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1.
Musculoskelet Surg ; 108(2): 215-224, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38602604

RESUMEN

Osteoarthrosis is a degenerative musculoskeletal disease that presents a major public health problem, due to the increasing average age of the active population, as well as the increasing percentage of obesity or overweight of the general population. New therapeutic approaches have been developed, such as regenerative medicine that uses mesenchymal stromal cells taken from adipose tissue. This study analyzed the clinical potential benefits of using autologous adipose tissue to treat patients with moderate-severe knee osteoarthritis.In 2021, a total of 50 knees, affected by moderate-severe knee osteoarthritis, were treated with an intra-articular injection of micro-fragmented subcutaneous adipose tissue. Patients were submitted to the KOOS questionnaire before the operation and one year after the operation and VAS pain score at time 0, 3, 6, 12 months.Of the 50 patients treated, 2 patients were excluded from the study. Of the remaining 48 patients, improvements have been achieved in all subclasses of KOOS. In particular, VAS score proves that improvements are more considerable starting from the 3rd month after surgery.The results obtained in this study show the safety and potential benefit of the use of autologous micro-fragmented adipose on people who are affected by moderate-severe knee osteoarthritis.


Asunto(s)
Osteoartritis de la Rodilla , Humanos , Osteoartritis de la Rodilla/terapia , Femenino , Masculino , Persona de Mediana Edad , Inyecciones Intraarticulares , Anciano , Resultado del Tratamiento , Índice de Severidad de la Enfermedad , Trasplante Autólogo , Dimensión del Dolor , Tejido Adiposo/trasplante , Grasa Subcutánea/trasplante
2.
Eur Rev Med Pharmacol Sci ; 26(1 Suppl): 119-126, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36448869

RESUMEN

OBJECTIVE: The IlluminOss® System (IS) based on photodynamic bone stabilization (PBS) is a recent option in between the minimally invasive surgical techniques available to treat bone metastases when medical or radiation therapy is neither effective nor indicated, and major surgery is not possible. In this study, the results obtained using IS in the treatment of impending fractures or bone metastases of the upper limb have been analyzed in terms of improvement in pain, quality of life and recovery of function. PATIENTS AND METHODS: Between January 2017 and October 2019, 8 patients over 65 years old with impending fractures or pathological fractures or myeloma of the upper limb have been treated in our institute with IS. All patients were assessed about pain, general health and function of the affected limb before surgery and 1, 3, 6 (consistent with survival) months after the procedure. RESULTS: Mean VAS score improved from 8.88 before surgery to 1.00 six months after surgery, mean Karnofsky index improved at 1 and 3 months post-operative follow-up, and Musculoskeletal Tumor Society Score (MSTS) raised from 44.6 before surgery to 74.7 six months after surgery. Moreover, good reduction and stable fixation of the osteolytic lesion were achieved in all patients, and no complications were found. CONCLUSIONS: Numerous studies have been reported in the literature on the use of this system in osteoporotic elderly fractures, whereas only few articles are currently available regarding its use in the treatment of bone metastases or pathological fractures. From our study PBS seems to be an effective solution in the management of bone metastases or myeloma in both pathological fractures and impending upper limb fractures in patients with low life expectancy.


Asunto(s)
Fracturas Espontáneas , Mieloma Múltiple , Fracturas Osteoporóticas , Anciano , Humanos , Fracturas Espontáneas/cirugía , Mieloma Múltiple/terapia , Calidad de Vida , Extremidad Superior , Dolor
3.
J Biol Regul Homeost Agents ; 34(4 Suppl. 3): 289-294. Congress of the Italian Orthopaedic Research Society, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33261292

RESUMEN

Sarcomas are a heterogeneous group of rare tumours. Improvements in immunotherapy and the important role of PD1 and PD-L1 expression in advancement and prognosis have opened new fields of research for the treatment of these neoplasia. We evaluated the immunohistochemistry of PD1 and PD-L1 expression in 60 adults' patients affected by high-grade sarcomas of the limbs. PD1 expression was 65% while PD-L1 was 68.3%. PD-L1 expression seems to correlate to Ki67 in liposarcomas, fibrosarcoma's and pleomorphic sarcomas, while it does not show any correlation to chondrosarcomas, while in rhabdomyosarcomas there is a correlation but, given the small sample size, it was not possible to perform a statistic analysis. Our study shows positivity among the different subgroups of positive PD1 lymphocytes infiltration and PD-L1 expression in high-grade sarcomas of the limbs.


