Isokinetic flexion strength recovery after ACL reconstruction: a comparison between all inside graft-link technique and full tibial tunnel technique

Introduction: Recently, a new minimally invasive single bundle technique for anatomic ACL reconstruction has been described, called the ‘All-Inside graft-link technique’. One of the advantages of this procedure is the reduced morbidity at the donor site as the graft choice is the quadrupled semitendinosus, thus sparing the gracilis tendon. The aim of this study was to evaluate isokinetic flexion strength recovery in patients who underwent a gracilis sparing technique compared to those with a full-tibial tunnel technique using a doubled gracilis and semitendinosus tendons (DGST) graft.

Methods: Patients were divided into two groups: Group A (22 patients) who underwent ACL reconstruction performed with an All-Inside graft-link technique; Group B (22 patients) who underwent ACL reconstruction with an Out-In technique and DGST graft. At a mean follow-up of 13 months, quadriceps and hamstring isokinetic peak torque deficits were recorded.

Results: In group A, the mean side to side peak torque flexion difference between the operated and non-operated limbs was ?3% and the mean torque at 30° was ?7.5% at high angular velocity (180°/sec); the mean peak flexion torque was 7.2% and the mean torque at 30° was 3.1% at low angular velocity (60°/sec).

In group B, the mean side to side peak flexion torque was ?3.5% and the mean torque at 30° was ?7.6% at high angular velocity (180°/sec); the mean peak flexion torque was ?7.2% and the mean torque at 30° was ?11% at low angular velocity (60°/sec).

A statistically significant difference was found between the two groups at lower angular velocity both for the mean peak flexion torque and the mean torque at 30° (p = 0.009), with better results in the study group.

Discussion/conclusion: Gracilis sparing technique is a minimally invasive technique for ACL reconstruction and yielded a significantly better flexion strength recovery at lower angular velocity compared to a full tibial tunnel technique with DGST for ACL reconstruction.     

Adipose tissue as target organ in the treatment of hormone-dependent breast cancer: new therapeutic perspectives

Breast cancer is the female malignant neoplasia with the highest incidence in the industrialized world. Despite many undeniable therapeutic successes obtained, breast cancer still remains, however, a major health issue. In the last few years, thanks to aromatase inhibitors, the hormone therapy for oestrogen-dependent breast cancer has evolved in terms of efficacy and tolerability; at the same time, it has enabled us to better define the role of oestrogens in the etiopathogenesis of this tumour. Weight increase and obesity have been identified as the most important risk and prognostic factors for breast cancer in postmenopausal women. Several hypotheses have been proposed to explain the association of obesity with postmenopausal breast cancer. A more recent hypothesis suggests that adipocytes and their autocrine (paracrine and endocrine actions) are at the centre of such an etiopathogenetic mechanism. A better understanding of the main mechanisms that link together menopause, body-weight increase and hormone-dependent breast cancer is paramount to enable the identification of key molecules involved in the development of breast carcinoma and suggest new therapeutic options. The present review will discuss important findings on the therapeutic aspects of adipose tissue and adipokines as a target for treatment of hormone-dependent breast cancer.     

Is the evidence from clinical trials for cardiovascular risk or harm for glitazones convincing?

Thiazolidinediones (TZDs), agonists of the nuclear receptor peroxisome proliferator-activated receptor-γ, induce the expression of many genes, including several enzymes and transporters involved in glucose and lipid metabolism. Although the efficacy of TZDs on blood glucose control in type 2 diabetes is not questionable, their cardiovascular effects have been debated, with beneficial or harmful actions suggested by different authors. This article reviews the available clinical evidence on the cardiovascular effects of TZDs, discussing possible mechanisms underlying the observed effects and suggesting some directions for future research.     

Influence of subacute starvation on cardiac response to isoproterenol in rats.

Several studies have reported that the heart is severely affected by chronic malnutrition. However, the influence of these alterations on cardiac function remains unclear. The aim of this study was to evaluate the effects of subacute starvation on the heart chronotropic response to a beta-adrenergic agonist (isoproterenol). Twelve rats were fed rat chow ad libitum or a 50%-restricted diet for 17 days. The rats were killed, the right atrium was isolated and incubated, and in vitro spontaneous cardiac contractions and frequency were registered. Cumulative doses of isoproterenol were added to the solution until maximal cardiac frequency was achieved. A deficit of 25% in the weight gain was observed in study rats compared with controls (92.6 +/- 10.2 vs. 113.8 +/- 19.2 g, p less than 0.05). Mean daily food intake was 4.8 +/- 0.1 and 9.8 +/- 0.5 g/day for semistarved and control rats, respectively. The in vitro cardiac frequency of the semistarved rats was similar to that of controls (290 +/- 15 and 305 +/- 23 beats/min, respectively, NS). However, when isoproterenol was added to the solution, maximal cardiac frequency of the semistarved rats (435 +/- 51 beats/min) was lower than that of control rats (508 +/- 34 beats/min, p less than 0.005). These findings suggest that subacute starvation may alter the cardiac response to beta-adrenergic agonists.     

Action in cases of suspected chemical food poisoning

Chemical food poisoning is a periodic menace both for the health of the consumers and for trade. It can be intentional or unintentional. In the latter case, poisoning may have a very large attack rate and it may be caused by sophistication (e.g., the methanol poisoning in Italy in 1985) or by environmental pollution (e.g., the Iraq accident in 1971-1972 due to mercury-contaminated flour). As a general statement, they are acute events, often noticed by outbreaks of unexplained deaths or sickness. The purposed lines for intervention (monitoring and biological testing) and some related problems are briefly described. Emphasis is placed on biological of suspected food items by a sensitive method to detect the presence of a noxious agent of unknown origin. The basic principle is to administer the highest amount possible of the suspected food to two different species of rodents for 5 days. Finally it should be noted that the characteristics and severity of every episode depend on the food and the chemical involved; thus only general suggestions may be given.     

Hydra: a C-language environment for real-time DOS multitasking at the bedside

Patient monitoring at the bedside is an inherently parallel job, best handled by multiple individual tasks running concurrently. Cost and diffusion considerations strongly favor the use of PC's at the bedside, but their most widespread operating system, DOS, is not built for multitasking. Hence, a software platform in C language has been prepared, allowing the intermediate programmer to easily write independent modules which will then run simultaneously without conflicts.Such a platform aims at allowing effortless sharing of data among concurrently running processes, while providing strong insulation between tasks, enough to allow multiple copies of any one task to run simultaneously unknown to each other. A cooperative, memory sharing multitasking paradigm has been chosen, which offers fine granularity of timeslicing and low execution overhead at the price of some loss in generality of design.Speed, data exchange capability and number of stackable windows are greater than with commercial packages like Windows or LabWinows. Dynamical reprioritization of tasks is built in, allowing the computerized monitor to focus its attention and resources on urgent tasks.