187,392 research outputs found
Devices for Mitral Valve Repair
No full textThe natural history of severe mitral regurgitation (MR) is unfavorable, leading to left ventricular failure, atrial fibrillation, stroke, and death. Many patients affected by severe regurgitation (MR) do not currently undergo surgery, mainly due to the perceived risk of the procedure (old age, impaired left ventricular function, and comorbidities). Mitral transcatheter interventions carry the hope of minimizing risks while preserving clinical efficacy of surgical repair, as an alternative to conventional treatment. Multiple technologies and diversified approaches are under development with the purpose of treating MR in less invasive ways. They can be categorized based on the anatomical and patho-physiological addressed target. Among them, MitraClip (Abbott Vascular, Inc., Menlo Park, California) has emerged as a clinically safe and effective method for percutaneous mitral valve repair in patients either with degenerative and functional regurgitation. This device mimics the surgical edge-to-edge repair initially described by Alfieri in the early 1990s. Other repair technologies include percutaneous direct and indirect annuloplasty, neochordae implantation, and left ventricular reshaping. They are still in early phase clinical trials or preclinical studies. The combination of different repair techniques is likely to be required to achieve good long-lasting results. In the future, novel devices, improved knowledge, more efficient imaging, and transcatheter mitral prosthetic valve implantation may expand the indications to those patients currently not treated, as well as improve the results both in terms of early efficacy and long-term durability. These treatments are currently reserved to high-risk and inoperable patients, and their application requires an integrated Heart-Team approach. They represent the natural evolution of surgery and promise to expand treatment options and improve patients' outcomes in the near future. OI Denti, Paolo/0000-0002-3075-020
I denti di Michelangelo
No full textRecensione di: Marco Bussagli, I denti di Michelangelo, Viserba di Rimini, Edizioni Medusa, 2014, 175 p., ISBN: 9788876983122, € 19,00
Criteri per la valutazione del danno in sede civile da perdite plurime di denti
No full textGli AA. rilevano l’attuale estrema variabilità dei valori di stima del danno da perdite plurime di denti e l’ancora più ampia genericità degli elementi di giudizio.
Prospettano quindi in chiave sintetica alcuni recenti concetti di gnatologia e principi fondamentali di cinematica mandibolare come presupposto indispensabile ad una rigorosa interpretazione dei fenomeni biologici che sottendono il danno medesimo.
Indicano poi come parametri da tenere presenti nella valutazione del danno:
a) il tipo di denti perduti e l’attività lavorativa del leso;
b) la quantità di denti perduti;
c) la topografia delle zone edentule;
d) la possibilità di riabilitazione professionale;
e) l’età del leso;
f) lo stato anteriore.
Per ognuno di tali parametri discutono gli aspetti gli aspetti essenziali
Quantification of active ROM after arthroscopic Bankart repair with rotator interval closure
No full textSeveral series report patients homogeneously treated using arthroscopic Bankart repair exclusively, or in some cases arthroscopic Bankart repair with rotator interval closure. Current international literature has few reports on arthroscopic Bankart repair with rotator interval closure procedures undertaken on a homogeneous series of patients. The purpose of this study was to evaluate the residual active range of motion (ROM) and clinical outcome in this patient population. Fourteen patients affected by recurrent anterior instability were consecutively treated. Rowe, Walch-Duplay, and UCLA scores, as well as differences in active ROM of both shoulders (treated and contralateral), were recorded. A significant reduction in active external rotation was noted along the side of the arm (P<.001) and at 90 degrees of abduction (P=.007). The average reduction was 12.14 degrees and 7.21 degrees, respectively, which represents 17.8% and 8% of the arc of motion of the opposite side in external rotation. No significant differences were found for flexion, abduction, and internal rotation. According to Walch-Duplay and Rowe scores, 71.4% and 85.7% of patients had excellent or good results. Arthroscopic Bankart repair with rotator interval closure results in a reduction of external rotation and provides satisfactory stability results
I denti soprannumerari
No full textObiettivi- Focalizzare l’attenzione sull’iperdonzia, una tra le più frequenti anomalie dentali di numero, e sull’associazione tra questa e il ritardo di eruzione degli incisivi permanenti.