Asunto(s)
Neoplasias Óseas , Sarcoma , Adulto , Antígeno B7-H1/genética , Neoplasias Óseas/terapia , Humanos , Inmunohistoquímica , Inmunoterapia , Receptor de Muerte Celular Programada 1/genética , Sarcoma/terapia
4.
J Biol Regul Homeost Agents ; 34(4 Suppl. 3): 275-278. Congress of the Italian Orthopaedic Research Society, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33261289

RESUMEN

Infection is a significant complication in oncological megaprostheses. The purpose of our study is to indagate the innovations and new trend about the prevention of infection in this kind of surgery. The research focused on the use of antimicrobic prophylaxis, the defensive antibacterial coating and the use of silver coated.


Asunto(s)
Control de Infecciones , Antibacterianos/uso terapéutico , Materiales Biocompatibles Revestidos , Humanos , Infecciones , Plata
5.
J Biol Regul Homeost Agents ; 34(3 Suppl. 2): 63-69. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS - SOTIMI 2019, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32856442

RESUMEN

Implant-associated infections remain one of the main problems in trauma surgery, particularly for treatment of open tibial fractures. The role of systemic antibiotic prophylaxis is now established and accepted, but recent literature also seems to emphasize the importance of local antibiotic prophylaxis. Antibiotic coated nails play a crucial role, allowing at the same time the prevention of infections and favoring the stabilization of fractures. These devices appear to be a clinically effective and safe solution. The purpose of the study was to investigate the role of antibiotic coated nails in the treatment of tibia fractures. A literature review was performed on MEDLINE through PubMed to identify scientific publications relevant to the use of antibiotic coated nails in tibial fractures. Primary outcomes were infection rate and bone union rate. This review present numerous limits due primarily to the small number and different nature of studies published; the heterogeneity of the devices used.


Asunto(s)
Antibacterianos/uso terapéutico , Fijación Intramedular de Fracturas , Fracturas de la Tibia , Clavos Ortopédicos , Curación de Fractura , Humanos , Fracturas de la Tibia/diagnóstico por imagen , Fracturas de la Tibia/cirugía , Resultado del Tratamiento
6.
J Biol Regul Homeost Agents ; 34(3 Suppl. 2): 71-75. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS - SOTIMI 2019, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32856443

RESUMEN

Necrotizing fasciitis is a dreadful complication of the soft tissue. This pathology could be triggered by many factors, such as a fracture. We present a case of case of a necrotizing fasciitis in ankle fracture.


Asunto(s)
Fracturas de Tobillo , Fascitis Necrotizante , Fracturas de Tobillo/diagnóstico por imagen , Fascitis Necrotizante/etiología , Humanos
7.
J Biol Regul Homeost Agents ; 34(3 Suppl. 2): 77-81. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS - SOTIMI 2019, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32856444

RESUMEN

Proximal femur fractures are increasing, together with the aging of world population. One of the complications worsening this condition is infection. In this study, we try to identify risk factors that can lead to infection. We identified 122 patients with femoral neck fracture. The occurrence of infectious events were recorded (respiratory, urinary, superficial wound and periprostethic infection). There were 15 infections, mostly urinary and pulmonary, and all were treated using antibiotics. No statistical differences were found between infection and control group regarding waiting time for surgery, mean time of surgery, age, kind of fracture, type of surgery. Fever onset >38° within 72 hours from surgery was statistically correlated with early infections. Future studies must be led to identify risk factors for infection and to create a strategy to prevent this possibly lethal complication.


