17 results on '"Ceccoli M"'
Search Results
2. Clinical Outcome of Discordant Empirical Therapy and Risk Factors Associated to Treatment Failure in Children Hospitalized for Urinary Tract Infections
- Author
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Autore G., Neglia C., Di Costanzo M., Ceccoli M., Vergine G., La Scola C., Malaventura C., Falcioni A., Iacono A., Crisafi A., Iughetti L., Conte M. L., Pierantoni L., Gatti C., Biasucci G., Esposito S., Argentiero A., Bernardi L., Dal Canto G., Cortina I., Capra M. E., Benincasa C., Addeo A., Saia R. E., Lelli F., Pession A., Pasini A., Baccelli F., Bruni L., Gallotta G., Corvaglia A., Lanari M., Suppiej A., Cafolla C., Boselli F., Valletta E., Venturoli V., Casadio L., Polenzani I., Marchetti F., De Fanti A., Autore G., Neglia C., Di Costanzo M., Ceccoli M., Vergine G., La Scola C., Malaventura C., Falcioni A., Iacono A., Crisafi A., Iughetti L., Conte M.L., Pierantoni L., Gatti C., Biasucci G., Esposito S., Argentiero A., Bernardi L., Dal Canto G., Cortina I., Capra M.E., Benincasa C., Addeo A., Saia R.E., Lelli F., Pession A., Pasini A., Baccelli F., Bruni L., Gallotta G., Corvaglia A., Lanari M., Suppiej A., Cafolla C., Boselli F., Valletta E., Venturoli V., Casadio L., Polenzani I., Marchetti F., and De Fanti A.
- Subjects
Antibiotic resistance ,Antibiotic failure ,Discordant antibiotic ,Pediatrics, Perinatology and Child Health ,Socio-culturale ,Empirical therapy ,Urinary tract infections ,antibiotic failure ,antibiotic resistance ,empirical therapy ,discordant antibiotic ,urinary tract infections - Abstract
With the spread of antibiotic resistance in pediatric urinary tract infections (UTIs), more patients are likely to be started empirically on antibiotics to which pathogens are later found to be resistant (discordant therapy). However, in-vivo effectiveness may be different from in-vitro susceptibility. Aims of this study were to describe clinical outcomes of discordant empirical treatments in pediatric UTIs and to investigate risk factors associated to treatment failure. This observational, retrospective study was conducted on children hospitalized for febrile UTIs with positive urine culture and started on discordant empirical therapy. Failure rates of discordant treatments and associated risk factors were investigated. A total of 142/1600 (8.9%) patients were treated with inadequate empirical antibiotics. Clinical failure was observed in 67/142 (47.2%) patients, with no fatal events. Higher failure rates were observed for combinations of penicillin and beta-lactamase inhibitors (57.1%). Significant risk factors for failure of discordant treatment were history of recurrent UTIs (95% CI: 1.13–9.98, OR: 3.23, p < 0.05), recent use of antibiotics (95% CI: 1.46–21.82, OR: 5.02, p < 0.01), infections caused by Pseudomonas aeruginosa (95% CI: 1.85–62.10, OR: 7.30, p < 0.05), and empirical treatment with combinations of penicillin and beta-lactamase inhibitors (95% CI: 0.94–4.03, OR: 1.94, p = 0.05). This study showed that discordant empirical treatments may still be effective in more than half of pediatric UTIs. Clinical effectiveness varies between different discordant antibiotics in pediatric UTIs, and patients presenting risk factors for treatment failure may need a differentiated empirical approach.
- Published
- 2022
3. One-step reconstruction with custom-made 3D-printed scapular prosthesis after partial or total scapulectomy
- Author
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Grossi, S., D’arienzo, A., Sacchetti, F., Ceccoli, M., Cosseddu, F., Neri, E., Colangeli, S., Parchi, P. D., Lorenzo Andreani, and Capanna, R.
