Dynamic contact area ratio in shoulder instability: an innovative diagnostic technique measuring interplay of bony lesions

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Patient specific instrumentation influences hemoglobin decrease after total knee replacement.

Patient Specific Instrumentation (PSI) may contribute to reduce blood loss after total knee replacement (TKR) by avoiding violation of the medullary canal. The purpose of the study was to compare the hemoglobin (Hb) decrease in two groups of patients undergoing TKR with PSI and conventional instrumentation.Pre- and post-operative blood samples were collected for twenty-two patients randomly assigned to receive a PSI-assisted or conventional TKR. Post- to preoperative Hb difference was calculated.A significant difference in Hb reduction in favor of the PSI group was registered on the last day of stay but not on the previous post-operative days: these promising results suggest a beneficial effect of PSI in blood loss reduction. PSI may hence be considered among the strategies available to control and reduce blood loss related to TKR

The crucial questions on synovial biopsy: when, why, who, what, where, and how?

In the majority of joint diseases, changes in the organization of the synovial architecture appear early. Synovial tissue analysis might provide useful information for the diagnosis, especially in atypical and rare joint disorders, and might have a value in case of undifferentiated inflammatory arthritis, by improving disease classification. After patient selection, it is crucial to address the dialogue between the clinician and the pathologist for adequately handling the sample, allowing identifying histological patterns depending on the clinical suspicion. Moreover, synovial tissue analysis gives insight into disease progression helping patient stratification, by working as an actionable and mechanistic biomarker. Finally, it contributes to an understanding of joint disease pathogenesis holding promise for identifying new synovial biomarkers and developing new therapeutic strategies. All of the indications mentioned above are not so far from being investigated in everyday clinical practice in tertiary referral hospitals, thanks to the great feasibility and safety of old and more recent techniques such as ultrasound-guided needle biopsy and needle arthroscopy. Thus, even in rheumatology clinical practice, pathobiology might be a key component in the management and treatment decision-making process. This review aims to examine some essential and crucial points regarding why, when, where, and how to perform a synovial biopsy in clinical practice and research settings and what information you might expect after a proper patient selection

Microzonazione sismica di un centro abitato di piccole dimensioni: il caso studio di Sant’Agata Fossili (AL)

In questo lavoro sono descritte le attività svolte nell’ambito del Progetto Europeo Strategico RISKNAT riguardanti l’analisi di microzonazione di Sant’Agata Fossili (AL). Sono in particolare descritte tutte le indagini ed analisi numeriche condotte al fine di ottenere una microzonazione sismica di livello 3 secondo quanto previsto nelle recenti linee guida nazionali degli. Al fine inoltre di valutare le ricadute di tipo applicativo di una corretta microzonazione sismica del territorio, sono state realizzate delle simulazioni di scenario adottando come riferimento gli spettri di risposta ottenuti dall’analisi di microzonazione. Le valutazioni di scenario ottenute sono state infine confrontate con le previsioni di scenario realizzabili a priori sulla base dell’adozione degli spettri di risposta definiti nelle Norme Tecniche per le Costruzioni

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Total Joint Arthroplasty in Patients with Inflammatory Rheumatic Diseases

<p></p><p><b>Article full text</b></p> <p><br></p> <p>The full text of this article can be found here<b>. </b><a href="https://link.springer.com/article/10.1007/s12325-018-0750-9">https://link.springer.com/article/10.1007/s12325-018-0750-9</a></p><p></p><p></p><p> </p><p><br></p> <p><b>Provide enhanced content for this article</b></p> <p><br></p> <p>If you are an author of this publication and would like to provide additional enhanced content for your article then please contact <a href="http://www.medengine.com/Redeem/”mailto:[email protected]”"><b>[email protected]</b></a>.</p> <p><br></p> <p>The journal offers a range of additional features designed to increase visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the highest scientific standard and all features are marked as ‘peer reviewed’ to ensure readers are aware that the content has been reviewed to the same level as the articles they are being presented alongside. Moreover, all sponsorship and disclosure information is included to provide complete transparency and adherence to good publication practices. This ensures that however the content is reached the reader has a full understanding of its origin. No fees are charged for hosting additional open access content.</p> <p><br></p> <p>Other enhanced features include, but are not limited to:</p> <p><br></p> <p>• Slide decks</p> <p>• Videos and animations</p> <p>• Audio abstracts</p> <p>• Audio slides</p><br><p></p

Statistical model for random telegraph noise in Flash memories

This paper presents a new physics-based statistical model for random telegraph noise in Flash memories. From the probabilistic superposition of elementary Markov processes describing the trapping/detrapping events taking place in the cell tunnel oxide, the model can explain the main features of the random telegraph noise threshold-voltage instability. The results on the statistical distribution of the threshold-voltage difference between two subsequent read accesses show good agreement between measurements and model predictions, even considering the time drift of the distribution tails. Moreover, the model gives a detailed spectroscopic analysis of the oxide defects responsible for the random telegraph noise, allowing a spatial and energetic localization of the traps involved in the threshold-voltage instability process

What arthroscopic skills need to be trained before continuing safe training in the operating room?

The purpose of this study was to generate consensus among experienced surgeons on what skills a resident should possess before continuing safe training in the operating room (OR). An online survey of 65 questions was developed and distributed to surgeons in the European community. A total of 216 responded. The survey included 15 questions regarding generic and specific skills; 16 on patient and tissue manipulation, 11 on knowledge of pathology and 6 on inspection of e-anatomical structures; 5 methods to prepare residents; and 12 on specific skills exercises. The importance of each question (arthroscopic skill) was evaluated ranging from 1 (not important at all) to 6 (very important). Chi-square test, respondent agreement, and a qualitative ranking method were determined to identify the top ranked skills (p &lt; 0.05). The top four of general skills considered important were anatomical knowledge, tissue manipulation, spatial perception, and triangulation (all chi-square test &gt; 134, p &lt; 0.001, all excellent agreement &gt; 0.85, and all high priority level). The top ranked 2 specific arthroscopic skills were portal placement and triangulating the tip of the probe with a 30-degree scope (chi-square test &gt; 176, p &lt; 0.001, excellent agreement, and assigned high priority). The online survey identified consensus on skills that are considered important for a trainee to possess before continuing training in the OR. Compared with the Canadian colleagues, the European arthroscopy community demonstrated similar ranking.Medical Instruments & Bio-Inspired Technolog