9 research outputs found
L’utilizzo in associazione di un integratore alimentare a base di glucosamina, condroitin solfato, estratto di boswellia serrata, vitamina C, vitamina D e manganese in paziente con iniziali segni di gonartrosi
No full textEsperienza clinica di trattamento farmacologico della gonartrosi nelle fasi precosi mediante un composto a base di glucosamina condroitinsolfato e vit D
Oncogenic Osteomalacia Associated with Phosphaturic Mesenchymal Tumor of the Knee: Case Presentation and Review of the Literature
No full textCase report dim un raro tumore mesenchimale fosfaturico del ginocchio trattato chirurgicamente
Temporary bridging external fixation in distal tibial fracture.
No full textFractures that involve the distal area of the tibia are associated with a high percentage of complications. Soft tissue oedema, swelling, blisters, skin abrasions and open wounds could compromise the outcome of these lesions. The waiting time before surgery with ORIF is mostly due to soft tissue conditions. Early application of a simple joint-spanning external fixator would achieve the initial goal of stability and the respect of soft tissue, thereby decreasing the time necessary for definitive treatment. A total of 40 consecutive patients (22 male and 18 female) with a mean age of 52 years (range 17-82 years) with distal tibial fracture treated between January 2010 and January 2013 were evaluated. Early temporary external fixation was the first treatment step. Twenty patients had pilon fractures, characterised by the intra-articular involvement of the distal tibia with metaphyseal extension, and 20 patients had malleolar fracture-dislocation. Patients were divided into two groups, A and B. Group A comprised 10 patients with ankle fracture-dislocation and bone fragmentation, who were treated with a temporary bridging external fixation that was maintained after ORIF to exploit ligamentotaxis during the first phases of bone healing. In Group B (30 patients), the external fixation was removed after ORIF. The results of the study are in line with the recent literature: temporary external fixation in high-energy trauma and fracture-dislocation of the ankle enables soft tissue to be restored, which facilitates postoperative assessment of bone fragments by CT scan. The complication rate in this study was 5% in patients with malleolar fractures and 20% in patients with pilon fractures. The maintenance of temporary external fixation after ORIF synthesis during the entire first stage of bone healing seems to be a good method of treatment that has a low rate of soft tissue complications
A complication following ACL reconstruction using bioabsorbable cross-pins
No full textThis is a case of a proximal pin migration after ACL reconstruction in medial soft tissue with pain, inflammatory reaction and functional reduction. 33-year-old male presented at our clinic with a complete ACL rupture. Reconstruction with autogenous gracilis and semitendinosus hamstring tendons was performed and graft fixed in the femoral canal with two PLLA bioabsorbable pins (RIGIDFIX® Cross Pin System). Two months postoperatively the patient presented swelling and pain on the medial side of the knee, full range of motion and negative results at the Lachman and Pivot shift tests. MRI examination showed the superior femoral tunnel crossing both the lateral and medial cortex lodging the pin in the knee’s medial soft tissue corresponding to the swelling area reported by the patient. The tendon graft was properly positioned. After surgical removal of the pin through a small skin incision, the pain and swelling promptly subsided allowing the patient return to normal activities in few weeks without any pain. In our opinion the painful swelling of the knee was due to a displacement of the pin that had been accidentally lodged in the soft tissues instead of the bone causing a foreign-body reaction resulting in granuloma formation with local inflammation. This dislodgement could have been due to an inappropriately long femoral tunnel
Use of a non-medicated plaster in shoulder tendinopathies
No full textWe assessed 20 shoulders with rotator cuff tendinopathy and partial tendon tears treated with FIT® plasters (far infrared technology). The criteria for inclusion were pain at night and during active shoulder movement. Patients with restricted passive movement (adhesive capsulitis) and complete tendon tears were excluded. Two different types of FIT® plasters were used according to the different power of action. Plasters were replaced after 7 days and dismissed after 15 days. The patients were assessed using the VAS pain scale and the Constant Murley score for function. The use of FIT® plasters have shown a certain effectiveness in activation of the endogenous analgesic action, with a role in alleviate painful symptoms and improve function in rotator cuff tendinopathies, without adverse events. On the base of the safety of this technology and promising results of our study, further studies should be encouraged to confirm its effectiveness, increasing the sample number and follow up so as to demonstrate definitely that the use of technologies, on which FIT® plasters is based, may be a valid alternative as "non-medicated pain relief"
Antibiotic-Loaded Spacer for Two-Stage Revision of Infected Total Knee Arthroplasty
