"A conservative technique for fractured implant abutment screw retrieval on an internal connection implant: proof of concept (PoC)".

INTRODUCTION: Broken screw removal from the implant connection is a common but challenging process. Several proposed methods and technical solutions may result in unsuccessful removal; thus, a novel, more conservative, risk-free method is proposed as a first attempt. DESCRIPTION OF THE CASE: The proposal is to use a silicon restoration holder to be twisted counterclockwise on the dried surface of the broken fragment inside the implant connection. This method, within the limitations of a minimal case series, yielded 100% results; however, despite previous attempts with less con- servative techniques, this approach showed no efficacy. CONCLUSION: This article aims to promote the use of silicon restoration holders as a minimally invasive first attempt at broken screw retrieval treatment before considering other options.

Onychocryptosis: a retrospective study of clinical aspects, inflammation treatment and pain management using Ozoile as a hydrogel and cream formulation.

Ingrown toenails account for roughly 20% of all foot problems in primary care. It is most common in young men, with nail care habits and footwear being major contributors. Onychocryptosis is typically caused by self-treatment attempts to cure the condition in its early stages. Its clinical features are frequently confused with other osseous and soft tissue abnormalities. The goal of this study was to provide perspectives on the management of pain and inflammation in Onychocryptosis using an Ozoile-based hydrogel formulation in a semi-occlusive bandage for 14 days, while incorporating natural pharmacological solutions into established protocols. The primary outcomes measured were pain reduction on NRS and stadiation according to the Al Kline Classification. The reduction was statistically significant, with a mean decrease in VAS score from 10 to 4 (p < 0.05), and Al Kline classification decreased by an average of 1.6 stages. 42% of patients recovered within the first 15 days of treatment, and 93% by the end of the scheduled treatment.

Acute effects of prismatic adaptation on penalty kick accuracy and postural control in young soccer players: A pilot study.

Background: Prismatic adaptation (PA) is a visuomotor technique using prismatic glasses that are capable of moving the visual field and to affect the excitability of certain brain areas. The aim of this pilot study was to explore potential acute effects of PA on penalty kick accuracy and postural control in youth soccer players. Methods: In this randomized crossover study, seven young male soccer players performed three PA sessions (rightward PA, r-PA; leftward PA, l-PA; sham PA, s-PA) with a washout period of 1-week between them. Immediately before and after each PA session, penalty kick accuracy and postural control were assessed. Results: We detected an increase in penalty kick accuracy following PA, regardless of the deviation side of the prismatic glasses (F1,5 = 52.15; p = 0.08; ηp2 = 0.981). In detail, our results showed an increase in the penalty kick accuracy toward the right target of the football goal following r-PA and toward the left target of the football goal following l-PA. We detected a significant effect on the sway path length (F2,12 = 10.42; p = 0.002; ηp2 = 0.635) and the sway average speed (F2,12 = 9.17; p = 0.004; ηp2 = 0.605) parameters in the stabilometric test with open eyes following PA, regardless of the deviation side of the prismatic glasses. In detail, our results showed a significant difference in both the stabilometric parameters (p = 0.016 and p = 0.009, respectively) only following l-PA. Conclusion: The findings of this pilot study indicate that PA could positively affect penalty kick accuracy and postural control suggesting that PA could be used as a visual training technique in athletes.

Impact of genotype on multi-organ iron and complications in patients with non-transfusion-dependent ß-thalassemia intermedia.

