1,721,019 research outputs found
Mortality Risk Assessment at the Admission in Patient With Proximal Femur Fractures: Electrolytes and Renal Function
Full text linkIn patients over 65y.o. who were surgically treated for a hip fracture, electrolytes have not been specifically studied as predictors of mortality. The main purpose of this study was to assess whether electrolytes and chronic kidney disease (CKD) stages, evaluated at admission, could represent a pre-operative prognostic factor in this population. Moreover, the role of epidemiological and clinical parameters was analyzed with and without a surgical timing stratification. This retrospective study included 746 patients. For each patient, their age, gender, fracture classification, Hb value, comorbidities, ASA class, chronic kidney disease, creatinine levels, electrolytes and surgical timing were collected. CKD-epi, MDRD, modified MDRD and BIS1 were used to obtain eGFR and CKD stages. All parameters were analyzed individually and in relation to the different surgical timing. Descriptive statistics, Chi-square test and survivability analysis with Kaplan Meier curve were used. In patients with a hip fracture non-significant association with increased mortality was shown for the following variables: Hb value, sodium values, calcium values, CKD stages and creatinine values. Otherwise altered kalemia was associated with a statistically significant increase in mortality as well as male gender, two or more comorbid medical conditions, advanced age (>75 years), higher ASA class. Surgery performed within 72h resulted in a statistically significant reduction in mortality at 6 months and, when performed in 24h-48h, a further reduction at 4 years. Age and ASA class statistically significant increased mortality regardless the surgical timing. Male patients operated after 48h from hospitalization were associated with a statistically significant increase in mortality rate. Two or more comorbidities were related to a statistically significant increased number of deaths when patients were treated after 96h. Altered kalemia values at hospitalization are associated with a statistically significant increase in mortality in patients operated after 72h from admission
Does the association of therapeutic exercise and supplementation with sucrosomial magnesium improve posture and balance and prevent the risk of new falls?
Full text linkBackground Fracture of the proximal femur is the most feared complication of osteoporosis. Given the numerous physiological functions that magnesium performs in our body, in the literature there is a correlation between osteoporosis and
low serum levels of magnesium.
Aim Evaluate the incidence of hypomagnesemia in patients with lateral fragility fracture of the proximal femur, the possible
correlation between serum magnesium levels and fractures, and the efectiveness of supplementing Sucrosomial® magnesium
associated with therapeutic exercise on the outcome of these patients.
Methods We divided the study into two parts. In the frst part, we assessed the preoperative incidence of hypomagnesemia
in patients using a blood test. In the second part, patients with hypomagnesemia were divided, in the post-operative period,
into two groups, who received, respectively, only therapeutic exercise or oral supplementation with sucrosomial magnesium
associated with therapeutic exercise.
Results Half of the patients with fragility femoral fracture had hypomagnesemia, with a higher incidence of the subclinical
form. From the comparison between the two groups, the T1 treatment group showed a signifcant improvement in blood
levels of magnesium (2.11±0.15 vs. 1.94±0.11; p<0.05), on the NRS scale (5.7±0.81 vs. 6.6±1.18; p<0.05), the Tinetti
scale (17.3±1.15 vs. 15.2±2.98; p<0.05) and the SarQoL questionnaire (47.3±5.21 vs. 44.9±5.54; p<0.05).