No full textBackground Infection of total knee arthroplasty (TKA) is a challenge in orthopedic surgery. In literature TKA infection is classified according to the time after surgery: acute postoperative; late chronic; acute hematogenous; positive intraoperative microbiological growth. Purpose The purpose of this study is to present the results of the use of a preformed antibiotic-loaded spacer in TKA infections, treated by a two-stage revision procedure. Patients and Methods A series of 19 consecutive patients (20 knees) with a diagnosis of infected TKA were treated from January 2003 to February 2012. Two-stage reimplantation protocols were completed only in 16 patients and these data were included in the study. We lost three patients at follow-up. An antibiotic-loaded preformed articulating polymethylmethacrylate spacer was applied. Patients were observed 1, 3, and 6 months postoperatively and then yearly for clinical and radiographic examination. Results The mean American Knee Society Score improved from 68.4 preoperatively (range, from 34 to 108) to 112.7 at final follow-up (range, from 49 to 180). The pain was evaluated as part of clinical score. It improved from an average of 19.3 preoperatively (range, from 10 to 30) to 34.3 at final follow-up (range, from 10 to 50). The average range of motion improved from 40.1 degrees (range, from 6 to 90 degrees) to 79.3 degrees (range, from 45 to 125 degrees). Conclusions The use of the spacer allows obtaining a reduction of pain, an improvement of quality of life in the period of time between the two surgical stages and an easier reimplantation of TKA
Acute Treatment of Osteochondral Detachment Following Patellar Dislocation: Clinical and Short-Term MRI Follow-Up
No full textBackground: The aim of our study is to emphasizes the significance of prompt diagnosis and intervention in younger patients affected by osteochondral detachment after patellar dislocation, where the first objective is to minimize in the shortest possible time complications and ingravescence. The method involves a clinical patient assessment and MRI follow-up in subjects who underwent to an immediate surgical intervention for osteochondral damage. Methods: From January 2020 to December 2022, 22 patellar dislocation cases were assessed; osteochondral lesions were identified in 12 (54%) patients; nine of these patients were treated immediately with knee arthroscopy, while in seven instances the osteochondral fragment was reattached using bioabsorbable pins. Post-operative clinical evaluations were conducted at one-, three-, and six-month intervals; finally, a six-month post-operative MRI was performed for all surgically treated patients. Results: The MRI evaluations, conducted six months post-operation for all seven patients, indicated successful integration of the reattached osteochondral fragment. Every patient returned to their pre-injury activities after surgery. However, two of them reported mild pain in the anterior region of the knee post-surgery. Conclusions: in young patients, swift diagnosis and immediate surgical intervention for osteochondral detachment resulting from patellar dislocation are crucial. This approach has been identified as the best practice, since it substantially minimizes immediate functional restrictions and significantly lowers the long-term risk of femoral-patellar osteoarthritis
MuSIV : Musical Sustainable Inclusive Vltava. Studio del comportamento meccanico e acustico di pannelli di facciata a base di materiali cementizi ad alte prestazioni e applicazione alla nuova filarmonica di Praga
No full textLAUREA SPECIALISTICA A CICLO UNICOL'oggetto del lavoro di tesi illustrato si incentra sullo studio del comportamento meccanico e acustico di pannelli
di facciata a base di materiali cementizi ad alte prestazioni, reso possibile grazie ad una campagna sperimentale
volta ad indagare differenti combinazioni di matrici cementizie e rinforzi.
In particolare, vengono riportati i risultati delle prove di carico, d'impatto e di flessione a 4 punti svolti presso
lo stabilimento dell'azienda Magnetti e il Laboratorio del Politecnico di Milano, che hanno permesso non solo
di costruire un modello ad elementi finiti che potesse descrivere in maniera sufficientemente vicina il loro
comportamento reale, ma anche di effettuare scelte progettuali per la realizzazione di una nuova filarmonica
a Praga.
Il progetto MuSIV: Musical Sustainable Inclusive Vltava nasce dunque come risposta alla richiesta da parte della
municipalità della città di Praga di dotare la capitale ceca di un nuovo teatro filarmonico.
Gli altri edifici per concerti musicali della città, infatti, per quanto ben progettati, non rispettano gli alti
standard acustici richiesti oggi ad una sala di musica classica, e vanno dunque integrati con sale più moderne,
anche per far fronte al numero crescente di cittadini e turisti che cercano eventi musicali di alta qualità in una
delle capitali della musica classica europea.
Il progetto della nuova filarmonica di Praga si inserisce in un contesto estremamente centrale rispetto allo
sviluppo del tessuto cittadino, ed è parte di un importante progetto di rigenerazione urbana, volto a valorizzare
uno scalo ferroviario ora dismesso.
Questo vuole ricucire una divisione creata in uno dei distretti più centrali della capitale ceca, dandogli nuova
vita e rispettandone la vocazione artistica acquisita nell’arco di decenni, oltre a dare una spinta alla mobilità
lenta e sostenibile migliorando la connessione tra questo importante quartiere e il centro città.
Le richieste del bando di concorso indetto dalla municipalità di Praga includono la progettazione di spazi
pubblici che possano essere usufruibili da parte dei cittadini per suonare e ascoltare musica anche all'aperto.
