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Gravina C, Romagnoli M, Nacchia A, Lombardo R, Franco G, Giammò A, De Nunzio C. Re: Edward Lambert, Emmanuel Chartier-Kastler, Christophe Vaessen, et al. Robot-assisted Periprostatic Artificial Urinary Sphincter Implantation in Men with Neurogenic Stress Urinary Incontinence: Description of the Surgical Technique and Comparison of Long-term Functional Outcomes with the Open Approach. Eur Urol. 2024;85:139-45. Eur Urol 2024; 85:e138-e139. [PMID: 38176991 DOI: 10.1016/j.eururo.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Carmen Gravina
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
| | - Matteo Romagnoli
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonio Nacchia
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Riccardo Lombardo
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Giorgio Franco
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Alessandro Giammò
- Neurourology Department, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Lombardo R, Romagnoli M, De Nunzio C, Albisinni S. Editorial: new horizons in robotic platforms. Prostate Cancer Prostatic Dis 2024; 27:7-8. [PMID: 37932521 DOI: 10.1038/s41391-023-00753-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
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Nacchia A, Franco A, Cicione A, Riolo S, Santoro G, Romagnoli M, Sarcinelli L, Fiasconaro D, Ghezzo N, Gallo G, Tema G, Pastore AL, Salhi YA, Fuschi A, Carbone A, Franco G, Lombardo R, Tubaro A, De Nunzio C. Medications Mostly Associated With Ejaculatory Disorders: Assessment of the Eudra-Vigilance and Food and Drug Administration Pharmacovigilance Databases Entries. Urology 2024; 185:59-64. [PMID: 38331221 DOI: 10.1016/j.urology.2023.12.021] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/08/2023] [Accepted: 12/26/2023] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To identify which medications are mostly associated with ejaculatory disorders through a disproportionality analysis. METHODS The Food and Drug Administration Adverse Event Reporting System (FDA-FAERS) and the Eudra-Vigilance (EV) database were queried to identify medications more commonly associated to ejaculatory disorders from September 10, 2012 to June 1, 2023. Proportional Reported Ratios (PRRs) were computed for all the selected drugs. RESULTS Overall, 7404 reports of ejaculatory disorders reports were identified, and of these, 6854 cases (92.6%) were attributed to ten specific medications. On FDA-FAERS and EV databases, Paroxetine and Tamsulosin were the main responsible of delayed ejaculation (103/448 events, 23.0%) and retrograde ejaculation (366/1033 events, 35.4%), respectively. Finasteride was mostly related to painful ejaculation and ejaculation failure, with 150 events (7.8%) and 735 events (38.4%) respectively. Within the group of high-risk medications, Sildenafil presented higher risk of ejaculatory disorders than Tadalafil (PRR=5.85 (95%CI 5.09-6.78), P < .01). CONCLUSION Ten drugs were recognized to display significant reporting levels of ejaculatory disorders. Among them, Finasteride and Sildenafil were responsible for the most reports in FDA-FAERS and in EV databases, respectively. Physicians should thoroughly counsel patients treated with these drugs about the risk of ejaculatory disorders. Further integration into clinical trials is needed to enhance the applicability and significance of these results.
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Affiliation(s)
- Antonio Nacchia
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Antonio Franco
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Antonio Cicione
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Sara Riolo
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Giuseppe Santoro
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Matteo Romagnoli
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Luca Sarcinelli
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | | | - Nicola Ghezzo
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Giacomo Gallo
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Giorgia Tema
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | | | - Yazan Al Salhi
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Andrea Fuschi
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Antonio Carbone
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Giorgio Franco
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | | | - Andrea Tubaro
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy
| | - Cosimo De Nunzio
- 'Sapienza' University of Rome, Department of Urology, Rome, Italy.
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Lombardo R, Russo GI, Romagnoli M, Tema G, Nacchia A, Franco A, Cicione A, Franco G, Tubaro A, De Nunzio C. Yoga, benign prostatic hyperplasia and lower urinary tract symptoms: a new path for clinical trials. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00788-1. [PMID: 38233471 DOI: 10.1038/s41391-024-00788-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/22/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Affiliation(s)
| | | | | | - Giorgia Tema
- Department of Urology, Sapienza University, Rome, Italy
| | | | | | | | | | - Andrea Tubaro
- Department of Urology, Sapienza University, Rome, Italy
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Lombardo R, Gallo G, Stira J, Turchi B, Santoro G, Riolo S, Romagnoli M, Cicione A, Tema G, Pastore A, Al Salhi Y, Fuschi A, Franco G, Nacchia A, Tubaro A, De Nunzio C. Quality of information and appropriateness of Open AI outputs for prostate cancer. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00789-0. [PMID: 38228809 DOI: 10.1038/s41391-024-00789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 12/22/2023] [Accepted: 01/05/2024] [Indexed: 01/18/2024]
Abstract
Chat-GPT, a natural language processing (NLP) tool created by Open-AI, can potentially be used as a quick source for obtaining information related to prostate cancer. This study aims to analyze the quality and appropriateness of Chat-GPT's responses to inquiries related to prostate cancer compared to those of the European Urology Association's (EAU) 2023 prostate cancer guidelines. Overall, 195 questions were prepared according to the recommendations gathered in the prostate cancer section of the EAU 2023 Guideline. All questions were systematically presented to Chat-GPT's August 3 Version, and two expert urologists independently assessed and assigned scores ranging from 1 to 4 to each response (1: completely correct, 2: correct but inadequate, 3: a mix of correct and misleading information, and 4: completely incorrect). Sub-analysis per chapter and per grade of recommendation were performed. Overall, 195 recommendations were evaluated. Overall, 50/195 (26%) were completely correct, 51/195 (26%) correct but inadequate, 47/195 (24%) a mix of correct and misleading and 47/195 (24%) incorrect. When looking at different chapters Open AI was particularly accurate in answering questions on follow-up and QoL. Worst performance was recorded for the diagnosis and treatment chapters with respectively 19% and 30% of the answers completely incorrect. When looking at the strength of recommendation, no differences in terms of accuracy were recorded when comparing weak and strong recommendations (p > 0,05). Chat-GPT has a poor accuracy when answering questions on the PCa EAU guidelines recommendations. Future studies should assess its performance after adequate training.
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Affiliation(s)
| | - Giacomo Gallo
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Jordi Stira
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Beatrice Turchi
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Giuseppe Santoro
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Sara Riolo
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Matteo Romagnoli
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Cicione
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Giorgia Tema
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Pastore
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Yazan Al Salhi
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Andrea Fuschi
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Giorgio Franco
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Antonio Nacchia
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Andrea Tubaro
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
| | - Cosimo De Nunzio
- Department of Urology, 'Sapienza' University of Rome, Rome, Italy
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Buda M, Coco V, Grassi A, Filanti M, Musiani C, Solaro L, Guerra E, Romagnoli M. McLaughlin technique and humeral grafting provide similar results for treatment of reverse Hill-Sachs lesions: A systematic review. J Exp Orthop 2024; 11:e12001. [PMID: 38464507 PMCID: PMC10924757 DOI: 10.1002/jeo2.12001] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/20/2023] [Indexed: 03/12/2024] Open
Abstract
Purpose Various surgical treatments have been described for the treatment of reverse Hill-Sachs lesions (rHSls) sized between 20% and 50% in the case of posterior shoulder dislocation. The aim of this systematic review is to report the clinical and radiological outcomes of subscapularis or lesser tuberosity transfer (McLaughlin and modified procedures) compared to bone or osteochondral autograft or allograft. Methods A systematic review was performed on five medical databases up to December 2022. The inclusion criteria were clinical studies of all levels of evidence describing clinical or radiological outcomes of either procedure. The assessment of the quality of evidence was performed with the Modified Coleman Score. Results A total of 14 studies (five prospective and nine retrospective) were included. A total of 153 patients (155 shoulders, 78.4% male) with a mean age of 37.2 (22-79) years were reviewed at an average follow-up of 53.1 (7.1-294) months. No relevant difference was found for the clinical scores, range of motion, complications and redislocation rate between the two treatments. Radiological osteoarthritis (OA) was reported in 11% (10/87) in the McLaughlin group and in 21% (16/73) in the humeral reconstruction group. Conclusions McLaughlin and anatomic humeral reconstruction lead to similar satisfactory clinical results and a low redislocation rate in the treatment of rHSls. Anatomic humeral reconstruction seems associated with an increased risk of OA progression. Level of Evidence Level IV.
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Affiliation(s)
- Matteo Buda
- Ortopedia e Traumatologia Rizzoli ArgentaArgentaFerraraItaly
| | - Vito Coco
- Ortopedia e Traumatologia Rizzoli ArgentaArgentaFerraraItaly
| | - Alberto Grassi
- II Clinica Ortopedica e TraumatologicaIRCCS Istituto Ortopedico RizzoliBolognaItaly
| | - Mattia Filanti
- Ortopedia e Traumatologia Rizzoli ArgentaArgentaFerraraItaly
| | | | - Luca Solaro
- Chirurgia della Spalla e del GomitoIRCCS Istituto Ortopedico RizzoliBolognaItaly
| | - Enrico Guerra
- Chirurgia della Spalla e del GomitoIRCCS Istituto Ortopedico RizzoliBolognaItaly
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Romagnoli M, Zaffagnini M, Carillo E, Raggi F, Casali M, Leardini A, Marcheggiani Muccioli GM, Grassi A, Zaffagnini S. Custom-made implants for massive acetabular bone loss: accuracy with CT assessment. J Orthop Surg Res 2023; 18:742. [PMID: 37777776 PMCID: PMC10544156 DOI: 10.1186/s13018-023-04230-5] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Custom-made implants are a valid option in revision total hip arthroplasty to address massive acetabular bone loss. The aim of this study was to assess the accuracy of custom-made acetabular implants between preoperative planning and postoperative positioning using CT scans. METHODS In a retrospective analysis, three patients who underwent an acetabular custom-made prosthesis were identified. The custom-made designs were planned through 3D CT analysis considering surgical points of attention. The accuracy of intended implants positioning was assessed by comparing pre- and postoperative CT analyzing the center of rotation (CoR), anteversion, inclination, screws, and implant surface in contact with the bone. RESULTS The three cases presented satisfactory accuracy in positioning. A malpositioning in the third case was observed due to the posterization of the CoR of the implant of more than 10 mm. The other CoR vectors considered in the third patient and all vectors in the other two cases fall within 10 mm. All the cases were positioned with a difference of less than 10° of anteversion and inclination with respect to the planning. CONCLUSIONS The current case series revealed promising accuracy in the positioning of custom-made acetabular prosthesis comparing the planned implant in preoperative CT with postoperative CT.