- Subjects
Prosthesis Implantation ,Scapula ,Printing, Three-Dimensional ,Humans ,Orthopedic Procedures ,Total Scapulectomy ,Prostheses and Implants ,Prosthesis Design ,Scapular Prosthesis, Total Scapulectomy ,Scapular Prosthesis - Abstract
En bloc scapulectomy with covering muscles was historically considered the only procedure available for surgical treatment of bone and soft tissue tumors of the scapula. When possible, reconstruction with scapular allograft is the gold standard, and gives satisfactory functional, cosmetic, and oncological outcomes. While good results have recently been reported with 3D-printed prostheses for reconstruction of bone loss, there is little information available in the medical literature regarding scapula reconstruction with a 3D-printed prosthesis. Between 2016 and 2018, we performed four scapular resections (two total and two involving the superior 1/3) followed by reconstruction with a 3D-printed prosthesis made of a porous titanium alloy (Ti-6Al-4V, diameter between 100 and 400 mm), using computer-aided design (CAD) and patient-specific implants (PSI) with previously acquired CT-MR fusion images. At 2 years follow-up, the patients with partial scapulectomy had an MSTS score of 76%, no local or systemic recurrence, good clinical results and no pain. At 1 year 6 months follow-up, the patients with total scapulectomy had an MSTS score of 46%, no local or systemic recurrence, fair clinical results and no pain. Thus, custom-made 3D-printed prostheses appear to be valuable in orthopedic surgery. However, a larger cohort and longer-term analysis are needed to evaluate the scapular 3D-printed prosthesis as a reliable reconstruction technique.
- Published
- 2020
4. Traumatology in Judo Discipline
- Author
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Scaglione, M., primary, Citarelli, C., additional, De Paola, G., additional, Palmieri, G., additional, Ceccoli, M., additional, and Casella, F., additional
- Published
- 2019
- Full Text
- View/download PDF
5. Cryotherapy efficacy and safety as local therapy in surgical treatment of musculoskeletal tumours. A retrospective case series of 143 patients
- Author
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Colangeli, S., Parchi, P., Lorenzo Andreani, Beltrami, G., Scoccianti, G., Sacchetti, F., Ceccoli, M., Totti, F., Campanacci, D. A., and Capanna, R.
- Subjects
Osteosarcoma ,Treatment Outcome ,musculoskeletal tumours ,Cryotherapy ,Giant Cell Tumors ,Humans ,Cryotherapy , musculoskeletal tumours ,Bone Neoplasms ,Neoplasm Recurrence, Local ,Retrospective Studies - Abstract
Cryotherapy, also called Cryoablation (CA), is a technique that provides a local treatment to various pathological conditions. In Musculoskeletal tumours management, Cryoablation is well accepted and validated as a treatment in palliative cures for metastatic patients. Recently, CA has been proposed also as an alternative to radiofrequency ablation in osteoid osteoma and other benign tumour treatment with promising results. Cryotherapy with argon ice-balls as local adjuvant in open surgery is a tool that can provide enlargement of surgical margins if used properly. There is still not enough evidence supporting use of cryotherapy as local adjuvant in Musculoskeletal open surgery as the series cited above are very small and there is no comparative RCT between local adjuvant therapies including CA. One-hundred-and-eighty-three patients were treated with Cryoablation from 2000 and 2018 in the Musculoskeletal Tumours Surgery Unit of Careggi (Florence) and the University 2nd Clinic of Pisa. In our study group, 38 patients (26.6%) were affected by bone metastasis, 16 patients (11.1%) by aneurismal bone cysts or angiomas, 22 patients (15.4%) by low-grade malignant musculoskeletal tumours, 2 patients (1,4%) by fibromatosis, 63 patients (44.1%) by benign musculoskeletal tumours (principally Giant Cell Tumours-GCT) and 2 patients (1.4%) by Osteosarcomas. In 125 cases (87.4%), CA has been used as an adjuvant therapy, in 12 cases (8.4%) as a percutaneous ablation therapy and in 6 cases (4.2%) as adjuvant to remove tumoral lesions 'en bloc' or as a 'poor technique' for its sterilizing effect on previously resected bones. Mean follow-up was 10 years. Twenty-three patients (16%) were classified as Alive with Disease (AWD) due to local recurrence or tumour progression (14 metastases, 5 low-grade malignant bone tumours, 4 Giant Cell Tumours). Eight patients died due to the disease (6 metastases, 2 osteosarcomas), while 1 died from leukaemia. One-hundred-and-eleven patients (78%) were classified as Continues Disease Free (CDF). All patients reported decrease in pain-related symptoms after surgery and all surgeons reported better control of blood loss. Three cases (2%) of local skin necrosis or wound dehiscence were reported. No local recurrences were reported after fibromatosis ablation. Our results confirm that CA could be considered as a safe and effective technique to treat various conditions as adjuvant and palliative therapy. In particular, in open surgery, cryotherapy as an adjuvant treatment could lead to very low rates of recurrence in locally aggressive tumours like Giant Cell Tumours. These results could be generalized but a better understanding about indications and outcomes can be reached studying CA in specific populations with comparation to other adjuvant techniques.
