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Ciatti C, Maniscalco P, Bosio S, Puma Pagliarello C, Bianchi G, Quattrini F. Pseudotumor from ceramic-on-ceramic total hip arthroplasty. Int J Surg Case Rep 2024; 116:109374. [PMID: 38401324 PMCID: PMC10943669 DOI: 10.1016/j.ijscr.2024.109374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/26/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Total hip arthroplasty is one of the most performed surgical interventions in the world. Adverse local tissue reactions and pseudotumors are infrequent but dangerous eventualities, which are often related with metal-on-metal or metal-on-polyethylene implants. This study wants to highlight how adverse local tissue reactions and pseudotumors must be taken into consideration during the diagnostic process. CASE PRESENTATION We report the case of a patient with ceramic-on-ceramic modular total hip arthroplasty with titanium neck. 12 years after surgery, he complained of pain and swelling on the hip. Diagnostic tests revealed the presence of a bulky pseudotumor. During the revision surgery biopsy samples were taken and microscopical analysis revealed the presence of fibrous tissue, fibrin hemorrhagic collections, histiocytes and chronic inflammation due to foreign body, with dark refractive material of an exogenous nature. CLINICAL DISCUSSION The possible formation of pseudotumor and metallosis reactions in hip prostheses with metal-on-metal coupling or in couplings with polyethylene is known. Many cases of pseudotumor are reported after revision of prostheses due to the breakage of ceramic components, but we did not observe any damage or corrosion of the prosthetic elements; on the other hand, we noticed an excessive retroversion of the femoral neck. It may be possible that an accurate microscopic analysis could clarify the failure of this implant. CONCLUSION To date ceramic-ceramic coupling remains the gold standard in terms of resistance and durability for hip arthroplasty but there is still a gap of knowledge in the field of tribology and individual immune response mechanisms.
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Affiliation(s)
- Corrado Ciatti
- U.O.C. Orthopedics and Traumatology, Guglielmo Da Saliceto Hospital, AUSL Piacenza, Italy; University of Parma
| | - Pietro Maniscalco
- U.O.C. Orthopedics and Traumatology, Guglielmo Da Saliceto Hospital, AUSL Piacenza, Italy; University of Parma.
| | - Silvia Bosio
- Pathology Unit, Onco-Hematologic Department, Guglielmo Da Saliceto Hospital, AUSL Piacenza, Piacenza, Italy
| | | | - Giuseppe Bianchi
- Clinica Ortopedica III, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Fabrizio Quattrini
- U.O.C. Orthopedics and Traumatology, Guglielmo Da Saliceto Hospital, AUSL Piacenza, Italy; University of Parma
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2
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Guasconi M, Zilli Riboni D, Civardi A, Bolzoni M, Granata C, Beretta M, Genovese A, Mozzarelli F, Quattrini F, Maniscalco P. The use of adhesive elastic tape for hand oedema control in patients with a wrist fracture treated in a cast: A pilot study. Int J Orthop Trauma Nurs 2023:101059. [PMID: 38261469 DOI: 10.1016/j.ijotn.2023.101059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/03/2023] [Accepted: 10/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND The adhesive elastic tape use is indicated for controlling oedema, although currently there is not the definitive evidence regarding its effectiveness. Wrist fractures are a frequent occurrence, often leading to oedema development in patients treated with forearm casts. This pilot study aims to investigate the effects of elastic tape in controlling hand oedema among patients with forearm casts for wrist fractures and the feasibility of a future randomized controlled trial. METHODS The study was conducted on adult patients with unilateral conservatively treated wrist fracture. The tape was applied to the intervention group after cast application, while the control group received the standard treatment. The circumference difference between baseline and the 7-day follow-up of both the 1st finger and the remaining 4 fingers merged together was evaluated. Ethical approval for the study has been obtained. RESULTS 23 participants were enrolled. The intervention group showed a higher reduction in finger circumferences compared to the control group (median difference T1-T0 No tape vs Tape: 0 cm vs -0.2 cm for the 1st finger and 0.5 cm vs -0.5 cm for the remaining 4 fingers), although the changes were not statistically significant. CONCLUSION Although the number of enrolled patients was limited due to Covid-19 pandemic, the study results suggest a potential reduction in oedema after the use of adhesive elastic tape, justifying the needed of a future full-scale study. Given its low cost and ease of use, we believe that tape can be considered in clinical practice. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04683887.
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Affiliation(s)
- Massimo Guasconi
- University of Parma, Department of Medicine and Surgery, Parma, Italy; Azienda USL of Piacenza, Piacenza, Italy.
| | | | | | | | | | - Maurizio Beretta
- University of Parma, Department of Medicine and Surgery, Parma, Italy; Azienda USL of Piacenza, Piacenza, Italy
| | - Anna Genovese
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Fabio Mozzarelli
- University of Parma, Department of Medicine and Surgery, Parma, Italy; Azienda USL of Piacenza, Piacenza, Italy
| | - Fabrizio Quattrini
- University of Parma, Department of Medicine and Surgery, Parma, Italy; Azienda USL of Piacenza, Piacenza, Italy
| | - Pietro Maniscalco
- University of Parma, Department of Medicine and Surgery, Parma, Italy; Azienda USL of Piacenza, Piacenza, Italy
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Miedico M, Quattrini F, Attardo SE, Marchioni M, Bassi MC, Lucenti E, Sarli L, Guasconi M. The use of skin traction in the adult patients with proximal femur fracture. What are the effects, advantages and disadvantages? A scoping review. Int J Orthop Trauma Nurs 2023; 49:101004. [PMID: 36878122 DOI: 10.1016/j.ijotn.2023.101004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Hip surgery is normally the chosen therapy for proximal femur fractures. Surgery within 24-48 h after hip fracture is recommended, but surgery may not always be performed promptly. Consequently, skin-traction is applied to reduce complications. The purpose of this review is to assess both advantages and disadvantages of skin traction. METHODS A scoping review was conducted. The research question was: which are the effects of skin traction, its advantages and disadvantages in adult patients with proximal femur fractures hospitalised in orthopaedic wards? The search was done in the databases PubMed, CINAHL, Cochrane, Embase, DOAJ, ClinicalTrials.gov and OpenDissertation. RESULTS 9 records were included, skin traction effects were summarised in 7 categories: pain, pressure sores, comfort and relaxation, thromboembolism, damage from adhesive, complications and quality of care. The possible advantage is pain reduction between 24 and 60 h, the possible disadvantage is skin damage. DISCUSSION AND CONCLUSION The routine use of skin traction does not appear recommended, but more consistent evidence is necessary to make clinic decisions. Future RCTs could focus on the effects of skin traction 24-60 h after hospitalisation and before surgery.
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Affiliation(s)
- Melania Miedico
- "Azienda Unità Sanitaria Locale di Piacenza", Piacenza, Italy
| | - Fabrizio Quattrini
- "Azienda Unità Sanitaria Locale di Piacenza", Piacenza, Italy; University of Parma, Department of Medicine and Surgery, Parma, Italy
| | | | | | - Maria Chiara Bassi
- "Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia", Reggio Emilia, Italy
| | - Enrico Lucenti
- "Azienda Unità Sanitaria Locale di Piacenza", Piacenza, Italy
| | - Leopoldo Sarli
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Massimo Guasconi
- "Azienda Unità Sanitaria Locale di Piacenza", Piacenza, Italy; University of Parma, Department of Medicine and Surgery, Parma, Italy.
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Petrini M, Colombi D, Bodini FC, Morelli N, Ciatti C, Quattrini F, Maniscalco P, Michieletti E. Thoracic duct leakage in a patient with Type B-Non-Hodgkin lymphoma treated with transvenous retrograde access embolization: a case report. Acta Biomed 2023; 94:e2023043. [PMID: 36718781 DOI: 10.23750/abm.v94is1.12732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/30/2022] [Indexed: 02/01/2023]
Abstract
Thoracic duct (TD) is the largest lymphatic vessel in the body and drains the lymph at the junction between the left subclavian and jugular veins. Chylothorax (CTX) represents an accumulation of lymphatic fluid in the pleural space. We present a case of a 65 years-old man with an histologically diagnosed mediastinal type B non-Hodgkin Lymphoma, treated with chemo-immunotherapy. CT scan during follow up showed significant left side pleural effusion, amounting to 2.8 litres after drainage. Conservative treatment with low fat parenteral nutrition was started without reduction of drainage output, then lymphangiography (LP) with Lipiodol was performed demonstrating a leak in the distal TD. CTX increased in the following days, and a further LP was performed. Using transvenous retrograde access we catheterized TD at the left subclavian jugular veins using a microcatheter. The leak was treated with multiple conventional and controlled delivery microcroils and cyanoacrylate, obtaining complete embolization without residual leak.
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Affiliation(s)
- Marcello Petrini
- 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy.
| | - Davide Colombi
- 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy.
| | - Flavio Cesare Bodini
- 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy.
| | - Nicola Morelli
- 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy.
| | - Corrado Ciatti
- Guglielmo da Saliceto Hospital, Department of Orthopaedics and Traumatology, Via Taverna 49, 29121, Piacenza, Italy.
| | - Fabrizio Quattrini
- Guglielmo da Saliceto Hospital, Department of Orthopaedics and Traumatology, Via Taverna 49, 29121, Piacenza, Italy.
| | - Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Emanuele Michieletti
- 1Guglielmo da Saliceto Hospital, Department of Radiology, Via Taverna 49, 29121, Piacenza, Italy.
