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Maggini E, Tedah Djemetio MD, Husband I, Paganelli L, Saccomanno MF, Milano G. Criteria, Timing, and Factors Associated With Return to Competitive Sport After Rotator Cuff Surgery. Sports Med Arthrosc Rev 2024; 32:22-32. [PMID: 38695500 DOI: 10.1097/jsa.0000000000000396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
Rotator cuff pathology in competitive athletes is common and may produce chronic symptoms and joint disability, impairing sports participation and leading to premature retirement. Athletes are a high-functioning patient population with unique characteristics. Decision-making for return to sport is a complex and multifactorial process. Literature is sparse and does not provide precise guidelines to assist physicians to make the right decision. This review aimed to highlight factors affecting outcome, timing, and criteria for return to competitive sport after rotator cuff surgery to help physicians to clearly counsel athletes and make high-quality decisions for return to sport.
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Affiliation(s)
- Emanuele Maggini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
| | - Mac Donald Tedah Djemetio
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
| | - Isabella Husband
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
| | - Luca Paganelli
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
| | - Maristella F Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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Adriani M, Saccomanno MF, Motta M, Galli S, Milano G. Reliability of Magnetic Resonance Imaging Criteria for the Preoperative Assessment of Rotator Cuff Tears: A Systematic Review. Am J Sports Med 2024; 52:845-858. [PMID: 37183988 DOI: 10.1177/03635465231166077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Magnetic resonance (MR) imaging is the most common modality for assessment of the rotator cuff before and after surgery. Several classifications have been described aiming to define main tear characteristics. However, there is still confusion when it comes to the reliability of those classifications. PURPOSE (1) To identify all MR classifications available in the literature for preoperative assessment of rotator cuff tears, (2) to summarize available data on the reliability of identified classifications, and (3) to assess the methodological quality of reliability studies. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS This systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All studies reporting MR assessment in patients with a superior or posterosuperior rotator cuff tear were included. After identification of the available MR criteria, reliability studies were analyzed. Descriptive statistics were used to summarize findings. Methodological quality was assessed using the Quality Appraisal of Reliability Studies checklist. RESULTS A total of 75 studies were included in this review. Eight categories of outcomes could be identified. Of the total, 62 studies reported interobserver reliability whereas 32 reported intraobserver reliability of some of the identified criteria. Each category reflected a variety of reliability, ranging from poor to excellent agreement. MR proved to be a reliable imaging modality to detect the structural integrity of the posterosuperior cuff, especially in cases of full-thickness tear; it was also reliable in terms of tear width and length and muscle atrophy based on a tangent sign or Thomazeau classification. All other classifications did not prove acceptable reliability. Methodological quality was high for 23 articles and moderate for 14. CONCLUSION Preoperative MR is a reliable imaging modality to identify full-thickness tears, measure tear size and morphology, and identify muscle atrophy with tangent sign or Thomazeau classification. All other outcomes and classifications did not show acceptable reliability; therefore, caution is needed when using them for preoperative evaluation of a rotator cuff tear.
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Affiliation(s)
- Marco Adriani
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Maristella Francesca Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Marcello Motta
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Galli
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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Suzuki T, De Nicola A, Inoue S, Okada T, Hasegawa T, Milano G, Matsui H. Flip-flop dynamics in smectic liquid-crystal organic semiconductors revealed by molecular dynamics simulations. Chem Commun (Camb) 2024; 60:2192-2195. [PMID: 38299633 DOI: 10.1039/d3cc05222b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Asymmetric liquid-crystal (LC) organic semiconductors, such as 2-decyl-7-(p-tolyl)-[1]benzothieno[3,2-b][1]benzothiophene (pTol-BTBT-C10), exhibit high mobilities exceeding 10 cm2 V-1 s-1. The LC phases play important roles in thermal stability and self-assembly ordering during film deposition and annealing. In this study, we show molecular dynamics simulations of pTol-BTBT-C10 and reveal a unique mechanism of the molecular flip-flop motion at the smectic E/smectic B phase transition.
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Affiliation(s)
- Tomoka Suzuki
- Research Center for Organic Electronics, Yamagata University, Yonezawa, Japan.
| | | | - Satoru Inoue
- Department of Applied Physics, The University of Tokyo, Tokyo, Japan
| | - Tomoharu Okada
- Research Center for Organic Electronics, Yamagata University, Yonezawa, Japan.
| | - Tatsuo Hasegawa
- Department of Applied Physics, The University of Tokyo, Tokyo, Japan
| | - Giuseppe Milano
- Department of Chemical, Materials and Industrial Production Engineering, University of Naples Federico II, Naples, Italy.
| | - Hiroyuki Matsui
- Research Center for Organic Electronics, Yamagata University, Yonezawa, Japan.
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Milano G, Fresta L, Cerciello S, Cattaneo S, Paderno M, Galante C, Passiatore M, Saccomanno MF. Cross-cultural adaptation and validation of the Italian version of the Western Ontario Rotator Cuff (WORC) index. Musculoskelet Surg 2024:10.1007/s12306-023-00812-y. [PMID: 38285314 DOI: 10.1007/s12306-023-00812-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024]
Abstract
The aim of the study was to accomplish translation, cross-cultural adaptation and validation of the Western Ontario Rotator Cuff (WORC) Index questionnaire for its use in Italy. The WORC original version was translated and cross-culturally adapted into Italian. Subsequently, it was administered to a population of 60 patients suffering from rotator cuff disease to evaluate the validity and reliability of the Italian version. The content validity evaluated the correlation between questions and total score of each domain through Pearson's correlation coefficient. The construct validity was similarly assessed through Pearson's correlation coefficient by testing the correlation between the Italian WORC and the Italian version of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Reliability was assessed using two methods: internal consistency by calculating the Cronbach's alpha coefficient for each domain; and test-retest by means of the intraclass correlation coefficient (ICC). The translation and cross-cultural adaptation of the Italian version did not reveal any major problems. No significant floor or ceiling effects were found. All the questions were linearly related to the concept expressed by the domain of belonging. Overall correlation with the DASH score was 0.75. Internal consistency was very high overall (α = 0.93) as well as reliability (overall ICC = 0.87). The Italian version of the WORC questionnaire is a valid and reproducible measuring instrument and can be considered a valid tool for the evaluation of the effectiveness of a treatment in terms of quality of life, in Italian patients affected by rotator cuff diseases.Level of evidence Diagnostic study, level II.
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Affiliation(s)
- G Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy.
| | - L Fresta
- Department of Orthopaedics and Traumatology, San Carlo di Nancy Hospital, Rome, Italy
| | - S Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - S Cattaneo
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
| | - M Paderno
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
| | - C Galante
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
| | - M Passiatore
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
| | - M F Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Unit of Orthopaedics, Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy
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Cucchi D, Di Giacomo G, Compagnoni R, Castricini R, Formigoni C, Radici M, Melis B, Brindisino F, De Giorgi S, De Vita A, Lisai A, Mangiavini L, Candela V, Carrozzo A, Pannone A, Menon A, Giudici LD, Klumpp R, Padua R, Carnevale A, Rosa F, Marmotti A, Peretti GM, Berruto M, Milano G, Randelli P, Bonaspetti G, De Girolamo L. A high level of scientific evidence is available to guide treatment of primary shoulder stiffness: The SIAGASCOT consensus. Knee Surg Sports Traumatol Arthrosc 2024; 32:37-46. [PMID: 38226696 DOI: 10.1002/ksa.12017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 11/21/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE Shoulder stiffness (SS) is a condition characterised by active and passive restricted glenohumeral range of motion, which can occur spontaneously in an idiopathic manner or be associated with a known underlying aetiology. Several treatment options are available and currently no consensus has been obtained on which treatment algorithm represents the best choice for the patient. Herein we present the results of a national consensus on the treatment of primary SS. METHODS The project followed the modified Delphi consensus process, involving a steering, a rating and a peer-review group. Sixteen questions were generated and subsequently answered by the steering group after a thorough literature search. A rating group composed by professionals specialised in the diagnosis and treatment of shoulder pathologies rated the question-answer sets according to the scientific evidence and their clinical experience. RESULTS Recommendations were rated with an average of 8.4 points out of maximum 9 points. None of the 16 answers received a rating of less than 8 and all the answers were considered as appropriate. The majority of responses were assessed as Grade A, signifying a substantial availability of scientific evidence to guide treatment and support recommendations encompassing diagnostics, physiotherapy, electrophysical agents, oral and injective medical therapies, as well as surgical interventions for primary SS. CONCLUSIONS A consensus regarding the conservative and surgical treatment of primary SS could be achieved at a national level. This consensus sets basis for evidence-based clinical practice in the management of primary SS and can serve as a model for similar initiatives and adaptable guidelines in other European countries and potentially on a global scale. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Davide Cucchi
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany
- SIAGASCOT "Basic Science" Committee, Rome, Italy
- SIAGASCOT "Guidelines" Work-group, Rome, Italy
| | | | - Riccardo Compagnoni
- SIAGASCOT "Guidelines" Work-group, Rome, Italy
- U.O.C. 1° Clinica Ortopedica, ASST G. Pini-CTO, Milan, Italy
| | - Roberto Castricini
- SIAGASCOT "Shoulder" Committee, Rome, Italy
- Casa di Cura Villa Verde, Fermo, Italy
| | - Chiara Formigoni
- SIAGASCOT "Guidelines" Work-group, Rome, Italy
- GIDIF-RBM - Italian Group of Information Specialist from Pharmaceutical Company and Biomedical Research Institutes, Milan, Italy
| | - Mattia Radici
- U.O.C. 1° Clinica Ortopedica, ASST G. Pini-CTO, Milan, Italy
| | - Barbara Melis
- SIAGASCOT "Shoulder" Committee, Rome, Italy
- Unità di Ortopedia e traumatologia dello sport, Casa di cura "Policlinico Città di Quartu", Quartu Sant'Elena, Italy
| | - Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise c/o Cardarelli Hospital, C/da Tappino, Campobasso, Italy
| | - Silvana De Giorgi
- SIAGASCOT "Basic Science" Committee, Rome, Italy
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari, Bari, Italy
| | - Andrea De Vita
- Concordia Hospital Roma, Rome, Italy
- SIAGASCOT "Shoulder" Committee, Rome, Italy
| | - Andrea Lisai
- SIAGASCOT "Shoulder" Committee, Rome, Italy
- Unità Funzionale Chirurgia della Spalla, Humanitas San Pio X, Milan, Italy
| | - Laura Mangiavini
- SIAGASCOT "Basic Science" Committee, Rome, Italy
- IRCCS Istituto Ortopedico Galeazzi-Sant'Ambrogio, Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo Candela
- SIAGASCOT "Shoulder" Committee, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Alessandro Carrozzo
- SIAGASCOT "Guidelines" Work-group, Rome, Italy
- Department of Orthopaedic Surgery and Traumatology, AOU Sant'Andrea, La Sapienza University of Rome, Rome, Italy
| | - Antonello Pannone
- SIAGASCOT "Shoulder" Committee, Rome, Italy
- Policlinico "Città di Udine", Udine, Italy
| | - Alessandra Menon
- SIAGASCOT "Basic Science" Committee, Rome, Italy
- U.O.C. 1° Clinica Ortopedica, ASST G. Pini-CTO, Milan, Italy
- Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Scuola di Specializzazione in Statistica Sanitaria e Biometria, Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy
| | - Luca Dei Giudici
- SIAGASCOT "Shoulder" Committee, Rome, Italy
- Casa di Cura "Villa dei Pini", Civitanova Marche, Italy
| | - Raymond Klumpp
- SIAGASCOT "Guidelines" Work-group, Rome, Italy
- Department of Orthopaedics and Trauma Surgery, ASST Bergamo Ovest, Treviglio, Italy
| | | | - Arianna Carnevale
- SIAGASCOT "Guidelines" Work-group, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Francesco Rosa
- SIAGASCOT "Guidelines" Work-group, Rome, Italy
- Humanitas Clinical and Research Center -IRCCS, Rozzano, Italy
| | - Antongiulio Marmotti
- SIAGASCOT "Basic Science" Committee, Rome, Italy
- Department of Orthopaedics and Traumatology, University of Torino, Turin, Italy
| | - Giuseppe M Peretti
- IRCCS Istituto Ortopedico Galeazzi-Sant'Ambrogio, Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Berruto
- U.O.C. 1° Clinica Ortopedica, ASST G. Pini-CTO, Milan, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- ASST Spedali Civili, UOC Clinica Ortopedica, Brescia, Italy
| | - Pietro Randelli
- U.O.C. 1° Clinica Ortopedica, ASST G. Pini-CTO, Milan, Italy
- Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Research Center for Adult and Pediatric Rheumatic Diseases (RECAP-RD), Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Bonaspetti
- Department of Orthopaedics and Traumatology, Clinica S. Anna, Brescia, Italy
| | - Laura De Girolamo
- SIAGASCOT "Basic Science" Committee, Rome, Italy
- IRCCS Istituto Ortopedico Galeazzi-Sant'Ambrogio, Milan, Italy
- Laboratorio di Biotecnologie applicate all'Ortopedia, Milan, Italy
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Galante C, Djemetio MDT, Fratus A, Cattaneo S, Ronchi S, Domenicucci M, Milano G, Casiraghi A. Management of distal femoral fractures with metaphyseal and articular comminution (AO/OTA 33C) using nail and plate fixation: a technical note and case series of 14 patients. Eur J Orthop Surg Traumatol 2023; 33:3519-3529. [PMID: 37204623 DOI: 10.1007/s00590-023-03577-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/05/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE To describe the surgical technique and the outcome of a case series of comminuted intra-articular distal femur fractures (AO/OTA 33C) treated with a nail-plate combination (NPC) implant. METHODS We retrospectively analyzed a case series of 14 patients with comminuted intra-articular distal femur fractures (DFF) treated with an intramedullary retrograde nail in combination with a lateral low-contact condylar locking plate, in a period between June 2020 and January 2023 at a Level 1 trauma center. Baseline demographic and clinical data were recorded. Time to bone healing, function using Schatzker Lambert Score, and complications were documented. RESULTS Fourteen patients, 8 males and 6 females, with a total of 15 NPC implants, were included in this study. Eight out of 14 patients had open fractures, all with a Gustilo Anderson type IIIA exposure. The mean age was 48.5 ± 18.05 years. The median follow-up was 392 days, with only one patient lost to follow-up. 11 out of 15 implants achieved complete radiographic consolidation during follow-up, at a mean of 5.40 ± 1.07 months. At the 12-month follow-up, all patients could fully bear weight painlessly or with mild pain. Schatzker Lambert Score was excellent for 4 patients, good for 2 patients, fair for 5 patients, and failure for 2 patients. The main postoperative complications were rigidity (3 cases), limb shortening (2 cases), and septic non-union (1 case). CONCLUSION This study suggests that the nail-plate combination (NPC) may provide a more effective surgical technique for addressing the challenges associated with comminuted intra-articular distal femur fractures (AO/OTA 33C). LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Claudio Galante
