I progetti gestiti dai Coordinatori: analisi del loro profilo e successo

Obiettivo. Descrivere la storia dei progetti affidati/ gestiti dai Coordinatori infermieristici ospedalieri. Metodi. \uc8 stato incluso un campione di 56 Coordinatori in ruolo da almeno un anno nei reparti di 13 Ospedali del nord Italia, contattati con criterio di convenienza. Tramite un\u2019intervista strutturata sono stati raccolti dati sui progetti gestiti nel 2009, tipologia, origine (bottom up; top down), il numero di operatori coinvolti e stato del progetto al momento dell\u2019intervista (concluso, incompleto, abbandonato). Risultati. Nel 2009 i Coordinatori hanno gestito 114 progetti, in media 1.8/ciascuno (\ub11.2): 94 (82.5%) erano progetti di miglioramento, 17 (14.9%) di accreditamento, e 3 (2.6%) di ricerca. I progetti avevano coinvolto complessivamente 2.732 persone (73.7% dei team) con un impegno medio di 84 ore ciascuno; 55 (48.2%) progetti erano ancora in corso, 52 (45.6%) conclusi, 5 (4.4%) incompleti (ovvero mancavano di valutazione) mentre 2 (1.8%) erano stati abbandonati. Conclusioni. Gli infermieri sono coinvolti in numerosi progetti nelle aziende sanitarie. La fase pi\uf9 trascurata \ue8 il monitoraggio dei risultati e il loro consolidamento: i progetti assorbono molte risorse e per questo \ue8 fondamentale che siano correttamente gestiti e partano da reali problemi ed esigenze dei pazienti

L\u2019utilizzo in associazione di un integratore alimentare a base di glucosamina, condroitin solfato, estratto di boswellia serrata, vitamina C, vitamina D e manganese in paziente con iniziali segni di gonartrosi

Esperienza clinica di trattamento farmacologico della gonartrosi nelle fasi precosi mediante un composto a base di glucosamina condroitinsolfato e vit D

Temporary bridging external fixation in distal tibial fracture.

Fractures that involve the distal area of the tibia are associated with a high percentage of complications. Soft tissue oedema, swelling, blisters, skin abrasions and open wounds could compromise the outcome of these lesions. The waiting time before surgery with ORIF is mostly due to soft tissue conditions. Early application of a simple joint-spanning external fixator would achieve the initial goal of stability and the respect of soft tissue, thereby decreasing the time necessary for definitive treatment. A total of 40 consecutive patients (22 male and 18 female) with a mean age of 52 years (range 17-82 years) with distal tibial fracture treated between January 2010 and January 2013 were evaluated. Early temporary external fixation was the first treatment step. Twenty patients had pilon fractures, characterised by the intra-articular involvement of the distal tibia with metaphyseal extension, and 20 patients had malleolar fracture-dislocation. Patients were divided into two groups, A and B. Group A comprised 10 patients with ankle fracture-dislocation and bone fragmentation, who were treated with a temporary bridging external fixation that was maintained after ORIF to exploit ligamentotaxis during the first phases of bone healing. In Group B (30 patients), the external fixation was removed after ORIF. The results of the study are in line with the recent literature: temporary external fixation in high-energy trauma and fracture-dislocation of the ankle enables soft tissue to be restored, which facilitates postoperative assessment of bone fragments by CT scan. The complication rate in this study was 5% in patients with malleolar fractures and 20% in patients with pilon fractures. The maintenance of temporary external fixation after ORIF synthesis during the entire first stage of bone healing seems to be a good method of treatment that has a low rate of soft tissue complications

Subtalar dislocation: a narrative review

Subtalar joint dislocation (1% of all dislocations) is the permanent loss of articular relationships in the talonavicular and talocalcaneal joints, without other involvement of the foot. Dislocation can occur medially (85%), laterally (15%), posteriorly (2.5%) and anteriorly (1%). Reduction can be performed by closed or open technique; lateral dislocations often require open reduction because of inclusion of soft tissues or bone fragments. Lateral dislocations are frequently complicated by bone exposure, risk of infection and associated soft tissues injuries

Clinical comparison of oral administration and viscosupplementation of hyaluronic acid (HA) in early knee osteoarthritis

Purpose: Osteoarthritis (OA) is a progressive, chronic and degenerative joint disease characterized by a loss of articular cartilage. Treatment of OA is largely palliative based on nonsteroidal anti-inflammatory drugs, opioids and injections of steroids. Regarding conservative treatment, intra-articular injections of hyaluronic acid (HA) can play a role in early symptomatic knee OA. Materials and methods: Between August 2015 and September 2015, sixty patients (32 males and 28 females) between 40 and 70 years old were randomly allocated into two groups: Half were treated with three weekly intra-articular injections of hyaluronic acid 1.6 % (group A), while the others were treated with Syalox 300 Plus\uae (hyaluronic acid 300 mg + Boswellia serrata extract 100 mg) 1 tab/die for 20 days and afterward Syalox 150\uae (hyaluronic acid 150 mg) 1 tab/die for other 20 days (group B). All patients were evaluated clinically with American Knee Society Score (AKSS) and visual analogue scale (VAS) for the pain before the treatment and after 3 months. Results: AKSS of the patients in both groups was significantly increased by the treatment, and VAS score was significantly reduced. In both groups, two subgroups were created with patients older than 60 years and patients younger than 60 years. Better results are reported in younger patients of group A and older subjects in group B. Conclusions: Despite several limitations, the results of the study have shown that HA injection and oral administration may have beneficial therapeutic effects on patients with early osteoarthritis. Different outcomes in younger and older subject suggested a combined therapy first with local infiltrations and then with oral composition

Splicing mutation causes infantile Sandhoff disease

no abstract availabl

A novel 4-bp deletion creates a premature stop codon and dramatically decreases HEXB mRNA levels in a severe case of Sandhoff disease

We present the molecular genetic analysis of an infantile-onset Sandhoff disease patient. Genomic DNA amplification, heteroduplex analysis, cloning and sequencing revealed a 4-bp deletion in exon 4 (497 ΔAGTT). The result is a frameshift mutation that leads to a stop codon in exon 5. This mutation is associated with a dramatic decrease of HEXB mRNA levels. © 2001 Academic Press