Measurement of lead, mercury, and cadmium in blood donors in Canada.

BACKGROUND: Fetal and neonatal exposure to lead is associated with irreversible adverse effects on neural development. There is no reliable threshold for lead effect, so limiting exposure is recommended. A significant correlation has been reported between post-transfusion blood lead level (BLL) in infants and lead levels in transfused RBC units. We measured levels of lead, mercury, and cadmium, in Canadian donor blood to investigate if concerning levels for neonatal transfusion exist. STUDY DESIGN AND METHODS: Whole blood samples from blood donors (n = 2529) were shipped cold within 7 days of donation. All permanent blood donation clinics across Canada were sampled. Twelve of these permanent clinics and 8 mobile clinics with a greater potential for having higher lead or mercury levels were oversampled. Heavy metals were measured by inductively coupled plasma mass spectrometry. RESULTS: Of all donations, 2.2% (lead) and 0.4% (mercury) had levels higher than the recommended thresholds for safe neonatal transfusion. BLLs were higher in males but there was no significant difference in the blood mercury levels of males versus females. Cadmium levels were higher in females. There was a positive correlation between donor age and levels of heavy metals, with lead having the strongest correlation (r = 0.47, p < .0001). Three clinics in close proximity to two lead-producing mines were among the clinics with the highest BLLs. Significantly higher blood mercury levels were observed in coastal clinics. CONCLUSION: Our data on donor blood heavy metal levels supports considering blood transfusion as an exposure source to heavy metals and encourages informed selection of blood units for transfusion to vulnerable groups.

Fracture Dislocation of the Pisiform Bone in 14-Year-Old Boy-A Case Report.

We present the case of a 14-year-old patient who suffered fracture dislocation of the pisiform bone (PB) along with fractures of the scaphoid, proximal radius, and proximal phalanx of the thumb due to high-energy trauma directly to the extended wrist. This combination of fractures has not been previously reported in the literature. Currently, there is no consensus in the literature regarding the optimal treatment approach for such cases. In our management, initial attempts at closed and open reduction were unsuccessful, leading to the decision for primary pisiformectomy. Our report includes a follow-up of 3.5 years, demonstrating a very good outcome. Based on this case and a few similar published cases, primary pisiformectomy appears to be a viable and well-accepted option, particularly among young patients. Additionally, we conducted a review of radiographic criteria and management strategies for this specific injury and related conditions.

Dissecting components of the Campylobacter jejuni fetMP-fetABCDEF gene cluster under iron limitation.

IMPORTANCE: Campylobacter jejuni is a bacterium that is prevalent in the ceca of farmed poultry such as chickens. Consumption of ill-prepared poultry is thus the most common route by which C. jejuni infects the human gut to cause a typically self-limiting but severe gastrointestinal illness that can be fatal to very young, old, or immunocompromised people. The lack of a vaccine and an increasing resistance to current antibiotics highlight a need to better understand the mechanisms that make C. jejuni a successful human pathogen. This study focused on the functional components of one such mechanism-a molecular system that helps C. jejuni thrive despite the restriction on growth-available iron by the human body, which typically defends against pathogens. In providing a deeper understanding of how this system functions, this study contributes toward the goal of reducing the enormous global socioeconomic burden caused by C. jejuni.

In Vitro Imaging and Molecular Characterization of Ca2+ Flux Modulation by Nanosecond Pulsed Electric Fields.

In recent years, the application of pulsed electric fields with very short durations (nanoseconds) and extremely high amplitudes (MV/m) has been investigated for novel medical purposes. Various electric protocols have been explored for different objectives, including the utilization of fractionated pulse doses to enhance cell electrosensitization to the uptake of different markers or an increase in apoptosis. This study focused on the use of fluorescence imaging to examine molecular calcium fluxes induced by different fractionated protocols of short electric pulses in neuroblastoma (SH-SY5Y) and mesenchymal stem cells (HaMSCs) that were electroporated using nanosecond pulsed electric fields. In our experimental setup, we did not observe cell electrosensitization in terms of an increase in calcium flux following the administration of fractionated doses of nanosecond pulsed electric fields with respect to the non-fractionated dose. However, we observed the targeted activation of calcium-dependent genes (c-FOS, c-JUN, EGR1, NURR-1, ß3-TUBULIN) based on the duration of calcium flux, independent of the instantaneous levels achieved but solely dependent on the final plateau reached. This level of control may have potential applications in various medical and biological treatments that rely on calcium and the delivery of nanosecond pulsed electric fields.