Asunto(s)
Fracturas del Fémur , Infecciones , Fracturas del Fémur/epidemiología , Fémur , Fijación Interna de Fracturas , Humanos , Estudios Retrospectivos , Factores de Riesgo
8.
J Biol Regul Homeost Agents ; 34(5 Suppl. 1): 101-106. IORS Special Issue on Orthopedics, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33739013

RESUMEN

In the orthopaedic field the foreign body reaction is well known for therapeutic purposes in the alleged Masquelet technique consisting of segmental bone loss two-stage reconstruction. The induced membrane creates advantageous local conditions that promote bone graft remodeling and osteointegration. The aim of our study was to describe the first two cases in Literature of induced membrane observed following silver-coated knee megaprosthesis reconstruction. In addition, it was our interest to evaluate their histological features.


Asunto(s)
Procedimientos de Cirugía Plástica , Plata
9.
Eur Rev Med Pharmacol Sci ; 23(2 Suppl): 210-216, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30977888

RESUMEN

OBJECTIVE: Wide diaphyseal bone defects, above all those infected, encounter into Masquelet technique a suitable treatment. The two-step procedure allows the surgeon to eliminate the infected tissues and then to promote new bone formation. We analyzed the literature about the use of the induced membrane technique in osteomyelitis and the innovations recently suggested. MATERIALS AND METHODS: We reviewed some of the most common web databases using the key-words: Masquelet technique, induced membrane, and osteomyelitis. 66 studies were analyzed. RESULTS: Comparing the Masquelet technique to other surgical procedures it shows better functional results in large bone defects due to infection. The induced membrane is like a biological chamber that protects the autograft and induces new bone formation promoting growth factors secretion. Different authors tried to improve one or more steps of the surgical procedure. Some studies focused on polymethyl methacrylate role and the possibility to use different materials instead of cement to induce the membrane. Others analyzed the autograft harvesting and placing techniques trying to reduce the amount of bone essential to fill the gap, like the RIA technique. Moreover, bone substitutes have been used, as beta-tricalcium phosphate, that showed an osteoconductive ability. CONCLUSIONS: The survey is not a systematic review. Nevertheless, new concepts are introduced and analyzed identifying 6 areas of interest and induced membrane technique development.


Asunto(s)
Sustitutos de Huesos/uso terapéutico , Trasplante Óseo , Fosfatos de Calcio/uso terapéutico , Osteomielitis/terapia , Procedimientos de Cirugía Plástica , Humanos
10.
J Biol Regul Homeost Agents ; 32(6 Suppl. 1): 151-155, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30644296

RESUMEN

Cephalomedullary nailing (CMN) currently represents the best surgical technique for the treatment of intertrochanteric hip fractures. Although the success of CMN in terms of functional recovery and fracture healing, in clinical practice there are many complications. Later femur fracture following treatment of trochanteric fracture with CMN is not a very frequent complication but, when it occurs, its treatment is the most complex, because of the increase of peri-operative mortality. There are studies in literature, which have demonstrated that the incidence of this complication is about 0.5-3%. Diagnosis and classification are made with standard radiographs, using the AO classification and the modified Vancouver classification. In the actual literature, to determinate the predisposing factor to the secondary fractures, the authors focused their attention on patient-related and surgical related risk factors. The treatment is variable and it depends on the type and characteristics of fracture and device. Outcomes analyzed in literature were mortality and bone healing. The aim of this manuscript is to provide an overview of this topic and to describe the state of the art of the secondary fracture after surgical treatment with intramedullary nailing.


Asunto(s)
Clavos Ortopédicos , Fracturas del Fémur/etiología , Fijación Intramedular de Fracturas , Fracturas de Cadera/complicaciones , Curación de Fractura , Fracturas de Cadera/cirugía , Humanos , Resultado del Tratamiento
11.
J Biol Regul Homeost Agents ; 32(6 Suppl. 1): 157-162, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30644297

RESUMEN

Müller-Weiss (MW) disease is a spontaneous osteonecrosis of the tarsal navicular bone in adults. It is a rare cause of chronic medial midfoot pain and deformity characterized by the collapse of the dorso-lateral part of the navicular, progressive navicular fragmentation and talonavicular joint destruction. This study provides a review of the literature about the epidemiology, etio-pathogenesis, clinical, radiological findings and therapeutic alternatives.