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Affiliation(s)
- Matteo Romagnoli
- Ortopedia e Traumatologia Rizzoli Argenta, Via Nazionale Ponente 5, 44011, Argenta, FE, Italy
| | - Marco Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy.
| | - Eleonora Carillo
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy
| | - Federico Raggi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy
| | - Marco Casali
- Ortopedia e Traumatologia Rizzoli Argenta, Via Nazionale Ponente 5, 44011, Argenta, FE, Italy
| | - Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136, Bologna, Italy
| | | | - Alberto Grassi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy
| | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy
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Romagnoli M, Casali M, Zaffagnini M, Cucurnia I, Raggi F, Reale D, Grassi A, Zaffagnini S. Tricalcium Phosphate as a Bone Substitute to Treat Massive Acetabular Bone Defects in Hip Revision Surgery: A Systematic Review and Initial Clinical Experience with 11 Cases. J Clin Med 2023; 12:jcm12051820. [PMID: 36902607 PMCID: PMC10003370 DOI: 10.3390/jcm12051820] [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: 12/16/2022] [Revised: 01/28/2023] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
The use of tricalcium phosphate (TCP) as a bone substitute is gaining increasing interest to treat severe acetabular bone defects in revision total hip arthroplasty (rTHA). The aim of this study was to investigate the evidence regarding the efficacy of this material. A systematic review of the literature was performed according to the PRISMA and Cochrane guidelines. The study quality was assessed using the modified Coleman Methodology Score (mCMS) for all studies. A total of eight clinical studies (230 patients) were identified: six on TCP used as biphasic ceramics composed of TCP and hydroxyapatite (HA), and two as pure-phase ceramics consisting of TCP. The literature analysis showed eight retrospective case series, of which only two were comparative studies. The mCMS showed an overall poor methodology (mean score 39.5). While the number of studies and their methodology are still limited, the available evidence suggests safety and overall promising results. A total of 11 cases that underwent rTHA with a pure-phase ceramic presented satisfactory clinical and radiological outcomes at initial short-term follow-up. Further studies at long-term follow-up, involving a larger number of patients, are needed before drawing more definitive conclusions on the potential of TCP for the treatment of patients who undergo rTHA.
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Affiliation(s)
- Matteo Romagnoli
- Ortopedia e Traumatologia Rizzoli Argenta, 44011 Argenta, FE, Italy
| | - Marco Casali
- Ortopedia e Traumatologia Rizzoli Argenta, 44011 Argenta, FE, Italy
- Correspondence:
| | - Marco Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, BO, Italy
| | - Ilaria Cucurnia
- Ortopedia e Traumatologia Rizzoli Argenta, 44011 Argenta, FE, Italy
| | - Federico Raggi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, BO, Italy
| | - Davide Reale
- Ortopedia e Traumatologia Rizzoli Argenta, 44011 Argenta, FE, Italy
| | - Alberto Grassi
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, BO, Italy
| | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, BO, Italy
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Merriman NA, Roudaia E, Ondřej J, Romagnoli M, Orvieto I, O’Sullivan C, Newell FN. “CityQuest,” A Custom-Designed Serious Game, Enhances Spatial Memory Performance in Older Adults. Front Aging Neurosci 2022; 14:806418. [PMID: 35356302 PMCID: PMC8959141 DOI: 10.3389/fnagi.2022.806418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/11/2022] [Indexed: 11/29/2022] Open
Abstract
Spatial cognition is known to decline with aging. However, little is known about whether training can reduce or eliminate age-related deficits in spatial memory. We investigated whether a custom-designed video game involving spatial navigation, obstacle avoidance, and balance control would improve spatial memory in older adults. Specifically, 56 healthy adults aged 65 to 84 years received 10 sessions of multicomponent video game training, based on a virtual cityscape, over 5 weeks. Participants were allocated to one of three training conditions: the main intervention, the “CityQuest” group (n = 19), and two control groups, spatial navigation without obstacle avoidance (“Spatial Navigation-only” group, n = 21) and obstacle avoidance without spatial navigation (“Obstacles-only” group, n = 15). Performance on object recognition, egocentric and allocentric spatial memory (incorporating direction judgment tasks and landmark location tasks, respectively), navigation strategy preference, and executive functioning was assessed in pre- and post-intervention sessions. The results showed an overall benefit on performance in a number of spatial memory measures and executive function for participants who received spatial navigation training, particularly the CityQuest group, who also showed significant improvement on the landmark location task. However, there was no evidence of a shift from egocentric to allocentric strategy preference. We conclude that spatial memory in healthy older participants is amenable to improvement with training over a short term. Moreover, technology based on age-appropriate, multicomponent video games may play a key role in cognitive training in older adults.
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Affiliation(s)
- Niamh A. Merriman
- School of Psychology, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Eugenie Roudaia
- School of Psychology, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Jan Ondřej
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | | | | | - Carol O’Sullivan
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Fiona N. Newell
- School of Psychology, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- *Correspondence: Fiona N. Newell,
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Marcheggiani Muccioli GM, Rinaldi VG, Lullini G, Ritali A, Mosca M, Romagnoli M, Guerra E, Zaffagnini S. Mid-Term outcomes following fresh-frozen humeral head osteochondral allograft reconstruction for reverse Hill Sachs lesion: a case series. BMC Musculoskelet Disord 2021; 22:768. [PMID: 34496807 PMCID: PMC8427886 DOI: 10.1186/s12891-021-04657-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/08/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
Background Locked posterior glenohumeral dislocations with a reverse Hill-Sachs impaction fracture involving less than 30% of the humeral head are most frequently treated with lesser tuberosity transfer into the defect, whereas those involving more than 50% undergo humeral head arthroplasty. Reconstruction of the defect with segmental femoral osteochondral allografts has been proposed to treat patients between these two ranges, but the medium−/long-term outcomes of this joint-preserving procedure are controversial. Methods Between 2001 and 2018, 12 consecutive patients with a unilateral locked posterior shoulder dislocation and an impaction fracture from 30 to 50% (mean 31% ± 1.32) of the humeral head were treated with segmental reconstruction of the defect with fresh-frozen humeral head osteochondral allografts. Patients were assessed clinically, radiographically and with computed tomography (CT) at a medium follow-up of 66 ± 50.25 months (range, 24–225). Results All twelve shoulders presented a slight limitation in anterior elevation (average, 166.6° ± 22.76). The mean active external rotation with the shoulder at 90° of abduction was 82.5° ± 6.61, and that with the arm held in stable adduction was 79.16 ± 18.80. The mean abduction was 156.25° ± 25.09. The mean Constant-Murley score (CS) was 82 ± 15.09 points (range, 40–97 points), and the mean ASES was 94 ± 8.49 points. The mean pre- and postoperatively Western Ontario Shoulder Instability index (WOSI) was 236.5 ± 227.9 and 11.20 ± 10.85, respectively. Development of osteoarthrosis (OA) was minimal. The average allograft resorption rate was 4% ± 2.4. There were no cases of failure (reoperation for any reason) in this series. Conclusion Segmental humeral head reconstruction with humeral head fresh-frozen osteochondral allografts provides good to excellent clinical results with low-grade OA and low allograft resorption in patients with locked posterior shoulder dislocation. Trial registration ClinicalTrials.gov PRS, ClinicalTrials.gov ID: NCT04823455. Registered 29 March 2021 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AU8P&selectaction=Edit&uid=U0004J36&ts=12&cx=6cykp8 Level of evidence Level IV, Case Series, Treatment Study.
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Affiliation(s)
- Giulio Maria Marcheggiani Muccioli
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. .,DIBINEM, University of Bologna, via Pupilli, 1 c/o IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy.
| | - Vito Gaetano Rinaldi
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giada Lullini
- UOC Medicina Riabilitativa e Neuroriabilitazione, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Alice Ritali
- Chirurgia della Spalla e del Gomito, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Massimiliano Mosca
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Matteo Romagnoli
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Enrico Guerra
- Chirurgia della Spalla e del Gomito, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Zaffagnini
- II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.,DIBINEM, University of Bologna, via Pupilli, 1 c/o IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy
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11
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Vega ML, Dongilli R, Olaizola G, Colaianni N, Sayat MC, Pisani L, Romagnoli M, Spoladore G, Prediletto I, Montiel G, Nava S. COVID-19 pneumonia and ROX index: Time to set a new threshold for patients admitted outside the ICU. Authors' reply. Pulmonology 2021; 27:475-476. [PMID: 34334332 PMCID: PMC8321775 DOI: 10.1016/j.pulmoe.2021.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 01/21/2023] Open
Affiliation(s)
- M L Vega
- Non-Invasive Respiratory Support Unit, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires. Argentina; IRCCS Azienda Ospedaliera-Universitaria, Division of Respiratory and Critical Care SantOrsola Hospital, Bologna Italia
| | - R Dongilli
- Division of Respiratory Diseases with intermediate respiratory intensive care units, Central Hospital of Bolzano, Bolzano, Italy
| | - G Olaizola
- Unidad Asistencial Cesar Milstein. Ciudad Autónoma de Buenos Aires. Argentina
| | - N Colaianni
- Non-Invasive Respiratory Support Unit, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires. Argentina; Intensive Care Unit, Clínica Zabala, Ciudad Autónoma de Buenos Aires. Argentina
| | - M C Sayat
- Non-Invasive Respiratory Support Unit, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires. Argentina; Intensive Care Unit, Clínica Zabala, Ciudad Autónoma de Buenos Aires. Argentina
| | - L Pisani
- IRCCS Azienda Ospedaliera-Universitaria, Division of Respiratory and Critical Care SantOrsol Hospital, Bologna Italia. Alma Mater Studiorum University of Bologna Department of Clinical, Integrated and Experimental Medicine (DIMES), Bologna, Italy
| | - M Romagnoli
- Pulmonology Unit, Santa Maria di Ca' Foncello Hospital, Treviso, Italy
| | - G Spoladore
- Division of Infectious Diseases, Central Hospital of Bolzano, Bolzano, Italy
| | - I Prediletto
- IRCCS Azienda Ospedaliera-Universitaria, Division of Respiratory and Critical Care SantOrsol Hospital, Bologna Italia. Alma Mater Studiorum University of Bologna Department of Clinical, Integrated and Experimental Medicine (DIMES), Bologna, Italy
| | - G Montiel
- Non-Invasive Respiratory Support Unit, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires. Argentina
| | - S Nava
- IRCCS Azienda Ospedaliera-Universitaria, Division of Respiratory and Critical Care SantOrsol Hospital, Bologna Italia. Alma Mater Studiorum University of Bologna Department of Clinical, Integrated and Experimental Medicine (DIMES), Bologna, Italy.
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12
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Schuler S, Muench JE, Ruocco A, Balci O, Thourhout DV, Sorianello V, Romagnoli M, Watanabe K, Taniguchi T, Goykhman I, Ferrari AC, Mueller T. High-responsivity graphene photodetectors integrated on silicon microring resonators. Nat Commun 2021; 12:3733. [PMID: 34145226 PMCID: PMC8213857 DOI: 10.1038/s41467-021-23436-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 04/14/2021] [Indexed: 02/05/2023] Open
Abstract
Graphene integrated photonics provides several advantages over conventional Si photonics. Single layer graphene (SLG) enables fast, broadband, and energy-efficient electro-optic modulators, optical switches and photodetectors (GPDs), and is compatible with any optical waveguide. The last major barrier to SLG-based optical receivers lies in the current GPDs' low responsivity when compared to conventional PDs. Here we overcome this by integrating a photo-thermoelectric GPD with a Si microring resonator. Under critical coupling, we achieve >90% light absorption in a ~6 μm SLG channel along a Si waveguide. Cavity-enhanced light-matter interactions cause carriers in SLG to reach ~400 K for an input power ~0.6 mW, resulting in a voltage responsivity ~90 V/W, with a receiver sensitivity enabling our GPDs to operate at a 10-9 bit-error rate, on par with mature semiconductor technology, but with a natural generation of a voltage, rather than a current, thus removing the need for transimpedance amplification, with a reduction of energy-per-bit, cost, and foot-print.