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
| | - Mac D Tedah Djemetio
- Orthopaedics and Traumatology, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Abramo Fratus
- Orthopaedics and Traumatology, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Cattaneo
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Silvia Ronchi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Marco Domenicucci
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Giuseppe Milano
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
- Orthopaedics and Traumatology, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alessandro Casiraghi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
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Colosio A, Scaini A, Motta M, Paderno M, Saccomanno MF, Bettinsoli P, Bonaspetti G, Milano G. BLU-DAT: a new reliable and accurate arthrometer for measuring anterior knee laxity. Knee Surg Sports Traumatol Arthrosc 2023; 31:4782-4790. [PMID: 37553553 PMCID: PMC10598137 DOI: 10.1007/s00167-023-07534-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Abstract
PURPOSE Although many arthrometers have been developed to assess anterior knee laxity, reliability and diagnostic accuracy of these devices are still debated. The aim of the present study was to evaluate the validity of a new arthrometer in the outpatient setting, with the hypothesis that it had good validity in terms of reliability and diagnostic accuracy. METHODS Seventy-eight subjects (39 with ACL injury and 39 with normal ACL) were tested. ATT was assessed by means of the Lachman test at 30° of flexion with a new testing device (BLU-DAT) under three different loading conditions: 7 kg (69 N), 9 kg (88 N) and maximum (MMT). The tests were performed on both knees to obtain SSD. In the ACL injury group, the tests were performed by two examiners and one of them repeated a second test series. Inter- and intra-observer reliability were assessed with the intraclass correlation coefficients (ICCs) for the average SSD measures. In the normal-ACL group, the analysis was performed with the same testing setup. Side-to-side difference measures of the two groups at every loading condition were compared by Student's t test. Data of test series were dichotomized based on the threshold value of 3-mm SSD as pathological ATT and 2 × 2 contingency tables were used to assess diagnostic accuracy. RESULTS The ICCs for intra-observer reliability at 7-kg (69 N), 9-kg (88 N) and MMT measurements were 0.781, 0.855 and 0.913, respectively. The ICC for inter-observer reliability at 7-kg (69 N), 9-kg (88 N) and MMT measurements were 0.701, 0.845 and 0.834, respectively. Comparison between the two groups showed a significant mean difference ranging from 3.4 mm for 7-kg (69 N) load to 4.6 mm for MMT. Overall accuracy ranged from 84.6% for 7-kg load to 98.7% for MMT. CONCLUSION The BLU-DAT has proven to be an instrument with good intra- and inter-observer reliability and very good accuracy in the diagnosis of ACL injuries in the outpatient setting. So, the BLU-DAT can be a new useful tool in everyday clinical practice to assist in the diagnosis of ACL injury. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Alessandro Colosio
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- ASST Spedali Civili, UOC Clinica Ortopedica, Piazzale Spedali Civili 1, 25123 Brescia, BS Italy
| | - Alessandra Scaini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Marcello Motta
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marco Paderno
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
- ASST Spedali Civili, UOC Clinica Ortopedica, Piazzale Spedali Civili 1, 25123 Brescia, BS Italy
| | - Maristella F. Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
- ASST Spedali Civili, UOC Clinica Ortopedica, Piazzale Spedali Civili 1, 25123 Brescia, BS Italy
| | | | - Giovanni Bonaspetti
- Department of Orthopaedics and Traumatology, Clinica S. Anna, Brescia, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
- ASST Spedali Civili, UOC Clinica Ortopedica, Piazzale Spedali Civili 1, 25123 Brescia, BS Italy
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Cattaneo S, Domenicucci M, Galante C, Biancardi E, Casiraghi A, Milano G. Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion. 3D Print Med 2023; 9:24. [PMID: 37672114 PMCID: PMC10481603 DOI: 10.1186/s41205-023-00184-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/01/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Scapular osteotomy for malunion can lead to resolution of pain and functional improvement in scapula fracture sequelae. Understanding three-dimensional bone morphology and analysing post-traumatic deformity is the main step of planning and the key to success of the procedure. 3D models and patient-specific guides are a growing technology to enhance accuracy of planning and to assist during surgery. CASE PRESENTATION We report the case of a 50 years old male, complaining of pain and limited function after a malunited scapular body fracture. Clinical assessment showed a severe impairment of shoulder function with active and passive forward flexion limited to 80°, absent external rotation, and internal rotation limited to the buttock. X-rays and CT scan showed an excessive lateral border offset of 53 mm and complete displacement of the glenoid segment anteriorly and medially to the scapular body, with impingement between the lateral most prominent scapular bone spur and humeral shaft. Glenopolar angle was 19°, scapular body angulation on the sagittal plane was 12°. Corrective osteotomy was planned on a virtual interactive rendering and on 3D printed models. Patient-specific guides were developed to perform a body-spine osteotomy with removal of a bone wedge, and a glenoid-spine osteotomy; a patient-specific wedge spacer was used to hold the reduction during plate fixation. Follow-up up to 12 months after surgery demonstrated improvement in scapula anatomy, shoulder girdle function, and patient-reported outcomes. CONCLUSIONS For the first time in scapula malunion surgery, patient-specific osteotomy guides were succesfully used during surgery to perform osteotomies and to assist in reduction maneuvers.
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Affiliation(s)
- Stefano Cattaneo
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, Brescia (BS), 25123, Italy.
| | - Marco Domenicucci
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, Brescia (BS), 25123, Italy
| | - Claudio Galante
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, Brescia (BS), 25123, Italy
| | - Elena Biancardi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, Brescia (BS), 25123, Italy
| | - Alessandro Casiraghi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, Brescia (BS), 25123, Italy
| | - Giuseppe Milano
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, Brescia (BS), 25123, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 11, Brescia, 25123, BS, Italy
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9
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Cattaneo S, Galante C, Biancardi E, Domenicucci M, Paderno M, Pianelli A, Milano G, Casiraghi A. Use of the iliac-outlet and iliac-inlet combined views in percutaneous posterior column retrograde screw fixation. Arch Orthop Trauma Surg 2023; 143:5713-5717. [PMID: 37284880 PMCID: PMC10449713 DOI: 10.1007/s00402-023-04939-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/26/2023] [Indexed: 06/08/2023]
Abstract
Posterior column fractures are common acetabular injuries. Although displaced fractures require open reduction and fixation, undisplaced patterns may benefit from percutaneous screw fixation. The combination of iliac oblique with inlet and outlet views offers an intuitive and panoramic rendering of the bony corridor into the posterior column; lateral cross table view completes the sequence of fluoroscopic projections. Herein we describe the use of outlet/inlet iliac views and a detailed procedure for percutaneous retrograde posterior column screw fixation.
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Affiliation(s)
- Stefano Cattaneo
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, BS, Italy.
| | - Claudio Galante
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, BS, Italy
| | - Elena Biancardi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, BS, Italy
| | - Marco Domenicucci
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, BS, Italy
| | - Marco Paderno
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, BS, Italy
| | - Antonio Pianelli
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, BS, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, BS, Italy
| | - Alessandro Casiraghi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, BS, Italy
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10
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Colosio A, Bergomi A, Pratobevera A, Paderno M, Saccomanno MF, Milano G. Combined Biologic Augmentation Strategies with Collagen Patch Graft, Microfractures, and Platelet Concentrate Injections Improve Functional and Structural Outcomes of Arthroscopic Revision Rotator Cuff Repair. J Clin Med 2023; 12:5694. [PMID: 37685760 PMCID: PMC10488949 DOI: 10.3390/jcm12175694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Arthroscopic revision rotator cuff repair (ARRCR) is challenging. Biologic strategies seem to be promising. The aim was to evaluate the effectiveness of the combination of microfractures of the greater tuberosity, augmentation with collagen patch graft, and platelet concentrate injections in ARRCR. METHODS A retrospective comparative study was conducted on patients that underwent ARRCR with a minimum follow-up of two years. Patients in the augmentation group underwent ARRCR combined with microfractures, collagen patch graft, and postoperative subacromial injections of platelet concentrate. A standard rotator cuff repair was performed in the control group. PRIMARY OUTCOME Constant-Murley score (CMS). SECONDARY OUTCOMES disease-specific, health-related quality of life using the Disabilities of the Arm, Shoulder, and Hand (DASH) score; assessment of tendon integrity with magnetic resonance at least six months after surgery. Significance was set at p < 0.05. RESULTS Forty patients were included. Mean follow-up was 36.2 ± 8.7 months. The mean CMS was greater in the augmentation group (p = 0.022). No differences could be found for DASH score. Healing failure rate was higher in the control group (p = 0.002). CONCLUSION Biologic augmentation of ARRCR using a combination of microfractures, collagen patch graft, and subacromial injections of platelet concentrate is an effective strategy in improving tendon healing rate. LEVEL OF EVIDENCE retrospective cohort study, level III.
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Affiliation(s)
- Alessandro Colosio
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25121 Brescia, Italy (G.M.)
| | - Andrea Bergomi
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25121 Brescia, Italy (G.M.)
| | - Andrea Pratobevera
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25121 Brescia, Italy (G.M.)
| | - Marco Paderno
- Department of Bone and Joint Surgery, Spedali Civili, 25121 Brescia, Italy
| | - Maristella Francesca Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25121 Brescia, Italy (G.M.)
- Department of Bone and Joint Surgery, Spedali Civili, 25121 Brescia, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, 25121 Brescia, Italy (G.M.)
- Department of Bone and Joint Surgery, Spedali Civili, 25121 Brescia, Italy
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11
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Adriani M, Becker R, Milano G, Lachowski K, Prill R. High variation among clinical studies in the assessment of physical function after knee replacement: a systematic review. Knee Surg Sports Traumatol Arthrosc 2023; 31:3854-3860. [PMID: 36907938 PMCID: PMC10435639 DOI: 10.1007/s00167-023-07375-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE The purpose of this study was to summarise the current use of outcome measures for the assessment of physical function after knee joint replacement. METHODS A systematic approach following the PRISMA guidelines was used. Literature search was performed on MEDLINE database via PubMed and on Epistemonikos. Clinical trials (level of evidence I-II) on knee joint replacement reporting data on the 'physical function' domain published between January 2017 and June 2022 were included. Descriptive statistics were used to summarise the evidence. RESULTS In the 181 articles that met the inclusion criteria, 49 different outcome measurements were used to evaluate clinical outcomes after knee joint replacement. The most frequently adopted patient-reported outcome measures (PROMs) were the Knee Society Score (KSS) (78 studies; 43.1%), the Western Ontario and McMaster Universities (WOMAC) Arthritis Index (62 studies; 34.3%), the Oxford Knee Score (OKS) (51 studies; 28.2%) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) (36 studies; 20%). The most frequently used performance-based outcome measures (PBOMs) were the Timed-Up-and-Go (TUG) test (30 studies; 16.6%) and the 6-min-walk test (6MWT) (21 studies; 11.6%). Among impairment-based outcome measures (IBOMs), range of motion (ROM) was the most used (74 studies; 40.9%). CONCLUSION There is considerable variation among clinical studies regarding the assessment of the physical function of patients after knee joint replacement. PROMs were found to be the most commonly adopted outcome measures; however, no single PROM was used in more than half of the papers analysed. LEVEL OF EVIDENCE Level II, systematic review of level I-II studies.
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Affiliation(s)
- Marco Adriani
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Krzysztof Lachowski
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H., Germany
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12
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Santos DS, De Nicola A, dos Santos VF, Milano G, Soares TA. Exploring the Molecular Dynamics of a Lipid-A Vesicle at the Atom Level: Morphology and Permeation Mechanism. J Phys Chem B 2023; 127:6694-6702. [PMID: 37467380 PMCID: PMC10405212 DOI: 10.1021/acs.jpcb.3c02848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/18/2023] [Indexed: 07/21/2023]
Abstract
Lipid-A was previously shown to spontaneously aggregate into a vesicle via the hybrid particle field approach. We assess the validity of the proposed vesiculation mechanism by simulating the resulting lipid-A vesicle at the atom level. The spatial confinement imposed by the vesicle geometry on the conformation and packing of lipid-A induces significant heterogeneity of physical properties in the inner and outer leaflets. It also induces tighter molecular packing and lower acyl chain order compared to the lamellar arrangement. Around 5% of water molecules passively permeates the vesicle membrane inward and outward. The permeation is facilitated by interactions with water molecules that are transported across the membrane by a network of electrostatic interactions with the hydrogen bond donors/acceptors in the N-acetylglucosamine ring and upper region of the acyl chains of lipid-A. The permeation process takes place at low rates but still at higher frequencies than observed for the lamellar arrangement of lipid-A. These findings not only substantiate the proposed lipid-A vesiculation mechanism but also reveal the complex structural dynamics of an important nonlamellar arrangement of lipid-A.
