Exploiting magnetic properties of Fe doping in zirconia

In this study we explore, both from theoretical and experimental side, the effect of Fe doping in ZrO2 (ZrO2:Fe). By means of first principles simulation we study the magnetization density and the magnetic interaction between Fe atoms. We also consider how this is affected by the presence of oxygen vacancies and compare our findings with models based on impurity band and carrier mediated magnetic interaction. Experimentally thin films (~ 20 nm) of ZrO2:Fe at high doping concentration are grown by atomic layer deposition. We provide experimental evidence that Fe is uniformly distributed in the ZrO2 by transmission electron microscopy and energy dispersive X-ray mapping, while X-ray diffraction evidences the presence of the fluorite crystal structure. Alternating gradient force magnetometer measurements show magnetic signal at room temperature, however with low magnetic moment per atom. Results from experimental measures and theoretical simulations are compared.Comment: 8 pages, 9 figures. JEMS 201

Reproductive trend of White Stork, Ciconia ciconia, in the area of Vercelli and Biella

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Clinical and psychological outcome after surgery for lumbar spinal stenosis: A prospective observational study with analysis of prognostic factors

Background The identification of psychological risk factors is important for the selection of patients before spinal surgery. Moreover, the effect of surgical decompression in lumbar spinal stenosis (LSS) on psychological outcome is not previously well analyzed. Aim of paper to investigate clinical and psychological outcome after surgery for LSS and the effect of depressive symptoms and anxiety on the clinical outcome. Materials and methods A total of 25 patients with symptomatic LSS underwent decompressive surgery with or without spinal stabilization were prospectively enrolled in this observational surgery. The Symptom Checklist-90-Revised (SCL-90-R) was used to assess global psychological distress with a summary score termed Global Severity Index (GSI) and single psychological disorders including depression (DEP) and anxiety (ANX). The clinical outcome of surgery was evaluated with the Oswestry Disability Index (ODI) and visual analogue scale (VAS) pain assessment. Results Compared with baseline, there was a statistically significant improvement in VAS, ODI and GSI after surgery (p<0.05) in all patients. Univariate analysis revealed that patients with high GSI and anxiety and depression scores had significantly higher ODI and VAS scores in the follow-up with a bad outcome. Conclusions Surgery for spinal stenosis was effective to treat pain and disability. In this prospective study baseline global psychological distress, depression and anxiety were associated with poorer clinical outcome

Značajke liječenja i ishoda u starijih bolesnika s glioblastomom mozga: retrospektivna analiza niza slučajeva

Treatment modalities affecting quality of life and survival in elderly brain glioblastoma patients are not well defined. A single-institution data were analyzed during a 3-year period to disclose prognostic difference in management related to age. Karnofsky Performance Scale (KPS), overall survival (OS), and adjuvant therapy were evaluated. The case group comprised of elderly patients (>75 years), while the control group included those of younger age (<65 years). The investigated variables were correlated between the groups. Twenty elderly patients and a corresponding number of younger ones were analyzed. Preoperative KPS >70 indicated longer overall survival. Statistically significant correlation was recorded in both the control (p=0.036) and case (p=0.0053) groups. Lower postoperative KPS was significantly correlated with shorter OS in elderly patients (p=0.023). The correlation between the extent of tumor resection and OS was statistically significant in younger patients only (p=0.04). Overall survival was significantly shorter in elderly patients regardless of the extent of tumor resection (p=0.0057). Adjuvant therapy was significantly associated with longer OS in both the case (p=0.032) and control (p=0.013) groups. Elderly population is a more endangered group of surgical brain glioblastoma patients having lower quality of life and shorter overall survival. The management protocol should be personalized for each individual case in this age group of patients to reduce postoperative complications and grant a satisfactory quality of life.Modaliteti liječenja od utjecaja na kvalitetu života i preživljavanje starijih bolesnika s glioblastomom još nisu jasno određeni. Kako bi se utvrdila prognostička razlika u primijenjenim oblicima liječenja u odnosu na dob bolesnika analizirani su podaci dobiveni trogodišnjim istraživanjem uzorka. Istraživani su sljedeći pokazatelji: Karnofskyjeva ljestvica (KPS), vrijeme ukupnog preživljavanja i primjena pomoćnog liječenja. Oglednu skupinu činili su stariji bolesnici (≥75 godina), a kontrolnu skupinu oni mlađe dobi (≤65 godina). Međusobno su uspoređivani istraživani parametri iz obje skupine bolesnika. Promatrano je 20 starijih i odgovarajući broj mlađih bolesnika. Prijeoperacijski KPS >70 upućivao je na dulje sveukupno preživljavanje. Statistički značajna korelacija zabilježena je u bolesnika kontrolne (p=0,036) i ogledne (p=0,0053) skupine. Niže poslijeoperacijske vrijednosti KPS bile su značajno povezane s kraćim vremenom preživljavanja u starijih bolesnika (p=0,023). Korelacija između opsežnosti tumorske resekcije i sveukupnog preživljavanja bila je statistički značajna samo u mlađoj dobnoj skupini (p=0,04). Vrijeme sveukupnog preživljavanja bilo je značajno kraće u starijih bolesnika neovisno o stupnju kirurške resekcije (p=0,0057). Primjena pomoćne terapije bila je značajno povezana s duljim sveukupnim preživljavanjem u oglednoj (p=0,032) i kontrolnoj (p=0,013) skupini. U zaključku, starija je populacija ugroženija skupina kirurških bolesnika s glioblastomom u kojih je smanjena kvaliteta života i skraćeno vrijeme sveukupnog preživljavanja. Stoga je potrebno protokol liječenja prilagoditi svakom pojedinom bolesniku iz ove dobne skupine kako bi se smanjio udio poslijeoperacijskih komplikacija i poboljšala kvaliteta života

clinical outcome of patients over 90 years of age treated for chronic subdural hematoma

