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Introduction: An ability to assess longitudinal changes in health status is crucial for the outcome measures used in treatment efficacy trials. The aim of this study was to verify the responsiveness of the Italian versions of the Oswestry Disability Index (ODI) and the Roland Morris Disability Questionnaire (RMDQ) in subjects with subacute or chronic low back pain (LBP).Material and Methods: At the beginning and end of an 8 week rehabilitation programme, 179 patients completed a booklet containing the ODI, the RMDQ, a 0-10 numerical rating scale (NRS), and the 36-item Short-Form Health Survey (SF-36). A global perception of change scale was also completed at the end of the programme, and collapsed to produce a dichotomous outcome (i.e. improved vs. not improved). Responsiveness was assessed by means of distribution methods [minimum detectable change (MDC); effect size (ES); standardised response mean (SRM)] and anchor-based methods (ROC curves).Results: The MDC for the ODI and RMDQ was, respectively, 13.67 and 4.87; the ES was 0.53 and 0.68; and the SRM was 0.80 and 0.81. ROC analysis revealed an area under the curve of 0.71 for the ODI and 0.64 for the RMDQ, thus indicating discriminating capacity; the best cut-off point for the dichotomous outcome was 9.5 for the ODI (sensitivity 76% and specificity 63%) and 2.5 for the RMDQ (sensitivity 62% and specificity 55%). These estimates were comparable between the subacute and chronic subjects. Both the ODI and the RMDQ moderately correlated with the SF-36 and NRS (Spearman's and Pearson's correlation coefficients of >0.30).Conclusion: The Italian ODI and RMDQ proved to be sensitive in detecting clinical changes after conservative treatment for subacute and chronic LBP. Our findings are consistent with those published in the literature, thus allowing cross-cultural comparisons and stimulating cross-national studies. [ABSTRACT FROM AUTHOR]

Study design:Clinical controlled trial.Objectives:To evaluate the effectiveness of an occupational therapy (OT) program combined with neuromotor rehabilitation, by assessing the degree of functional independence reached by patients with spinal cord injuries at first hospitalization.Settings:Subjects selected from the Spinal Cord Unit of the Rehabilitation Institute of Montecatone (Imola, Italy).Participants:Thirty-six male patients below age 60, with complete paraplegia (ASIA-A) in thoracic-lumbar level, at first hospitalization.Methods:Patients were divided into experimental and control groups. Subjects in the experimental group underwent neuromotor rehabilitation coupled with an OT program, whereas those in the control group followed neuromotor rehabilitation only. Increase in functional independence at discharge was evaluated by the Valutazione Funzionale Mielolesi (VFM) assessment scale.Results:Patients in the experimental group showed a significant increase in the total VFM score, and in domains concerning transfers and wheelchair use. A significant improvement was observed in unmarried patients as compared to married ones.Conclusion:An OT service within a Spinal Cord Unit allows us to achieve a higher level of functional independence.Spinal Cord (2008) 46, 78–81; doi:10.1038/sj.sc.3102072; published online 24 April 2007 [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR) program as compared to a Stabilization Exercise (SE) program in subjects with persistent low back pain (LBP) at short- and mid-term follow-up (ie. 3 and 6 months). Methods According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI). Secondary outcome measures were lumbar Visual Analogue Scale (VAS) and Fingertip-to-floor test (FFT). Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned. Results Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline) in all outcome measures with respect to the SE group. The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores) for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7). Conclusions Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects. Trial registration NCT00789204

