24 research outputs found
experimental evaluation of tactile sensors for oral and maxillofacial surgery
No full textThe sense of touch is fundamental in surgery. It provides information about the clinical condition of tissues and feedback for controlling surgical gestures. In the last decade the use of sophisticated and low-invasive surgical techniques has limited the interaction of surgeons via their own hands. In fact the introduction of laparoscopic, endoscopic and robotic surgery has reduced the invasiveness of procedures of but also the possibility of direct control and palpation. Despite the clinical evidence on the advantages and added value of such new surgical technologies, the lack of tactile interaction remains a limiting factor. The role of tactile information concerns sensing, for example, the pressure necessary to incise a tissue or to tighten the knot of a suture or the palpation of an anatomical structure. Traditionally, tactile information is received by the own hand of the operator or through the surgical instrumentation. In fact, palpation using hands has always been a prominent part of the objective examination, allowing the physician to determine the location of pathological conditions that escape sight. In addition, it also provides information about extension, consistency and pain of hidden pathologies. Each tissue has its own tactile peculiarities as well as each procedure requires specific tool-tissue interaction. Errors in a surgical procedure due to the lack of tactile information or inadequate tool-tissue interaction forces are common and, therefore, acquiring this kind of knowledge is paramount to enhance surgical performance and education
Sublingual Sufentanil Tablet System (SSTS-Zalviso®) for Postoperative Analgesia after Orthopedic Surgery: A Retrospective Study
No full textThe aim of this study is to compare sublingual sufentanil and the administration device for its delivery (SSST-Zalviso®) with the traditional strategies used for the control of postoperative pain to establish if there is an actual benefit for the patient and healthcare personnel.
Materials and Methods: A retrospective study was conducted to compare the efficacy of SSTS in the management of postoperative pain after orthopedic surgery between October 2018 and June 2020. We analyzed 50 patients who underwent a total knee arthroplasty (TKA). The control group consisted of 21 patients who underwent TKA and during the hospitalized recovery received a continuous femoral nerve block (cFNB). The statistical study was conducted with a level of significance p = 0.05 using “U” test, Mann–Whitney, to verify if patients had a better control of pain and fewer calls for rescue analgesia. Results: Patients involved in the study showed a significant reduction in pain intensity with the use of SSTS in the 24 h following surgery (p = 0.0568), also a drastic drop of the calls for rescue analgesia (p < 0.0001) reduces the number of calls for its control. Conclusions: This study
demonstrates how SSTS might reduce pain intensity in the first 24 h after surgery and reduce the number of calls for its control, indicating better analgesic coverage and implying reduced interventions from healthcare personnel. This could allow a redistribution of resources and a reduction in the use of analgesic drugs in wards where the SSTS is used
The Use of Tactile Sensors in Oral and Maxillofacial Surgery: An Overview
No full textBackground: This overview aimed to characterize the type, development, and use of haptic technologies for maxillofacial surgical purposes. The work aim is to summarize and evaluate current advantages, drawbacks, and design choices of presented technologies for each field of application in order to address and promote future research as well as to provide a global view of the issue. Methods: Relevant manuscripts were searched electronically through Scopus, MEDLINE/PubMed, and Cochrane Library databases until 1 November 2022. Results: After analyzing the available literature, 31 articles regarding tactile sensors and interfaces, sensorized tools, haptic technologies, and integrated platforms in oral and maxillofacial surgery have been included. Moreover, a quality rating is provided for each article following appropriate evaluation metrics. Discussion: Many efforts have been made to overcome the technological limits of computed assistant diagnosis, surgery, and teaching. Nonetheless, a research gap is evident between dental/maxillofacial surgery and other specialties such as endovascular, laparoscopic, and microsurgery; especially for what concerns electrical and optical-based sensors for instrumented tools and sensorized tools for contact forces detection. The application of existing technologies is mainly focused on digital simulation purposes, and the integration into Computer Assisted Surgery (CAS) is far from being widely actuated. Virtual reality, increasingly adopted in various fields of surgery (e.g., sino-nasal, traumatology, implantology) showed interesting results and has the potential to revolutionize teaching and learning. A major concern regarding the actual state of the art is the absence of randomized control trials and the prevalence of case reports, retrospective cohorts, and experimental studies. Nonetheless, as the research is fast growing, we can expect to see many developments be incorporated into maxillofacial surgery practice, after adequate evaluation by the scientific community