We evaluated the impact of the genotype on clinical and hematochemical features, hepatic and cardiac iron levels, and endocrine, hepatic, and cardiovascular complications in non-transfusion-dependent (NTD) ß-thalassemia intermedia (TI) patients. Sixty patients (39.09 ± 11.11 years, 29 females) consecutively enrolled in the Myocardial Iron Overload in Thalassemia project underwent Magnetic Resonance Imaging to quantify iron overload, biventricular function parameters, and atrial areas and to detect replacement myocardial fibrosis. Three groups of patients were identified: homozygous ß+ (N = 18), heterozygous ß0ß+ (N = 22), and homozygous ß0 (N = 20). The groups were homogeneous for sex, age, splenectomy, hematochemical parameters, chelation therapy, and iron levels. The homozygous ß° genotype was associated with significantly higher biventricular end-diastolic and end-systolic volume indexes and bi-atrial area indexes. No difference was detected in biventricular ejection fractions or myocardial fibrosis. Extramedullary hematopoiesis and leg ulcers were significantly more frequent in the homozygous ß° group compared to the homozygous ß+ group. No association was detected between genotype and liver cirrhosis, hypogonadism, hypothyroidism, osteoporosis, heart failure, arrhythmias, and pulmonary hypertension. Heart remodelling related to a high cardiac output state cardiomyopathy, extramedullary hematopoiesis, and leg ulcers were more pronounced in patients with the homozygous ß° genotype compared to the other genotypes analyzed. The knowledge of the genotype can assist in the clinical management of NTD ß-TI patients.

Liver steatosis in patients with transfusion-dependent thalassaemia.

We evaluated the prevalence and the clinical associations of liver steatosis (LS) in patients with transfusion-dependent thalassaemia (TDT). We considered 301 TDT patients (177 females, median age = 40.61 years) enrolled in the Extension-Myocardial Iron Overload in Thalassaemia Network, and 25 healthy subjects. Magnetic resonance imaging was used to quantify iron overload and hepatic fat fraction (FF) by T2* technique and cardiac function by cine images. The glucose metabolism was assessed by the oral glucose tolerance test (OGTT). Hepatic FF was significantly higher in TDT patients than in healthy subjects (median value: 1.48% vs. 0.55%; p = 0.013). In TDT, hepatic FF was not associated with age, gender, serum ferritin levels or liver function parameters, but showed a weak inverse correlation with high-density lipoprotein cholesterol. The 36.4% of TDT patients showed LS (FF >3.7%). Active hepatitis C virus (HCV) infection, increased body mass index and hepatic iron were independent determinants of LS. A hepatic FF >3.53% predicted the presence of an abnormal OGTT. Hepatic FF was not correlated with cardiac iron, biventricular volumes or ejection fractions, but was correlated with left ventricular mass index. In TDT, LS is a frequent finding, associated with iron overload, increased weight and HCV, and conveying an increased risk for the alterations of glucose metabolism.

Examining the association between speed and myoelectric activity: Time-based differences and muscle group balance.

The purpose of this study is to investigate the relationship between speed and myoelectric activity, measured during an incremental 25m shuttle running test, exploring the time-based variations and assessing muscle group balance within the context of this association. Twelve male young soccer players (n = 12) aged 18±1.2 years, with an average body mass of 68.4±5.8kg and average body height of 1.72±0.08m, from a professional Italian youth team (Italian "Primavera"), volunteered as participants for this study. The speed of each player during testing was measured using GPS technology, sampling at 50Hz. Myoelectrical activities of the gluteus, hamstrings, and quadriceps muscles were recorded through wearable sEMG devices, sampled at 100Hz. To ensure alignment of the sampling frequencies, the sEMG data was resampled to 50Hz, matching the GPS data sampling rate. This allowed for direct comparison and analysis of the data obtained from both measurement systems. The collected data were then analyzed to determine the relationship between the investigated variables and any potential differences associated with different sides of the body. The results revealed a robust correlation (r2≈0.97) between the speed of the participants (m·s-1) and their myoelectrical activity (µV) during the test. Factorial ANOVA 2x11 showed no significant differences between the sides of the analyzed muscles (p>0.05). The interpolation lines generated by the association of speed and sEMG exhibit very similar angular coefficients (0.9 to 0.12) in all six measurements obtained from electromyography of the three investigated muscle groups on each side of the body. In conclusion, the concurrent validity between the two instruments in this study indicates that GPS and sEMG are valid and consistent in estimating external load and internal load during incremental shuttle running.

State of art of mobility medicine: some more abstracts and evidence that the success of Pdm3 is based on extra-session relationships.

