Operando SXRD study of the structure and growth process of Cu2S ultra-thin films

Electrochemical Atomic Layer Deposition (E-ALD) technique has demonstrated to be a suitable process for growing compound semiconductors, by alternating the under-potential deposition (UPD) of the metallic element with the UPD of the non-metallic element. The cycle can be repeated several times to build up films with sub-micrometric thickness. We show that it is possible to grow, by E-ALD, Cu₂S ultra-thin films on Ag(111) with high structural quality. They show a well ordered layered crystal structure made on alternating pseudohexagonal layers in lower coordination. As reported in literature for minerals in the Cu-S compositional field, these are based on CuS₃ triangular groups, with layers occupied by highly mobile Cu ions. This structural model is closely related to the one of the low chalcocite. The domain size of such films is more than 1000 Å in lateral size and extends with a high crystallinity in the vertical growth direction up to more than 10 nm. E-ALD process results in the growth of highly ordered and almost unstrained ultra-thin films. This growth can lead to the design of semiconductors with optimal transport proprieties by an appropriate doping of the intra metallic layer. The present study enables E-ALD as an efficient synthetic route for the growth of semiconducting heterostructures with tailored properties.

Orthopaedic procedures in haemophilia

Haemophilia may nowadays be considered an "ortho paedic" disease given due to the involvement of musculoskeletal system in almost all haemophilic subjects. The modern haematological prophylaxis has dramatically improved the quality of life reducing bleedings and life-threatening complications; however, joint bleedings, progressive and irreversible arthropathy and osteoporosis are still now common challenging issues to be faced. One of the tissues involved by Haemophilia is the bone, particularly in the periarticular zone: poor bone quality and decrease of bone stock are typical patterns, and the worse is the arthropathy, the greater the bone loss. The orthopaedic management of such condition is now mandatory and characterized by several surgical techniques. The purpose of this work is to provide an overview of these options derived from our experience in managing haemophilic patients.

Hip Arthropathy in Haemophilia

Hip arthropathy in haemophilic patients is disabling for hip and other common target joints. Even if bleedings in the hip are not frequent, femoroacetabular alterations may affect the functional ability of patients at a very young age. A haematologic prophylaxis combined with an adequate lifestyle and regular and low-traumatic physical activity are the keys to preventing such arthropathy. In the early stages of arthropathy, anti-inflammatory drugs and physical therapy may be sufficient to limit its progression. In cases of recurrent symptoms, viscosupplementation with hyaluronic acid, and chemical synoviorthesis are useful options. In more advanced stages, hip arthroscopy may be treated by synovectomy or loose body removal. For late stages, total hip arthroplasty (THA) is mandatory. Until a few decades ago, the clinical outcomes after hip arthroplasty were variable, due to the different management of patients and the use of old generation implants and couplings. In the last decade, the introduction of the multidisciplinary management and the use of modern cementless implants with high performing materials and less invasive surgical techniques have dramatically improved the functional results. Nowadays, as is the case for other target joints, the purpose of the management in haemophilia centers is the early detection of any hip alterations—by clinical and ultrasound (US) evaluations of patients in childhood—to reveal any early articular damage and to provide adequate treatment in case of symptoms. The present paper represents an updated review of the several approaches to hip arthropathy in haemophilia.

The Survival of Total Knee Arthroplasty: Current Data from Registries on Tribology: Review Article

BACKGROUND

Polyethylene (PE) wear is a major contributor to implant loosening following total knee arthroplasty (TKA), and advanced bearings in TKA are being investigated with hopes of reducing or eliminate wear-related loosening. Currently, information on knee tribology is available from national joint registries and may be the best tools to evaluate the efficacy and safety of design innovations in joint arthroplasty.

QUESTIONS/PURPOSES

We performed a review of national joint registries trying to answer the following questions: "Which is the main factor directly related to revisions rate in TKA?" and "Are there new bearing options better than conventional ones?"

METHODS

A review was performed of all published annual reports of National Joint Registers, as well as of the literature. The search was carried out using and comparing the National Joint Registers.

RESULTS

Current data from registries for total knee arthroplasty indicates that age is the major factor affecting the outcome of primary total knee replacement. The 10-year cumulative revision rate for non-cross-linked PE was 5.8% and for XLPE it was 3.5%. The effect of cross-linked polyethylene was more evident in the younger patients. The survival of the oxidized zirconium (OxZr) femoral component appears better when compared to a similar age group of patients with conventional group of prostheses. Our review suggests that the revision rates are half for the OxZr components compared to conventional CoCr femoral components.

