1,720,993 research outputs found
”Il trattamento con tutori funzionali nei ritardi di consolidazione e nelle pseudoartrosi diafisarie”
No full textImpiego clinico della stimolazione elettrica in ortopedia e traumatologia
No full textLa scelta terapeutica del medico, nel trattamento di patologie dell’apparato muscolo-scheletrico, si fonda su una diagnosi appropriata e sulla scelta della terapia efficace per la patologia in cura. La terapia potrà essere attuata con un farmaco oppure con un dispositivo medico. La terapia con un dispositivo medico per la stimolazione elettrica dell’osteogenesi o della condroprotezione deve garantire:
la sicurezza elettrica del dispositivo;
la sicurezza biologica, intesa come assenza di effetti collaterali;
l’efficacia del dispositivo nella specifica patologia, dimostrata da studi clinici;
l’assenza di controindicazioni specifiche per il paziente che dovrà utilizzare il dispositivo medico.
La letteratura dimostra che l’efficacia terapeutica di un dispositivo medico è legata alle caratteristiche fisiche del segnale elettrico, magnetico o elettromagnetico generato dall’applicatore. Pertanto, l’impiego di un dispositivo deve fondarsi o su documentate esperienze cliniche condotte con il dispositivo stesso o su una chiara dimostrazione di equivalenza con dispositivi che erogano segnali efficaci. Attualmente è presente nel mercato italiano una pletora di dispositivi per “magnetoterapia” o “CEMP”, privi di documentazione clinica che ne documentino l’efficacia e la sicurezza biologica. Questi dispositivi sono proposti ai pazienti per le più svariate e ampie indicazioni: dalla pseudoartrosi alla cellulite. Non è facile se non impossibile per l’ortopedico reperire in letteratura le necessarie informazioni sulle caratteristiche dei diversi dispositivi di “magnetoterapia” o “CEMP”. Indicazioni, controindicazioni ed effetti collaterali sono contenuti unicamente nel manuale di istruzione, che rimanda alla responsabilità del medico l’uso del dispositivo, il quale, in assenza di adeguata documentazione clinica, potrebbe esporre il paziente ad un trattamento inefficace se non dannoso. Nella pratica clinica, la prescrizione all’uso della stimolazione elettrica si deve fondare su una corretta diagnosi e su una specifica indicazione all’uso del dispositivo più idoneo. In questo modo, il medico ottempera al suo dovere di proporre una terapia efficace e sicura
Minimally invasive plate osteosynthesis in proximal humeral fractures: one-year results of a prospective multicenter study
No full textPurpose: The aim of this multicentric study was to evaluate results of minimally invasive plate osteosynthesis (MIPO) for proximal humeral fractures in terms of postoperative shoulder function, radiological outcome and number of complications. Methods: A consecutive series of 76 patients with proximal humeral fractures were treated with locking plate using a minimally invasive antero-lateral approach in two orthopaedic departments. Functional results with Constant score and radiographic evaluation were available for 74 patients at one-year follow up. Results: The patients achieved a mean Constant score of 71 (range 28–100). Each functional result was evaluated also for both centres without significant differences. Significant statistical differences were only found for younger patients with better results (p < 0.05). Twenty patients (27 %) developed complications. Subacromial impingement occurred in 16.2 % of cases for varus malreduction (6.7 %) and for too proximal plate positioning (9.5 %). Primary screws perforation (2.7 %), secondary perforation due to cut-out (1.4 %), avascular necrosis (AVN) of humeral head (1.4 %), partial resorption of greater tuberosity (2.7 %), secondary dislocation of the greater tuberosity (2.7 %) and stiffness (2.7 %) were the other complications observed. Conclusions: The MIPO technique for proximal humeral fractures was safe and reproducible for most common patterns of fracture. Major complication rate was apparently low due to a soft tissue sparing, deltoid muscle and circumflex vessels, with easy access of the bar area to correct positioning of the plate
Specificity and accuracy of bone scanning with radio-labelled blood elements in differential diagnosis of a loose total hip and knee arthroplasty
No full text
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
Current concepts in hip–spine relationships: making them practical for total hip arthroplasty
No full text
Ceramic-on-metal coupling in THA: long term clinical and radiographic outcomes using two different short stems
Full text linkBackground: Hip prosthetic replacement surgery is the gold standard for patients affected by symptomatic osteoarthritis. The ceramic-on-metal hybrid hard-on-hard bearing was initially launched on the market with the purpose of reducing adhesive and corrosion wear, loss of metal debris and ions and risk of fracture and squeaking. However, this bearing was withdrawn from the market, in the apprehension of local and systemic toxicity. The aim of this study is to evaluate the reliability and safety of ceramic-on-metal bearing at long term follow-up. Methods: From 2 cohorts of patients suffering of hip osteoarthritis who underwent total hip arthroplasty using ceramic-on-metal bearing with two different short stems, 19 of the GROUP A and 25 of the GROUP B were suitable for this study. All patients were compared clinically using the Harris Hip Score (HHS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analogue scale (VAS), 12-item Short Form Health Survey (SF12P/M), and radiographically. Blood samples were collected in order to evaluate chromium and cobalt ions level. The two groups were compared in terms of metal ions blood levels, and finally all the implanted prostheses were compared with a healthy control group. Results: All the implanted stems were well-positioned and osseointegrated at a mean follow-up of 114 months. Improvements were observed for all clinical scores comparing preoperative and postoperative values in both groups. Radiographic evaluation showed a good ability to restore proper articular geometry. Chromium and cobalt ion analysis revealed values below the safety threshold except for 1 case in GROUP A (cup malposition) and 2 cases in GROUP B (6.1%). No revision occurred. Conclusions: Ceramic-on-metal bearing is safe and reliable at long term follow-up in association to short stems arthroplasty, if the implant is correctly positioned. Chromium and cobalt metal ions blood levels evaluation should be performed annually
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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