Reamed versus unreamed intramedullary nailing in the treatment of elderly pertrochanteric femoral fractures: evaluation of the systemic inflammatory response and organ dysfunction

Background: Currently, the most widely used technique of osteosynthesis in the treatment of proximal femur fractures is the intramedullary nailing and canal reaming. However, intramedullary canal reaming causes a significant release of IL-6 and an important systemic inflammatory reaction. A surgical variant technique is the introduction of the nail with no canal reaming in order to reduce the trauma produced, to simplify and speed up the process of osteosynthesis and, presumably, to reduce the systemic inflammatory response produced by the reaming procedure.The purpose of the study is the comparative evaluation between the reamed and unreamed surgical techniques in terms of increased biochemical markers of organ damage and inflammation. Material and methods: The retrospective observational study was conducted between March 2014 and October 2015 on a sample of 199 patients. The following values were recorded: D-dimer, Troponin, alkaline phosphatase(ALP), ESR, CRP, LDH at admission, at 1st and 4th postoperative days, and the percentage change was calculated between the values of the fourth postoperative day, and those at admission. The Mann-Whitney test was administered for the significance of differences, with p-value

CHRONIC COMPARTMENT SYNDROME OF LOWER LEG. AN UNUSUAL CASE IN NON ATHLETIC PATIENT.

Chronic exertional anterior compartment syndrome is debilitating disease of lower limb. The clinical picture is characterised by limited symptomology at rest, pain during sporting activities, tumefaction and contractures of limb as well impotency by pain of the entire forefoot and hypoesthesia. Usually the most affected patients are athletes. We analyse a case of chronic post traumatic compartment syndrome of the anterior tibial muscle in an unsportsmanlike patient

IS BASELINE STRAIN INDEX A PROGNOSTIC FACTOR FOR SMALL UNILATERAL SUPRASPINATUS TENDON TEARS? A PROSPECTIVE STUDY

Purpose. From prospectively report the 2-year follow-up clinical and real-time sonoelastography (RTSE) outcomes of a group of patients affected by small unilateral supraspinatus tendon tears. Our hypothesis was that patients with lower baseline strain indexes would have worst outcomes at follow-up. Methods. We recruited patients suffering by a unilateral rotator cuff tear. All patients have prospectively scrutinized. Patients were initially managed non-operatively, after at least 3 months of failed conservative treatment patients went under surgery. Our clinical evaluation and follow up was done by: complete physical examination; VAS for pain; Quick DASH; Constant–Murley score; Simple Shoulder Test; ASES score and UCLA score. The mechanical properties of tissues were evalutated by Conventional ultrasounds and RTSE and they were estimated uging the Strain index. Results. Forty-three patients were available for evaluation at 2 years. Fifteen had undergone surgery (operative group), while 28 recovered from pain and dysfunction with conservative management andhad not required surgery (non-operative group). Patients in both groups significantly improved at follow-up, and no differences were found in all considered clinical outcomes. The biomechanical properties of repaired tendons were maintained, while non-operatively treated tendons softened over time. Baseline and follow-up strain indexes were linearly correlated with clinical outcomes at 2 years. Conclusions. Baselinestrain index could be associated with post-operative functional outcomes at 2-year follow-up. The biomechanical properties of surgically repaired tendons were maintained, while non-operatively treated tendons softened over time. At least in this cohort of patients, baseline strain index did not suggest who could be managed conservatively and who will need surgery

EPIDEMIOLOGY OF INJURIES AND DISEASES DUE TO OVERUSE IN RUGBY: OBSERVATIONAL STUDY OF THE PLAYERS OF “CUS PERUGIA RUGBY”

Background: Rugby is a contact sport and for this reason is very demanding from a physical point of view. Up to now few studies describe the incidence and types of the most frequent traumas. The present study aims to evaluate the epidemiology of the major accidents related to the practice of this sport. Materials and methods: We collected data on a total of 321 players belonging to the Sports Club "CUS Rugby Perugia" for a total of three years taking into consideration the type of injury, the part of the body concerned, if the injury occurred during official competitions or in training, and also the lapse of time necessary for recovery. Results: We had a total of 240 accidents (45.8% of minor gravity, 36.6% of average gravity and 17.6% serious). In relation to the type of trauma, we noticed that minor injuries consisted in most cases and above all in facial injuries, while the average and the serious severity accidents affected in most cases the knees: (sprains, meniscal and ligamentous tears). Discussion: By analyzing the collected data we have noticedthat the highest number of accidents occurred during official competitions, and especially during the last minutes of the game, probably due to a greater muscle fatigue. The role of the players is also important because it correlates to a different type of risk. Conclusions: This study confirms that rugby has a higher accident rate than other contact sports. Therefore specific training strategies and techniques should be implemented, in order to reduce the incidence of injuries, especially at the level of the lower limbs

Children\u27s Oncology Group\u27s 2023 blueprint for research: Pharmacy

Children\u27s Oncology Group (COG) pharmacists and pharmacy technicians from more than 200 COG-member institutions comprise the COG Pharmacy Discipline. Discipline members serve an essential role in the design and execution of COG clinical trials. Core activities include study drug management, study drug access, clinical trial operations, protocol harmonization, and direct patient care. Discipline members are also actively involved in continuing education, membership engagement, and research across other COG committees/domains. Future areas of committed growth for the discipline include pharmacogenomics, pharmacokinetics, pharmacoeconomics, pharmaceutics, and implementation science