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Scrivano M, Vadalà A, Fedeli G, Di Niccolo R, Topa D, Porcino S, Pallotta F, De Carli A. A comparison between ilioinguinal and modified Stoppa approach in anterior column acetabular fractures. Injury 2024; 55:111166. [PMID: 37984012 DOI: 10.1016/j.injury.2023.111166] [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: 05/17/2023] [Revised: 08/19/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Pelvis fractures are among the most difficult fractures to manage and treat for Orthopedic surgeons. Anatomic reduction is the main goal to reach in the acetabular fractures' treatment. The following study compares clinical outcomes and complications of Ilioinguinal versus modified Stoppa approach in Open Reduction and Internal Fixation (ORIF) of anterior column acetabulum fractures. MATERIALS AND METHODS A comparative analysis on 90 patients undergoing ORIF on acetabular fracture has been performed. Patients have been divided into two groups. The first group was treated by Ilioinguinal approach (n = 48), the second group by modified Stoppa approach (n = 42). The following parameters have been compareted: quality of fragment reduction; operative time; peri‑ and post-operative blood loss; complications; clinical and radiographic outcomes. RESULTS The modified Stoppa approach has shown a shorter mean operative time (146 min vs 175 min), fewer complications (14/48 vs 6/42), less blood loss both in the perio-operative phase (0.8 Hb pt vs 1.3 Hb pt) than in postoperative one (1.1 Hb pt vs 1.5 Hb pt), a lower rate of nerve, infections and critical complications. On the other hand, the ilioinguinal approach has showed better results in terms of quality of fracture reduction (43/48 patiens with anatomical or near anatomical reduction vs. 37/42). No significant differences concerning vascular lesions, clinical and functional outcomes have been found between the two groups. CONCLUSIONS The modified Stoppa approach results in shorter operative time, less intra-operative blood loss and fewer complications than the ilioinguinal one. Greater anatomic reduction is achieved by Ilioinguinal approach; however, this does not necessarily translate into better clinical and functional outcomes which, overall, are comparable in the two analysed approaches. In conclusion, the modified Stoppa approach is deemed to be a better alternative in treating these fractures.
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Affiliation(s)
- M Scrivano
- Department of Orthopaedic and Trauma surgery, S. Andrea Hospital, University of Rome "La Sapienza", Italy.
| | - A Vadalà
- Department of Orthopaedic and Trauma surgery, S. Andrea Hospital, University of Rome "La Sapienza", Italy
| | - G Fedeli
- Department of Orthopaedic and Trauma surgery, S. Andrea Hospital, University of Rome "La Sapienza", Italy
| | - R Di Niccolo
- Department of Orthopaedic and Trauma surgery, S. Andrea Hospital, University of Rome "La Sapienza", Italy
| | - D Topa
- Department of Orthopaedic and Trauma Surgery, Ospedale San Giovanni Addolorata, Rome, Italy
| | - S Porcino
- Department of Orthopaedic and Trauma Surgery, Ospedale San Giovanni Addolorata, Rome, Italy
| | - F Pallotta
- Department of Orthopaedic and Trauma Surgery, Ospedale San Giovanni Addolorata, Rome, Italy
| | - A De Carli
- Department of Orthopaedic and Trauma surgery, S. Andrea Hospital, University of Rome "La Sapienza", Italy
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De Carli A, Gaj E, Pagnotta S, Picconi O, Ferretti A. Clinical and Functional Comparison between Anatomical and Non-Anatomical Acute Repair of Tears of the Distal Tendon of Biceps Brachii. Muscles Ligaments Tendons J 2021. [DOI: 10.32098/mltj.03.2021.07] [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: 11/05/2022]
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Oliva F, Vittadini F, Frizziero A, Costantino C, Fusco A, Giai Via A, Foti C, Nanni G, Forte A, Biz C, Vulpiani M, De Carli A, Berardi A, Fini M, Padulo J, Maffulli N. I.S.Mu.L.T. Reccomendations for Intra and Periarticular Injections during COVID19 Pandemic. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.03.2020.00] [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: 11/05/2022]
Affiliation(s)
- F. Oliva
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - F. Vittadini
- Department of Physical and Rehabilitation Medicine, Casa di Cura Policlinico San Marco, Venice, Italy
| | - A. Frizziero
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - C. Costantino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A. Fusco
- Clinical Laboratory of Experimental Neurorehabilitation, I.R.C.C.S. Santa Lucia Foundation, Rome, Italy
| | - A. Giai Via
- Department of Emergency and Acceptance, Orthopaedics and Traumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - C. Foti
- Physical and Rehabilitation Medicine, University of Rome Tor Vergata, Rome, Italy
| | - G. Nanni
- Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - A. Forte
- Biomedical Research Centre, Gruppo Forte, Salerno, Italy
| | - C. Biz
- Department of Surgery, Oncology and Gastroenterology DiSCOG, Orthopedic Clinic, University of Padova, Padova, Italy
| | - M.C. Vulpiani
- Physical Medicine and Rehabilitation Unit, SantAndrea Hospital, Sapienza University of Rome, Rome, Italy
| | - A. De Carli
- Physical Medicine and Rehabilitation Unit, SantAndrea Hospital, Sapienza University of Rome, Rome, Italy
| | - A. Berardi
- UOC Immunohematology and Transfusion Medicine Laboratories, Laboratory of Stem Cells, Spirito Santo Hospital, Pescara, Italy
| | - M. Fini
- Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopedic Institute, Bologna, Italy
| | - J. Padulo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - N. Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy
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Vetrano M, Oliva F, Bisicchia S, Bossa M, De Carli A, Di Lorenzo L, Erroi D, Forte A, Foti C, Frizziero A, Gasparre G, Giai Via A, Innocenti B, Longo U, Mahmoud A, Masiero S, Mazza D, Natali S, Notarangelo C, Osti L, Padulo J, Pellicciari L, Perroni F, Piccirilli E, Ramponi C, Salvatore G, Panni A, Suarez T, Tarantino U, Vittadini F, Vulpiani M, Ferretti A, Maffulli N. I.S.Mu.L.T. first-time patellar dislocation guidelines. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2017.01] [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: 11/05/2022]
Affiliation(s)
- M. Vetrano
- Physical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - F. Oliva
- Department of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, Rome, Italy
| | - S. Bisicchia
- Department of Orthopaedic Surgery, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - M. Bossa
- Department of Physical Medicine and Rehabilitation, University of Rome “Tor Vergata”, Rome, Italy
| | - A. De Carli
- Orthopaedic Department and “Kirk Kilgour” Sports Injury Center, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - L. Di Lorenzo