Objectives: Proximal row carpectomy is a well-accepted surgical procedure for the management of traumatic and degenerative wrist pathologies. It is routinely performed through a dorsal approach; a volar surgical access was presented in order to enable concomitant carpal tunnel release and avoid flexion limitation or disabilities caused by adhesions of the dorsal capsule and extensor tendons. We propose a modification to the volar approach, with detailed description of skin incision (reproducing the standard palmar access to the scaphoid), capsular section (beginning with a longitudinal cut radial to flexor carpi radialis tendon and prolonged transversally along the radio-lunate joint) and sequence of carpal bone removal (starting with the scaphoid rather than the lunate)., Materials and Methods: The patients who underwent surgical treatment with modified volar proximal row carpectomy between 1992 and 2015 were enrolled in a retrospective analysis., Results: We report postoperative improvement in both the Mayo Wrist score and total active range of motion in 38 patients, in line with the outcomes of dorsal proximal row carpectomy., Conclusions: The modified volar approach is highly recommended when better visualization and access to proximal carpal bones are needed (particularly useful for inveterate perilunate dislocations), moreover if concomitant carpal tunnel syndrome or extensor tendon pathologies are present., (© 2024 Society for Indian Hand Surgery and Micro Surgeons. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Electron microscopy has become increasingly essential as an investigative research resource in various fields of science. Despite the evolution of the equipment and preparation techniques, little has been published on techniques for affixation and removal of samples on the stubs after analysis. This work aims to illustrate a quick and low-cost procedure for fixing and removing a sample from the support for analysis by electronic microscopy, applied to crustacean and insect species, as well as other invertebrates. It thus makes it feasible to use specimens or anatomical portions of specimens represented by a few individuals, or designated as paratypes or holotypes in a collection. RESEARCH HIGHLIGHTS: This study presents a quick and low-cost procedure for fixing and removing samples from support for electron microscopy analysis. This technique makes it possible to use individual specimens or anatomical portions represented in a collection. Fluidization of the adhesive and its complete removal allow easy recovery and repositioning of samples., (© 2023 Wiley Periodicals LLC.)

Brazilian biodiversity is still poorly studied, especially in the northeast region of Brazil. In the state of Maranhão, the rich fauna is still under-explored in relation to the Cladocera, and this geographic area covers four biomes, which makes it an important field of research on the Cladocera community. In this work, the record of three species is reported: Dadaya macrops Sars, 1901 first record of the genus for the state, Simocephalus serrulatus (Koch, 1841) and Simocephalus latirostris (Stingelin, 1906). The work presents brief descriptions and illustrations of the morphology of the studied species.

Our knowledge of the mating systems in burrowing shrimps (infraorders Axiidea and Gebiidea) is still rather limited. Here we describe the burrow use pattern, sex ratio, and sexual dimorphism of the burrowing shrimp Axianassa australis to test for monogamy, considering that monogamous species live in heterosexual pairs and exhibit a low degree of sexual dimorphism. To this end, a total of 226 individuals of A. australis were collected from the northeast region of Brazil. Our results showed that A. australis inhabited its burrows mainly as pairs, most of which were male-female pairs. In agreement with the expectations, specimens of A. australis were found dwelling as heterosexual pairs more frequently than expected by chance alone. The presence of ovigerous females was associated with the burrow occupation; that is, brooding females were more frequently observed in male-female combinations than solitarily. Also supporting theoretical considerations, we did not observe sexual dimorphism in body size between males and females of the population and the different categories of the burrow occupation. Conversely, sexual dimorphism in cheliped size was evident in the population, with larger chelipeds in males than in females. This observation agrees with that reported for most burrowing shrimps in which male-male competition is the main evolutionary force of sexual selection. The observations above favor the hypothesis that A. australis is primarily monogamous, with a small fraction of the males moderately promiscuous.

This study presents a list of parasitic fish nematodes from the Brazilian Amazon based on the previous Brazilian list including scientific assessments carried out between 2010 and 2021. A total of 16 families, 48 species and 28 undetermined species of nematodes associated with fish are included in the checklist, in addition to 93 host species and 15 geographical records.

The state of Maranho, northeast Brazil, has four different biomes. The water bodies in Maranho belongs to three hydrographic regions. Thus, the state potentially contributes to a high biodiversity. Despite that, in the state, the study of cladocerans can still be considered incipient. This work aims to summarize the list of species of cladocerans in the state of Maranho, including the results of new fauna surveys. We report ten new species records for the state, two species represent the new record of the genus Pseudosida Herrick, 1884. The results found point to the occurrence of 82 valid taxa in the state of Maranho.