Design, development and experimental evaluation of tactile sensors for surgery: optimization by means of FEM analysis combined with inverse modelling via neural networks
No full textIl lavoro di tesi ha riguardato la progettazione, lo sviluppo, la realizzazione e la validazione sperimentale di uno strumento sensorizzato per chirurgia maxillofacciale con ottimizzazione mediante analisi FEM combinata a modellazione inversa con reti neurali. Il dispositivo è stato realizzato in alluminio mediante tecniche di additive manufacturing. Successivamente sono stati integrati nel dispositivo dei sensori tattili FBG. Infine è proposto un Set-Up sperimentale per una valutazione finale del prototipo
Perineural dexamethasone: neurotoxicity or neuroprotection? A systematic review of preclinical evidence
No full textBackground: Perineural dexamethasone is widely used as an adjuvant to local anesthetics in regional anesthesia to prolong analgesia. However, concerns persist regarding its potential neurotoxic effects, particularly when administered perineurally. This systematic review aims to synthesize preclinical evidence evaluating the neurotoxicity or neuroprotective properties of perineural dexamethasone. Methods: A systematic search of PubMed, CENTRAL, Scopus, and Embase was conducted through May 22, 2025. Eligible studies included in vivo or in vitro preclinical models assessing the neurotoxic or neuroprotective effects of perineural dexamethasone compared to control conditions. Risk of bias was assessed using the SYRCLE tool for in vivo studies and a narrative evaluation for in vitro studies. A total of 14 studies (11 in vivo, 3 in vitro) met inclusion criteria. Results: In vitro studies showed that dexamethasone alone was not neurotoxic at clinically relevant doses but could enhance cytotoxicity when combined with local anesthetics at higher concentrations. In vivo models generally demonstrated no significant long-term nerve inflammation, degeneration or demyelination, with some early protective effects observed in perineural dexamethasone groups. However, all in vivo studies were rated at high risk of bias. In nerve injury models, dexamethasone reduced apoptotic and inflammatory markers when administered immediately post-injury, with limited effect when delayed. Conclusions: Preclinical evidence supports the general safety of low-dose, preservative-free perineural dexamethasone. Nonetheless, high-dose use, additives, and application in patients with neuropathies may pose risks. Given the high risk of bias in existing studies and minimal added benefit over systemic administration, clinical caution is advised
Identifying and analyzing extremely productive authors in intensive care medicine: A scientometric analysis
No full textIntroduction: Clinical progress relies heavily on research, however, recent years have seen distortions in this process due to the “publish or perish” model. This model is further amplified by team science, leading to inflated author counts and metrics. Recently the rise of hyperprolific (HA) and almost hyperprolific (AHA) authors has been highlighted in the global literature scenario, but data on intensive care medicine (ICM) is lacking. This study aims to investigate HA and AHA authors in ICM and the impact of COVID-19 pandemic on publication rates. Material and methods: We identified authors publishing in ICM journals indexed by Scopus from 2019 to 2023, retrieving their Scopus IDs, publication details, and gender. HA were defined as authors who published at least 73 articles per year, while AHA as authors who published more than 60. The effect of COVID-19 literature was assessed by excluding COVID-related articles from the dataset. Results: We identified 42860 articles in ICM journals, involving 186150 unique authors with a median of 5 publications per author. Only 248 (0.1 %) were extremely productive, with 131 being hyperprolific (HA). Removing COVID-19 papers significantly reduced HA and AHA counts by up to 40 %. Extremely productive authors were predominantly male (91.5 %) and globally distributed, primarily from Europe, Asia, and the Americas. Conclusions: Hyperprolific authors in ICM represent a very small minority. These authors are typically related to ICM, male, senior researchers with a global distribution, who publish high-quality research through a significant research network