- Rehabilitation Unit, Neuroscience Department, “RUMMO” Hospital, Benevento, Italy
- Biomedical Research Centre, Gruppo Forte, Salerno, Italy
| | - D. Erroi
- Physical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - A. Forte
- Biomedical Research Centre, Gruppo Forte, Salerno, Italy
| | - C. Foti
- Department of Physical Medicine and Rehabilitation, University of Rome “Tor Vergata”, Rome, Italy
| | - A. Frizziero
- Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy
| | - G. Gasparre
- Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy
| | - A. Giai Via
- Department of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, Rome, Italy
| | - B. Innocenti
- BEAMS Department (Bio Electro and Mechanical Systems), École Polytechnique de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - U.G. Longo
- Department of Orthopedic and Traumatology, University Campus Bio-Medico of Rome, Rome, Italy
| | - A. Mahmoud
- Department of Physical Medicine and Rehabilitation, University of Rome “Tor Vergata”, Rome, Italy
| | - S. Masiero
- Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy
| | - D. Mazza
- Orthopaedic Department and “Kirk Kilgour” Sports Injury Center, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - S. Natali
- Department of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, Rome, Italy
| | - C. Notarangelo
- Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy
| | - L. Osti
- Unit of Arthroscopy and Sports Trauma Surgery, Hesperia Hospital, Modena, Italy
| | - J. Padulo
- University eCampus, Novedrate, Italy; Tunisian Research Laboratory “Sports Performance Optimization”, National Center of Medicine and Science in Sport, Tunis, Tunisia; Faculty of Kinesiology, University of Split, Split, Croatia
| | - L. Pellicciari
- Department of Physical Medicine and Rehabilitation, University of Rome “Tor Vergata”, Rome, Italy
| | - F. Perroni
- School of Exercise and Sport Sciences (SUISM), Department of Medical Sciences, University of Turin, Turin, Italy
| | - E. Piccirilli
- Department of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, Rome, Italy
| | - C. Ramponi
- Sport Physical Therapist, Kinè Physiotherapic Center, Conegliano, Italy
| | - G. Salvatore
- Department of Orthopedic and Traumatology, University Campus Bio-Medico of Rome, Rome, Italy
| | - A.S. Panni
- Multidisciplinary Department of Medical-Surgical and Dental Specialty, University of Campania Luigi Vanvitelli, Naples, Italy
| | - T. Suarez
- Physical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - U. Tarantino
- Department of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, Rome, Italy
| | - F. Vittadini
- Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy
| | - M.C. Vulpiani
- Physical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - A. Ferretti
- Orthopaedic Department and “Kirk Kilgour” Sports Injury Center, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - N. Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy; Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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De Carli A, Fabbri M, Lanzetti R, Ciompi A, Gaj E, Beccarini G, Vetrano M, Ferretti A. Functional treatment in rotator cuff tears: is it safe and effective? A retrospective comparison with surgical treatment. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.01.2017.06] [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: 11/05/2022]
Affiliation(s)
- A. De Carli
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - M. Fabbri
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - R.M. Lanzetti
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - A. Ciompi
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - E. Gaj
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - G. Beccarini
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - M. Vetrano
- Physical Medicine and Rehabilitation Unit, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
| | - A. Ferretti
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre, Sant’Andrea Hospital, “Sapienza” University of Rome, Rome, Italy
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Oliva F, Rugiero C, Giai Via A, Baldassarri M, Bernardi G, Biz C, Bossa M, Buda R, Buonocore D, Chianca V, Collina A, De Carli A, De Luna A, Di Lanno I, Di Lorenzo L, Di Pietto F, Dossena M, Fantoni I, Farsetti P, Fini M, Finotti P, Forte A, Foti C, Frizziero A, Gaj E, Galeone C, Gamberini J, Gasparini M, Innocenti B, Lupariello D, Mahmoud A, Marsilio E, Moretti B, Natali S, Padulo J, Pellicciari L, Perazzo L, Piccirilli E, Picerno P, Ruggeri P, Tarantino U, Vadalà A, Veronesi F, Verri M, Vetrano M, Vulpiani M, Zappia M, Maffulli N. I.S.Mu.L.T. Achilles tendon ruptures guidelines. Muscles Ligaments Tendons J 2019. [DOI: 10.32098/mltj.03.2018.03] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- F. Oliva
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Roma, Italy
| | - C. Rugiero
- Department of Orthopaedics and Traumatology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - A. Giai Via
- Department of Orthopaedic and Traumatology, Hip Surgery Center, IRCCS San Donato Hospital, San Donato Milanese, Milan, Italy
| | - M. Baldassarri
- Department of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - G. Bernardi
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Roma, Italy
| | - C. Biz
- Orthopaedics Unit, Department of Surgical, Oncologic and Gastroenterological Sciences DiSCOG, University of Padua, Padua, Italy
| | - M. Bossa
- Department of Physical and Rehabilitation Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - R. Buda
- Department of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - D. Buonocore
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - V. Chianca
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - A. Collina
- Department of Diagnostic Imaging, Campolongo Hospital, Eboli (SA), Italy
| | - A. De Carli
- Department of Orthopaedics and Traumatology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - A.V. De Luna
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Roma, Italy
| | - I. Di Lanno
- Department of Diagnostic Imaging, Campolongo Hospital, Eboli (SA), Italy
| | - L. Di Lorenzo
- Department of Diagnostic Imaging, Campolongo Hospital, Eboli (SA), Italy
| | - F. Di Pietto
- Department of Diagnostic Imaging, AORNA, Cardarelli Hospital, Naples, Italy
| | - M. Dossena
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - I. Fantoni
- Orthopaedics Unit, Department of Surgical, Oncologic and Gastroenterological Sciences DiSCOG, University of Padua, Padua, Italy
| | - P. Farsetti
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Roma, Italy
| | - M. Fini
- Laboratory of Preclinical and Surgical Studies, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - P. Finotti
- Department of Physical and Rehabilitation Medicine, University of Padua, Padua, Italy
| | - A.M. Forte
- Centre of Rehabilitation and Biomedical Research, Biomedical Research Center Gruppo Forte, Salerno, Italy
