Use of an Elastomeric Knee Brace in Patellofemoral Pain Syndrome: Short-Term Results

Purpose This article verifies the effectiveness of a new brace on patellofemoral pain syndrome (PFPS) in adjunct to a specifically developed rehabilitation program. Methods Two groups of 30 patients with PFPS were prospectively and randomly allocated to a rehabilitation protocol, with (group A) or without (group B) the use of a specific brace. All the patients were assessed at 3, 6, and 12 months using the disease specific Kujala scale and a visual analog scale (VAS) for pain; time to return to sport and patient satisfaction with the brace were also recorded. Results Kujala scale’s values showed constant and progressive improvement. The mean score at 6 months was 79.8 � 6.8 points in group A and 76.8 � 8.6 in group B, rising at 12 months to 80.9 � 7.5 in group A and 78.4 � 8.3 in group B. VAS scores significantly differed (p < 0.05) between the two groups at both 6 and 12 months; the score recorded at 12months was 0.9 � 1.3 in the brace-treated group and 1.8 � 1.6 in the controls. The patients who used a brace showed a quicker return to sports and 75% of the patients in this group were satisfied. Conclusion All the scores improved progressively in both groups. The most significant improvement concerned pain, showing that the brace used in this study may allow a better subjective outcome and a quicker return to sport. Level of Evidence Level 2, prospective randomized controlled trial

Treatment of primary shoulder stiffness: Results of a survey on surgeon practice patterns in Italy

Objectives Shoulder stiffness is a condition of restricted glenohumeral range of motion (ROM), which can arise spontaneously or as consequence of a known cause. Several treatment options are available and currently no consensus has been obtained on which treatment algorithm represents the best choice for the patient. The aim of this study was to investigate surgeon practice patterns in Italy regarding treatment of primary shoulder stiffness. Methods A literature review was performed to identify randomized controlled trials reporting results of shoulder stiffness treatment. The following controversial or critical points in the treatment of primary shoulder stiffness were identified: modalities of physical therapy; indication for oral corticosteroid; indication and frequency for injective corticosteroid; technique and site of injection; and indication, timing, and technique for surgery. A survey composed by 14 questions was created and administrated to the members of a national association specialized in orthopaedics and sports traumatology (SIGASCOT at the time of survey completion, recently renamed SIAGASCOT after the fusion of the societies SIGASCOT and SIA). Results A total of 204 completed questionnaires were collected. Physical therapy was recommended by 98% of the interviewed. The use of oral corticosteroids was considered by 51%, and injections of corticosteroids by 72%. The posterior injection approach was the one preferred and a number of three was considered the upper limit..

Impact of different exposure models and spatial resolution on the long-term effects of air pollution.

Abstract Long-term exposure to air pollution has been related to mortality in several epidemiological studies. The investigations have assessed exposure using various methods achieving different accuracy in predicting air pollutants concentrations. The comparison of the health effects estimates are therefore challenging. This paper aims to compare the effect estimates of the long-term effects of air pollutants (particulate matter with aerodynamic diameter less than 10 μm, PM10, and nitrogen dioxide, NO2) on cause-specific mortality in the Rome Longitudinal Study, using exposure estimates obtained with different models and spatial resolutions. Annual averages of NO2 and PM10 were estimated for the year 2015 in a large portion of the Rome urban area (12 × 12 km2) applying three modelling techniques available at increasing spatial resolution: 1) a chemical transport model (CTM) at 1km resolution; 2) a land-use random forest (LURF) approach at 200m resolution; 3) a micro-scale Lagrangian particle dispersion model (PMSS) taking into account the effect of buildings structure at 4 m resolution with results post processed at different buffer sizes (12, 24, 52, 100 and 200 m). All the exposures were assigned at the residential addresses of 482,259 citizens of Rome 30+ years of age who were enrolled on 2001 and followed-up till 2015. The association between annual exposures and natural-cause, cardiovascular (CVD) and respiratory (RESP) mortality were estimated using Cox proportional hazards models adjusted for individual and area-level confounders. We found different distributions of both NO2 and PM10 concentrations, across models and spatial resolutions. Natural cause and CVD mortality outcomes were all positively associated with NO2 and PM10 regardless of the model and spatial resolution when using a relative scale of the exposure such as the interquartile range (IQR): adjusted Hazard Ratios (HR), and 95% confidence intervals (CI), of natural cause mortality, per IQR increments in the two pollutants, ranged between 1.012 (1.004, 1.021) and 1.018 (1.007, 1.028) for the different NO2 estimates, and between 1.010 (1.000, 1.020) and 1.020 (1.008, 1.031) for PM10, with a tendency of larger effect for lower resolution exposures. The latter was even stronger when a fixed value of 10 μg/m3 is used to calculate HRs. Long-term effects of air pollution on mortality in Rome were consistent across different models for exposure assessment, and different spatial resolutions