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Affiliation(s)
- Denys
E. S. Santos
- Departmento
de Química Fundamental, Universidade
Federal de Pernambuco, Recife 50740-560, Brazil
| | - Antonio De Nicola
- Scuola
Superiore Meridionale, Largo S. Marcellino 10, Napoli 80138, Italy
- Graduate
School of Organic Materials Science, Yamagata
University, Yonezawa 992-8510, Yamagata, Japan
| | - Vinicius F. dos Santos
- Departamento
de Química, Faculdade de Filosofia, Ciências e Letras
de Ribeirão Preto, Universidade de
São Paulo, Ribeirão
Preto 14040-901, Brazil
| | - Giuseppe Milano
- Department
of Chemical, Materials and Production Engineering, University of Naples Federico II, Piazzale Tecchio 80, Napoli 80125, Italy
| | - Thereza A. Soares
- Departamento
de Química, Faculdade de Filosofia, Ciências e Letras
de Ribeirão Preto, Universidade de
São Paulo, Ribeirão
Preto 14040-901, Brazil
- Hylleraas
Centre for Quantum Molecular Sciences, University
of Oslo, Oslo 0315, Norway
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13
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Saccomanno MF, Colosio A, De Filippo F, Adriani M, Motta M, Cattaneo S, Milano G. Combined Arthroscopic-Assisted Lower Trapezius Tendon Transfer and Superior Capsule Reconstruction for Massive Irreparable Posterior-Superior Rotator Cuff Tears: Surgical Technique. Arthrosc Tech 2023; 12:e823-e830. [PMID: 37424661 PMCID: PMC10323695 DOI: 10.1016/j.eats.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/11/2023] [Indexed: 07/11/2023] Open
Abstract
Primary or revision irreparable rotator cuff tears remain a challenge. Clear algorithms do not exist. Several joint-preserving options are available, but no technique has been definitely proven to be better than another. Although superior capsule reconstruction has been shown to be effective in restoring motion, lower trapezius transfer can provide strong external rotation and abduction moment. The aim of the present article was to describe an easy and reliable technique to combine both options in 1 surgery, aiming to maximize the functional outcome by getting motion and strength back.
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Affiliation(s)
- Maristella F. Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Alessandro Colosio
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Francesco De Filippo
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marco Adriani
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marcello Motta
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Cattaneo
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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14
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De Nicola A, Montis C, Donati G, Molinaro A, Silipo A, Balestri A, Berti D, Di Lorenzo F, Zhu YL, Milano G. Bacterial lipids drive compartmentalization on the nanoscale. Nanoscale 2023; 15:8988-8995. [PMID: 37144495 PMCID: PMC10210972 DOI: 10.1039/d3nr00559c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
The design of cellular functions in synthetic systems, inspired by the internal partitioning of living cells, is a constantly growing research field that is paving the way to a large number of new remarkable applications. Several hierarchies of internal compartments like polymersomes, liposomes, and membranes are used to control the transport, release, and chemistry of encapsulated species. However, the experimental characterization and the comprehension of glycolipid mesostructures are far from being fully addressed. Lipid A is indeed a glycolipid and the endotoxic part of Gram-negative bacterial lipopolysaccharide; it is the moiety that is recognized by the eukaryotic receptors giving rise to the modulation of innate immunity. Herein we propose, for the first time, a combined approach based on hybrid Particle-Field (hPF) Molecular Dynamics (MD) simulations and Small Angle X-Ray Scattering (SAXS) experiments to gain a molecular picture of the complex supramolecular structures of lipopolysaccharide (LPS) and lipid A at low hydration levels. The mutual support of data from simulations and experiments allowed the unprecedented discovery of the presence of a nano-compartmentalized phase composed of liposomes of variable size and shape which can be used in synthetic biological applications.
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Affiliation(s)
- Antonio De Nicola
- Scuola Superiore Meridionale, Via Largo San Marcellino 10, 80132 Napoli, Italy
- Graduate School of Organic Materials Science, Yamagata, University, Jonan 4-3-16, Yonezawa, Yamagata, 992-8510, Japan
| | - Costanza Montis
- Dipartimento di Chimica "Ugo Schiff", Università degli Studi di Firenze and CSGI, 50019 Firenze, Italy.
| | - Greta Donati
- Department of Chemistry and Biology, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, SA, Italy
| | - Antonio Molinaro
- Department of Chemical Sciences, University of Napoli Federico II, Complesso Universitario Monte Santangelo, Via Cintia 4, 80126 Napoli, Italy.
| | - Alba Silipo
- Department of Chemical Sciences, University of Napoli Federico II, Complesso Universitario Monte Santangelo, Via Cintia 4, 80126 Napoli, Italy.
| | - Arianna Balestri
- Dipartimento di Chimica "Ugo Schiff", Università degli Studi di Firenze and CSGI, 50019 Firenze, Italy.
| | - Debora Berti
- Dipartimento di Chimica "Ugo Schiff", Università degli Studi di Firenze and CSGI, 50019 Firenze, Italy.
| | - Flaviana Di Lorenzo
- Department of Chemical Sciences, University of Napoli Federico II, Complesso Universitario Monte Santangelo, Via Cintia 4, 80126 Napoli, Italy.
| | - You-Liang Zhu
- State Key Laboratory of Theoretical and Computational Chemistry, Institute of Theoretical Chemistry, Jilin University, Changchun 130021, China
| | - Giuseppe Milano
- University of Naples Federico II, Department of Chemical, Materials and Production Engineering, Piazzale V. Tecchio, 80, 80125 Napoli, Italy.
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15
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Casiraghi A, Galante C, Rohayem M, Vittone G, Domenicucci M, Cattaneo S, Paderno M, Grava G, Van Hauwermeiren E, Milano G. Implant retention with serial debridement and use of antibiotic-loaded calcium sulfate beads in acute fracture-related infection (FRI) after pelvic ring or acetabular fractures: A retrospective case series of 7 cases. Injury 2023; 54:1082-1087. [PMID: 36740475 DOI: 10.1016/j.injury.2023.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 01/20/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND The development of a pelvic wound infection in the presence of hardware after open reduction and internal fixation presents a clinical dilemma and there is little literature to aid in decision-making. The purpose of this study was to describe the possibility of debridement, antibiotic pearls and retention of the implant (DAPRI) procedure to eradicate the infection. METHODS Tumor-like debridement, antibiotic pearls and retention of the implant (DAPRI) aimed to remove the biofilm allowing a higher and prolonged local antibiotic concentration by using calcium sulfate antibiotic-added beads. Wound status, radiological signs of bone healing, gait and functional activity of the patient were evaluated. RESULTS Seven patients underwent this technique. The mean follow up time was nine months (range: 6 -16 months). Complete wound healing was achieved in all the patients with no major complications. Average time of bony union was 4.3 months (range: 3-6 months) with no need for implant removal. CONCLUSION The DAPRI technique might represent a safe and more conservative treatment for management of early fracture-related infections (FRI) of the pelvis and acetabulum.
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Affiliation(s)
| | - Claudio Galante
- Department of Bone and Joint Surgery, ASST Spedali Civili, Brescia, Italy.
| | - Mohamed Rohayem
- Orthopedic surgery department, Tanta University Hospitals, Egypt
| | - Giulio Vittone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Marco Domenicucci
- Department of Bone and Joint Surgery, ASST Spedali Civili, Brescia, Italy
| | - Stefano Cattaneo
- Department of Bone and Joint Surgery, ASST Spedali Civili, Brescia, Italy
| | - Marco Paderno
- Department of Bone and Joint Surgery, ASST Spedali Civili, Brescia, Italy
| | - Giuseppe Grava
- Department of Bone and Joint Surgery, ASST Spedali Civili, Brescia, Italy
| | | | - Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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16
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Lugrin J, Parapanov R, Milano G, Cavin S, Debonneville A, Krueger T, Liaudet L. The systemic deletion of interleukin-1α reduces myocardial inflammation and attenuates ventricular remodeling in murine myocardial infarction. Sci Rep 2023; 13:4006. [PMID: 36899010 PMCID: PMC10006084 DOI: 10.1038/s41598-023-30662-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
Myocardial inflammation following myocardial infarction (MI) is crucial for proper myocardial healing, yet, dysregulated inflammation may promote adverse ventricular remodeling and heart failure. IL-1 signaling contributes to these processes, as shown by dampened inflammation by inhibition of IL-1β or the IL-1 receptor. In contrast, the potential role of IL-1α in these mechanisms has received much less attention. Previously described as a myocardial-derived alarmin, IL-1α may also act as a systemically released inflammatory cytokine. We therefore investigated the effect of IL-1α deficiency on post-MI inflammation and ventricular remodeling in a murine model of permanent coronary occlusion. In the first week post-MI, global IL-1α deficiency (IL-1α KO mice) led to decreased myocardial expression of IL-6, MCP-1, VCAM-1, hypertrophic and pro-fibrotic genes, and reduced infiltration with inflammatory monocytes. These early changes were associated with an attenuation of delayed left ventricle (LV) remodeling and systolic dysfunction after extensive MI. In contrast to systemic Il1a-KO, conditional cardiomyocyte deletion of Il1a (CmIl1a-KO) did not reduce delayed LV remodeling and systolic dysfunction. In conclusion, systemic Il1a-KO, but not Cml1a-KO, protects against adverse cardiac remodeling after MI due to permanent coronary occlusion. Hence, anti-IL-1α therapies could be useful to attenuate the detrimental consequences of post-MI myocardial inflammation.
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Affiliation(s)
- J Lugrin
- Service of Adult Intensive Care Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Service of Thoracic Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Laboratoire de Chirurgie Thoracique, Centre des Laboratoires d'Epalinges, Chemin des Boveresses 155, 1066, Epalinges, Switzerland.
| | - R Parapanov
- Service of Adult Intensive Care Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Thoracic Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - G Milano
- Department Coeur-Vaisseaux, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - S Cavin
- Service of Thoracic Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - A Debonneville
- Service of Thoracic Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - T Krueger
- Service of Thoracic Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - L Liaudet
- Service of Adult Intensive Care Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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17
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Zini R, Panascì M, Santori N, Potestio D, Di Pietto F, Milano G, et A. The Italian Consensus Conference on FAI Syndrome in Athletes (Cotignola Agreement). Muscles Ligaments Tendons J 2023. [DOI: 10.32098/mltj.01.2023.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
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18
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Domenicucci M, Galante C, Cavina Pratesi F, Monica MAT, Aloj DC, Milano G, Casiraghi A. New bone formation using antibiotic-loaded calcium sulfate beads in bone transports for the treatment of long-bone osteomyelitis. Eur J Orthop Surg Traumatol 2022:10.1007/s00590-022-03461-2. [PMID: 36547706 DOI: 10.1007/s00590-022-03461-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Bone transport is one of the most frequently used techniques for critical-sized bone defects due to trauma or infection. To fill the defect area and avoid the collapse of soft tissues during transport, some authors have described the use of polymethylmethacrylate or absorbable antibiotic carriers in the form of cylindrical blocks. METHODS In this article, we present our experience in the treatment of post-traumatic osteomyelitis of the lower and upper limbs, using a bone transport technique with antibiotic-loaded calcium sulfate in the form of beads. Results With the progressive absorption of calcium sulfate, we observed the formation of a bone-like tissue envelope at the periphery of the defect area. Histological analysis and direct visualization during open revision surgery of the docking site in all patients confirmed the presence of newly formed bone tissue with a high presence of osteoblasts and few osteoclasts; no areas of necrosis or signs of infection were observed. This bone envelope maintained the mechanical protective function of the transport path and docking site, and also provided a biological stimulus to avoid the development of necrotic areas and optimize the consolidation phase. Conclusion Bone transport with calcium sulfate beads improves biological and mechanical support and reduces the number of surgeries required.
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Affiliation(s)
- Marco Domenicucci
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia (BS), Italy.
| | - Claudio Galante
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia (BS), Italy
| | - Franco Cavina Pratesi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia (BS), Italy
| | - Melissa Anna Teresa Monica
- Department of Laboratory Diagnostics, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia (BS), Italy
| | - Domenico Costantino Aloj
- Department of Orthopedics and Traumatology, Sant' Andrea Hospital, Corso Mario Abbiate 21, 13100, Vercelli (VC), Italy
| | - Giuseppe Milano
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia (BS), Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia (BS), Italy
| | - Alessandro Casiraghi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia (BS), Italy
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Oransky M, Galante C, Cattaneo S, Milano G, Motta M, Biancardi E, Grava G, Johnson EE, Casiraghi A. Endosteal plating for the treatment of malunions and nonunions of distal femur fractures. Eur J Orthop Surg Traumatol 2022:10.1007/s00590-022-03458-x. [PMID: 36539626 DOI: 10.1007/s00590-022-03458-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE To describe the surgical technique and the outcome of a case series of nonunion and malunion of distal femur fractures treated with an endosteal medial plate combined with a lateral locking plate and with autogenous bone grafting. METHODS We retrospectively analyzed a series of patients with malunion or nonunion of the distal femur treated with a medial endosteal plate in combination with a lateral locking plate, in a period between January 2011 and December 2019, Database from chart review was obtained including all the clinical relevant available baseline data (demographics, type of fracture, mechanism of injury, time from injury to surgery, number of previous surgical procedures, type of bone graft, and type of lateral plate). Time to bone healing, limb alignment at follow-up and complications were documented. RESULTS Ten patients were included into the study: 7 male and 3 female with mean age of 48.3 years (range 21-67). The mechanism of trauma was in 8 cases a road traffic accident and in 2 cases a fall from height. According to AO/OTA classification 5 fractures were 33 A3, 3 were 33 C1, 1 was 33 C2 and 1 was 33 C3. The average follow up was 13.5 months. In all cases but one bony union was achieved. Bone healing was observed in average 3.3 months after surgery. No intraoperative or postoperative complications were reported. CONCLUSION A medial endosteal plate is a useful augmentation for lateral plate fixation in nonunion or malunion following distal femur fractures, particularly in cases of medial bone loss, severe comminution, or poor bone quality. LEVEL OF EVIDENCE Level IV (retrospective case series).