| | - C. Foti
- Department of Physical and Rehabilitation Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - A. Frizziero
- Department of Physical and Rehabilitation Medicine, University of Padua, Padua, Italy
| | - E. Gaj
- Department of Orthopaedics and Traumatology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - C. Galeone
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - J. Gamberini
- Department of Physical and Rehabilitation Medicine, University of Padua, Padua, Italy
| | - M. Gasparini
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Roma, Italy
| | - B. Innocenti
- BEAMS Department (Bio Electro Mechanical System), ècole polytechnique de Bruxelles, Universitè Libre de Bruxelles, Brussels, Belgium
| | - D. Lupariello
- Department of Orthopaedics and Traumatology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - A. Mahmoud
- Department of Physical and Rehabilitation Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Physical Medicine, Rheumatology and Rehabilitation, University of Cairo "Ain Shams", Cairo, Egypt
| | - E. Marsilio
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Roma, Italy
| | - B. Moretti
- Department of Orthopaedics and Traumatology, Bari Hospital, Bari, Italy
| | - S. Natali
- Department of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - J. Padulo
- Sport Science, University e-Campus, Novedrate, Italy; Tunisian Laboratory of Research for Sporty Perfomance Optimization, National Center of Medicine and Sport Sciences, Tunis, Tunisia
| | - L. Pellicciari
- Department of Physical and Rehabilitation Medicine, University of Rome "Tor Vergata", Rome, Italy
- Sport Science, University e-Campus, Novedrate, Italy; Tunisian Laboratory of Research for Sporty Perfomance Optimization, National Center of Medicine and Sport Sciences, Tunis, Tunisia
| | - L. Perazzo
- Department of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - E. Piccirilli
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Roma, Italy
| | - P. Picerno
- Telematics University e-Campus, Novedrate, Italy
| | - P. Ruggeri
- Orthopaedics Unit, Department of Surgical Oncologic and Gastroenterogical Sciences DISCOG, University of Padua, Padua, Italy
| | - U. Tarantino
- Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Roma, Italy
| | - A. Vadalà
- Department of Orthopaedics and Traumatology, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - F. Veronesi
- Rizzoli Orthopaedic Institute, Bologna, Italy
| | - M. Verri
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - M. Vetrano
- Department of Physical and Rehabilitation Medicine, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - M.C. Vulpiani
- Department of Physical and Rehabilitation Medicine, "Sapienza" University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - M. Zappia
- Department of Medicine and Health Science, University of Molise, Campobasso, Italia; Varelli Institute, Naples, Italy
| | - N. Maffulli
- Department of Physical and Rehabilitation Medicine, San Giovanni di Dio e Ruggi d'Aragona Hospital, University of Salerno, Italy; University of London Queen Mary, Barts and the London School of Medicine Dentistry, Sport Medicine Center, Mile End Hospital, London, UK
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Galante E, Guzzon A, Gallus G, Mauri M, Bono A, De Carli A, Merson M, Di Pietro S. Prognostic Significance of the Growth Rate of Breast Cancer: Preliminary Evaluation on the Follow-Up of 196 Breast Cancers. Tumori 2018; 67:333-40. [PMID: 7314261 DOI: 10.1177/030089168106700410] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The doubling time (DT) of 196 consecutive breast cancers was studied by means of a double mammographic examination (average time between the 2 mammographies, 30 days) and calculated with the formula of exponential growth. On the basis of DT values the case series was divided into 3 groups of growth: fast (DT from 1 to 30 days), 31 cases (15.8 %), intermediate (DT from 31 to 90 days), 84 cases (42.9 %), slow (DT more than 90 days), 81 cases (41.3 %). No relationship was found between growth rate and size of tumor, or menopausal status of the patient. After mastectomy fast and slow cases were equally distributed in the N− and N+ groups, whereas for the intermediate cases the N−: N+ ratio was 1: 2. One hundred and thirty-four cases were followed for a period of 12 to 52 months. Evaluation was done on the basis of the subdivision into N− and N+, and the latter group into N+ (1–3) and N+ (> 3). For N− tumors the course of the disease was apparently not affected by the growth rate. However, the case of fast growing tumors showed a higher proportion of recurrences with respect to N+ slow growing tumors. This difference was even more noticeable the higher the number of involved lymph nodes, but not statistically significant. The course of slow growing tumors was identical in the N− and N+ groups, but all the N+ tumors were subjected to adjuvant chemotherapy.
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Iorio C, Lanzetti RM, Lupariello D, Vadalà A, Fabbri M, Ciompi A, Ferretti A, De Carli A. The effect of subscapularis tenotomy in athletes operated on for recurrent anterior shoulder dislocation. Musculoskelet Surg 2018; 102:283-288. [PMID: 29388030 DOI: 10.1007/s12306-018-0531-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 01/25/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Some authors consider preservation of the subscapularis tendon as one of the most important elements for a successful long-term outcome in patients operated on with open capsulorrhaphy for recurrent anterior shoulder dislocation. The purpose of this study was to evaluate whether vertical tenotomy of the subscapularis tendon might affect internal rotation strength recovery in patients operated on with open capsulorrhaphy for recurrent anterior shoulder dislocation. METHODS Ninety-six patients were retrospectively followed up at a mean of 72.5 months. They underwent clinical evaluation, Rowe and Walch-Duplay scoring scales, the Visual Analog Scale (VAS), and dynamometric measurements (side-to-side) of internal and external rotation, forward elevation, and abduction. All patients were athletes: 25% were practising risk-free sports, 44% contact sports, 14.5% sports with cocking of the arm, and 14.5% high-risk sports activities. RESULTS Five (5.2%) recurrences were registered, and all patients returned to pre-operative sports activity. The Rowe score was 98.12, the Walch-Duplay score 92.25, and the VAS score 0.1. Dynamometric assessment showed no significant differences (side-to-side) in internal rotation (p = 0.34), external rotation (p = 0.9), flexion (p = 0.7), and abduction (p = 0.7). Dominant arms showed better results than non-dominant arms (p < 0.01). CONCLUSION Complete tenotomy of the subscapularis tendon does not seem to negatively affect internal rotation strength recovery or external rotation movement in athletes.