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Affiliation(s)
- S Schuler
- Vienna University of Technology, Institute of Photonics, Vienna, Austria
- Cambridge Graphene Centre, University of Cambridge, Cambridge, UK
| | - J E Muench
- Cambridge Graphene Centre, University of Cambridge, Cambridge, UK
| | - A Ruocco
- Cambridge Graphene Centre, University of Cambridge, Cambridge, UK
| | - O Balci
- Cambridge Graphene Centre, University of Cambridge, Cambridge, UK
| | - D van Thourhout
- Ghent University-IMEC, Photonics Research Group, Gent, Belgium
| | - V Sorianello
- Consorzio Nazionale per le Telecomunicazioni and Inphotec, Pisa, Italy
| | - M Romagnoli
- Consorzio Nazionale per le Telecomunicazioni and Inphotec, Pisa, Italy
| | - K Watanabe
- National Institute for Materials Science, Tsukuba, Japan
| | - T Taniguchi
- National Institute for Materials Science, Tsukuba, Japan
| | - I Goykhman
- Cambridge Graphene Centre, University of Cambridge, Cambridge, UK
- Technion-Israel Institute of Technology, Haifa, Israel
| | - A C Ferrari
- Cambridge Graphene Centre, University of Cambridge, Cambridge, UK.
| | - T Mueller
- Vienna University of Technology, Institute of Photonics, Vienna, Austria.
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13
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Marconi S, Giambra MA, Montanaro A, Mišeikis V, Soresi S, Tirelli S, Galli P, Buchali F, Templ W, Coletti C, Sorianello V, Romagnoli M. Photo thermal effect graphene detector featuring 105 Gbit s -1 NRZ and 120 Gbit s -1 PAM4 direct detection. Nat Commun 2021; 12:806. [PMID: 33547318 PMCID: PMC7864989 DOI: 10.1038/s41467-021-21137-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 01/13/2021] [Indexed: 01/30/2023] Open
Abstract
One of the main challenges of next generation optical communication is to increase the available bandwidth while reducing the size, cost and power consumption of photonic integrated circuits. Graphene has been recently proposed to be integrated with silicon photonics to meet these goals because of its high mobility, fast carrier dynamics and ultra-broadband optical properties. We focus on graphene photodetectors for high speed datacom and telecom applications based on the photo-thermo-electric effect, allowing for direct optical power to voltage conversion, zero dark current, and ultra-fast operation. We report on a chemical vapour deposition graphene photodetector based on the photo-thermoelectric effect, integrated on a silicon waveguide, providing frequency response >65 GHz and optimized to be interfaced to a 50 Ω voltage amplifier for direct voltage amplification. We demonstrate a system test leading to direct detection of 105 Gbit s-1 non-return to zero and 120 Gbit s-1 4-level pulse amplitude modulation optical signals.
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Affiliation(s)
- S. Marconi
- grid.263145.70000 0004 1762 600XTecip Institute – Scuola Superiore Sant’Anna, Pisa, Italy
| | - M. A. Giambra
- Photonic Networks and Technologies Lab – CNIT, Pisa, Italy
| | - A. Montanaro
- Photonic Networks and Technologies Lab – CNIT, Pisa, Italy
| | - V. Mišeikis
- grid.25786.3e0000 0004 1764 2907Center for Nanotechnology Innovation @NEST - Istituto Italiano di Tecnologia, Pisa, Italy ,grid.25786.3e0000 0004 1764 2907Graphene Labs, Istituto Italiano di Tecnologia, Genova, Italy
| | - S. Soresi
- Photonic Networks and Technologies Lab – CNIT, Pisa, Italy ,Fondazione INPHOTEC, Pisa, Italy
| | - S. Tirelli
- Photonic Networks and Technologies Lab – CNIT, Pisa, Italy ,Fondazione INPHOTEC, Pisa, Italy
| | - P. Galli
- Nokia Solutions and Networks Italia, Vimercate, Italy
| | - F. Buchali
- grid.425792.fNokia Bell Labs, Stuttgart, Germany
| | - W. Templ
- grid.425792.fNokia Bell Labs, Stuttgart, Germany
| | - C. Coletti
- grid.25786.3e0000 0004 1764 2907Center for Nanotechnology Innovation @NEST - Istituto Italiano di Tecnologia, Pisa, Italy ,grid.25786.3e0000 0004 1764 2907Graphene Labs, Istituto Italiano di Tecnologia, Genova, Italy
| | - V. Sorianello
- Photonic Networks and Technologies Lab – CNIT, Pisa, Italy
| | - M. Romagnoli
- Photonic Networks and Technologies Lab – CNIT, Pisa, Italy
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14
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Saracco A, Grassi A, Romagnoli M, Camarda L, Logishetty K, Zaffagnini S, Cobb J. Reduced-dose computed tomography is the most accurate method to measure ceramic hip resurfacing cup version. Eur J Radiol 2020; 128:109040. [PMID: 32442835 DOI: 10.1016/j.ejrad.2020.109040] [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: 10/08/2019] [Revised: 04/22/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND A precise assessment of cup version after hip resurfacing is generally requested, especially in clinical trials or in case of complications. AIMS To identify which diagnostic imaging modality, between AP pelvis X-rays, the AP Pelvis CT Scout image and reduced-dose axial CT scan, is the most precise to assess cup version of an all-ceramic hip resurfacing implant in a first-in-human clinical trial. METHODS We retrospectively assessed the cup version of the first 20 patients who underwent an experimental all-ceramic hip resurfacing on AP pelvis X-rays (0.8 mSv of radiation), AP pelvis CT scout images (0.016 mSv) and axial CT slices performed using a reduced dose protocol (0.3 mSv). The intra-observer and inter-observer reliabilities were calculated. RESULTS Reduced dose Pelvis CT scan was the most precise imaging modality to detect cup version (Pearson Correlation Coefficient, PCC = 0.98, p < 0.001). The AP Pelvis CT Scout image was found to be sufficient to measure cup version within an acceptable margin of tolerance (mean difference ± 4.7° from pelvis CT scan) and highly correlated to axial pelvis CT scan measurements (PCC 0.97, p < 0.001). Analysis of cup version from AP X-rays poorly correlated with measurements from Pelvis CT (PCC 0.59, p = 0.006). CONCLUSIONS Due to lower radiation exposure and highest accuracy, reduced dose CT is a valid modality to measure acetabular cup version after ceramic hip resurfacing. Plain X-rays are not accurate nor precise to measure version, whereas high agreement of measurements between AP Pelvis CT Scout and axial pelvis CT scan was found.
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Affiliation(s)
| | - Alberto Grassi
- IRCSS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, BO, Italy
| | - Matteo Romagnoli
- IRCSS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, BO, Italy
| | - Lawrence Camarda
- Università Degli Studi Di Palermo, Via Del Vespro 129, 90127 Palermo, PA, Italy
| | | | - Stefano Zaffagnini
- IRCSS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli, 1, 40136 Bologna, BO, Italy
| | - Justin Cobb
- Imperial College London, MSk Lab, London W6 8RP, UK
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15
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Grassi A, Samuelsson K, D'Hooghe P, Romagnoli M, Mosca M, Zaffagnini S, Amendola A. Dynamic Stabilization of Syndesmosis Injuries Reduces Complications and Reoperations as Compared With Screw Fixation: A Meta-analysis of Randomized Controlled Trials. Am J Sports Med 2020; 48:1000-1013. [PMID: 31188642 DOI: 10.1177/0363546519849909] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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] [Indexed: 01/31/2023]
Abstract
BACKGROUND Several devices for obtaining dynamic fixation of the syndesmosis have been introduced in recent years, but their efficacy has been tested in only a few randomized controlled trials (RCTs), without demonstrating any clear benefit over the traditional static fixation with screws. PURPOSE To perform a level 1 meta-analysis of RCTs to investigate the complications, subjective outcomes, and functional results after dynamic or static fixation of acute syndesmotic injuries. STUDY DESIGN Meta-analysis of RCTs. METHODS A systematic literature search was performed of the Medline/PubMed, Cochrane Central Register of Controlled Trials, and Embase electronic databases, as well as ClinicalTrials.gov for unpublished studies. Eligible studies were RCTs comparing dynamic fixation and static fixation of acute syndesmosis injuries. A meta-analysis was performed, while bias and quality of evidence were rated according to the Cochrane Database questionnaire and the Grading of Recommendations Assessment, Development and Evaluation guidelines. RESULTS Dynamic fixation had a significantly reduced relative risk (RR = 0.55, P = .003) of complications-in particular, the presence of inadequate reduction at the final follow-up (RR = 0.36, P = .0008) and the clinical diagnosis of recurrent diastasis or instability (RR = 0.10, P = .03). The effect was more evident when compared with permanent screws (RR = 0.10, P = .0001). The reoperation rate was similar between the groups (RR = 0.64, P = .07); however, the overall risk was reduced after dynamic fixation as compared with static fixation with permanent screws (RR = 0.24, P = .007). The American Orthopaedic Foot & Ankle Society score was significantly higher among patients treated with dynamic fixation-6.06 points higher (P = .005) at 3 months, 5.21 points (P = .03) at 12 months, and 8.60 points (P < .00001) at 24 months-while the Olerud-Molander score was similar. The visual analog scale for pain score was reduced at 6 months (-0.73 points, P = .003) and 12 months (-0.52 points, P = .005), and ankle range of motion increased by 4.36° (P = .03) with dynamic fixation. The overall quality of evidence ranged from "moderate" to "very low," owing to a substantial risk of bias, heterogeneity, indirectness of outcome reporting, and evaluation of a limited number of patients. CONCLUSION The dynamic fixation of syndesmotic injuries was able to reduce the number of complications and improve clinical outcomes as compared with static screw fixation-especially malreduction and clinical instability or diastasis-at a follow-up of 2 years. A lower risk of reoperation was found with dynamic fixation as compared with static fixation with permanent screws. However, the lack of patients or personnel blinding, treatment heterogeneity, small samples, and short follow-up limit the overall quality of this evidence.