Background: This article outlines our methods for thumb reconstruction following dorsal skin loss injury located between the metacarpophalangeal joint (MPj) and the entire nail affecting skin, nail, tendon, and bone in different combinations but with intact sensate palmar skin., Methods: Between 1990 and 2015, 24 patients were treated for dorsal thumb defects using 4 different surgical techniques. Five cases of dorsal compound traumatic loss were reconstructed by custom-made dorsal great toe transfer. Four patients with dorsal skin and nail loss located at the distal phalanx level were covered with the homodigital flap with reverse flow vascularization. In 9 patients presenting skin defects between the MPj and the nail, reconstruction was achieved by means of the kite flap. Six cases suffered extensive dorsal skin loss, and reconstruction was performed using different types of radial forearm flaps (cutaneous, tendineocutaneous, osteocutaneous, and fascial)., Results: Flap survival was obtained in all cases. No vascular complications occurred with free vascularized compound toe transfer., Conclusions: Reconstruction of dorsal thumb defects is imperative and its approach is strictly correlated to type of defect, patient's requests, and flap alternatives. For defects with nail involvement, the free osteo-onychocutaneous flap harvested from the great toe provides the best aesthetic result in selected young and well-motivated patients. An alternative is represented by the dorsoulnar flap, when the defect is located distally, or the fascial pedicle radial forearm flap, for major dorsal thumb defects, in patients refusing microsurgical reconstruction. The kite flap still represents a feasible solution for medium-size defects with an intact nail.

Introduction: As the popularity of volar locked plate fixation for distal radius fractures has increased, so have the number and variety of implants, including variations in plate design, the size and angle of the screws, the locking screw mechanism, and the material of the plates., Hypothesis: Carbon-fiber reinforced polyetheretherketone (CFR-PEEK) plate features similar biomechanical properties to metallic plates, representing, therefore, an optimal alternative for the treatment of distal radius fractures., Materials and Methods: Three different materials-composed plates were evaluated: stainless steel volar lateral column (Zimmer); titanium DVR (Hand Innovations); CFR-PEEK DiPHOS-RM (Lima Corporate). Six plates for each type were implanted in sawbones and an extra-articular rectangular osteotomy was created. Three plates for each material were tested for load to failure and bending stiffness in axial compression. Moreover, 3 constructs for each plate were evaluated after dynamically loading for 6000 cycles of fatigue., Results: The mean bending stiffness pre-fatigue was significantly higher for the stainless steel plate. The titanium plate yielded the higher load to failure both pre and post fatigue. After cyclic loading, the bending stiffness increased by a mean of 24% for the stainless steel plate; 33% for the titanium; and 17% for the CFR-PEEK plate. The mean load to failure post-fatigue increased by a mean of 10% for the stainless steel and 14% for CFR-PEEK plates, whereas it decreased (-16%) for the titanium plate. Statistical analysis between groups reported significant values (p<001) for all comparisons except for Hand Innovations vs. Zimmer bending stiffness post fatigue (p=.197)., Discussion: The significant higher load to failure of the titanium plate, makes it indicated for patients with higher functional requirements or at higher risk of trauma in the post-operative period. The CFR-PEEK plate showed material-specific disadvantages, represented by little tolerance to plastic deformation, and lower load to failure., Level of Evidence: N/A., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Background: The treatment of comminuted radial head fractures can include prosthetic replacement or open reduction and internal fixation. The purpose of this study is to evaluate the results of two different internal fixation systems for Mason type II-III radial head fractures., Methods: Between 2005 and 2015, 82 patients were treated using pins and 65 patients by mini-screws. The follow-up protocol included: a clinical evaluation 15 days after surgery, and clinical and radiographic evaluations performed at 30 and 60 day intervals, unless any complications were reported by the patient. Over a period of at least 12-months of follow-up, patients were checked and interviewed. Clinical examinations included elbow range of motion (ROM), arm, shoulder and hand Disabilities, (DASH), and the Mayo Elbow Performance Score (MEPS)., Results: Sixty-one subjects who had been treated with mini-screws were clinically reviewed at a mean 47.3 ± 35.8 month of follow-up; all patients who had been treated using absorbable pins were evaluated at a mean 82.5 ± 20.6 month of follow-up. No significant statistically differences were observed between the two groups in the mean ROM, DASH, and MEPS scores. Residual pain was reported in 15.8%of the patients treated by pins and 9.2% patients treated by mini-screws. Secondary displacement of fracture fragments was observed in 8.5% patients treated by pins and 1.6% using mini-screws., Conclusions: Both absorbable pins and mini-screws provided adequate strength and rigidity, allowing good clinical and functional scores at a mid-term follow-up. However, a higher rate of secondary displacement of the fracture fragments was reported among subjects who had been treated using absorbable pins.

