La Valoración del Análisis de la Marcha en la Planificación de la Osteotomía Alta de Tibia

El objetivo de este trabajo ha sido el de valorar una nueva metódica clínica y biomecánica de los pacientes que presentan un genu varo y tratados quirúrgicamente mediante osteotomía tibial alta. De acuerdo a la metódica de Andriacchi e Insall y de nuestra pequeña experiencia hemos aplicado el estudio mediante "gait analysis" a estos pacientes preoperatoriamente. El cálculo preoperatorio del "momento adductor" parece ser discriminativo con respecto a los pacientes que tendrán un buen o mal resultado debido a la recidiva de la deformidad, dolor, etc. Tomando como referencia los resultados de estos estudios sugerimos algunas indicaciones pre y postoperatorias con referencia a la rehabilitación y la orientación quirúrgica más adecuada según el valor del momento adductor (alto o bajo) que presenten este tipo de pacientes.The purpose of this study has been to assess a new clinical and biomechanical approach of genu varum patients treated by high tibial osteotomy. According to Andriacchi, Insall, and their awn small experienc e the author s apply gait analysis to study the genu varum of patients pre-operatively. The assessment during preoperative gait of the adductor moment (high or low value s with respec t to the normal) seems to be discriminant in define patien that are goint to have good or bad results due to the recurrence of the pathology: pain, varus deformity, etc. Starting from the results the studies the authors suggest some indications in the pre and postoperative with reference to rehabilitation and surgical orientation taking in account the high or low level of preoperative the adductor moment

Novel nano-composite multi-layered biomaterial for the treatment of multifocal degenerative cartilage lesions

We report on a 46-year-old athletic patient, previously treated with anterior cruciate ligament reconstruction, with large degenerative chondral lesions of the medial femoral condyle, trochlea and patella, which was successfully treated with a closing-wedge high tibial osteotomy and the implant of a newly developed biomimetic nanostructured osteochondral bioactive scaffold. After 1 year of follow-up the patient was pain-free, had full knee range of motion, and had returned to his pre-operation level of athletic activity. MRI evaluation at 6 months showed that the implant gave a hyaline-like signal as well as a good restoration of the articular surface, with minimal subchondral bone oedema. Subchondral oedema was almost non-visible at 12 months

A PRELIMINARY STUDY TO MODEL CARRYING ANGLE VARIATIONS DURING FLEXION-EXTENSION OF THE ELBOW

The aim of this work was to identify an accurate method to evaluate the variability of the carrying angle during the flexion extension of the elbow and to define a mathematical description of this movement applicable in sport and rehabilitation field. In order to develop this objective, we marked the arm and the forearm by six reflective markers of six healthy subjects performing the flexion extension movement and acquired the coordinates using six infrared cameras (VICON Motion System). Five repeated measures were performed for each subject in order to verify the reliability of the measures. Our results demonstrated that this movement can be easily modelled as a linear variation of the carrying angle in function of the flexion angle. The reliability between repeated measures was high and adopting a linear fit the accuracy was more than 94% in all cases. This is the first study to compute the flexion-extension movement by a carrying angle evaluation

Patients with multiple myeloma infected with COVID-19 during autologous stem cell transplantation

: Despite the global vaccination campaigns, certain patient groups remain highly vulnerable to SARS-CoV-2 and are at high risk for unfavorable COVID-19 outcomes. As previously shown by our group and a more recent report by Chang Su and coworkers, patients with multiple myeloma (MM) undergoing autologous stem cell transplantation (ASCT) represent one of such high-risk populations. This is due to the underlying disease-related immunodeficiency, suboptimal response to vaccines, heavy exposure to dexamethasone, and the use of high-dose melphalan prior to the ASCT procedure. Contracting SARS-CoV-2 and developing COVID-19 during the ASCT procedure remain high-risk events for these patients. It is then crucial to maintain and implement all appropriate strategies to prevent COVID-19 breakthroughs in this clinical setting. This might include targeted pre- and post-exposure prophylaxis with monoclonal antibodies, based on the circulation and prevalence of different SARS-CoV-2 variants/subvariants, and the prompt use of antivirals if, despite prophylaxis, MM patients develop COVID-19 during the transplantation procedure. We emphasize the importance of regularly monitoring MM patients for SARS-CoV-2 infection at all stages of the ASCT procedure. This is crucial to promptly implement measures to reduce the risk of unfavorable COVID-19 outcomes during the current post-pandemic phase

Satisfactory clinical results and low failure rate of medial collagen meniscus implant (CMI) at a minimum 20 years of follow-up