Scientific conferences increasingly suffer from the need for short presentations in which speakers like to dwell on the details of their work. A mitigating factor is to encourage discussion and planning of collaborations by organizing small meetings in a hotel large enough to host all attendees. This extends discussions' opportunities during morning breakfasts, lunches, dinners and long evenings together. Even if the vast majority of participants will not stay for the entire duration of the Conference, the possibilities for specialists to interact with specialists who are even very distant in terms of knowledge increase enormously. In any case, the results in terms of new job opportunities for young participants outweigh the costs for the organizers. Thirty years of Padova Muscle Days offer many examples, but the authors of this report on the state of the art of Mobility Medicine testify that this also happened in the 2024 Five Days of Muscle and Mobility Medicine (2024Pdm3) hosted at the Hotel Petrarca, Thermae of Euganea Hills and Padua, Italy which is in fact a valid countermeasure to the inevitable tendencies towards hyperspecialization that the explosive increase in scientific progress brings with it.

Telecoaching as a new training method for elderly people: a systematic review.

BACKGROUND: The numerous restrictive measures implemented during the recent COVID-19 pandemic have reduced the levels of physical activity (PA) carried out by elderly people and telecoaching (TC) could be a training method to maintain the recommended levels of PA. In fact, TC uses information and digital communications technologies, such as computers and mobile devices, to access training services remotely. Thus, this study aimed to systematically review the scientific literature to verify the application, efficacy, and safety of TC training programs. METHODS: PubMed, Scopus, and Web of Sciences databases were used for this review, and randomized controlled trials analyzing TC training programs for elderly people were included. Only articles written in English and published in the last decade were considered. RESULTS: 3 articles were included in the qualitative synthesis including 194 elderly people. The sample size ranged from 12 to 117 and the TC training program from 8 to 12 weeks. The TC training programs were applied to elderly people with metabolic diseases and respiratory diseases. TC training program was effective in elderly people with metabolic diseases while the benefits for respiratory diseases have yet to be clarified. CONCLUSION: TC seems to be a safe, effective, and injury-free training method, despite its limited application in elderly population. Future studies should better investigate this training method in elderly people in order to evaluate the effectiveness in a wider range of diseases.

Effects of Proprioceptive Insoles and Specific Core Training on Postural Stability for Preventing Injuries in Tennis.

Tennis is a complex sport based on unpredictability that requires adequate physical and psychological preparation to prevent injuries. The aim of this study was to investigate the effects of 8-week specific core stability training on postural stability in competitive adolescent tennis players, aged between 14 and 19 years old. Sixty-one participants were randomly allocated into two groups: experimental (n = 32) and control (n = 29) groups. The first group wore proprioceptive insoles 8 h a day and performed a detailed training 3 times a week for 8 weeks; the second group only received proprioceptive insoles to wear 8 h a day for 8 weeks. The postural stability parameters (center-of-pressure length, center-of-pressure velocity, and 95% confidence ellipse sway area) included three assessment times: baseline (T0), intermediate test (T1), post-test (T2), and retention test (T3). Data analysis showed a significant improvement in the experimental group compared with the control group, indicating a large effect size in center-of-pressure length, ellipse sway area, and center-of-pressure velocity at T2 and T3 (p < 0.05). In conclusion, our results suggest that a specific and detailed core stability training plays a significant role in improving balance and postural stability in young tennis players, especially in terms of preventing the risk of injury.

The Optimal Targeting for Focused Ultrasound Thalamotomy Differs between Dystonic and Essential Tremor: A 12-Month Prospective Pilot Study.

BACKGROUND: Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy is increasingly used to treat drug-resistant essential tremor (ET). Data on MRgFUS thalamotomy in dystonic tremor (DT) are anecdotal. OBJECTIVES: To investigate efficacy, safety, and differences in target coordinates of MRgFUS thalamotomy in DT versus ET. METHODS: Ten patients with DT and 35 with ET who consecutively underwent MRgFUS thalamotomy were followed for 12 months. Although in both groups the initial surgical planning coordinates corresponded to the ventralis intermediate (Vim), the final target could be modified intraoperatively based on clinical response. RESULTS: Tremor significantly improved in both groups. The thalamic lesion was significantly more anterior in DT than ET. Considering both ET and DT groups, the more anterior the lesion, the lower the odds ratio for adverse events. CONCLUSIONS: MRgFUS thalamotomy is safe and effective in DT and ET. Compared to classical Vim coordinates used for ET, more anterior targeting should be considered for DT.