Purpose: This study aims to analyse the influence on total knee arthroplasty (TKA) clinical outcomes of biomechanical intra-operative computer-assisted surgery-measured parameters, together with radiographic and demographical data., Methods: Between 2007 and 2009, 227 computer-assisted surgery (CAS) primary TKAs were performed in 219 consecutive patients. Information about gender, age and body mass index (BMI) was collected for each patient. Before knee replacement, all patients underwent a complete radiographic examination and passive flexion-extension range of motion was recorded. All TKAs were implanted using an image-free knee navigation system. Patients included in the study were evaluated at 3, 6 and 12 months of follow-up and then yearly. At each follow-up, subjects were asked to answer the validated Italian version of the Knee Injury and Osteoarthritis Outcome Score., Results: One hundred and eighty patients (187 knees) had data available for analysis. Complications were reported in 13 patients (7.0 %). Intra-operative CAS-measured parameters, together with age, BMI, gender, pre- and post-operative radiographic alignment, did not influence TKA clinical results at a mean 2 years of follow-up. On the other hand, higher post-operative flexion arc of movement was suggestive of better clinical outcomes., Conclusion: TKA clinical outcome is influenced by post-operative knee flexion, other than neutral mechanical limb alignment. Therefore, it is recommended to prefer TKA designs that allow high flexion and to encourage early physical rehabilitation., Level of Evidence: IV.

Aim: To review the current literature regarding corrective osteotomies to provide the best evidence of the rule of bone grafting., Methods: Our MEDLINE literature search included 280 studies using the following key words "Malunited distal radius fracture" and 150 studies using key words "Corrective osteotomy of the distal radius". Inclusion criteria were: Malunited distal radial, extra articular fracture, volar locking plate, use of iliac bone graft (cancellous or corticocancellous), non-use of bone graft. Twelve studies met the inclusion criteria., Results: Seven of the 12 studies considered, described the use of a graft; the remaining five studies didn't use any graft. Type of malunion was dorsal in most of the studies. The healing time was comparable using the graft or not (mean 12.5 wk), ranging from 7.5 to 16 wk. The mean disabilities of the arm, shoulder and hand score improvement was 23 points both in the studies that used the graft and in those not using the graft., Conclusion: This review demonstrated that corrective osteotomy of extra-articular malunited fractures of the distal radius treated by volar locking plate does not necessarily require bone graft.

Background: Various surgical techniques were reported with excellent result for the treatment of trapeziometacarpal joint arthritis. However, the best treatment option was not defined yet., Methods: This randomized prospective study compared the result of two surgical techniques: tendon interposition arthroplasty (64 patients) and K. wire distraction (56 patients) after trapeziectomy for stage 3 or 4 osteoarthritis of the trapeziometacarpal joint., Results: After a mean follow-up period of 6.8 (range, 3-10) years it was possible to observe a higher rate of pain relief following trapeziectomy with K. wire suspension, but no significant differences in strength, range of motion and DASH score between the two groups. On lateral unloaded radiographs the height of the space between the base of the thumb metacarpal and the scaphoid showed a mean value of 6.5 mm for both groups; the average distance between the metacarpal base and the trapezium was not statistically significant in the two groups. Complications were observed only in patients treated with trapeziectomy and interposition arthroplasty and were represented by tendinitis of the FCR in 15% of cases., Conclusions: We demonstrate that the trapezium excision and bone space distraction technique requires a smaller incision, a shorter surgical time, an easier surgical technique, and a less painful recovery, maintaining overlapping levels of functional restore.

The range of geographical distribution of Anthalona acuta Van Damme, Sinev & Dumont 2011 and Anthalona brandorffi (Sinev & Hollwedel, 2002) in Brazil has increased by almost 2000 km to the south. New records of Anthalona verrucosa verrucosa (Sars, 1901) were also added. Populations of Anthalona brandorffi from Central Brazil showed a peculiar morphological variation, with some individuals having only a single denticle on the labral keel. A new species of the simplex-branch, Anthalona neotropica sp. nov., was described based on Brazilian material, and this is the first taxon of this branch registered in the Neotropics. It differs from Anthalona simplex Van Damme, Sinev & Dumont 2011, a Central African species, in the morphology of underneath sack of the lateral head pores, length of IDL setae and armature of first flaming-torch seta of limb IV. It could be distinguished from Anthalona sanoamuangae Sinev & Kotov, 2012 (distributed through the South- East Asia) by the morphology of the main head pores, length of IDL setae and armature of the pecten of postabdominal claw. Anthalona neotropica sp. nov. seems to have a benthic/hyporheic habit. All studied species have a wide geographical distribution and could be confused with Anthalona verrucosa Sars, 1901, thus at least some if not all previous records of this species on the continent must be revised.