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Affiliation(s)
- C Iorio
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via Grottarossa 1035, Rome, RM, Italy
| | - R M Lanzetti
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via Grottarossa 1035, Rome, RM, Italy
| | - D Lupariello
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via Grottarossa 1035, Rome, RM, Italy.
| | - A Vadalà
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via Grottarossa 1035, Rome, RM, Italy
| | - M Fabbri
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via Grottarossa 1035, Rome, RM, Italy
| | - A Ciompi
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via Grottarossa 1035, Rome, RM, Italy
| | - A Ferretti
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via Grottarossa 1035, Rome, RM, Italy
| | - A De Carli
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via Grottarossa 1035, Rome, RM, Italy
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Vadalà A, Lanzetti RM, De Carli A, Lupariello D, Guzzini M, Desideri D, Ferretti A. Latarjet procedure: evolution of the bone block and correspondent clinical relevance-a clinical and radiological study. Musculoskelet Surg 2017; 101:113-120. [PMID: 28756510 DOI: 10.1007/s12306-017-0482-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 02/27/2017] [Accepted: 06/05/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE The purpose of this study was to correlate the bone block graft position, its dimension, its reabsorption and its integration with clinical outcome in patients operated on for recurrent anterior shoulder instability. METHODS Twenty-four patients affected by recurrent anterior shoulder dislocation and operated on using the Latarjet procedure were enrolled in this study. At 6 and 24 months, patients were evaluated with the following scales: ROWE, WOSI, Oxford instability score, UCLA, DASH and Constant score. Patients underwent two postoperative CT scans: immediately after surgery (T0) and at 24 months post-op (T1). RESULTS At 24 months, none of the 24 patients reported further episodes of dislocation. Clinically at the final follow-up, we found excellent results in all the evaluation scales. Mean reduction in bone graft from T0 to T1 was 42% of the overall volume; similarly reduction in the overall surface was 29.3%; decrease in length, width and depth was, respectively, 3.4, 2.2 and 1.0 mm; all these parameters decreased significantly (p < 0.05). No correlations were found between radiological parameters and clinical and functional outcomes. CONCLUSIONS The results confirm that a lack of integration or a significant reabsorption of the graft is present in the Latarjet procedure, but they do not significantly affect the clinical and functional results.
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Affiliation(s)
- A Vadalà
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via grotta rossa 1053, 00100, Rome, Italy
| | - R M Lanzetti
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via grotta rossa 1053, 00100, Rome, Italy
| | - A De Carli
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via grotta rossa 1053, 00100, Rome, Italy
| | - D Lupariello
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via grotta rossa 1053, 00100, Rome, Italy.
| | - M Guzzini
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via grotta rossa 1053, 00100, Rome, Italy
| | - D Desideri
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via grotta rossa 1053, 00100, Rome, Italy
| | - A Ferretti
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Via grotta rossa 1053, 00100, Rome, Italy
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Monaco E, Lanzetti RM, Fabbri M, Redler A, De Carli A, Ferretti A. Anterolateral ligament reconstruction with autologous grafting: A biomechanical study. Clin Biomech (Bristol, Avon) 2017; 44:99-103. [PMID: 28384527 DOI: 10.1016/j.clinbiomech.2017.03.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 09/20/2016] [Revised: 03/25/2017] [Accepted: 03/30/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND To evaluate the reliability of the Iliotibial band compared to gracilis tendon as a graft to be used in anterolateral ligament reconstruction. METHODS Gracilis tendon and a strip of Iliotibial band compared were harvested from 8 fresh human cadaveric knees. The gracilis tendon was prepared to obtain a graft of 10cm in length (Group 1). Iliotibial band compared was prepared to obtain a graft of 10cm in length and 0.5cm in width from the middle portion (Group 2). All the specimens were fixed on a servo hydraulic tensile machine with dedicated cryo-clamp. The loading protocol, used to compare the previously published results of ultimate failure load and Stiffness of the anterolateral ligament (Group 3), included a cyclic preconditioning between 10 and 25N at 0.1Hz for 10cycles and then a load to failure test at 20mm/min. FINDINGS Gracilis tendon showed higher Ultimante Failure Load and stiffness when compared to a strip of Iliotibial band. Gracilis tendon and a strip of Iliotibial band compared showed higher Ultimante Failure Load and stiffness when compared with native anterolateral ligament as reported by Kennedy. INTERPRETATION Both grafts tested in the present studies are suitable for an anatomical anterolateral ligament reconstruction.
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Affiliation(s)
- E Monaco
- University of Rome "La Sapienza", II School of Medicine, Sant'Andrea Hospital, Kirk Kilgour Sports Injury Center, Via di Grottarossa 1035, 00189 Rome, Italy
| | - R M Lanzetti
- University of Rome "La Sapienza", II School of Medicine, Sant'Andrea Hospital, Kirk Kilgour Sports Injury Center, Via di Grottarossa 1035, 00189 Rome, Italy.
| | - M Fabbri
- University of Rome "La Sapienza", II School of Medicine, Sant'Andrea Hospital, Kirk Kilgour Sports Injury Center, Via di Grottarossa 1035, 00189 Rome, Italy
| | - A Redler
- University of Rome "La Sapienza", II School of Medicine, Sant'Andrea Hospital, Kirk Kilgour Sports Injury Center, Via di Grottarossa 1035, 00189 Rome, Italy
| | - A De Carli
- University of Rome "La Sapienza", II School of Medicine, Sant'Andrea Hospital, Kirk Kilgour Sports Injury Center, Via di Grottarossa 1035, 00189 Rome, Italy
| | - A Ferretti
- University of Rome "La Sapienza", II School of Medicine, Sant'Andrea Hospital, Kirk Kilgour Sports Injury Center, Via di Grottarossa 1035, 00189 Rome, Italy
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Lanzetti RM, Monaco E, De Carli A, Grasso A, Ciompi A, Sigillo R, Argento G, Ferretti A. Can an adjustable-loop length suspensory fixation device reduce femoral tunnel enlargement in anterior cruciate ligament reconstruction? A prospective computer tomography study. Knee 2016; 23:837-41. [PMID: 27338510 DOI: 10.1016/j.knee.2016.01.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 09/06/2015] [Revised: 12/11/2015] [Accepted: 01/13/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study was to compare bone femoral tunnel enlargement in patients who underwent anterior cruciate ligament (ACL) transtibial reconstruction using an adjustable-loop length suspensory fixation device and a fixed-loop length suspensory fixation device. METHODS All patients treated for ACL reconstruction with an ipsilateral hamstring between March 2013 and March 2014 were evaluated. Subjects were assigned to Group A (TightRope™ (TR) femoral fixation) or Group B (EndoButton® (EB) femoral fixation). All patients were evaluated with the Lachman test, pivot-shift test, 2000 International Knee Documentation Committee (IKDC) knee examination and KT1000 arthrometer. The subjective evaluation was performed using the 2000 IKDC Subjective Knee score, the Lysholm knee score, and the Tegner activity scale. CT examination was performed to evaluate femoral tunnel enlargement at four different levels. All patients were assessed at a 12month follow-up visit. Power analysis was performed a priori in accordance with the femoral tunnel enlargement values from the CT scans. Differences with P-values of ≤0.05 were considered to be statistically significant. RESULTS The groups were homogenous at baseline with regard to age, gender, BMI, dominance and disease duration. At the final follow-up, no statistically significant differences (P>0.05) were found according to subjective and objective clinical outcome measures. According to the femoral tunnel enlargement, no statistically significant difference was found between the two groups (P>0.05). CONCLUSION In transtibial ACL reconstruction, the use of a fixed or adjustable-loop length device products, on the femoral side, led to similar clinical and radiological results.