Il cuore pulsante della nostra proposta progettuale per la filarmonica di Praga è dunque un teatro all'aperto,
collocato tra due corpi di fabbrica destinati ad ospitare le due sale da concerti richieste per rispondere a
esigenze di carattere urbanistico, acustico e ambientale.
Attorno ad esso verte lo studio dell'acustica, il quale indaga la risposta dei pannelli di cui le geometrie sono
state definite per perfezionare la loro risposta acustica e dunque offrire la possibilità agli spettatori di godersi
esperienze musicali indimenticabili anche in spazi all'aperto.
Una parte rilevante dello studio è stata rivolta all’analisi della sostenibilità dell’intervento col metodo del
Life Cycle Assessment. Attraverso questo, è stato cercato di rendere il progetto meno impattante possibile dal
punto di vista ambientale, sfruttando le masse dell’edificio come pozzi di stoccaggio del carbonio atmosferico
utilizzando materiali biogenici, in particolare per l’isolamento, ed ottimizzando il più possibile i materiali
della struttura. Sono state difatti indagate diverse tipologie di strutture e le loro rispettive emissioni di CO2, e
infine è stata scelta quella che potesse essere maggiormente compatibile con i limiti di natura architettonica e
tecnologica.The subject of the thesis focuses on the study of the mechanical and acoustic behavior of façade panels based on high-performance cementitious materials, made possible by a campaign of experiments aimed at investigating different combinations of cementitious matrices and reinforcements.
In particular, the results of load, impact, and 4-point bending tests carried out at the Magnetti manufacturer company's plant and the Milan Polytechnic University Laboratory are reported, which allowed not only the creation of a finite element model that could describe their real behavior closely enough, but also the making of design choices for the construction of a new philharmonic in Prague.
The MuSIV: Musical Sustainable Inclusive Vltava project thus came about as a response to a request from the Prague city municipality to provide the Czech capital with a new philharmonic theater.
The city's other musical concert buildings, in fact, however well designed, do not meet the high acoustic standards required of a classical music hall today, and therefore need to be supplemented with more modern halls, in part to cope with the growing number of citizens and tourists seeking high-quality musical events in one of Europe's classical music capitals.
The new Prague Philharmonic project is extremely central to the urbam development of the city, and is part of a major urban regeneration project aimed at enhancing a currently abandoned railway yard.
This aims to mend a division created in one of the most central districts of the Czech capital, giving it a new life and respecting its artistic vocation acquired over the decades, as well as enhancing the sustainable transport by improving the connection between this important district and the city centre.
The requirements for the philharmonic hall in the competition brief issued by the Prague municipality include the design of public spaces that can be used by citizens to play and listen to music even outdoors.
The heart of our design proposal for the Prague Philharmonic Hall is therefore an open-air theatre, located between two buildings which will house the two concert halls required to meet urban, acoustic and environmental requirements.
The acoustics study revolves around the theatre and investigates the response of the panels of which the geometries were defined to perfect their acoustic response and thus offer the possibility for spectators to enjoy unforgettable musical experiences even in outdoor spaces.
A major part of the study was devoted to the analysis of the sustainability of the project with the Life Cycle Assessment method. An attempt was made to make the project as environmentally less impactful as possible by using the masses of the building as atmospheric carbon sinks using biogenic materials, particularly for insulation, and optimizing the materials of the structure as much as possible. As a matter of fact, different types of structures and their respective CO2 emissions were investigated, and finally the one that could be most compatible with architectural and technological constraints was chosen
Childhood neglect, the neglected trauma. A systematic review and meta-analysis of its prevalence in psychiatric disorders.
No full textTraumatic events increase risk of mental illnesses, but childhood neglect prevalence in psychiatric disorders is understudied. This systematic review and meta-analysis assessed neglect prevalence, including emotional neglect (EN) and physical neglect (PN), among adults with psychiatric disorders. We conducted a systematic search and meta-analysis in 122 studies assessing different psychiatric disorders. Prevalence was 46.6% for unspecified neglect (Ne), 43.1% for EN, and 34.8% for PN. Although a moderating effect of the psychiatric diagnostic category was not confirmed, some clinical diagnoses had significantly lower prevalence rates than others. Patients with bipolar disorder and major depressive disorder showed lower prevalence rates of EN and PN, whereas lower prevalence was found in psychotic disorders and eating disorders for PN only. Neglect assessment was a significant moderator for Ne and PN. No moderating effect of age and sex on neglect prevalence was found. Heterogeneity levels within and between psychiatric diagnostic categories remained high. This is the first meta-analysis examining diverse types of neglect prevalence considering different psychiatric diagnoses. Our results explore the prevalence of childhood neglect and its subtypes among adults with psychiatric disorders, contributing to understanding the nuanced interplay between neglect and specific psychiatric conditions, and guiding interventions for affected individuals