The Hyporheic Zone is among the most important interstitial freshwater habitats, but the relationship between biotic and abiotic factors in this zone remains under-explored. Enterobacteria were expected to be present, but no specific studies had ever confirmed this prediction. The aim of this study was, therefore, to evaluate the total coliforms, Escherichia coli and Salmonella spp. in hyporheic water and to determine the relationship of the physical, chemical and environmental factors at different depths in a rainforest stream. To this end, thirty-six water samples were collected at three depths in sites located in the first, second and third orders in diverse substrates. The total coliforms, Escherichia coli and Salmonella sp. were evaluated in terms of their CFU/ml. In the interstitial samples, coliforms were detected in 100% of the samples. The total coliform counts had higher values at intermediate depths, while E. coli and Salmonella spp. instead had higher values at intermediate and large depths, often reaching or exceeding the values of the surface samples. Our results revealed that Salmonella spp. and the coliforms have different microhabitat preferences. Salmonella spp. and coliform species prefer deposition areas, such as lateral sides of pools, curves and bars, but they have a tendency to distribute into different depths, likely due to temperature differences. Salmonella spp. prefer compact substrata, with fewer fluids passing through and with upwelling areas with lower oxygen inflow. The coliform species showed the opposite preference. Our results suggest that bacterial variation is related to environmental factors and physical-chemical parameters within the HZ and may play a key role in the microbial diversity and distribution in these ecosystems.

Background: Intra-articular incarceration of the epicondylar fragment occurs in 5-18 % of all cases of medial epicondyle fracture. It requires stable fixation to allow early motion, since elbow stiffness is the most common complication following medial epicondyle fracture. In this retrospective study, we report the clinical and functional outcomes and the complications that occurred following open reduction and screw fixation of medial epicondyle fractures with intra-articular fragment incarceration., Methods: Thirteen children who had a fracture of the medial epicondyle with incarceration of the fragment in the elbow joint (type III) were surgically treated in our university hospital between 1998 and 2012. There were eight male and five female patients. The mean age at the time of injury was 13 years (range 9-16). Operative treatment consisted of open reduction and internal fixation with one or two 4.0-mm cannulated screws under fluoroscopic control., Results: All of the patients were clinically reviewed at an average follow-up of 29 months. The overall range of motion limitation was about 5° for flexion-extension and 2° for pronation-supination. The score was excellent in all patients (mean 96.3). Complications occurred in four (31 %) children: two cases of symptomatic screw head prominence, irritation with partial lesion of the distal triceps myotendinous junction in one patient, and median nerve entrapment syndrome in one patient., Conclusions: In conclusion, open reduction and screw fixation yielded excellent clinical and functional outcomes for the treatment of medial epicondyle fractures with intra-articular fragment incarceration. However, particular attention is should be paid when treating these potentially serious injuries in order to minimize the risk of possible complications., Level of Evidence: Therapeutic IV.

Introduction: The management of distal triceps tears must address each patient's medical and functional status: in general, the literature has described satisfactory nonsurgical treatment in tears less than 50%. Tears greater than 50% are treated nonsurgically in a sedentary person and surgically in active patients. Complete tears are generally managed surgically: most reported repair techniques describe the use of Bunnell or Krakow whipstitch techniques, passing the sutures through transosseous drill holes in the ulna. Other described techniques include the use of suture anchors and direct tendon repair to a periosteal flap raised from the olecranon., Case Presentation: In the presented report we describe the surgical technique used to treat a complete traumatic distal triceps tendon rupture associated with olecranon fracture in a 40-year-old Caucasian man with underlying poor tendon quality and postoperative assessment. To the best of our knowledge no studies describing the performed surgical technique, utilizing Krakow whipstitches, olecranon fixation with K wires and Zuggurtung tension band through transosseous drill holes have been previously described in the literature. At 30 days postoperatively the patient had regained full elbow flexion/extension and pronation/supination., Conclusions: The described methodology, using a double ulnar tunnel to obtain fixation of the fragment, associated with a whipstitch locking-type suture for the triceps tendon, allowed proper fixation of the fracture and optimal reinsertion of the detached tendon on its footprint with sufficient strength.