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Affiliation(s)
- Alberto Grassi
- IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Kristian Samuelsson
- Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pieter D'Hooghe
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Matteo Romagnoli
- IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Massimiliano Mosca
- IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Zaffagnini
- IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.,Dipartimento di scienze Biomediche e Neuromotorie DIBINEM, Università di Bologna, Bologna, Italy
| | - Annunziato Amendola
- Michael W. Krzyzewski Human Performance Laboratory, Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
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16
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Raggi F, Roberti di Sarsina T, Signorelli C, Marcheggiani Muccioli GM, Macchiarola L, Cucurnia I, Romagnoli M, Grassi A, Zaffagnini S. Triaxial accelerometer can quantify the Lachman test similarly to standard arthrometers. Knee Surg Sports Traumatol Arthrosc 2019; 27:2698-2703. [PMID: 30474693 DOI: 10.1007/s00167-018-5306-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 12/22/2017] [Accepted: 11/15/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the relationship between the KiRA triaxial accelerometer and the KT-1000 measurements in the intact, anterior cruciate ligament (ACL) deficient, and ACL reconstructed knee joint for the quantification of the Lachman test. Moreover, the intra- and inter-examiner repeatability of the KiRA device will be determined. It was hypothesized that the side-to-side difference of the anterior tibial translation as measured by the KiRA device would be equivalent to the one measured by the KT-1000 during the Lachman test. METHODS Sixty patients were divided into three groups and have been prospectively included in the present study. Group_A composed of 20 patients with a diagnosis of an isolated ACL tear. Group_B composed of 20 patients who underwent ACL reconstruction with a Single-Bundle Lateral Plasty (SBLP) technique with at least 20 years of follow-up. Group_C was the control group and included 20 patients with no history of ACL lesion. Lachman test has been performed at manual-maximum load on both sides, the involved and the contralateral and analyzed with the two different devices. RESULTS The KiRA device in terms of side-to-side difference resulted not statistically different from the measurement of the KT-1000 arthrometer for the three study groups (n.s): Group_A: (4 ± 2 mm KiRA, 4 ± 2 mm KT1000), Group_B: (4 ± 2 mm KiRA, 4 ± 2 mm KT-1000), Group_C: (4 ± 2 mm KiRA, 4 ± 2 mm KT-1000), an excellent intra- (ICC = 0.88-0.89) and inter-examiner (ICC = 0.79) agreement was found for KiRA measurements. CONCLUSION The KiRA (I+, Italy) device offers a valid method to quantify the Lacham test. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Federico Raggi
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via U. Foscolo 7, Bologna, BO, Italy
| | - Tommaso Roberti di Sarsina
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via U. Foscolo 7, Bologna, BO, Italy
| | - Cecilia Signorelli
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy. .,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.
| | - Giulio Maria Marcheggiani Muccioli
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via U. Foscolo 7, Bologna, BO, Italy
| | - Luca Macchiarola
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via U. Foscolo 7, Bologna, BO, Italy
| | - Ilaria Cucurnia
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via U. Foscolo 7, Bologna, BO, Italy
| | - Matteo Romagnoli
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy
| | - Alberto Grassi
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via U. Foscolo 7, Bologna, BO, Italy
| | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.,Laboratorio di Biomeccanica e Innovazione Tecnologica, Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Via U. Foscolo 7, Bologna, BO, Italy
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17
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Grassi A, Amendola A, Samuelsson K, Svantesson E, Romagnoli M, Bondi A, Mosca M, Zaffagnini S. Minimally Invasive Versus Open Repair for Acute Achilles Tendon Rupture: Meta-Analysis Showing Reduced Complications, with Similar Outcomes, After Minimally Invasive Surgery. J Bone Joint Surg Am 2018; 100:1969-1981. [PMID: 30480601 DOI: 10.2106/jbjs.17.01364] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is no consensus on the optimal technique for repairing an acute Achilles tendon rupture. The purpose of this meta-analysis was to compare the complications, subjective outcomes, and functional results between minimally invasive surgery and open repair of an Achilles tendon rupture. METHODS A systematic literature search of MEDLINE/PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EBSCOhost, and ClinicalTrials.gov was performed. Eligible studies were randomized controlled trials (RCTs) comparing minimally invasive surgery and open repair of acute Achilles tendon ruptures. A meta-analysis was performed, while bias and the quality of the evidence were rated according to the Cochrane Database questionnaire and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. The meta-analysis was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. RESULTS Eight studies, with 182 patients treated with minimally invasive surgery and 176 treated with open repair, were included. The meta-analysis showed a significantly decreased risk ratio (RR) of 0.21 (95% confidence interval [CI] = 0.10 to 0.40, p = 0.00001) for overall complications and 0.15 (95% CI = 0.05 to 0.46, p = 0.0009) for wound infection after minimally invasive surgery. Patients treated with minimally invasive surgery were more likely to report good or excellent subjective results (RR = 1.18, 95% CI = 1.04 to 1.33, p = 0.009). No differences between groups were found with respect to reruptures, sural nerve injury, return to preinjury activity level, time to return to work, or ankle range of motion. The overall quality of evidence was generally low because of a substantial risk of bias, heterogeneity, indirectness of outcome reporting, and evaluation of a limited number of patients. CONCLUSIONS There was a significantly decreased risk of postoperative complications, especially wound infection, when acute Achilles tendon rupture was treated with minimally invasive surgery compared with open surgery. Patients treated with minimally invasive surgery were significantly more likely to report a good or excellent subjective outcome. Current evidence is associated with high heterogeneity and a considerable risk of bias. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Alberto Grassi
- Dipartimento di Scienze Biomediche e Neuromotorie (DIBINEM), University of Bologna, Bologna, Italy.,II Clinica Ortopedica e Traumatologica (A.G., M.R., M.M., and S.Z.) and Dipartimento Rizzoli Sicilia (A.B.), IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Annunziato Amendola
- Michael W. Krzyzewski Human Performance Laboratory, Department of Orthopaedic Surgery, Duke University, Durham, North Carolina
| | - Kristian Samuelsson
- Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eleonor Svantesson
- Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Matteo Romagnoli
- II Clinica Ortopedica e Traumatologica (A.G., M.R., M.M., and S.Z.) and Dipartimento Rizzoli Sicilia (A.B.), IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Alice Bondi
- II Clinica Ortopedica e Traumatologica (A.G., M.R., M.M., and S.Z.) and Dipartimento Rizzoli Sicilia (A.B.), IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Massimiliano Mosca
- II Clinica Ortopedica e Traumatologica (A.G., M.R., M.M., and S.Z.) and Dipartimento Rizzoli Sicilia (A.B.), IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Stefano Zaffagnini
- Dipartimento di Scienze Biomediche e Neuromotorie (DIBINEM), University of Bologna, Bologna, Italy.,II Clinica Ortopedica e Traumatologica (A.G., M.R., M.M., and S.Z.) and Dipartimento Rizzoli Sicilia (A.B.), IRCCS Rizzoli Orthopaedic Institute, Bologna, Italy
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18
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Grassi A, Perdisa F, Samuelsson K, Svantesson E, Romagnoli M, Raggi F, Gaziano T, Mosca M, Ayeni O, Zaffagnini S. Association between incision technique for hamstring tendon harvest in anterior cruciate ligament reconstruction and the risk of injury to the infra-patellar branch of the saphenous nerve: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 2018; 26:2410-2423. [PMID: 29423546 DOI: 10.1007/s00167-018-4858-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 09/11/2017] [Accepted: 02/02/2018] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine how the incision technique for hamstring tendon (HT) harvest in anterior cruciate ligament (ACL) reconstruction affects the risk of injury to the IPBSN and clinical outcome. METHODS A systematic literature search of the MEDLINE/Pubmed, Cochrane Central Register of Controlled Trials (CENTRAL) and EBSCOhost electronic databases and clinicaltrials.gov for unpublished studies was performed to identify comparative studies investigating injury to the IPBSN after HT ACL reconstruction by comparing at least two different incision techniques. Data were extracted for the number of patients with evidence of any neurologic deficit corresponding to injury to the IPBSN, area of sensory deficit, the Lysholm score and patient satisfaction. The mean difference (MD) in study outcome between incision groups was assessed. The relative risk (RR) and the number needed to treat (NNT) were calculated. The Chi-square and Higgins' I2 tests were applied to test heterogeneity. Data were pooled using a Mantel-Haenszel random-effects model if the statistical heterogeneity was > 50% and a fixed-effects model if the statistical heterogeneity was < 50%. The risk of bias was evaluated according to the Cochrane Database questionnaire and the quality of evidence was graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS A total of eight studies (three randomized controlled trials (RCTs) and five comparative studies) were included, of which six compared vertical and oblique incisions, one horizontal and vertical incisions, and one compared all three techniques. HT harvest was performed through a vertical incision in 329 patients, through an oblique incision in 195 patients and through a horizontal incision in 151 patients. Considering the meta-analysis of the RCTs, the performance of a vertical incision significantly increased the risk of causing IPBSN deficiency compared with both oblique and horizontal incision [RR 1.65 (CI 1.10-2.49, p = 0.02) and RR 2.45 (CI 1.73-3.47, p < 0.0001), respectively]. A significantly larger area of sensory deficit was found with vertical incisions compared with oblique ones, with an MD of 22.91 cm2 (95% CI 7.73-38.08; p = 0.04). No significant differences were found between the incision techniques in relation to patient-reported outcomes. The same trend was obtained after the performing a meta-analysis of all eight included studies. The quality of evidence in this meta-analysis was determined as "low" to "moderate", mostly due to inadequate methods of randomization and high heterogeneity among the included studies. CONCLUSION The performance of a vertical incision to harvest HTs for ACL reconstruction significantly increased the risk of iatrogenic injury to the IPBSN compared with both oblique and horizontal incisions. LEVEL OF EVIDENCE Level I-III, meta-analysis of comparative studies.
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Affiliation(s)
- Alberto Grassi
- Sicily Department, Rizzoli Orthopaedic Institute, Bagheria, Palermo, Italy
- II Orthopaedic Clinic, Rizzoli Orthopadic Institute, University of Bologna, Via di Barbiano 1/10, 40136, Bologna, Italy
| | - Francesco Perdisa
- Sicily Department, Rizzoli Orthopaedic Institute, Bagheria, Palermo, Italy.
- II Orthopaedic Clinic, Rizzoli Orthopadic Institute, University of Bologna, Via di Barbiano 1/10, 40136, Bologna, Italy.
| | - Kristian Samuelsson
- Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Eleonor Svantesson
- Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Matteo Romagnoli
- Sicily Department, Rizzoli Orthopaedic Institute, Bagheria, Palermo, Italy
| | - Federico Raggi
- Sicily Department, Rizzoli Orthopaedic Institute, Bagheria, Palermo, Italy
| | - Teide Gaziano
- Sicily Department, Rizzoli Orthopaedic Institute, Bagheria, Palermo, Italy
| | - Massimiliano Mosca
- II Orthopaedic Clinic, Rizzoli Orthopadic Institute, University of Bologna, Via di Barbiano 1/10, 40136, Bologna, Italy
| | - Olufemi Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Stefano Zaffagnini
- Sicily Department, Rizzoli Orthopaedic Institute, Bagheria, Palermo, Italy
- II Orthopaedic Clinic, Rizzoli Orthopadic Institute, University of Bologna, Via di Barbiano 1/10, 40136, Bologna, Italy
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Romagnoli M, Grassi A, Costa GG, Lazaro LE, Lo Presti M, Zaffagnini S. The efficacy of dual-mobility cup in preventing dislocation after total hip arthroplasty: a systematic review and meta-analysis of comparative studies. Int Orthop 2018; 43:1071-1082. [PMID: 30032356 DOI: 10.1007/s00264-018-4062-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/12/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Although long-term reports of total hip arthroplasty (THA) showed successful results, instability remains a major complication. Recently, dual-mobility cups (DMC) have gained more and more interest among clinicians, with encouraging results in terms of lower rate of dislocation associated with good clinical results, but a lack of evidence exists regarding the real efficacy of this implant design compared to traditional fixed-bearing total hip arthroplasties. METHODS A systematic search was performed in PubMed, Google scholar, Cochrane Library, and EMBASE by two independent reviewers for comparative studies available till December 2017, with the primary objective to demonstrate a real lower dislocation rate of DMC implants compared to unipolar fixed-bearing cup designs. A meta-analysis was conducted with the collected pooled data about dislocation rate, calculating the risk difference (RD) and relative risk (RR) with 95% CI for dichotomous variables. Heterogeneity was tested using the χ2 and Higgins' I2 tests. A fixed-effect model was used because the statistical heterogeneity was below 50%. RESULTS After performing a critical exclusion process, the number of eligible studies included for final synthesis considered was 15, describing the results of a total of 2408 total hip arthroplasties (50.6% with a dual-mobility acetabular cup design, 49.4% with a standard fixed-bearing design). The fixed-effect meta-analysis showed a slight significant risk ratio of 0.16 (95% CI, 0.09, 0.28; I2 = 0%, p < 0.00001); a statistically significant difference in favor of the DMC group was maintained also considering only primary or revision arthroplasties, traumatic fractures or elective patients with diagnosis of osteoarthritis, avascular osteonecrosis or rheumatic arthritis. CONCLUSIONS With the intrinsic limitations of our study design and based on the current available data, this study demonstrates that dual-mobility acetabular components decrease the risk of post-operative instability also in high-risk patients, both in primary and revision hip arthroplasties. However, new high-quality studies, possibly with a randomized control design, should be undertaken in order to strengthen the present data. STUDY DESIGN Level of Evidence III, therapeutic study.