Maize plant expresses SWEET transporters differently when interacting with Trichoderma asperellum and Fusarium verticillioides, two fungi with different lifestyles.

Most Trichoderma species are beneficial fungi that promote plant growth and resistance, while Fusarium genera cause several crop damages. During the plant-fungi interaction there is a competition for sugars in both lifestyles. Here we analyzed the plant growth promotion and biocontrol activity of T. asperellum against F. verticillioides and the effect of both fungi on the expression of the maize diffusional sugar transporters, the SWEETs. The biocontrol activity was done in two ways, the first was by observing the growth capacity of both fungus in a dual culture. The second one by analyzing the infection symptoms, the chlorophyl content and the transcript levels of defense genes determined by qPCR in plants with different developmental stages primed with T. asperellum conidia and challenged with F. verticillioides. In a dual culture, T. asperellum showed antagonist activity against F. verticillioides. In the primed plants a delay in the infection disease was observed, they sustained chlorophyll content even after the infection, and displayed upregulated defense-related genes. Additionally, the T. asperellum primed plants had longer stems than the nonprimed plants. SWEETs transcript levels were analyzed by qPCR in plants primed with either fungus. Both fungi affect the transcript levels of several maize sugar transporters differently. T. asperellum increases the expression of six SWEETs on leaves and two at the roots and causes a higher exudation of sucrose, glucose, and fructose at the roots. On the contrary, F. verticillioides reduces the expression of the SWEETs on the leaves, and more severely when a more aggressive strain is in the plant. Our results suggest that the plant is able to recognize the lifestyle of the fungi and respond accordingly by changing the expression of several genes, including the SWEETs, to establish a new sugar flux.

Dynamics of High-Density Unipolar Epicardial Electrograms During PFA.

BACKGROUND: Pulsed field ablation (PFA) is a novel nonthermal cardiac ablation technology based on irreversible electroporation (IRE). While areas of IRE lead to durable lesions, the surrounding regions, where reversible electroporation occurs, recover. The behavior of local electrograms in areas of different electroporation levels remains unknown. The goal of this study is to characterize electrogram dynamics after PFA in IRE and reversible electroporation areas. METHODS: A total of 6 domestic swine were used. PFA was applied in the epicardium of the right and left ventricles using a focal monopolar catheter. Additional radiofrequency ablations were performed. Epicardial unipolar electrograms were acquired at baseline and for 60 minutes post PFA/radiofrequency ablation using a high-density electrode matrix attached to the epicardium. Electrogram dynamics were analyzed in areas corresponding to different levels of electroporation. Acute lesion formation was assessed after 3 to 5 hours by triphenyl tetrazolium chloride staining. RESULTS: Electrogram analysis demonstrated a clear association between electrogram changes and the level of electroporation. Immediately after PFA, electrograms displayed the following: a significant decrease in R/S-wave amplitude; a large elevation of the ST-segment; and a large decrease in their |(dV/dt)|max. Marked changes in electrograms were observed beyond the lesion area. Thereafter, a gradual recovery was observed. The evolution of all the electrogram parameters throughout the 60 minutes after PFA was significantly different (P<0.05) between the IRE and reversible electroporation areas. Acute lesion staining showed significantly larger depth for PFA lesions compared with radiofrequency ablation. CONCLUSIONS: This study shows that unipolar electrograms can differentiate between reversible electroporation and IRE areas during the first 30 minutes post ablation. Differences after the first 30 minutes are less evident. Our findings could result useful for immediate lesion assessment after PFA and warrant further investigation.

Dissecting components of the Campylobacter jejuni fetMP-fetABCDEF gene cluster in iron scavenging.