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Affiliation(s)
- Michel Oransky
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Claudio Galante
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Stefano Cattaneo
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Giuseppe Milano
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, BS, Italy
| | - Marcello Motta
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, BS, Italy.
| | - Elena Biancardi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Giuseppe Grava
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Eric E Johnson
- Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA Center for the Health Sciences, Los Angeles, CA, 90095-6902, USA
| | - Alessandro Casiraghi
- Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy
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Scherillo G, Mensitieri G, Baldanza A, Loianno V, Musto P, Pannico M, Correa A, De Nicola A, Milano G. Weak Interactions between Poly(ether imide) and Carbon Dioxide: A Multiscale Investigation Combining Experiments, Theory, and Simulations. Macromolecules 2022. [DOI: 10.1021/acs.macromol.2c01382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Giuseppe Scherillo
- Department of Materials and Production Engineering, University of Naples Federico II, P.le Tecchio 80, 80125, Naples, Italy
| | - Giuseppe Mensitieri
- Department of Materials and Production Engineering, University of Naples Federico II, P.le Tecchio 80, 80125, Naples, Italy
| | - Antonio Baldanza
- Department of Materials and Production Engineering, University of Naples Federico II, P.le Tecchio 80, 80125, Naples, Italy
| | - Valerio Loianno
- Department of Materials and Production Engineering, University of Naples Federico II, P.le Tecchio 80, 80125, Naples, Italy
| | - Pellegrino Musto
- Institute for Polymers, Composites and Biomaterials, National Research Council of Italy, Via Campi Flegrei, 34, 80078Pozzuoli (NA), Italy
| | - Marianna Pannico
- Institute for Polymers, Composites and Biomaterials, National Research Council of Italy, Via Campi Flegrei, 34, 80078Pozzuoli (NA), Italy
| | - Andrea Correa
- Department of Chemical Science, University of Naples Federico II, Via Cintia 21, 80126Napoli, Italy
| | - Antonio De Nicola
- Scuola Superiore Meridionale, Via largo San Marcellino 10, 80138Napoli, Italy
| | - Giuseppe Milano
- Department of Materials and Production Engineering, University of Naples Federico II, P.le Tecchio 80, 80125, Naples, Italy
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21
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De Nicola A, Touloupidis V, Kanellopoulos V, Albunia AR, Milano G. A combined experimental and molecular simulation study on stress generation phenomena during the Ziegler-Natta polyethylene catalyst fragmentation process. Nanoscale Adv 2022; 4:5178-5188. [PMID: 36504732 PMCID: PMC9680958 DOI: 10.1039/d2na00406b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/14/2022] [Indexed: 06/17/2023]
Abstract
The morphology of particles obtained under different pre-polymerization conditions has been connected to the stress generation mechanism at the polymer/catalyst interface. A combination of experimental characterization techniques and atomistic molecular dynamics simulations allowed a systematic investigation of experimental conditions leading to a certain particle morphology, and hence to a final polymer with specific features. Atomistic models of nascent polymer phases in contact with magnesium dichloride surfaces have been developed and validated. Using these detailed models, in the framework of McKenna's hypothesis, the pressure increase due to the polymerization reaction has been calculated under different conditions and is in good agreement with experimental scenarios. This molecular scale knowledge and the proposed investigation strategy would allow the pre-polymerization conditions to be better defined and the properties of the nascent polymer to be tuned, ensuring proper operability along the whole polymer production process.
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Affiliation(s)
- Antonio De Nicola
- Scuola Superiore Meridionale Largo San Marcellino 10 80132 Napoli Italy
| | - Vasileios Touloupidis
- Innovation & Technology, Borealis Polyolefine GmbH St. Peter Strasse 25 4021 Linz Austria
| | | | - Alexandra R Albunia
- Innovation & Technology, Borealis Polyolefine GmbH St. Peter Strasse 25 4021 Linz Austria
| | - Giuseppe Milano
- Dipartimento di Ingegneria Chimica dei Materiali e della Produzione Industriale, Università degli Studi di Napoli Federico II Piazzale V. Tecchio 80 80125 Napoli Italy
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22
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Milano G, Colosio A, Scaini A, Motta M, Raggi A, Zanoni F, Galli S, Saccomanno MF. A new knee arthrometer demonstrated to be reliable and accurate to assess anterior tibial translation in comparison with stress radiographs. Arch Orthop Trauma Surg 2022; 143:3241-3250. [PMID: 36344784 DOI: 10.1007/s00402-022-04679-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION For several years, many arthrometers have been developed to assess anterior knee laxity. The aim of our study was to evaluate the validity of a new practical and handy testing device with the hypothesis that the new arthrometer had good validity in terms of reliability and accuracy. METHODS Lachman test was performed on five fresh frozen cadaveric knees by five examiners. Anterior tibial translation (ATT) was measured with a new arthrometer (BLU-DAT) and on lateral stress radiographs. Data on ATT were obtained under 7 kg (69 N), 9 kg (88 N), and maximum manual traction (MMT). Tests were performed on the same specimens before and after arthroscopic ACL excision. Inter-rater reliability of the BLU-DAT measures was assessed with the intraclass correlation coefficient (ICC) for single and average measurements. The Bland-Altman method was used to estimate agreement between the BLU-DAT and stress radiographs. RESULTS ICC values for single measurements were 0.62, 0.54 and 0.58 for 7-kg, 9-kg and MMT assessment, respectively. Overall reliability was good (ICC = 0.63). ICC values for average measurements were 0.89, 0.85 and 0.88 for 7-kg, 9-kg and MMT assessment, respectively. Overall reliability was very good (ICC = 0.90) SEM ranged from 1.4 mm to 1.6 mm for single measurements and was below 1 mm at each testing condition for average measurements. Analysis of agreement between BLU-DAT and radiographic measurements showed a mean difference equal to 0.83 mm ± 2.1 mm (95% CI: 0.55-1.11). Upper LOA was equal to 4.9 mm (95% CI: 5.39-4.41). Lower LOA was equal to - 3.2 mm (95% CI: - 2.71 to - 3.69). CONCLUSION Measurement of anterior knee laxity with the BLU-DAT testing device has a good to very good inter-rater reliability and good agreement with a gold standard such as stress radiographs. Cadaveric Diagnostic Study, Level of Evidence IV.
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Affiliation(s)
- Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili 1 c/o Ortopedia e Traumatologia 2, 25123, Brescia, Italy.,Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Alessandro Colosio
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili 1 c/o Ortopedia e Traumatologia 2, 25123, Brescia, Italy.
| | - Alessandra Scaini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili 1 c/o Ortopedia e Traumatologia 2, 25123, Brescia, Italy
| | - Marcello Motta
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili 1 c/o Ortopedia e Traumatologia 2, 25123, Brescia, Italy
| | - Andrea Raggi
- Department of Biomedical Engineering, FGP Srl, Dossobuono, VR, Italy
| | - Fabio Zanoni
- Department of Biomedical Engineering, FGP Srl, Dossobuono, VR, Italy
| | - Stefano Galli
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Maristella F Saccomanno
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili 1 c/o Ortopedia e Traumatologia 2, 25123, Brescia, Italy.,Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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Cattaneo S, Adriani M, Tonolini S, Oransky M, Galante C, Grava G, Milano G, Casiraghi A. FRAGILITY FRACTURES OF THE SACRUM: A SILENT EPIDEMIC. Orthop Rev (Pavia) 2022; 14:38572. [DOI: 10.52965/001c.38572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Fragility fractures of the sacrum (FFS) are caused by low-energy trauma in the elderly population. Due to the nuanced symptomatology, many FFS remains unrecognized and the prevalence is underestimated. The clinical presentation varies, typically presenting with weightbearing low back pain without even remembering of a previous trauma. Radiographs are usually insufficient for the diagnosis and second level imaging modalities are required. In particular, magnetic resonance demonstrated the highest diagnostic accuracy. Treatment should aim to guarantee early mobilization and weightbearing, efficient pain relief and early discharge from the hospital to a proper facility for rehabilitation. Conservative treatment is reserved to non-displaced fractures with an adequate pain relief within one week allowing early mobilization. Otherwise, surgical treatment must be preferred. Nowadays, minimally invasive techniques, such as ileo-sacral screws or trans-sacral bar osteosynthesis, are safe and effective procedures and have overcome open procedures. In more complex patterns, with complete dissociation between the pelvic ring and the ilio-lumbar spine, spino-pelvic fixation is the procedure of choice.
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Affiliation(s)
| | | | | | | | | | | | - Giuseppe Milano
- Department of Bone and Joint Surgery, ASST Spedali Civili, Brescia, Italy; Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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Cerciello S, Corona K, Morris BJ, Proietti L, Mercurio M, Cattaneo S, Milano G. Hybrid coracoclavicular and acromioclavicular reconstruction in chronic acromioclavicular joint dislocations yields good functional and radiographic results. Knee Surg Sports Traumatol Arthrosc 2022; 30:2084-2091. [PMID: 34841469 DOI: 10.1007/s00167-021-06790-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Optimal treatment of chronic unstable acromioclavicular (AC) joint dislocations (stage 3-5 according the Rockwood classification) is still debated. Anatomic coracoclavicular (CC) reconstruction is a reliable option in terms of two-dimensional radiographic reduction, clinical outcomes, and return to sports, but there remain concerns regarding anterior-posterior stability of the AC joint with CC ligament reconstruction alone. The aim of the present study was to describe the mid-term results of a new hybrid technique with CC and AC ligament reconstruction for chronic AC joint dislocations. METHODS Twenty-two patients surgically treated for chronic AC joint dislocations (grade 3 to 5) were retrospectively reviewed. All patients were assessed before surgery and at final follow-up with the Constant-Murley score (CMS) and the American Shoulder and Elbow Surgeons (ASES) score. The CC vertical distance (CCD) and the CCD ratio (affected side compared to unaffected side) were measured on Zanca radiographs preoperatively, at 6 months postop and at final follow-up. The same surgical technique consisting in a primary fixation with a suspensory system, coracoclavicular ligaments reconstruction with a double loop of autologous gracilis and acromioclavicular ligaments reconstruction with autologous coracoacromial ligament was performed in all cases. RESULTS Twenty-two shoulders in 22 patients (19 males and 3 females) were evaluated with a mean age of 34.4 ± 9 years at the time of surgery. The mean interval between the injury and surgery was 53.4 ± 36.7 days. The mean duration of postoperative follow-up was 49.9 ± 11.8 months. According to the Rockwood classification, there were 5 (22.6%) type-III and 17 (77.2%) type-V dislocations. Mean preoperative ASES and CMS were 54.4 ± 7.6 and 64.6 ± 7.2, respectively. They improved to 91.8 ± 2.3 (p = 0.0001) and 95.2 ± 3.1 (p = 0.0001), respectively at final FU. The mean preoperative CCD was 22.4 ± 3.2 mm while the mean CCD ratio was 2.1 ± 0.1. At final FU, the mean CCD was 11.9 ± 1.4 mm (p = 0.002) and the mean CCD ratio was 1.1 ± 0.1 (p = 0.009). No recurrence of instability was observed. One patient developed a local infection and four patients referred some shoulder discomfort. Heterotopic ossifications were observed in three patients. CONCLUSIONS The optimal treatment of chronic high-grade AC joint dislocations requires superior-inferior and anterior-posterior stability to ensure good clinical outcomes and return to overhead activities or sports. The present hybrid technique of AC and CC ligaments reconstruction showed good clinical and radiographic results and is a reliable an alternative to other reported techniques. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Simone Cerciello
- A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy
- Marrelli Hospital, Crotone, Italy
- Casa Di Cura Villa Betania, Rome, Italy
| | - Katia Corona
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy.
| | - Brent Joseph Morris
- Baptist Health Medical Group Orthopedics and Sports Medicine, Lexington, KY, USA
| | | | - Michele Mercurio
- Department of Orthopaedic and Trauma Surgery, Magna Græcia" University, Mater Domini" University Hospital, Catanzaro, Italy
| | - Stefano Cattaneo
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Giuseppe Milano
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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25
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Hohmann E, Glatt V, Tetsworth K, Bak K, Beitzel K, Bøe B, Calvo E, Di Giacomo G, Favard L, Franceschi F, Funk L, Glanzmann M, Imhoff A, Lädermann A, Levy O, Ludvigsen T, Milano G, Moroder P, Rosso C, Siebenlist S, Abrams J, Arciero R, Athwal G, Burks R, Gillespie R, Kibler B, Levine W, Mazzocca A, Millett P, Ryu R, Safran M, Sanchez-Sotelo J, Savoie FB, Sethi P, Shea K, Verma N, Warner JJ, Weber S, Wolf B. Subacromial Decompression in Patients With Shoulder Impingement With an Intact Rotator Cuff: An Expert Consensus Statement Using the Modified Delphi Technique Comparing North American to European Shoulder Surgeons. Arthroscopy 2022; 38:1051-1065. [PMID: 34655764 DOI: 10.1016/j.arthro.2021.09.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To perform a Delphi consensus for the treatment of patients with shoulder impingement with intact rotator cuff tendons, comparing North American with European shoulder surgeon preferences. METHODS Nineteen surgeons from North America (North American panel [NAP]) and 18 surgeons from Europe (European panel [EP]) agreed to participate and answered 10 open-ended questions in rounds 1 and 2. The results of the first 2 rounds were used to develop a Likert-style questionnaire for round 3. If agreement at round 3 was ≤60% for an item, the results were carried forward into round 4. For round 4, the panel members outside consensus (>60%, <80%) were contacted and asked to review their response. The level of agreement and consensus was defined as 80%. RESULTS There was agreement on the following items: impingement is a clinical diagnosis; a combination of clinical tests should be used; other pain generators must be excluded; radiographs must be part of the workup; magnetic resonance imaging is helpful; the first line of treatment should always be physiotherapy; a corticosteroid injection is helpful in reducing symptoms; indication for surgery is failure of nonoperative treatment for a minimum of 6 months. The NAP was likely to routinely prescribe nonsteroidal anti-inflammatory drugs (NAP 89%; EP 35%) and consider steroids for impingement (NAP 89%; EP 65%). CONCLUSIONS Consensus was achieved for 16 of the 71 Likert items: impingement is a clinical diagnosis and a combination of clinical tests should be used. The first line of treatment should always be physiotherapy, and a corticosteroid injection can be helpful in reducing symptoms. The indication for surgery is failure of no-operative treatment for a minimum of 6 months. The panel also agreed that subacromial decompression is a good choice for shoulder impingement if there is evidence of mechanical impingement with pain not responding to nonsurgical measures. LEVEL OF EVIDENCE Level V, expert opinion.
