Search

Abstract Background Dupuytren disease, a chronic thickening and retraction of the palmar aponeurosis of the hands, may result in permanent and progressive flexion of one or more fingers. Percutaneous needle fasciotomy is a simple method that uses a hypodermic needle usually performed under local anaesthesia. The study aim was to report the postoperative results and complications using a percutaneous approach to treat Dupuytren contracture in a consecutive series of patients with advanced Dupuytren disease, also considering the relevant medico-legal implications. Methods Retrospective multicentre study of all patients with Tubiana stage 3–4 Dupuytren contracture treated with percutaneous needle aponeurotomy, with no ultrasound assistance, from 2012 to 2022. Patient demographics, disease severity, treatment-related complications, and the incidence of recurrence were identified. An overview of therapeutic treatment options has accounted for 52 relevant sources spanning the 2007–2023 time period. Results Overall, 41.7% (N = 200) of patients were females, the mean age was 72 years (60–89), the right hand was treated in 54.2% (N = 260) of patients. The little finger was involved in 50% of the patients. The 12 months mean PED was 9°, the mean quickDASH was 8, the mean URAM 6. Minor complications were reported in 18.7% (N = 90) of patients, typically skin lacerations (83.3%) with no clinical sequelae, and no major complications were reported. Recurrence occurred in 30% (N = 144) of patients. Conclusions Percutaneous needle fasciotomy is safe and reliable even in patients with advanced Dupuytren disease, resulting in predictably acceptable outcome with low risk of complications.

Septic arthritis of the pediatric hip joint (SAH) is a rare but serious orthopedic emergency requiring immediate diagnosis and management. Delayed recognition can lead to severe complications, emphasizing the need for timely intervention. This systematic review aims to provide a comprehensive analysis of SAH in the pediatric population, focusing on its diagnosis, management, and outcomes. The review included 11 studies involving 391 patients with SAH, aged between three months and 12 years. Staphylococcus aureus was identified as the most common causative pathogen, with increasing cases of methicillin-resistant strains. Diagnosis is challenging due to nonspecific clinical presentations, necessitating validated criteria and a multidisciplinary approach. Ultrasound emerged as a valuable tool for early detection, and MRI was used in challenging cases. Treatment options include hip aspiration, arthrotomy, and arthroscopy, often combined with appropriate antibiotic therapy. Success rates were comparable among different surgical procedures. Early intervention is vital for optimal outcomes. However, the review highlights the need for standardized protocols and further prospective studies to address limitations and improve understanding and management of SAH in the pediatric hip joint.

Today's adolescents represent an elective target in addressing environmental challenges. Education is a key factor in achieving a sustainable future for them. However, formal education can represent a challenge when youths are its target, as they are considered the "interactive generation". Game-based learning, and, in particular, Digital Educational Escape Rooms (DERs), have emerged as innovative methods in education, with promising applications in environmental sustainability studies. In this study, we developed 14 Digital Escape Rooms using the Social Cognitive Theory of Bandura as a theoretical framework. These were focused on environmental education and we tested them on a sample of 411 students (aged 12–18 years; 158 female, 38.4%). A one-group quasi-experimental research design was adopted, carrying out a pre-test post-test analysis. Each participant completed assessments at two time points: before engaging in the escape rooms (T0) and after (T1). The assessment tools included the Goal Assessment Scale (GAS) and the Perceived Climate Self-Efficacy Scale. Our findings revealed no significant gender differences in goal achievement. However, at T0, females exhibited higher levels of perceived climate self-efficacy in both individual and collective dimensions. Instead, the Digital Escape Rooms appeared particularly effective in increasing self-efficacy among male participants. These results suggest that Digital Escape Rooms hold potential for enhancing environmental self-efficacy, although gender differences in baseline efficacy levels warrant further exploration. [ABSTRACT FROM AUTHOR]

Nonunion (NU) is one of the most feared complications of femoral shaft fracture treatment. Femoral shaft fracture treatment is often linked with poor bone stock and reduced bone metabolism. In this paper, the goal is to carefully analyze the best treatment options for patients who developed nonunion after the intramedullary nailing of a femoral shaft fracture. A systematic review of the literature available in the PubMed, EMBASE and Cochran library databases was carried out, and 16 studies were included. Exclusion criteria included case reports and case series that do not have data about clinical outcomes or functional outcomes and included fewer than 10 patients. The reviewed data provide evidence for very good results about the treatment of this pathology with exchanging intramedullary nails or the implantation of a plate and screws (general healing rate of 96.3%). Moreover, the data support the utilization of autologous bone graft in order to stimulate the healing process. In conclusion, the choice between these two types of treatment must be guided by the type of pseudarthrosis that the patient presents. Additionally, bone grafting or growth factors promote bone regenerative processes, especially in patients with oligo-atrophic pseudoarthrosis.