Correction to: Patients in intensive care unit for COVID-19 pneumonia: the lung ultrasound patterns at admission and discharge. An observational pilot study (The Ultrasound Journal, (2021), 13, 1, (10), 10.1186/s13089-021-00213-x)
No full textFollowing publication of the original article [1], we were notified that the first and last author names have been swapped. The original article has been corrected
Cultural Adaptation and Testing of the Italian Version of the Edmonton Functional Assessment Tool-2 (EFAT2-I)
No full textBackground: Physiotherapy in Palliative Care (PC) is effective in the management of a series of respiratory, circulatory and motor symptoms, and often has a positive impact on the patient's mood. The Edmonton Functional Assessment Tool (EFAT) is the only existing validated tool specifically designed for functional assessment in PC, and its use has been recommended in clinical practice. To date, no Italian version of the tool has been validated. The aim of this study was to translate, cross-culturally adapt, and evaluate the psychometric properties of the Italian version of the EFAT2. Method: After receiving formal permission from the author, Beaton guidelines for cross-cultural adaptation were followed, namely: (1) forward translation; (2) a multidisciplinary focus group (including 4 physiotherapists, 1 physician, 3 nurses, 1 occupational therapist, 1 psychologist) to assess semantic, idiomatic, experiential, and conceptual equivalence; (3) backward translation. The Content Validity Index (CVI) was used to assess content validity of the tool. Construct and concurrent validity were also evaluated. To evaluate the reliability of the EFAT2-I, reliability was measured using Cronbach alfa, item-total correlation, and Cohen's Kappa. Results: 119 patients admitted to a Palliative Care Unit (Italy) agreed to participate in the study. The EFAT2-I mean score was 11.3, ranging from 0 to 30. Very good CVI scores were achieved, both in terms of single item validity (I-CVI) and of whole scale validity (S-CVI). Positive results were obtained from construct, concurrent validity assessment and measures of reliability. Discussion: The EFAT2-I showed good psychometric properties and can be used as a rehabilitation assessment tool in palliative care settings. The validation of the Italian version will allow comparison of different centres and palliative care facilities on national and international levels
The Enduring Table 1 Fallacy: A Meta-research Study of Baseline Testing in Anesthesiology and Pain Trials
No full textBackground: Randomized controlled trials (RCTs) are designed to achieve balanced distribution of baseline characteristics across study arms through random allocation, rendering null-hypothesis significance testing on these characteristics unnecessary and potentially misleading. Despite longstanding guidance discouraging this practice, its prevalence and patterns within anesthesiology and pain medicine literature remain unclear. Methods: The authors conducted a meta-research study of parallel-group RCTs published from 1996 to 2025 across 101 journals indexed under the "Anesthesiology and Pain Medicine" category in Scopus (Elsevier, The Netherlands). Data extraction included study characteristics, reporting of baseline testing, number of variables tested, and statistical significance. Multivariable logistic regression was used to identify factors associated with baseline testing, and a binomial test assessed whether the observed rate of significant findings exceeded the expected false-positive rate under the null hypothesis. Results: Of 2,453 eligible RCTs, 1,186 (48.3%) reported statistical testing of baseline characteristics. Among studies performing such testing, 228 (19.2%) reported at least one statistically significant difference, and 58 (25.4%) discussed it as a study limitation. A total of 11,516 variables were tested, with 424 (3.7%) reported as statistically significant-below the 5% expected by chance ( P < 0.001). Larger author teams were associated with lower odds of baseline testing (odds ratio, 0.95; 95% CI, 0.93 to 0.97), while a higher number of variables tested increased the odds of finding at least one significant difference (odds ratio, 1.10; 95% CI, 1.07 to 1.12). Conclusions: Despite methodologic guidance and Consolidated Standards of Reporting Trials (CONSORT) recommendations, statistical testing of baseline characteristics remains common in anesthesiology RCTs and has not declined over time. This practice likely reflects persistent misunderstanding of randomization and may lead to misinterpretation of study validity. Education and stronger editorial policies are needed to align reporting behavior with best practices and improve trial transparency