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Affiliation(s)
- Erik Hohmann
- Department of Orthopaedic Surgery and Sportsmedicine, Valiant Clinic/Houston Methodist, Dubai, United Arab Emirates.
| | - Vaida Glatt
- University of Texas Health Science Centre, San Antonio, Texas, U.S.A
| | - Kevin Tetsworth
- Department of Orthopaedic Surgery, Royal Brisbane Hospital, Herston, Australia; Orthopaedic Research Centre of Australia, Sydney, Australia
| | | | - Klaus Bak
- Adeas Hospitals Skodsborg&Parken, Copenhagen, Denmark.
| | | | - Berte Bøe
- Division of Orthopaedic Surgery, Oslo University Hospital, Norway.
| | - Emilio Calvo
- Department of Orthopaedic Surgery and Traumatology, Universidad Autonoma, Madrid, Spain.
| | | | - Luc Favard
- Tours University Hospital, University of Tours, France.
| | | | - Lennard Funk
- Upper Limb Unit, Wrightington Hospital, Wrightington, UK.
| | | | - Andreas Imhoff
- Department of Orthopaedic Sports Medicine, Technical University Munich, Germany.
| | - Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland.
| | - Ofer Levy
- Reading Shoulder Unit, Berkshire Independent Hospital, Reading, Berkshire, United Kingdom; The Israeli Shoulder Institute, Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.
| | - Tom Ludvigsen
- Division of Orthopaedic Surgery, Oslo University Hospital, Norway.
| | - Giuseppe Milano
- Unit of Orthopaedics and Traumatology, University of Brescia, Italy.
| | - Philipp Moroder
- Department of Shoulder and Elbow Surgery, Centrum for Muskuloskeletale Chirurgie, Charite Universitätsmedizin Berlin, Germany.
| | | | - Sebastian Siebenlist
- Department of Orthopaedic Sports Medicine, Technical University Munich, Germany.
| | - Jeffrey Abrams
- Princeton Orthopeadic Associates Princeton, New Jersey , USA.
| | - Robert Arciero
- Department of Orthopaedic Surgery, UCONN Health, Farmington, CT, USA.
| | - George Athwal
- Roth/McFarlane Hand&Upper limb Centre, St Joseph's Health Care, London, Ontario, Canada.
| | | | - Robert Gillespie
- Department of Orthopaedics Case Western Reserve University, University Hospital Cleveland Medical Center, Cleveland, Ohio, USA.
| | - Ben Kibler
- Lexington Orthopaedic Clinic, Sports Medicine Center Lexington, Kentucky, USA.
| | - William Levine
- Department of Orthopaedic Surgery, Columbia University Medical Center New York, NY, USA.
| | - Augustus Mazzocca
- Department of Orthopaedic Surgery, UCONN Health, Farmington, CT, USA.
| | | | - Richard Ryu
- The Ryu Hurvitz Orthopaedic Clinic, Santa Barbara, California, USA.
| | - Marc Safran
- Department of Orthopaedic Surgery, Stanford University Stanford, CA, USA.
| | | | - Felix Buddy Savoie
- Department of Orthopaedic Surgery, Tulane University New Orleans, LA, USA.
| | - Paul Sethi
- The ONS Sports and Shoulder Service, Greenwich, CT, USA.
| | - Kevin Shea
- Department of Orthopaedic Surgery, UCONN Health, Farmington, CT, USA.
| | - Nikhil Verma
- Midwest Orthopaedics at Rush University, Chicago, IL, USA.
| | - Jon Jp Warner
- Massachusetts General Hospital, The Boston Shoulder Institute Boston, MA USA.
| | | | - Brian Wolf
- Department of Orthopaedic Surgery, University of Iowa, Iowa City, IA USA.
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De Nicola A, Correa A, Bracco S, Perego J, Sozzani P, Comotti A, Milano G. Collective dynamics of molecular rotors in periodic mesoporous organosilica: a combined solid-state 2H-NMR and molecular dynamics simulation study. Phys Chem Chem Phys 2022; 24:666-673. [PMID: 34904981 DOI: 10.1039/d1cp05013c] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Molecular rotors offer a platform to realize controlled dynamics and modulate the functions of solids. The motional mechanisms in arrays of rotors have not been explored in depth. Crystal-like porous organosilicas, comprising p-phenylene rotators pivoted onto a siloxane scaffold, were modelled using molecular dynamics (MD) simulations. Long simulations, on a microsecond scale, allowed to follow the reorientation statistics of rotor collections and single out group configurations and frequency distributions as a function of temperature. The motions observed in the MD simulations support a multiple-site model for rotor reorientations. Computed motional frequencies revealed a complex rotatory phenomenon combining an ultra-fast libration motion (oscillation up to 30°) with a slow and fast 180° flip reorientation. Adopting a multiple-site model provides a more accurate simulation of the 2H-NMR spectra and a rationalization of their temperature dependence. In particular, rotators endowed with distinct rates could be explained by the presence of slower rings locked in a T-shaped conformation.
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Affiliation(s)
- Antonio De Nicola
- Scuola Superiore Meridionale, Largo San Marcellino 10, 80138 Napoli, Italy.
| | - Andrea Correa
- Department of Chemical Sciences, University of Naples Federico II, Via Cintia, Complesso Monte S. Angelo, 80126, Napoli, Italy
| | - Silvia Bracco
- Department of Materials Science, University of Milano - Bicocca, Via R. Cozzi 55, 20125, Milano, Italy.
| | - Jacopo Perego
- Department of Materials Science, University of Milano - Bicocca, Via R. Cozzi 55, 20125, Milano, Italy.
| | - Piero Sozzani
- Department of Materials Science, University of Milano - Bicocca, Via R. Cozzi 55, 20125, Milano, Italy.
| | - Angiolina Comotti
- Department of Materials Science, University of Milano - Bicocca, Via R. Cozzi 55, 20125, Milano, Italy.
| | - Giuseppe Milano
- Department of Chemical, Materials and Production Engineering, University of Naples Federico II, Piazzale Tecchio 80, 80125 Naploli, Italy
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Chiarcos R, Antonioli D, Gianotti V, Laus M, Munaò G, Milano G, De Nicola A, Perego M. Short vs. long chains competition during “ grafting to” process from melt. Polym Chem 2022. [DOI: 10.1039/d2py00364c] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A preferential grafting of short chains occurs during the “grafting to” reaction of hydroxy terminated P(S-st-MMA) blends consisting of short and long chains. The enrichment is enhanced when the chain length difference increases.
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Affiliation(s)
- Riccardo Chiarcos
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
| | - Diego Antonioli
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
| | - Valentina Gianotti
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
| | - Michele Laus
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
| | - Gianmarco Munaò
- Dipartimento di Scienze Matematiche e Informatiche, Scienze Fisiche e Scienze della Terra, Università degli Studi di Messina, Viale F. Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Giuseppe Milano
- Department of Chemical, Materials and Production Engineering, University of Naples Federico II, Naples 80125, Italy
| | - Antonio De Nicola
- Scuola Superiore Meridionale, University of Naples Federico II, Largo S. Marcellino 10, Naples 80138, Italy
| | - Michele Perego
- CNR-IMM, Unit of Agrate Brianza, Via C. Olivetti 2, 20864 Agrate Brianza, Italy
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Passiatore M, De Vitis R, Cilli V, Milano G, Saccomanno MF, Cotroneo C, Brozzini E, Vigliarolo D, Taccardo G. The Italian Version of the Michigan Hand Outcomes Questionnaire (MHQ): Translation, Cross-Cultural Adaptation and Validation. J Hand Surg Asian Pac Vol 2021; 26:666-683. [PMID: 34789093 DOI: 10.1142/s242483552150065x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Patient-reported outcome measures are largely used in clinical practice and scientific community. Michigan hand questionnaire (MHQ) is widely recognized as a standardized reliable instrument for the assessment of any kind of hand disorders. Aim of the study: translation, cross-cultural adaptation and validation of the Italian version of MHQ. Methods: The study was composed by two phases. Phase 1 consisted in translation and cross-cultural adaptation of MHQ, from original language version (English) into Italian, according to the standard procedure of translation and back translation. The final Italian version of MHQ was tested on 136 Italian patients with hand disorders (Phase 2), in addition to Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, Visual analogue scale (VAS) for pain assessment and grip strength, to psychometric properties of the new version, 55 patients repeated the questionnaire after 7 days for test-retest to assess the reproducibility of the questionnaire. All data were subsequently analyzed (descriptive statistics, multitrait analysis, reliability and construct validity assessment). Results: Phase 1 was performed without major problems, thus the final Italian version was approved for Phase 2. The questionnaire was clear and easily understood (missing data 0-2.9%). Multitrait analysis brought very good results for each outcome measure. High reliability (Cronbach's alpha: 0.91-0.99) and very good reproducibility (Intraclass correlation coefficients: 0.83-0.98) were revealed. High to moderate correlation was found between MHQ and DASH, grip strength and VAS. Conclusions: The Italian version of MHQ has demonstrated to be reliable and valid.
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Affiliation(s)
- Marco Passiatore
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Rocco De Vitis
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vitale Cilli
- Hand Surgery Unit, CHIREC site Delta, Bruxelles, Belgium
| | - Giuseppe Milano
- Department of Orthopaedics, University of Brescia, Brescia, Italy
| | | | - Claudia Cotroneo
- Hand Therapy Service, Fondazione Policlinico Universitario A. Gemelli, Roma, Italy
| | - Elisa Brozzini
- Hand Therapy Service, Fondazione Policlinico Universitario A. Gemelli, Roma, Italy
| | - Daniela Vigliarolo
- Hand Therapy Service, Fondazione Policlinico Universitario A. Gemelli, Roma, Italy
| | - Giuseppe Taccardo
- Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Milano G, Saccomanno MF. Editorial Commentary: Acromioplasty Does Not Improve Clinical Outcome of Arthroscopic Rotator Cuff Repair: The Game Is Over! Arthroscopy 2021; 37:3079-3080. [PMID: 34602149 DOI: 10.1016/j.arthro.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 02/02/2023]
Abstract
Acromioplasty is a well-known, simple, and reproducible surgical technique that is used in isolation or in combination with other arthroscopic procedures. The clinical value of acromioplasty combined with arthroscopic rotator cuff repair has been largely investigated. Main theoretical benefits lie in the opportunity to improve the visualization, decrease abrasive wear with prominent acromial morphology, and release natural growth factors. On the other hand, acromioplasty and release of the coracoacromial ligament may weaken the insertion of the deltoid muscle, induce scar formation in the subacromial space, theoretically limiting shoulder mobility, and increase risk of anterior-superior humeral escape, especially in patients with large to massive rotator cuff tears. Clinical studies report conflicting results. My results show no differences in clinical outcomes in rotator cuff repairs with or without subacromial decompression, regardless of the acromial morphology. At the same time, I do believe that confirmatory studies are always necessary, especially if the aim is to disprove the usefulness of a common practice.