Asunto(s)
Enfermedades Óseas , Enfermedades de los Cartílagos , Osteonecrosis , Huesos Tarsianos/patología , Humanos
12.
J Biol Regul Homeost Agents ; 30(4 Suppl 1): 159-164, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-28002914

RESUMEN

The solitary bone cyst is a typical tumor-like lesion of the immature skeleton, whose etio-pathogenesis is still unclear. The purpose of this work is to perform a review of the literature about the different surgical approaches focusing on the role of bone substitutes and growth factors. Literature analysis shows injection techniques of substances such as methylprednisolone, autologous bone marrow, demineralized bone matrix, calcium sulphate and surgical techniques that involve the resection and curettage associated with bone graft and/or intramedullary nailing. Although there are good results currently associated to these techniques and the different ways of treatment, the only evidence-based treatment is given by injections of steroids. However, given the high rate of failure, autologous bone marrow and platelet gel represent a viable therapeutic option.


Asunto(s)
Quistes Óseos/terapia , Sustitutos de Huesos/uso terapéutico , Trasplante Óseo , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , Quistes Óseos/tratamiento farmacológico , Quistes Óseos/cirugía , Legrado , Humanos , Metilprednisolona/uso terapéutico
13.
J Biol Regul Homeost Agents ; 29(4 Suppl): 149-55, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26652484

RESUMEN

Silver coatings, used in many surgical devices, have demonstrated good antimicrobial activity and low toxicity. Oncological musculoskeletal surgery have a high risk of infection, so in the last decades, silver-coated mega-prostheses have been introduced and are becoming increasingly widespread. In this study, a retrospective analysis of 158 cases of bone tumors, primary or metastatic, treated between 2005- 2015 with wide margins resection and tumor implants reconstruction, was performed. The average age was 59 years (range 11-78 years), the same surgeon with antibiotic prophylaxis according to a standard protocol treated all patients. Silver-coated prostheses were implanted in 58.5% of patients and uncoated tumor prostheses in the remaining 41.5%. Patients were re-evaluated annually and complications were recorded, focusing analysis on infective complications. The average follow-up was 39.7 months: 23.4% of patients died at a median time of 35.3 months after surgery; 18.4% developed complications that required new surgery, of which 12.6% of these were due to infection. Patients treated with silver-coated implants developed early infection in 2.2% of cases against the 10.7% of the patients treated with standard tumor prosthesis. This difference between the two groups was statistically significant. The percentage of late infections occurring from 6 months after surgery was similar in both groups. Silver blood level taken in a sample of patients at different times after surgery, always showed values well below the threshold of toxicity and no patient showed any sign of local or general toxicity secondary to silver. Our study demonstrates that tumor silver-coated implants have a rate of early infection significantly lower than traditional implants, while there were no differences in the rate of late infections as described also in the literature. We recommend the use of silver–coated prosthesis as primary implants for limb salvage surgery in primary or metastatic bone tumors, considering the absence of toxicity and the lower rate of early infection.

