Abstract
Traumatic injuries of the ankle are the most common injuries in sports. Up to 40% of patients who have undergone inversion ankle sprain report residual symptoms. The primary purpose of the ...study is to evaluate the incidence of SPN entrapment as consequence of acute severe inversion ankle sprain in children and adolescents; the secondary is to report the diagnostic pathway and the results after surgical treatment. From 2000 to 2015 were reviewed to summarize patients under the age of 15 years treated for a first episode of severe inversion ankle sprain. Cases with persistent symptoms (more than 3 months) indicative for SPN neuropathy were then identified. Instrumental investigations were recovered and a pre-operative assessment of pain (VAS) was recorded. Patients were evaluated at minimum of 1-year post-operative follow-up. 981 acute ankle sprains have been evaluated. 122 were considered severe according to van Dijk criteria. 5 patients were considered affected by neuropathy of the SPN. All patients underwent surgery consisting in neurolysis and capsular retention and ligament reconstruction. At 25 months of follow-up AOFAS moved from 57.6 to 98.6. The study highlights a previously unreported condition of perineural fibrosis of the superficial peroneal nerve at the level of the ankle following first acute severe inversion ankle sprain in children.
Otitis media (OM) affects the middle ear and is typically characterized by earache. OM may be classified as acute (AOM) or chronic (COM), based on symptom duration. OM may be clinically suspected, ...but the diagnosis is usually confirmed by the otoscopy. Antibiotic therapy is frequently used in clinical practice. However, antibiotics often induce intestinal and respiratory dysbiosis associated with some clinical problems. A one-month course of a probiotic mixture (Abincol® containing Lactobacillus plantarum LP01 (1 billion of living cells), Lactobacillus lactis subspecies cremoris LLC02 (800 million living cells), and Lactobacillus delbrueckii LDD01 (200 million living cells), was prescribed in the Group A, and was compared with no addon treatment, such as the Group B. Patients were evaluated at baseline (T0), at the end of antibiotic treatment (T1), at the end of probiotic course (T2), and at the end of 3-month follow-up (T3).
Rhinosinusitis (RS) affects the nose and the paranasal sinus and is characterized by nasal and systemic symptoms. It may be classified as acute or chronic, based on duration. Rhinosinusitis may be ...clinically suspected, but the diagnosis is usually based on the endoscopy. Antibiotic therapy is frequently used for RS patients in clinical practice. However, antibiotics often induce intestinal dysbiosis associated with some clinical problems and respiratory microbiota impairment. The current clinical experience was conducted in patients with pharyngotonsillitis and treated with antibiotics. A one-month course of a probiotic mixture (Abincol® containing Lactobacillus plantarum LP01 (1 billion of living cells), Lactobacillus lactis subspecies cremoris LLC02 (800 million living cells), and Lactobacillus delbrueckii LDD01 (200 million living cells), was prescribed in the Group A, and was compared with no addon treatment, such as the Group B. Patients were evaluated at baseline (T0), at the end of antibiotic treatment (T1), at the end of probiotic course (T2), and at the end of 3-month follow-up (T3).
No study reports the histological features of the various zone of the anterior tubercle of the tibia in the different stages of the Osgood-Schlatter (O-S) lesion. For this reason we carried on an ...histological study. Specimens were taken from 13 patients with O-S lesion prior to surgery. In 4 cases in the apophyseal stage lesions were present in an altered fibrocartilage anterior to the ossification centre. In 9 cases in the epiphyseal stage varying degrees of reparative tissues were observed in the bed of the fragment of the secondary ossification centre. In 3 of them a zone of lesion was observed within the fibrocartilage anterior to the ossification centre. These results suggest that the slippage of the patellar tendon insertion may be progressive and caused by pathological fibrocartilage.