CONCLUSIONS

Age is the most relevant single factor related to revision rate. Cross-linked PE has a statistical lower revision rate at 10 years compared to conventional PE and, in the OxZr group, the revision rate is 2 times lower than Co-Cr in the same group of age.

Carbon supported Rh nanoparticles for the production of hydrogen and chemicals by the electroreforming of biomass-derived alcohols

An electrolyzer assembled with a Rh/C nanostructured anode electrode, promotes the partial oxidation of alcohols and high-purity hydrogen evolution in alkaline media at low energy input.

A comparison of two fixation methods for femoral trochanteric fractures: a new generation intramedullary system vs sliding hip screw

INTRODUCTION

Trochanteric fractures are frequent and generally associated with bone fragility. There is still debate on the best fixation device to treat stable or rather stable trochanteric fractures: we report our clinical and radiological results of fixation with Proximal Femoral Nail "antirotation" (PFNa) in a population of patients compared to a control group treated by Sliding Hip Screw (SHS).

MATERIALS AND METHODS

A prospective study was conducted in 71 consecutive patients treated by PFNa (group A), and 69 by a SHS (group B), with a mean age of 81.6 and 83.4 years respectively. Short Form 12 was administered to check postoperative results, and the following parameters were evaluated: range of motion, evaluation of pain, gait ability, X-rays, and Tip Apex Distance Index.

RESULTS

A minimum follow-up was conducted in 128 patients: 66 subjects belonging to the PFNa group and 62 to the DHS group. All patients in the group A were able to reach partial or full weight-bearing on the operated leg before leaving the hospital. Forty-four patients (63.8%) of the group B were able to walk with partial weight-bearing before discharge. We recorded 17 complications with a final overall percentage of 17.2% on the overall study population with one single case of failure in both the two groups.

DISCUSSION

A statistical significance (p<0.01) of superiority for PFNa was demonstrated regarding surgical time, amplioscope time, intraoperative blood loss, hospital stay, recovery of weight-bearing before discharge. Less significant results (p<0.05) were found for walking ability at the three-months follow-up and patients' satisfaction 6 months after surgery.

CONCLUSIONS

PFNa may be considered an useful choice for the treatment of stable or rather stable trochanteric fractures as well as DHS. The light superiority of PFNa may be principally related to its mechanical advantages.

Comment on: “A case report of a complete degloving injury of the penile skin”

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Genitalia are a key element for male self-esteem, contributing towards mental and physical balance and influencing their social life.

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Scrotal dartos-fascio-mio-cutaneous flap for shaft coverage offers a large amount of tissue with low donor site morbidity, avoiding unsightly scars in more visible parts of the body.

Introduction

We recently published an article in the International Journal of Surgical Case Reports titled: “Scrotal dartos-fascio-myo-cutaneous flap for penis elongation after catastrophic iatrogenic skin shaft sub-amputation: A case of recovery using an extremely adaptable flap”.

Presentation of case

We propose a comment on a recent article titled “A case report of a complete degloving injury of the penile skin” by Helena Aineskog and Frederik Huss that we read with great interest.

Discussion

Genitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Various techniques are available for pe-nile skin covering, such as skin grafts or cutaneous flaps. The skin of the scrotum seems to be the most suitable tissue to be used to reconstruct the skin covering of the shaft as it is the most similar.

Conclusion

Scrotal flap is a single stage procedure that is easy and safe to perform.

Densitometric evaluation of bone-prosthetic counterface in hip and knee arthroplasty with modern implants

INTRODUCTION

Recent acquisitions of the complex mechanisms of osseointegration between implants and host bone have gained attention, accordingly to the methods of evaluation of these interactions. DEXA analysis is considered an useful tool to assess such phenomena, in order to analyse in a quantitative manner the local metabolic activity of the bone, and to evaluate over the time the integration between host bone and prosthetic components. The purpose of the present study is to report about a preliminary experience in the analysis of osseointegration processes of patients undergoing a primary Total Hip Arthroplasty (THA) or a revision Total Knee Arthroplasty (rTKA).