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Affiliation(s)
- R M Lanzetti
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy.
| | - E Monaco
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy
| | - A De Carli
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy
| | - A Grasso
- Villa Valeria Clinic, Rome, Italy
| | - A Ciompi
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy
| | - R Sigillo
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy
| | - G Argento
- Diagnostic Imaging Unit, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy
| | - A Ferretti
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "La Sapienza", Italy, Via di Grottarossa 1035, 00189 Rome, Italy
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Fabbri M, Ciompi A, Lanzetti RM, Vadalà A, Lupariello D, Iorio C, Serlorenzi P, Argento G, Ferretti A, De Carli A. Muscle atrophy and fatty infiltration in rotator cuff tears: Can surgery stop muscular degenerative changes? J Orthop Sci 2016; 21:614-8. [PMID: 27370531 DOI: 10.1016/j.jos.2016.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 01/12/2016] [Revised: 04/20/2016] [Accepted: 06/07/2016] [Indexed: 02/09/2023]
Abstract
BACKGROUND Rotator cuff tears are closely related with muscle atrophy and fatty infiltration and both affect healing after surgical treatment. The aim of this study was to compare surgical versus conservative management of medium-to-large reparable rotator cuff tears. METHODS Forty-one patients with clinical and radiological (MRI) diagnosis of medium-to-large rotator cuff tears were retrospectively identified and divided into two groups: Group A, arthroscopic repair; Group B, conservative treatment. At follow-up (T1) all patients underwent a new clinical (VAS, SST, Constant and Relative Constant Scale) and radiological evaluation (MRI). RESULTS When comparing the two groups at T1 (mean follow-up: Group A, 50 months; Group B, 61 months), we registered better results in Group A in the SST (p < 0.05), the VAS score (p < 0.01), the Constant and the Relative Constant Scale (p < 0.05). Radiological evaluation did not show a significant increase of fatty infiltration (p = 0.16) in Group A (no progression in 15 out of 17 patients -82.3%-, and an increase in 2 out of 17 patients -11.7%-), while in Group B a significant increase was detected (p < 0.01) in all patients; in regard to muscle atrophy, no cases of progression were detected in Group A (4 out of 17 patients -23.5%- showed an increased post-operative supraspinatus trophysm), while a significant worsening (p < 0.05) was found in Group B. In Group B a significant worsening of tendon retraction (p < 0.01) and of tear size (p = 0.01) was also detected. CONCLUSIONS Surgical treatment of complete rotator cuff tears seems to decrease the irreversible changes that involve muscle belly.
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Affiliation(s)
- M Fabbri
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
| | - A Ciompi
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
| | - R M Lanzetti
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
| | - A Vadalà
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
| | - D Lupariello
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy.
| | - C Iorio
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
| | - P Serlorenzi
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
| | - G Argento
- Radiological Department, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
| | - A Ferretti
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
| | - A De Carli
- Orthopaedic Department and "Kirk Kilgour" Sports Injury Center, Sant' Andrea Hospital, "La Sapienza" University of Rome, Via di Grottarossa, 1035, 00189, Roma, Italy
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Lanzetti RM, Ciompi A, Lupariello D, Guzzini M, De Carli A, Ferretti A. Safety of third-generation artificial turf in male elite professional soccer players in Italian major league. Scand J Med Sci Sports 2016; 27:435-439. [DOI: 10.1111/sms.12654] [Citation(s) in RCA: 20] [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] [Accepted: 01/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- R. M. Lanzetti
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - A. Ciompi
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - D. Lupariello
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - M. Guzzini
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - A. De Carli
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - A. Ferretti
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
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De Carli A, Mossa L, Larciprete M, Ferretti M, Argento G, Ferretti A. The gymnast's shoulder MRI and clinical findings. J Sports Med Phys Fitness 2012; 52:71-79. [PMID: 22327089] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The aim of the study was to evaluate effects of shoulder overuse in elite symptomatic or asymptomatic gymnasts. METHODS This was a university-based sport traumatology research, a cohort study, with a control group comparison. Patients included were: 21 elite male gymnasts performing in the Italian National team for at least 10 years and a control group of 10 patients (20 shoulders) of the same age and sex, randomly selected among a healthy non-athletic population who underwent shoulder MRI. Magnetic resonance imaging without contrast were performed to all participants and clinical findings were summarized. Two experienced musculoskeletal radiologists interpreted each MRI scan for multiple variables (rotator cuff tendons, labral signal, capsule), including type of measurements performed on soft tissues (muscles, tendons) to assess global modifications of the shoulders. RESULTS Signal abnormalities were detected in 36/36 (100%) gymnasts' shoulders, and in 4/20 (20%) of the controls. Sixteen of 36 (44.4%) shoulders had findings consistent with SLAP tears, bilateral in four patients; anteroinferior labrum lesions were identified in 10/36 (27.7%) shoulders, as compared with none (0%) in the controls. Eight of 36 (22%) shoulders had findings consistent with partial- or full-thickness tears of the rotator cuff as compared with none (0%) of the controls. Increased thickness of rotator cuff tendons and hypertrophy of rotator cuff muscles and deltoid muscles were recorded: such reports were symmetrical between dominant and non dominant arms, and increased when compared to controls. CONCLUSION Gymnasts' shoulders are significantly different from those of the general population. MRI findings, especially SLAP tears, and hypertrophy are symmetrical. SLAP tears seem to be responsible of most early retirement.
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Affiliation(s)
- A De Carli
- Sant'Andrea Hospital, Unit of Orthopedics and Traumatology, La Sapienza University, Rome, Italy
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Ramenghi LA, Bassi L, Fumagalli M, Ometto A, Groppo M, De Carli A, Pisoni S, Dessimone F, Farè P, Mosca F. Neonatal stroke. Minerva Pediatr 2010; 62:177-179. [PMID: 21089737] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The perinatal ischemic stroke is defined as "a group of heterogenous conditions with a focal disruption of cerebral flow secondary to an arterial or a venous thrombosis or embolization between the 20 week of foetal life through the 28 post-natal day". Three subgroups are identified: arterial ischemic stroke (AIS), cerebral sinovenous thrombosis (CSVT) and haemorragic infarct. Many strokes are detected in the neonatal period due to early onset seizures, although symptoms can be more subtle leading to a significant delay in the diagnosis. MRI-DWI remains the best tool for a correct diagnosis, extension of the lesion and suggestion of timing. Lesions detected in utero or at early neonatal imaging with signs of tissue loss are considered "foetal stroke". The "neonatal stroke", with the symptoms in the first 4 days, shows the typical abnormalities of the acute phase evolving later in a white matter loss. The AIS shows the ischemic area of restriction at the early DWI in a arterial territory, mainly the middle cerebral artery. The MR-Venogram is useful in the CVST to detect the thrombus in a sinovenous vessel and the potentially associated lesion, such as intraventricular haemorrage and parenchymal oedema. The extension of the lesion and the involvement of the basal ganglia and thalami have a negative prognostic value for the development of hemiplegia especially in the presence of abnormal PLIC. An early diagnosis.