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Attanasio M, Masedu F, Quattrini F, Pino MC, Vagnetti R, Valenti M, Mazza M. Are Autism Spectrum Disorder and Asexuality Connected? Arch Sex Behav 2022; 51:2091-2115. [PMID: 34779982 DOI: 10.1007/s10508-021-02177-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/10/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
Asexuality is a lack of sexual attraction to any gender. There is some evidence to suggest that many self-identified asexuals have a formal diagnosis of autism spectrum disorder which is characterized by deficits in social interaction and communication, as well as by restricted and repetitive interests and behaviors. Additionally, the literature shows that asexuality and lack of sexual attraction or low sexual interest is overrepresented in people with autism spectrum disorder compared with neurotypical samples. Nevertheless, no studies have been conducted to investigate the relationship between autism and asexuality in depth. We conducted a systematic review of the literature to examine whether asexuality and autism spectrum disorder are connected. We conclude that asexuality and autism share various aspects, such as a possible role of prenatal factors, reference to romantic dimensions of sexual attraction and sexual orientation, and non-partner-oriented sexual desire, but future research should explore and clarify this link.
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Affiliation(s)
- Margherita Attanasio
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy.
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L'Aquila, Italy.
| | - Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Fabrizio Quattrini
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Maria Chiara Pino
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Roberto Vagnetti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L'Aquila, Italy
| | - Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Località Coppito, Italy
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Maiello A, Rivera F, Maniscalco P, Colombo M, Di Stefano G, Quattrini F. Tronco-conical locking plate in distal radius fractures. Injury 2022; 53 Suppl 1:S19-S22. [PMID: 33158498 DOI: 10.1016/j.injury.2020.10.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/11/2020] [Accepted: 10/17/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Volar locked plates represent the most popular fixation technique for distal radius fracture (DRF). However, threaded screw-hole angular stability mechanism has some issues. The purpose of our study is to evaluate clinical and radiological outcome of a tronco-conical locking mechanism for volar plating of DRF. MATERIALS AND METHODS Eighty patients with DRF treated with tronco-conical locking volar plates between May 2013 to December 2017 in two institutions were collected. We analysed clinical and radiological outcomes and peri-operative complications, like loss of reduction, fragment displacement, deformation or implant-related problems and surgical and other general complications. RESULTS 78 patients were available for at final follow-up. The average follow-up period was 11.4 months (range, 6-18 months). All fractures healed within three months. Five cases of final reductions were defined unsatisfying. According to Gartland and Werley's scoring system at final follow up, 36 patients had excellent results, 40 patients had good results, one patient had fair and one patient had poor results. Five complications were observed. No complications were observed during surgical plate removal. CONCLUSION Complications found in our study are not related to tronco-conical locking mechanism and are like those found in the literature. Further studies are needed to evaluate functional results or radiographic parameters of this new type of angular stability mechanism. Tronco-conical locking plate is an attractive alternative threaded screw-hole angular stability mechanism.
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Affiliation(s)
- Alessio Maiello
- Orthopaedic and Trauma Department, S.S. Annunziata Hospital, Savigliano (CN), Italy.
| | - Fabrizio Rivera
- Orthopaedic and Trauma Department, S.S. Annunziata Hospital, Savigliano (CN), Italy
| | - Pietro Maniscalco
- Orthopaedic and Traumatology Department, G. da Saliceto Hospital, Piacenza, Italy
| | | | - Giovanni Di Stefano
- Orthopaedic and Traumatology Department, G. da Saliceto Hospital, Piacenza, Italy
| | - Fabrizio Quattrini
- Orthopaedic and Traumatology Department, G. da Saliceto Hospital, Piacenza, Italy
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Maniscalco P, Puma Pagliarello C, Ciatti C, Gattoni S, Burgio V, Cauteruccio M, Di Stefano G, Quattrini F, Guerra G, Polidoro F, Raggini F, Belluati A, Giolitti A, Rivera F. Retrospective analysis of outcomes and complications after Korus hemiarthroplasty in elderly patients with neck femur fractures. Acta Biomed 2022; 93:e2022008. [PMID: 35315417 PMCID: PMC8972873 DOI: 10.23750/abm.v93i1.11249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/23/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Femoral neck fractures (FNF) is one of the most common traumatic events in elderly patients: the choice of an appropriate treatment is necessary to decrease the related mortality and to achieve the best possible outcomes. Nowadays, it is still debated whether or not to cement the stem in hemiarthroplasty and above all, which stem to use to best respect the integrity of the elderly bone. METHODS From January 2017 to December 2019, a bi-centric study utilizing prospectively collected databases of elderly patients with FNF treated with uncemented Korus stem hemiarthroplasty was performed. Patients were preoperatively classified according to ASA score. Patients' clinical and X-ray follow-up was at 1, 3, 6, 12 months. Harris Hip Score (HHS) was used for analysed clinical improvement. On the X-rays, we analysed iatrogenic fractures, osteolysis area and radiolucent lines in the stem region during follow up. RESULTS 233 patients were identified. Median follow-up was 12 months. Over time, 51 patients died (21.88%). Mean age was 89,56 ± 6,25. 75 patients had ASA score of 2 (32.3%), 102 patients a score of 3 (43.7%), 56 an ASA score of 4 (24,0%). The main Harris hip score was 68,66 ± 8.53 at 1 month of follow-up, 71,74 ± 9.65 after 3 months, 72,50 ± 10.66 at 6 months and 75,61 ± 9.63 at 12 months control. CONCLUSIONS Hydroxyapatite coated stem with an accurate design guarantee early fixation, good clinical and radiographic results, low rate of re-intervention and mortality rate and a satisfying return to pre-injury activities.
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Affiliation(s)
- Pietro Maniscalco
- Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Corrado Ciatti
- Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Serena Gattoni
- Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Valeria Burgio
- Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Michele Cauteruccio
- Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Giovanni Di Stefano
- Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Fabrizio Quattrini
- Department of Orthopedics and Traumatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Giovanni Guerra
- Department of Orthopedics and Traumatology, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Federico Polidoro
- Department of Orthopedics and Traumatology, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Filippo Raggini
- Department of Orthopedics and Traumatology, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Alberto Belluati
- Department of Orthopedics and Traumatology, Santa Maria delle Croci Hospital, Ravenna, Italy
| | - Andrea Giolitti
- Orthopeadics and Traumatology Department, University of Turin, Torino, Italy
| | - Fabrizio Rivera
- Orthopedics and Trauma Department, SS Annunziata Hospital, Savigliano (CN), Italy
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Quattrini F, Ciatti C, Gattoni S, Puma Pagliarello C, Ceccarelli F, Maniscalco P. The Use of Low-Profile Angular-Stability Plates in a "Nutcracker" Tarsal Navicular Fracture Combined with a Cuboid Fracture: ORIF Experience. J Funct Morphol Kinesiol 2021; 6:99. [PMID: 34940508 PMCID: PMC8707129 DOI: 10.3390/jfmk6040099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Clear recommendations about the optimal treatment of traumatic tarsal navicular fractures are still very debated in the literature, and this is due to several factors: navicular fractures are rare and often misdiagnosed injuries, they are frequently associated with other fractures or a dislocation of the midfoot, and the current knowledge is based on few papers mainly considering a limited number of cases and dealing with different therapeutic approaches. The treatment of navicular body fractures is controversial and burdened by a high incidence of complications; in particular, Sangeorzan type III comminuted fractures represent a real challenge for the orthopedic surgeon. An accurate preoperative planning, a scrupulous surgical technique aimed at restoring volume and bony anatomy, and the use of low-profile angular-stability plates can lead to optimal clinical and functional results, decreasing the chances of arthritic evolution of mid-foot joints.
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Affiliation(s)
- Fabrizio Quattrini
- Orthopaedic and Traumatology Department, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy; (F.Q.); (C.C.); (S.G.); (C.P.P.)
| | - Corrado Ciatti
- Orthopaedic and Traumatology Department, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy; (F.Q.); (C.C.); (S.G.); (C.P.P.)
| | - Serena Gattoni
- Orthopaedic and Traumatology Department, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy; (F.Q.); (C.C.); (S.G.); (C.P.P.)
| | - Calogero Puma Pagliarello
- Orthopaedic and Traumatology Department, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy; (F.Q.); (C.C.); (S.G.); (C.P.P.)
| | - Francesco Ceccarelli
- Department of Medicine and Surgery, Orthopedic Clinic, University Hospital of Parma, 43100 Parma, Italy;
| | - Pietro Maniscalco
- Orthopaedic and Traumatology Department, Ospedale Guglielmo da Saliceto, 29121 Piacenza, Italy; (F.Q.); (C.C.); (S.G.); (C.P.P.)
