Cutaneous nerve lesions of the shoulder and arm after arthroscopic shoulder surgery

Increasing use of shoulder arthroscopy has caused developing awareness of the associated complications. A consecutive series of patients who had undergone arthroscopic surgery of the shoulder was reviewed. The overall incidence of a sensory deficit was 21 (7%) in 304 patients at 2 weeks after operation, and in approximately half (3.3%) of these patients this condition was still present at 8 months' average follow-up. These deficits fell into three distinct patterns, suggesting that damage was occurring to three different nerve branches. Most of these areas of hypesthesia corresponded to lesions of cutaneous branches of the axillary nerve; the most likely cause was direct injury at the portal sites, particularly the lateral portal.

Impact of alcohol consumption on winter sports-related injuries

INTRODUCTION

This study was carried out to evaluate data about trauma-related winter sports, including risk factors such as high speed, gender, age, alcohol consumption, details about the accident and snow conditions.

METHODS

A retrospective review was conducted to determine the injury patterns and crash circumstances in holiday skiers and snowboarders. The data recorded were obtained from the database of the Pre-Hospital Emergency Registry of six skiing areas in the Dolomite mountains during the winter seasons November 2004-May 2009, injury data for major traumas from Ski Patrol Injury reports (helicopter, ambulance or ski slopes' patrol reports), and intrahospital Emergency Department data. Alcohol concentration in blood was detected in 200 individuals suffering from major trauma.

RESULTS

A total of 4550 injured patients, predominantly male (69%), mean age 22 years (range 16-72), were included in the observational analysis. Knee, wrist and shoulder injuries were frequently associated with major thoracic, abdominal or head traumas (64% of cases). Suboptimal technical level, high speed, low concentration, snow or weather conditions, faulty equipment and protective devices were among the various causes of accidents. The analysis revealed that high alcohol blood concentration was present in 43% of 200 patients.

CONCLUSIONS

Even though the major causes of accidents were excessive speed, excessive fatigue, technical errors and bad weather conditions, alcohol abuse was often discovered. Random sampling and a non-systematic detection of alcohol blood levels likely led to an underestimation of alcohol consumption-related injuries. It is recommended that investigations into alcoholic intoxication in injured skiers should be carried out on a large scale.

Mild Cognitive Impairment and Mild Dementia: The Role of Ginkgo biloba (EGb 761®)

Mild cognitive impairment (MCI) and dementia are clinically prevalent in the elderly. There is a high risk of cognitive decline in patients diagnosed with MCI or dementia. This review describes the effectiveness of Ginkgo biloba leaf special extract EGb 761^® for the treatment of dementia syndromes and EGb 761^® combination therapy with other medications for symptomatic dementia. This drug has shown convincing results, improving cognitive function, neuropsychiatric symptoms and consequent reduction of caregiver stress and maintenance of autonomy in patients with age-related cognitive decline, MCI and mild to moderate dementia. Currently, there is little evidence to support the combination therapy with anti-dementia drugs and, therefore, more evidence is needed to evaluate the role of EGb 761^® in mixed therapy.

Cardiospermum halicacabum in atopic dermatitis: Clinical evidence based on phytotherapic approach

Atopic dermatitis is a chronic inflammatory disease that mainly affects children, causing a strong impact on the quality of life. The most affected subjects live in urban areas or in developed countries, with prevalence increased up to 15%-20% in children and from 1% to 3% in adults during the past 30 years. Most adults had the first signs of illness before the age of 5, many of them before the age of 1. Many therapies in use are associated with side effects and often induce intolerance; therefore, many studies are based on the search for topical products that have an effective benefit, are well tolerated and appreciated by patients. Natural products are expected to have promising prospects in the management of atopy. Cardiospermum halicacabum is a member of the Sapindaceae family that seems to express its cortisone-like anti-inflammatory activity by activating phospholipase A2 while maintaining the stability of cell membranes, an effect due to the presence of phytosterols, having an affinity for lipids in the epidermis and cell membranes. We report our experience during a 15 days observational clinical study aimed to demonstrate efficacy and safety of the treatment with HALICAR: a cream containing C. halicacabum. Clinical data indicates that the treatment with HALICAR leads to positive effects in subjects with dermatitis of various degrees, regardless of which concomitant treatment is considered.

[Comparison of vectorcardiography and echocardiography in the evaluation of the site and extent of necrosis in myocardial infarction without Q wave]

In order to improve the evaluation of the site and extent of the necrosis in acute myocardial infarction without Q wave (IMNQ), we used a multiparametric method taking into account the enzymatic values of the total CK, a score derived from Frank's VCG and a kinetic score of the VG segments estimated by echo-2D. The literature data have shown, according to the clinical and anatomical correlations, the frequency of the transmural lesions in the IMNQ cases and, on the contrary, of the lesions limited to the endocardial region and partially transmural in infarctions with new pathological Q waves. The heterogeneousness of the anatomo-pathological data can be explained by the mechanisms of the ischaemia, the site of the coronary occlusion, the presence or not of a spasm, the compensation by the collateral flux and eventually the effects of a treatment by fibrinolytic drugs.