Blog e giornalismo: l'era della complementarietà

Manche lieben sie, manchen sind sie zutiefst zuwider. Manche halten sie für das Kommunikationsmittel der Zukunft, manche nur für eine Modeerscheinung und somit ein vorübergehendes Phänomen. Tatsächlich scheinen die Blogs in eine neue Phase eingetreten zu sein, in der man sie als Ergänzung zu den traditionellen Medien sieht. Die Blogs sind so ein Weg, um Zugang zum Journalismus zu finden. In anderen Fällen fördern sie neue Kommunikationsmodelle wie den noch in den Kinderschuhen steckenden und weiter zu beobachtenden Citizen Journalism. Blogosphäre und Mediasphäre lernen also allmählich, nebeneinander zu existieren und sich in einer Welt, die beide braucht, gegenseitig anzupassen.Some people love them, while others hate them. Some people think that they are the medium of future interactions; others think they’re just a passing fad. In reality, blogs appear to be entering a new phase of complementarities with traditional media. Blogs open the door to journalism. In other cases, they benefit new models such as the still embryonic and, consequently, still to be tested citizen journalism. In conclusion: blogosphere and mediasphere are learning to co-exist, each one adapting itself to the other in a world that needs both.C’è chi li ama e c’è chi li odia. C’è chi pensa che siano il mezzo di comunicazione del futuro e chi li considera una moda e in quanto,tale transitoria. In realtà i blog sembrano entrati in una nuova fase: quella della complementarietà con i media tradizionali. Il blog rappresenta una porta di accesso al giornalismo. In altri casi favorisce lo sviluppo di nuovi modelli come quello, ancora embrionale e dunque ancora da verificare, del citizen jourrnalism. In conclusione, blogosfera e mediasfera stanno imparando a convivere, adattandosi l’una all’altra, in un mondo dove c’è bisogno di entrambe

Adaptive observations and assimilation in the unstable subspace by breeding on the data-assimilation system

Results of targeting and assimilation experiments in a quasi-geostrophic atmospheric model are presented and discussed. The basic idea is to assimilate observations in the unstable subspace (AUS) of the data-assimilation system. The unstable subspace is estimated by breeding on the data-assimilation system (BDAS). The analysis update has the same local structure as the observationally forced bred modes. Use of adaptive observations, taken at locations where bred vectors have maximum amplitude, enhances the efficiency of the procedure and allows the use of a very limited number of observations and modes. The performance of the targeting and assimilation design is tested in an idealized context, under perfect model conditions. It is shown that the process of driving the control solution toward the true trajectory accomplished by the assimilation reduces the number and growth of unstable modes. By observing and assimilating the unstable structures it is then possible to stabilize the assimilation system so that few observations are sufficient to keep the analysis error within very low bounds, even in the presence of observational noise. In an idealized limited area model configuration the number and frequency of observations necessary to control the system is shown to be related to the properties of its unstable subspace

Data assimilation as a nonlinear dynamical systems problem: stability and convergence of the prediction-assimilation system

We study prediction-assimilation systems, which have become routine in meteorology and oceanography and are rapidly spreading to other areas of the geosciences and of continuum physics. The long-term, nonlinear stability of such a system leads to the uniqueness of its sequentially estimated solutions and is required for the convergence of these solutions to the system’s true, chaotic evolution. The key ideas of our approach are illustrated for a linearized Lorenz system. Stability of two nonlinear prediction-assimilation systems from dynamic meteorology is studied next via the complete spectrum of their Lyapunov exponents; these two systems are governed by a large set of ordinary and of partial differential equations, respectively. The degree of data-induced stabilization is crucial for the performance of such a system. This degree, in turn, depends on two key ingredients: (i) the observational network, either fixed or data-adaptive, and (ii) the assimilation method

Patellofemoral instability: classification and imaging

Patellofemoral disorders must be approached through an appropriate process of diagnostic framing, performed using language that is, as far as possible, unequivocal and a validated and organic classification system. At present, the classification proposed by the Lyonnaise school, which fulfills these requirements, is the most complete. This classification divides patellofemoral disorders into three groups: objective patellar instability, potential patellar instability and painful patella syndrome. It also identifies three principal factors of instability: trochlear dysplasia, abnormal patellar height and pathological tibial tubercle-trochlear groove (TT-TG) distance. Imaging is crucial for correct classification and for identifying and measuring the principal factors of instability. Up to now, the emphasis has been placed on the contribution made by traditional diagnostic radiology and computed to - mography. In recent years, however, growing attention has been paid to the use of magnetic resonance imaging in the assessment of the patellofemoral joint and in the study of factors of instability, even though there is still a need for validation of this approach before it can be routinely used in preoperative plannin