14.
Eur Rev Med Pharmacol Sci ; 19(15): 2906-15, 2015 08.
Artículo en Inglés | MEDLINE | ID: mdl-26241547

RESUMEN

OBJECTIVE: Acrometastases are a rare observation, and account for approximately 0.1% of metastases. Every age can be affected, with a male predominance. The most common primary cancer site is the lung, followed by the colo-rectal, breast and genito-urinary tract. They are most commonly seen in pre-terminal patients with wide-spread disseminated disease. Rarely, they may be the first presentation of occult silent cancer, mimicking a benign condition. There is no standard treatment. We reviewed last 20 years literature in order to describe the most common sites of primary tumours and the more commonly used treatments. MATERIALS AND METHODS: We searched the Cochrane Central Library (CENTRAL), MEDLINE/PubMed (from 1940 to February 2014), SCOPUS database, and EMBASE/Ovid using a combination of controlled vocabulary and text word terms. RESULTS: Lung cancer was the first most common cause of acrometastases both in hands and feet, with 32.9% of all the cases; 20% of cases were renal cell cancer (RCC) metastases, followed by breast (12.9%) and colon (10%). Primary malignancies and site of metastasis (hand vs foot) suggest that the tumour cells reach the bones through the circulation and not the lymphatic system; in foot acrometastases Batson's plexus may play a fundamental role in dissemination. CONCLUSIONS: Treatment depends on staging and tumor extent. Amputation or disarticulation is the most common approach. It allows a wide margin resection and pain control. In some cases palliative treatment with radiation therapy, bisphosphonates and chemotherapy have been attempted with good results. The prognosis of the patients with acrometastases is poor; the mean survival time after diagnosis is 7 (±7) months. Special reference needs to be made to metastasis from renal cell carcinoma; if treated with radical surgical resection and nephrectomy a better outcome and survival rate shall be expected.


Asunto(s)
Pie/patología , Mano/patología , Neoplasias/diagnóstico , Neoplasias/mortalidad , Huesos/patología , Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/mortalidad , Carcinoma de Células Renales/cirugía , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/mortalidad , Neoplasias Renales/cirugía , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/cirugía , Neoplasias/cirugía , Nefrectomía/métodos , Cuidados Paliativos/métodos , Pronóstico , Tasa de Supervivencia/tendencias
15.
J Biol Regul Homeost Agents ; 29(2): 501-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26122243

RESUMEN

Pathological fractures have a high incidence in musculo-skeletal oncology, and localization in long bone causes severe pain, disability and poor quality of life. The aim of this retrospective case series is to evaluate the clinical results, in particular regarding the quality of life, in patients affected by lower long bone pathological fractures surgically treated. We analyzed 93 patients with pathological fractures of tibia and femur surgically treated in our Orthopaedic Department and followed up for at least 3 years or until their death. Intramedullary nailing or endoprosthetic reconstruction for pathologic fractures located in the metadiaphyseal and diaphyseal or proximal regions in advanced-stage cancer patients are suitable methods for a stable fixation or reconstruction. These approaches guarantee a good mechanical stability, a faster mobilization, a better control of pain with an overall improvement in quality of life in all patients, confirmed also by the trend of the ECOG performance status and QOL-ACD.


Asunto(s)
Neoplasias Óseas/secundario , Carcinoma/secundario , Fracturas del Fémur/cirugía , Fémur/cirugía , Fijación Interna de Fracturas/métodos , Fracturas Espontáneas/cirugía , Calidad de Vida , Tibia/cirugía , Fracturas de la Tibia/cirugía , Anciano , Cementos para Huesos , Neoplasias Óseas/psicología , Neoplasias Óseas/cirugía , Neoplasias Óseas/terapia , Carcinoma/psicología , Carcinoma/cirugía , Carcinoma/terapia , Terapia Combinada , Legrado , Embolización Terapéutica , Femenino , Fracturas del Fémur/etiología , Fracturas del Fémur/psicología , Fracturas Espontáneas/etiología , Fracturas Espontáneas/psicología , Humanos , Fijadores Internos , Masculino , Persona de Mediana Edad , Mieloma Múltiple/complicaciones , Dolor/etiología , Dolor/psicología , Recuperación de la Función , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Fracturas de la Tibia/etiología , Fracturas de la Tibia/psicología
16.
Eur Rev Med Pharmacol Sci ; 16(14): 1908-14, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23242715