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Affiliation(s)
- Matteo Romagnoli
- II Orthopaedic Clinic and Biomechanics Laboratory, IRCSS Istituto Ortopedico Rizzoli, Via di Barbiano n. 1/10, 40136, Bologna, Italy
| | - Alberto Grassi
- II Orthopaedic Clinic and Biomechanics Laboratory, IRCSS Istituto Ortopedico Rizzoli, Via di Barbiano n. 1/10, 40136, Bologna, Italy
| | - Giuseppe Gianluca Costa
- II Orthopaedic Clinic and Biomechanics Laboratory, IRCSS Istituto Ortopedico Rizzoli, Via di Barbiano n. 1/10, 40136, Bologna, Italy.
| | - Lionel E Lazaro
- Hospital for Special Surgery and New York Presbyterian Hospital, 535 East 70th Street, New York, NY, 10021, USA
| | - Mirco Lo Presti
- II Orthopaedic Clinic and Biomechanics Laboratory, IRCSS Istituto Ortopedico Rizzoli, Via di Barbiano n. 1/10, 40136, Bologna, Italy
| | - Stefano Zaffagnini
- II Orthopaedic Clinic and Biomechanics Laboratory, IRCSS Istituto Ortopedico Rizzoli, Via di Barbiano n. 1/10, 40136, Bologna, Italy
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Giannini S, Cadossi M, Mazzotti A, Persiani V, Tedesco G, Romagnoli M, Faldini C. Bioabsorbable Calcaneo-Stop Implant for the Treatment of Flexible Flatfoot: A Retrospective Cohort Study at a Minimum Follow-Up of 4 Years. J Foot Ankle Surg 2018. [PMID: 28633776 DOI: 10.1053/j.jfas.2017.02.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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] [Indexed: 02/05/2023]
Abstract
Arthroereisis of the subtalar joint is a common surgical technique in Europe for the management of flexible flatfoot in the pediatric population. In most cases, it is performed using a calcaneo-stop metallic screw. Despite the good clinical results, screw removal is always advised after 2 to 3 years. The use of a bioabsorbable screw might overcome the need for a second operation to remove a nonabsorbable device. We report the results of a biodegradable calcaneo-stop screw at a minimum of 4 years of follow-up. Eighty-eight procedures were performed on 44 children. All patients were clinically and radiologically evaluated preoperatively and at a minimum 4-year follow-up period. Patient satisfaction and plantar collapse using Viladot's classification were recorded. Meary's talus-first metatarsal angle and talocalcaneal angle were measured on radiographs preoperatively and at the last follow-up visit. The presence of the device at the last follow-up examination was assessed by magnetic resonance imaging. The mean follow-up duration was 56 months. Of the 44 patients, 33 (75%) reported excellent clinical outcomes, 9 (20.5%) good outcomes, and 2 (4.5%) poor. Foot print improvement was registered for all patients. The mean Meary's talus-first metatarsal angle had improved from 160.6° ± 7.7° preoperatively to 170.6° ± 6.5° at the last follow-up visit (p < .001). The talocalcaneal angle had decreased from 39.9° ± 5.2° preoperatively to 29.4° ± 4° at the last follow-up examination (p < .001). At the 4-year follow-up point, the implant could be seen to have almost completely biodegraded on magnetic resonance imaging. Two screw breakages occurred. The bioabsorbable calcaneo-stop screw seems to be an effective solution for flexible flatfoot in pediatric patients. Also, owing to its biodegradable composition, the need of a second operation for implant removal will not always be necessary.
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Affiliation(s)
- Sandro Giannini
- Professor Emeritus, Istituto Ortopedico Rizzoli, Bologna University, Bologna, Italy
| | - Matteo Cadossi
- Orthopaedic Surgeon, II Clinic of Orthopaedic and Traumatology, Istituto Ortopedico Rizzoli, Bologna University, Bologna, Italy
| | - Antonio Mazzotti
- Medical Doctor, II Clinic of Orthopaedic and Traumatology, Istituto Ortopedico Rizzoli, Bologna University, Bologna, Italy.
| | - Valentina Persiani
- Orthopaedic Surgeon, II Clinic of Orthopaedic and Traumatology, Istituto Ortopedico Rizzoli, Bologna University, Bologna, Italy
| | - Giuseppe Tedesco
- Orthopaedic Surgeon, II Clinic of Orthopaedic and Traumatology, Istituto Ortopedico Rizzoli, Bologna University, Bologna, Italy
| | - Matteo Romagnoli
- Orthopaedic Surgeon, II Clinic of Orthopaedic and Traumatology, Istituto Ortopedico Rizzoli, Bologna University, Bologna, Italy
| | - Cesare Faldini
- Professor and Director, II Clinic of Orthopaedic and Traumatology, Istituto Ortopedico Rizzoli, Bologna University, Bologna, Italy
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Figus M, Carpineto P, Romagnoli M, Ferretti C, Di Antonio L, Nardi M. Optical Coherence Tomography Findings of Incomplete Posterior Vitreoschisis with Vitreomacular Traction Syndrome and Impending Macular Hole: A Case Report. Eur J Ophthalmol 2018; 18:147-9. [DOI: 10.1177/112067210801800127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose Vitreomacular traction syndrome is a clinical entity characterized by partial posterior vitreous detachment in combination with persistent macular adherence. Recently, optical coherence tomography (OCT) allowed visualization of incomplete posterior vitreoschisis leading to vitreomacular traction. Methods The authors report on a 57-year-old woman with blurred vision in her left eye. Results OCT scan showed incomplete posterior vitreoschisis with vitreomacular traction syndrome and impending macular hole in her left eye. Conclusions The intraoperative findings together with the evidence that the internal limiting membrane (ILM) thickness is thinner than the axial resolution of the Stratus OCT (8 μm) and a spontaneous ILM detachment has never been demonstrated are likely to support the hypothesis that posterior vitreoschisis exists and can be associated with vitreomacular traction syndrome.
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Affiliation(s)
- M. Figus
- Neurosciences Department, Ophthalmology, University of Pisa, University “G. D'Annunzio” Chieti-Pescara - Italy
| | - P. Carpineto
- Department of Medicine and Aging Sciences, Section of Ophthalmology, University “G. D'Annunzio” Chieti-Pescara - Italy
| | - M. Romagnoli
- Neurosciences Department, Ophthalmology, University of Pisa, University “G. D'Annunzio” Chieti-Pescara - Italy
| | - C. Ferretti
- Neurosciences Department, Ophthalmology, University of Pisa, University “G. D'Annunzio” Chieti-Pescara - Italy
| | - L. Di Antonio
- Department of Medicine and Aging Sciences, Section of Ophthalmology, University “G. D'Annunzio” Chieti-Pescara - Italy
| | - M. Nardi
- Neurosciences Department, Ophthalmology, University of Pisa, University “G. D'Annunzio” Chieti-Pescara - Italy
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Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, Raggi F, Romagnoli M, Bondi A, Calderone S, Signorelli C. The Anterolateral Ligament Does Exist. Clin Sports Med 2018; 37:9-19. [DOI: 10.1016/j.csm.2017.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Grassi A, Nitri M, Moulton SG, Marcheggiani Muccioli GM, Bondi A, Romagnoli M, Zaffagnini S. Does the type of graft affect the outcome of revision anterior cruciate ligament reconstruction? a meta-analysis of 32 studies. Bone Joint J 2017; 99-B:714-723. [PMID: 28566389 DOI: 10.1302/0301-620x.99b6.bjj-2016-0929.r2] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [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: 09/19/2016] [Accepted: 02/16/2017] [Indexed: 01/02/2023]
Abstract
AIMS Our aim was to perform a meta-analysis of the outcomes of revision anterior cruciate ligament (ACL) reconstruction, comparing the use of different types of graft. MATERIALS AND METHODS A search was performed of Medline and Pubmed using the terms "Anterior Cruciate Ligament" and "ACL" combined with "revision", "re-operation" and "failure". Only studies that reported the outcome at a minimum follow-up of two years were included. Two authors reviewed the papers, and outcomes were subdivided into autograft and allograft. Autograft was subdivided into hamstring (HS) and bone-patellar tendon-bone (BPTB). Subjective and objective outcome measures were analysed and odds ratios with confidence intervals were calculated. RESULTS A total of 32 studies met the inclusion criteria. Five studies used HS autografts, eight reported using BPTB autografts, two used quadriceps tendon autografts and eight used various types. Seven studies reported using allografts, while the two remaining used both BPTB autografts and allografts. Overall, 1192 patients with a mean age of 28.7 years (22.5 to 39) and a mean follow-up of 5.4 years (2.0 to 9.6) were treated with autografts, while 269 patients with a mean age of 28.4 years (25 to 34.6) and a mean follow-up of 4.0 years (2.3 to 6.0) were treated with allografts. Regarding allografts, irradiation with 2.5 mrad was used in two studies while the graft was not irradiated in the seven remaining studies. Reconstructions following the use of autografts had better outcomes than those using allograft with respect to laxity, measured by KT-1000/2000 (MEDmetric Corporation) and the rates of complications and re-operations. Those following the use of allografts had better mean Lysholm and Tegner activity scores compared with autografts. If irradiated allografts were excluded from the analysis, outcomes no longer differed between the use of autografts and allografts. Comparing the types of autograft, all outcomes were similar except for HS grafts which had better International Knee Documentation Committee scores compared with BPTB grafts. CONCLUSION Autografts had better outcomes than allografts in revision ACL reconstruction, with lower post-operative laxity and rates of complications and re-operations. However, after excluding irradiated allografts, outcomes were similar between autografts and allografts. Overall, the choice of graft at revision ACL reconstruction should be on an individual basis considering, for instance, the preferred technique of the surgeon, whether a combined reconstruction is required, the type of graft that was previously used, whether the tunnels are enlarged and the availability of allograft. Cite this article: Bone Joint J 2017;99-B:714-23.