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Affiliation(s)
- L A Ramenghi
- Ospedale Ca' Granda Fondazione Policlinico IRCCS, Milano, Italy
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De Carli A, Vadalà A, Ciardini R, Iorio R, Ferretti A. Spontaneous Achilles tendon ruptures treated with a mini-open technique: clinical and functional evaluation. J Sports Med Phys Fitness 2009; 49:292-296. [PMID: 19861935] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM AND METHODS Spontaneous ruptures of the Achilles tendon are frequent among occasional and high level athletes. Despite the frequency of this problem, there is no agreement about the treatment of this pathology. The purpose of this study was to show the results of 20 consecutive patients (14 males and 6 females) surgically treated between 1995 and 2001 with a mini-open technique (mean follow-up: 52 months; range 20-95 months). Postoperatively, all these patients were assessed with a new functional scoring scale and a functional jumping test (Ergo-Jump Bosco System). RESULTS A very low rate of minor complications have been reported and most of these patients are now practicing their favoured sport at the same pre-injury level. CONCLUSIONS Mini open repair should be considered an excellent method of treatment of this pathology, with a very low rate of complications. The authors recommend this technique for young professional and occasional athletes.
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Affiliation(s)
- A De Carli
- Orthopedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, La Sapienza University, Rome, Italy.
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Iorio R, Vadalà A, Di Vavo I, De Carli A, Conteduca F, Argento G, Ferretti A. Tunnel enlargement after anterior cruciate ligament reconstruction in patients with post-operative septic arthritis. Knee Surg Sports Traumatol Arthrosc 2008; 16:921-7. [PMID: 18592216 DOI: 10.1007/s00167-008-0575-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Accepted: 05/16/2008] [Indexed: 10/21/2022]
Abstract
Tunnel enlargement is a frequent issue after ACL reconstruction and the "synovial bathing effect" is thought to be among the biological factors contributing to this phenomenon. Since the amount and the pressure of the synovial fluid inside the knee joint are higher and the length of its presence is longer in patients with post-operative septic arthritis after ACL reconstruction, we reviewed the tunnel enlargement in these cases in order to better evaluate this phenomenon in such a hostile environment. The null hypothesis of this study was that the highly represented phenomenon of the "synovial bathing effect" that occurs in an infected ACL reconstruction would not affect the amount of post-operative tunnel widening. A case-control study was done. At a mean follow up of 10 months (range 9-11 months) eight patients with septic arthritis following ACL reconstruction (group A) were radiologically reviewed using a CT scan and the diameters of femoral and tibial tunnels were measured. The results were compared with a control group (B) of uncomplicated ACL reconstruction cases operated by the same surgeon using the same technique. Although patients of Group A experienced a bigger amount of tunnel enlargement than patients of group B both on femoral (9.53 +/- 1.07 vs. 9.35 +/- 1.52 mm) and tibial side (10.07 +/- 1.3 vs. 9.92 +/- 0.74 mm), no clinical or statistically significant differences were detected between the groups (P > 0.05). No significant tunnel enlargement could be detected in patients of group A when compared with patients of group B. This seems to minimize the role of biological factors contributing to tunnel widening.
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Affiliation(s)
- R Iorio
- Orthopaedic Unit and "Kirk Kilgour" Sports Injury Centre, S. Andrea Hospital, University of Rome "Sapienza", Rome, Italy
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Monaco E, Labianca L, Conteduca F, De Carli A, Ferretti A. Double bundle or single bundle plus extraarticular tenodesis in ACL reconstruction? A CAOS study. Knee Surg Sports Traumatol Arthrosc 2007; 15:1168-74. [PMID: 17589826 DOI: 10.1007/s00167-007-0368-y] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2007] [Accepted: 05/14/2007] [Indexed: 12/15/2022]
Abstract
Anatomic reconstructions of anterior cruciate ligament (ACL) with double bundle gracilis and semitendonosus tendons graft, reproducing AM and PL bundles, have been introduced to offer a better biomechanical outcome, especially during rotatory loads. On the other hand, many methods of tenodesing the lateral aspect of the tibia to the femur to reduce internal rotation (IR) of the tibia and minimize anterior translation of the tibia relative to the femur as a backup for intra-articular reconstruction, have been also suggested. The goal of this study is to evaluate the effect, on the IR of the tibia, of a lateral reconstruction in addition to a standard single bundle ACL reconstruction as compared with an anatomic double bundle ACL reconstruction. Computer assisted ACL reconstruction has been used because it could be very effective in evaluating the global kinematic performance of the reconstructed knee. We selected 20 consecutive ACL reconstruction procedures to be performed in males in our hospital. Patients were alternately assigned to one of the two groups--group A: standard single bundle ACL reconstruction with doubled gracilis and semitendinosus tendons graft with an arthroscopically assisted two incisions technique and a lateral extraarticular reconstruction; group B: double bundle ACL reconstruction with doubled gracilis and semitendinosus tendons graft with an arthroscopically assisted two incisions technique. In all ACL reconstruction procedures navigation process was performed. Both surgical techniques reduced significantly AP displacement, IR and external rotation (ER) of the tibia respect to pre-operative ACL deficient condition (p<0.05). Comparing the group A after the single bundle reconstruction and the group B after the AM bundle fixation, non differences were found in AP displacement, IR and ER of the tibia (p=0.75, p=0.07 and p=0.07 respectively; power: 0.94). Comparing the group A after the addition of the lateral tenodesis and group B after the PL bundle fixation (AM+PL) no differences in AP tibial displacement and in ER of tibia were found (p=0.9 and 0.15, respectively; power: 0.99); however a significant reduction in IR of the tibia was found in group A after the addition of the lateral tenodesis respect to the group B after the addition of the PL bundle (p=0.0001; power: 0.26). On the basis of our study, the addition of a lateral extraarticular reconstruction to a standard single bundle ACL reconstruction with hamstrings tendons graft in an "in vivo" reconstruction, is more effective in reducing the IR of the tibia at 30 degrees of knee flexion, as compared with a standard single bundle ACL reconstruction and with an anatomic double bundle reconstruction is confirmed.