Purpose: The aim of the study was to evaluate the long-term clinical results, reoperations, surgical failure and complications at a minimum of 20 year of follow-up of the first 8 medial CMI scaffolds implanted by a single surgeon during a pilot European Prospective study. Methods: Seven (88%) out of 8 patients were contacted. The Cincinnati Score, VAS, and Lysholm score were collected. Moreover, magnetic resonance imaging (MRI) was performed on 4 patients at the last follow-up. Complications, reoperations and failures were also investigated. Results: The average follow-up was 21.5 ± 0.5 years. One patient underwent TKA after 13 years from CMI implantation; a second patient underwent valgus high tibial osteotomy 8 years after the index surgery and another patient underwent anterior cruciate ligament hardware removal at 21 years of follow-up. At the final follow-up, 3 patients were rated as “Excellent”, 1 as “Good” and 2 as “Fair” according to the Lysholm score. The Cincinnati score and the VAS were substantially stable over time. The MRI showed a mild osteoarthritis progression in 3 out of 4 patients according to the Yulish score, and the CMI signal was similar to the mid-term follow-up revealing 3 cases of myxoid degeneration and 1 case of normal signal with reduced scaffold size. Conclusion: The medial CMI is a safe procedure: satisfactory clinical results and a low failure rate could be expected even at a long-term follow-up. For this purpose, the correct indication as well as correcting axial malalignment and addressing knee instability at the time of the index surgery is mandatory. On the other hand, a mild osteoarthritis progression could be expected even after meniscus replacement. Level of evidence: IV

A Risk-Based Methodology and Tool Combining Threat Analysis and Power System Security Assessment

A thorough investigation of power system security requires the analysis of the vulnerabilities to natural and man-related threats which potentially trigger multiple contingencies. In particular, extreme weather events are becoming more and more frequent due to climate changes and often cause large load disruptions on the system, thus the support for security enhancement gets tricky. Exploiting data coming from forecasting systems in a security assessment environment can help assess the risk of operating power systems subject to the disturbances provoked by the weather event itself. In this context, the paper proposes a security assessment methodology, based on an updated definition of risk suitable for power system risk evaluations. Big data analytics can be useful to get an accurate model for weather-related threats. The relevant software (SW) platform integrates the security assessment methodology with prediction systems which provide short term forecasts of the threats affecting the system. The application results on a real wet snow threat scenario in the Italian High Voltage grid demonstrate the effectiveness of the proposed approach with respect to conventional security approaches, by complementing the conventional "N - 1" security criterion and exploiting big data to link the security assessment phase to the analysis of incumbent threat

INFLUENCE OF AGE AND HAND GRIP STRENGTH ON FREESTYLE PERFORMANCES IN MASTER SWIMMERS

The aim of our work was to examine whether age and hand grip strength are correlated with 50m, 100m, 200m, 400m, 800m swimming performance times in Master swimmers and how correlation varies considering short, middle or long distances. The main finding of this work was that hand grip strength and age correlated significantly at each distance. Hand grip strength showed a relevant influence on performance time and explained 52% of variance of performance time in 50m race freestyle and only 15% in 800m race. Increasing age was a disadvantageous factor for performance time, and explained 45% of variance of performance time in 800m race freestyle and only 20% in 50 m race

Fotemustine plus etoposide, cytarabine and melphalan (FEAM) as a new conditioning regimen for lymphoma patients undergoing auto-SCT: A multicenter feasibility study

BEAM is a widely used conditioning regimen for relapsed/refractory lymphoma patients undergoing auto-SCT. We conducted a multicenter study with an alternative regimen (fotemustine plus etoposide, cytarabine and melphalan (FEAM)) in which BCNU was substituted by the chloroethylnitrosourea fotemustine (FTM). Eighty-four patients with relapsed/refractory Hodgkin's (n20) and non-Hodgkin's lymphoma (n64) were conditioned with a FEAM regimen (FTM 150 mg/m 2 on days -7, -6, etoposide 200 mg/m 2 and cytarabine 400 mg/m 2 on days -5, -4, -3, -2 and melphalan 140 mg/m 2 on day -1). Patients were evaluated for toxicity and engraftment parameters. Median times to neutrophil (500 × 10 9 /l) and plt (20 000 × 10 9 /l) engraftment were 11 and 13 days, respectively. Grade 3 mucositis occurred in 19 patients (23%), while G3 nausea/vomiting and G3 diarrhea were observed in 13 (15%) and 6 (7%) patients, respectively. No severe hepatic, renal or pulmonary toxicity was detected. Seven patients (7%) experienced G4 mucositis, while no other G4 toxicities or unexpected adverse events of any grade were recorded. Transplant-related mortality was 2.4%. We conclude that a FEAM regimen is feasible and safe. Although toxicity and engraftment times compared favorably with BEAM, longer follow-up is needed to evaluate fully its efficacy and long-term safety. © 2010 Macmillan Publishers Limited All rights reserved