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Milano G, Martetschläger F, Kovačič L. Evolving concepts and consensus in challenging shoulder problems: a European perspective. Knee Surg Sports Traumatol Arthrosc 2021; 29:2021-2023. [PMID: 33991209 DOI: 10.1007/s00167-021-06593-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. .,Department of Bone and Joint Surgery, ASST Spedali Civili, Piazzale Spedali Civili 1, 25123, Brescia, Italy.
| | - Frank Martetschläger
- Department for Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany.,Center for Shoulder and Elbow Surgery, ATOS Clinic, Effnerstrasse 38, 81925, Munich, Germany
| | - Ladislav Kovačič
- University Medical Centre of Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia
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Saccomanno MF, Marchi G, Mocini F, Vismara V, Campana V, Salvi AG, Scaini A, Milano G. Anatomic reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation provides good clinical and radiological results. Knee Surg Sports Traumatol Arthrosc 2021; 29:2356-2363. [PMID: 33108527 DOI: 10.1007/s00167-020-06285-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 09/14/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To evaluate clinical and radiographic outcomes of anatomical reconstruction of the coracoclavicular and acromioclavicular ligaments with single-strand semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation. METHODS Patients affected by chronic type III-V acromioclavicular joint dislocations were included. Exclusion criteria were: age under 18 years, concomitant rotator cuff tears, previous surgery to the same shoulder, degenerative changes of the glenohumeral joint, infections, neurologic diseases, patients with a previous history of ligament reconstruction procedures that had required harvesting of the semitendinosus tendon from the ipsilateral or contralateral knee. All patients underwent the same surgical technique and rehabilitation. Primary outcome was the normalized Constant score. Secondary outcomes were: DASH score, radiographic evaluation of loss of reduction and acromioclavicular joint osteoarthritis. RESULTS Thirty patients with a mean age of 28.9 ± 8.3 years were included. Mean time to surgery was 12.8 ± 10 months. Mean follow-up was 28.1 ± 2.4 months (range: 24-32). Comparison between pre- and postoperative functional scores showed significant clinical improvement (p < 0.001). Time to surgery was independently associated with a poorer Constant score (p < 0.0001). On radiographs, 4 patients (13.3%) showed asymptomatic partial loss of reduction. CONCLUSION Anatomic reconstruction of coracoclavicular and acromioclavicular ligaments using a semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation provided good clinical and radiological results at minimum 2-year follow-up. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
| | - Giacomo Marchi
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Fabrizio Mocini
- Orthopaedics Institute, Fondazione Policilinico A. Gemelli IRCCS, Rome, Italy
| | - Valeria Vismara
- Orthopaedics Institute, Fondazione Policilinico A. Gemelli IRCCS, Rome, Italy
| | - Vincenzo Campana
- Orthopaedics Institute, Fondazione Policilinico A. Gemelli IRCCS, Rome, Italy
| | | | | | - Giuseppe Milano
- University of Brescia, Brescia, Italy.,Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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Doglietto F, Vezzoli M, Gheza F, Lussardi GL, Domenicucci M, Vecchiarelli L, Zanin L, Saraceno G, Signorini L, Panciani PP, Castelli F, Maroldi R, Rasulo FA, Benvenuti MR, Portolani N, Bonardelli S, Milano G, Casiraghi A, Calza S, Fontanella MM. Factors Associated With Surgical Mortality and Complications Among Patients With and Without Coronavirus Disease 2019 (COVID-19) in Italy. JAMA Surg 2021; 155:691-702. [PMID: 32530453 DOI: 10.1001/jamasurg.2020.2713] [Citation(s) in RCA: 222] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Importance There are limited data on mortality and complications rates in patients with coronavirus disease 2019 (COVID-19) who undergo surgery. Objective To evaluate early surgical outcomes of patients with COVID-19 in different subspecialties. Design, Setting, and Participants This matched cohort study conducted in the general, vascular and thoracic surgery, orthopedic, and neurosurgery units of Spedali Civili Hospital (Brescia, Italy) included patients who underwent surgical treatment from February 23 to April 1, 2020, and had positive test results for COVID-19 either before or within 1 week after surgery. Gynecological and minor surgical procedures were excluded. Patients with COVID-19 were matched with patients without COVID-19 with a 1:2 ratio for sex, age group, American Society of Anesthesiologists score, and comorbidities recorded in the surgical risk calculator of the American College of Surgeons National Surgical Quality Improvement Program. Patients older than 65 years were also matched for the Clinical Frailty Scale score. Exposures Patients with positive results for COVID-19 and undergoing surgery vs matched surgical patients without infection. Screening for COVID-19 was performed with reverse transcriptase-polymerase chain reaction assay in nasopharyngeal swabs, chest radiography, and/or computed tomography. Diagnosis of COVID-19 was based on positivity of at least 1 of these investigations. Main Outcomes and Measures The primary end point was early surgical mortality and complications in patients with COVID-19; secondary end points were the modeling of complications to determine the importance of COVID-19 compared with other surgical risk factors. Results Of 41 patients (of 333 who underwent operation during the same period) who underwent mainly urgent surgery, 33 (80.5%) had positive results for COVID-19 preoperatively and 8 (19.5%) had positive results within 5 days from surgery. Of the 123 patients of the combined cohorts (78 women [63.4%]; mean [SD] age, 76.6 [14.4] years), 30-day mortality was significantly higher for those with COVID-19 compared with control patients without COVID-19 (odds ratio [OR], 9.5; 95% CI, 1.77-96.53). Complications were also significantly higher (OR, 4.98; 95% CI, 1.81-16.07); pulmonary complications were the most common (OR, 35.62; 95% CI, 9.34-205.55), but thrombotic complications were also significantly associated with COVID-19 (OR, 13.2; 95% CI, 1.48-∞). Different models (cumulative link model and classification tree) identified COVID-19 as the main variable associated with complications. Conclusions and Relevance In this matched cohort study, surgical mortality and complications were higher in patients with COVID-19 compared with patients without COVID-19. These data suggest that, whenever possible, surgery should be postponed in patients with COVID-19.
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Affiliation(s)
- Francesco Doglietto
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Marika Vezzoli
- Biostatistics, Department of Molecular and Translational Medicine, University of Brescia, Bescia, Italy
| | - Federico Gheza
- General Surgery, Department of Clinical and Experimental Sciences, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Gian Luca Lussardi
- Vascular Surgery, Department of Clinical and Experimental Sciences, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Marco Domenicucci
- Department of Bone and Joint Surgery, Spedali Civili Hospital, Brescia, Italy
| | - Luca Vecchiarelli
- Thoracic Surgery, Department of Cardio-Thoracic Surgery, Spedali Civili Hospital, Brescia, Italy
| | - Luca Zanin
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Giorgio Saraceno
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Liana Signorini
- Department of Infectious Disease, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Pier Paolo Panciani
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Francesco Castelli
- Department of Infectious Disease, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Roberto Maroldi
- Radiology, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Francesco Antonio Rasulo
- Intensive Care and Anesthesiology, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Mauro Roberto Benvenuti
- Thoracic Surgery, Department of Cardio-Thoracic Surgery, Spedali Civili Hospital, Brescia, Italy
| | - Nazario Portolani
- General Surgery, Department of Clinical and Experimental Sciences, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Stefano Bonardelli
- Vascular Surgery, Department of Clinical and Experimental Sciences, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | - Giuseppe Milano
- Orthopaedics, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy
| | | | - Stefano Calza
- Biostatistics, Department of Molecular and Translational Medicine, University of Brescia, Bescia, Italy
| | - Marco Maria Fontanella
- Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy
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Milano G, D'Ortenzi L, Bejtka K, Ciubini B, Porro S, Boarino L, Ricciardi C. Metal-insulator transition in single crystalline ZnO nanowires. Nanotechnology 2021; 32:185202. [PMID: 33503595 DOI: 10.1088/1361-6528/abe072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this work, we report on the metal-insulator transition and electronic transport properties of single crystalline ZnO nanowires synthetized by means of Chemical Vapor Deposition. After evaluating the effect of adsorbed species on transport properties, the thermally activated conduction mechanism was investigated by temperature-dependent measurements in the range 81.7-250 K revealing that the electronic transport mechanism in these nanostructures is in good agreement with the presence of two thermally activated conduction channels. More importantly, it was observed that the electrical properties of ZnO NWs can be tuned from semiconducting to metallic-like as a function of temperature with a metal-to-insulator transition (MIT) observed at a critical temperature above room temperature (T c ∼ 365 K). Charge density and mobility were investigated by means of field effect measurements in NW field-effect transistor configuration. Results evidenced that the peculiar electronic transport properties of ZnO NWs are related to the high intrinsic n-type doping of these nanostructures that is responsible, at room temperature, of a charge carrier density that lays just below the critical concentration for the MIT. This work shows that native defects, Coulomb interactions and surface states influenced by adsorbed species can significantly influence charge transport in NWs.
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Affiliation(s)
- G Milano
- Advanced Materials Metrology and Life Science Division, INRiM (Istituto Nazionale di Ricerca Metrologica), Strada delle Cacce 91, I-10135, Torino, Italy
- Department of Applied Science and Technology, Politecnico di Torino, c.so Duca degli Abruzzi 24, I-10129 Torino, Italy
| | - L D'Ortenzi
- Advanced Materials Metrology and Life Science Division, INRiM (Istituto Nazionale di Ricerca Metrologica), Strada delle Cacce 91, I-10135, Torino, Italy
| | - K Bejtka
- Center for Sustainable Future Technologies, Istituto Italiano di Tecnologia, c.so Trento 21, I-10129 Torino, Italy
| | - B Ciubini
- Department of Applied Science and Technology, Politecnico di Torino, c.so Duca degli Abruzzi 24, I-10129 Torino, Italy
| | - S Porro
- Department of Applied Science and Technology, Politecnico di Torino, c.so Duca degli Abruzzi 24, I-10129 Torino, Italy
| | - L Boarino
- Advanced Materials Metrology and Life Science Division, INRiM (Istituto Nazionale di Ricerca Metrologica), Strada delle Cacce 91, I-10135, Torino, Italy
| | - C Ricciardi
- Department of Applied Science and Technology, Politecnico di Torino, c.so Duca degli Abruzzi 24, I-10129 Torino, Italy
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Caputo S, Hristov V, Nicola AD, Herbst H, Pizzirusso A, Donati G, Munaò G, Albunia AR, Milano G. Efficient Hybrid Particle-Field Coarse-Grained Model of Polymer Filler Interactions: Multiscale Hierarchical Structure of Carbon Black Particles in Contact with Polyethylene. J Chem Theory Comput 2021; 17:1755-1770. [PMID: 33577311 PMCID: PMC8023654 DOI: 10.1021/acs.jctc.0c01095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Indexed: 11/28/2022]
Abstract
In the present study, we propose, validate, and give first applications for large-scale systems of coarse-grained models suitable for filler/polymer interfaces based on carbon black (CB) and polyethylene (PE). The computational efficiency of the proposed approach, based on hybrid particle-field models (hPF), allows large-scale simulations of CB primary particles of realistic size (∼20 nm) embedded in PE melts. The molecular detailed models, here introduced, allow a microscopic description of the bound layer, through the analysis of the conformational behavior of PE chains adsorbed on different surface sites of CB primary particles, where the conformational behavior of adsorbed chains is different from models based on flat infinite surfaces. On the basis of the features of the systems, an optimized version of OCCAM code for large-scale (up to more than 8 million of beads) parallel runs is proposed and benchmarked. The computational efficiency of the proposed approach opens the possibility of a computational screening of the bound layer, involving the optimal combination of surface chemistry, size, and shape of CB aggregates and the molecular weight distribution of the polymers achieving an important tool to address the polymer/fillers interface and interphase engineering in the polymer industry.
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Affiliation(s)
- Stefano Caputo
- Dipartimento
di Chimica e Biologia, Università
di Salerno, Via Giovanni Paolo II, 132, I-84084, Fisciano, Salerno, Italy
| | - Velichko Hristov
- Innovation
& Technology, Borealis Polyolefine GmbH, St.-Peter-Straße 25, 4021, Linz, Austria
| | - Antonio De Nicola
- Department
of Organic Materials Science, Yamagata University, 4-3-16 Jonan, Yonezawa, Yamagata-ken 992-8510, Japan
| | - Harald Herbst
- Innovation
& Technology, Borealis Polyolefine GmbH, St.-Peter-Straße 25, 4021, Linz, Austria
| | - Antonio Pizzirusso
- Dipartimento
di Chimica e Biologia, Università
di Salerno, Via Giovanni Paolo II, 132, I-84084, Fisciano, Salerno, Italy
| | - Greta Donati
- Dipartimento
di Chimica e Biologia, Università
di Salerno, Via Giovanni Paolo II, 132, I-84084, Fisciano, Salerno, Italy
| | - Gianmarco Munaò
- Dipartimento
di Scienze Matematiche e Informatiche, Scienze Fisiche e Scienze della
Terra, Università degli Studi di
Messina, Viale F. Stagno
d’Alcontres 31, 98166 Messina, Italy
| | | | - Giuseppe Milano
- Dipartimento
di Chimica e Biologia, Università
di Salerno, Via Giovanni Paolo II, 132, I-84084, Fisciano, Salerno, Italy
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De Nicola A, Correa A, Giunchi A, Muccioli L, D'Avino G, Kido J, Milano G. Bidimensional H‐Bond Network Promotes Structural Order and Electron Transport in BPyMPMs Molecular Semiconductor. Adv Theory Simul 2021. [DOI: 10.1002/adts.202000302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Antonio De Nicola
- Frontier Center for Organic Materials (FROM) Yamagata University 4‐3‐16 Jonan Yonezawa Yamagata 992‐8510 Japan
| | - Andrea Correa
- Dipartment of Chemistry University of Naples Federico II Complesso di Monte S. Angelo Napoli 80126 Italy
| | - Andrea Giunchi
- Department of Industrial Chemistry “Toso Montanari” University of Bologna Bologna 40136 Italy
| | - Luca Muccioli
- Department of Industrial Chemistry “Toso Montanari” University of Bologna Bologna 40136 Italy
| | - Gabriele D'Avino
- Grenoble Alpes University CNRS Grenoble INP Institut Néel 25 Rue des Martyrs Grenoble 38042 France
| | - Junji Kido
- Frontier Center for Organic Materials (FROM) Yamagata University 4‐3‐16 Jonan Yonezawa Yamagata 992‐8510 Japan
| | - Giuseppe Milano
- Frontier Center for Organic Materials (FROM) Yamagata University 4‐3‐16 Jonan Yonezawa Yamagata 992‐8510 Japan
- Department of Chemistry and Biology “Adolfo Zambelli” University of Salerno Fisciano 84084 Italy
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Antonioli D, Chiarcos R, Gianotti V, Terragno M, Laus M, Munaò G, Milano G, De Nicola A, Perego M. Inside the brush: partition by molecular weight in grafting to reactions from melt. Polym Chem 2021. [DOI: 10.1039/d1py01303c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
A substantial partition by molecular weight takes place during the grafting to reactions.