Materiali e metodi - Attraverso l’analisi della letteratura sono state esaminate le varie teorie eziologiche, le diverse classificazioni dei denti soprannumerari e le complicazioni cliniche associate a tale anomalia dentale. Nella maggior parte dei casi un dente soprannumerario nella regione della premaxilla è responsabile di un’alterazione del processo eruttivo degli incisivi permanenti fino a determinarne l’inclusione. Sono stati analizzati i mezzi diagnostici e le opzioni terapeutiche.
Risultati e Conclusioni- Una diagnosi precoce, un approccio chirurgico conservativo e un trattamento ortodontico accurato permettono il corretto riposizionamento dell’incisivo permanente. L’insuccesso del trattamento può essere dovuto all’applicazione di forze inappropriate, a un’insufficiente rimozione di osso durante l’intervento chirurgico, all’anchilosi dell’elemento incluso o alla presenza di fattori prognostici negativi
Trattamento artroscopico dell’epicondilite laterale
No full textL’epicondilite laterale, detta anche gomito del tennista,
è una comune causa di dolore cronico del gomito
e di disfunzione degli estensori del polso. Si
presenta come un fastidioso dolore sulla superficie
laterale del gomito ed un’invalidante debolezza che
si estende all’avambraccio, soprattutto nei movimenti
di flessione del gomito e di estensione del
polso.
Questa patologia riguarda circa l’1-3% della popolazione
adulta, soprattutto fra i 35 ed i 55 anni; i
giocatori di tennis rappresentano solo il 5-8% dei
casi, anche se il 40-50% rischia di andare incontro
a questa patologia durante la sua vita sportiva.Il presente articolo si occupa dell'epicondilite, dalla diagnosi al trattamento
Percutaneous edge-to-edge repair in high-risk and elderly patients with degenerative mitral regurgitation: Midterm outcomes in a single-center experience
No full textObjective: The study objective was to report the midterm outcomes of MitraClip implantation in inoperable or high-risk surgical candidates with degenerative mitral regurgitation. Methods: From October 2008, data of all high-risk or elderly patients with severe degenerative mitral regurgitation who underwent MitraClip implantation were prospectively collected. Results: Forty-eight high-risk consecutive patients with severe degenerative mitral regurgitation underwent MitraClip implantation (mean age, 78.5 +/- 10.8 years; 56.6% of the patients were aged >= 80 years). Mean Society of Thoracic Surgeons score was 12% +/- 10%, and 71% were in New York Heart Association class III or IV. Mean left ventricular ejection fraction was 57% +/- 11%. The device was successfully implanted in 47 of 48 patients (98%). In-hospital mortality was 2%. The median intensive care unit stay was 22 hours; patients were discharged from the hospital in an average of 4.5 +/- 2.4 days. Predischarge echocardiography showed a mitral regurgitation reduction to grade 2+ or less in 43 of 47 patients (91.5%). Actuarial survival was 89% +/- 5.2% and 70.2% +/- 9% at 1 and 2 years, respectively (82% +/- 9% in patients aged = 80 years at 1 year; P = .9). Freedom from mitral regurgitation 3+ or greater was 80% +/- 7% at 1 year and 76.6% +/- 7% at 2 years. At 1 year, 93% of survivors were in New York Heart Association class I or II (100% of patients aged = 80 years; P = .4). Significant quality of life improvements were documented. A significant improvement in 6-minute walk test performance was observed. Conclusions: MitraClip therapy is a valuable alternative to surgery in high-risk and elderly patients with degenerative mitral regurgitation. Clinical benefits also are obtained in octogenarians. OI Denti, Paolo/0000-0002-3075-020
Experimental Results on Fingerprint Liveness Detection
No full textFingerprint liveness detection is aimed to detect if a fingerprint image, sensed by an electronic device, belongs to an "alive" fingertip or to be an artificial replica of it. Recent studies have shown that a fingerprint can be replicated and, if a clever attacker tries to evade the system, this is an issue. Accordingly, several countermeasures in terms of "fingerprint liveness" detection algorithms have been proposed, but never compared on a benchmark data set, internationally accepted by the research community. In this paper, we present some recent experimental results on several state-of-the-art fingerprint liveness detection algorithms on the datasets available at Second International Fingerprint Liveness Detection Competition (LivDet 2011). The results we proposed help assessing which are the more effective approaches used so far. © 2012 Springer-Verlag
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