Campylobacter jejuni is a leading cause of bacterial gastroenteritis worldwide. Acute infection can be antecedent to highly debilitating long-term sequelae. Expression of iron acquisition systems is vital for C. jejuni to survive the low iron availability within the human gut. The C. jejuni fetMP-fetABCDEF gene cluster is known to be upregulated during human infection and under iron limitation. While FetM and FetP have been functionally linked to iron transport in prior work, here we assess the contribution by each of the downstream genes ( fetABCDEF ) to C. jejuni growth during both iron-depleted and iron-replete conditions. Significant growth impairment was observed upon disruption of fetA , fetB, fetC , and fetD , suggesting a role in iron acquisition for each encoded protein. FetA expression was modulated by iron-availability but not dependent on the presence of FetB, FetC, FetD, FetE or FetF. Functions of the putative thioredoxins FetE and FetF were redundant in iron scavenging, requiring a double deletion (Δ fetEF ) to exhibit a growth defect. C. jejuni FetE was expressed and the structure solved to 1.50 Å, revealing structural similarity to thiol-disulfide oxidases. Functional characterization in biochemical assays showed that FetE reduced insulin at a slower rate than E. coli Trx and that together, FetEF promoted substrate oxidation in cell extracts, suggesting that FetE (and presumably FetF) are oxidoreductases that can mediate oxidation in vivo . This study advances our understanding of the contributions by the fetMP-fetABCDEF gene cluster to virulence at a genetic and functional level, providing foundational knowledge towards mitigating C. jejuni -related morbidity and mortality.

Parametric Study of Pulsed Field Ablation With Biphasic Waveforms in an In Vivo Heart Model: The Role of Frequency.

BACKGROUND: Pulsed field ablation (PFA) is a novel nonthermal cardiac ablation technology based on irreversible electroporation. Unfortunately, the characteristics of the electric field waveforms used in clinical and experimental PFA are not typically reported. This study examines the effect of the frequency of biphasic waveforms and compares biphasic to monophasic waveforms. METHODS: A total of 29 Sprague-Dawley rats were treated with PFA using an epicardial monopolar electrode. Biphasic waveforms with three different frequencies, 90, 260, and 450 kHz (10 bursts of 100 µs duration at 500 V or 800 V) and monophasic waveforms (10 pulses of 100 µs duration at 500 V) were studied. Collateral neuromuscular stimulation and temperature increase in the point of application were directly measured. Lesion formation was assessed 3 weeks after treatment by histopathologic analysis. Computer simulations were used to estimate the electric field lethal threshold for each condition. A previous in vitro study was performed to draw a complete characterization of the studied dependencies. RESULTS: Morphometric analysis demonstrated a significant association between chronic lesion size and waveform characteristics. For the same voltage level, monophasic waveforms yielded the largest lesions compared with any of the biphasic protocols (P<0.05). Increasing PFA frequency was associated with reduced neuromuscular stimulation but also with reduced ablation efficacy. Maximum absolute temperature increase recorded along a complete treatment was 3 °C. Vascular structures inside the lesions were preserved for all conditions. Computer simulation-based analysis showed that waveform frequency had a graded effect on the lethal electric field threshold, with threshold of 600 V/cm for monophasic waveforms versus 2000 V/cm for biphasic waveforms with a frequency of 450 kHz. CONCLUSIONS: Frequency is a major determinant of efficacy in biphasic PFA. Our results highlight the critical need of disclosing waveform characteristics when reporting the results of different PFA systems.

A computational comparison of radiofrequency and pulsed field ablation in terms of lesion morphology in the cardiac chamber.

Pulsed Field Ablation (PFA) has been developed over the last years as a novel electrical ablation technique for treating cardiac arrhythmias. It is based on irreversible electroporation which is a non-thermal phenomenon innocuous to the extracellular matrix and, because of that, PFA is considered to be safer than the reference technique, Radiofrequency Ablation (RFA). However, possible differences in lesion morphology between both techniques have been poorly studied. Simulations including electric, thermal and fluid physics were performed in a simplified model of the cardiac chamber which, in essence, consisted of a slab of myocardium with blood in motion on the top. Monopolar and bipolar catheter configurations were studied. Different blood velocities and catheter orientations were assayed. RFA was simulated assuming a conventional temperature-controlled approach. The PFA treatment was assumed to consist in a sequence of 20 biphasic bursts (100 µs duration). Simulations indicate that, for equivalent lesion depths, PFA lesions are wider, larger and more symmetrical than RFA lesions for both catheter configurations. RFA lesions display a great dependence on blood velocity while PFA lesions dependence is negligible on it. For the monopolar configuration, catheter angle with respect to the cardiac surface impacted both ablation techniques but in opposite sense. The orientation of the catheter with respect to blood flow direction only affected RFA lesions. In this study, substantial morphological differences between RFA and PFA lesions were predicted numerically. Negligible dependence of PFA on blood flow velocity and direction is a potential important advantage of this technique over RFA.