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Affiliation(s)
- Diego Antonioli
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
| | - Riccardo Chiarcos
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
- CNR-IMM, Unit of Agrate Brianza, Via C. Olivetti 2, 20864 Agrate Brianza, Italy
| | - Valentina Gianotti
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
| | - Margherita Terragno
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
| | - Michele Laus
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, 15121 Alessandria, Italy
| | - Gianmarco Munaò
- Dipartimento di Scienze Matematiche e Informatiche, Scienze Fisiche e Scienze della Terra, Università degli Studi di Messina, Viale F. Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Giuseppe Milano
- Department of Chemical, Materials and Production Engineering, University of Naples Federico II, Naples 80125, Italy
| | - Antonio De Nicola
- Dipartimento di Chimica e Biologia “A. Zambelli”, Universitá degli Studi di Salerno, via G. Paolo II 134, 84084, Fisciano, SA, Italy
| | - Michele Perego
- CNR-IMM, Unit of Agrate Brianza, Via C. Olivetti 2, 20864 Agrate Brianza, Italy
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Sevink GJA, Blokhuis EM, Li X, Milano G. Efficient and realistic simulation of phase coexistence. J Chem Phys 2020; 153:244121. [PMID: 33380071 DOI: 10.1063/5.0027778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We show how an existing concurrent multi-scale method named hybrid particle field-molecular dynamics (hPF-MD) can be adapted to enable the simulation of structure and/or structural dynamics in compressible systems. Implementing such new equations of state (EOS) into hPF-MD, while conserving the efficiency associated with treating intermolecular interactions in a continuum fashion, opens this method up to describe a new class of phenomena in which non-uniform densities play a role, for example, evaporation and crystallization. We carefully consider how compressible hPF-MD compares to its mean-field counterpart for two particular EOS, adopted from the Cell Model for polymers and the Carnahan-Starling expression for hard spheres. Here, we performed a very basic analysis for a single-component system, focusing on the significance of various particle-based parameters and the particle-to-field projection. Our results illustrate the key role of the particle density per field grid cell and show that projection based on a Gaussian kernel is preferred over the standard cloud-in-cell projection. They also suggest that the behavior of hPF-MD close to the critical point is non-classical, i.e., in agreement with a critical exponent for a pure particle description, despite the mean-field origin of the method.
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Affiliation(s)
- G J A Sevink
- Leiden Institute of Chemistry, Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
| | - E M Blokhuis
- Leiden Institute of Chemistry, Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
| | - X Li
- Leiden Institute of Chemistry, Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
| | - G Milano
- Department of Chemistry and Hylleraas Centre for Quantum Molecular Sciences, University of Oslo, P.O. Box 1033 Blindern, 0315, Oslo, Norway
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Laus M, Chiarcos R, Gianotti V, Antonioli D, Sparnacci K, Munaò G, Milano G, De Nicola A, Perego M. Evidence of Mechanochemical Control in “Grafting to” Reactions of Hydroxy-Terminated Statistical Copolymers. Macromolecules 2020. [DOI: 10.1021/acs.macromol.0c02142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Michele Laus
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, Alessandria 15121, Italy
| | - Riccardo Chiarcos
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, Alessandria 15121, Italy
| | - Valentina Gianotti
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, Alessandria 15121, Italy
| | - Diego Antonioli
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, Alessandria 15121, Italy
| | - Katia Sparnacci
- Dipartimento di Scienze e Innovazione Tecnologica (DISIT), Universitá del Piemonte Orientale “A. Avogadro”, Viale T. Michel 11, Alessandria 15121, Italy
| | - Gianmarco Munaò
- Scienze Matematiche e Informatiche, Scienze Fisiche e Scienze della Terra, Università degli Studi di Messina, Viale F. Stagno d’Alcontres 31, Messina 98166, Italy
| | - Giuseppe Milano
- Department of Organic Materials Science, Yamagata University, 4-3-16 Jonan Yonezawa, Yamagata-ken 992-8510, Japan
| | - Antonio De Nicola
- Department of Organic Materials Science, Yamagata University, 4-3-16 Jonan Yonezawa, Yamagata-ken 992-8510, Japan
| | - Michele Perego
- CNR-IMM, Unit of Agrate Brianza, Agrate Brianza 20864, Italy
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39
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Wu Z, Milano G, Müller-Plathe F. Combination of Hybrid Particle-Field Molecular Dynamics and Slip-Springs for the Efficient Simulation of Coarse-Grained Polymer Models: Static and Dynamic Properties of Polystyrene Melts. J Chem Theory Comput 2020; 17:474-487. [PMID: 33275441 DOI: 10.1021/acs.jctc.0c00954] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A quantitative prediction of polymer-entangled dynamics based on molecular simulation is a grand challenge in contemporary computational material science. The drastic increase of relaxation time and viscosity in high-molecular-weight polymeric fluids essentially limits the usage of classic molecular dynamics simulation. Here, we demonstrate a systematic coarse-graining approach for modeling entangled polymers under the slip-spring particle-field scheme. Specifically, a frequency-controlled slip-spring model, a hybrid particle-field model, and a coarse-grained model of polystyrene melts are combined into a hybrid simulation technique. Via a rigorous parameterization strategy to determine the parameters in slip-springs from existing experimental or simulation data, we show that the reptation behavior is clearly observed in multiple characteristics of polymer dynamics, mean-square displacements, diffusion coefficients, reorientational relaxation, and Rouse mode analysis, consistent with the predictions of the tube theory. All dynamical properties of the slip-spring particle-field models are in good agreement with classic molecular dynamics models. Our work provides an efficient and practical approach to establish chemical-specific coarse-grained models for predicting polymer-entangled dynamics.
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Affiliation(s)
- Zhenghao Wu
- Eduard-Zintl-Institut für Anorganische und Physikalische Chemie, Technische Universität Darmstadt, Alarich-Weiss-Str. 8, 64287 Darmstadt, Germany
| | - Giuseppe Milano
- Department of Organic Materials Science, Yamagata University, 4-3-16 Jonan, Yonezawa, 992-8510 Yamagata-ken, Japan
| | - Florian Müller-Plathe
- Eduard-Zintl-Institut für Anorganische und Physikalische Chemie, Technische Universität Darmstadt, Alarich-Weiss-Str. 8, 64287 Darmstadt, Germany
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40
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Milano G, Marchi G, Bertoni G, Vaisitti N, Galli S, Scaini A, Saccomanno MF. Augmented Repair of Large to Massive Delaminated Rotator Cuff Tears With Autologous Long Head of the Biceps Tendon Graft: The Arthroscopic "Cuff-Plus" Technique. Arthrosc Tech 2020; 9:e1683-e1688. [PMID: 33294326 PMCID: PMC7695575 DOI: 10.1016/j.eats.2020.07.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/11/2020] [Indexed: 02/03/2023] Open
Abstract
An anatomic and tension-free repair is the goal of arthroscopic rotator cuff repair. However, this purpose is not always achievable in large and massive tears, and sometimes, even when intraoperative results seem acceptable, clinical and radiologic outcomes can be disappointing shortly afterward. Superior capsule reconstruction has been claimed as a valid and viable joint-preserving option for treating irreparable rotator cuff tears. However, the role of the superior capsule in repairable cuff tears has also been questioned. The aim of this article is to present the so-called arthroscopic cuff-plus technique. This technique consists of superior capsule reconstruction using the proximal part of the long head of the biceps tendon associated with a tension-free repair of the rotator cuff tendons in large to massive delaminated tears.
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Affiliation(s)
- Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.,Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Giacomo Marchi
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Giuseppe Bertoni
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Niccolò Vaisitti
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Galli
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Alessandra Scaini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Maristella F Saccomanno
- Department of Orthopaedics and Traumatology, Catholic University, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
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41
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Milano G, Saccomanno MF, Colosio A, Adriani M, Galli S, Scaini A, Marchi G. Arthroscopic Superior Capsule Reconstruction With Doubled Autologous Semitendinosus Tendon Graft. Arthrosc Tech 2020; 9:e1665-e1672. [PMID: 33294324 PMCID: PMC7695576 DOI: 10.1016/j.eats.2020.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/09/2020] [Indexed: 02/03/2023] Open
Abstract
Massive and irreparable rotator cuff tears remain a difficult condition to treat. Fatty infiltration of the muscles and excessive retraction of the tendons predispose to high failure rates of arthroscopic repair techniques. In recent years, studies on the superior capsule have shown that it plays a key role in reducing superior humeral head translation and restoring balance to the force couples required for dynamic shoulder function. Superior capsule reconstruction has become common in clinical practice. Several techniques with different types of grafts have been described, such as fascia lata autograft, dermal allograft patch, and long head of the biceps tendon autograft. More recently, an open technique with semitendinosus tendon autograft has been proposed. Our aim is to describe an all-arthroscopic technique for superior capsule reconstruction using a doubled semitendinosus tendon autograft in a box-shaped configuration. We believe that the technique can combine the advantages of other techniques, such as graft availability, low harvest-site morbidity, limited cost, and mechanical strength.
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Affiliation(s)
- Giuseppe Milano
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy,Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Maristella F. Saccomanno
- Department of Orthopaedics and Traumatology, Catholic University, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Alessandro Colosio
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marco Adriani
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Galli
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
| | - Alessandra Scaini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy,Address correspondence to Alessandra Scaini, M.D., Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia (BS), Italy.
| | - Giacomo Marchi
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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42
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Schäfer K, Kolli HB, Killingmoe Christensen M, Bore SL, Diezemann G, Gauss J, Milano G, Lund R, Cascella M. Supramolecular Packing Drives Morphological Transitions of Charged Surfactant Micelles. Angew Chem Int Ed Engl 2020; 59:18591-18598. [PMID: 32543728 PMCID: PMC7589243 DOI: 10.1002/anie.202004522] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/29/2020] [Indexed: 12/16/2022]
Abstract
The shape and size of self-assembled structures upon local organization of their molecular building blocks are hard to predict in the presence of long-range interactions. Combining small-angle X-ray/neutron scattering data, theoretical modelling, and computer simulations, sodium dodecyl sulfate (SDS), over a broad range of concentrations and ionic strengths, was investigated. Computer simulations indicate that micellar shape changes are associated with different binding of the counterions. By employing a toy model based on point charges on a surface, and comparing it to experiments and simulations, it is demonstrated that the observed morphological changes are caused by symmetry breaking of the irreducible building blocks, with the formation of transient surfactant dimers mediated by the counterions that promote the stabilization of cylindrical instead of spherical micelles. The present model is of general applicability and can be extended to all systems controlled by the presence of mobile charges.
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Affiliation(s)
- Ken Schäfer
- Department ChemieJohannes Gutenberg-Universität MainzDuesbergweg 10–1455128MainzGermany
| | - Hima Bindu Kolli
- Department of Physics and AstronomyThe University of SheffieldWestern BankSheffieldS10 2TNUK
| | - Mikkel Killingmoe Christensen
- Department of Chemistry and Hylleraas Centre for Quantum Molecular SciencesUniversity of OsloPO-Box 1033 Blindern0315OsloNorway
| | - Sigbjørn Løland Bore
- Department of Chemistry and Hylleraas Centre for Quantum Molecular SciencesUniversity of OsloPO-Box 1033 Blindern0315OsloNorway
| | - Gregor Diezemann
- Department ChemieJohannes Gutenberg-Universität MainzDuesbergweg 10–1455128MainzGermany
| | - Jürgen Gauss
- Department ChemieJohannes Gutenberg-Universität MainzDuesbergweg 10–1455128MainzGermany
| | - Giuseppe Milano
- Department of Organic Materials ScienceYamagata University4-3-16 JonanYonezawaYamagata-ken992-8510Japan
| | - Reidar Lund
- Department of Chemistry and Hylleraas Centre for Quantum Molecular SciencesUniversity of OsloPO-Box 1033 Blindern0315OsloNorway
| | - Michele Cascella
- Department of Chemistry and Hylleraas Centre for Quantum Molecular SciencesUniversity of OsloPO-Box 1033 Blindern0315OsloNorway
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43
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Wu Z, Kalogirou A, De Nicola A, Milano G, Müller‐Plathe F. Atomistic hybrid
particle‐field
molecular dynamics combined with
slip‐springs
: Restoring entangled dynamics to simulations of polymer melts. J Comput Chem 2020; 42:6-18. [DOI: 10.1002/jcc.26428] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/07/2020] [Accepted: 09/11/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Zhenghao Wu
- Eduard‐Zintl‐Institut für Anorganische und Physikalische Chemie, Technische Universität Darmstadt Darmstadt Germany
| | - Andreas Kalogirou
- Eduard‐Zintl‐Institut für Anorganische und Physikalische Chemie, Technische Universität Darmstadt Darmstadt Germany
| | - Antonio De Nicola
- Department of Organic Materials Science Yamagata University Yamagata‐ken Japan
| | - Giuseppe Milano
- Department of Organic Materials Science Yamagata University Yamagata‐ken Japan
| | - Florian Müller‐Plathe
- Eduard‐Zintl‐Institut für Anorganische und Physikalische Chemie, Technische Universität Darmstadt Darmstadt Germany
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44
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Sevink GJA, Liwo JA, Asinari P, MacKernan D, Milano G, Pagonabarraga I. Unfolding the prospects of computational (bio)materials modeling. J Chem Phys 2020; 153:100901. [PMID: 32933271 DOI: 10.1063/5.0019773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In this perspective communication, we briefly sketch the current state of computational (bio)material research and discuss possible solutions for the four challenges that have been increasingly identified within this community: (i) the desire to develop a unified framework for testing the consistency of implementation and physical accuracy for newly developed methodologies, (ii) the selection of a standard format that can deal with the diversity of simulation data and at the same time simplifies data storage, data exchange, and data reproduction, (iii) how to deal with the generation, storage, and analysis of massive data, and (iv) the benefits of efficient "core" engines. Expressed viewpoints are the result of discussions between computational stakeholders during a Lorentz center workshop with the prosaic title Workshop on Multi-scale Modeling and are aimed at (i) improving validation, reporting and reproducibility of computational results, (ii) improving data migration between simulation packages and with analysis tools, (iii) popularizing the use of coarse-grained and multi-scale computational tools among non-experts and opening up these modern computational developments to an extended user community.