Platelets-rich-plasma in management of non operative post cruciate ligament injury.

Posterior cruciate ligament (PCL) injury is a rare ligamentous knee injury which most commonly occurs due to direct trauma; it represents only 0.65% of knee injuries. On the basis of magnetic resonance imaging (MRI), PCL injury is divided into surgical and non-surgical. In the last few years we have witnessed an increasing interest in regenerative medicine. The use of innovative techniques allow the reduction of rehabilitation times in sports injuries. Platelet-Rich-Plasma (PRP) is a plasma-derived which stimulate the tissue repair. The objective of our work is to compare the rehabilitation times in PCL non-operative injuries treated with standard conservative treatment and PCL injuries treated with autologous PRP followed by rehabilitation program. We divided patients into two different groups: Group A formed by patients who underwent a standard conservative rehabilitation program and Group B which included patients treated by ultrasound guided PRP injection and following physiotherapy program. Both groups of patients resumed sports activities; however the rehabilitation times for patients which had undergone treatment with autologous PRP injection were reduced compared to patients who underwent a standard conservative treatment.

Effects of the New COVID-19-Induced Rule on Substitutions and Performance in Italian Elite Soccer.

COVID-19 has resulted in widespread changes, including within the realm of sports. Professional soccer has adapted by allowing more substitutions, leading to tactical adjustments and potential physical benefits. Accordingly, this study analyzed the impact of the new rule in Italian top-level soccer, focusing on substitution patterns and performance differences between the pre-COVID (2017-2018, 2018-2019 seasons) and post COVID (2020-2021, 2021-2022 seasons) eras. As such, publicly available data from 1520 matches (760 matches per era) were recorded. The sample included matches played from 40 Italian top division teams in both the pre- and post-COVID eras. Analyses confirmed substitutions follow a consistent temporal pattern throughout the match in both eras, highlighting a slight difference in second-half management, and showed the new rule is still not used to its full potential, thus raising concerns about teams' financial strength, as not all managers possess "deep benches" (i.e., a large number of top-level players available to play). Further analyses revealed a statistically significant increment (p = 0.002) in the quantity of collectively produced sprints in the post-COVID era compared to the pre-COVID one. The results from this study emphasize the need to carefully address sprint preparation and repeated sprint abilities, also considering factors such as the number of substitutes and their skill level.

Effects of Cycling on Spine: A Case-Control Study Using a 3D Scanning Method.

BACKGROUND: Few studies have investigated the effects of adopting a specific and prolonged posture on cyclists. This study aimed to evaluate the upright spine in a sample of recreational cyclists and compare it with a sample of non-cyclists, though still athletes, through a 3D scanning method. METHODS: Forty-eight participants were enrolled in this observational study. The sample consisted of 25 cyclists for the cycling group and 23 non-cyclist athletes for the control group. The Spine3D device (Sensor Medica, Guidonia Montecelio, Rome, Italy) was used to evaluate the spine of the participants in both groups. RESULTS: The results showed significantly greater spine inclination in the cycling group compared to the control group (p < 0.01). Furthermore, there was a significant decrease in lumbar lordosis in the cycling group compared to the control group (p < 0.01). CONCLUSIONS: This case-control study raises the possibility that the onset of lower back pain in cyclists may be due to a reduction in lumbar lordosis. Furthermore, this study demonstrated that the Spine3D device can be used in sports to monitor the spine of athletes to prevent and reduce musculoskeletal deficits.

Risk factors and prevention of choking.

