Short-term clinical and radiological comparisons between two Medial Pivot Total Knee Arthroplasty implants with different geometries.

BACKGROUND AND AIM: Different total knee arthroplasty (TKA) implants were created for the treatment of severe symptomatic gonarthrosis and Medial Pivot TKA (MP TKA) seem to reproduce the normal kinematics of the knee. We compare two different prosthetic designs of MP TKA in order to identify whether there is a difference between the two in terms of degree of patient satisfaction.  Methods: A total of 89 patients were analyzed. A group of 46 patients who benefited from a TKA with the Evolution® prosthesis and one of 43 patients who received a TKA with the Persona® prosthesis. KSS, OKS, FJS and the ROM were analyzed at follow up. RESULTS: The values of KSS and OKS were similar between the two groups (p>0,05). Our statistical analysis revealed a statistically significant increase (p <0.05) in ROM in the Persona® group and in FJS in the Evolution® group. No radiolucent lines were observed in both groups at the radiological final follow-up.  Conclusions: MP TKA models analysed are a valuable tool to achieve satisfactory clinical outcomes. This study demonstrates that the FJS is an important score for the evaluation of patient's satisfaction: a ROM's limitation can be accepted by the patient in exchange for a more natural perceived knee.

The treatment of irreparable massive rotator cuff tears with inspace balloon: rational and medium-term results.

BACKGROUND AND AIM: The treatment of irreparable massive rotator cuff tears (MIRCTs) represents a challenge for the orthopedic surgeon both for the affected population and for the intrinsic characteristics of the injury. There are different types of treatment ranging from bursectomy to reverse shoulder prosthesis and subacromial spacers. The aim of the work is to establish the clinical and functional improvement of patients treated with subacromial spacer. METHODS: we conducted 2 studies: the first analyzing a sample of 24 patients (14 females and 10 male, mean age 65.7 years) operated between 2015 and 2017 whose last follow up dates back to October 2021 and a second one analyzing 55 patients (including patients of the first sample) (30 females and 25 males, mean age 64 years) over a period of time from 2015 to 2021. The mean follow up was 56 months. All patients were diagnosed with irreparable massive rotator cuff  tears and treated with subacromial spacer. RESULTS: the result in both studies was an increase of Constant score, tripled from the pre-operative values, in ROM, doubled, and a reduction of VAS. CONCLUSIONS: the clinical results are encouraging and the use of the subacromial spacer could be a valid surgical alternative for patients with MIRCTs.  However, we needed randomized trials with long-term follow-up.

The impact of regional co-payment and national reimbursement criteria on statins use in Italy: an interrupted time-series analysis.

BACKGROUND: Statins are among the most commonly prescribed drugs worldwide in the prevention of cardiovascular diseases and their effectiveness is largely acknowledged. The consumption of statins increased four-fold during the 2000-2010 decade in Italy and national and regional control policies were developed. Restrictions to reimbursement were fixed at the national level, whereas co-payment was introduced in some, but not all, regions. The aim of the present study is to assess the impact of such policies on the consumption of statins in Italy between 2001-2007 among outpatients. METHODS: The statin use was measured in terms of defined daily doses per 1,000 inhabitants per day (DDD/1000 inh. day) from May 2001 to December 2007. The study was conducted in 17 out of 21 regions, nine of which had implemented a co-payment policy. Time trends in consumption before and after the introduction of co-payment policies and reimbursement criteria were examined using segmented regression analysis of interrupted time-series, adjusting for seasonal components. RESULTS: The consumption of statins increased by 22.9 DDD/1000 inh. day in May 2001 to 54.7 DDD/1000 inh. day in December 2007. On average, there was a 1.7% increase in statin use each month before the national guideline changed while the increase was about 0.5% afterwards. The revision of the reimbursement criteria was associated with a significant decrease in level (coefficient = -2.80, 95% CI -3.70 to -1.90 p-value <0.001) and trend (coefficient = -0.33, 95% CI -0.37 to -0.29 p-value <0.001). The introduction of co-payment was associated with a significant change in trend of consumption so that the overall use of the drug increased by 0.04 (95% CI 0.02 to 0.07, p-value < 0.001) DDD/1000 inh. day per month in the post-intervention period, but there was no evidence of a change in level of consumption (p-value = 0.163). CONCLUSIONS: Consumption of statins in Italy increased almost three-fold during the study period. The restriction to reimbursement Interventions was associated with an immediate drop and a decrease in trend of statin use, while the regional copayment was associated with a small increase in trend of statin use.

