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One of the surgical options for the supracondylar femoral fractures is plating. These fractures are often unstable because of many factors depending on the type of fracture (medial wall often involved) and quality of bone (osteoporosis). Supracondylar lateral plates, even if provided by long plates and good distribution of screws, may fail because of high mechanical stress. In fact, in the literature a non-union rate 21% of is described. PEEK materials are already used regularly in pathological fractures where better mechanical properties are required where the callogenesis is often slow and uncomplete because of pathological healing process. Since 2016, the authors used these better mechanical properties (biocompatibility, resistance and elasticity) of PEEK plates in selected trauma cases in the supracondylar femoral site. Among the few cases successfully treated with lateral PEEK plate, the authors report one peculiar case with 3 years of follow-up highlighting the good properties of reinforced carbon fibers.

Since a decade in Apulia, south-east of Italy, an increasing number of olive trees developed the quick decline syndrome (OQDS) leading to partial or total dessication of the canopy and subsequent death. Currently six million of olive trees show the symptoms of the decline, despite the mitigation measures which were undertaken to contrast the progression of the dessication. Associated with the syndrome, several phytopathogenic fungi were detected in the rhizosphere, endosphere and phyllosphere of the trees, along with the phytopathogenic bacterium Xylellafastidiosasubsp. pauca. Alongside, other pathogenic events were clearly identified, mostly defeating soil resilience: salinization, pollution, erosion, decline of biodiversity. Further events include delays in the adoption of appropriate mitigation measures not directed to challenge solely a bacterial pathogen, misuse of the territory, erratic agronomic management practices. The OQDS impacted also societal aspects. All the above concurrent causes strongly suggest that (1) the olive quick decline in Apulia is not a too symplistic epidemic outbreak due to a bacterium, but rather a syndemic outbreak formed by several diverse biotic and abiotic pathologies and (2) only a more holistic approach can help coping with the uncertainties and difficulties of an enduring co- existance with this syndemic events.

One-stage or two-stage revision total knee arthroplasty (TKA) in periprosthetic joint infections has been at the center of scientific debate for many years. As regards two-stage revision TKA, cement spacers have a good infection control rate with successful results reportable up to 96%, though some studies describe related spacer complications such as stiffness and loss of bone stock. We report a case of a fracture close to the antibiotic-loaded cement spacer in a 74-year-old female patient. Due to the blood tests and high risk of infection, we performed a hybrid external fixator. Six months after the surgery, X-rays did not show signs of fracture consolidation and nonunion was considered as an impending complication; therefore, the decision was made to perform tumor-like total knee arthroplasty. The postoperative evolution was satisfactory and return to daily activity without pain. At the 5-year follow-up, the patient showed a good score of 36-Item Short Form Health Survey and a range of motion from 0 to 90° without pain. The X-rays did not show signs of mobilization, dislocation, recurrence of infection, or other complications.

Background: this study aimed to evaluate the impact of COVID-19 lockdown on Orthopedic and trauma care in apulia, using as a reference point the orthopedic activity performed in the previous three years in the same bimester;and to assess any relationship between the COVID-19 spreading in apulia and changes in orthopedic and trauma working activity MetHOdS: eight apulian level 1 or level 2 orthopedic and trauma centers took part in the present study in each trauma center, between March 9 and May 3 (eight weeks), the following data were prospectively recorded: the number of patients referring to Orthopedic and trauma emergency room (er) and their cause of injury (i e motor vehicle accident, domestic injury, working injury or sports injury);the number of patients referring to outpatient department and the number and type of surgical interventions performed all trauma centers were also asked to gather the data summarizing surgical, outpatient and er activities during the same period in the previous three years (2017-2019) Furthermore, data about COVID-19 total confirmed cases and total deaths in Apulia were daily recorded reSultS: during COVID-19 lockdown, the mean number of trauma surgeries performed for non-femur fractures, and the mean number of Orthopedic er referrals for motor vehicle accidents, work injuries and sports injuries were significantly reduced, compared with the same period in the previous three years Nonetheless, no significant differences were observed in domestic injuries (p=0 1417) and pFFs (p=0 5462) the mortality rate at discharge in patients with pFFs during COVID-19 lockdown, compared with the same period in the previous three years, was not statistically different (P=0 162) A significantly positive correlation was observed between the COVID-19 total cases number and PFFs patients’ discharge to home (P=0 003), whereas a significant negative correlation was recorded with PFFs patients’ discharge to rehabilitation centers (p=0 001) CONCLUSIONS: Although orthopedic and trauma care significantly changed in Apulia during COVID-19 lockdown, the mean number of patients referring to Orthopedic and Trauma ER for home injuries and PFFs showed no significant differences, compared to the same bimester in the previous three years © 2020 Edizioni Minerva Medica