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9
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Ciatti C, Maniscalco P, Quattrini F, Gattoni S, Magro A, Capelli P, Banchini F, Fiazza C, Pavone V, Puma Pagliarello C, Valenti F, Maccauro G, Cauteruccio M, Accetta R, Basile G, Ruosi C, Di Santo F, Orabona N, Coppola C, Perugia D, Lanzetti RM, Roselli M, Montanari G, Benazzo F, Mosconi M, Perticarini L, Pesce V, Maccagnano G, Moretti L, Moretti B, Solarino G. The epidemiology of proximal femur fractures during COVID-19 emergency in Italy: a multicentric study. Acta Biomed 2021; 92:e2021398. [PMID: 34738558 PMCID: PMC8689341 DOI: 10.23750/abm.v92i5.11925] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 07/21/2021] [Indexed: 11/23/2022]
Abstract
Background and aim: After the first Italian case of Covid-19, the Government imposed the complete closure of all areas involved by the spread of the virus to contain transmissions. There was a massive reorganization of Hospitals, a stop of all elective activities and a convertion of many hospitals in “Covid Centers’’. AITOG (Associazione Italiana Traumatologia e Ortopedia Geriatrica) conducted a retrospective study on all proximal femur fractures surgeries that occurred in this period, to find out whether the pandemic and the correlated lockdown somehow changed the incidence of these events. Methods: 10 Italian orthopedic centers were involved in the study. Considering the geographic location, three groups were created (North, Centre and South). The considered period is the Italian “Phase 1” (February 23rd - May 3rd 2020). Results: the cohort is composed of 412 patients, 116 male and 296 female (mean age 81.1 ± 9.1 years). The same period of 2019 has been used as control group, with 558 patients, 156 male and 402 female (mean age 84.2 ± 8.0 years). In 2020 we counted 323 (78.4%) fractures occurred at home, 61 (14.8%) in retirement houses and 28 (6.8%) in different locations. We mainly treated fractures with intramedullary nails (n.237 57.5%). Among all patients we had 46 (11.1%) Covid-19 positive. The mortality rate within 30 days was of 51 patients (12.4%); 23 of these died because of complications related to Covid-19 while 31 of these were in treatment with anticoagulant/antiaggregant. Conclusions: AITOG analysis demonstrates a decrease in surgical interventions for proximal femur fractures from 2019 to 2020, a reduction in patients mean age and an increase in trauma occurred in domestic environment. We also registered a consistent difference between the North, Center and South of the Country. (www.actabiomedica.it)
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Affiliation(s)
- Corrado Ciatti
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Fabrizio Quattrini
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Serena Gattoni
- Orthogeriatric Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Alessandra Magro
- Orthogeriatric Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Patrizio Capelli
- Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Filippo Banchini
- Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Caterina Fiazza
- Hospital Pharmacy, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Vito Pavone
- Orthopedics and Traumatology Department, University of Catania, Italy.
| | | | - Fabiana Valenti
- Orthopedics and Traumatology Department, University of Catania, Italy.
| | - Giulio Maccauro
- Orthopedics Department, IRCCS Fondazione Policlinico Gemelli, Rome, Italy.
| | | | - Riccardo Accetta
- Trauma Unit and Emergency Department, IRCCS Galeazzi Orthopedics Institute, Milano, Italy.
| | - Giuseppe Basile
- Trauma Unit and Emergency Department, IRCCS Galeazzi Orthopedics Institute, Milano, Italy.
| | - Carlo Ruosi
- Department of Orthopaedics, Federico II University, Napoli.
| | - Fabio Di Santo
- Orthopedics and Traumatology Department, AORN "Cardarelli" Hospital, Napoli.
| | - Nicola Orabona
- Orthopedics and Traumatology Department, ASL 1 "Ospedale del Mare " Hospital, Napoli.
| | - Cristiano Coppola
- Orthopedics and Traumatology Department, ASL 1 "Ospedale del Mare " Hospital, Napoli.
| | - Dario Perugia
- Orthopedics and Traumatology Department, San Camillo Forlanini Hospital, Rome, Italy.
| | | | - Mauro Roselli
- Orthopedic and Traumatology Unit, Maria Vittoria Hospital, Turin, Italy.
| | | | - Francesco Benazzo
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
| | - Mario Mosconi
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
| | - Loris Perticarini
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
| | - Vito Pesce
- U.O.C. di Ortopedia e Traumatologia Universitaria, Azienda Ospedaliero Universitaria Policlinico "Riuniti di Foggia", Dipartimento di Medicina Clinica e Sperimentale, Università di Medicina e Chirurgia Università di Foggia.
| | - Giuseppe Maccagnano
- U.O.C. di Ortopedia e Traumatologia Universitaria, Azienda Ospedaliero Universitaria Policlinico "Riuniti di Foggia", Dipartimento di Medicina Clinica e Sperimentale, Università di Medicina e Chirurgia Università di Foggia.
| | - Lorenzo Moretti
- School of Medicine, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, University of Bari Aldo Moro, Bari, Italy.
| | - Biagio Moretti
- School of Medicine, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, University of Bari Aldo Moro, Bari, Italy.
| | - Giuseppe Solarino
- School of Medicine, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic & Trauma Unit, University of Bari Aldo Moro, Bari, Italy.
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10
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Quattrini F, Ortolani A, Ciatti C, Puma Pagliarello C, Martucci A, Gurrieri L, Stallone S, Melucci G, Domenico T, Maniscalco P. Static vs dinamic short nail in pertrochanteric fractures: experience of two center in Northern Italy. Acta Biomed 2021; 92:e2021021. [PMID: 34313660 PMCID: PMC8420836 DOI: 10.23750/abm.v92is3.11745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/01/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Lateral fractures of proximal femur are the most frequent to treat for the traumatologist surgeon. Intramedullary nailing is the gold standard treatment of this type of fracture. The aim of the study is to analyze the results obtained with the Elos Intrauma nail by the experience of two Departments of Orthopedics and Traumatology ("Guglielmo da Saliceto" Hospital in Piacenza and the Maggiore hospital in Bologna). METHODS We performed a retrospective cohort study of 400 patients with lateral femoral neck fracture surgically treated with Elos Intrauma standard nail. The examined period is from 1st Jannuary 2018 to 31st Dicember 2020. In all patients we implanted Elos® - Intrauma nail, a titanium cervical diaphyseal nail, according to the standard technique. RESULTS We evaluate at a minumum of three months of follow up 286/400 patients. Average follow up was 3.94 months, minimum 3 months and maximum 24 months. We obtain the 96.85 % of fracture healing, recording 33 complications (11.54%). The incidence of surgical revision was 2.8% (8 cases). No mechanical complications was found in stable fractures treated with short nail and without distal locking. CONCLUSIONS With the use of Elos nail we obtained 95% of radiographic healings within three months with a complication rate comparable to literature report. Distal locking is absolutely recommended in complex fractures, it may be superfluous after careful evaluation of the fracture pattern and morphological characteristics of the femur to be treated; future in-depth studies may narrow the criteria to choose distal locking or non locking.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
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11
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Maniscalco P, Ciatti C, Gattoni S, Quattrini F, Puma Pagliarello C, Patane' AC, Capelli P, Banchini F, Rivera F, Sanna F, Nonne D, Di Maggio B, Scaravilli G. Proximal humerus fractures in COVID-19 lockdown: the experience of three orthopedics and traumatology departments in the first ten weeks of the Italian epidemic. Acta Biomed 2021; 92:e2021104. [PMID: 33682805 PMCID: PMC7975920 DOI: 10.23750/abm.v92i1.11231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/30/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Coronavirus disease (CoVID-19) is causing millions of deaths worldwide and the crisis of the global healthcare system. Aim Of The Study: evaluate the preliminary impact of CoVID-19 in three Italian Orthopedics and Traumatology Departments in the first 10 weeks of the national lockdown. We focused on proximal humerus fractures, analyzing data and results in comparison with the same period of 2019. MATERIALS AND METHODS From February 22nd to May 3rd 2020, 55 patients were admitted to our departments for promixal humerus fractures. Our cohort of patients is composed by 13 males (23.6%) and 42 females (76.4%), with an average age of 73.8 ± 11.7 years (range 44 - 94). Trauma occurred at home in 43 cases (78.2%), by the roadside in 10 cases (18.2%), in a retirement home in 1 case (1.8%), and at work in 1 case (1.8%). We proposed surgical treatment in 15/55 cases, but 4 patients refused hospitalization, mainly because of the risk of contracting n-CoV19 infection. RESULTS We noticed a decrease in proximal humerus fractures compared to 2019 (-37.5%). Particularly, we observed a significant drop in traumas occurred on the road and at work respectively 23.9% and 3.4%% in 2019, and 18.2% and 1.8% in 2020, probably due to the consequences of the national lockdown. Sports traumas had a reset during the pandemic (6 cases in 2019, 0 in 2020). As consequence, surgical treatment had a decrease due to the reduction in number of fractures, indications and patient's consent. CONCLUSION The incidence of proximal humerus fractures had a significant reduction during CoVID-19 spread. We assume that the reasons of this reduction are to be found in the national lockdown (since March 10th, 2020) and Ministerial Decrees that limited the access to the E.R. only in case of severe traumas in order to avoid CoVID-19 spread.
