RESUMO
We employ spherical t-designs for the systematic construction of solids whose rotational degrees of freedom can be made robust to decoherence due to external fluctuating fields while simultaneously retaining their sensitivity to signals of interest. Specifically, the ratio of signal phase accumulation rate from a nearby source to the decoherence rate caused by fluctuating fields from more distant sources can be incremented to any desired level by using increasingly complex shapes. This allows for the generation of long-lived macroscopic quantum superpositions of rotational degrees of freedom and the robust generation of entanglement between two or more such solids with applications in robust quantum sensing and precision metrology as well as quantum registers.
RESUMO
Bone metastases are the most common tumours affecting the musculoskeletal system. The most frequently affected area of the skeleton is the spine. The vertebral bodies are reached largely via the bloodstream and neoplastic substitution of the bone tissue causes progressive structural destruction leading to loss of stability and compression of the intracanal nerve structures. The treatment of bone metastases in the spine is different and controversial, mostly because of the wide spectrum of clinical and radiographic pattern of the local and systemic disease. Percutaneous vertebroplasty is emerging as one of the most promising new interventional procedures for relieving (or reducing) pain and improve stability. In this article we review indications, contraindications, technique, and complications of percutaneous vertebroplasty in spine metastases.
Assuntos
Dor nas Costas/etiologia , Cimentos Ósseos/uso terapêutico , Procedimentos Ortopédicos/métodos , Polimetil Metacrilato/uso terapêutico , Neoplasias da Coluna Vertebral/cirurgia , Coluna Vertebral/cirurgia , Adulto , Dor nas Costas/diagnóstico por imagem , Dor nas Costas/cirurgia , Cimentos Ósseos/efeitos adversos , Árvores de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/efeitos adversos , Polimetil Metacrilato/efeitos adversos , Guias de Prática Clínica como Assunto , Radiografia , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/secundário , Coluna Vertebral/diagnóstico por imagem , Resultado do TratamentoRESUMO
Patients with Crohn's disease (CD) are at higher risk of hepatitis C (HCV) and B virus (HBV) infection, because of surgical and/or endoscopic procedures. However, the prevalence of HCV and HBV infection in CD is unknown. This issue may be relevant because of the growing use of immunomodulatory drugs in CD. The purpose of this study was to assess, in a multicenter study, the prevalence and risk factors of HCV and HBV infection in CD. The effect of immunomodulatory drugs for CD on the clinical course of hepatitis virus infections and of interferon-alpha (IFN-alpha) on the course of CD was examined in a small number of patients. Sera from 332 patients with CD and 374 control subjects (C) were tested for the following: hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), HBcAb, HBeAg, HBeAb, anti-HCV, and HCV-RNA. An additional 162 patients with ulcerative colitis (UC) were tested as a disease control group. Risk factors were assessed by multivariate statistical analysis. Infection by either HCV or HBV was detected in 24.7% of patients with CD. In the age groups younger than 50 years, HCV prevalence was higher in CD than in C (p = 0.01). HCV infection in CD was associated with surgery (OR 1.71; 95% CI 1.00-2.93; p = 0.04), blood transfusions (OR 3.39; 95% CI 1.04-11.04; p = 0.04), and age (OR 2.3; 95% CI 1.61-3.56; p < 0.001). The event CD-related surgery appeared to be the main risk factor for HCV infection in CD. HCV prevalence was higher in CD (7.4%) than in UC (0.6%) (p = 0.001). HBcAb positivity was higher in CD (10.9%) and UC (11.5%) than in C (5.1%) (CD vs. C: p = 0.016; UC vs. C: p = 0.02), associated with age (OR 2.08; 95% CI 1.37-3.17; p = 0.001) and female gender (OR 2.68; 95% CI 1.37-3.17; p = 0.001) in CD and to UC duration (OR 1.20; 95% CI 1.06-1.36; p = 0.002). Immunomodulatory drugs did not influence the course of HBV or HCV infection in seven patients with CD, and IFN-alpha for chronic hepatitis C did not affect CD activity in six patients with CD. It is concluded that HBV prevalence is higher in CD than in C at all ages, whereas HCV prevalence is increased in young patients with CD, because of a greater need for surgery. The higher HCV (but not HBV) prevalence in CD than in UC suggests that the host immune response may influence the risk of HCV infection. Although a relatively high proportion of patients with CD showed HBV and/or HCV infections, this should not influence treatment strategies for CD.