There are few entities in the cosmos that convey an analogous sense of God’s mystery and awesomeness. Water is one of them. In this essay, I discuss the spirituality of water and water-related practices. Specifically, I look to what swimmers do when they get a feel for the water as a model for approaching and understanding revelation. I begin my essay with a discussion of the gravity of water, and then move to an analysis of water-related religious rituals, elaborating mostly on the water traditions in Judaism and Christianity, including Mikveh baths and baptism. Next, I explain the practice of swimming as an exercise that can open us to a deeper respect for the environment, enhance our embrace of divine revelation, and connect us in richer ways to others. Swimmers are trained to get a “feel for the other.” They develop this feel through learning how to navigate hydrodynamic drag, which is the resistance to the physical movement of their swimming stroke caused by the surrounding fluid. As I build this analogy between water/creator and swimmer/creature, I explain how getting a feel for God and others, like when a swimmer works through drag, involves being open to improvisation in which we are called to relinquish damaging patterns of relating to others, mourn those ways, and create spaces for a more flourishing life. Finally, I discuss how opening ourselves to improvisation and mourning allows us to relate to all others with empathy and grace. Emmanuel Levinas, Hans Urs von Balthasar, as well as Leslie Jamison, an American novelist and essayist, are important interlocutors here.

Because of its commitment to the Incarnation and the Resurrection, Catholic theology is impelled to deal productively with the issues of embodiment and particularity. These have been noticeably absent in postmodern discussions of religious experience, which tend to be abstract, “dis-embodied,” and dismissive of specific religious traditions. This symposium continues the important intervention of Catholic fundamental theology in these discussions, so that theology might respond more adequately to the embodied religious experience of Christians and the sacramental imagination of the Catholic tradition. The authors argue for the necessary employment of “incarnation” as a fundamental hermeneutical strategy, and apply it to issues in eschatology, theological anthropology, interreligious dialogue, and theological epistemology.

The author considers how Christians are called to bear witness to difference specifically in a global context where boundaries are becoming increasingly ambiguous. After arguing that it is particularly important for Christians to embrace the responsibility associated with ambiguous borders and hybrid existence, the author explains how American culture works against being open to others at borders because of the emotional conflict they bring. An attitude of entitlement embedded in a narcissistic mentality prevents some from inviting otherness into their lives. By developing empathy and through mourning privilege, human beings can overcome a posture of entitlement. Christ's ministry, incarnation, and death are highlighted, finally, as resources for dealing with the loss of privilege that emerges at the borders of self and other.

The histopathological changes associated with rotator cuff tears include thinning and disorganization of collagen fibers, the presence of granulation tissue, increased levels of glycosaminoglycans, fibrocartilaginous metaplasia, calcification, fatty infiltration, and necrosis of the tendon margin with cell apoptosis. The biochemical changes include an increase in the expression of matrix metalloproteinases (MMPs) and a decrease in tissue inhibitor of metalloproteinases (TIMP) messenger ribonucleic acid expression. Histological evidence of tendinopathy has been found in patients with rotator cuff tear. Biochemical changes include significant increases in MMP1, MMP2, MMP3, and in TIMP1 and TIMP2 levels, not only at the lateral supraspinatus edge, but also in the macroscopically intact portion of the supraspinatus tendon and in the intact subscapularis. The tissue in the ruptured area of the supraspinatus tendon undergoes marked rearrangement at molecular levels. This involves the activity of MMP1, 2, and 3 and supports a critical role of MMPs in tendon physiology. Intact parts of the torn supraspinatus tendon can present the histopathological changes associated with rotator cuff tears. These findings suggest that biochemical changes can already occur in a macroscopically intact tendon and seem to point to a global degenerative process in the shoulder.