MATERIALS AND METHODS

Thirty patients undergoing THA and nineteen undergoing rTKA were included in this study. In fifteen cases of THA a standard cementless stem was used; in the other fifteen a short cementless stem was chosen. In all cases a cementless cup was implanted. In all patients undergoing rTKA, all implants had pressfit femoral and tibial diaphyseal stems; only the femoral component and the tibial plateau were cemented. DEXA evaluation was performed preoperatively, and at 3, 6, 12, and 24 months postoperatively for rTKA, and at 6 and 12 months for THA.

RESULTS

DEXA in THA showed a significant decrease at the femoral ROIs 1 and 7, and an increase in ROI 4. In rTKA a reduction of femoral BMD in R1, R7, and R4 was found, with maximum values of -13.6% in R1 and -11.89% in R7 at 24 months and a value of -2.55% in R4 at 12 months. On the tibial side, an increase in BMD R4 (with values of 2.18% still at 24 months), and a reduction in R7 (progressively lesser over the time) and in R1 (progressively higher) were found.

CONCLUSIONS

After a joint replacement a full adhesion of the prosthetic surface to the host bone should be achieved through a local biological process named osseointegration. In some cases this process may not fully realize, so the secondary stability of the implant may fail. DXA is a valuable tool to follow over time the bone remodelling at the bone-prosthesis counterface in THA and in rTKA, in order to early detect any alterations of such phenomenon.

Hypersensitivity reactions to metal implants: laboratory options

Background

All implant compounds undergo an electrochemical process when in contact with biological fluids, as well as mechanical corrosion due to abrasive wear, with production of metal debris that may inhibit repair processes. None of the commonly-used methods can diagnose implant allergies when used singly, therefore a panel of tests should be performed on allergic patients as pre-operative screening, or when a postoperative metal sensitisation is suspected.

Methods

We analysed patients with painful prostheses and subjects prone to allergies using the Patch Test in comparison with the Lymphocyte Transformation Test. Cytokine production was evaluated to identify prognostic markers for early diagnosis of aseptic loosening. Metal debris endocytosis and cytoskeletal rearrangement was visualised by confocal microscopy.

Results

Our results demonstrate that the Lymphocyte Transformation Test can identify patients who have a predisposition to develop allergic reactions and can confirm the diagnosis of hypersensitivity in patients with painful prostheses.

The prevalence of a Th2-cytokine pattern may be used to identify predisposition to the development of allergic diseases, while the selective presence of osteoclastogenic cytokines may be used as predictor of a negative outcome in patients with painful prosthesis.

The hypothesis of the prognostic value of these cytokines as early markers of aseptic loosening is attractive, but its confirmation would require extensive testing.

Conclusions

The Lymphocyte Transformation Test is the most suitable method for testing systemic allergies. We suggest that the combined use of the Patch Test and the Lymphocyte Transformation Test, associated with cytokine detection in selected patients, could provide a useful tool for preventive evaluation of immune reactivity in patients undergoing primary joint replacement surgery, and for clinical monitoring of the possible onset of a metal sensitization in patients with implanted devices.

Aziridine-Functionalized Multiwalled Carbon Nanotubes: Robust and Versatile Catalysts for the Oxygen Reduction Reaction and Knoevenagel Condensation

This paper describes the exohedral N-decoration of multiwalled carbon nanotubes (MWCNTs) with NH-aziridine groups via [2 + 1] cycloaddition of a tert-butyl-oxycarbonyl nitrene followed by controlled thermal decomposition of the cyclization product. The chemical grafting with N-containing groups deeply modifies the properties of the starting MWCNTs, generating new surface microenvironments with specific base (Brønsted) and electronic properties. Both of these features translate into a highly versatile single-phase heterogeneous catalyst (MW@N^Az) with remarkable chemical and electrochemical performance. Its surface base character promotes the Knoevenagel condensation with activity superior to that of related state of the art N-doped and N-decorated carbon nanomaterials; the N-induced electronic surface redistribution drives the generation of high-energy surface "C" sites suitable for O₂ activation and its subsequent electrochemical reduction (ORR).

Scrotal dartos-fascio-myo-cutaneous flaps for penis elongation after catastrophic iatrogenic skin shaft sub-amputation: A case of recovery using an extremely adaptable flap

INTRODUCTION

Genitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Among the surgical procedures requested for aesthetical purposes, circumcision is one of the most popular. Although it can be considered to be a simple surgical practice, it may cause severe complications such as penile skin necrosis.