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Relationship between Burr-Hole position and pneumocephalus in patients operated for chronic subdural hematoma

Objective: Chronic subdural hematoma (CSDH) is one of the most frequent neurosurgical conditions in people aging between 70 and 80 years. The cranial burr-hole (CBH) with surgical cavity irrigation through the burr hole and closed drainage system is the treatment of choice but -post-operative outcome can be influenced by pneumocephalus. In this study, we aimed to explore the relationship between the anterior-posterior (AP) burr-hole position and the volume of post-operative pneumocephalus. Patients and Methods: We identified 153 consecutive patients who underwent BHC for CSDH at our institution. Baseline and post-operative data were retrospectively collected from medical records. The linear regression model was used to estimate the association between the volume of post-operative subdural air collection and burr-hole position along with other baseline patients and hematoma variables. Results: The AP position of the burr-hole was independently associated with the volume of post-operative pneumocephalus: lower volume of subdural air was observed in patients with more anterior cranial burr-hole. Conclusions: In patients operated for CSDH, the cranial burr-hole should be performed anteriorly to grant a lesser amount of subdural post-operative air collection

Sixth Cranial Nerve Palsy and Craniocervical Junction Instability due to Metastatic Urothelial Bladder Carcinoma

Metastases involving the clivus and craniocervical junction (CCJ) are extremely rare. Skull base involvement can result in cranial nerve palsies, while an extensive CCJ involvement can lead to spinal instability. We describe an unusual case of clival and CCJ metastases presenting with VI cranial nerve palsy and neck pain secondary to CCJ instability from metastatic bladder urothelial carcinoma. The patient was first treated with an endoscopic endonasal approach to the clivus for decompression of the VI cranial nerve and then with occipitocervical fixation and fusion to treat CCJ instability. At the 6-month follow-up, the patient experienced complete recovery of VI cranial nerve palsy. To the best of our knowledge, the simultaneous involvement of the clivus and the CCJ due to metastatic bladder carcinoma has never been reported in the literature. Another peculiarity of this case was the presence of both VI cranial nerve deficit and spinal instability. For this reason, the choice of treatment and timing were challenging. In fact, in case of no neurological deficit and spinal stability, palliative chemo- and radiotherapy are usually indicated. In our patient, the presence of progressive diplopia due to VI cranial nerve palsy required an emergent surgical decompression. In this scenario, the extended endoscopic endonasal approach was chosen as a minimally invasive approach to decompress the VI cranial nerve. Posterior occipitocervical stabilization is highly effective in avoiding patient’s neck pain and spinal instability, representing the approach of choice

A case of very delayed surgical site infection after instrumented spine surgery

This is a case of a 69-year-old obese woman treated with posterior spinal stabilization for lumbar degenerative stenosis who developed delayed and persistent surgical site infection sustained by Bacteriodes fragilis. This microorganism is characterized by slow growth and resistance to antimicrobial agents. The patient underwent a surgical treatment with debridement of the surgical wound without hardware removal. After fourteen months the patient had a recurrence of low back pain, low-grade fever and dehiscence of surgical wound with the need of hardware removal. The intra-operative culture was positive for the same microrganism, than she healed with target antibiotic therapy

The Incidence of Adjacent Segment Degeneration after the Use of a Versatile Dynamic Hybrid Stabilization Device in Lumbar Stenosis: Results of a 5–8-Year Follow-up

Study DesignRetrospective study with long-term follow-up.PurposeTo evaluate the long-term incidence of adjacent segment degeneration (ASD) and clinical outcomes in a consecutive series of patients who underwent spinal decompression associated with dynamic or hybrid stabilization with a Flex+TM stabilization system (SpineVision, Antony, France) for lumbar spinal stenosis.Overview of LiteratureThe incidence of ASD and clinical outcomes following dynamic or hybrid stabilization with the Flex+TM system used for lumbar spinal stenosis have not been well investigated.MethodsTwenty-one patients with lumbar stenosis and probable post-decompressive spinal instability underwent decompressive laminectomy followed by spinal stabilization using the Flex+TM stabilization system. The indication for a mono-level dynamic stabilization was a preoperative magnetic resonance imaging (MRI) demonstrating evidence of severe disc disease associated with severe spinal stenosis. The hybrid stabilization (rigid-dynamic) system was used for multilevel laminectomies with associated initial degenerative scoliosis, first-grade spondylolisthesis, or rostral pathology.ResultsThe improvement in Visual Analog Scale and Oswestry Disability Index scores at follow-up were statistically significant (p<0.0001 and p<0.0001, respectively). At the 5–8-year follow-up, clinical examination, MRI, and X-ray findings showed an ASD complication with pain and disability in one of 21 patients. The clinical outcomes were similar in patients treated with dynamic or hybrid fixation.ConclusionsPatients treated with laminectomy and Flex+TM stabilization presented a satisfactory clinical outcome after 5–8 years of follow-up, and ASD incidence in our series was 4.76% (one patient out of 21). We are aware that this is a small series, but our long-term follow-up may be sufficient to contribute to the expanding body of literature on the development of symptomatic ASD associated with dynamic or hybrid fixation