Choking (or foreign body airway obstruction) is a widespread phenomenon with serious consequences of morbidity and mortality. Choking (often also called suffocation) can be caused by food or inedible objects and leads to various degrees of asphyxiation or lack of oxygen in the blood stream. The incidence is very high in both young children and adults, especially seniors. However, since not all choking episodes end up in the emergency room or become fatalities, they often escape statistics. Although episodes of choking from non-edible bodies are infrequent, they affect mostly young children. Three of the most common risks for choking in general are neurological disorders, dysphagia and dental issues (few or no teeth, unstable or unsuitable prosthesis or orthodontic appliances).  The purpose of this study was to evaluate the risk factors of choking and ways to reduce/avoid this event. We reported data on a series of 138 patients admitted to the emergency department following a choking event, at a hospital in Rome, Italy. The age group of the analyzed population ranged from 1 to 88 years, with the most represented age group of these between 40 and 59, with a similar distribution between males and females. The types of foods on which people choked reflected the seasonal, traditional and local foods: 67% of patients reported choking on fish bones followed by meat bones (9%)  and artichokes (3%). Three relevant non-food choking elements reported were: orthodontic items, toothpicks and pins (one occurrence each). We also reported on two clinical cases of patients choking on meat and a chicken bone. In conclusion, choking awareness and prevention are essential for implementing potential life-saving precautions. Prevention is the first tool to reduce the occurrence of this event, therefore it is necessary to analyze the risk factors and educate the population to eliminate them. Proper chewing and oral manipulation are paramount functions in preventing choking, along with meal-time supervision if little children and elderly. Then, it behooves the healthcare professionals to disseminate knowledge.

Experimental study on physical exercise in diabetes: pathophysiology and therapeutic effects.

Diabetes is a chronic disease. Some complications can be prevented, their effects can be slowed down.  Sedentary lifestyle increases the risk of obesity and consequently the predisposition to diabetes II. The article aimed to demonstrate the positive and negative effects of exercise on active and sedentary diabetics and on pathophysiology, evaluating the effects after 3 and 6 months. The study involved 90 participants, both male and female, with type II diabetes, aged 45, divided into two groups: Group A (n=50, sedentary) and Group B (n=40, active). We evaluated anthropometric parameters, blood chemistry values, which are fundamental for the transversal evaluation of the results. In group A improvements were less noticeable than group B. The most improved parameter is blood sugar, Glycemic values and BMI. Cholesterol and Hb1Ac decreased but more slowly than previous parameters. The expectations of the study were, not only in recognizing the therapeutic and preventive powers of exercise, but above all in choosing to program a motor protocol after a team work between diabetologist, sports doctor and kinesiologist and/ or personal trainer. Physical activity is an additional therapy to insulin.

Impact of the COVID-19 Pandemic on Iron Overload Assessment by MRI in Patients with Hemoglobinopathies: The E-MIOT Network Experience.

BACKGROUND: The E-MIOT (Extension-Myocardial Iron Overload in Thalassemia) project is an Italian Network assuring high-quality quantification of tissue iron overload by magnetic resonance imaging (MRI). We evaluated the impact of the COVID-19 pandemic on E-MIOT services. METHODS: The activity of the E-MIOT Network MRI centers in the year 2020 was compared with that of 2019. A survey evaluated whether the availability of MRI slots for patients with hemoglobinopathies was reduced and why. RESULTS: The total number of MRI scans was 656 in 2019 and 350 in 2020, with an overall decline of 46.4% (first MRI: 71.7%, follow-up MRI: 36.9%), a marked decline (86.9%) in the period March-June 2020, and a reduction in the gap between the two years in the period July-September. A new drop (41.4%) was recorded in the period October-December for two centers, due to the general reduction in the total amount of MRIs/day for sanitization procedures. In some centers, patients refused MRI scans for fear of getting COVID. Drops in the MRI services >80% were found for patients coming from a region without an active MRI site. CONCLUSIONS: The COVID-19 pandemic had a strong negative impact on MRI multi-organ iron quantification, with a worsening in the management of patients with hemoglobinopathies.

Pancreatic T2* Magnetic Resonance Imaging for Prediction of Cardiac Arrhythmias in Transfusion-Dependent Thalassemia.