Impact of regional copayment policy on selective serotonin reuptake inhibitor (SSRI) consumption and expenditure in Italy.

PURPOSE: The continuous growth of antidepressant consumption and expenditure, especially for selective serotonin reuptake inhibitors (SSRIs), has led to the adoption of several policy measures directed toward cost control in Western countries. In Italy, copayment policies have been heterogeneously introduced at a regional level as part of a strategy designed to reduce drug consumption. The aim of our study was to evaluate whether regional copayment policies have affected trends in the consumption of and expenditure for SSRIs from 2001 to 2007. METHODS: The consumption of SSRIs was measured in terms of defined daily doses per 1,000 inhabitants (DDD/1000) per day from May 2001 to December 2007. Time trends in consumption and expenditure before and after the introduction of copayment policies were examined using segmented regression analysis of interrupted time-series, adjusting for seasonal components. The study was conducted for 17 regions, nine of which had implemented a copayment policy. RESULTS: The overall consumption of SSRIs in Italy increased during the study period, from a monthly consumption of 12.85 DDD/1000 per day in May 2001 to 23.40 DDD/1000 per day in December 2007. The average monthly increase in SSRI use was 0.82 % in regions with a copayment policy versus 0.77 % in regions without a copayment policy (P = 0.329). According to the multivariable analysis, copayment was associated with a 1 % reduction in the monthly growth rate of SSRI consumption (P = 0.01). The impact of copayment on expenditure was statistically significant (P < 0.005) on both the level and the trend, even though the estimate of the effect was negligible. CONCLUSIONS: The implementation of copayment policies in Italy affected both the use and expenditure of SSRIs between 2001 and 2007 to only to a minor extent.

Patterns of Long Term Care in 29 European countries: evidence from an exploratory study.

BACKGROUND: The challenges posed by the rapidly ageing population, and the increased preponderance of disabled people in this group, coupled with the rising level of public expenditure required to service the complex organization of long term care (LTC) delivery are causing increased pressure on LTC systems in Europe. A pan-European survey was carried out to evaluate whether patterns of LTC can be identified across Europe and what are the trends of the countries along them. METHODS: An ecological study was conducted on the 27 EU Member States plus Norway and Iceland, referring to the period 2003-2007. Several variables related to organizational features, elderly needs and expenditure were drawn from OECD Health Data and the Eurostat Statistics database and combined using Multiple Factor Analysis (MFA). RESULTS: Two global Principal Components were taken into consideration given that their expressed total variance was greater than 60%. They were interpreted according to the higher (more than 0.5) positive or negative correlation coefficients between them and the original variables; thus patterns of LTC were identified. High alignment between old age related expenditure and elderly needs characterizes Nordic and Western European countries, the former also having a higher level of formal care than the latter. Mediterranean as well as Central and South Eastern European countries show lower alignment between old age related expenditure and elderly needs, coupled with a level of provision of formal care that is around or slightly above the average European level. In the dynamic comparison, linear, stable or unclear trends were shown for the studied countries. CONCLUSIONS: The analysis carried out is an explorative and descriptive study, which is an attempt to reveal patterns and trends of LTC in Europe, allowing comparisons between countries. It also stimulates further researches with lower aggregated data useful to gain meaningful policy-making evidence.Please see related article: http://www.biomedcentral.com/1741-7015/9/124.

Cricotirotomia y traqueotomia recurso de urgencia ante una obstrucción respiratoria alta / Tracheotomy and cricotracheotomy recourse of the urgency front hight respiratory obstrucction

Every patient with upper airway obstruction needs tobe thoroughly evalueated. The possible origins can be broken down to many classifications and the new modalitis in treatmet is done. The key to succesful therapy of airway obstruction is always to understand the airway anatomy and the cause of airway obstruction

Prevención de la recurrencia del herpes labial con el uso de antisolares en una base emoliente / Preventive incidence of labialis herpes used suscreen in emolient base