VEMERS 2.0: Upgrading of an Emergency Use Ventilator from a Single Mandatory Volume Control Mode of Ventilation (VEMERS 1.0) to 8 Modes of Ventilation.

The upgrading of an emergency use ventilator from a single mandatory volume control mode of ventilation (VEMERS 1.0) to 8 modes of ventilation (VEMERS 2.0) is described. The original VEMERS 1.0 was developed in the midst of the COVID-19 crisis in Chile (April to August 2020) following special but nonetheless strict guidelines specified by local medical associations and national health and scientific ministries. The upgrade to 8 modes of ventilation in VEMERS 2.0 was made possible with minor but transcendental changes to the original architecture. The main contribution of this research is that starting from a functional block diagram of an ICU mechanical ventilator and carrying a systematic analysis, the main function blocks are implemented in such a way that combinations of standard off-the-shelf pneumatic and electronic components can be used. This approach has both economical and technical advantages. No special parts need to be fabricated at all, and because of a wider variety of options, the use of extensively field-proven off-the-shelf commercial components assures better availability and lower costs when compared to that of conventional ICU mechanical ventilators, without sacrificing reliability. Given the promising results obtained with VEMERS 2.0 in the subsequent national certification process, the production of 40 VEMERS 2.0 units was sponsored by the Ministry of Science and the Ministry of Economy. Twenty units have been distributed among hospitals along the country. The purpose of VEMERS 2.0, as a low-cost but very reliable option, is to increase the number of mechanical ventilators available (3,000 for a population of 18,000,000) in the country to eventually reach a ratio similar to that of more developed countries. VEMERS is an open-source project for others to use the knowledge gained.

Absceso mastoideo como presentación de colesteatoma congénito en preescolar ¿cuál es el origen? / Mastoid abscess as congenital cholesteatoma presentation in a child what is the origin?

Resumen El colesteatoma congénito es una entidad que puede manifestarse con una amplia variedad de síntomas o ser silente durante largo tiempo y constituir un hallazgo incidental. Una vez diagnosticada es importante valorar su extensión y el compromiso de estructuras adyacentes, para lograr una adecuada planificación quirúrgica, eliminando la enfermedad y manteniendo la mejor funcionalidad posible. Se presenta un caso de colesteatoma congénito infantil.

Abstract Congenital cholesteatoma is an entity that can manifest with a wide variety of symptoms or be silent for a long time and constitute an incidental finding. Once diagnosed, it is important to assess the extension to apply the most efficient treatment, eliminating the disease and providing functionality if possible. A case of congenital cholesteatoma in a child is presented.

Modeling Methods for Treatment Planning in Overlapping Electroporation Treatments.

OBJECTIVE: Irreversible electroporation (IRE) is a non-thermal tissue ablation therapy which is induced by applying high voltage waveforms across electrode pairs. When multiple electrode pairs are sequentially used, the treatment volume (TV) is typically computed as the geometric union of the TVs of individual pairs. However, this method neglects that some regions are exposed to overlapping treatments. Recently, a model describing cell survival probability was introduced which effectively predicted TV with overlapping fields in vivo. However, treatment overlap has yet to be quantified. This study characterizes TV overlap in a controlled in vitro setup with the two existing methods which are compared to an adapted logistic model proposed here. METHODS: CHO cells were immobilized in agarose gel. Initially, we characterized the electric field threshold and the cell survival probability for overlapping treatments. Subsequently, we created a 2D setup where we compared and validated the accuracy of the different methods in predicting the TV. RESULTS: Overlap can reduce the electric field threshold required to induce cell death, particularly for treatments with low pulse number. However, it does not have a major impact on TV in the models assayed here, and all the studied methods predict TV with similar accuracy. CONCLUSION: Treatment overlap has a minor influence in the TV for typical protocols found in IRE therapies. SIGNIFICANCE: This study provides evidence that the modeling method used in most pre-clinical and clinical studies seems adequate.