We assessed the value of pancreatic T2* magnetic resonance imaging (MRI) for predicting cardiac events from a large prospective database of transfusion-dependent thalassemia (TDT) patients. We considered 813 TDT patients (36.47 ± 10.71 years, 54.6% females) enrolled in the Extension-Myocardial Iron Overload in Thalassemia Network. MRI was used to measure hepatic, pancreatic, and cardiac iron overload (IO), to assess biventricular function and atrial dimensions, and to detect replacement myocardial fibrosis. The mean follow-up was 50.51 ± 19.75 months. Cardiac complications were recorded in 21 (2.6%) patients: one with heart failure (HF) and 20 with arrhythmias. The single patient who developed HF had, at the baseline MRI, a reduced pancreas T2*. Out of the 20 recorded arrhythmias, 17 were supraventricular. Pancreatic T2* values were a significant predictor of future arrhythmia-related events (hazard ratio = 0.89; p = 0.015). Pancreas T2* remained significantly associated with future arrhythmias after adjusting for any other univariate predictor (age and male sex, diabetes, history of previous arrhythmias, or left atrial area index). According to the receiver-operating characteristic curve analysis for arrhythmias, a pancreas T2* < 6.73 ms was the optimal cut-off value. In TDT, pancreatic iron levels had significant prognostic power for arrhythmias. Regular monitoring and the development of targeted interventions to manage pancreatic IO may help improve patient outcomes.

The impact of HCV chronic positivity and clearance on extrahepatic morbidity in thalassemia major patients: an observational study from MIOT Network.

BACKGROUND: No study has evaluated the effect of hepatitis C virus (HCV) infection on the wide spectrum of complications affecting patients with thalassemia. OBJECTIVES: This multicenter study prospectively assessed the relationship of HCV infection with diabetes mellitus and cardiovascular complications in patients with thalassemia major (TM). METHODS: We considered 1057 TM patients (539 females; 29.79±10.08 years) enrolled in the MIOT Network and categorized into 4 groups: negative patients (group 1a, N=460), patients who spontaneously cleared the virus within 6months (group 1b, N=242), patients who eradicated the virus after the treatment with antiviral therapy (group 2, N=102), and patients with chronic HCV infection (group 3, N=254). RESULTS: Group 1a and 1b were considered as a unique group (group 1). For both groups 1 and 3, a match 1:1 for age and sex with group 2 was performed. The effective study cohort consisted of 306 patients (three groups of 102 patients). During a mean follow-up of 67.93±39.20months, the group 3 experienced a significantly higher % increase/month in aspartate transaminase levels and left ventricular mass index than both groups 1 and 2. The changes in iron overload indexes were comparable among the three groups. Compared to group 1, the chronic HCV group showed a significantly higher risk of diabetes (hazard ratio-HR=5.33; p=0.043) and of cardiovascular diseases (HR=3.80; p=0.034). CONCLUSION: Chronic HCV infection is associated with a significant higher risk of diabetes mellitus and cardiovascular complications in TM patients and should be approached as a systemic disease in which extrahepatic complications increase the weight of its pathological burden.

Evaluation of Posturographic and Neuromuscular Parameters during Upright Stance and Hand Standing: A Pilot Study.

Upright bipedal posture is the physiological human posture; however, it is not the only possible form of human standing; indeed, an inverted position, a handstand, is required during gymnastics or other sports. Thus, this study aimed to understand the differences between the two standing strategies from a postural and neuromuscular perspective. Thirteen gymnasts with at least three years of sports experience underwent a baropodometric assessment and a surface electromyography (sEMG) examination in a standard upright bipodalic stance and during a handstand. The sEMG examination was performed on the gastrocnemius during an upright stance and on the flexor carpi radialis during the handstand. Limb weight distribution presented differences between the two vertical stances (p < 0.01). During the handstand, the weight ratio was prevalently observed on the palm of the hand for both hands with a significant difference between the front and rear aspect of the hand compared to the standing tasks (p < 0.01). Normalized sEMG amplitude showed significant differences during bipedal standing and hand standing; however, over a 5 s period, the normalized median frequency (MDF) value was similar for the two tasks. Both standing tasks presented similar postural weight managing patterns when analysed on the frontal plane, but they were different on the sagittal plane. In addition, the neuromuscular patterns during a 5 s window differ in amplitude but not for the frequency domain.