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Affiliation(s)
- A Grassi
- Orthopedic Institute Rizzoli, 90011 Bologna, Italy
| | - M Nitri
- Orthopedic Institute Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy
| | - S G Moulton
- Oregon Health & Science University, 3181 SW, Sam Jackson Park Rd, Portland, Oregon, USA
| | | | - A Bondi
- Orthopedic Institute Rizzoli, 90011 Bologna, Italy
| | - M Romagnoli
- Orthopedic Institute Rizzoli, 90011 Bologna, Italy
| | - S Zaffagnini
- Orthopedic Institute Rizzoli, 90011 Bologna, Italy
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Sorianello V, Contestabile G, Midrio M, Pantouvaki M, Asselbergs I, Van Campenhout J, Huyghebaerts C, D'Errico A, Galli P, Romagnoli M. Chirp management in silicon-graphene electro absorption modulators. Opt Express 2017; 25:19371-19381. [PMID: 29041131 DOI: 10.1364/oe.25.019371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/19/2017] [Indexed: 06/07/2023]
Abstract
We study the frequency chirp properties of graphene-on-silicon electro-absorption modulators (EAMs). By experimentally measuring the chirp of a 100 µm long single layer graphene EAM, we show that the optoelectronic properties of graphene induce a large positive linear chirp on the optical signal generated by the modulator, giving rise to a maximum shift of the instantaneous frequency up to 1.8 GHz. We exploit this peculiar feature for chromatic-dispersion compensation in fiber optic transmission thanks to the pulse temporal lensing effect. In particular, we show dispersion compensation in a 10Gb/s transmission experiment on standard single mode fiber with temporal focusing distance (0-dB optical-signal-to-noise ratio penalty) of 60 km, and also demonstrate 100 km transmission with a bit error rate largely lower than the conventional Reed-Solomon forward error correction threshold of 10-3.
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Giannini S, Romagnoli M, Barbadoro P, Marcheggiani Muccioli GM, Cadossi M, Grassi A, Zaffagnini S. Results at a minimum follow-up of 5 years of a ligaments-compatible total ankle replacement design. Foot Ankle Surg 2017; 23:116-121. [PMID: 28578794 DOI: 10.1016/j.fas.2017.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 01/14/2017] [Revised: 03/19/2017] [Accepted: 03/21/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND A new design of 3-part ankle replacement was developed to achieve compatibility with the natural ligaments by allowing certain fibers to remain isometric during passive motion. METHODS We evaluate 75 ankle prostheses implanted from July 2003 to December 2008, at a mean follow-up 6.5±1.1years (range 5-9 years). The mean age at surgery was 62±13years (range 29-82). RESULTS The mean AOFAS scores achieved at pre-op and at last follow-up were respectively 37±5 (23-45) and 78±8 (64-98). (p<0.001). Clinical range of motion of the ankle measured by goniometer pre op was 1°±2 of dorsiflexion and 12°±4° of plantarflexion; at last follow-up range of motion increased to 6°±5° in dorsiflexion (p<0.01) and 18°±7° in plantarflexion (p<0.05). Radiographs showed no loosening and little signs of radiolucency. Two revisions necessitated component removal, neither for implant loosening. The overall survival rate was 97.3%. CONCLUSIONS Function and Range-of-motion showed significant improvements. These results demonstrate that ligaments-compatible shaped talar and tibial components, with a fully conforming interposed meniscal bearing, can provide satisfactory survival rates and clinical outcomes in the middle term.
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Affiliation(s)
- Sandro Giannini
- Department of Orthopaedic Surgery, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Matteo Romagnoli
- Department of Orthopaedic Surgery, Dipartimento Rizzoli Sicilia, Istituto Ortopedico Rizzoli, Bagheria, Italy.
| | - Paolo Barbadoro
- Department of Orthopaedic Surgery, Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Matteo Cadossi
- Department of Orthopaedic Surgery, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alberto Grassi
- Department of Orthopaedic Surgery, Dipartimento Rizzoli Sicilia, Istituto Ortopedico Rizzoli, Bagheria, Italy
| | - Stefano Zaffagnini
- Department of Orthopaedic Surgery, Dipartimento Rizzoli Sicilia, Istituto Ortopedico Rizzoli, Bagheria, Italy
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De Fine M, Romagnoli M, Toscano A, Bondi A, Nanni M, Zaffagnini S. Is there a role for femoral offset restoration during total hip arthroplasty? A systematic review. Orthop Traumatol Surg Res 2017; 103:349-355. [PMID: 28159679 DOI: 10.1016/j.otsr.2016.12.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 10/17/2016] [Revised: 12/16/2016] [Accepted: 12/29/2016] [Indexed: 02/02/2023]
Abstract
UNLABELLED Benefits of femoral offset restoration during total hip arthroplasty should be the reduction of bearing surfaces wear, implant loosening and dislocation rates. Modular neck stems ensure offset customization but fretting corrosion and catastrophic failures are well-documented complications. Since clinical evidences are needed to substantiate the effectiveness of femoral offset restoration and promote modular neck choice, we systematically reviewed the literature to ascertain whether femoral offset itself has a proven clinical influence: (1) on bearing surfaces wear, (2) implant loosening, (3) and dislocation rates. A systematic literature screening was conducted to find papers dealing with the influence of femoral offset on wear, dislocation and loosening, including articles with conventional radiographic femoral offset assessment and with comparative design. Observational studies, case reports, instructional course lectures, cadaveric and animal studies as well as biomechanical studies, letters to the editor, surgical techniques or technical notes were all excluded. No limits about publication date were supplied but only papers in English were taken into account. Data were extracted into an anonymous spreadsheet. Offset values, dislocation rates, wear rates, follow-up and surgical approaches were all detailed. Ten manuscripts were finally selected. A statistically significant correlation between femoral offset restoration and the reduction of conventional ultrahigh-molecular-weight polyethylene wear was found in two out of three papers investigating this issue, but no correlations were found between femoral offset and dislocation rates or implant loosening. Femoral offset modification influences ultrahigh-molecular-weight polyethylene liners wear, but no correlation was found with dislocation rates or implant loosening. Advantages on wear can be counterbalanced by the use of hard bearing surfaces or highly cross-linked polyethylene liners, besides the availability of larger femoral heads improving implant stability further reduces the importance of femoral offset restoration by means of modularity. We believe that efforts in restoring femoral offset during total hip arthroplasty do not translate into tangible clinical profits and consequently, we do not advise the routinely usage of modular neck stems in total hip arthroplasty. LEVEL OF EVIDENCE level III, systematic review of case-control studies.
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Affiliation(s)
- M De Fine
- General Orthopaedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, SS 113, km 246, 90011, Bagheria (PA), Italy.
| | - M Romagnoli
- General Orthopaedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, SS 113, km 246, 90011, Bagheria (PA), Italy
| | - A Toscano
- General Orthopaedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, SS 113, km 246, 90011, Bagheria (PA), Italy
| | - A Bondi
- General Orthopaedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, SS 113, km 246, 90011, Bagheria (PA), Italy
| | - M Nanni
- General Orthopaedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, SS 113, km 246, 90011, Bagheria (PA), Italy
| | - S Zaffagnini
- General Orthopaedic Surgery, Rizzoli-Sicilia Department, Rizzoli Orthopaedic Institute, SS 113, km 246, 90011, Bagheria (PA), Italy
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Sambri A, Pignatti G, Romagnoli M, Donati D, Marcacci M, Cadossi M. Intraoperative diagnosis of Staphylococcus aureus and coagulase-negative Staphylococcus using Xpert MRSA/SA SSTI assay in prosthetic joint infection. New Microbiol 2017; 40:130-134. [PMID: 28255603] [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] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 05/15/2017] [Indexed: 06/06/2023]
Abstract
The aim of this prospective study was to evaluate the performance of the Polymerase Chain Reaction (PCR) tool Xpert MRSA/SA SSTI test (Cepheid, Sunnyvale, CA, USA) on periprosthetic samples from a cohort of patients with suspected prosthetic joint infection (PJI). Seventy adult patients were included in this prospective study. On the basis of the preoperative evaluation, 39 patients were clinically considered to have a PJI, whereas 31 were presumed to suffer from an aseptic mobilization of the implant. Xpert MRSA/SA SSTI identified 4 out of 4 MRSA, 7 out of 7 MSSA, and 14 out of 16 methicillin resistant CoNS. Among the 31 patients not having a PJI, the rapid PCR did not find any bacteria among those identifiable, thus demonstrating an excellent performance in terms of specificity. Statistical analysis of the analytical performance showed a high correlation (p<0.001) between the result of Xpert MRSA/SA SSTI and culture. Xpert MRSA/SA SSTI assay is a novel, yet well known, rapid and accurate method for the identification of different species of staphylococci. The test can be used with peri-operative samples thus dramatically improving the diagnostic sensitivity. In addition, thanks to the very short turnaround time the use of Xpert assay can modify the clinical management of patients suffering from PJI during the ongoing operative procedure.
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Sorianello V, De Angelis G, Cassese T, Midrio M, Romagnoli M, Moshin M, Otto M, Neumaier D, Asselberghs I, Van Campenhout J, Huyghebaert C. Complex effective index in graphene-silicon waveguides. Opt Express 2016; 24:29984-29993. [PMID: 28059383 DOI: 10.1364/oe.24.029984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We report for the first time and characterize experimentally the complex optical conductivity of graphene on silicon photonic waveguides. This permits us to predict accurately the behavior of photonic integrated devices encompassing graphene layers. Exploiting a Si microring add/drop resonator, we show the effect of electrical gating of graphene on the complex effective index of the waveguide by measuring both the wavelength shift of the resonance and the change in the drop peak transmission. Due to electro-refractive effect of graphene a giant (>10-3) change in the effective index is demonstrated for the first time on Si photonics waveguides and this large effect will crucially impact performances and consumption of Si photonics devices. We confirmed the results by two independent experiments involving two different gating schemes: Si gating through the ridge waveguide, and polymer-electrolyte gating. Both the experiments demonstrate a very large phase effect in good agreement with numerical calculations. The reported results validate the Kubo model for the case of graphene-Si photonics interfaces and for propagation in this type of waveguide. This is fundamental for the next design and fabrication of future graphene-silicon photonics devices.
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Velha P, Sorianello V, Preite MV, De Angelis G, Cassese T, Bianchi A, Testa F, Romagnoli M. Wide-band polarization controller for Si photonic integrated circuits. Opt Lett 2016; 41:5656-5659. [PMID: 27973482 DOI: 10.1364/ol.41.005656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A circuit for the management of any arbitrary polarization state of light is demonstrated on an integrated silicon (Si) photonics platform. This circuit allows us to adapt any polarization into the standard fundamental TE mode of a Si waveguide and, conversely, to control the polarization and set it to any arbitrary polarization state. In addition, the integrated thermal tuning allows kilohertz speed which can be used to perform a polarization scrambler. The circuit was used in a WDM link and successfully used to adapt four channels into a standard Si photonic integrated circuit.
