12 research outputs found
All-Inside Arthroscopic Repair For Longitudinal Meniscal Tears: Clinical and Functional Results
No full text: Meniscal injuries are a common challenge in orthopaedic surgery. Depending on their location and the patient's age and functional needs, they can be treated either conservatively or surgically. A surgical approach can consist of arthroscopic meniscectomy or meniscal suture. The latter is the treatment of choice in case of lesions involving the red-red or red-white areas of the meniscus, especially for young high-demanding patients. We report here our experience with the repair of longitudinal meniscal tears using the all-inside technique with the Fast-FixTM 360 Meniscal Repair System (Smith & Nephew Endoscopy, Andover, MA). We retrospectively evaluated 20 consecutive cases of longitudinal meniscal tears. In 4 cases, concomitant ACL rupture was diagnosed and treated alongside the meniscal repair. All patients underwent periodic clinical evaluations. At the latest check-up, their functional outcomes were rated according to the Tegner-Lysholm Knee and KOOS scoring scales. The mean Tegner-Lysholm Knee score was 84.85 (44-100) and the mean KOOS score was 88.58. No failure or major complications were observed. Furthermore, a negative statistical association was observed between age at surgery and the post-operative Tegner-Lysholm Knee score (coef. = -1.01189 [-1.942073,-0.0817063], p = 0.035). This relation, independent of gender, meniscus involved, eventual associated ACL reconstruction, and chondral injury, suggests that functional outcomes worsen with increasing patient age. Our results suggest that the arthroscopic all-inside suture is both safe and effective in cases of longitudinal meniscal tear, considering the good post-operative functionality and low rates of local complications and surgical failures
The two sides of a ghost: Twenty years without the wall
No full textThis paper compares individual preferences for a market economy in Western and Eastern Europe over more than one decade, since the fall of Berlin Wall. The aim is to understand whether preferences in the two blocks have converged towards the current orientation of the EU's economic policy: a market economy, where the Government decides the rules, but does not enter the game directly. This is important as in a democratic system the approved guidelines need the support of the population to be fully effective and not reversed by a change of the government. In the EU the integration process is still going on, especially since the entrance of several Eastern countries. This paper shows that Eastern and Western Europeans have different preferences: the first would like a larger direct intervention of the public hand in the economy, while the second prefer a more private-oriented market than their Eastern peers. In addition for the citizens of ex-soviet countries, the concept of "competition" seems to represent more the new ideology that defeated the communism rather than a real market mechanism. Nevertheless some convergence emerges from data, especially during the last years, i.e. after the negative impact of transition over Eastern economies left the place to a beneficial recovery.transition, Eastern Europe, Western Europe, people's support, market economy
Crioterapia: indicazioni e risultati clinici
No full textSince ages cryotherapy has been used to treat several medical conditions. In the twentieth century, after XXII, liquid nitrogen become easily available and started to be used as cryogenic source for surgical purposes. Marcove has been a very pioneer in using liquid nitrogen for tumour ablation in the field of orthopaedic surgery. Since the sixties he developed a technique of freezing the bone tumour interface directly pouring liquid nitrogen into the cavity made from tumour manual curettage. That method has been used for decades and has still its indications. Thanks to technological progress has been fine tuned in years cryoprobes capable to carry and use the cryogenic power of argon gas, thanks to the Joule Thompson effect. That made possible for orthopaedic surgeons to use cryotherapy in different applications that spread the way of treating musculoskeletal tumours beyond the adjuvant application of nitrogen into cavities produced by curettage. In this paper is presented our twenty-year experience in this field. In a period between 2000 and 2021, 235 patients affected by musculoskeletal tumours has been treated with cryotherapy, at the Oncological Orthopaedic Division at the Florence CTO Hospital or the II Orthopaedic Clinic at the Cisanello University Hospital in Pisa. Five different indications for cryotherapy will be presented, along with five different operative techniques. A review of the available literature on this field, published from 1968 to 2021, will be presented and the results will be compared to what we have reached. Present applications and alternative techniques will be discussed. Cryotherapy is a valuable therapeutical strategy in orthopaedic oncology, with the aim of combine oncological safety and anatomic preservation. Very promising fields of study are combination therapy of cryosurgery and immune-stimulation, along with chemotherapy or radiotherapy, aimed at taking advantage of the immune-modulating effects operated by cryotherapy, as well as new strategies of surgical planning and navigation, based on combining, with dedicated software, 3D modelling and virtual reality
Image-guided Cryotherapy for Musculoskeletal Tumors
No full textBackground: This article represents a review about the use of image-guided cryotherapy in the treatment of musculoskeletal tumor lesions. Cryotherapy is able to induce a lethal effect on cancer cells through direct and indirect mechanisms. In this manuscript, we combined our experience with that of other authors who have published on this topic in order to provide indications on when to use cryotherapy in musculoskeletal oncology.
