EVOLUTION AND HEALING OF FRAGILITY FRACTURES OF THE PROXIMAL FEMUR

After a traumatic fracture a physiological process begins to heal the fracture. The steps of the process are inflammation, granulation, formation of fibrous callus and finally bone. There are many factors that may influence the healing of the fracture: adequate blood supply, good contact between bone fragments, good stability of the fracture, general health, age, smoking, related pathology, use of drugs, etc. In elderly patients the variations in bone structure and healing processes have a negative influence on fracture healing. Fragility fractures require careful placement of the implants to reduce the risk of failure of osteosynthesis. Appropriate surgical devices and facilitation factors must be used to allow bone healing

Semiclassical interferences and catastrophes in the ionization of Rydberg atoms by half-cycle pulses

A multi-dimensional semiclassical description of excitation of a Rydberg electron by half-cycle pulses is developed and applied to the study of energy- and angle-resolved ionization spectra. Characteristic novel phenomena observable in these spectra such as interference oscillations and semiclassical glory and rainbow scattering are discussed and related to the underlying classical dynamics of the Rydberg electron. Modifications to the predictions of the impulse approximation are examined that arise due to finite pulse durations

Excitation of weakly bound Rydberg electrons by half-cycle pulses

The interaction of a weakly bound Rydberg electron with an electromagnetic half-cycle pulse (HCP) is described with the help of a multidimensional semiclassical treatment. This approach relates the quantum evolution of the electron to its underlying classical dynamics. The method is nonperturbative and is valid for arbitrary spatial and temporal shapes of the applied HCP. On the basis of this approach angle- and energy-resolved spectra resulting from the ionization of Rydberg atoms by HCPs are analyzed. The different types of spectra obtainable in the sudden-impact approximation are characterized in terms of the appearing semiclassical scattering phenomena. Typical modifications of the spectra originating from finite pulse effects are discussed.Comment: Submitted to Phys. Rev.

Can Clinical and Surgical Parameters Be Combined to Predict How Long It Will Take a Tibia Fracture to Heal? A Prospective Multicentre Observational Study: The FRACTING Study

Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days) score, calculated soon after tibia fracture treatment, to predict healing time. Methods: The study included 363 patients. Information on patient health, fracture morphology, and surgical treatment adopted were combined to calculate the FRACTING score. Fractures were considered healed when the patient was able to fully weight-bear without pain. Results: 319 fractures (88%) healed within 12 months from treatment. Forty-four fractures healed after 12 months or underwent a second surgery. FRACTING score positively correlated with days to healing: r = 0.63 (p < 0.0001). Average score value was 7.3 ± 2.5; ROC analysis showed strong reliability of the score in separating patients healing before versus after 6 months: AUC = 0.823. Conclusions: This study shows that the FRACTING score can be employed both to predict months needed for fracture healing and to identify immediately after treatment patients at risk of prolonged healing. In patients with high score values, new pharmacological and nonpharmacological treatments to enhance osteogenesis could be tested selectively, which may finally result in reduced disability time and health cost savings

Techniques of cognitive rehabilitation in patients with disorders of consciousness: a systematic review

Acquired brain injury can produce severe impairments of alertness, cognition, behavior, and, sometimes, an impairment of consciousness. Several studies defined the criteria to distinguish the different level of disorders of consciousness (DOC) and many tools to evaluate awareness, alertness, and response to stimuli were created. The aim of this review is to assess the advanced research of rehabilitative protocols and which rehabilitative techniques are used in the care of DOC patients

Can Clinical and Surgical Parameters Be Combined to Predict How Long It Will Take a Tibia Fracture to Heal? A Prospective Multicentre Observational Study: The FRACTING Study

Background. Healing of tibia fractures occurs over a wide time range of months, with a number of risk factors contributing to prolonged healing. In this prospective, multicentre, observational study, we investigated the capability of FRACTING (tibia FRACTure prediction healING days) score, calculated soon after tibia fracture treatment, to predict healing time. Methods. The study included 363 patients. Information on patient health, fracture morphology, and surgical treatment adopted were combined to calculate the FRACTING score. Fractures were considered healed when the patient was able to fully weight-bear without pain. Results. 319 fractures (88%) healed within 12 months from treatment. Forty-four fractures healed after 12 months or underwent a second surgery. FRACTING score positively correlated with days to healing: r = 0.63 (p &lt; 0.0001). Average score value was 7.3 ± 2.5; ROC analysis showed strong reliability of the score in separating patients healing before versus after 6 months: AUC = 0.823. Conclusions. This study shows that the FRACTING score can be employed both to predict months needed for fracture healing and to identify immediately after treatment patients at risk of prolonged healing. In patients with high score values, new pharmacological and nonpharmacological treatments to enhance osteogenesis could be tested selectively, which may finally result in reduced disability time and health cost savings