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Affiliation(s)
- E Monaco
- Orthopaedic Unit and Kirk Kilgour Sports Injury Center, Sant'Andrea Hospital, University La Sapienza, Rome, Italy.
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Maiorca R, Brunori G, Viola BF, Zubani R, Cancarini G, Parrinello G, De Carli A. Diet or dialysis in the elderly? The DODE study: a prospective randomized multicenter trial. J Nephrol 2000; 13:267-70. [PMID: 10946805] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
There are no solid data on the real advantage of an early start of dialysis, as suggested by the DOQI guidelines. Uremic patients frequently have a poor nutritional status. However, we cannot distinguish between the detrimental effect on nutrition of too low a residual renal function or too long a period of low protein-diet, per se. However, it appears that a very-low-protein diet (VLPD) supplemented with essential amino acids and keto-analogs of amino acids, and with an adequate quantity of calories, can prevent hypoalbuminemia at the start of dialysis and can slow the progression of chronic renal failure. EDTA and USRDS data suggest that most patients starting dialysis nowadays are elderly, who also have the highest incidence of morbidity and mortality. Moreover, hospitalization rate becomes higher after the start of dialysis compared to the pre-dialysis period. Can an aminoacid-supplemented VLPD, prolonged beyond the GFR limits suggested by DOQI, offer elderly patients better survival and better quality of life than dialysis? The answer can only come from a prospective, randomized trial, in elderly patients, starting at the GFR values suggested by the NKF-DOQI for starting dialysis, comparing outcomes with a vegetarian VLPD supplemented with a mixture of keto-analogs of amino acids and essential amino acids, and with dialysis.
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Affiliation(s)
- R Maiorca
- Institute and Division of Nephrology, University School of Medicine and Spedali Civili, Brescia, Italy.
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Abstract
From 1985 to 1996, we observed 38 cases of isolated atrophy of the infraspinatus muscle in athletes; all were involved in volleyball at a competitive level. There were 20 men and 18 women with a mean age of 26 years (range, 15 to 27). At the time of the first examination, 35 of these athletes had no pain and were treated with exercises to strengthen the external rotators. The remaining three patients underwent surgery because of pain at the posterior aspect of the shoulder. Sixteen of the 35 players treated nonoperatively were reviewed at a mean follow-up of 5.5 years (range, 3 to 10). Thirteen were still involved in volleyball and three had retired symptom-free at the end of their careers. On physical examination, atrophy of the infraspinatus muscle was unchanged in all cases. The patients treated surgically were reviewed at a mean follow-up of 2 years. All of them were able to play volleyball at their preinjury levels, but one had pain at the anterior aspect of the shoulder after strenuous activity. Physical examination showed a notable reduction of the atrophy in one patient. Entrapment of the suprascapular nerve at the spinoglenoid notch is a usually painless syndrome that is frequently observed in volleyball players. Surgical treatment is indicated in the rare cases of painful neuropathies after careful patient selection.
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Affiliation(s)
- A Ferretti
- First Department of Orthopaedic Surgery, University of Rome, La Sapienza, Italy
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21
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Abstract
Forty of 42 consecutive open capsulorrhaphies with suture anchors for treatment of traumatic recurrent anterior dislocation of the shoulder were reviewed after a minimum follow-up of 2 years. Two patients were lost to follow-up. Follow-up was conducted according to the rating systems of Rowe and the Society of American Shoulder and Elbow Surgeons. The surgical outcome was satisfactory in 38 patients (95%). Eighteen of the 22 patients who were involved in competitive overhead or collision sports before surgery returned to their preoperative sports levels. One patient, whose operation was unsuccessful, experienced recurrent dislocation. In one patient a deep infection that occurred as a complication of the surgical technique healed after suture anchor removal. Although a longer follow-up is necessary, this technique appears to have encouraging results as it avoids the risks related to the use of screws and staples.
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Affiliation(s)
- A Ferretti
- First Department of Orthopaedic Surgery, University of Rome La Sapienza, Italy
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22
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De Carli A, Carra E. Enhancement of professional skills to address gender differences at Ente per le Nuove Tecnologie, l'energia e l'ambiente (ENEA). INSTRAW News 1997:33-4. [PMID: 12294037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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23
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Abstract
We reviewed the films of 1760 patients who had magnetic resonance image scanning of the knee joint to assess the most common pathologic changes associated with an incidental finding of a Baker's cyst. Of the 1760 knees scanned, Baker's cysts were noted in 238. The cysts were classified as small (55%), medium (30%), or large (15%) and were primarily found on the medial side of the knee (94%). The menisci were evaluated and changes were classified as complete tears, where signal contacts the surface, or degenerative intrasubstance tears. One hundred eleven (47%) complete meniscal tears were found, and 88 (37%) degenerative tears. The majority of tears were found in the posterior horn of the medial meniscus (65 complete tears and 45 degenerative tears). Thus, 199 tears were found in 170 knees, and 106 of the 170 knees (62%) had tears of the posterior horn of the medial meniscus. Baker's cysts are frequent findings on physical examinations and on magnetic resonance imaging scans of the knee. They are thought to be due to intraarticular pathologic changes, usually posterior meniscal tears. This study documents the association between Baker's cysts and meniscal tears and notes that a complete tear is not necessary for the cyst to be present.