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Affiliation(s)
- G J Agur Sevink
- Leiden Institute of Chemistry, Leiden University, P.O. Box 9502, 2300 RA Leiden, The Netherlands
| | - Jozef Adam Liwo
- Laboratory of Molecular Modeling, Faculty of Chemistry, University of Gdansk, Wita Stwosza 63, 80-308 Gdansk, Poland
| | - Pietro Asinari
- Department of Energy, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129 Turin, Italy
| | - Donal MacKernan
- UCD School of Physics, University College Dublin, Dublin 4, Ireland
| | - Giuseppe Milano
- Theoretical Physical Chemistry, Organic Materials Modeling, Department of Organic Materials Science, Yamagata University, 4-3-16 Jonan Yonezawa, Yamagata-ken 992-8510, Japan
| | - Ignacio Pagonabarraga
- CECAM Centre Européen de Calcul Atomique et Moléculaire, École Polytechnique Fédérale de Lausanne (EPFL), Batochime, Avenue Forel 2, Lausanne CH-1015, Switzerland
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45
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Fra V, Beccaria M, Milano G, Guastella S, Bianco S, Porro S, Laurenti M, Stassi S, Ricciardi C. Hydrothermally grown ZnO nanowire array as an oxygen vacancies reservoir for improved resistive switching. Nanotechnology 2020; 31:374001. [PMID: 32492668 DOI: 10.1088/1361-6528/ab9920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Resistive switching (RS) devices based on self-assembled nanowires (NWs) and nanorods (NRs) represent a fascinating alternative to conventional devices with thin film structure. The high surface-to-volume ratio may indeed provide the possibility of modulating their functionalities through surface effects. However, devices based on NWs usually suffer from low resistive switching performances in terms of operating voltages, endurance and retention capabilities. In this work, we report on the resistive switching behaviour of ZnO NW arrays, grown by hydrothermal synthesis, that exhibit stable, bipolar resistive switching characterized by SET/RESET voltages lower than 3 V, endurance higher than 1100 cycles and resistance state retention of more than 105 s. The physical mechanism underlying these RS performances can be ascribed to nanoionic processes involving the formation/rupture of conductive paths assisted by oxygen-related species in the ZnO active layer. The reported results represent, to the best of our knowledge, the best resistive switching performances observed in ZnO NW arrays in terms of endurance and retention.
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Affiliation(s)
- V Fra
- Department of Applied Science and Technology, Politecnico di Torino, c.so Duca degli Abruzzi 24, I-10129, Torino, Italy
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46
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Saada E, Koudou Y, Daste A, Fayette J, Lefebvre G, Zanetta S, Toullec C, Cupissol D, Salas S, Kaminsky-Forrett MC, Johnson A, Vauleon E, Ebran N, Schmidt M, Texier M, Peyrade F, Milano G, Guigay J, Even C, Etienne-Grimaldi MC. 946P Germinal immunogenetics and response to nivolumab in recurrent/metastatic head and neck squamous cell carcinoma (RM HNSCC) patients (pts): TopNIVO ancillary study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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47
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Mourad F, Patuzzo A, Tenci A, Turcato G, Faletra A, Valdifiori G, Gobbo M, Maselli F, Milano G. Management of whiplash-associated disorder in the Italian emergency department: the feasibility of an evidence-based continuous professional development course provided by physiotherapists. Disabil Rehabil 2020; 44:2123-2130. [PMID: 32853029 DOI: 10.1080/09638288.2020.1806936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The management of whiplash and associated disorders (WAD) in the Italian Health System is still empirical and influenced by a single professional's expertise. Therefore, the purpose of our study is to describe a structured management changes in an Italian emergency department (ED) after an evidence based continuous professional development (CPD) course. METHODS A CPD course was organized by Orthopedic Manipulative Physical Therapists (OMPT) for personnel of ED in the hospital Girolamo Fracastoro (San Bonifacio, Verona, Italy), based on latest scientific evidence. Data regarding the number of X-Rays, computed tomography (CT) scan, orthopaedic referrals, neck collars and WAD IV (i.e., severe diagnosis) before and after the course were compared. RESULTS 3066 cases of WAD have been analyzed in 2016 and 2185 in 2017/2018. The number of X-Rays dropped down from 15.1% to 13.5%; the CT scans increased from 1.3% to 1.9%; the WAD IV diagnosis increased from 0.7% to 1.6%; the orthopaedic referrals dropped from 1.5% to 1.1%; the collars prescription dropped from 8.8% to 2.5%. CONCLUSION An updated framework increased the efficiency of ED's maintaining the same level of safety (i.e., WAD IV diagnosis). Given that, it can also be argued that, in line with other countries, the implementation of an OMPT role within the ED multidisciplinary team is advised also in Italy.Implications for rehabilitationPhysiotherapists were commissioned to organize a management change of patients in an Italian Emergency Department clinical setting for the management of whiplash;Guidelines and other appropriate clinical rules facilitate the delivery of an evidence-based and more appropriate management and care plan;An inter-disciplinary continuous professional development course has the potential to positively influence patients' journey and to optimize the use of departmental resources;The involvement of other health professionals (e.g., Physiotherapists) within the Italian Emergency Department organizational chart might lead to further improvement of service provided.
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Affiliation(s)
| | | | - Andrea Tenci
- Emergency Department, Ospedale "Girolamo Fracastoro", S. Bonifacio (VR). Aulss 9 "Scaligera" della Regione Veneto, Veneto, Italy
| | - Gianni Turcato
- Emergency Department, Ospedale Franz Tappeiner Merano, Bolzano, Italy
| | | | | | - Massimiliano Gobbo
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Filippo Maselli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Campus of Savona, University of Genoa, Savona, Italy.,Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy
| | - Giuseppe Milano
- Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy
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48
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Schäfer K, Kolli HB, Killingmoe Christensen M, Bore SL, Diezemann G, Gauss J, Milano G, Lund R, Cascella M. Supramolecular Packing Drives Morphological Transitions of Charged Surfactant Micelles. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202004522] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Ken Schäfer
- Department Chemie Johannes Gutenberg-Universität Mainz Duesbergweg 10–14 55128 Mainz Germany
| | - Hima Bindu Kolli
- Department of Physics and Astronomy The University of Sheffield Western Bank Sheffield S10 2TN UK
| | - Mikkel Killingmoe Christensen
- Department of Chemistry and Hylleraas Centre for Quantum Molecular Sciences University of Oslo PO-Box 1033 Blindern 0315 Oslo Norway
| | - Sigbjørn Løland Bore
- Department of Chemistry and Hylleraas Centre for Quantum Molecular Sciences University of Oslo PO-Box 1033 Blindern 0315 Oslo Norway
| | - Gregor Diezemann
- Department Chemie Johannes Gutenberg-Universität Mainz Duesbergweg 10–14 55128 Mainz Germany
| | - Jürgen Gauss
- Department Chemie Johannes Gutenberg-Universität Mainz Duesbergweg 10–14 55128 Mainz Germany
| | - Giuseppe Milano
- Department of Organic Materials Science Yamagata University 4-3-16 Jonan Yonezawa Yamagata-ken 992-8510 Japan
| | - Reidar Lund
- Department of Chemistry and Hylleraas Centre for Quantum Molecular Sciences University of Oslo PO-Box 1033 Blindern 0315 Oslo Norway
| | - Michele Cascella
- Department of Chemistry and Hylleraas Centre for Quantum Molecular Sciences University of Oslo PO-Box 1033 Blindern 0315 Oslo Norway
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49
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Donati G, De Nicola A, Munaò G, Byshkin M, Vertuccio L, Guadagno L, Le Goff R, Milano G. Simulation of self-heating process on the nanoscale: a multiscale approach for molecular models of nanocomposite materials. Nanoscale Adv 2020; 2:3164-3180. [PMID: 36134283 PMCID: PMC9418708 DOI: 10.1039/d0na00238k] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/17/2020] [Indexed: 06/15/2023]
Abstract
A theoretical-computational protocol to model the Joule heating process in nanocomposite materials is presented. The proposed modeling strategy is based on post processing of trajectories obtained from large scale molecular simulations. This protocol, based on molecular models, is the first one to be applied to organic nanocomposites based on carbon nanotubes (CNT). This strategy allows to keep a microscopic explicit picture of the systems, to directly catch the molecular structure underlying the process under study and, at the same time, to include macroscopic boundary conditions fixed in the experiments. As validation and first application of the proposed strategy, a detailed investigation on CNT based organic composites is reported. The effect of CNT morphologies, concentration and working conditions on Joule heating has been modelled and compared with available experiments. Further experiments are performed also in this work to increase the number of comparisons especially in specific voltage ranges where available references from literature were missing. Simulations are in both qualitative and quantitative agreement with several experiments and trends reported in the recent literature, as well as with experiments performed in this work. The proposed approach combined with large scale hybrid particle-field molecular simulations can give insights and opens to way to a rational design of self-heating nanocomposites.
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Affiliation(s)
- Greta Donati
- Department of Chemistry and Biology, University of Salerno Via Giovanni Paolo II 132 84084 Fisciano SA Italy
| | - Antonio De Nicola
- Department of Organic Materials Science, Yamagata University 4-3-16 Jonan Yonezawa Yamagata-ken 992-8510 Japan
| | - Gianmarco Munaò
- Department of Mathematical and Computer Sciences, Physical Sciences and Earth Sciences, University of Messina Viale F. Stagno d'Alcontres 31 98166 Messina Italy
| | - Maksym Byshkin
- Institute of Computational Science Unversità della Svizzera Italiana 6900 Lugano Swizerland
| | - Luigi Vertuccio
- Department of Industrial Engineering, University of Salerno Via Giovanni Paolo II 132 84084 Fisciano SA Italy
| | - Liberata Guadagno
- Department of Industrial Engineering, University of Salerno Via Giovanni Paolo II 132 84084 Fisciano SA Italy
| | - Ronan Le Goff
- IPC Technical Center - Centre Technique Industriel de la Plasturgie et des Composites Bellignat France
| | - Giuseppe Milano
- Department of Chemistry and Biology, University of Salerno Via Giovanni Paolo II 132 84084 Fisciano SA Italy
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50
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Abstract
![]()
We investigate the
self-assembly process of a surfactant with inverted
polarity in water and cyclohexane using both all-atom and coarse-grained
hybrid particle-field molecular dynamics simulations. Unlike conventional
surfactants, the molecule under study, proposed in a recent experiment,
is formed by a rigid and compact hydrophobic adamantane moiety, and
a long and floppy triethylene glycol tail. In water, we report the
formation of stable inverted micelles with the adamantane heads grouping
together into a hydrophobic core and the tails forming hydrogen bonds
with water. By contrast, microsecond simulations do not provide evidence
of stable micelle formation in cyclohexane. Validating the computational
results by comparison with experimental diffusion constant and small-angle
X-ray scattering intensity, we show that at laboratory thermodynamic
conditions the mixture resides in the supercritical region of the
phase diagram, where aggregated and free surfactant states coexist
in solution. Our simulations also provide indications as to how to
escape this region to produce thermodynamically stable micellar aggregates.
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Affiliation(s)
- Manuel Carrer
- Department of Chemistry and Hylleraas Centre for Quantum Molecular Sciences, University of Oslo, P.O. Box 1033, Blindern, 0315 Oslo, Norway
| | - Tatjana Škrbić
- Department of Physics and Institute for Fundamental Science, University of Oregon, Eugene, Oregon 97403, United States.,Dipartimento di Scienze Molecolari e Nanosistemi, Università Ca' Foscari di Venezia,Campus Scientifico, Edificio Alfa, via Torino 155, 30170 Venezia Mestre, Italy
| | - Sigbjørn Løland Bore
- Department of Chemistry and Hylleraas Centre for Quantum Molecular Sciences, University of Oslo, P.O. Box 1033, Blindern, 0315 Oslo, Norway
| | - Giuseppe Milano
- Department of Organic Materials Science, Yamagata University, 4-3-16 Jonan, Yonezawa, 992-8510 Yamagata-ken, Japan.,Dipartimento di Chimica e Biologia, Università di Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy
| | - Michele Cascella
- Department of Chemistry and Hylleraas Centre for Quantum Molecular Sciences, University of Oslo, P.O. Box 1033, Blindern, 0315 Oslo, Norway
| | - Achille Giacometti
- Dipartimento di Scienze Molecolari e Nanosistemi, Università Ca' Foscari di Venezia,Campus Scientifico, Edificio Alfa, via Torino 155, 30170 Venezia Mestre, Italy.,European Centre for Living Technology (ECLT) Ca' Bottacin, 3911 Dorsoduro, Calle Crosera, 30123 Venice, Italy
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