Morphological and topographical anatomy of nutrient foramina in the lower limb long bones and its clinical importance

Background

Knowledge regarding nutrient foramina of bones is useful in surgical procedures such as microvascular bone transfer in order to preserve the circulation. The objective of the present study was to study the morphology and topography of nutrient foramina and to determine the foraminal index of the lower limb long bones to provide detailed data on such features.

Method

The study comprised examination of 206 lower limb long bones which included femora, tibiae and fibulae. The nutrient foramina were identified analysed macroscopically and the foramen index calculated. Each bone was divided into five parts and topographical analysis was performed on each section.

Results

Femora had single nutrient foramen in 47.7% of the cases, double foramen in 44.2% of the cases, triple in 3.5% of the cases and an absence of foramen in 4.6%. In the case of tibiae, 98.6% showed single foramen and in 1.4% of the cases, the foramen was absent. With respect to fibulae, 90.2% had single foramen and foramen was absent in 9.8%. The mean foraminal index was 38.9 for the femora, 32.5 for tibiae and 49.2 for fibulae. The majority (51.3%) of the foramina in the femora were located at the 2/5^th part, 98.3% of the tibiae foramina at the 2/5^th part and 60% of the fibulae at the 3/5^th part.

Conclusion

The study provides information on the morphology and topography of nutrient foramina in lower limb long bones. The double foramina were more common in femur and rare in the tibia and fibula. The foramina of the femur and tibia were commonly observed at their upper part, whereas in the fibula they were present on the lower part. This knowledge of the nutrient foramina has to be kept in mind during surgical procedures.     

Bap: a family of surface proteins involved in biofilm formation

A group of surface proteins sharing several structural and functional features is emerging as an important element in the biofilm formation process of diverse bacterial species. The first member of this group of proteins was identified in a Staphylococcus aureus mastitis isolate and was named Bap (biofilm-associated protein). As common structural features, Bap-related proteins: (i) are present on the bacterial surface; (ii) show a high molecular weight; (iii) contain a core domain of tandem repeats; (iv) confer upon bacteria the capacity to form a biofilm; (v) play a relevant role in bacterial infectious processes; and (vi) can occasionally be contained in mobile elements. This review summarizes recent studies that have identified and assigned roles to Bap-related proteins in biofilm biology and virulence.     

Animal-assisted interventions in internal and rehabilitation medicine: a review of the recent literature

While conventional wisdom has always affirmed the value of animals in promoting human well-being, only recently has their therapeutic role in medicine become the focus of dedicated research. Therapeutic modalities that use animals as a tool for improving the physical, emotional, cognitive and/or social functioning of humans are called animal-assisted interventions (AAI), and are classified into: animal-assisted activities (AAA); animal-assisted therapy (AAT); and service animal programs (SAP). The aim of this review is to analyze the papers published between 2001 and 2010 in the most influential medical journals dealing with AAI, and discuss their findings in the light of what may be of interest for internal medicine and rehabilitation. A total of 35 articles met the strict inclusion criteria for this review: 18 papers dealing with AAA, 8 with AAT, and 9 with SAP. The therapeutic outcomes associated with AAA are: enhancement of socialization; reduction of stress, anxiety and loneliness; improvement in mood and general well-being; and development of leisure/recreation skills. Regarding AAT, horses are often used as a complementary strategy to facilitate the normalization of muscle tone and improve motor skills in children with cerebral palsy and persons with lower limb spasticity. Finally, most SAP utilize dogs, that assist people with various disabilities in performing everyday activities, thus reducing their dependence on other persons. Further studies are needed to better define the fields and programs for the therapeutic use of animals and to increase their utilization in medicine, as a promising, complementary and natural means to improve both functional autonomy and quality of life.     