(1) Background. A definition of healthcare-associated infections is essential also for the attribution of the restorative burden to healthcare facilities in case of harm and for clinical risk management strategies. Regarding M. chimaera infections, there remains several issues on the ecosystem and pathogenesis. We aim to review the scientific evidence on M. chimaera beyond cardiac surgery, and thus discuss its relationship with healthcare facilities. (2) Methods. A systematic review was conducted on PubMed and Web of Science on 7 May 2024 according to PRISMA 2020 guidelines for reporting systematic reviews, including databases searches with the keyword "Mycobacterium chimaera". Article screening was conducted by tree authors independently. The criterion for inclusion was cases that were not, or were improperly, consistent with the in-situ deposition of aerosolised M. chimaera. (3) Results. The search yielded 290 eligible articles. After screening, 34 articles (377 patients) were included. In five articles, patients had undergone cardiac surgery and showed musculoskeletal involvement or disseminated infection without cardiac manifestations. In 11 articles, respiratory specimen reanalyses showed M. chimaera. Moreover, 10 articles reported lung involvement, 1 reported meninges involvement, 1 reported skin involvement, 1 reported kidney involvement after transplantation, 1 reported tendon involvement, and 1 reported the involvement of a central venous catheter; 3 articles reported disseminated cases with one concomitant spinal osteomyelitis. (4) Conclusions. The scarce data on environmental prevalence, the recent studies on M. chimaera ecology, and the medicalised sample selection bias, as well as the infrequent use of robust ascertainment of sub-species, need to be weighed up. The in-house aerosolization, inhalation, and haematogenous spread deserve experimental study, as M. chimaera cardiac localisation could depend to transient bacteraemia. Each case deserves specific ascertainment before tracing back to the facility, even if M. chimaera represents a core area for healthcare facilities within a framework of infection prevention and control policies. [ABSTRACT FROM AUTHOR]

Background: No consensus in the literature has been found about the necessity of implementing a decolonization screening protocol for Staphylococcus aureus in patients who undergo prosthesis implantation of the knee (TKA) or of the hip (THA), with the aim of reducing periprosthetic infections (PJIs). Methods: A systematic literature search was conducted using PubMed, Web of Science, and Embase in April 2024. Studies conducted on patients who underwent a TKA or THA and who followed a screening and decolonization protocol from S. aureus were included. The benefits of implementing this protocol were evaluated through the number of infections overall caused by S. aureus and other pathogens. The risk of bias and quality of evidence were assessed using Cochrane guidelines. Results: A total of 922 articles were evaluated, and of these, 12 were included in the study for a total of 56,930 patients. The results of the meta-analysis showed a reduced risk of overall PJI (p = 0.002), PJI caused by S. aureus (p < 0.0001), and PJI caused by MRSA (p < 0.0001) and highlighted no differences between the two groups in the onset of a PJI caused by other bacteria (p = 0.50). Conclusions: This study showed that the screening and decolonization of S. aureus in patients undergoing THA or THA procedures reduced the risk of a PJI. The screening and decolonization protocol for this kind of patient represents an important procedure for the safety of the patient and in social-economic and medico-legal terms. [ABSTRACT FROM AUTHOR]

Water pollution is the most serious problem threatening global water resources. The release of both natural and anthropogenic factors in the aquatic environment is affecting the quality of water bodies, with Contaminants of Emerging Concern (CECs) being one of the major issues. In recent years, the availability of robust and sensitive analytical methods has allowed the detection and identification of a wide variety of pollutants. Pharmaceutically Active Compounds (PhACs) represent one large category of CECs detected in the aquatic environment, posing serious threats to human health and ecosystems. Hence, there is an urgent need for a better understanding of their environmental occurrence, fate, exposure-associated risks, and degradation in order to regulate exposure to pharmaceuticals in the environment. This review covers the current trends, newly developed state-of-the-art analytical methods, their challenges for PhACs detection in different water matrices, and the occurrence patterns in the aquatic environment. We also make a compressive assessment of the ineffective classic drinking water treatment plants (DWTPs) and the novel technologies such as membrane filtration and advanced oxidation processes that have been implemented to upgrade DWTPs. Their efficiency in removing PhACs is here discussed, as well as other embryonic technologies as promising solutions. The aim of this review article is to provide a comprehensive summary of the pathways and fate of PhACs in the environment, solutions for improving their monitoring assessments and the best methods for their removal in drinking water treatment plants.