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Affiliation(s)
- Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
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12
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Quattrini F, Ciatti C, Gattoni S, Burgio V, Puma Pagliarello C, Rivera F, Maniscalco P. DIPHOS® nail for proximal humeral fractures: our experience with more than 190 procedures and surgical tips. Acta Biomed 2021; 92:e2021566. [PMID: 35604258 PMCID: PMC9437691 DOI: 10.23750/abm.v92is3.12565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/03/2022] [Indexed: 11/16/2022]
Abstract
AIM evaluate the outcome of proximal humeral nailing over 5 years follow-up, focusing on possible complications. Secondary endpoint is the description and analysis of some technical notes to simplify surgical procedure. MATERIALS AND METHODS the cohort is composed by 194 fractures fixed with short nail. Neer Classification was used to assess the type of fracture; Deltoid Tuberosity Index (DTI) was applied to verify local bone quality. Follow-up with X-rays and orthopaedic evaluation was conducted on every operated subject. RESULTS mean follow up of the study was 25.4 months. We registered an average CMS score of 84.66 points for 2-parts fractures, 79.05 points for 3-part fractures and 68.62 points for 4-parts fractures. We obtained radiographical healing in 95.9% of patients (186/194) after 2.7 months on average. We recorded "very good" / "good" results in 90.3% of 2-parts fractures, 88.5% of 3-parts fractures and 46.2% of 4-part fractures. Overall complication rate was 10.3% (20/194 nails). Second surgery was performed in 8.2% (16/194) of cases. CONCLUSION intramedullary nailing is an effective treatment for 2 and 3-part fractures with relatively low incidence of complications, small surgical accesses and short surgical time. Future researches are necessary to analyze the results related to nailing in 4-fragment fractures, still uncertain and influenced by multiple factors. The presence of the intramedullary nail reduces the lever arm of the screws making the osteosynthesis more reliable. Modern nails guarantee angular stability for proximal cancellous screws and allows 1 or 2 screws at calcar level to get a valid medial support.
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Affiliation(s)
- Fabrizio Quattrini
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Corrado Ciatti
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Serena Gattoni
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Valeria Burgio
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - Fabrizio Rivera
- Orthopedic Surgery Department, SS Annunziata Savigliano Hospital, Azienda Sanitaria Locale CN1, Savigliano, Cuneo, Italy
| | - Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
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13
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Rivera F, Maiello A, Maiello A, Pietro M, Di Stefano G, Quattrini F. Conical coupling angular stable plate fixation: a retrospective study. Acta Biomed 2020; 91:e2020002. [PMID: 33559632 PMCID: PMC7944703 DOI: 10.23750/abm.v91i14-s.10598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/30/2020] [Indexed: 12/03/2022]
Abstract
Backgrounds. Conical coupling represents an alternative to screw coupling on angular stable plate fixation. Aims of the present study was to evaluate clinical effectiveness and ease of plate removal of conical coupling locking plates into different scenario regarding quality of bone, type of fracture and operative technique. Methods. From May 2013 to December 2017, 198 patients with 206 fractures underwent open reduction and internal fixation with conical locking plate. In most cases fixation involved wrist (38%) and clavicle (24%) fractures but a varied type of fractures and bone were included in the study. Results. Ten complications related to plate fixation were observed (5,1%). Two case of intra-articular positioning of screws of wrist plate. One case of loss of reduction and breakage of wrist plate due to an inappropriate proximal fracture fixation. Five cases of complications involved clavicle fixation: three cases of non-union, one case of peri-implant fracture, one screw loosening. One non-union of distal tibial fracture, one non-union in olecranon fracture were finally observed. Thirty-four patients that have symptoms that could be traceable to the implants in-situ underwent plate removal. No complications were observed during surgical plates removal. Conical coupling angular stability plate represents an actractive alternative to threaded angular stability plate. Bush titanium insert, eliminating the problems of cold welding and cross-threading, simplifies surgical screws and plate removal
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Affiliation(s)
- Fabrizio Rivera
- Orthopedics and Trauma Department, SS Annunziata Hospital, Savigliano (CN), Italy.
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14
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Maniscalco P, Ciatti C, Gattoni S, Puma Pagliarello C, Moretti G, Cauteruccio M, Carpaneto D, Capelli P, Gurrieri L, Banchini F, Quattrini F. The impact of COVID-19 pandemic on the Emergency Room and Orthopedic Departments in Piacenza: a retrospective analysis. Acta Biomed 2020; 91:e2020028. [PMID: 33559619 PMCID: PMC7944696 DOI: 10.23750/abm.v91i14-s.11003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/18/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION AND AIM The Coronavirus pandemic represents one of the most massive health emergencies in the last century. Aim of the study is to evaluate the trend of E.R. accesses and orthopaedic events during the pandemic of Covid-19. MATERIALS AND METHODS we retrospectively analysed all data related to patients admitted to the E.R. Department of the Hospital of Piacenza from August 26th 2019 to August 23rd 2020, splitting this period on February 23rd 2020. RESULTS Our analysis shows a reduction of -18.0% in E.R. accesses. We calculated a growth of deaths in the E.R. equal to +220%. Our orthopaedic pathway recorded a drop of -26.8%. Traumas occurred at home increased (+19.1%). We note an actual drop only on proximal femur fractures (weighted average of -17.7%), while all the others underwent an increase. DISCUSSION The amount of E.R. accesses registered a drop -18.0%, while the pathway dedicated to emergency cases underwent an increase. The major complexity of clinical conditions influenced the number of hospitalizations and the fear of the infection increased hospitalization refusals. There has been a zeroing of school traumas, a reduction in sport, transfer home-work/work-home, work, roadside, injuries. Total amount of fractures strongly increase after the end of the lockdown. CONCLUSION our data confirmed the decrease of retirement houses, sports, works and roadsides traumas and a zeroing of schools ones, while those occurred inside domestic environment underwent a consistent raise. We noticed a reduction in femur fractures and significant spread of all fractures after the end of the lockdown.
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Affiliation(s)
- Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | | | | | | | | | | | | | | | | | - Filippo Banchini
- Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
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15
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Maniscalco P, Quattrini F, Ciatti C, Gattoni S, Puma Pagliarello C, Burgio V, Di Stefano G, Cauteruccio M, Giovanelli M, Magro A, Capelli P. The Italian Covid-19 Phase 2 in Piacenza: results of the first semester of 2020 and future prospective of new orthopedics surgical procedures. Acta Biomed 2020; 91:e2020159. [PMID: 33525208 PMCID: PMC7927514 DOI: 10.23750/abm.v91i4.10377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/02/2020] [Indexed: 12/23/2022]
Abstract
Introduction: During the pandemic, Piacenza’s Orthopedic and Traumatology Department firstly dealt with the emergency with the complete closure of all the elective surgical and outpatient activities. As general population, also healthcare workers were affected by Coronavirus, increasing difficulties of epidemic management. The aim of our study is to evaluate the activity trend of the first six months of 2020 in our hospital. Data will be compared to the two semesters of 2019, in order to have two objective samples. Materials and Methods: We retrospectively analyzed all the orthopedics surgical procedures performed at Guglielmo da Saliceto Hospital (Piacenza, Emilia Romagna, Northern Italy) between January 1st and June 30th 2020. 2019 semesters (January 1st - June 30th 2020 and July 1st - December 31st 2020) have been used as control group to evaluate the activity trend of the first six months of 2020, compared to the two semesters of 2019. Results: We noticed a significant increase of domestic and retirement houses accidents, a consistent increase in one-month mortality rate of 2020 first semester and a decrease of mean hospitalization time. About surgical procedures, we detect a drop in the total number: in the first semester of 2020 we performed 499 (-39.9%) surgeries less than the first semester of 2019 and 337 (-30.9%) then the second one. Traumatology recorded a decrease of 27.6% than the first semester of 2019 (-204 surgeries) and of 26.3% than the second one (-191 surgeries). Concerning orthopedic procedures, in comparison to the first semester of 2019 we registered a reduction of 57.6% (-295 surgeries) and of 40.2% to the second semester (-146 surgeries) Discussion and conclusion: Covid-19 forced a reorganization of the Italian Health System that led to a clear reduction of surgical procedures performed in the orthopedic and traumatology department. The “Phase 2” can’t be consider the last step of the emergency. We surely will have to get used to live with this enemy, at least until we will find an effective cure or a vaccine. (www.actabiomedica.it)
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Affiliation(s)
- Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
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16
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Benazzo F, Rossi SMP, Maniscalco P, Moretti B, Vaienti E, Ruggieri P, Massè A, Medici A, Formica A, Di Maggio B, Caiaffa V, Mosconi M, Murena L, D'Angelo F, Belluati A, Mazza EL, Rivera F, Castelli A, Ghiara M, Rosolani M, Cioffi R, Pezzella R, Scaravilli G, Bove G, Stissi P, Mazzacane M, Quattrini F, Ciatti C, Trovarelli G, Pala E, Angelini A, Sanna F, Nonne D, Colombelli A, Raggini F, Puzzo A, Canton G, Maritan G, Iuliano A, Randelli P, Solarino G, Moretti L, Vicenti G, Garofalo N, Nappi V, Ripanti S, Chinni C, Pogliacomi F, Visigalli A, Bini N, Aprato A, Perticarini L. The orthopaedic and traumatology scenario during Covid-19 outbreak in Italy: chronicles of a silent war. Int Orthop 2020; 44:1453-1459. [PMID: 32591960 PMCID: PMC7319215 DOI: 10.1007/s00264-020-04637-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND From February 21, the day of hospitalisation in ICU of the first diagnosed case of Covid-19, the social situation and the hospitals' organisation throughout Italy dramatically changed. METHODS The CIO (Club Italiano dell'Osteosintesi) is an Italian society devoted to the study of traumatology that counts members spread in public and private hospitals throughout the country. Fifteen members of the CIO, Chairmen of 15 Orthopaedic and Trauma Units of level 1 or 2 trauma centres in Italy, have been involved in the study. They were asked to record data about surgical, outpatients clinics and ER activity from the 23rd of February to the 4th of April 2020. The data collected were compared with the data of the same timeframe of the previous year (2019). RESULTS Comparing with last year, overall outpatient activity reduced up to 75%, overall Emergency Room (ER) trauma consultations up to 71%, elective surgical activity reduced up to 100% within two weeks and trauma surgery excluding femoral neck fractures up to 50%. The surgical treatment of femoral neck fractures showed a stable reduction from 15 to 20% without a significant variation during the timeframe. CONCLUSIONS Covid-19 outbreak showed a tremendous impact on all orthopaedic trauma activities throughout the country except for the surgical treatment of femoral neck fractures, which, although reduced, did not change in percentage within the analysed timeframe.