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Affiliation(s)
- K R Stone
- Stone Clinic, San Francisco, CA 94123, USA
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24
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Corrao G, Torchio P, De Carli A, Galatola G, Aricò S, di Orio F. Effect of age, birth cohort and period of death on Italian liver cirrhosis mortality, 1972-1986. Int J Epidemiol 1993; 22:475-82. [PMID: 8359964 DOI: 10.1093/ije/22.3.475] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [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: 01/30/2023] Open
Abstract
Liver cirrhosis is one of the main causes of death in Mediterranean countries. A trend towards a global reduction in the mortality rate has been recently reported. In order to clarify better this trend and in an attempt to hypothesize the future pattern of mortality, we analysed data from 254,834 Italian subjects aged 30-79 who died from liver cirrhosis during the period 1972-1986. We used a log-linear Poisson model to examine the effects of age, calendar period of death and birth cohort. Our data confirm that both in the population as a whole and after stratification for three geographical areas (Northern, Central and Southern Italy) the mortality rate is decreasing. The age-effect analysis showed an exponentially rising effect in the Southern population, in accordance with the viral aetiology of cirrhosis, whereas an increased effect followed by a decreased effect was observed in the Northern and Central population, suggesting the alcoholic aetiology for the disease. The results from the birth-cohort effect suggested that in the Northern and Central populations mortality should continue to decrease over the next decade, possibly due to the implementation of better prevention programmes for cirrhotics and to decreased alcohol consumption in Italy. In the Southern population, however, mortality is still rising and this will probably continue for the next decade, as the generations born between 1940 and 1950 who are at high risk of carrying chronic hepatitis B virus infection, reach the age of higher risk of death from liver cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- G Corrao
- Centro Interdipartimentale di Epidemiologia, Università degli Studi di L'Aquila, Italy
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25
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Abstract
One hundred and fourteen knees with deficiency of the anterior cruciate ligament (ACL) which had undergone reconstruction of the ligament using semitendinosus and gracilis were reviewed at a mean of 61 months after operation. Radiological and clinical evaluation was undertaken. A significant correlation was found between the number of meniscectomies performed in acute cases and those undertaken on the chronic knee. There was also significant correlation between meniscectomy and the Fairbank grading of degenerative changes seen on the radiographs. There was no correlation between the clinical results, residual laxity and the development of osteoarthritis. In ACL deficient knees with irreparable meniscal tears, or in which meniscectomy had been undertaken, the development of osteoarthritis seemed independent of the degree of stability, but in such knees with no meniscal tear or meniscal repair, reconstruction appeared to save the menisci and preserve the joint.
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Affiliation(s)
- A Ferretti
- Department of Orthopaedic Surgery, University of Rome, Italy
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26
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Ferretti A, Conteduca F, De Carli A, Fontana M, Mariani PP. Results of reconstruction of the anterior cruciate ligament with the tendons of semitendinosus and gracilis in acute capsulo-ligamentous lesions of the knee. Ital J Orthop Traumatol 1990; 16:452-8. [PMID: 2099927] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This report presents the mid-term results of 55 cases of anterior cruciate ligament (ACL) lesions surgically treated in "acute phase" using intra-articular transfer of the semitendinosus and gracilis tendons, performed at the First Orthopedic Clinic of "La Sapienza" University in Rome since 1979. The follow-up is based on clinical (point system comprising subjective and objective criteria), instrumental (KT-1000 arthrometer), and radiographic (comparative AP view radiographic exam of the knees under load) data. On the basis of the results obtained, ACL reconstruction with the semitendinosus and gracilis tendons in the treatment of acute lesions can provide the patient with a good possibility of complete functional recovery of the knee.
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Affiliation(s)
- A Ferretti
- I Clinica Ortopedica, Università La Sapienza, Roma
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27
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Ferretti A, De Carli A, Conteduca F, Mariani PP, Fontana M. The results of reconstruction of the anterior cruciate ligament with semitendinosus and gracilis tendons in chronic laxity of the knee. Ital J Orthop Traumatol 1989; 15:415-24. [PMID: 2634635] [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] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The authors report the medium term results (41 months) in 88 patients submitted to surgery for reconstruction of the anterior cruciate ligament according to the method currently in use at our Clinic which uses the semitendinosus and gracilis tendons. The results were evaluated according to a score card method and in 28 patients a KT-1000 arthrometer was also used. The method gives a probability of full success in approximately 85% of cases, with significantly better results in patients not submitted to meniscectomy. A comparison with other methods of autogenous transplant and prosthetic substitution, even on the basis of the data provided by the KT-1000, still places the semitendinosus and gracilis method at the forefront.
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Affiliation(s)
- A Ferretti
- Ia Clinica Ortopedica, Università La Sapienza, Roma
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28
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De Carli A, Heer M, Espinosa N, Benz J, Krampf K, Sulser H, Hany A. [Colorectal carcinoma following radiotherapy of gynecological carcinoma]. Schweiz Med Wochenschr 1988; 118:716-21. [PMID: 3133762] [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] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
To assess the risk of radiation-induced cancer of the colon we studied 196 patients with a history of radiation treatment for cancer of the female genital system. After a median follow-up of 12.4 years (range 10-15 years) corresponding to 1172 patient-years, 94 (48%) patients were still alive. 84 (89%) of these patients were evaluated for a second primary cancer to the colon. In 38 (45%) colonoscopic examination was performed. 3 patients were found to have a second primary cancer to the colon compared with 0.32 expected (relative risk 9.3) on the basis of rates from the Zürich Tumor Registry. Due to partial long-term survival, patient non-compliance and non-feasibility of colonoscopic examination, only one fourth of all patients initially treated by radiotherapy for cancers of the female genital system were suitable for colon screening. For these high risk women, colorectal tumor screening should be integrated into a gynecologic tumor follow-up.
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Affiliation(s)
- A De Carli
- Medizinische und Chirurgische Klinik, Kantonsspital Winterthur
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29
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Scherrer R, De Carli A, Marsch S, Hany A. [The Mantoux test using Berna and Copenhagen tuberculins in comparison with the epicutaneous Mérieux Monotest in adults]. Schweiz Med Wochenschr 1987; 117:1628-32. [PMID: 3423757] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
New infection with tuberculosis is a risk for hospital patients, and it would therefore be desirable to evaluate the proportion of converters by a simple epicutaneous test. It is also known that reactions to Mantoux tests of different manufacturers may vary widely. Simultaneous tuberculin skin tests with tuberculin Berna, tuberculin Kopenhagen and Monotest Mérieux have been compared in 81 geriatric patients and 54 young volunteers. Monotest Mérieux and Mantoux test with tuberculin Berna were administered in 222 additional patients, and it was therefore possible to compare a Monotest and a tuberculin test in a total of 357 patients. There was no statistically significant difference between the two Mantoux tests. An unexpectedly high false positive rate was found with Monotest. The reasons for this are discussed. The two products used in Switzerland today are equivalent. Positive reactions to Monotest need confirmations by Mantoux test.
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Affiliation(s)
- R Scherrer
- Medizinische Klinik, Kantonsspital, Winterthur
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30
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Secchi GC, Scotti PG, Cambiaghi G, Aresini G, De Carli A, Guerrieri MC. [Respiratory function tests in adolescents with beta-thalassemia major (author's transl)]. Haematologica 1982; 67:23-32. [PMID: 6800901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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31
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Cambiaghi G, Paina S, De Carli A, Colombo B, Carrabba M, Paresce E. Defect of bone marrow granulocyte reserve in rheumatic diseases evaluated with etiocholanolone. Acta Haematol 1980; 63:13-8. [PMID: 6768203 DOI: 10.1159/000207362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In 10 patients with rheumatoid arthritis, with normal baseline granulocyte count, the etiocholanolone test showed a decrease in the bone marrow granulocyte reserve; factors causing such a defect are discussed.
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