Biological effects of ultrashort electric pulses in a neuroblastoma cell line: the energy density role.

BACKGROUND: Despite the numerous literature results about biological effects of electromagnetic field (EMF) exposure, the interaction mechanisms of these fields with organisms are still a matter of debate. Extremely low frequency (ELF) MFs can modulate redox homeostasis and we showed that 24 h exposure to 50 Hz-1 mT has a pro-oxidant effect and effects on the epigenome of SH-SY5Y cells, decreasing miR-34b/c expression through the hypermethylation of their promoter. METHODS: Here, we investigated the role of the electromagnetic deposited energy density (ED) during exposures lasting 24 h to 1 mT amplitude MFs at a frequency of 50 Hz in inducing the above mentioned effects. To this end, we delivered ultrashort electric pulses, in the range of microsecond and nanosecond duration, with the same ED of the previously performed magnetic exposure to SH-SY5Y cells. Furthermore, we explored the effect of higher deposited energy densities. Analysis of i) gene and microRNA expression, ii) cell morphology, iii) reactive oxygen species (ROS) generation, and iv) apoptosis were carried out. RESULTS: We observed significant changes in egr-1 and c-fos expression at very low deposited ED levels, but no change of the ROS production, miR-34b/c expression, nor the appearance of indicators of apoptosis. We thus sought investigating changes in egr-1 and c-fos expression caused by ultrashort electric pulses at increasing deposited ED levels. The pulses with the higher deposited ED caused cell electroporation and even other morphological changes such as cell fusion. The changes in egr-1 and c-fos expression were more intense, but, again, no change of the ROS production, miR-34b/c expression, nor apoptosis induction was observed. CONCLUSIONS: These results, showing that extremely low levels of electric stimulation (never investigated until now) can cause transcriptional changes, also reveal the safety of the electroporating pulses used in biomedical applications and open up the possibility to further therapeutic applications of this technology.

Examining the immune signatures of SARS-CoV-2 infection in pregnancy and the impact on neurodevelopment: Protocol of the SIGNATURE longitudinal study.

The COVID-19 pandemic represents a valuable opportunity to carry out cohort studies that allow us to advance our knowledge on pathophysiological mechanisms of neuropsychiatric diseases. One of these opportunities is the study of the relationships between inflammation, brain development and an increased risk of suffering neuropsychiatric disorders. Based on the hypothesis that neuroinflammation during early stages of life is associated with neurodevelopmental disorders and confers a greater risk of developing neuropsychiatric disorders, we propose a cohort study of SARS-CoV-2-infected pregnant women and their newborns. The main objective of SIGNATURE project is to explore how the presence of prenatal SARS-CoV-2 infection and other non-infectious stressors generates an abnormal inflammatory activity in the newborn. The cohort of women during the COVID-19 pandemic will be psychological and biological monitored during their pregnancy, delivery, childbirth and postpartum. The biological information of the umbilical cord (foetus blood) and peripheral blood from the mother will be obtained after childbirth. These samples and the clinical characterisation of the cohort of mothers and newborns, are tremendously valuable at this time. This is a protocol report and no analyses have been conducted yet, being currently at, our study is in the recruitment process step. At the time of this publication, we have identified 1,060 SARS-CoV-2 infected mothers and all have already given birth. From the total of identified mothers, we have recruited 537 SARS-COV-2 infected women and all of them have completed the mental health assessment during pregnancy. We have collected biological samples from 119 mothers and babies. Additionally, we have recruited 390 non-infected pregnant women.

