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Reporting rotator cuff tears on magnetic resonance arthrography using the Snyder's arthroscopic classification

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World Journal of Radiology 2017年第3期9卷 126-133页

作者： Alberto Aliprandi Carmelo Messina Paolo Arrigoni Michele Bandirali Giovanni di Leo Stefano Longo Sandro Magnani Chiara Mattiuz Filippo Randelli Silvana Sdao Francesco Sardanelli Luca Maria Sconfienza Pietro Randelli Servizio di Radiologia IRCCS Policlinico San Donato Scuola di Specializzazione in Radiodiagnostica Università degli Studi di Milano unità operativa di ortopedia e traumatologia Ⅱ IRCCS Policlinico San Donato dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano unità operativa di ortopedia e traumatologia v IRCCS Policlinico San Donato unità operativa di Radiologia/diag-nostica per Immagini con Servizio di Radiologia Interventistica IRCCS Istituto Ortopedico Galeazzi unità operativa Complessa I Divisione Istituto Ortopedico Gaetano Pini

AIM To determine diagnostic performance of magnetic resonance arthrography(MRA) in evaluating rotator cuff tears(RCTs) using Snyder's classification for *** One hundred and twenty-six patients(64 males, 62 females; median age 55 years) underwent shoulder MRA and arthroscopy, which represented our reference standard. Surgical arthroscopic reports were reviewed and the reported Snyder's classification was recorded. MRA examinations were evaluated by two independent radiologists(14 and 5 years' experience) using Snyder's classification system, blinded to arthroscopy. Agreement between arthroscopy and MRA on partial-and fullthickness tears was calculated, first regardless of their extent. Then, analysis took into account also the extent of the tear. Interobserver agreement was also calculated the quadratically-weighted Cohen kappa *** On arthroscopy, 71/126 patients(56%) had a fullthickness RCT. The remaining 55/126 patients(44%) had a partial-thickness RCT. Regardless of tear extent, out of 71 patients with arthroscopically-confirmed fullthickness RCTs, 66(93%) were correctly scored by both readers. All 55 patients with arthroscopic diagnosis of partial-thickness RCT were correctly assigned as having a partial-thickness RCT at MRA by both readers. Interobserver reproducibility analysis showed total agreement between the two readers in distinguishing partial-thickness from full-thickness RCTs, regardless of tear extent(k = 1.000). With regard to tear extent, in patients in whom a complete tear was correctly diagnosed, correct tear extent was detected in 61/66 cases(92%); in the remaining 5/66 cases(8%), tear extent was underestimated. Agreement was k = 0.955. Interobserver agreement was total(k = 1.000).CONCLUSION MRA shows high diagnostic accuracy and reproducibility in evaluating RCTs using the Snyder's classification for reporting. Snyder's classification may be adopted for routine reporting of MRA.

关键词： Arthroscopy Magnetic resonance imaging Shoulder Arthrography Supraspinatus tendon Rotator cuff tear

Off-the-shelf 3D printed titanium cups in primary total hip arthroplasty

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World Journal of Orthopedics 2021年第6期12卷 376-385页

作者： Francesco Castagnini Filippo Caternicchia Federico Biondi Claudio Masetti Cesare Faldini Francesco Traina Department of ortopedia-traumatologia e Chirurgia Protesica e dei Reimpianti di Anca e Ginocchio IRCCS Istituto Ortopedico RizzoliBologna 40136Italy Department of Clinica I di ortopedia e traumatologia Rizzoli Orthopedic InstituteUniversity of BolognaBologna 40136Italy Department of diBINeM Scienze Biomediche e Neuromotorie Alma Mater Studiorum Universitàdi BolognaBologna 40139Italy

Three-dimensional(3D)-printed titanium cups used in primary total hip arthroplasty(THA)were developed to combine the benefits of a low elastic modulus with a highly porous *** aim was to improve local vascularization and bony ingrowth,and at the same time to reduce periprosthetic stress *** manufacturing,starting with a titanium alloy powder,allows serial production of devices with large interconnected pores(trabecular titanium),overcoming the drawbacks of tantalum and conventional manufacturing *** date,3D-printed cups have achieved dependable clinical and radiological outcomes with results not inferior to conventional sockets and with good rates of *** mechanical failures and no abnormal ion release and biocompatibility warnings have been *** this review,we focused on the manufacturing technique,cup features,clinical outcomes,open questions and future developments of off-the-shelf 3D-printed titanium shells in THA.

