Role of frailty in functional recovery after hip fracture, the variable impact in restoring autonomy

Background: In an old or very older adult, frailty is a common geriatric syndrome resulting from aging-associated decline including loss of autonomy related to multiple pathologies. Aim: The study aims to evaluate the frailty affects on functional and rehabilitative recovery of the elderly patient. Design: This is a retrospective study of subjects over 65 years old who underwent hip surgery following a traumatic femoral fracture. Setting: Patients admitted to intensive rehabilitation department after hip fracture event. Population: The sudy include records of 350 patients over-65-year-old with hip fracture treated in hospital with surgery. Methods: Patients enrolled were classified into three groups: youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, 6585 years. Each patient underwent a multidimensional evaluation capable of identifying the deficient domains, defining the presence of frailty, and the different degrees of severity. All patients underwent a project and rehabilitation program according to the literature protocol. Results: The average age of the enrolled patients was 73.2 \ub1 5.6, 38.6% were over 75 years of age, mostly females (58.9%). The prevalence of frailty increased with age, and cognitive functions were associated with both the frailty measured with the Rockwood and Lacks scales. The recovery of Barthel and Tinetti scores correlates to the level of fragility. Conclusion: The approach based on the diagnosis and treatment of the individual disease should be radically changed to a culture and an assessment capacity of elderly persons that take into account the indicators which characterize it as comorbidity, psychological, cultural factors, and environmental health status. Frailty is the sum of these conditions, and it is the most impacting variable in the recovery of autonomy. Clinical rehabilitation impact: The approach based on the diagnosis and treatment of the individual disease should include comorbidity, psychological condition, cultural factors, and environmental health status

From histo-anatomy to sonography in lymphedema: EURO-MUSCULUS/USPRM approach

Lymphedema is a disorder characterized by the accumulation of protein-rich lymphatic fluid in the cutaneous and subcutaneous tissue. Based on the underlying causes, it is classified into primary and secondary forms. The use of ultrasound has recently become widespread in the field of lymphedema – especially for its diagnosis and treatment planning. In this study, we briefly reviewed the anatomy and histology of the skin and subcutaneous tissue – to propose a standardized ultrasound assessment of the superficial tissues in patients with upper-/lower-limb lymphedema. We believe that identification of the sono-histological patterns of the dermo-epidermal complex and subcutaneous tissue has place to serve as a simple and reproducible strategy to evaluate their edema diseases that are often subject to an inaccurate diagnosis in daily clinical practic

Histopathology and high-resolution ultrasound imaging for peripheral nerve (injuries)

Background Neuropathies are commonplace in clinical practice and ultrasound assessment of the peripheral nerves is increasingly becoming a valuable diagnostic tool to support the physical and electrophysiological examinations. In the pertinent literature, several sonographic approaches have been proposed to evaluate the peripheral nerve tissue-mainly based on (semi)-quantitative measures. Objective To define a standardized sonographic approach aiming to evaluate the different sono-histological sections of the peripheral nerve also in a qualitative way. Methods Using high-frequency ultrasound probes and high-level ultrasound machines, we matched the histopathological features of the peripheral nerve (in acute and chronic phase) and the different sonographic patterns. Moreover, high-sensitive power Doppler assessments have been performed to assess the microcirculation of the peripheral nerve in physiological and pathological conditions. Results Modern ultrasound equipment allows a "real-time dissection" of the peripheral nerve evaluating the sonographic patterns of its different histological compartments in physiological and pathological conditions. Moreover, high-sensitive power Doppler allows clear visualization of the microcirculation of the peripheral nerve both in the acute and chronic phases of the neuropathy. Conclusion In clinical practice, using adequate technological equipment, (semi)-quantitative measurements of the peripheral nerve can be coupled with different sonographic patterns of its histological components-both in the acute and chronic phase of the peripheral neuropathy. This way, better/prompt diagnosis and optimal management of the patients would be possible

From physical to ultrasound examination in lymphedema: a novel dynamic approach

In daily practice, medical history and physical examination are commonly coupled with anthropometric measurements for the diagnosis and management of patients with lymphatic diseases. Herein, considering the current progress of ultrasound imaging in accurately assessing the superficial soft tissues of the human body; it is noteworthy that ultrasound examination has the potential to augment the diagnostic process. In this sense/report, briefly revisiting the most common clinical maneuvers described in the pertinent literature, the authors try to match them with possible (static and dynamic) sonographic assessment techniques to exemplify/propose an 'ultrasound-guided' physical examination for different tissues in the evaluation of lymphedema

K/Ka-Band Very High Data-Rate Receivers: A Viable Solution for Future Moon Exploration Missions

This paper presents a feasibility study for a very high data rate receiver operating in the K/Ka-band suitable to future Moon exploration missions. The receiver specifications are outlined starting from the mission scenario and from a careful system analysis. The designed architecture uses a low noise front-end to down-convert the incoming K/Ka-band signal into a 3.7 GHz intermediate frequency (IF). For maximum flexibility, a software defined radio (SDR) is adopted for the I/Q demodulation and for the analog to digital conversion (ADC). The decoding operations and the data interface are carried out by a processor based on field programmable gate array (FPGA) circuits. To experimentally verify the above concepts, a preliminary front-end breadboard is implemented, operating between 27.5 and 30 GHz. The breadboard, which uses components off the shelf (COTS) and evaluation boards (EVBs), is characterized by a 46 dB gain, a 3.4 dB noise figure and a − 37 dBm input-referred 1 dB compression point. Finally, a 40 Msym / s quadrature phase shift keying (QPSK) signal is demodulated by means of a commercially available SDR, demonstrating the above concept. The importance of these results is that they have been obtained exploiting a class of miniaturized and low cost microwave integrated circuits currently available on the market, opening the way to a dense communication infrastructure on cislunar space