Custom-design implants for severe distorted proximal anatomy of the femur in young adults followed for 4-8 years

BACKGROUND: Treatment of hips with abnormal anatomy is challenging, and requires demanding surgical technique. We report the preoperative planning and the functional outcome of 38 patients with severe distorted anatomy who were treated with custom implants. PATIENTS AND METHODS: 38 consecutive patients (48 hips) were selected for customized femoral implants. The diagnosis was arthrosis due to congenital dislocation of the hip (CDH). We used plain radiographs, CT, and CAD-CAM analysis. The mean age was 47 (22-69) years and the mean preoperative D'Aubigne score was 10 (6-12). The mean follow-up time was 6 (4-8) years. RESULTS: All implants had optimal fit and fill. There were 2 revisions due to infection. No patients had thigh pain and no patients had aseptic loosening. There were 5 intraoperative and 6 postoperative complications. The mean postoperative D'Aubigne score was 17 (10-18). INTERPRETATION: Preoperative planning with modern technology and customized implants makes the procedure accurate, easier for the surgeon, and safer for the patient.Acta Ortho

Addressing Mental Health Needs After a Public Health Crisis in Southern Switzerland: Stakeholders’ Perspectives

ObjectivesThis paper examines a stakeholder engagement initiative to develop public health recommendations for addressing mental health gaps after the COVID-19 pandemic in southern Switzerland. It explores local healthcare professionals’ experiences with the pandemic’s impact on mental health and service use.MethodsWe used a stakeholder dialogue methodology based on participatory research. After mapping, we selected participants based on their power and interest on the subject. Data were gathered through two structured dialogues. We conducted thematic content analysis to identify and interpret patterns within dialogues. We used multi-step coding to assign codes to text segments, grouping similar patterns into themes and subthemes while ensuring consistency and exclusivity.ResultsThirty-two healthcare stakeholders from diverse sectors across urban and rural southern Switzerland participated in the dialogues. They emphasized flexible mental health service restructuring to address evolving patient needs and advocated for stronger prevention and promotion efforts, especially for vulnerable groups.ConclusionEngaging local healthcare stakeholders turned up as an effective strategy to derive public health recommendations to improve mental health prevention and promotion along with the access and use of related services

CEOs from Orthopaedic Centers Worldwide Meet to Discuss Common Challenges: 2010 Annual Meeting of the International Society of Orthopaedic Centers

The International Society of Orthopaedic Centers was formed in 2006 as a think tank that would bring together thought leaders in orthopaedic surgery from major orthopaedic academic centers around the world. The Society’s mission is to share knowledge and strategies, improve patient care, and foster clinical, educational, and scientific collaboration. As the Society’s agendas developed, the members recognized that many of their aims intersected with those of hospital leadership. Thus, CEOs from member centers were invited to join their physician colleagues at the 2010 meeting in Bologna, Italy in order to explore solutions to administrative challenges related to patient care, volume growth, and costs. This paper describes the dialogue that took place at the meeting

Estrogen Related Receptor Alpha (ERRα) a Bridge between Metabolism and Adrenocortical Cancer Progression

The aim of this study was to investigate the metabolic changes that occur in adrenocortical cancer (ACC) cells in response to the modulation of Estrogen Related Receptor (ERR)α expression and the impact on ACC progression. Proteomics analysis and metabolic profiling highlighted an important role for ERRα in the regulation of ACC metabolism. Stable ERRα overexpression in H295R cells promoted a better mitochondrial fitness and prompted toward a more aggressive phenotype characterized by higher Vimentin expression, enhanced cell migration and spheroids formation. By contrast, a decrease in ERRα protein levels, by molecular (short hairpin RNA) and pharmacological (inverse agonist XCT790) approaches modified the energetic status toward a low energy profile and reduced Vimentin expression and ability to form spheroids. XCT790 produced similar effects on two additional ACC cell lines, SW13 and mitotane-resistant MUC-1 cells. Our findings show that ERRα is able to modulate the metabolic profile of ACC cells, and its inhibition can strongly prevent the growth of mitotane-resistant ACC cells and the progression of ACC cell models to a highly migratory phenotype. Consequently, ERRα can be considered an important target for the design of new therapeutic strategies to fight ACC progression