Defining and Evaluating a Core Genome Multilocus Sequence Typing Scheme for Whole-Genome Sequence-Based Typing of Listeria monocytogenes

Whole-genome sequencing (WGS) has emerged today as an ultimate typing tool to characterize Listeria monocytogenes outbreaks. However, data analysis and interlaboratory comparability of WGS data are still challenging for most public health laboratories. Therefore, we have developed and evaluated a new L. monocytogenes typing scheme based on genome-wide gene-by-gene comparisons (core genome multilocus the sequence typing [cgMLST]) to allow for a unique typing nomenclature. Initially, we determined the breadth of the L. monocytogenes population based on MLST data with a Bayesian approach. Based on the genome sequence data of representative isolates for the whole population, cgMLST target genes were defined and reappraised with 67 L. monocytogenes isolates from two outbreaks and serotype reference strains. The Bayesian population analysis generated five L. monocytogenes groups. Using all available NCBI RefSeq genomes (n = 36) and six additionally sequenced strains, all genetic groups were covered. Pairwise comparisons of these 42 genome sequences resulted in 1,701 cgMLST targets present in all 42 genomes with 100% overlap and ≥90% sequence similarity. Overall, ≥99.1% of the cgMLST targets were present in 67 outbreak and serotype reference strains, underlining the representativeness of the cgMLST scheme. Moreover, cgMLST enabled clustering of outbreak isolates with ≤10 alleles difference and unambiguous separation from unrelated outgroup isolates. In conclusion, the novel cgMLST scheme not only improves outbreak investigations but also enables, due to the availability of the automatically curated cgMLST nomenclature, interlaboratory exchange of data that are crucial, especially for rapid responses during transsectorial outbreaks.     

About 1% of the breast and ovarian Spanish families testing negative for BRCA1 and BRCA2 are carriers of RAD51D pathogenic variants

RAD51D mutations have been recently identified in breast (BC) and ovarian cancer (OC) families. Although an etiological role in OC appears to be present, the association of RAD51D mutations and BC risk is more unclear. We aimed to determine the prevalence of germline RAD51D mutations in Spanish BC/OC families negative for BRCA1/BRCA2 mutations. We analyzed 842 index patients: 491 from BC/OC families, 171 BC families, 51 OC families and 129 patients without family history but with early‐onset BC or OC or metachronous BC and OC. Mutation detection was performed with high‐resolution melting, denaturing high‐performance liquid chromatography or Sanger sequencing. Three mutations were found in four families with BC and OC cases (0.82%). Two were novel: c.1A>T (p.Met1?) and c.667+2_667+23del, leading to the exon 7 skipping and one previously described: c.674C>T (p.Arg232*). All were present in BC/OC families with only one OC. The c.667+2_667+23del cosegregated in the family with one early‐onset BC and two bilateral BC cases. We also identified the c.629C>T (p.Ala210Val) variant, which was predicted in silico to be potentially pathogenic. About 1% of the BC and OC Spanish families negative for BRCA1/BRCA2 are carriers of RAD51D mutations. The presence of several BC mutation carriers, albeit in the context of familial OC, suggests an increased risk for BC, which should be taken into account in the follow‐up and early detection measures. RAD51D testing should be considered in clinical setting for families with BC and OC, irrespective of the number of OC cases in the family.     

西藏自治区城乡居民健康素养比较分析

目的了解西藏自治区城乡居民健康素养现状,为制定相关健康教育策略提供科学依据。方法采用多阶段分层随机抽样的方法对西藏自治区6个县(区)15～69岁居民进行现场问卷调查,采用χ2检验进行比较分析。结果共调查2024人。调查居民的健康理念和基本健康知识知晓率为50.2%,城市居民和农村居民分别为55.4%和45.3%,城乡间差异有统计学意义(P<0.05)。调查对象健康生活方式和行为形成率为60.6%,城市居民和农村居民分别为61.3%和59.9%,城乡间比较,差异有统计学意义(P<0.05)。调查对象健康技能总体掌握率为36.4%,城市居民和农村居民分别为46.7%和26.7%,城乡间比较,差异有统计学意义(P<0.05)。结论西藏自治区居民健康素养水平较低,城乡差异较大,需根据不同地区的主要问题,制定针对性的健康教育策略,逐步提高全区居民的健康素养。