关键词： Socket Highly porous Additive manufacturing Ultraporous Trabecular Beam melting

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World Journal of Gastroenterology 2021年第42期27卷 7299-7310页

作者： Sinan Sadalla Andrea Lisotti Lorenzo Fuccio Pietro Fusaroli unitàoperativa Complessa di Gastroenterologia e endoscopia digestiva Universitàdi Bologna/Ospedale di ImolaImola(BO)40024Italy unitàoperativa Complessa di Gastroenterologia e endoscopia digestiva Universitàdi Bologna/Ospedale di ImolaImola(BO)40026Italy divisione di Gastroenterologia Dipartimento di Scienze Medico-Chirurgiche(DIMEC)IRCSS-Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy

Colonoscopy is a risk factor for colon *** colon is susceptible to ischemia due to its minor blood flow compared to other abdominal organs;the etiology of colon ischemia after colonoscopy is *** causative mechanisms include splanchnic circulation impairment,bowel preparation,drugs used for sedation,bowel wall ischemia due to insufflation/barotrauma,and introduction of the *** must be aware of this condition and its risk factors for risk minimization,early diagnosis,and proper treatment.

关键词： endoscopy Colon ischemia Colonoscopy Bowel preparation Mesenteric circulation Ischemic colitis

Dual mobility in primary total hip arthroplasty:A temptation from the devil or a blessing from above

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World Journal of Orthopedics 2024年第6期15卷 512-519页

作者： Raymond Klumpp Linda Boerci Francesco Buonanotte Marco Zeppieri unita operativa Complessa ortopedia e traumatologia Ospedale Treviglio-Caravaggio ASSTBergamo Ovest 24047Italy Department of Orthopedics Universitàdegli Studi di Milano-BicoccaMonza 20090Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy

Dual mobility(DM)bearings have gained significant attention in the field of total hip arthroplasty(THA)as a valid treatment option in cases of revision for instability after THA whereas its use in primary THA is still a matter of *** manuscript explores the pathology,incidence,diagnosis,treatment options,prognosis,ongoing studies in the literature,and future perspectives related to the use of DM bearings employed in primary *** bearings are primarily designed to address one of the major concerns in THA:Instability of the prosthetic *** is both for the surgeon and the patient a devastating postoperative complication,leading to significant pain and subsequent apprehension by the patient and may require revision *** use of DM implants poses the worry of wear-related complications,such as accelerated polyethylene wear and osteolysis,which also pose challenges to long-term implant *** technique has seen a steady rise in recent years,with multiple studies reporting favorable *** incidence of their utilization varies among institutions and surgeons,reflecting differing preferences and patient *** diagnosis of instability and wear-related complications in THA often involves clinical assessment,imaging modalities such as X-rays,computed tomography scans,and sometimes advanced imaging techniques like magnetic resonance *** bearings can be considered as an option when patients present neurologic pathologies such as Parkinson's disease or recurrent dislocations after *** bearings provide an additional articulation point within the implant,facilitating a greater range of motion and inherent *** design allows for reduced risk of dislocation and improved functional *** implant manufacturers offer different designs and sizes of DM bearings to suit individual patient *** literature suggests that the use of DM bearings in primary THA has demonstrated promising outcomes in terms

关键词： Dual mobility First implant Hip arthroplasty Surgical technique differential diagnosis

Taper-wedge stem suitable for anterior approach total hip arthroplasty:Adequate biomechanical reconstruction parameters and excellent clinical outcome at mid-term follow-up

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World Journal of Orthopedics 2022年第12期13卷 1047-1055页

作者： Carlo Trevisan Antonino Salvatore Lombardo Gianluca Gallinari Marco Zeppieri Raymond Klumpp UOC ortopedia e traumatologia Ospedale Bolognini Seriate ASSTBergamo Est 24068Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy UOC ortopedia e traumatologia Ospedale Treviglio-Caravaggio ASSTBergamo Ovest 24047Italy

BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have reported high complication and revision rates due to the technical difficulties related to the femoral *** To evaluate the usefulness and safety of a new stem equipped with a morphometric design and a size-specific medial curvature in DAA for *** This retrospective study was based on 130 patients that underwent mini-invasive DAA procedures for THA using the Accolade Ⅱ stem. A total of 144 procedures were included in the assessment, which was based on postoperative complications, survival rates, functional parameters, and patient related *** Overall complications were recorded in 6 procedures(4.2%). There were no complications related to the stem implantation and no intraoperative fractures. Only one patient was revised for deep infection. On radiographs, biomechanical hip reconstruction was satisfactory and no stem showed any subsidence greater than 2 mm. Full osseointegration based on engh scores was seen in all of the implanted stems. Median Harris hip score at final follow-up was 99 points(range 44-100 points), which resulted excellent in 91.3% of patients. The median values of the osteaorthritis outcome score ranged from 87.5 to *** The mid-term positive outcomes and low complication rate in our consecutive series of patients support the safety and suitability of this new stem design in DAA for THA.