RESUMEN

BACKGROUND: In lung cancer patients, metastases to soft tissues (STs), including skeletal muscle, subcutaneous tissue and skin, are rarely reported. Besides, lung cancer, primary carcinomas of the kidney and colon are the most commonly associated with ST metastases. AIM: To determine the prevalence, clinical-pathological features and treatment options of ST metastases originating from lung carcinoma. MATERIALS AND METHODS: A literature search was performed using the following terms: lung cancer, ST metastasis, skeletal muscle metastasis, cutaneous metastasis, subcutaneous metastasis. RESULTS: Autopsy series have detected STs metastases in 0.75-9% of patients who died from metastatic lung carcinoma. Pain and the presence of a palpable mass are the most frequent clinical features. The biopsy is recommended after MRI for diagnosis. Due to the rarity of ST metastases, the differential diagnosis must be posed especially with primary ST sarcomas. The type of treatment depends on the patient's clinical status and prognosis, and includes observation, radiotherapy, chemotherapy and surgery. CONCLUSIONS: In lung cancer patients, ST metastases are rare, but not exceptional. Their presence should be suspected in the presence of a palpable mass either painful or asymptomatic. Radiological and histological examinations are required for the definite diagnosis. The choice of treatment should be based on considerations related to the stage of the primary tumor and the patient's global health status.


Asunto(s)
Carcinoma/secundario , Neoplasias Pulmonares/patología , Neoplasias de los Tejidos Blandos/secundario , Biopsia , Carcinoma/mortalidad , Carcinoma/terapia , Humanos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/terapia , Imagen por Resonancia Magnética , Imagen Multimodal , Tomografía de Emisión de Positrones , Valor Predictivo de las Pruebas , Prevalencia , Pronóstico , Neoplasias de los Tejidos Blandos/mortalidad , Neoplasias de los Tejidos Blandos/terapia , Tomografía Computarizada por Rayos X
17.
J Biol Regul Homeost Agents ; 26(1): 139-44, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22475106

RESUMEN

The mucopolysaccharidoses (MPS) are a group of rare diseases characterized by deficiencies in different enzymes required for degradation of complex carbohydrates. The enzymatic deficiencies lead to lysosomal accumulation of dermatan sulphate, heparan sulphate, and keratan sulphate in different tissue resulting in multi-system complications. Six different principal types are described. Most MPS types, with the exception of MPS III, are associated with widespread skeletal abnormalities and joint disease. Authors analyzed clinical pathological and radiographical features of mucopolysaccharidoses focusing on pelvic and spine pathologies that generally limit activity and normal life so they have to be treated at the beginning of their manifestations in order to avoid major complication and improve quality of life.


Asunto(s)
Huesos/fisiopatología , Mucopolisacaridosis/diagnóstico por imagen , Mucopolisacaridosis/fisiopatología , Huesos/diagnóstico por imagen , Humanos , Mucopolisacaridosis/clasificación , Radiografía
18.
Int J Immunopathol Pharmacol ; 25(4): 1131-6, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23298503

RESUMEN

Pigmented villonodular synovitis (PVNS) is a rare condition, most commonly involving the knee joint. PVNS is locally aggressive and can invade and destroy surrounding soft tissue and bone, leading to anatomical and functional deterioration of the affected joint. Localized PVNS is an unusual presentation of the disease, generally consisting of a nodular lesion protruding into the articular cavity. Localized PVNS of the knee can mimic other joint disorders which may pose a challenge for a correct diagnosis. Given the locally aggressive behavior of PVNS, prompt identification and excision of the lesion are instrumental to avoid complications. Here, we report a rare case of localized cystic PVNS involving the anterior cruciate ligament of the knee in a 32-year-old woman with persistent knee pain, in whom magnetic resonance imaging was inconclusive. The diagnosis was achieved via arthroscopy and histology. We also present a concise review of the literature on this pathological entity as well as a discussion on the differential diagnosis between localized PVNS and other intra-articular cystic lesions.