PRESENTATION OF CASE

We report a case of a catastrophic situation after a circumcision performed on a 27-year-old HIV positive man resulted in a drastic reduction in the length of the penile shaft due to extensive skin loss; this was subsequently restored using dartos-fascio-myo-cutaneous flaps. Primary healing occurred in 10days. No infection, dehiscence or flap ischemia were reported. Donor site morbidity was minimal. An adequate aesthetical appearance and satisfactory functional results were obtained.

DISCUSSION AND CONCLUSION

Various techniques are available for penile skin covering, such as skin grafts or cutaneous flaps. The skin of the scrotum seems to be the most suitable tissue to be used to reconstruct the skin covering of the shaft as it is the most similar. Dartos-fascio-myo-cutaneous flap is a single stage procedure that is easy and safe to perform. It can provide satisfactory cosmetic and functional results, offering a large amount of tissue, with minimal donor site morbidity.

Aluminium Electrodeposition from Ionic Liquid: Effect of Deposition Temperature and Sonication †

Since their discovery, ionic liquids (ILs) have attracted a wide interest for their potential use as a medium for many chemical processes, in particular electrochemistry. As electrochemical media they allow the electrodeposition of elements that are impossible to reduce in aqueous media. We have investigated the electrodeposition of aluminium from 1-butyl-3-methyl-imidazolium chloride ((Bmim)Cl)/AlCl₃ (40/60 mol %) as concerns the effect of deposition parameters on the quality of the deposits. Thick (20 μm) aluminium coatings were electrodeposited on brass substrates at different temperatures and mixing conditions (mechanical stirring and sonication). These coatings were investigated by means of scanning electron microscope, roughness measurements, and X-ray diffraction to assess the morphology and the phase composition. Finally, electrochemical corrosion tests were carried out with the intent to correlate the deposition parameters to the anti-corrosion properties.

Physico-chemical properties of quartz from industrial manufacturing and its cytotoxic effects on alveolar macrophages: The case of green sand mould casting for iron production

Industrial processing of materials containing quartz induces physico-chemical modifications that contribute to the variability of quartz hazard in different plants. Here, modifications affecting a quartz-rich sand during cast iron production, have been investigated. Composition, morphology, presence of radicals associated to quartz and reactivity in free radical generation were studied on a raw sand and on a dust recovered after mould dismantling. Additionally, cytotoxicity of the processed dust and ROS and NO generation were evaluated on MH-S macrophages. Particle morphology and size were marginally affected by casting processing, which caused only a slight increase of the amount of respirable fraction. The raw sand was able to catalyze OH and CO2(-) generation in cell-free test, even if in a lesser extent than the reference quartz (Min-U-Sil), and shows hAl radicals, conventionally found in any quartz-bearing raw materials. Enrichment in iron and extensive coverage with amorphous carbon were observed during processing. They likely contributed, respectively, to increasing the ability of processed dust to release CO2- and to suppressing OH generation respect to the raw sand. Carbon coverage and repeated thermal treatments during industrial processing also caused annealing of radiogenic hAl defects. Finally, no cellular responses were observed with the respirable fraction of the processed powder.

Comparative study of oncoplastic versus non-oncoplastic breast conserving surgery in a group of 211 breast cancer patients

OBJECTIVE

Breast conserving surgery (BCS) followed by radiotherapy is the standard of care for most patients with early breast cancers; however, the aesthetic outcomes of this procedure is not always desirable. Oncoplastic breast surgery is an innovative approach that aims at the safe and effective treatment of the cancerous lesion while achieving the best possible aesthetic outcome. The aim of this study was to evaluate and compare oncoplastic and non-oncoplastic procedures.

PATIENTS AND METHODS

A retrospective observational study was conducted on a group of patients who underwent oncoplastic or non-oncoplastic breast surgery at the Breast Unit of the University of Rome Tor Vergata.

RESULTS

Out of 211 patients, 154 (73%) underwent non-oncoplastic surgery, while 61 (27%) underwent an oncoplastic procedure. The percentage of patients requiring re-excision was twice greater for women in the non-oncoplastic group: 12.9% vs. 6.5% in the oncoplastic group. The rate of complications was higher in the oncoplastic group compared to the non-oncoplastic one (4.9% vs. 1.3%). The size of the tumor, the number of the patients receiving post-operative radiation, the interval between surgery and radiotherapy and follow-up were similar between the two groups.