Depresión mayor en población general de Envigado (Colombia): prevalencia y factores asociados / Major depression in the general population of Envigado (Colombia): prevalence and associated factors

Resumen Introducción: La depresión afecta a más de 300 millones de personas en el mundo, es la principal causa de discapacidad y contribuye de forma importante a la carga mundial de morbilidad. Objetivo: Determinar la prevalencia y algunos factores personales, sociales y familiares asociados al trastorno de depresión mayor en población de 15 a 65 años del municipio de Envigado (Colombia) en el año 2017. Método: Estudio transversal con intención analítica, a partir de la información de 905 participantes del "Estudio Poblacional de Salud Mental, Envigado 2017", recopilada a través de entrevistas realizadas con la World Health Organization Composite International Diagnostic Interview -CIDI-OMS. El procesamiento se realizó mediante el programa SPSS versión 23. Resultados: Cuatro factores explican la probabilidad de depresión mayor en el último año, en la población de estudio: el abuso de drogas diferentes al alcohol (ORaj=4,43 [1,164-16,833]), la muerte o enfermedad de un familiar cercano (ORaj=4,15 [1,583-10,880]), presentar altos niveles de resiliencia (ORaj=0,22 [0,112-0,425]) y una percepción excelente o buena de su salud mental (ORaj=0,19 [0,098-0,378]). Conclusiones: Los factores que aumentan la probabilidad de depresión mayor en la población de estudio son: abuso de drogas diferentes al alcohol y la muerte o enfermedad de un familiar de primer grado de consanguinidad; y los factores protectores son altos niveles de resiliencia y una percepción excelente o buena de la propia salud mental. Esta evidencia refuerza la necesidad de implementar programas de promoción centrados en el mejoramiento de habilidades para la vida, que propicien estrategias adecuadas frente a los desafíos.

Abstract Introduction: Depression affects more than 300 million people in the world, it is the leading cause of disability and contributes significantly to the global burden of disease. Objective: To determine the prevalence and some social, personal, and family factors associated with major depressive disorder in a population aged from 15 to 65 in Envigado (Colombia) in 2017. Methods: A cross-sectional study with analytical intent was conducted, based on the information from 905 participants for the "Population study of mental health 2017", collected through interviews administered by means of the World Health Organization Composite International Diagnostic Interview -CIDI-OMS. The processing was performed using the SPSS program version 23. (CES University License). Results: Four factors correlate with major depression in the last year in the study population: drug abuse other than alcohol (ORaj = 4,43 [1,164-16,833]), a close relative´s death or illness (ORaj = 4,15 [1,583-10,880]), high resilience (ORaj = 0.22 [0,112-0,425]) and an excellent or good mental health perception (ORaj = 0.19 [0.098-0.378]). Conclusions: the factors that increase the probability of major depression in the study population are drug abuse other than alcohol and the death or illness of a first-degree relative; and the protective factors are high levels of resilience and an excellent or good perception of one's own mental health. This evidence reinforces the need to implement promotion programs focused on improvement of life skills, which provide adequate strategies to face the challenges.

Comparing High-Frequency With Monophasic Electroporation Protocols in an In Vivo Beating Heart Model.

This study compared monophasic 100-µs pulses with high-frequency electroporation (HF-EP) bursts using an in vivo animal model. Myocardial damage was evaluated by histologic analysis. Compared with 10 monophasic pulses, 20 bursts of HF-EP at 100 and 150 kHz were associated with less damage. However, when the number of HF-EP bursts was increased to 60, myocardial damage was comparable to that of the monophasic group. HF-EP protocols were associated with attenuated collateral muscle contractions. This study shows that HF-EP is feasible and effective and that pulse frequency has a significant effect on extent of ablation.

Graphite to diamond transition induced by photoelectric absorption of ultraviolet photons.

The phase transition from graphite to diamond is an appealing object of study because of many fundamental and also, practical reasons. The out-of-plane distortions required for the transition are a good tool to understand the collective behaviour of layered materials (graphene, graphite) and the van der Waals forces. As today, two basic processes have been successfully tested to drive this transition: strong shocks and high energy femtolaser excitation. They induce it by increasing either pressure or temperature on graphite. In this work, we report a third method consisting in the irradiation of graphite with ultraviolet photons of energies above 4.4 eV. We show high resolution electron microscopy images of pyrolytic carbon evidencing the dislocation of the superficial graphitic layers after irradiation and the formation of crystallite islands within them. Electron energy loss spectroscopy of the islands show that the sp2 to sp3 hybridation transition is a surface effect. High sensitivity X-ray diffraction experiments and Raman spectroscopy confirm the formation of diamond within the islands.