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Affiliation(s)
- Francesco Benazzo
- Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Università degli Studi di Pavia, Pavia, Italy
| | - Stefano Marco Paolo Rossi
- Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy.
| | - Pietro Maniscalco
- Orthopaedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Biagio Moretti
- UOC Ortopedia E Traumatologia- Azienda Ospedaliero-Universitaria, "Policlinico" Universita, Bari, Italy
| | - Enrico Vaienti
- Clinica Ortopedica, Azienda Ospedaliero - Universitaria di Parma, Parma, Italy
| | - Pietro Ruggieri
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padua, PD, Italy
| | - Alessandro Massè
- School of Medicine Clinica Ortopedica e Traumatologica I Città della Salute e della Scienza - C.T.O, University of Torino, Torino, Italy
| | | | - Alessandro Formica
- UOC Ortopedia e Traumatologia, Az. Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Bruno Di Maggio
- Orthopaedic and Traumatology Unit, A.S.L. Caserta, Piedimonte Matese Hospital, Piedimonte Matese, Italy
| | - Vincenzo Caiaffa
- Orthopedics and Trauma Department, Di Venere Hospital, Bari, Italy
| | - Mario Mosconi
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Università degli Studi di Pavia, Pavia, Italy
| | - Luigi Murena
- SC (UCO) Clinica Ortopedica e Traumatologica, Azienda sanitaria universitaria Giuliano Isontina (ASU GI), Trieste, Italy
| | - Fabio D'Angelo
- Division of Orthopaedics and Traumatology, ASST dei Sette Laghi, Department of Biotechnologies and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Alberto Belluati
- Orto-Trauma Dept., Ospedale Santa Maria delle Croci Ravenna, Ravenna, Italy
| | - Emilio Luigi Mazza
- Centro Specialistico Ortopedico Traumatologico Gaetano Pini - CTO (ASST Pini-CTO), Milan, MI, Italy
| | - Fabrizio Rivera
- Orthopaedics and Trauma Department, SS Annunziata Hospital, Savigliano, CN, Italy
| | - Alberto Castelli
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Matteo Ghiara
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Rosolani
- Clinica Ortopedica e Traumatologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | - Gabriele Scaravilli
- Orthopaedic and Traumatology Unit, A.S.L. Caserta, Piedimonte Matese Hospital, Piedimonte Matese, Italy
| | - Giovanni Bove
- Department of Orthopaedic Surgery, "Federico II" University, Naples, Italy
| | - Placido Stissi
- Division of Orthopaedics and Traumatology, ASST dei Sette Laghi, Department of Biotechnologies and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Michael Mazzacane
- Division of Orthopaedics and Traumatology, ASST dei Sette Laghi, Department of Biotechnologies and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Fabrizio Quattrini
- Orthopaedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Corrado Ciatti
- Orthopaedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Giulia Trovarelli
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padua, PD, Italy
| | - Elisa Pala
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padua, PD, Italy
| | - Andrea Angelini
- Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padua, PD, Italy
| | - Francesco Sanna
- Orthopaedics and Trauma Department, SS Annunziata Hospital, Savigliano, CN, Italy
| | - Daniela Nonne
- Orthopaedics and Trauma Department, SS Annunziata Hospital, Savigliano, CN, Italy
| | - Andrea Colombelli
- Orto-Trauma Dept., Ospedale Santa Maria delle Croci Ravenna, Ravenna, Italy
| | - Filippo Raggini
- Orto-Trauma Dept., Ospedale Santa Maria delle Croci Ravenna, Ravenna, Italy
| | - Agnese Puzzo
- Orto-Trauma Dept., Ospedale Santa Maria delle Croci Ravenna, Ravenna, Italy
| | - Gianluca Canton
- SC (UCO) Clinica Ortopedica e Traumatologica, Azienda sanitaria universitaria Giuliano Isontina (ASU GI), Trieste, Italy
| | - Guido Maritan
- SC (UCO) Clinica Ortopedica e Traumatologica, Azienda sanitaria universitaria Giuliano Isontina (ASU GI), Trieste, Italy
| | - Angela Iuliano
- Centro Specialistico Ortopedico Traumatologico Gaetano Pini - CTO (ASST Pini-CTO), Milan, MI, Italy
| | - Pietro Randelli
- Centro Specialistico Ortopedico Traumatologico Gaetano Pini - CTO (ASST Pini-CTO), Milan, MI, Italy
| | - Giuseppe Solarino
- UOC Ortopedia E Traumatologia- Azienda Ospedaliero-Universitaria, "Policlinico" Universita, Bari, Italy
| | - Lorenzo Moretti
- UOC Ortopedia E Traumatologia- Azienda Ospedaliero-Universitaria, "Policlinico" Universita, Bari, Italy
| | - Giovanni Vicenti
- UOC Ortopedia E Traumatologia- Azienda Ospedaliero-Universitaria, "Policlinico" Universita, Bari, Italy
| | - Nunzia Garofalo
- Orthopedics and Trauma Department, Di Venere Hospital, Bari, Italy
| | - Vittorio Nappi
- Orthopedics and Trauma Department, Di Venere Hospital, Bari, Italy
| | - Simone Ripanti
- UOC Ortopedia e Traumatologia, Az. Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Carmela Chinni
- UOC Ortopedia e Traumatologia, Az. Ospedaliera San Giovanni Addolorata, Rome, Italy
| | | | - Alberto Visigalli
- Clinica Ortopedica, Azienda Ospedaliero - Universitaria di Parma, Parma, Italy
| | - Nathalie Bini
- School of Medicine Clinica Ortopedica e Traumatologica I Città della Salute e della Scienza - C.T.O, University of Torino, Torino, Italy
| | - Alessandro Aprato
- School of Medicine Clinica Ortopedica e Traumatologica I Città della Salute e della Scienza - C.T.O, University of Torino, Torino, Italy
| | - Loris Perticarini
- Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy
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Giordano C, Monica I, Quattrini F, Villaggi E, Gobbi R, Barbattini L. EVALUATION OF THE RADIATION DOSE TO THE HANDS OF ORTHOPAEDIC SURGEONS DURING FLUOROSCOPY USING STORED IMAGES. Radiat Prot Dosimetry 2020; 189:157-162. [PMID: 32318702 DOI: 10.1093/rpd/ncaa026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/16/2019] [Accepted: 02/12/2020] [Indexed: 06/11/2023]
Abstract
Data were collected from 642 orthopaedic interventions during which the images produced by X-rays were recorded. By examining these images, it is possible to determine the time that the orthopaedic surgeons' hands were exposed to the direct radiation beam. The procedures with greater exposure to the direct beam were those involving the hand (median 15 s) and the wrist (median 13 s). Two surgeons wore a ring to measure the absorbed dose at the fingers: one on the dominant hand and the other on the non-dominant hand. The two surgeons performed 34 and 48 operations, respectively, in 14 months. The total doses measured with the rings were 2.30 and 1.04 mSv, respectively. The images of the interventions were examined, determining how much each individual hand was exposed. The interventional reference point (IRPeff (left or right)) was calculated by comparing the doses at the IRP with the exposure times of the right or the left hand. Summing the IRPeff of the two surgeons in 14 months, it is obtained the maximum values of 2.87 mGy for the left hand of one and 6.74 mGy for the right hand of the other, which are of the order of 1/100 of the annual dose limit for the extremities.
