Long-term follow-up of dorsal wedge osteotomy for pediatric freiberg disease

Background: Treatment for Freiberg disease has been largely conservative despite availability of various operative options for severe or refractory cases. The aim of this study was to evaluate the long-term results of pediatric patients with symptomatic Freiberg disease treated with intra-articular dorsal wedge osteotomy. Methods: Pediatric patients treated for Freiberg disease with surgery between January 1982 and 1999 were identified and selected for long-term clinical evaluation. Patients were evaluated regarding operative satisfaction and clinical outcome, performed according to the American Orthopaedic Foot & Ankle Society (AOFAS) lesser toe metatarsophalangeal-interphalangeal scale and range of motion (ROM) of metatarsophalangeal (MTP) joint. Patients had radiographic assessment of degenerative joint status with anteroposterior and oblique foot x-ray. Twenty patients (18 female, 2 male; mean age 15.2 years; range 12-17 years) were identified. The mean follow-up period was 23.4 (range 15-32) years. Results: The clinical outcomes of our patients were classified as excellent in 16 (80%) and good in 4 (20%). The AOFAS mean score was 96.8 (range 91-100) points at the last clinical appointment. A negative correlation between AOFAS score and time of follow-up (r's = -0.61, P < .001) was found. Also, a strong negative correlation was found between Smillie classification and AOFAS final score (r's = -0.88, P < .001). Conclusion: The patients were very satisfied with pain and quality of life at a mean follow-up time of 23.4 years. To our knowledge, this is the first long-term follow-up report supporting the procedure described by Gauthier and Elbaz as a good option for operative treatment of Freiberg disease.info:eu-repo/semantics/publishedVersio

Novel heterococcolithophores, holococcolithophores and life cycle combinations from the families Syracosphaeraceae and Papposphaeraceae and the genus Florisphaera

Abstract. Coccolithophores are a diverse group of calcifying phytoplankton, which are responsible for a large part of the modern oceanic carbonate production. Here, we describe novel or poorly known coccolithophores and novel life cycle combination coccospheres detected in samples collected either in the Gulf of Aqaba in the northern Red Sea or in the Gulf of Naples in the western Mediterranean. These include Syracosphaera winteri, for which detached coccoliths have previously been recorded but both a formal description and taxonomic affiliation were lacking, and five undescribed sets of combination cells linking HET and HOL forms for S. pulchra, S. mediterranea, S. azureaplaneta, S. lamina and S. orbicula. We also propose the replacement name S. kareniae for the fossil species Deutschlandia gaarderae. We describe a new species of the genus Ophiaster, O. macrospinus, displaying a unique morphological and ecological distribution as well as putative combination cells of two variants of the deep-dwelling Florisphaera profunda, which provide new insights on the affiliation of this genus within the Calcihaptophycideae. Additionally, in the family Papposphaeraceae we detected a new species, Pappomonas vexillata, and combination cells of Picarola margalefi and of a species resembling Papposphaera arctica. Finally, we detected three novel, unpaired holococcolithophore forms (Calyptrosphaera lluisae, Calicasphaera bipora and one form designated as Holococcolithophore A). Overall, this set of novel observations and ensuing discussions provide further insights into the diversity, evolution and life cycle complexity of coccolithophores in the oceans

A molecular insight into algal-oomycete warfare : cDNA analysis of Ectocarpus siliculosus infected with the basal oomycete Eurychasma dicksonii

Peer reviewedPublisher PD

Anesthesiology Consensus in the Management of the Airway

Os consensos na gestão clínica da via aérea em anestesiologia pretendem disponibilizar informação, baseada na evidência atual ou, na falta desta, na opinião de peritos, no que respeita à abordagem da via aérea difícil previsível ou não previsível. Reforçamos a importância da avaliação da via aérea e da identificação de potenciais problemas que possam condicionar dificuldade na sua abordagem e a adoção de uma estratégia segura que permita identificar e responder em crescendo de intervenção às dificuldades encontradas. Na impossibilidade de intubação traqueal (não intubo) otimizada e limitada a 4 tentativas, da impossibilidade de ventilar e oxigenar (não oxigeno) após 2 tentativas de usar um dispositivo supraglótico ou de uso de máscara facial inicialmente adequada é importante realizar, em tempo útil, uma cricotirotomia para assegurar oxigenação. As situações clínicas de exceção só com planos simples, conhecidos por todos e regularmente treinados e adaptados à nossa atividade clinica podem assegurar melhores “outcomes”. O registo destes eventos e a informação ao nosso doente da dificuldade encontrada e modo como foi resolvido o problema é essencial e constitui ainda um desafio a alargar a uma base nacional.info:eu-repo/semantics/publishedVersio