关键词： Total hip arthroplasty Orthopedics direct anterior approach Orthopedic surgery Stem implantation Accolade II stem

Preoperative and postoperative risk factors for periprosthetic joint infection in primary total hip arthroplasty:A 1-year experience

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World Journal of Orthopedics 2022年第10期13卷 903-910页

作者： Giuseppe Ferdinando Tella Cesare Donadono Francesco Castagnini Barbara Bordini Monica Cosentino Michele di Liddo Francesco Traina ortopedia-traumatologia e Chirurgia protesica e dei reimpianti d'anca e di ginocchio IRCCS Istituto Ortopedico RizzoliBologna 40125Italy Laboratorio di Tecnologia Medica IRCCS Istituto Ortopedico RizzoliBologna 40125Italy

BACKGROUND Periprosthetic joint infection(PJI)in primary total hip replacement(THR)is one of the most important threats in orthopedic surgery,so one important surgeon’s target is to avoid or early diagnose a *** the incidence of PJI is very low(0.69%)in our department,with an average follow-up of 595 d,this infection poses a serious threat due to the difficulties of treatment and the lower functional outcomes after *** To study the incidence of PJI in all operations occurring in the year 2016 in our department to look for predictive signs of potential *** We counted 583 THR for 578 patients and observed only 4 cases of infection(0.69%)with a mean follow-up of 596 d(min 30,max 1451).We reviewed all medical records to collect the data:duration and time of the surgery,presence,type and duration of the antibiotic therapy,preoperative diagnosis,blood values before and after surgery,transfusions,presence of preoperative drugs(in particularly anticoagulants and antiaggregant,corticosteroids and immunosuppressants),presence of some comorbidities(high body mass index,blood hypertension,chronic obstructive pulmonary disease,cardiac ischemia,diabetes,rheumatological conditions,previous local infections).ReSULTS No preoperative,intraoperative,or postoperative analysis showed a higher incidence of *** did not find any class with evident major odds of *** our study,we did not find any border value to predict PJI and all patients had similar values in both groups(non-PJI and PJI).Only some categories,such as female patients,showed more frequency of PJI,but this difference related to sex was not statistically *** We did not find any category with a higher risk of PJI in THR,probably due to the lack of few cases of infection.

关键词： Primary total hip replacement Periprosthetic joint infection Preoperative risk factors Postoperative risk factors Preoperative and postoperative blood value Total hip arthroplasty

vitamin e for the treatment of children with hepatitis B e antigen-positive chronic hepatitis:a systematic review and meta-analysis

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World Journal of Hepatology 2017年第6期9卷 333-342页

作者： Sirio Fiorino Maria Letizia Bacchi-Reggiani Paolo Leandri elisabetta Loggi Pietro Andreone unità operativa di Medicina Interna C Ospedale Maggiore unità operativa Malattie Cardiovascolari Azienda Ospedaliero Universitaria di BolognaPoliclinico Sant’Orsola-Malpighi dipartimento di Scienze Mediche e Chirurgiche Azienda Ospedaliero Universitaria di BolognaPoliclinico Sant’Orsola-Malpighi

AIM To assess vitamin e efficacy,defined as its ability to induce hepatitis B e antigen(HBeAg) seroconversion,in children with HBeAg-positive persistent *** In July 2016,we extracted articles published in MeDLINe and the Cochrane Library using the following search terms:"chronic hepatitis B","children","childhood","therapy","treatment","vitamin e","tocopherols","tocotrienols".Only randomized controlled trials(RCTs) published in english language were *** Three RCTs met inclusion criteria and were considered in the present ***,23/122 children in the treatment group underwent HBeAg seroconversion vs 3/74 in the control group(OR=3.96,95%CI:1.18-13.25,P=0.025).CONCLUSION Although our meta-analysis has several limits,including the very small number of available studies and enrolled children with HBeAg positivity-related hepatitis,it suggests that vitamin e use may enhance the probability to induce HBeAg seroconversion in these *** well designed and adequately sized trials are required to confirm or deny these very preliminary results.