El Virus del Herpes Simple causa enfermedades que van desde infecciones clínicamente invisibles y vesículas en los labios, hasta encefalitis mortal. Dado que la infección por el virus es seguida por el desarrollo de anticuerpos, es posible diferenciar una infección primaria de una recurrente. Existen profesionales con alto riesgo de contagiarse por esta enfermedad viral, como son los Odontólogos, Enfermeras, Médicos y Esteticistas. Se han propuesto numerosas alternativas que tratan de mejorar la lesión clínicamente instalada, pero hasta el presente no se ha encontrado un producto capaz de prevenir la recurrencia clínica de esta afección, cuya aparición varía desde cada mes en algunos pacientes hasta una vez al año, e incluso menos en otros. Puede considerarse que la exposición a las radiaciones del Ultravioleta B constituye un potente agente desencadenante y estimulante del Herpes Simple recurrente. Esto motivó el estudio de un grupo de 100 pacientes con Herpes recurrente, a los cuales se les aplicó en los labios una formulación que contenía filtros antisolares y activos biológicos, en una base emoliente, que provée de una película capaz de soportar el mecanismo de protección de la piel. Posteriormente, estos pacientes fueron expuestos a las radiaciones solares, o simplemente se les indicaba lo usaran frecuentemente, obteniéndose resultados altamente satisfactorios. Concluimos que la aplicación de antisolares en una basa emoliente puede considerarse de alta eficacia en la prevención, tratamiento y prevención del Herpes labial recurrente

Hepatitis B: aspectos inmunológicos, prevención para el odontólogo / Hepatitis B: immunological aspects, prevention for the dentistry

Se hace una revisión de la literatura concerniente a la hepatitis B (VHB), se tratarán: avances inmunológicos, estudios epidemiológicos y aplicabilidad en Venezuela. Se destacará la importancia de la evaluación del paciente con infección por VHB, así como también la aplicación de la vacuna de ingeniería genética. Frente a la sospecha de un paciente portador de hepatitis B y el riesgo de adquisición de la enfermedad en el curso de una consulta odontológica se orientar sobre la conducta a seguir

Consideraciones en el tratamiento de la candidiasis bucal / Criteria for the treatment of the oral candidiasis

El presente trabajo es una revisión de la literatura concerniente a la Candidiasis Bucal. Se destacan: prevalencia, cuadro inmunológico, etiopatogenia, aspectos clínicos, diagnóstico y tratamiento. Se establecen, comoel presente tema se titula,algunas consideraciones para abordar, identificar y tratar esta entidad que es frecuente en nuestro pacientes

Adenoma pleomórfico del paladar: reporte de un caso / Pleomorphic adenoma of the palate: report of a case

Se presenta el caso clínico de una paciente con aumento del volumen en el hemipaladar derecho, la cual fue sometida a tratamiento quirúrgico realizado en la Facultad de Odontología, Cátedra de Cirugía Estomatológica de la U.C.V., cuyo diagnóstico definitivo fue adenoma pleomorfo, siendo esta entidad el tumor de glándula salival más frecuente en incidencia y localización de la literatura, en donde se destacan la histogénesis, aspectos epidemiológicos, histopatológicos, tratamiento y pronósticos del mismo

Tratamiento quirúrgico de las comunicaciones bucosinusales mediante el uso del colgajo palatino con desección de la arteria palatina superior o descendente. Presentación de un caso / Surgical treatment of the oroantral communication by the use of palatal flap disection with disection of the major or descending palatine artery. A case presentation

Existe una diversidad de técnicas para resolver quirúrgicamente el problema de las comunicaciones bucosinusales que van desde técnicas sencillas que pueden ser realizadas por el odontólogo general, técnicas sencillas que pueden ser realizadas a nivel hospitalario. La presente técnica es una modificación de los colgajos palatinos que durante muchos tiempo han sido usados enn el tratamiento de fístulas y comunicaciones bucosinusales. Se presenta un caso en el cual se describe la técnica propiamente dicha, se hacen comparaciones con otras técnicas semejantes haciendo incapié en lo importante de la buena disección del paquete vasculonervioso palatina y el manejo de los tejidos blandos

Estudio epidemiológico de 147 casos de papiloma bucal (Venezuela). Parte I / Epidemiologic study of 147 cases of oral papiloma (Venezuela). Part I

Se presenta un análisis clínico de 147 papilomas de la cavidad bucal en donde se destacan los siguientes aspectos: edad, sexo, localización, tamaño, aspecto clínico (forma, color, superficie e implantación), recurrencia y multiplicidad, diagnóstico clínico y motivo de consulta. La lesión se presenta en un rango grande de edades, encontrándose la mayor incidencia entre los 20 y 49 años. Los datos recolectados indican que la lesión es ligeramente más frecuente en el sexo femenino que en el sexo masculino. el mayor número de casos se encontró en la lengua, siguiendo en orden decreciente: paladar, encia y labio. La recurrencia y multiplicidad del papiloma fueron bajas