CONCLUSIONS

Oncoplastic surgery represents a valid alternative to breast conserving surgery for patients with breast cancer, with only minimal differences in long-term complications and similar results in terms of local recurrence and number of metastasis.

Traumatic bilateral Achilles tendon rupture in a young athlete treated with percutaneous tenorrhaphy

While rupture of the Achilles tendon is one of the most frequent injuries sustained in sports and physical activity, bilateral Achilles tendon rupture is uncommon. We present the case of a 33-year-old man who sustained a bilateral Achilles tendon rupture in the absence of predisposing factors. The lesions were managed by percutaneous tenorrhaphy and casting. Six months after surgery he was able to return to his daily-life activities and to perform light sports activity. The Authors review the current literature on the management of this rare condition in young people, with or without risk factors.

Chemical functionalization of N-doped carbon nanotubes: a powerful approach to cast light on the electrochemical role of specific N-functionalities in the oxygen reduction reaction

Two different synthetic approaches to carbon nanotube N-decoration/doping are used to foster the hypothesis of a unique N-configuration (N-pyridinic) at work in the ORR.

Heat treated carbon supported iron(ii)phthalocyanine oxygen reduction catalysts: elucidation of the structure–activity relationship using X-ray absorption spectroscopy

Correlation between atomic structure and oxygen reduction activity by X-ray absorption spectroscopy.

Clinical, instrumental, serological and histological findings suggest that hemophilia B may be less severe than hemophilia A

Recent evidence suggests that patients with severe hemophilia B may have a less severe disease compared to severe hemophilia A. To investigate clinical, radiological, laboratory and histological differences in the arthropathy of severe hemophilia A and hemophilia B, 70 patients with hemophilia A and 35 with hemophilia B with at least one joint bleeding were consecutively enrolled. Joint bleedings (<10, 10-50, >50), regimen of treatment (prophylaxis/on demand), World Federation of Hemophilia, Pettersson and ultrasound scores, serum soluble RANK ligand and osteoprotegerin were assessed in all patients. RANK, RANK ligand and osteoprotegerin expression was evaluated in synovial tissue from 18 hemophilia A and 4 hemophilia B patients. The percentage of patients with either 10-50 or more than 50 hemarthrosis was greater in hemophilia A than in hemophilia B (P<0.001 and P=0.03, respectively), while that with less than 10 hemarthrosis was higher in hemophilia B (P<0.0001). World Federation of Hemophilia (36.6 vs. 20.2; P<0.0001) and ultrasound (10.9 vs. 4.3; P<0.0001) score mean values were significantly higher in hemophilia A patients. Serum osteoprotegerin and soluble RANK ligand were decreased in hemophilia A versus hemophilia B (P<0.0001 and P=0.006, respectively). Osteoprotegerin expression was markedly reduced in synovial tissue from hemophilia A patients. In conclusion, the reduced number of hemarthrosis, the lower World Federation of Hemophilia and ultrasound scores, and higher osteoprotegerin expression in serum and synovial tissue in hemophilia B suggest that hemophilia B is a less severe disease than hemophilia A. Osteoprotegerin reduction seems to play a pivotal role in the progression of arthropathy in hemophilia A.

Total Hip Arthroplasty in Haemophilic Patients with Modern Cementless Implants

Hip arthropathy due to recurrent haemarthrosis in patients with haemophilia can be disabling. When severe degeneration occurs, total hip arthroplasty is indicated. Reported outcomes are variable and out of date. The aim of this study is to evaluate the survivorship of Total Hip Arthroplasty performed in a patient population with modern cementless implants. Twenty-three haemophilic patients were treated and followed by a multidisciplinary team dedicated to haemophilia. The mean age was 40.6 years. No failures or complications were recorded at a mean follow-up of 8.1 years (range: 3.1-13.7). A multidisciplinary team and the use of modern cementless implants may represent the keys to achieve good outcomes, fewer complications, and better survivorship in the approach to these difficult cases.