Assuntos
Doença de Crohn/epidemiologia , Doença de Crohn/virologia , Hepacivirus/imunologia , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Colite Ulcerativa/virologia , Doença de Crohn/complicações , Doença de Crohn/tratamento farmacológico , Feminino , Antígenos de Hepatite/sangue , Hepatite B/complicações , Hepatite C/complicações , Humanos , Imunossupressores/uso terapêutico , Interferon-alfa/uso terapêutico , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , RNA Viral/sangue , Fatores de RiscoRESUMO
Between September 1996 and April 1998 a total of 26 open fractures of the tibia (Gustilo Anderson grade I in 4 cases, grade II in 3, grade IIIA in 8, grade IIIB in 11) were treated by debridement and monoaxial external fixation followed by locked intramedullary nailing after healing of the soft tissues had been observed. Nailing by reamed Grosse Kempf nail was carried out in all of the cases. The mean duration of external fixation was 50 days (with a minimum of 18 days and a maximum of 6 months). Upon removal of the external fixator intramedullary osteosynthesis was performed during the same surgical session in 25 cases. Nailing was carried out 45 days after removal of the external fixator in 1 case. Healing was obtained in all of the patients an average of 6 months after trauma, and 3 and 1/2 months after the second operation. There were two cases of infection, one deep (3.8%) and the other superficial (3.8%). No cases of chronic osteomyelitis were ever observed. Poor consolidation with valgus equal to 10 degrees and 15 degrees was observed in 2 patients. This method of treatment, based on our experience, allows for healing in some open fractures of the tibia in a relatively short amount of time and with an acceptable risk of complications.
Assuntos
Fixadores Externos , Fixação Intramedular de Fraturas , Fraturas Expostas/cirurgia , Fraturas da Tíbia/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Consolidação da Fratura , Fraturas Expostas/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Reoperação , Fraturas da Tíbia/diagnóstico por imagem , Fatores de TempoRESUMO
Based on anatomo-pathological findings in fractures in bones affected with Paget's disease, the authors discuss problems related to treatment. One case is reported in which treatment involved intramedullary osteosynthesis with locked nailing and corrective osteotomy. This type of treatment achieved a dual purpose of obtaining fracture consolidation within a short amount of time, and correcting the deformity.
Assuntos
Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas , Osteíte Deformante/complicações , Pinos Ortopédicos , Parafusos Ósseos , Fraturas do Fêmur/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The authors report the results obtained in a review of all of the young patients who have been found to be affected with vertebral deformity in an epidemiological study conducted during the academic years 1983-84 and 1984-85. There is predilection for the female sex, which is also more vulnerable to the risk of progression. Menarchal age constitutes the most important period for the progression of the deformity. The most frequent type of curve observed is the double primary one, in particular, right thoracic and left lumbar, which proved to be that most vulnerable to angular progression. The cases which in a previous screening had been defined risk cases were followed-up, and thanks to early diagnosis and suitable treatment surgery was not required in any of these.
Assuntos
Escoliose/epidemiologia , Adolescente , Feminino , Seguimentos , Humanos , Itália/epidemiologia , Masculino , Programas de Rastreamento , Escoliose/terapia , Fatores SexuaisAssuntos
Doenças Ósseas , Equinococose , Ílio , Adolescente , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/cirurgia , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Feminino , Seguimentos , Humanos , Ílio/diagnóstico por imagem , Ílio/cirurgia , Radiografia , Fatores de TempoAssuntos
Lesões no Cotovelo , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Luxações Articulares/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Fraturas Ósseas/complicações , Fraturas Ósseas/fisiopatologia , Humanos , Luxações Articulares/complicações , Luxações Articulares/fisiopatologia , Masculino , Pessoa de Meia-Idade , MovimentoAssuntos
Hallux/anormalidades , Adolescente , Criança , Pré-Escolar , Feminino , Hallux/diagnóstico por imagem , Hallux/cirurgia , Humanos , Lactente , Masculino , RadiografiaAssuntos
Articulação do Tornozelo/cirurgia , Artrodese/métodos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Paralisia Cerebral/complicações , Pé Equino/cirurgia , Tendões/cirurgia , Criança , Pré-Escolar , Pé Equino/etiologia , Feminino , Humanos , Masculino , MétodosRESUMO
Sixty-seven patients selectively chosen from 354 undergoing conventional transabdominal (TA) sonography for evaluation of a clinically suspected adnexal mass subsequently underwent transvaginal (TV) sonography either because the TA sonograms were technically suboptimal or because it was not possible to characterize with certainty an abnormality identified with TA sonography. TV sonography added diagnostically useful information in 25 of 28 patients with cystic pathologic changes in the adnexa uteri. Eight of 12 patients with tuboovarian abscess and nonspecific adnexal masses visualized with TA sonography had tube-shaped fluid collections characteristic of pyosalpinx identified with TV sonography. TV sonography added diagnostically useful information in all seven patients with diseases of the cul-de-sac (rectouterine fossa) and allowed differentiation of adnexal from primary uterine disease in three patients with TA sonograms on which findings were equivocal. It also expedited the diagnosis of a tubal pregnancy in ten of 14 patients and was useful in the detection of adhesions and perforated intrauterine devices. These results indicate that adjunctive TV sonography can provide important diagnostic information.
Assuntos
Doenças dos Anexos/diagnóstico , Ultrassonografia/métodos , Adolescente , Adulto , Idoso , Diagnóstico Diferencial , Doenças das Tubas Uterinas/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Ovarianas/diagnóstico , Gravidez , Gravidez Tubária/diagnóstico , Doenças Uterinas/diagnósticoRESUMO
Arthroplasty can be a successful treatment for arthritis even in cases of severe axial deviation of the knee. Since significant bone loss is often present in these cases, the technique and extent of the resection is very important. In this paper we review our series and compare it with solutions proposed by other authors, focusing our attention on the techniques of resection and replacement of lost bone employed in order to achieve optimal axial alignment and anchoring of the prosthetic components.