关键词： Hepatitis B Pediatric hepatology viral hepatitis Immunology

Possible association between hepatitis C virus and malignancies different from hepatocellular carcinoma:A systematic review

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World Journal of Gastroenterology 2015年第45期21卷 12896-12953页

作者： Sirio Fiorino Letizia Bacchi-Reggiani Dario de Biase Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Giorgia Acquaviva Luca di Tommaso Arrigo Bondi Michela visani Sergio Sabbatani Laura Pontoriero Carlo Fabbri Andrea Cuppini Annalisa Pession elio Jovine unità operativa di Medicina Interna Ospedale di Budrio dipartimento di Medicina Sperimentale Istituto di Cardiologia Policlinico S. Orsola-Malpighi Università degli Studi di Bologna dipartimento di Medicina Sperimentale Università di Bologna Unità Operativa Biologia Molecolare Anatomia Patologica Ospedale Bellaria Servizio di Anatomia Patologica Ospedale Maggiore unità operativa di Chirurgia A Ospedale Maggiore Institute of Neuroscience National Research Council Humanitas Clinical and Research Center Rozzano dipartimento di Farmacia e Biotecnologie Università di Bologna Istituto di Malattie Infettive Policlinico S. Orsola-Malpighi Università degli Studi di Bologna unità di Cura Materno-Infantile Distretto Lametino U.O. endoscopia Ospedale Maggiore

AIM: To summarize the current knowledge about the potential relationship between hepatitis C virus(HCv) infection and the risk of several extra-liver cancers. MeTHODS: We performed a systematic review of the literature, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) Statement. We extracted the pertinent articles, published in MeDLINe and the Cochrane Library, using the following search terms: neoplasm/cancer/malignancy/tumor/carcinoma/adeno-carcinoma and non-Hodgkin lymphomas, kidney/renal-, cholangio-, pancreatic-, thyroid-, breast-,oral-, skin-, prostate-, lung-, colon-, stomach-, haematologic. Case series, case-series with control-group, case-control, cohort-studies as well as meta-analyses, written in english were collected. Some of the main characteristics of retrieved trials, which were designed to investigate the prevalence of HCv infection in each type of the above-mentioned human malignancies were summarised. A main table was defined and included a short description in the text for each of these tumours, whether at least five studies about a specific neoplasm, meeting inclusion criteria, were available in literature. According to these criteria, we created the following sections and the corresponding tables and we indicated the number of included or excluded articles, as well as of meta-analyses and reviews:(1) HCv and haematopoietic malignancies;(2) HCv and cholangiocarcinoma;(3) HCv and pancreatic cancer;(4) HCv and breast cancer;(5) HCv and kidney cancer;(6) HCv and skin or oral cancer; and(7) HCv and thyroid cancer. ReSULTS: According to available data, a clear correlation between regions of HCv prevalence and risk of extra-liver cancers has emerged only for a very small group of types and histological subtypes of malignancies. In particular, HCv infection has been associated with:(1) a higher incidence of some B-cell Non-HodgkinLymphoma types, in countries, where an elevated prevalence of this pathogen is de

关键词： Neoplasm Cancer Hepatitis C virus Risk factors ext

evolving role of FDG-PeT/CT in prognostic evaluation of resectable gastric cancer

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World Journal of Gastroenterology 2017年第38期23卷 6923-6926页

作者： emilio De Raffele Mariateresa Mirarchi Dajana Cuicchi Ferdinando Lecce Bruno Cola unità operativa di Chirurgia Generale Dipartimento dell’Apparato Digerente Azienda Ospedaliero-Universitaria di Bologna U.O. di Chirurgia Generale Dipartimento Strutturale Chirurgico Ospedale 'SS Antonio e Margherita'

Gastric cancer (GC) remains a leading cause of cancer death worldwide. Radical gastrectomy is the only potentially curative treatment, and perioperative adjuvant therapies may improve the prognosis after curative resection. Prognosis largely depends on the tumour stage and histology, but the host systemic inflammatory response (SIR) to GC may contribute as well, as has been determined for other malignancies. In GC patients, the potential utility of positron emission tomography/computed tomography (PeT/CT) with the imaging radiopharmaceutical 18F-fluorodeoxyglucose (FDG) is still debated, due to its lower sensitivity in diagnosing and staging GC compared to other imaging modalities. There is, however, growing evidence that FDG uptake in the primary tumour and regional lymph nodes may be efficient for predicting prognosis of resected patients and for monitoring tumour response to perioperative treatments, having prognostic value in that it can change therapeutic strategies. Moreover, FDG uptake in bone marrow seems to be significantly associated with SIR to GC and to represent an efficient prognostic factor after curative surgery. In conclusion, PeT/CT technology is efficient in GC patients, since it is useful to integrate other imaging modalities in staging tumours and may have prognostic value that can change therapeutic strategies. With ongoing improvements, PeT/CT imaging may gain further importance in the management of GC patients.

关键词： Gastric cancer Prognosis 18F-fluorodeoxyglucose Positron emission tomography-computed tomography Bone marrow