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Affiliation(s)
- Carlo Giordano
- Medical Physics Department, AUSL Piacenza, via Taverna 49, 29121 Piacenza, Italy
| | - Ivo Monica
- Orthopaedics and Traumatology Department, AUSL Piacenza, via Taverna 49, 29121 Piacenza, Italy
| | - Fabrizio Quattrini
- Orthopaedics and Traumatology Department, AUSL Piacenza, via Taverna 49, 29121 Piacenza, Italy
| | - Elena Villaggi
- Medical Physics Department, AUSL Piacenza, via Taverna 49, 29121 Piacenza, Italy
| | - Rossana Gobbi
- Medical Physics Department, AUSL Piacenza, via Taverna 49, 29121 Piacenza, Italy
| | - Lorenzo Barbattini
- Radiology Department, AUSL Piacenza, via Taverna 49, 29121 Piacenza, Italy
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Raciti L, De Cola MC, Ortelli P, Corallo F, Lo Buono V, Morini E, Quattrini F, Filoni S, Calabrò RS. Sexual Dysfunction in Parkinson Disease: A Multicenter Italian Cross-sectional Study on a Still Overlooked Problem. J Sex Med 2020; 17:1914-1925. [PMID: 32665210 DOI: 10.1016/j.jsxm.2020.06.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/30/2020] [Accepted: 06/10/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Prevalence rates of sexual dysfunction (SD) in Parkinson's disease (PD) are likely to be underestimated and their etiology is still unknown. More understanding of this issue is needed. AIM To investigate prevalence of SD and its variables, including gender differences, in a sample of PD patients. METHODS This multicenter observational study included 203 patients (113 males and 90 females) affected by PD (diagnosed according to UK Parkinson's Disease Society Brain Bank clinical diagnostic criteria 28), and living in 3 different Italian regions. Patients were evaluated using a semi-structured interview (a 40-item ad hoc questionnaire, developed by the authors to investigate patient's 3 main life areas: sociodemographic information, illness perception, and sexuality) and specific standardized scales to investigate SD, as well as by means of tools to assess their motor impairment, daily life activities, and disease-related caregiver burden (CBI). MAIN OUTCOME MEASURES The International Index of Erectile Function and the Female Sexual Function Index. RESULTS Sexual dysfunction was observed in about 68% of men, and in around 53% of women loss of libido being the main sexual concern in both sexes. Men were significantly more affected by SD than women (χ2 (1) = 4.34, P-value = .037), but no difference in the severity of the dysfunction emerged between genders. Around 85% of PD patients had a stable couple relationship, and about 40% were satisfied with such a relationship. However, about 57% of the patients stated that the disease affected their sexual life, especially due to reduced sexual desire, and the frequency of sexual intercourses. Moreover, significant differences between subjects with SD and subjects without SD were found in UPDRS (I-II-III domains), in Hamilton Depression Rating Scale and CBI scores. CLINICAL IMPLICATIONS Clinicians dealing with PD should pay more attention to sexual issues, as discussing and treating sexual problems enters the framework of a holistic approach, which is mandatory in chronic illness. STRENGTHS & LIMITATIONS The major strengths of this study include the multicenter nature of the study, to overcome single-center methodological bias. The main limitation is the relatively small sample size, and the absence of a control group, even if there are growing literature data on sexuality and aging supporting our findings. CONCLUSION SD is a highly prevalent and devastating problem in patients affected by PD, negatively affecting their quality of life. Raciti L, De Cola MC, Ortelli P, et al. Sexual Dysfunction in Parkinson Disease: A Multicenter Italian Cross-sectional Study on a Still Overlooked Problem. J Sex Med 2020;17:1914-1925.
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Affiliation(s)
| | | | - Paola Ortelli
- Department of PD, Movement Disorder and brain Injury rehab, Moriggia Pelascini Hospital, Gravedona, Italy
| | | | | | | | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, San Giovanni Rotondo, Foggia, Italy
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Maniscalco P, Quattrini F, Ciatti C, Ghidoni L, Ghidoni G, Burgio V, Pogliacomi F, Vaienti E, Ceccarelli F. Neck modularity in total hip arthroplasty: a retrospective study of nine hundred twenty-eight titanium neck implants with a maximum follow-up of eighteen years. Int Orthop 2020; 44:2261-2266. [PMID: 32601721 DOI: 10.1007/s00264-020-04686-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/23/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Neck modularity was introduced to improve total hip arthroplasty (THA) accuracy, but it has been associated with early breakages and corrosion issues. In our hospital, modular necks have been in clinical use since the 1990s. We retrospectively analysed the occurrence of these sequelae in implants placed between January 2000 and December 2014. METHODS Survival data from patients operated on in our hospital were obtained from the regional arthroplasty registry (Registro dell'Impiantologia Protesica Ortopedica, RIPO). The cohort comprised 928 THAs on 908 patients. The average patient age was 67.8 years. Main indications were primary osteoarthritis (71.4%), fracture (9.2%), congenital dysplasia or congenital luxation (7.8%), and idiopathic osteonecrosis (6.4%). All femoral stems were cementless, with 318 anatomically shaped (34.3%), 579 straight (62.4%), and 31 short stems (3.3%). All necks used were made of titanium alloy. The average follow-up time was 9.6 years (range, 4-18 years). RESULTS In total, 66 revisions were reported. The main revision causes were periprosthetic fractures (33.3%), aseptic stem loosening (19.7%), luxation (18.2%), and implant breakage (12.1%). Five modular neck breakages were recorded. The overall survival rate was 87.7% at 17 years. We did not observe any component corrosion. The neck breakage rate was 0.5%, and the luxation rate was 1.3%. CONCLUSIONS Our experience suggests that neck modularity is a safe, effective way to reconstruct the proximal femur in THA patients. We attribute the absence of corrosion to the exclusive use of titanium necks.
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Affiliation(s)
- Pietro Maniscalco
- Guglielmo da Saliceto Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | | | - Corrado Ciatti
- Guglielmo da Saliceto Hospital, Via Taverna 49, 29121, Piacenza, Italy.
| | - Laura Ghidoni
- Guglielmo da Saliceto Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Giuseppe Ghidoni
- Guglielmo da Saliceto Hospital, Via Taverna 49, 29121, Piacenza, Italy
| | - Valeria Burgio
- Guglielmo da Saliceto Hospital, Via Taverna 49, 29121, Piacenza, Italy
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Maniscalco P, Quattrini F, Ciatti C, Burgio V, Rivera F, Di Stefano G, Pavone V. A preliminary experience with a new intramedullary nail for trochanteric fractures. Acta Biomed 2020; 91:122-127. [PMID: 32555087 PMCID: PMC7944840 DOI: 10.23750/abm.v91i4-s.9726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 11/23/2022]
Abstract
Background and aim of the work: The worldwide incidence of fractures of the proximal end of the femur is increasing as the average age of the population rises. The current surgical gold treatment standard is intramedullary nail fixation. The Authors present their experience with the D-Nail system for intertrochanteric femur fractures. Methods: From January 1st to February 21st 2020 (breakout of COVID-19 pandemic) 34 patients were treated with the D-Nail system: 11 with basicervical fractures, 16 with intertrochanteric stable fractures and 7 with intertrochanteric unstable fractures. In 11 cases, a single cephalic screw was used; in 23 cases, two of them were used. Distal locking was executed in 7 patients. Follow-up time ranged from 2 to 3 months. Results: None of the reported intra- or post-operative complication was linked to the fixation device or the surgical technique. Patients were monitored with clinical and radiological checkups using modified Harris Hip Score to accurately evaluate the fluctuations in the rehabilitation period. Conclusion: The main advantages of this synthesis device are the proximal hole’s peculiar shape, which allows the possibility to position one or two cephalic screws on the same nail, and the silicon coating, which provides numerous biological advantages. Distal locking was executed in selected cases only, based on fracture type. Optimum treatment involves rapid execution of surgery, minimal trauma during surgery, maximum mechanical stability, and rapid weight-bearing. Although our case number is small and follow-up time brief, our results are encouraging. (www.actabiomedica.it)
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Affiliation(s)
- Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Fabrizio Quattrini
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Corrado Ciatti
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Valeria Burgio
- Orthopaedic Surgery Department, SS Annunziata Savigliano Hospital, Savigliano (CN), Italy.
| | - Fabrizio Rivera
- Orthopaedic Surgery Department, SS Annunziata Savigliano Hospital, Savigliano (CN), Italy.
| | | | - Vito Pavone
- Orthopedics and Traumatology Department, University of Catania, Italy.
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Maniscalco P, Poggiali E, Quattrini F, Ciatti C, Magnacavallo A, Vercelli A, Domenichini M, Vaienti E, Pogliacomi F, Ceccarelli F. Proximal femur fractures in COVID-19 emergency: the experience of two Orthopedics and Traumatology Departments in the first eight weeks of the Italian epidemic. Acta Biomed 2020; 91:89-96. [PMID: 32420932 PMCID: PMC7569630 DOI: 10.23750/abm.v91i2.9636] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION CoVID-19 (Coronavirus disease) is a worldwide infection which is causing millions of deaths. A significant number of elderly patients require hospitalization and develop serious and sometimes life-threatening complications. The aim of this study is to evaluate the preliminary impact (8 weeks) of CoVID-19, focusing on proximal femur fractures, analyzing data and results compared to the same period of 2019. MATERIALS AND METHODS From February 22nd to April 18th, 2020 we surgically treated 121 proximal femur fractures (61 in Piacenza; 60 in Parma, 16 male, 44 female, mean age 81.1). In the same period of 2019, we treated 169 proximal femur fractures (90 in Piacenza, 33 male, 57 female, mean age 81.9; 79 in Parma, 29 males, 50 female, mean age 80.2). We had 21/61 (34.4%) patients resulted positive for COVID-19 and 11/61 in Parma (18.3%), based on nasal-pharyngeal swab, chest CT scan and/or lung US findings. RESULTS The incidence of proximal femur fractures had a significant reduction during CoVID-19 spread in Piacenza and Parma. Authors have noticed an elevated number of deaths within 21 days after surgery. Piacenza: 4 cases in 2019 (4.4%) and 11 in 2020 (18.0%), of which 9 cases CoVID positive. In Parma in 2019 two deaths were encountered; in 2020 6 patients died and 5 cases were CoVID positive. CONCLUSION In the first two months of the Italian epidemic, in the cities of Piacenza and Parma over 80% of deaths have occurred in patients over 70 years old. Even if preliminary, our study shows a significant increase in death in elderly patients surgically treated for proximal femur fractures, particularly in the Piacenza Hospital.