Discussion: Image-Guided percutaneous cryotherapy is a therapeutic method now widely accepted in the treatment of patients with musculoskeletal tumors. It can be used both for palliative treatments of metastatic bone lesions and for the curative treatment of benign bone tumors such as osteoid osteoma or osteoblastoma. In the treatment of bone metastases, cryotherapy plays a major role in alleviating or resolving disease-related pain but it has also been demonstrated that it can have a role in local disease control. In recent years, the use of cryotherapy have also expanded for the treatment of both benign and malignant soft tissue tumors.
Conclusion: Percutaneous cryotherapy can be considered a safe and effective technique in the treatment of benign and malignant musculoskeletal tumors. Cryotherapy can be considered the first option in benign tumor lesions such as osteoid osteoma and a valid alternative to radiofrequency ablation. In the treatment of painful bone metastases, it must be considered secondarily to other standard treatments (radiotherapy, bisphosphonate therapy and chemotherapy) where they are no longer effective in controlling the disease or when they cannot be repeated (for example radiotherapy)
Limiti prestazionali del sistema costruttivo ISOTEX e relativi criteri di ottimizzazione progettuale
No full textOne-step reconstruction with custom-made 3D-printed scapular prosthesis after partial or total scapulectomy
No full textEn bloc scapulectomy with covering muscles was historically considered the only procedure available for surgical treatment of bone and soft tissue tumors of the scapula. When possible, reconstruction with scapular allograft is the gold standard, and gives satisfactory functional, cosmetic, and oncological outcomes. While good results have recently been reported with 3D-printed prostheses for reconstruction of bone loss, there is little information available in the medical literature regarding scapula reconstruction with a 3D-printed prosthesis. Between 2016 and 2018, we performed four scapular resections (two total and two involving the superior 1/3) followed by reconstruction with a 3D-printed prosthesis made of a porous titanium alloy (Ti-6Al-4V, diameter between 100 and 400 mm), using computer-aided design (CAD) and patient-specific implants (PSI) with previously acquired CT-MR fusion images. At 2 years follow-up, the patients with partial scapulectomy had an MSTS score of 76%, no local or systemic recurrence, good clinical results and no pain. At 1 year 6 months follow-up, the patients with total scapulectomy had an MSTS score of 46%, no local or systemic recurrence, fair clinical results and no pain. Thus, custom-made 3D-printed prostheses appear to be valuable in orthopedic surgery. However, a larger cohort and longer-term analysis are needed to evaluate the scapular 3D-printed prosthesis as a reliable reconstruction technique
Cryotherapy efficacy and safety as local therapy in surgical treatment of musculoskeletal tumours. A retrospective case series of 143 patients
No full textCryotherapy, also called Cryoablation (CA), is a technique that provides a local treatment to various pathological conditions. In Musculoskeletal tumours management, Cryoablation is well accepted and validated as a treatment in palliative cures for metastatic patients. Recently, CA has been proposed also as an alternative to radiofrequency ablation in osteoid osteoma and other benign tumour treatment with promising results. Cryotherapy with argon ice-balls as local adjuvant in open surgery is a tool that can provide enlargement of surgical margins if used properly. There is still not enough evidence supporting use of cryotherapy as local adjuvant in Musculoskeletal open surgery as the series cited above are very small and there is no comparative RCT between local adjuvant therapies including CA. One-hundred-and-eighty-three patients were treated with Cryoablation from 2000 and 2018 in the Musculoskeletal Tumours Surgery Unit of Careggi (Florence) and the University 2nd Clinic of Pisa. In our study group, 38 patients (26.6%) were affected by bone metastasis, 16 patients (11.1%) by aneurismal bone cysts or angiomas, 22 patients (15.4%) by low-grade malignant musculoskeletal tumours, 2 patients (1,4%) by fibromatosis, 63 patients (44.1%) by benign musculoskeletal tumours (principally Giant Cell Tumours-GCT) and 2 patients (1.4%) by Osteosarcomas. In 125 cases (87.4%), CA has been used as an adjuvant therapy, in 12 cases (8.4%) as a percutaneous ablation therapy and in 6 cases (4.2%) as adjuvant to remove tumoral lesions 'en bloc' or as a 'poor technique' for its sterilizing effect on previously resected bones. Mean follow-up was 10 years. Twenty-three patients (16%) were classified as Alive with Disease (AWD) due to local recurrence or tumour progression (14 metastases, 5 low-grade malignant bone tumours, 4 Giant Cell Tumours). Eight patients died due to the disease (6 metastases, 2 osteosarcomas), while 1 died from leukaemia. One-hundred-and-eleven patients (78%) were classified as Continues Disease Free (CDF). All patients reported decrease in pain-related symptoms after surgery and all surgeons reported better control of blood loss. Three cases (2%) of local skin necrosis or wound dehiscence were reported. No local recurrences were reported after fibromatosis ablation. Our results confirm that CA could be considered as a safe and effective technique to treat various conditions as adjuvant and palliative therapy. In particular, in open surgery, cryotherapy as an adjuvant treatment could lead to very low rates of recurrence in locally aggressive tumours like Giant Cell Tumours. These results could be generalized but a better understanding about indications and outcomes can be reached studying CA in specific populations with comparation to other adjuvant techniques
