11 research outputs found
Aids e odontoiatria: dalla prevenzione primaria allo screening attraverso gli adeguamenti terapeutici
No full textSURGICAL TREATMENT OF MEDICATION-RELATED OSTEONECROSIS OF THE JAW: TECHNICAL REPORT AND PROGNOSIS ASSESSMENT
No full textSince the first reports concerning osteonecrosis of the jaws there has been a lot of debate about the treatment modalities: therapy of the established pathology can in fact be medical or surgical and, in the latter case, be conservative or radical. The widespread difference of clinical presentations and relative rarity of advanced stages disease at diagnosis has not yet been able to guarantee a complete standardization in the therapeutic planning phase. Although there is a well-defined staging of the pathology, the international debate is still heated about more or less invasive surgical attitudes.
We collected data about ONJ in oncological patients surgically treated in our centre during the last 14 years: particular attention was paid to the variables and correlations between relapse, disease staging and treatment modalities. This is to underline the correlation between stage and type of treatment, as well as the greater possibility of relapse in the more advanced stages, in addition to its constancy in relation to the types of treatment. Finally, particular attention was paid to the timing of the relapse, generally located in the second semester of follow-up.
Our clinical cases presentation, although far from statistical significance, aims to generate attention especially on this last parameter, in order to improve outpatient follow-up procedures
MRONJ ASSOCIATED WITH DENTAL INFECTION AND SECONDARY INVOLVEMENT OF THE NEARBY IMPLANT: A CASE REPORT
No full textSince the first reports concerning osteonecrosis of the jaws there has been a lot of debate about the treatment modalities: therapy of the established pathology can in fact be medical or surgical and, in the latter case, be conservative or radical. The widespread difference of clinical presentations and relative rarity of advanced stages disease at diagnosis has not yet been able to guarantee a complete standardization in the therapeutic planning phase. Although there is a well-defined staging of the pathology, the international debate is still heated about more or less invasive surgical attitudes.
We collected data about ONJ in oncological patients surgically treated in our centre during the last 14 years: particular attention was paid to the variables and correlations between relapse, disease staging and treatment modalities. This is to underline the correlation between stage and type of treatment, as well as the greater possibility of relapse in the more advanced stages, in addition to its constancy in relation to the types of treatment. Finally, particular attention was paid to the timing of the relapse, generally located in the second semester of follow-up.
Our clinical cases presentation, although far from statistical significance, aims to generate attention especially on this last parameter, in order to improve outpatient follow-up procedures
Safety and efficacy of the new bidirectional rotational Evolution® mechanical lead extraction sheath: results from a multicentre Italian registry
No full textThe aim of this prospective multicentre study is to evaluate safety and efficacy of the new bidirectional rotational mechanical lead extraction (LE) sheath (Evolution RL, Cook Medical, USA) in chronically implanted leads (>1-year-old leads).
Methods and results:
Between September 2013 and June 2016, a total of 238 leads in 124 consecutive patients were removed by using the new Evolution RL rotational mechanical sheath. Indications for LE were cardiac device infection in 63 (50.8%) cases, lead malfunction in 41 (33.1%), upgrade in 1 (0.8%) case and for other reasons in the remaining 19 cases (15.3%). Ninety-one leads (38.2%) were implantable cardioverter defibrillator leads (81 dual coil vs. 10 single coil), 38 (16%) right ventricular leads, 86 (36.1%) right atrial leads, and 23 (9.7%) coronary sinus leads. The mean implant duration was 92.2 ± 52.9 months (range 12-336). 91.6% of the leads (218/238) were extracted completely with the Evolution RL alone, with the complete success rate rising to 98.7% (235/238 leads) with combined use of a snare. Overall clinical success rate was 100%. No Evolution sheath-related complications were noted. There were no deaths or major complications. Five minor complications (4%) were encountered. In cases of companion leads no wrapping or lead damage were observed.
Conclusion:
On the basis of our prospective multicentre study, the new hand-powered bidirectional rotational mechanical LE sheath is an effective and safe tool for the extraction of chronically implanted leads without major complications and lead wrapping or lead damage
Intermuscular Two-Incision Technique for Subcutaneous Implantable Cardioverter Defibrillator Implantation: Results from a Multicenter Registry
No full textBackground: The traditional technique for subcutaneous implantable cardioverter defibrillator (S-ICD) implantation, which involves three incisions and a subcutaneous pocket, is associated with possible complications, including inappropriate interventions. The aim of this prospective multicenter study was to evaluate the efficacy and safety of an alternative intermuscular two-incision technique for S-ICD implantation.
Methods: The study population included 36 consecutive patients (75% male, mean age 44 +/- 12 years [range 20-69]) who underwent S-ICD implantation using the intermuscular two-incision technique. This technique avoids the superior parasternal incision for the lead placement and consists of creating an intermuscular pocket between the anterior surface of the serratus anterior and the posterior surface of the latissimus dorsi muscles instead of a subcutaneous pocket.
Results: All patients were successfully implanted in the absence of any procedure-related complications with a successful 65-J standard polarity defibrillation threshold testing, except in one, who received a second successful shock after pocket revision. During a mean follow-up of 10 months (range 330), no complications requiring surgical revision were observed. At device interrogation, stable sensing without interferences was observed in all patients. Two patients (5.5%) experienced appropriate and successful shock on ventricular fibrillation and in four patients (11%), a total of seven nonsustained self-terminated ventricular tachycardias were correctly detected. No inappropriate interventions were observed.
Conclusions: Our experience suggests that the two-incision intermuscular technique is a safe and efficacious alternative to the current technique for S-ICD implantation that may help reducing complications including inappropriate interventions and offer a better cosmetic outcome, especially in thin individuals
Unusually rapid development of a lateral neck mass: Diagnosis and treatment of a branchial cleft cyst. A case report
No full textMulticentre experience with the second-generation subcutaneous implantable cardioverter defibrillator and the intermuscular two-incision implantation technique
No full textThe recently developed second-generation subcutaneous implantable cardioverter defibrillator (S-ICD) and the intermuscular two-incision implantation technique demonstrate potential favorable features that reduce inappropriate shocks and complications. However, data concerning large patient populations are lacking. The aim of this multicentre prospective study was to evaluate the safety and outcome of second-generation S-ICD using the intermuscular two-incision technique in a large population study
