the measurement of T4 RIA (up to May, 1980), and T4 and TSH RIA (from may, 1980, to december, 1981). At december, 1981, 23.693 newborns have been screened. The recall rate was 2,5% up to may, 1980, and 0,11% from may, 1980 to december, 1981. Ten newborns with congenital hypothyroidism have been detected; the incidence is one in 2.400 live births. There were no cases of transient hypothyroidism and no cases of TBG deficiency. All patients are treated before the age of one month. The diagnosis is confirmed in seven cases at one year of life after stopterapy for one month. Our program confirm the high incidence of congenital hypothyroidism. Clinical control, based on physical and psychomotor development testing in seven patients treated confirmed that all infants are normal.