Explaining Variation in South Korean Attitudes toward Bilateral Free Trade Agreements with the United States, China, and Japan
No full textThe author granted permission to publish this paper. It was submitted to the archives on a a CD.When first signed in 2007, the Korea—U.S. Free Trade Agreement (KORUS FTA) was expected to obtain strong public support as many trade experts predicted economic gains for both countries. Contrary to such expectations, however, South Koreans displayed varying levels of support toward KORUS FTA when the official negotiations began in 2006. Therefore, the first part of this research is devoted to answering the following question: "what explains the variation in trade policy preferences among South Koreans to the 2007 KORUS FTA?" This paper identifies trade policy preferences of individuals and empirically examines individual-level factors for either supporting or opposing the
agreement. The project then uses rational choice, value framing, and national security frameworks to develop different hypotheses. These hypotheses are then tested using poll data from the East Asia Institute, JoongAng Daily, and the Chicago Council on Global Affairs. The second part of the research applies the same explanatory model to analyze the varying levels of support for Korea's bilateral FTAs with China and Japan. The national security framework is expanded further explain the variation in South Koreans' attitudes toward Korea's bilateral FTAs with the US, China, and Japan.This honors paper has been read and approved by Stephen J. Ceccoli, Teresa Beckham Gramm, Renee J. Johnson, Carl N. McKinney, and Shadrack W. Nasong'o
Possible Causes for the Increased Susceptibility of Radicalization among British and American Muslims
No full textThe author granted permission for the digitization of this paper. It was submitted by CD.The terrorist attacks of September 11, 2001 placed religiously motivated terrorism at the forefront of western security concerns. In the past decade, however, radical Islamist terrorism has transitioned from a centralized movement with an identifiable leadership to a decentralized one whose existence is dependent on self-radicalization at the local level.
Consequently, there have been rising rates of radicalization among primarily second and third generation Muslims living in the West. Due to the continually high threat level of terrorist attacks, it is important for states to understand why certain Muslims living in the West radicalize, a necessary, though not deterministic step on the path toward becoming a terrorist. While this paper does not delve into western foreign policy as a primary cause of radicalization, it does use case studies of the United Kingdom and the United States to compare the prevalence of three proposed possible causes for increased susceptibility to radicalization: identity crises caused by social alienation, feelings of relative deprivation, and a lack of access to political opportunity structures. The research demonstrates that the three variables listed above are more prevalent in the UK than they are in the US, thereby facilitating higher rates of radicalization in the UK than in the US.This honors paper was approved by Drs. Nuray Ibryamova, Stephen Ceccoli, and Yasir Kazi
First metatarsophalangeal fusion with dorsal plate: clinical outcomes
No full textAbstract Background First metatarsophalangeal joint (MTPJ) fusion is the most effective technique for the treatment of MTPJ primary arthritis, severe hallux valgus and failure of primary corrective surgery of these conditions. It can be achieved through different techniques. We evaluated the outcomes in a cohort of patients treated with dorsal plate arthrodesis. Materials and methods We treated 30 feet for 28 patients; the mean follow-up was 35 months. For each foot, we collected radiological and clinical assessment, with the visual analogue scale (VAS) for pain and the Manchester and Oxford Foot questionnaire (MOFQ). The technique consisted in a cup and cone arthrodesis with the application of a low profile dorsal plate. Patients were allowed for immediate weight bearing. Results Consolidation was achieved in all cases; in 29 cases, radiographic union was recorded within 6 months from surgery, in one case after 9 months. Comparison between the preoperative and postoperative of VAS and MOXFQ values showed a statistically significant difference (p < 0.05). Only one case developed wound dehiscence as complication. Conclusions Even if there is still a debate regarding the best system for MTPJ fusion, we believe cup and cone fusion with dorsal plating is an effective method. Moreover, the stability of the osteosynthesis obtained allows for immediate post-operative weight bearing, making patients able to return soon to their normal life. Trial registration We present a retrospective study; all patients enrolled were retrospectively registered