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Abstract
Among the nonpharmacological therapies, pulmonary rehabilitation (PR) is particularly appropriate for patients with chronic respiratory impairment who, despite any optimal drug management, are still symptomatic and experience restriction in every day activities. Pulmonary rehabilitation performed in inpatient, outpatient, or home settings demonstrates short–and long–term clinical efficacy. Although disease severity does not inherently dictate candidacy for exercise training, the degree of physiological and functional impairment may influence setting in which the training should occur. Therefore, inpatient rehabilitation is generally best–suited for the most sick and most disabled patients. The overall results from the literature confirm that the inpatient setting for a PR program is a feasible option and does not necessarily result in higher direct costs when balanced against duration and effectiveness in terms of improved outcomes.
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Affiliation(s)
- E M Clini
- Fondazione Villa Pineta and University of Modena-Reggio Emilia, Department of Pulmonary Rehabilitation, Pavullo, Italy.
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Sorianello V, De Angelis G, De Iacovo A, Colace L, Faralli S, Romagnoli M. High responsivity SiGe heterojunction phototransistor on silicon photonics platform. Opt Express 2015; 23:28163-28169. [PMID: 26561087 DOI: 10.1364/oe.23.028163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report on a novel near infrared SiGe phototransistor fabricated by a standard silicon photonics foundry. The device is first investigated by simulations. The fabricated devices are characterized in terms of current-voltage characteristics at different optical power. Typical phototransistors exhibit 1.55µm record responsivity at low optical power exceeding 232A/W and 42A/W at 5V and 1V bias, respectively. A differential detection scheme is also proposed for the dark current cancellation to significantly increase the device sensitivity.
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Alis R, Ibañez-Sania S, Basterra J, Sanchis-Gomar F, Romagnoli M. Effects of an acute high-intensity interval training protocol on plasma viscosity. J Sports Med Phys Fitness 2015; 55:647-653. [PMID: 24921613] [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: 06/03/2023]
Abstract
AIM High-intensity interval training (HIT) is an exercise model that has been seen to cause similar muscle adaptations and improvements in exercise performance to other traditional exercise models. This study aimed to examine the effects of low-volume HIT exercise on plasma viscosity (PV). METHODS Ten healthy male subjects (25.80±3.39 years) randomly performed a HIT running protocol (2-min warm up at 8 km/h, 5x2-min bouts at 90% maximal heart rate, separated by 2-min at 8 km/h, finished with another 2-min period at 8 km/h) or an aerobic (AER) running exercise (60'at 55% VO2max). Blood samples were drawn before and after exercise, and after 30-minute recovery. PV, hematocrit (Hct), fibrinogen, total proteins, triglycerides, total-cholesterol and glucose levels were analyzed. Plasma volume loss during exercise was calculated. RESULTS PV rose after HIT (P<0.05) while Hct rose after both protocols. Plasma volume loss was higher after HIT (-6.35±3.47%) than after AER (-3.11±2.49%) (P=0.045). Total-proteins (P<0.001), triglycerides (P=0.013), total-cholesterol (P<0.001) and glucose (P=0.001) concentrations increased after HIT. After AER no statistically significant differences were found in plasma constituents concentrations. CONCLUSION A low-volume HIT session causes a sufficient loss in plasma volume that leads to significantly incremented plasma constituents' concentrations and, therefore, a mild transient rise in PV.
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Affiliation(s)
- R Alis
- Universitary Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain -
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Pestalozza G, Romagnoli M, Tessitore E. Incidence and risk factors of acute otitis media and otitis media with effusion in children of different age groups. Adv Otorhinolaryngol 2015; 40:47-56. [PMID: 3291570 DOI: 10.1159/000415672] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- G Pestalozza
- Divisione di Otorinolaringoiatria, Ospedale dei Bambini V. Buzzi, Milano, Italia
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Manera V, Petit PD, Derreumaux A, Orvieto I, Romagnoli M, Lyttle G, David R, Robert PH. 'Kitchen and cooking,' a serious game for mild cognitive impairment and Alzheimer's disease: a pilot study. Front Aging Neurosci 2015; 7:24. [PMID: 25852542 PMCID: PMC4362400 DOI: 10.3389/fnagi.2015.00024] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 02/22/2015] [Indexed: 01/25/2023] Open
Abstract
Recently there has been a growing interest in employing serious games (SGs) for the assessment and rehabilitation of elderly people with mild cognitive impairment (MCI), Alzheimer’s disease (AD), and related disorders. In the present study we examined the acceptability of ‘Kitchen and cooking’ – a SG developed in the context of the EU project VERVE (http://www.verveconsortium.eu/) – in these populations. In this game a cooking plot is employed to assess and stimulate executive functions (such as planning abilities) and praxis. The game is installed on a tablet, to be flexibly employed at home and in nursing homes. Twenty one elderly participants (9 MCI and 12 AD, including 14 outpatients and 7 patients living in nursing homes, as well as 11 apathetic and 10 non-apathetic) took part in a 1-month trail, including a clinical and neuropsychological assessment, and 4-week training where the participants were free to play as long as they wanted on a personal tablet. During the training, participants met once a week with a clinician in order to fill in self-report questionnaires assessing their overall game experience (including acceptability, motivation, and perceived emotions). The results of the self reports and of the data concerning game performance (e.g., time spent playing, number of errors, etc) confirm the overall acceptability of Kitchen and cooking for both patients with MCI and patients with AD and related disorders, and the utility to employ it for training purposes. Interestingly, the results confirm that the game is adapted also to apathetic patients.
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Affiliation(s)
- Valeria Manera
- EA CoBTeK/IA (Cognition Behavior Technology), Institut Claude Pompidou, University of Nice Sophia Antipolis, Nice France
| | - Pierre-David Petit
- EA CoBTeK/IA (Cognition Behavior Technology), Institut Claude Pompidou, University of Nice Sophia Antipolis, Nice France
| | - Alexandre Derreumaux
- EA CoBTeK/IA (Cognition Behavior Technology), Institut Claude Pompidou, University of Nice Sophia Antipolis, Nice France
| | | | | | | | - Renaud David
- EA CoBTeK/IA (Cognition Behavior Technology), Institut Claude Pompidou, University of Nice Sophia Antipolis, Nice France ; Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer - Centre Méemoire de Ressources et de Recherche - Institut Claude Pompidou - CHU de Nice, Nice France
| | - Philippe H Robert
- EA CoBTeK/IA (Cognition Behavior Technology), Institut Claude Pompidou, University of Nice Sophia Antipolis, Nice France ; Centre Edmond et Lily Safra pour la Recherche sur la Maladie d'Alzheimer - Centre Méemoire de Ressources et de Recherche - Institut Claude Pompidou - CHU de Nice, Nice France
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Alis R, Sanchis-Gomar F, Primo-Carrau C, Lozano-Calve S, Dipalo M, Aloe R, Blesa JR, Romagnoli M, Lippi G. Hemoconcentration induced by exercise: Revisiting the Dill and Costill equation. Scand J Med Sci Sports 2014; 25:e630-7. [PMID: 25557039 DOI: 10.1111/sms.12393] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2014] [Indexed: 11/30/2022]
Abstract
The Dill and Costill equation is used to estimate the exercise-induced hemoconcentration. However, this calculation requires drawing an extra whole-blood sample, which cannot be frozen and has to be analyzed with dedicate instrumentation in a relative short time. The aim of the present study was to explore the usefulness of some serum biochemical parameters to estimate hemoconcentration induced by exhaustive exercise. Fourteen healthy male subjects (19-34 years) performed a15-min running test at 110% of anaerobic threshold speed. Hemoglobin, hematocrit, brain natriuretic peptide (BNP), creatinine, gamma-glutamyltransferase (GGT), total-proteins, albumin, total calcium (Ca), K(+), Na(+), and Cl(-) were determined in blood samples taken before, after exercise, and after a 30-min recovery period. Plasma volume loss (ΔPV) was calculated by Dill and Costill equation. At post-exercise and after recovery, the percentage increments of total-proteins, albumin, GGT and Ca correlated significantly with ΔPV. Bland-Altman analyses showed that correcting BNP, creatinine, and K(+) concentration by Ca percentage increments yield biases and limits of agreement that are acceptable when compared with Dill and Costill equation correction. Ca concentration may be used as a hemoconcentration biomarker in high-intensity exercise, which would allow scientists and physicians avoid extra costs, facilitate in-field research, and delayed estimation of hemoconcentration using stored serum samples.
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Affiliation(s)
- R Alis
- Research Institute "Dr. Viña Giner," Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.,School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - F Sanchis-Gomar
- Research Institute "Dr. Viña Giner," Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.,Department of Physiology, University of Valencia, Valencia, Spain.,Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - C Primo-Carrau
- Research Institute "Dr. Viña Giner," Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - S Lozano-Calve
- Research Institute "Dr. Viña Giner," Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - M Dipalo
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
| | - R Aloe
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
| | - J R Blesa
- Research Institute "Dr. Viña Giner," Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.,School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - M Romagnoli
- Research Institute "Dr. Viña Giner," Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.,Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - G Lippi
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
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Conti V, Grazia M, Romagnoli M, Poletti G, Cristino S, Ciliberti G, Piciucchi S, Mosconi G, Poletti V. Lung injury associated with mTOR inhibitors (sirolimus and everolimus). MINERVA UROL NEFROL 2014; 66:283-285. [PMID: 25531195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- V Conti
- Department of Medical Sciences, Research Centre on Asthma and COPD, University of Ferrara, Ferrara, Italy -
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Alis R, Sanchis-Gomar F, Ferioli D, La Torre A, Blesa JR, Romagnoli M. Exercise effects on erythrocyte deformability in exercise-induced arterial hypoxemia. Int J Sports Med 2014; 36:286-91. [PMID: 25429547 DOI: 10.1055/s-0034-1394395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Exercise-induced arterial hypoxemia (EIAH) is often found in endurance-trained subjects at high exercise intensity. The role of erythrocyte deformability (ED) in EIAH has been scarcely explored. We aimed to explore the role of erythrocyte properties and lactate accumulation in the response of ED in EIAH. ED was determined in 10 sedentary and in 16 trained subjects, both before and after a maximal incremental test, and after recovery, along with mean corpuscular volume (MCV) and red blood cell lactate concentrations. EIAH was found in 6 trained subjects (∆SaO2=-8.25±4.03%). Sedentary and non-EIAH trained subjects showed reduced ED after exercise, while no effect on ED was found in EIAH trained subjects. After exercise, lactate concentrations rose and MCV increased equally in all groups. ED is strongly driven by cell volume, but the different ED response to exercise in EIAH shows that other cellular mechanisms may be implicated. Interactions between membrane and cytoskeleton, which have been found to be O2-regulated, play a role in ED. The drop in SaO2 in EIAH subjects can improve ED response to exercise. This can be an adaptive mechanism that enhances muscular and pulmonary perfusion, and allows the achievement of high exercise intensity in EIAH despite lower O2 arterial transport.