The effect of the synthesis and processing parameters on the thermocatalytic performance of Ce-doped SrFeO3 inorganic perovskites was investigated to improve the reproducibility and reliability of the synthetic methodology and of the testing procedure. A structural, surface and redox characterization was performed to check the extent of variability in the chemical–physical properties of the prepared materials, revealing that a strict control of the synthesis parameters is indeed crucial to optimize the thermocatalytic properties of Ce-doped SrFeO3 inorganic perovskites. The thermocatalytic tests, aimed to degrade organic pollutants in water, were performed using Orange II and Bisphenol A as target compounds, in view of a later technological application. The main issues in the synthesis and testing of Ce-doped SrFeO3 perovskite thermocatalysts are highlighted and described, giving specific instructions for the resolution of each of them. A limited number of prepared materials showed an efficient thermocatalytic effect, indicating that a full gelification of the sol, an overstoichiometric reducer-to-oxidizer ratio, a nominal cerium content of 15 mol%, slightly higher than its solubility limit (i.e., 14 mol%), a pH of 6 and a thermal treatment at 800 °C/2 h are the best synthesis conditions to obtain an effective Ce-doped SrFeO3 perovskite. Regarding the testing conditions, the best procedure is to follow the degradation reaction without any preconditioning with the pollutant at room temperature. The severe leaching of the active perovskite phase during tests conducted at acidic pH is discussed. Briefly, we suggest confining the application of these materials to a limited pH range. Variability between thermocatalysts prepared in two different laboratories was also checked. The issues discussed and the proposed solutions overcome some of the obstacles to achieving a successful scale up of the synthesis process. Our results were favorable in comparison to those in the literature, and our approach can be successfully extended to other perovskite catalysts.

The assessment of environmental sustainability has assumed great importance during the study and implementation of a new process, including those aimed to waste valorization and reuse. In this research, the environmental performance of the photo-Fenton processes was evaluated using the life cycle assessment (LCA) methodology. In particular, photo-Fenton conducted in mild conditions (almost neutral pH), using soluble bio-organic substances as auxiliary agents were compared with the “classic” photo-Fenton run at pH 2.8. The evaluation was carried out both, at the laboratory level and at pilot plant scale. LCA analysis shows that working in mild conditions reduces the environmental burden associated with the use of chemicals. On the other hand, the occurring drop in effectiveness significantly increases the overall impact, thus evidencing the need of considering the process as a whole.

The Lab4treat experience has been developed to demonstrate the use of magnetic materials in environmental applications. It was projected in the frame of the European project Mat4Treat, and it was tested several times in front of different audiences ranging from school students to the general public in training and/or divulgation events. The experience lends itself to discuss several aspects of actuality, physics and chemistry, which can be explained by modulating the discussion depth level, in order to meet the interests of younger or more experienced people and expand their knowledge. The topic is relevant, dealing with the recycling of urban waste and water depollution. The paper is placed within the field of water treatment for contaminant removal; therefore, a rich collection of recent (and less recent) papers dealing with magnetic materials and environmental issues is described in the Introduction section. In addition, the paper contains a detailed description of the experiment and a list of the possible topics which can be developed during the activity. The experimental approach makes the comprehension of scientific phenomena effective, and, from this perspective, the paper can be considered to be an example of interactive teaching.

In the present work, the photo-Fenton degradation of pentachlorophenol (PCP, 1 mg/L) has been studied under simulated and natural solar irradiation; moreover, the effect on the process efficiency of urban waste-derived soluble bio-based substances (SBO), structurally comparable to humic acids, has been investigated. Experiments showed a crucial role of PCP photolysis, present in the solar pilot plant and hindered by the Pyrex® filter present in the solar simulator. Indeed, the SBO screen negatively affects PCP degradation when working under natural solar light, where the photolysis of PCP is relevant. In contrast, in the absence of PCP photolysis, a significant improvement of the photo-Fenton process was observed when added to SBO. Furthermore, SBO were able to extend the application of the photo-Fenton process at circumneutral pH values, due to their ability to complex iron, avoiding its precipitation as oxides or hydroxides. This positive effect has been observed at higher concentration of Fe(II) (4 mg/L), whereas at 1 mg/L, the degradation rates of PCP were comparable in the presence and absence of SBO.

The photodegradation of an aqueous solution of diclofenac (DCF) has been attempted in the presence of hydrogen peroxide and organic/inorganic hybrid magnetic materials under simulated and real solar light. The hybrid magnetic materials have been prepared via coprecipitation synthesis starting from iron(II) and iron(III) inorganic salts in the presence of bioderived organic products (i.e., chitosan or bio-based substances isolated from commercially available composted urban biowastes) acting as stabilizers of the iron-containing phase. In addition to the as prepared hybrid materials, the corresponding materials obtained after a pyrolytic step at low temperature (550 °C) have been tested. The obtained results evidenced the capability of the materials to activate hydrogen peroxide at mild pH promoting DCF (photo) degradation. All the materials feature also as adsorbents since a decrease of DCF is observed also when working in the dark and in the absence of hydrogen peroxide.