Cotile a doppia mobilità: nostra esperienza. Revisione clinica e bibliografica.

L’intervento di artroprotesi dell’anca ha subito un forte incremento negli ultimi decenni a causa dell’invecchiamento della popolazione generale. L’incremento della sostituzione protesica è causa naturalmente di un aumento delle complicanze ad essa legate in particolare della lussazione protesica. Diversi fattori possono influenzare la stabilità articolare quali fattori di rischio del paziente, fattori di rischio legati all’intervento ed al tipo di impianto utilizzato.Per oltre un decennio molti studi hanno concluso che l’incidenza di lussazione protesica è diminuita con l’utilizzo di impianto a doppia mobilità introdotto per la prima volta in Francia da Bousquet a metà degli anni settanta. La principale critica rivolta a quest’impianto riguarda la maggior usura cui sarebbe sottoposto, nel lungo periodo, l’inserto in polietilene rispetto agli altri modelli di protesi. Infatti il rischio teorico di maggior usura del polietilene sarebbe legato al fatto che entrambe le superfici concava e convessa dell’inserto si articolano con componenti metalliche (duplice articolarità). Negli ultimi anni alcuni autori hanno pubblicato dei lavori sui risultati a lungo termine degli impianti a doppia mobilità che concludono come l’usura del polietilene sia comparabile a quella degli altri modelli di protesi d’anca. In questa tesi presentiamo i nostri risultati clinici e radiografici nell’utilizzo di impianti protesici d’anca a doppia mobilità

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

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 \ub1 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

Acute juvenile cataract in newly diagnosed type 1 diabetic patients: a description of six cases

Cataract represents one of the most frequent eye complications in type 1 and type 2 patients; contrarily, acute cataract in young diabetic patients occurs very rarely. The aim of this study was to describe six cases of acute cataract in adolescents at the onset of type 1 diabetes. Eight hundred and twenty-six patients with type 1 diabetes were retrospectively studied. A multivariate analysis was applied to verify the weight of the following laboratory findings taken on admission (independent variables): glycemia, glycated hemoglobin (HbA1c), pH, base excess (BE), and on the occurrence of cataract (dependent variable). Six patients (0.7%) presented with acute lens opacities. Cataract development was significantly correlated with HbA1c and glycemia. The relative risk increases about twice for each percentage point from 12.8 to 14.1% of HbA1c; glycemic blood levels represent a moderate risk factor for cataractogenesis. Ketoacidosis and BE were not significantly correlated

Bilateral isolated acute cataracts in three newly diagnosed insulin dependent diabetes mellitus young patients

Cataract is a very frequent finding in adults with diabetes mellitus. On the contrary, acutely developed cataract in young insulin dependent diabetes mellitus (IDDM) patients at the onset of the disease has been rarely reported. In this paper we describe three cases of acute cataract in young patients with Type 1 Diabetes

Educational Robotics in Down Syndrome: A Feasibility Study

Educational robotics (ER) uses robotic kits as a channel for education and collaborative learning in a play setting. Thanks to adaptability of robots, ER could facilitate inclusion of special-needs children, such as children with Down syndrome (DS), in learning programs. In a previous study, we provided evidence that ER could promote superior cognitive functions, such as executive functions, which are involved in problem solving, reasoning and planning in typically developing preschool children. In this preliminary study, we aimed to evaluate ER training feasibility, adapting methodology and previously experimented activities to promote executive functions in DS children. Eight DS children carried out 45-min weekly group sessions for 8&nbsp;weeks in an ER laboratory (ER-Lab) using the Bee-Bot. Training setting was generally well-suited for this small sample of DS children. Due to sample heterogeneity, qualitative results of only two exemplificative children are presented and discussed. Results indicate that Bee-Bot is a very significant device for promoting interest, attention and interaction with adults and peers. Promotion of executive functions seemed to be possible in one child, who eagerly participated in ER-Lab activities

Educational Robotics intervention on Executive Functions in preschool children: A pilot study

Educational Robotics (ER) is known for its effects on academic achievement and scientific concepts. Few studies have demonstrated ER effects on cognitive skills and no evidence exists on the role of ER in promoting Executive Functions, key elements in early school readiness and cognitive milestone achievements. The aim of this study was to evaluate, for the first time, the short-term effects in Preschool children of an intensive ER training on Executive Functions. A sample of 12 children (age range: 5–6 years) took part to an intensive ER-Lab for 13 sessions (6 weeks) by using a bee-shaped robot, called Bee-Bot®. The children were tested three times (baseline, pre and post ER-Lab) with a neuropsychological battery. The main finding was a significant improvement in both visuo-spatial working memory and inhibition skills after the ER-Lab period, with a significant effect also on robot programming skills. These data provide scientific support to the hypothesis that ER is suitable in progressively improving abilities in planning and controlling complex tasks in early childhood, fostering executive functions development