Upper respiratory infections are widespread in clinical practice. Antibiotics are frequently used in the management of patients with airways infection. However, antibiotics can induce intestinal and ...respiratory dysbiosis that, in turn, worsens respiratory symptoms. Moreover, respiratory infections per se can cause dysbiosis. Consequently, probiotics may counterbalance the disturbed microbiota. The current clinical experience evaluated the efficacy and safety of an oral nutraceutical containing a probiotic mixture with Lactobacillus plantarum LP01 (1 billion of living cells), Lactobacillus lactis subspecies cremoris LLC02 (800 million living cells), and Lactobacillus delbrueckii subspecies delbrueckii LDD01 (200 million living cells), in 2928 outpatients with an upper respiratory infection and treated with antibiotics. Patients took one stick/daily for four weeks. Simultaneously, 2877 patients with an upper respiratory infection and treated with antibiotics were recruited as control. This probiotic mixture significantly diminished the presence and the severity of respiratory symptoms at the end of the probiotic course and, more evidently, after a 3-month follow-up. In conclusion, the current clinical experience suggested that this probiotic mixture may be considered an effective and safe therapeutic option in managing patients with an upper respiratory infection and treated with antibiotics.
Purpose: Few clinical decision support systems (CDSSs) are available to help clinicians calculate nutrition intake in infants in the neonatal intensive care unit (NICU) despite improvement in the ...accuracy of calculations and quality of nutrition delivered. The aim of this manuscript is to qualitatively define the barriers associated with the implementation of CDSSs to calculate fluid and nutrition intake. Methods: After defining the data necessary to calculate fluid and nutrition intake, multidisciplinary groups analyzed CDSS capabilities and barriers to implementation at two academically affiliated NICUs. They implemented CDSSs to calculate intake received in the past (retrospective) and to estimate future intake from orders (prospective). Barriers and measures to reduce them are reported. Results: Barriers to implementation include simultaneous enteral feeding orders, the use of free text in the electronic health record (EHR), and a large variety of enteral feeding types for clinical use. These barriers made implementation of prospective CDSSs more difficult. CDSSs reported values that were normalized by both the most recent measured weight (usually obtained daily) and a dosing weight, a weight updated less frequently and used by pharmacies to facilitate prescribing. Conclusion: Despite using an EHR from the same vendor, different solutions were implemented at each NICU. CDSSs improved access to individual infant data on fluid and nutrition intake; however, none of the CDSSs easily exported data to monitor the quality of intake for the entire NICU or specific populations (eg, infants with bronchopulmonary dysplasia). Comprehensive CDSSs that include prospective intake and monitor the quality of nutrition intake through standardized values will require continued investigation and resources.
Pharyngotonsillitis is a common disease, mainly characterized by a sore throat. It may be classified as acute or chronic, based on duration. The diagnosis is usually performed on the clinical ground, ...and antibiotic therapy is frequently used in clinical practice. However, antibiotics frequently induce intestinal dysbiosis associated with some clinical problems. Therefore, probiotics are commonly prescribed in patients treated with antibiotics. The current clinical experience was conducted in patients with pharyngotonsillitis and treated with antibiotics. A one-month course of a probiotic mixture (Abincol® containing Lactobacillus plantarum LP01 (1 billion of living cells), Lactobacillus lactis subspecies cremoris LLC02 (800 million of living cells), and Lactobacillus delbrueckii subspecies delbrueckii LDD01 (200 million of living cells), was prescribed in the Group A, and was compared with no add-on treatment, such as the Group B. Patients were evaluated at baseline (T0), at the end of antibiotic treatment (T1), at the end of probiotic course (T2), and at the end of 3-month follow-up (T3). Globally, 1118 outpatients were enrolled. Acute pharyngotonsillitis affected 795 subjects: 396 in Group A and 399 in Group B. Chronic pharyngotonsillitis affected 323 outpatients: 158 in Group A and 165 in Group B. All patients were usually treated with a 7-10-day course of antibiotic therapy. In patients with acute pharyngotonsillitis, the probiotic mixture significantly reduced the duration of all the symptoms (p<0.001 for all), except for the urinary tract infection, associated with antibiotic therapy which was already at the end of the antibiotic cycle (T1). The intergroup analysis showed that patients with chronic pharyngotonsillitis in Group A had significantly less tiredness, pain, and malaise (p<0.001 for all) than patients in Group B at T1. The probiotic course reduced the possible clinical relapse, and the use of additional medications at T2 and T3 in patients with both acute and chronic pharyngotonsillitis. In conclusion, the present clinical experience demonstrated that a probiotic mixture containing Lactobacillus plantarum LP01, Lactobacillus lactis subspecies cremoris LLC02, and Lactobacillus delbrueckii, was able to quickly reduce symptoms, possible relapse, and use of additional medications, associated with antibiotic therapy, in patients with both acute and chronic pharyngotonsillitis.