Possible molecular and cellular mechanisms at the basis of atmospheric electromagnetic field bioeffects.

Mechanisms of how electromagnetic (EM) field acts on biological systems are governed by the same physics regardless of the origin of the EM field (technological, atmospheric...), given that EM parameters are the same. We draw from a large body of literature of bioeffects of a man-made electromagnetic field. In this paper, we performed a focused review on selected possible mechanisms of how atmospheric electromagnetic phenomena can act at the molecular and cellular level. We first briefly review the range of frequencies and field strengths for both electric and magnetic fields in the atmosphere. Then, we focused on a concise description of the current knowledge on weak electric and magnetic field bioeffects with possible molecular mechanisms at the basis of possible EM field bioeffects combined with modeling strategies to estimate reliable outcomes and speculate about the biological effects linked to lightning or pyroelectricity. Indeed, we bring pyroelectricity as a natural source of voltage gradients previously unexplored. While very different from lightning, it can result in similar bioeffects based on similar mechanisms, which can lead to close speculations on the importance of these atmospheric electric fields in the evolution.

Surgical Management of a Latissimus Dorsi Costal Tear in an Elite Female Handball Player: A Case Report.

Introduction: Latissimus dorsi ruptures are rare injuries more commonly seen in elite overhead and hip throwers athletes. The most frequent mechanism of injury is indirect. The management of these injuries is unclear and controversial. Case Presentation: In this case report we present a professional female handball player with an acute intramuscular/costal tear of the latissimus dorsi, managed operatively. The patient injured extremity was the dominant throwing arm with a palpable muscle gap of 3 cm. Operative treatment was taken and objective follow-up using UCLA shoulder rating scale and DASH scores; demonstrating a progressive improvement between day zero (UCLA 13pts and DASH 36.7 pts) and the final 6 months (UCLA 33pts and DASH 0.8 pts) follow up; returning to sport at 12 weeks. Conclusion: Latissimus dorsi costal tears are uncommon injuries that can also be seen in hip throwing athletes. Surgical management should be considered if the dominant arm is affected and a 3cm muscle gap is present.

Bone-Preserving Arthroplasty With Abductor Pollicis Longus Tenodesis for Trapeziometacarpal Osteoarthritis.

Purpose: The objective of this study was to describe an original method of bone-preserving arthroplasty with abductor pollicis longus (APL) tenodesis and determine its safety and effectiveness as a treatment for early-stage osteoarthritis of the trapeziometacarpal joint. Methods: Eleven patients underwent a trapezium-preserving arthroplasty with APL tenodesis for stage 1 and 2 osteoarthritis were retrospectively reviewed. This arthroplasty consisted of a distally-based APL tendon being passed through the trapeziometacarpal joint. The proximal end of the tendon was then pulled and passed through a drill hole made at the neck of the second metacarpal and sutured to itself. Thus, distraction of the first metacarpal and interposition of the tendon were created. Postoperative radiologic and clinical follow-up visits were performed at 4, 8, and 12 weeks. Range of motion and strength were assessed after surgery. Patient satisfaction and outcome were assessed, and the disabilities of the arm, shoulder, and hand (DASH) score was used. Results: After a mean follow-up of 29.5 months (range, 16-43 months), the mean patient visual analog scale pain score improved from 7.1 to 2.3. The average DASH score of all patients at the follow-up examination was 18.3 ± 19.8. Patients' mean grip strength was 25.3 kg, which represented 102% of the value on the contralateral side. The key-pinch strength was 6.2 kg on the operated hand compared with 6.5 kg on the contralateral side. The mean thumb opposition Kapandji index was 9.4, which was similar to that of the contralateral side. Three patients were very satisfied with the postoperative outcome and 3 patients were satisfied. Two patients were lost to follow-up, 1 patient did not consent to share her data, and 2 patients had to undergo trapeziectomy. Conclusions: Although a larger study population and a longer follow-up period are needed to draw conclusions, bone-preserving arthroplasty with APL tenodesis showed satisfying results in patients presenting with early-stage osteoarthritis. This method is technically simple and time-efficient, does not reduce the range of motion, and leaves open all other surgical options. Type of study/level of evidence: Therapeutic IV, Case Series.