Assessment of sense of taste in Italian Centenarians

The Italian multicentric study on centenarians (IMSC) was aimed at assessing the level of preservation of the sense of taste, and at estimating to what extent the recognition of various gustative stimuli can give satisfaction and information regarding the surrounding environment for the centenarians. Taste sensitivity has been qualitatively established in a group of 126 Italian centenarians (mean age 101.9 \ub1 1.4 years) and compared to that of a group of 100 elderly subjects (mean age 70.5 \ub1 5.0 years). All the individuals included in the study groups had a mini mental state examination (MMSE) score larger than 19. The results revealed that taste sensitivity is significantly reduced in the centenarians; as a matter of fact, the elderly control subjects are able to perceive taste stimuli in 84.25 \ub1 3.40% of the testing, while the centenarians were successful only in 74.23 \ub1 6.19% of the experiments (P < 0.001). Furthermore, elderly subjects can correctly recognize taste stimuli in 70% of the testings, while correct recognition amounted only to 49.25% in cases of centenarians assessed. In spite of these differences between the elderly and centenarians, the latter are still able to perceive and recognize taste stimuli adequately, and as a consequence, are able to obtain information on tastes and receive a sufficient sensory stimulation through the tasting pathway

Nitric oxide production and antioxidant function during viral infection of the coccolithophore Emiliania huxleyi

Emiliania huxleyi is a globally important marine phytoplankton that is routinely infected by viruses. Understanding the controls on the growth and demise of E. huxleyi blooms is essential for predicting the biogeochemical fate of their organic carbon and nutrients. In this study, we show that the production of nitric oxide (NO), a gaseous, membrane-permeable free radical, is a hallmark of early-stage lytic infection in E. huxleyi by Coccolithoviruses, both in culture and in natural populations in the North Atlantic. Enhanced NO production was detected both intra- and extra-cellularly in laboratory cultures, and treatment of cells with an NO scavenger significantly reduced viral production. Pre-treatment of exponentially growing E. huxleyi cultures with the NO donor S-nitroso-N-acetylpenicillamine (SNAP) prior to challenge with hydrogen peroxide (H2O2) led to greater cell survival, suggesting that NO may have a cellular antioxidant function. Indeed, cell lysates generated from cultures treated with SNAP and undergoing infection displayed enhanced ability to detoxify H2O2. Lastly, we show that fluorescent indicators of cellular ROS, NO, and death, in combination with classic DNA- and lipid-based biomarkers of infection, can function as real-time diagnostic tools to identify and contextualize viral infection in natural E. huxleyi blooms

Ocean Acidification Affects Redox-Balance and Ion-Homeostasis in the Life-Cycle Stages of Emiliania huxleyi

Ocean Acidification (OA) has been shown to affect photosynthesis and calcification in the coccolithophore Emiliania huxleyi, a cosmopolitan calcifier that significantly contributes to the regulation of the biological carbon pumps. Its non-calcifying, haploid life-cycle stage was found to be relatively unaffected by OA with respect to biomass production. Deeper insights into physiological key processes and their dependence on environmental factors are lacking, but are required to understand and possibly estimate the dynamics of carbon cycling in present and future oceans. Therefore, calcifying diploid and noncalcifying haploid cells were acclimated to present and future CO2 partial pressures (pCO2; 38.5 Pa vs. 101.3 Pa CO2) under low and high light (50 vs. 300 µmol photons m-2 s-1). Comparative microarray-based transcriptome profiling was used to screen for the underlying cellular processes and allowed to follow up interpretations derived from physiological data. In the diplont, the observed increases in biomass production under OA are likely caused by stimulated production of glycoconjugates and lipids. The observed lowered calcification under OA can be attributed to impaired signal-transduction and ion-transport. The haplont utilizes distinct genes and metabolic pathways, reflecting the stage-specific usage of certain portions of the genome. With respect to functionality and energy-dependence, however, the transcriptomic OA-responses resemble those of the diplont. In both life-cycle stages, OA affects the cellular redox-state as a master regulator and thereby causes a metabolic shift from oxidative towards reductive pathways, which involves a reconstellation of carbon flux networks within and across compartments. Whereas signal transduction and ion-homeostasis appear equally OA-sensitive under both light intensities, the effects on carbon metabolism and light physiology are clearly modulated by light availability. These interactive effects can be attributed to the influence of OA and light on the redox equilibria of NAD and NADP, which function as major sensors for energization and stress. This generic mode of action of OA may therefore provoke similar cell-physiological responses in other protists

Loosening the Ties that Bind: Academic Librarians and Tenure

This article discusses the impact of faculty status and tenure on the professional lives of academic librarians. Included are a literature review, a discussion of the decline of tenure at academic institutions, and experiences at three universities. This article also includes the results of a survey that focused on the impact of faculty status and tenure on librarians’ participation in institutional governance, opportunities for professional growth, and presence of a faculty library advisory committee. Based on the results of this survey, the authors conclude that only faculty status and tenure guarantee full integration in the university’s governance and academic spheres.</jats:p