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Affiliation(s)
- R Alis
- Research Universitary Institute Dr. Viña Giner, Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - F Sanchis-Gomar
- Research Universitary Institute Dr. Viña Giner, Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - D Ferioli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - A La Torre
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - J R Blesa
- Research Universitary Institute Dr. Viña Giner, Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - M Romagnoli
- Research Universitary Institute Dr. Viña Giner, Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
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Parisi E, Genestreti G, Romeo A, Romagnoli M, Burgio M, Ghigi G, Arpa D, Sarnelli A, Tesei A, Polico R. Accelerated Hypofractionated Radiation Therapy Plus Chemotherapy for Inoperable Locally Advanced Lung Cancer: Final Results of Long-Term Follow-up. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.616] [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: 10/24/2022]
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Abstract
The discovery of irisin as a novel and promising peptidic hormone for the treatment of obesity and diabetes has recently been reported. As a result, great hopes have been raised based on this finding, hypothesizing that irisin might provide additional benefits, not only for obesity and diabetes, but also for a wide range of pathological conditions requiring therapeutical and clinical attention. However, controversial results and conclusions on circulating irisin concentrations and correlations with other variables, including its role in metabolism, have recently been reported. Although laboratory assessment of irisin by ELISA is easily available and may provide interesting information for therapeutics and clinical practice, the heterogeneous and often discrepant results published so far, raise serious concerns about its measurement, indicating that it may still not be ready for use or whether irisin really exists. We highlight here some aspects on these discrepancies and contradictions, and put forward their implications.
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Affiliation(s)
- F Sanchis-Gomar
- Department of Physiology, Faculty of Medicine, University of Valencia, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - R Alis
- University Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - H Pareja-Galeano
- Department of Physiology, Faculty of Medicine, University of Valencia, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - M Romagnoli
- University Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - C Perez-Quilis
- Department of Physiology, Faculty of Medicine, University of Valencia, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
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Ting A, Lehman N, Cardenes N, Kocyildirim E, Romagnoli M, Mroz L, Carceres E, Tedrow J, Bermudez C, Rojas M. The use of human bone marrow stem cells reduces endotoxin-induced lung injury in sheep. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.306] [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: 11/29/2022]
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Schieffer K, Tan K, Stamper P, Somogyi A, Andrea S, Wakefield T, Romagnoli M, Chapin K, Wolk D, Carroll K. Multicenter evaluation of the Sepsityper™ extraction kit and MALDI-TOF MS for direct identification of positive blood culture isolates using the BD BACTEC™ FX and VersaTREK®
diagnostic blood culture systems. J Appl Microbiol 2014; 116:934-41. [DOI: 10.1111/jam.12434] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/17/2013] [Accepted: 12/31/2013] [Indexed: 12/22/2022]
Affiliation(s)
| | - K.E. Tan
- Johns Hopkins University; Baltimore MD USA
| | | | | | | | | | | | - K.C. Chapin
- Rhode Island Hospital; Providence RI USA
- Brown University; Providence RI USA
| | - D.M. Wolk
- University of Arizona; Tucson AZ USA
- Geisinger Health System; Danville PA USA
| | - K.C. Carroll
- The Johns Hopkins Hospital; Baltimore MD USA
- Johns Hopkins University; Baltimore MD USA
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Stella GM, Romagnoli M, Balestro E. Idiopathic pulmonary fibrosis clustering based on cilium gene expression: profiling a new paradigm. Minerva Med 2014; 105:9-15. [PMID: 24619019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Idiopathic pulmonary fibrosis (IPF), the commonest form of the interstitial lung diseases identifies a specific form of chronic, progressive fibrosing interstitial pneumonia, occurring primarily in older adults, and limited to the lungs. IPF represents an unsolved health problem with an urgent medical need due to lack of effective therapies. Although precise IPF etiology remains elusive, during the past decade there has been a shift away from the pathogenetic theory of generalized inflammation progressing to a paradigm of disordered fibroproliferation and alveolar epithelial cell function. A better understanding of the molecular mechanisms driving IPF fibroblasts proliferation is mandatory to provide insights into the pathogenesis, and to identify highly reproducible biomarkers for disease onset and progression. In this review we aim to discuss and analyze the findings recently published by Yang et al. on Thorax, which reported a strong molecular signature as-sociated with the expression of cilium genes that divides IPF/ usual interstitial pneumonia into two subtypes, one with increased cilium gene expression and one with low expression of cilium genes. The study presents a number of methodology limitations, mainly related to samples characterization and to a general overstatement of the conclusions from class clustering analysis. Nevertheless, the study clearly demonstrates ‑ for the first time ‑ that the cilium apparatus is activated in microscopic honeycombing. In such setting, cilia are likely to act as signaling "machine" which cooperates in promoting proliferative and regenerative cellular processes. Although preliminary, these results sustain a rationale to develop further investigations to confirm the impact of cilium gene expression in IPF with the final perspective of therapeutic intervention.
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Affiliation(s)
- G M Stella
- Laboratory of Biochemistry and Genetics, Pulmonology Unit, Department of Molecular Medicine, University and Fondazione IRCCS, Policlinico San Matteo di Pavia, Pavia, Italy -
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Abstract
Total hip resurfacing has long been conceptually attractive to both surgeons and patients. However, historically it has been plagued by limited durability and marked acetabular bone loss. The recent development of wear-resistant bearings, such as metal-on-metal, has led to renewed interest in hip resurfacing in the orthopedic community. Several resurfacing implants have been designed and positive results, particularly in young patients, have been reported. Although comparative studies of hip resurfacing and standard total hip replacement are still lacking, we believe that there is now evidence to demonstrate that this surgical concept deserves consideration, particularly when treating young patients with hip diseases.
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Affiliation(s)
- Antonio Moroni
- Bologna University, Rizzoli Orthopaedic Institute, Bologna, Istituti Ortopedici Rizzoli, Via G C Pupilli 1, 40136 Bologna, Italy.
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Parisi E, Romeo A, Ghigi G, Burgio M, Neri E, Taurchini M, Romagnoli M, Sarnelli A, Arienti C, Polico R. Tomotherapy in the Treatment of Malignant Pleural Mesothelioma. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1390] [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: 11/30/2022]
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Tomassetti S, Ruy JH, Gurioli C, Ravaglia C, Buccioli M, Tantalocco P, Decker PA, Cavazza A, Dubini A, Agnoletti V, Gurioli C, Casoni GL, Romagnoli M, Poletti V. The effect of anticoagulant therapy for idiopathic pulmonary fibrosis in real life practice. Sarcoidosis Vasc Diffuse Lung Dis 2013; 30:121-127. [PMID: 24071883] [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] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND IPF is a common form of interstitial lung disease for which there is no effective therapy and usually results in death. Two previous contradictory studies showed anticoagulant therapy to be associated with both improved and worsened survival, respectively. OBJECTIVE The objective of this retrospective cohort study was to evaluate the effect of anticoagulant therapy on the survival and disease progression of patients with idiopathic pulmonary fibrosis (IPF) in real clinical practice. METHODS We compared the clinical characteristics, time to disease progression, incidence of acute exacerbation, and survival of 25 (20%) IPF patients receiving anticoagulant therapy to the remaining 97 IPF patients not receiving anticoagulant therapy. In addition we conducted a sensitivity analysis using as comparator a group of 25 patients matched by age, sex, functional impairment, cardiac comorbidities and pulmonary hypertension. RESULTS Patients on anticoagulant therapy had a worse 1- and 3-year survival (84% and 53% versus 89% and 64% in the non-anticoagulant group, respectively), a difference that persisted after adjusting for age and comorbidities (hazard ratio 3.1 - 95% confidence interval, 1.4 to 7.0; p=0.006) and after comparison with the matched group (adjusted HR=4.8, 95% CI: 1.8-12.8; p=0.002). IPF patients on anticoagulant therapy had a shorter interval to disease progression ( 0.7 years versus 1.6 years, adjusted HR 2.2 -95% CI, 0.96 to 5.1; p=0.063) confirmed also in the analysis with matched subgroups (HR=2.7 (95% CI: 1.2-6.5); p=0.023). The incidence of acute exacerbations did not differ in the two groups (22% versus 23%). Two patients (8%) experienced anticoagulant treatment related complications and included an episode of hemorrhagic shock. CONCLUSION In this retrospective study patients treated with anticoagulants had a worse survival and a shorter interval to disease progression. This support the recent finding that warfarin worsen the respiratory status and survival of IPF patients.
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Cenni F, Leardini A, Pieri M, Berti L, Belvedere C, Romagnoli M, Giannini S. Functional performance of a total ankle replacement: thorough assessment by combining gait and fluoroscopic analyses. Clin Biomech (Bristol, Avon) 2013. [PMID: 23177657 DOI: 10.1016/j.clinbiomech.2012.10.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND A thorough assessment of patients after total ankle replacement during activity of daily living can provide complete evidence of restored function in the overall lower limbs and replaced ankle. This study analyzes how far a possible restoration of physiological mobility in the replaced ankle can also improve the function of the whole locomotor apparatus. METHODS Twenty patients implanted with an original three-part ankle prosthesis were analyzed 12 months after surgery during stair climbing and descending. Standard gait analysis and motion tracking of the components by three-dimensional fluoroscopic analysis were performed on the same day using an established protocol and technique, respectively. FINDINGS Nearly physiological ankle kinematic, kinetic and electromyography patterns were observed in the contralateral side in both motor activities, whereas these patterns were observed only during stair climbing in the operated side. Particularly, the mean ranges of flexion at the replaced ankle were 13° and 17° during stair climbing and descending, respectively. Corresponding 2.1 and 3.1mm antero/posterior meniscal-to-tibial translations were correlated with flexion between the two metal components (p<0.05). In addition, a larger tibiotalar flexion revealed by fluoroscopic analysis resulted in a physiological hip and knee moment. INTERPRETATION The local and global functional performances of these patients were satisfactory, especially during stair climbing. These might be associated to the recovery of physiological kinematics at the replaced ankle, as also shown by the consistent antero/posterior motion of the meniscal bearing, according to the original concepts of this ankle replacement design.
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Affiliation(s)
- F Cenni
- Movement Analysis Laboratory, Istituto Ortopedico Rizzoli, Bologna, Italy.
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47
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Ravaglia C, Gurioli C, Romagnoli M, Casoni G, Tomassetti S, Gurioli C, Poletti V. Sarcoidosis and autoimmune thyroid disease. Pneumologie 2012. [DOI: 10.1055/s-0032-1329835] [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: 10/27/2022]
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48
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Ravaglia C, Gurioli C, Romagnoli M, Casoni G, Tomassetti S, Gurioli C, Poletti V. Sarcoidosis is a frequent benign cause of lymphadenopathy in neoplastic patients. Pneumologie 2012. [DOI: 10.1055/s-0032-1329836] [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: 10/27/2022]
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49
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Cenni F, Pieri M, Berti L, Belvedere C, Romagnoli M, Giannini S, Leardini A. FUNCTIONAL PERFORMANCE OF REPLACED ANKLES BY COMBINING GAIT AND FLUOROSCOPIC ANALYSES. J Biomech 2012. [DOI: 10.1016/s0021-9290(12)70201-4] [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: 11/30/2022]
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50
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Boccaccini D, Maioli M, Cannio M, Dlouhy I, Romagnoli M, Leonelli C, Boccaccini A. A lifetime prediction method based on Cumulative Flaw Length Theory. Ann Ital Chir 2012. [DOI: 10.1016/j.jeurceramsoc.2011.11.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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