Air quality biomonitoring: assessment of air pollution genotoxicity in the Province of Novara (North Italy) by using Trifolium repens L. and molecular markers

Mixed air pollutants are considered a major cause of DNA damage in living species. In this study Trifolium repens L. cv Regal was used as a bioindicator to assess the genotoxicity of air stressors in the Italian province of Novara. Two on-site biomonitoring experiments were performed during the spring and autumn of 2004. Test plants were exposed at 19 monitoring sites distributed homogeneously throughout the province, and each experiment lasted for a period of 6 weeks. Genotoxicity was evaluated with Amplified Fragment Length Polymorphism (AFLP) molecular markers. The results show the predominantly rural central-west region of the Novara Province to have the worst air quality with regard to genotoxicity. Analyses of geomorphology, land use and climatic factors suggest that the compromised air quality in the region could be attributed to wind strength and direction, transporting pollution from vehicular traffic on the A4 highway and from the urban/industrialized centres of Novara and Vercelli. Plant growth, changes in plant photochemical efficiency and the presence of ozone related leaf injuries were also measured to better interpret the results of genotoxicity. Statistical analyses show that although climatic factors such as light intensity and temperature influence plant growth, they do not contribute to atmospheric stressor-induced DNA damage. Further analyses indicated that, as expected, a mixture of genotoxic and non-genotoxic pollutants coexist in the Novara Province troposphere, and that the elevated ozone concentrations experienced during the study may have contributed to the DNA damage in the tested plants by enhancing genotoxicity via interaction with other air stressors.

Calcific tendinitis of the rotator cuff as a cause of drooping shoulder

We describe a case of inferior glenohumeral subluxation or drooping shoulder secondary to acute calcific tendinitis of the rotator cuff. The various etiologies of drooping shoulder and the specific causes determining glenohumeral widening in our report are discussed. The importance in recognizing this uncommon complication of a common abnormal finding and correction by aspiration is stressed.

The anterior tilt of the acromion: radiographic evaluation and correlation with shoulder diseases

The aim of this study was to test whether the anterior tilt of the acromion can be objectively evaluated on lateral radiographs, and whether there is a relation between this anatomical feature and the most common shoulder diseases. Lateral radiographs of 15 dried scapulas were performed in neutral position and with 5 degrees of caudal, cranial, anterior and posterior angulations. Two hundred and forty-three shoulders, both asymptomatic and affected by chronic and post-traumatic impingement, calcific tendinitis and instability, were examined by conventional radiography. The presence of rotator-cuff tears was investigated by sonography. A method was elaborated to obtain reproducible lateral radiographs and to determine the acromial tilt angle. Inter- and intraobserver and inter- and intraoperator variations in measurements were evaluated. Variations in tube angulation produced changes in tilt-angle values on dried scapulas. The average tilt angle for the chronic impingement and the instability groups were significantly different from the post-traumatic, calcific tendinitis and control groups. Rotator-cuff tears were significantly more frequent in the chronic impingement group and related to a more acute tilt angle. The inter- and intraobserver variability coefficients were 0.95 and 0.98, whereas the inter- and intraoperator variability coefficients were 0.94 and 0.96, respectively. Conventional radiography using fluoroscopy for positioning is a well-reproducible method for the evaluation of acromial tilt. There is a significant difference in tilt-angle values between some groups of subjects examined, but the lack of specificity limits the clinical importance of such measurement.

[Diagnostic reliability of radiography in shoulder trauma. Considerations on the use and choice of more radiographic projections]

The radiographic examination of the shoulder, one of the most common studies performed in the emergency department of examine trauma patients, very often yields poor and incorrect results. A radiographic study of the shoulder requires at least two radiographs, and different projections-namely, a frontal anteroposterior view and some additional projections, at right angles to one another. The shoulder radiographs of 126 patients examined for acute trauma were retrospectively reviewed to investigate the adequacy of lateral and oblique apical views in detecting shoulder injuries missed on anteroposterior view. The antero-posterior view was the most effective one, showing 88% of the injuries. Even though the oblique apical and the lateral views were less sensitive than the antero-posterior view, detecting 82% and 60% of the injuries, respectively, they were more sensitive for some specific injuries missed by the other views. Thus, glenohumeral dislocations with or without fracture and some clavicular fractures were best depicted by the oblique apical view, while the fractures of the body and coracoid process of the scapula were best detected by the lateral view. However, the two views had a complementary role and, in our series of patients, both of them showed four injuries missed by the anteroposterior view. Therefore, we conclude that the radiologist should collaborate with the orthopedist to choose which projections to use in each patient on the basis of physical and clinical examinations.

The Leclercq test in diagnosis of tear in the rotator cuff

The authors report their experience in using the Leclercq test to diagnose tear in the rotator cuff of the shoulder. When positive, this test consists in a radiographic demonstration of reduction in the subacromial space in opposing abduction of the shoulder. Twenty-five patients affected with chronic painful shoulder and suspected lesion of the rotator cuff were submitted to the Leclercq test and subsequently to arthrography in order to evaluate the conditions of the cuff. In all of the cases where the cuff was whole, and arthrography normal, the Leclercq test was negative. When lesion of the cuff was revealed by arthrography, the test was positive in 75% of the cases considered globally, and in 92% of the cases with complete tear in the rotator cuff.