In this work, γ-ray shielding and Cs immobilisation performances of high-density magnetite (MG) and iron powder (IP) in Portland cement (PC) based-S/S treatment were investigated. Experimental ...results were elaborated using a γ-radiation shielding (γRS) index-based approach for assessing the effectiveness of in situ S/S of
Cs-contaminated soils. Main results reveal that the replacement of PC by MG or IP (up to 50%) leads to a marked increase (up to about 4-fold) in the γ-ray shielding performance, whereas a further material addition decreases the S/S shielding performance. The highest γRS index of ∼26% (662 keV) was found in the case of IP addition (33.3%). The use of MG-mixes allows reaching slightly slower γRS index jointly with the highest Cs-immobilisation of 97.8%. In this case, calculation shows a maximum
Cs-contamination level successfully treatable by in situ S/S up to ∼2.9 or ∼14.5 kBq kg
for the realistic or low probability scenario, respectively, highlighting the possibility to remediate a very wide range of real contamination. Findings show MG - PC S/S as the best choice and could provide a basis for decision-making of S/S remediation of
Cs-contaminated sites.
LaryngoPharyngeal Reflux (LPR) is characterized by symptoms, signs, and/or tissue damage
resulting from the aggression of the gastrointestinal contents in the upper airways. The Reflux Finding
Score ...(RFS) assesses the laryngeal signs through laryngoscopy. The Reflux Symptom Index (RSI) scores
the LPR symptoms. The objective of this real-world study was to compare RFS with RSI in a cohort of
Italian LPR patients. Globally, 3932 patients with LPR were evaluated and RFS and RSI were assessed in
all subjects. A moderate correlation was found between RSI and RFS (r=0.484, p<0.0001). In conclusion,
the RSI and RFS can easily be included in the LPR work-up as objective and consistent parameters,
with low cost and high practicality. Based on these clinical outcomes, the specialist can easily use these
tests in clinical practice.
The objective of this study was to determine if newborn premature infants with severe respiratory distress syndrome (RDS) who developed bronchopulmonary dysplasia (BPD) demonstrate, within the first ...3 days of life, lower blood levels of antioxidants and higher urine levels of lipid peroxidation products than premature infants who recovered from RDS. Perinatal variables (gestational age, birth weight, and Apgar scores) and antioxidant indices in cord and in third day of life plasma and red blood cell (RBC) samples from healthy premature infants (n = 35), infants with RDS (n = 23) and infants with BPD (n = 23) were examined. Antioxidant indices included selenium, alpha-tocopherol, total and oxidized glutathione, glutathione peroxidase, superoxide dismutase, and urinary malondialdehyde. By inferential statistics, only the perinatal variables and cord plasma selenium distinguished healthy premature infants from premature infants with RDS or BPD. From perinatal variables and antioxidant indices we calculated: (1) cord to third-day-of-life variable differences, (2) variable-to-variable ratios, and (3) ratios of a difference for one variable to a difference for any second variable. Subset regression analysis yielded an equation (adjusted R2 = 0.8839) that correctly predicted infants who developed BPD 100% of the time. Predictor variables for BPD were gestational age, Apgar at 1 min, cord and third-day-of-life RBC selenium, cord total glutathione, cord and third-day-of-life glutathione peroxidase and nine different ratios involving Apgar scores, RBC selenium, total and oxidized glutathione, alpha-tocopherol, glutathione peroxidase, and superoxide dismutase. In this study, there was no relationship between lipid peroxidation and BPD. There was a higher rate of patent ductus arteriosus, congestive heart failure, and retinopathy of prematurity in infants with BPD. This study confirms that low plasma selenium and alpha-tocopherol levels in premature infants (< or = 30 weeks' gestational age or lower) were significantly associated with an increased respiratory morbidity.
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