Conclusions More attention would be needed in the diagnosis and correction of subclinical hypomagnesemia and not just
the simple and clinically evident one, including hypomagnesemia among the modifable risk factors for osteoporosis
Bilateral Bennett's fracture: A case report
Full text linkBennet's fracture represents one of the most common injuries of the hand district, involving the base of the thumb, and it is affects children and elderly patients the most. The fracture is caused by direct axial trauma to a partially flexed first metacarpal and it is always intra-articular: the fracture line separates the palmar ulnar aspect of the first metacarpal base from the remaining first metacarpal. The fracture pattern is such that the first metacarpal shaft moves dorsally, proximally, and radially due to the pull of the abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, and the adductor pollicis brevis, which remain attached to the fracture fragment. The surgical treatment consists of closed reduction with percutaneous pinning or open reduction with either pins or interfragmentary screws. The decision to treat these fractures with either open reduction or closed reduction is still a matter of debate. To the best of our knowledge, there are no cases of bilateral Bennett's fracture reported in literature. The aim of this paper is to present a rare case of bilateral Bennet's fracture, the decision of two different treatments, and the good clinical outcomes
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Is there a relationship between idiopathic scoliosis and body 2 mass? A scoping review
Full text linkThe etiopathogenesis of idiopathic scoliosis remains unknown, although genetic or hered- 12
itary factors, neurological disorders, hormonal and metabolic dysfunctions, biomechanical factors, 13
and environmental factors seem to be involved. Several studies have found that patients with scoli- 14
osis have common characteristics of taller stature, lower body mass index (BMI), and low systemic 15
bone mass. We conducted a scoping review to analyze the association between idiopathic scoliosis 16
and BMI. The search for articles was performed on PubMed and Cochrane, including the English 17
language, full-text and free-full-text articles published from December 31st, 2011 to December 31st, 18
2021. Most of the results analyzed are in favor of a relationship between low BMI and scoliosis. 19
Having a low BMI could be associated with the presence of scoliosis, although the reason for which 20
is still doubtful. However, further large-scale epidemiological studies on different ethnicities and a 21
comparison of BMI with the healthy population will be needed to better define the correlation be- 22
tween BMI and scoliosis
Association of Arthroscopically-Assisted Latissimus Dorsi Tendon Transfer with Implantation of a Subacromial Balloon Spacer for Patients with Irreparable Posterosuperior Rotator Cuff Tears
No full textPurpose. Massive irreparable posterosuperior rotator cuff tears in an active population, resulting in a pseudo-paralytic shoulder, pose a challenge for the orthopaedic surgeon. In an effort to avoid or delay arthroplasty surgery, other surgical strategies such as arthroscopically-assisted latissimus dorsi transfer (aLDT) or the implantation of a subacromial spacer (SAS) can be considered. The aim of the present study is to associate, for the first time, these two surgical procedures in order to demonstrate the surgical feasibility and the effectiveness of their synergistic biomechanical effect. Methods. The study group consisted of patients who underwent aLDT for a massive irreparable posterosuperior rotator cuff tear with or without SAS placement. The study population consisted of 17 patients. Patients were assessed with the following outcomes scores: Constant and Murley Score (CMS), Disability of Arm, Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), and Subjective Shoulder Value (SSV). Follow-up after surgery (T0) took place at the following time points: 40 days (T1), 3 months (T2), 9 months (T3), and 12 months (T4). Statistical analysis was performed by descriptive statistics, nonparametric ANOVA test, and a multivariate linear regression model. The effect of subscapularis repair on clinical outcomes was also examined with subgroup analysis. Results. In the entire population, the mean change in scores between T0 and T4 was: +30.5 for CMS,-35.14 for DASH, +18.06 for OSS, +40.47 for SSV. A statistically significant increase in all scores for both aLDT alone and aLDT with concomitant SAS was detected starting as early as T2. The subscapularis repair group had the following results as compared with the subscapularis intact group: CMS-9.5580 (p = 0.0164), OSS-5.6873 (p = 0.0378), and DASH +21.0424 (p = 0.0097). Conclusions. This study demonstrates, for the first time, the feasibility and efficacy of the arthroscopically-assisted latissimus dorsi transfer alone and with concomitant implantation of a subacromial spacer. Both surgeries demonstrate clinical efficacy as early as three months after surgery, with significant and progressive clinical improvements through 12 months postoperatively. © 2022, EDRA S.p.A. All rights reserved
Electromagnetic distal targeting system does not reduce the overall operative time of the intramedullary nailing for humeral shaft fractures
No full textIntroduction: We aimed to evaluate the efficacy of the use of the electromagnetic distal targeting system in treating humeral shaft fracture. Methods: Patients were divided in: Group 1) patients that received a distal locking screw placement following the free-hand technique; Group 2) patients in which the distal locking screw was performed using the SURESHOT device. Results: No differences were noted comparing Group 1 (freehand) [71,9 range 40–135 min] to Group 2 (SURESHOT)[70, range 25–125 min]. Conclusion: The use of the EM distal targeting system doesn't reduce the overall operative time of the humeral shaft fracture fixation using IMN
Self-inflicted long bone fractures for insurance fraud
No full textSelf-inflicted fractures simulating traffic accident represent a new social fraud opportunity for criminality. Recognising scams through an increase of awareness of existence of self-inflicted arm fractures for insurance fraud could help community health workers to report these injuries to the competent authorities. In this article, authors have recognised an unusual but consistent pattern of upper and lower limb fractures whose incidence does not coincide in numerical terms with what is reported in literature. The aim of the present study is to describe fracture patterns observed over the past 2 years. Further, authors describe clinical presentations of these fractures and attempt to define a possible mechanism of these types of injuries
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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