Asunto(s)
Ligamento Cruzado Anterior/patología , Sinovitis Pigmentada Vellonodular/patología , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Inflamación/diagnóstico , Inflamación/patología , Factor Estimulante de Colonias de Macrófagos/biosíntesis , Imagen por Resonancia Magnética , Neoplasias/diagnóstico , Neoplasias/patología , Enfermedades Raras/diagnóstico , Enfermedades Raras/patología , Sinovitis Pigmentada Vellonodular/diagnóstico
19.
Int J Immunopathol Pharmacol ; 24(1 Suppl 2): 107-11, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21669147

RESUMEN

In recent years, the use of ceramic materials in orthopaedics and dentistry is becoming increasingly popular. However, it is important to know their biological and mechanical properties to optimize their use. The aim of this study is to describe a specific method to assess in vivo the effects of chronic release of ceramic materials implanted, in relation also to the type of material, pellets or powders. This was achieved by implanting ceramic powders and pellets, formed by low cohesion grains, in the patellar tendon of 48 New Zealand adult rabbits (24 with powders and 24 with pellets). The motion of the joint allowed easily and progressively the release of grains, detached from surface of the pellets and released to the joint space. Animals were sacrificed at different intervals (1, 3, 6, 12 months). Retrieved knee joints underwent X-Ray, histological and ultrastructural analysis.


Asunto(s)
Materiales Biocompatibles , Cerámica , Prótesis Articulares , Ensayo de Materiales/métodos , Óxido de Aluminio , Animales , Femenino , Miembro Posterior/fisiología , Articulaciones/fisiología , Masculino , Microscopía Electrónica de Rastreo , Movimiento/fisiología , Conejos , Circonio
20.
Radiol Med ; 115(2): 238-45, 2010 Mar.
Artículo en Inglés, Italiano | MEDLINE | ID: mdl-19789960

RESUMEN

PURPOSE: To verify if a "two step" school-based scoliosis screening procedure could reduce childhood radiation exposure and, if so, to estimate the subsequent reduction in radiogenic cancer fatalities and in socio-economic burden. MATERIAL AND METHODS: Data from two different scoliosis screening programs (A and B) performed on a total of 8,995 children (age range 9-14) were examined. Children in program A (5,731 children) were screened using a "two-step" procedure in which school physicians performed the first clinical examination and uncertain cases were referred to an orthopaedist. The school physicians were previously instructed by orthopaedists in the recognition of a number of simple clinical signs. Children in program B (3,264 children) were screened using a "one-step" procedure in which the initial clinical examination was performed directly by an orthopedist. In both programs, suspected cases of scoliosis were then ascertained by the orthopaedist with Radiography. To evaluate the lifetime attributable risk of cancer mortality the guidelines of the International Commission on Radiological Protection Publication 60 were followed. The economic cost of the performed X-ray examination was calculated assuming the current National Health Service's reimbursement to hospitals of euro 35 per X-Ray exam. The statistic significance of the difference in these estimates between the two programs was assessed using the proportions z-test. The issues of the relative sensitivity and specificity of the two programs were also examined. RESULTS: In programs A and B, 86 (1.5 %) and 95 (2.91 %) X-ray examinations were performed respectively (z=4.452, p<0.001). Based on these observations, a screening of 10,000 children directly performed by orthopaedists would result in 291 X-ray exams (2.91 %). A screening of the same number of children using a two-step procedure would result in 150 X-ray exams (1.5 %), with a savings of euro 4,935 for the National Health Care System, a reduction of 0.283 Sv of collective dose, and an estimated 50% reduction in the number of radiogenic malignant tumours. CONCLUSIONS: Using a two-step scoliosis screening procedure provides reasonable sensitivity and specificity while reducing costs and radiation exposure to children.


Asunto(s)
Tamizaje Masivo/métodos , Servicios de Salud Escolar/organización & administración , Escoliosis/diagnóstico , Adolescente , Niño , Costos y Análisis de Costo , Femenino , Humanos , Italia/epidemiología , Masculino , Tamizaje Masivo/economía , Radiografía , Servicios de Salud Escolar/economía , Escoliosis/diagnóstico por imagen , Escoliosis/economía , Escoliosis/epidemiología , Sensibilidad y Especificidad
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