Synergy of Cobalt and Silver Microparticles Electrodeposited on Glassy Carbon for the Electrocatalysis of the Oxygen Reduction Reaction: An Electrochemical Investigation

The combination of two different metals, each of them acting on different steps of the oxygen reduction reaction (ORR), yields synergic catalytic effects. In this respect, the electrocatalytic effect of silver is enhanced by the addition of cobalt, which is able to break the O–O bond of molecular oxygen, thus accelerating the first step of the reduction mechanism. At the same time, research is to further reduce the catalyst’s cost, reducing the amount of Ag, which, even though being much less expensive than Pt, is still a noble metal. From this point of view, using a small amount of Ag together with an inexpensive material, such as graphite, represents a good compromise. The aim of this work was to verify if the synergic effects are still operating when very small amounts of cobalt (2–10 μg·cm⁻²) are added to the microparticles of silver electrodeposited on glassy carbon, described in a preceding paper from us. To better stress the different behaviour observed when cobalt and silver are contemporarily present in the deposit, the catalytic properties of cobalt alone were investigated. The analysis was completed by the Levich plots to evaluate the number of electrons involved and by Tafel plots to show the effects on the reaction mechanism.

The use of a dual mobility cup in the management of recurrent dislocations of hip hemiarthroplasty

Background

Dislocation is one of the most frequent causes of failure of hemiarthroplasties of the hip, which is the most common treatment for femoral neck fractures in elderly patients. A revision with conversion to total hip arthroplasty is the gold standard in case of failure of closed reduction: however, the use of standard or modular components shows variable outcomes. The use of a dual mobility cup has been evaluated in patients with unstable implants, given the good outcomes obtained in primary and revision surgery. The aim of this study was to assess the results of revisions by dual mobility cups in unstable hemiarthroplasties.

Materials and methods

Thirty-one patients (mean age 75.4 years) were retrospectively evaluated between 2006 and 2010 after conversion to total hip arthroplasty with dual mobility cups for recurrent dislocations. The mean number of dislocations was 2.6 (range 2–5). The evaluation was performed by the American Society of Anesthesiologists physical function score (ASA) and the Harris hip score, and several radiologic criteria.

Results

The mean follow-up was 3.8 years. No recurrence of dislocation was recorded. The ASA score remained unchanged, and the mean Harris hip score improved from 62.2 before dislocation to 76.0 points postoperatively.

Conclusions

Dual mobility cups may be a useful option in the treatment of a hemiarthroplasty dislocation. No risk of a new revision due to instability after insertion of dual mobility cups resulted in our experience, and this option may be strongly considered in cases of revisions of unstable hemiarthroplasties.

Level of evidence IV.

Preliminary results of an early vs delayed timing of surgery in the management of proximal femur fragility fractures

INTRODUCTION

The appropriate surgical timing for the treatment of proximal femur fractures is still debated. Advantages of a delayed surgery may be: stabilization of systemic diseases, decrease of the risk of perioperative mortality and morbidity. An early timing of surgery may allow: early mobilization, reduction of the risks of disability and hospital stays, early return to home of the patients. However, the effects on mortality are still discussed.

PURPOSE

The purpose of this study is to assess the influence of the surgical timing on clinical outcomes, complications, and mortality in a preliminary experience of the early management of these fractures vs the delayed surgery.

METHODS

A series of 176 patients was retrospectively evaluated. 132 patients were followed-up for one year after surgery. The evaluation was performed by the assessment of the comorbidities, preoperative wait for surgery, type of fracture and procedures, hospital stay, and functional outcomes: 33 patients were operated with an early timing, 99 with a delayed surgery.

RESULTS

The mean mortality rate was 18.2% in the early timing (6/33 patients), and 23.2% in the delayed timing (23/99 patients): no significant difference was recorded in the preliminary analysis. Postoperative complications were recorded in 28 patients (21.2%): 4 patients were operated within 48 hours (12.1%) and 24 after 48 hours (24.2%) with no substantial differences. The postoperative hospital stay showed no correlation with the timing of surgery, as no evidence was found on the functional recovery and postoperative disability.

CONCLUSIONS

No significant differences were found on the evaluated parameters in the two groups in the present preliminary study. A correlation between male sex and mortality, and male sex and postoperative complications was assessed. An enlargement of the study population is needed to surely clarify any effective differences, given the fact that recent studies seem to identify in the early treatment the better strategy to ensure the best recovery and the lower rate of mortality and complications.