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Affiliation(s)
- Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Erika Poggiali
- Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Fabrizio Quattrini
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Corrado Ciatti
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | | | - Andrea Vercelli
- Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Marco Domenichini
- Orthopedic Clinic, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy.
| | - Enrico Vaienti
- Orthopedic Clinic, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy.
| | - Francesco Pogliacomi
- Orthopedic Clinic, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy.
| | - Francesco Ceccarelli
- Orthopedic Clinic, Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy.
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Maniscalco P, Poggiali E, Quattrini F, Ciatti C, Magnacavallo A, Caprioli S, Vadacca G, Michieletti E, Cavanna L, Capelli P. The deep impact of novel CoVID-19 infection in an Orthopedics and Traumatology Department: the experience of the Piacenza Hospital. Acta Biomed 2020; 91:97-105. [PMID: 32420933 PMCID: PMC7569660 DOI: 10.23750/abm.v91i2.9635] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 11/23/2022]
Abstract
Since February 21st, 2020 CoVID-19 spread throughout all Italy expanding like a "tsunami" from Codogno (Lodi, Lombardy, Northern Italy) to neighboring cities. In a few days Lodi, Piacenza, Milano, Brescia and Bergamo were forced to deal with this disaster starting the lockdown at different time. No national plan had been prepared. As result, CoVID-19 has paralyzed the Italian healthcare system. At time of writing, in Italy there are 169 323 infected patients and 22 260 deaths. Italy is fighting hard to manage CoVID-19 crisis even if most hospitals were unprepared to deal with massive influx of critically ill CoVID-19 patients. Piacenza in Emilia-Romagna region (Northern Italy) is one of the epicenters of the Italian pandemic, and the local hospital - Guglielmo da Saliceto - has quickly become a "CoVID-19 hospital" with the great effort of all the medical staff. Here we report the experience of our hospital, particularly the strategy adopted in the Orthopedics and Traumatology Department.
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Affiliation(s)
- Pietro Maniscalco
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Erika Poggiali
- Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Fabrizio Quattrini
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Corrado Ciatti
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | | | - Serena Caprioli
- Administration Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Giovanni Vadacca
- Pathology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | | | - Luigi Cavanna
- Oncology and Hematology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
| | - Patrizio Capelli
- Surgery Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
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Strigini G, Ghidoni L, Quattrini F, Bellina G, Ciatti C, Fiazza C, Maniscalco P. Preliminary experience in the treatment of hip necrosis with BIOS screws associated with growth factors. Acta Biomed 2020; 91:41-43. [PMID: 32191652 PMCID: PMC7569593 DOI: 10.23750/abm.v91i1.7090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 11/23/2019] [Indexed: 11/23/2022]
Abstract
ntroduction: In this paper we present the preliminary results obtained in our clinic with the use of BIOS screws associated with injection of growth factors in the treatment of cephalic necrosis of the femoral head. MATERIALS AND METHODS In the division of Orthopedics and Traumatology at Guglielmo da Saliceto" hospital in Piacenza were treated between 2012 and 2016 with the proposed technique 8 case of necrosis of the femoral head in 6 patients with a mean age of 41.8 years (between 31 and 60 years). All patients before surgery were affected by debilitating pain with VAS greater than 7 and functional limitation of the range of motion of the hip. In all patients was performed a decompression of the femoral head using cannulated screws BIOS and injection through the implants of growth factors. RESULTS Our results have been extremely positive. All patients treated at two months have reported the resolution of the pain that affected them before surgery and the recovery of the function of the hip. At the last clinical control carried out no patient experienced recurrence of any symptoms related to necrosis. DISCUSSION Cephalic necrosis due to various possible etiologies is a not so rare condition, often affecting young patients with high functional demands. Only few years ago the gold standard treatment for this kind of pathological condition was hip prosthesis and this fact was associated with long term complications related with the young age of patients. The treatment presented is simple, fast and very effective in allowing the penetration of growth factors through bony trabeculae of the femoral head, due to the fenestratures inside the screws. The results obtained in our experience are certainly promising, though longer follow-up is needed to evaluate the functional outcome long and to evaluate the possible re-emergence of pain. CONCLUSION Conservative treatment using BIOS screws associated with growth factors in femoral head necrosis in our experience combine a low invasiveness to excellent functional results and should therefore be considered a valid option in treating this pathology in young patients.
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Affiliation(s)
- Giacomo Strigini
- Department of Ortopedia and Traumatologia - Ospedale Civile "Guglielmo da Saliceto" Piacenza.
| | - Laura Ghidoni
- Department of Ortopedia and Traumatologia - Ospedale Civile "Guglielmo da Saliceto" Piacenza.
| | - Fabrizio Quattrini
- Department of Ortopedia and Traumatologia - Ospedale Civile "Guglielmo da Saliceto" Piacenza.
| | - Giorgio Bellina
- Department of Ortopedia and Traumatologia - Ospedale Civile "Guglielmo da Saliceto" Piacenza.
| | - Corrado Ciatti
- Department of Ortopedia and Traumatologia - Ospedale Civile "Guglielmo da Saliceto" Piacenza.
| | - Caterina Fiazza
- Department of Ortopedia and Traumatologia - Ospedale Civile "Guglielmo da Saliceto" Piacenza.
| | - Pietro Maniscalco
- Department of Ortopedia and Traumatologia - Ospedale Civile "Guglielmo da Saliceto" Piacenza.
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Calabrò RS, Cacciola A, Bruschetta D, Milardi D, Quattrini F, Sciarrone F, la Rosa G, Bramanti P, Anastasi G. Neuroanatomy and function of human sexual behavior: A neglected or unknown issue? Brain Behav 2019; 9:e01389. [PMID: 31568703 PMCID: PMC6908863 DOI: 10.1002/brb3.1389] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/03/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Sexual desire, arousal, and orgasm are mediated by complex, yet still not fully understood, interactions of the somatic and autonomic nervous systems operating at the central and peripheral levels. Disruption of endocrine, neural, or vascular response, caused by aging, medical illness, neurological diseases, surgery, or drugs, can lead to sexual dysfunctions, thus significantly affecting patients' quality of life. PURPOSE This narrative review aims at characterizing the involvement of the central nervous system in human sexual behavior. METHODS A literature search was conducted using PubMed in its entirety up to June 2018, analyzing the studies dealing with the neurobiological and neurophysiological basis of human sexuality. RESULTS Sexual behavior is regulated by both subcortical structures, such as the hypothalamus, brainstem, and spinal cord, and several cortical brain areas acting as an orchestra to finely adjust this primitive, complex, and versatile behavior. At the central level, dopaminergic and serotonergic systems appear to play a significant role in various factors of sexual response, although adrenergic, cholinergic, and other neuropeptide transmitter systems may contribute as well. CONCLUSIONS Providing healthcare professionals with information concerning sexual behavior may overcome useless and sometimes dangerous barriers and improve patient management, since sexual well-being is considered one of the most important aspects of one's quality of life.
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Affiliation(s)
| | | | - Daniele Bruschetta
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | | | | | | | - Giuseppe Anastasi
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
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Calabrò RS, La Rosa G, Tomasello P, Manuli A, Quattrini F. Assessing sexual dysfunction in men with epilepsy: A need for specific tools! Epilepsy Behav 2019; 96:251-252. [PMID: 31130496 DOI: 10.1016/j.yebeh.2019.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 04/13/2019] [Indexed: 11/19/2022]
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Calabrò RS, De Luca R, Manuli A, Portaro S, Naro A, Quattrini F. Towards Improving Post-SSRI Sexual Dysfunction by Using Nutriceuticals: Lessons from a Case Study. J Sex Marital Ther 2019; 45:562-565. [PMID: 30640584 DOI: 10.1080/0092623x.2018.1556755] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Post-selective serotonin reuptake inhibitors (SSRIs) sexual dysfunction (PSSD) is a new clinical entity occurring after the antidepressant intake, and it is characterized by the fact that patients continue to present sexual side effects after the discontinuation of the drugs. PSSD mainly consists of hypo-anesthesia of the genital area, loss of libido, and erectile dysfunction. Although different management options have been proposed, there is no consensus on the treatment for this syndrome. Herein we report on a young man affected by PSSD who regained sexual functioning after 3-month treatment with EDOVIS, a dietary supplement containing L-citrulline and other commonly used aphrodisiacs. Clinicians should be aware about the possibility of persistent sexual side effects induced by serotoninergic antidepressants and take into considerations the use of nutraceuticals to overcome PSSD.
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Affiliation(s)
| | | | - Alfredo Manuli
- a IRCCS Centro Neurolesi "Bonino-Pulejo" , Messina , Italy
| | - Simona Portaro
- a IRCCS Centro Neurolesi "Bonino-Pulejo" , Messina , Italy
| | - Antonino Naro
- a IRCCS Centro Neurolesi "Bonino-Pulejo" , Messina , Italy
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Strigini G, Rendina M, Ghiara M, Quattrini F, Ghidoni L, Burgio V, Maniscalco P, Benazzo F. WITHDRAWN: Surgical treatment of radial head isolated Mason III fractures. Injury 2019; 50:382-385. [PMID: 30578086 DOI: 10.1016/j.injury.2018.11.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 11/23/2018] [Indexed: 02/02/2023]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published in Injury, 50(2) 2019 382–385, https://doi.org/https://doi.org/10.1016/j.injury.2018.11.044. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Giacomo Strigini
- Struttura Complessa di Ortopedia e Traumatologia AUSL Piacenza, Piacenza, Italy.
| | - Michele Rendina
- Clinica Ortopedica e Traumatologica IRCCS Fondazione Policlinico San Matteo di Pavia, Italy
| | - Matteo Ghiara
- Clinica Ortopedica e Traumatologica IRCCS Fondazione Policlinico San Matteo di Pavia, Italy
| | - Fabrizio Quattrini
- Struttura Complessa di Ortopedia e Traumatologia AUSL Piacenza, Piacenza, Italy
| | - Laura Ghidoni
- Struttura Complessa di Ortopedia e Traumatologia AUSL Piacenza, Piacenza, Italy
| | - Valeria Burgio
- Struttura Complessa di Ortopedia e Traumatologia AUSL Piacenza, Piacenza, Italy
| | - Pietro Maniscalco
- Struttura Complessa di Ortopedia e Traumatologia AUSL Piacenza, Piacenza, Italy
| | - Francesco Benazzo
- Clinica Ortopedica e Traumatologica IRCCS Fondazione Policlinico San Matteo di Pavia, Italy
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Quattrini F, Ciatti C, Strigini G, Maniscalco P. Preliminary experience in the arthroscopically assisted treatment of tibial plateau fractures. Acta Biomed 2018; 90:136-140. [PMID: 30715012 PMCID: PMC6503391 DOI: 10.23750/abm.v90i1-s.8023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 12/04/2022]
Abstract
Background and aim of the study: Fractures involving the tibial plateau make up 1% of all fractures. Treatment can take advantage of various techniques, including arthroscopically assisted surgical reduction. This procedure is certainly viable for Schatzker III fractures and, in some cases, for Schatzker II. The use of the arthroscope makes possible a smooth reduction of the fractured bone, decreasing the risk of post-traumatic osteoarthritis, and also allows to diagnose and, if necessary, also treat the associated intra-articular lesions, which often are not highlighted during the classical preoperative investigations. Methods: In the last year we have operated with this technique 8 of the 22 cases of fracture of the tibial plate that have come to our emergency Department. Using the Schaztker classification, we performed an arthroscopically assisted reduction to treat type II and III fractures. The surgical operations involved a first arthroscopic phase, to assess intrarticular damage (bone, cartilage, ACL, PCL, menisci), a second phase for possible treatment of intrarticular lesions and reduction of fractures under arthroscope or open osteosinthesis. Finally, a last arthroscopic check was performed. Results: We obtained excellent results, as we were able to always have a fracture reduction of less than 1 mm, while clinically all the patients could have an early and almost complete functional recovery after only 2 months. Conclusion: The arthroscopically assisted technique could be an effective way to adress the anatomical reduction of tibial plate fractures, but must only be used in the indicated cases. (www.actabiomedica.it)
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Affiliation(s)
- Fabrizio Quattrini
- Orthopedics and Traumatology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
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Calabrò RS, Casella C, Russo M, Naro A, Quattrini F. An uncommon side effect of perampanel: Severe delayed ejaculation with anorgasmia. Epilepsy Behav 2017; 72:198-199. [PMID: 28549886 DOI: 10.1016/j.yebeh.2017.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/22/2017] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | - Antonino Naro
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
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Calabrò RS, Grisolaghi J, Quattrini F, Bramanti P, Magaudda A. Prevalence and clinical features of sexual dysfunction in male with epilepsy: the first southern italy hospital-based study. Int J Neurosci 2013; 123:732-7. [DOI: 10.3109/00207454.2013.798783] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Despite the continuous advances of surgical solutions, still 1-7% of fractures develop non-unions. The delays in fracture healing increase the period of incapacity of the patient with major consequences, on the psychological and functional recovery, but also on the direct and indirect health-related costs. In particular, femoral diaphyseal non-unions are often characterised by a challenging and long-lasting period of healing. The clinician treating these complex cases has to consider amongst other parameters, the condition of the soft tissue envelope, the adequacy of any pre-existing fixation, the alignment and length of the affected limb, the potential presence of an infection, as well as the general condition of the patient. Open reduction and plate fixation of femoral diaphyseal non-unions offers a valid alternative of stabilisation and if applied to carefully selected cases, can give optimal results.
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Affiliation(s)
- Francesco Benazzo
- Clinic of Orthopaedics and Traumatology, Foundation IRCCS Policlinico S. Matteo, Viale Golgi 19, 27100 Pavia, Italy.
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Calabrò RS, Marra A, Quattrini F, Gervasi G, Levita A, Bramanti P. Central neuropathic pain: an unusual case of painful ejaculation responding to topiramate. J Sex Med 2010; 9:3274-8. [PMID: 20524978 DOI: 10.1111/j.1743-6109.2010.01855.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Painful ejaculation (PE) is an uncommon condition and it is usually associated with prostatitis, chronic pelvic pain syndrome, benign prostatic hyperplasia, ejaculatory duct obstruction, radical prostatectomy, and prostate radiation. Topiramate (TPM) is a new antiepileptic drug with recognized efficacy in neuropathic pain. AIM The study is aimed to evaluate TPM efficacy in ejaculation pain. METHODS Following a spinal cord injury, a 53-year-old man was referred to our institute for persistent PE. Neurological examination showed mild hypoesthesia of the genital area. Urogenital examination, neurophysiological tools, and computed tomography of the dorso-lumbar spine were normal. MAIN OUTCOME MEASURES The main outcome measure was the visual analogue scale. RESULTS Since pain was refractory to conventional neuropathic pharmacological therapies, TPM was introduced up to 150 mg daily with a dramatic improvement of PE. CONCLUSIONS TPM may be considered as a valid therapeutic option for the treatment of PE.
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Affiliation(s)
- Rocco Salvatore Calabrò
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino-Pulejo, Messina, Italy.
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Calabrò R, Quattrini F, Tallarico R, Imbesi D, Ferlazzo E, Musolino R, Magaudda A. T09-P-02 Sexual dysfunction in epileptic male outpatients: preliminary data. Sexologies 2008. [DOI: 10.1016/s1158-1360(08)72883-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pedrotti L, Mora R, Bertani B, Tuvo G, Galli GB, Pazzano S, Quattrini F, Crivellari I. [Ultrasound bone densitometry in children and adolescents; Italian refence curves with multi-site device (Omnisense)]. Pediatr Med Chir 2007; 29:194-201. [PMID: 17715602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
The values of bone density represent one of the best parameters for the prediction of the risk of fracture in the adult. Since the peak of bone mass depends over that on genetic factors also on modifiable environmental factors, the evaluation of the state of bone health in paediatric populations has assumed great importance; the ultrasound techniques seem to represent a potential alternative to DXA and QTC. Using Omnisense device (Omnisense, Sunlight Ultrasound Technologies) we have evaluated the bone strength in a champion of 652 children and teen-agers aged 6-18 (328 females, 324 males). The measurements have been made at the distal third of the radius and midshaft tibia. The purpose has been to record the values of SOS in a healthy paediatric population, building a normal database and to find a correlation between the SOS values and anthropometric data, dietary factors and physical activity. The comparison with an analogous study conducted by other Authors prompted us to conclude that in the paediatric population the construction of proper curves of reference, with which to compare the data of the patients, is essential to avoid errors in the evaluation of bone density, in agreement with how much already underlined in literature. Besides a correct interpretation of the data obtained with ultrasounds systems asks for a change of the thresholds values established by the OMS for the diagnosis of osteopenia/osteoporosis with the DXA. As already happened for the adult population in children also it will be therefore necessary to compare a great number of pathological subjects with the normal database, establishing so the new values of Z-Score and giving a clinical meaning to the effected measurements.
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Affiliation(s)
- L Pedrotti
- Clinica Ortopedica, Università di Pavia, Polo Universitario Città di Pavia
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Quattrini F, Biressi G, Juza M, Mazzotti M, Fuganti C, Morbidelli M. Enantiomer separation of alpha-ionone using gas chromatography with cyclodextrin derivatives as chiral stationary phases. J Chromatogr A 1999; 865:201-10. [PMID: 10674942 DOI: 10.1016/s0021-9673(99)00998-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The gas chromatographic enantiomer separation of alpha-ionone was studied with three different chiral stationary phases using as chiral selectors: (1) heptakis(2,3,6-tri-O-methyl)-beta-cyclodextrin, dissolved in polysiloxane PS-086, (2) octakis(2,6-di-O-pentyl-3-O-trifluoroacetyl)-gamma-cyclodextrin and (3) octakis(2,6-di-O-pentyl-3-O-butanoyl)-gamma-cyclodextrin, both dissolved in polysiloxane SE-54. The influence of the concentration of the chiral selector in the polysiloxane, coated on Chromosorb P AW-DMCS 80-100 mesh, is described and discussed, as well as the effect of Chromosorb loading. The feasibility of the preparative gas chromatographic separation of the enantiomers of alpha-ionone is considered; in order to provide a term of comparison, the estimated performances are compared with those achieved in the separation of the enantiomers of the inhalation anaesthetic enflurane.
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Affiliation(s)
- F Quattrini
- Laboratorium für Technische Chemie, ETH Zürich, Switzerland
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