6. Antibiotic Resistance in Paediatric Febrile Urinary Tract Infections
- Author
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Marcello Lanari, Alberto Argentiero, Giovanni Autore, Alessandro De Fanti, Claudia Gatti, Letizia Paglialonga, Barbara Predieri, Giulia Dal Canto, Andrea Pasini, Lorenzo Iughetti, Cristina Malaventura, Andrea Pession, Marcello Sella, Gianluca Vergine, Sante Lucio Cantatore, Chiara Sodini, Nicola Principi, Luca Casadio, Susanna Esposito, Luca Pierantoni, Claudio La Scola, Giacomo Biasucci, Martina Ceccoli, Agnese Suppiej, Luca Bernardi, Antonella Crisafi, Esposito S., Biasucci G., Pasini A., Predieri B., Vergine G., Crisafi A., Malaventura C., Casadio L., Sella M., Pierantoni L., Gatti C., Paglialonga L., Sodini C., La Scola C., Bernardi L., Autore G., Canto G.D., Argentiero A., Cantatore S., Ceccoli M., De Fanti A., Suppiej A., Lanari M., Principi N., Pession A., and Iughetti L.
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,paediatric ,antibiotic resistance ,medicine.drug_class ,Urinary system ,Renal parenchyma ,Immunology ,Antibiotics ,Socio-culturale ,antibiotic stewardship ,Microbiology ,Pediatrics ,ESBL ,paediatrics ,urinary tract infection ,Antimicrobial Stewardship ,Antibiotic resistance ,Antibiotic therapy ,Immunology and Allergy ,Medicine ,Humans ,Intensive care medicine ,Child ,business.industry ,Febrile urinary tract infection ,Drug Resistance, Microbial ,Anti-Bacterial Agents ,Increased risk ,Urinary Tract Infections ,Antibiotic Stewardship ,business - Abstract
Febrile urinary tract infection (UTI) is currently considered the most frequent cause of serious bacterial illness in children in the first 2 years of life. UTI in paediatrics can irreversibly damage the renal parenchyma and lead to chronic renal insufficiency and related problems. To avoid this risk, an early effective antibiotic treatment is essential. Moreover, prompt treatment is mandatory to improve the clinical condition of the patient, prevent bacteraemia, and avoid the risk of bacterial localization in other body sites. However, antibiotic resistance for UTI-related bacterial pathogens continuously increases, making recommendations rapidly outdated and the definition of the best empiric antibiotic therapy more difficult. Variation in pathogen susceptibility to antibiotics is essential for the choice of an effective therapy. Moreover, proper identification of cases at increased risk of difficult-to-treat UTIs can reduce the risk of ineffective therapy. In this review, the problem of emerging antibiotic resistance among pathogens associated with the development of paediatric febrile UTIs and the best potential solutions to ensure the most effective therapy are discussed. Literature analysis showed that the emergence of antibiotic resistance is an unavoidable phenomenon closely correlated with the use of antibiotics themselves. To limit the emergence of resistance, every effort to reduce and rationalise antibiotic consumption must be made. An increased use of antibiotic stewardship can be greatly effective in this regard.
- Published
- 2022
7. Treatment of a subcutaneous tibialis anterior tendon rupture with a semitendinosus autograft.
- Author
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Zmerly H, Russo M, Ceccoli M, Moscato M, and Akkawi I
- Subjects
- Humans, Female, Aged, Ankle, Autografts, Tendons transplantation, Rupture surgery, Hamstring Muscles, Tendon Injuries surgery
- Abstract
The subcutaneous rupture of the tibialis anterior tendon is a rare and silent lesion which can lead to foot and ankle dysfunction with gait difficulty. The treatment can be either conservative or surgical. Conservative management is reserved for inactive patients and those with a general or local contraindication to surgery, whereas surgical repair includes direct and rotational suture, as well as tendon transfer and auto- or allograft. The choice of surgical treatment is based on multiple factors, including the symptoms, the timespan from injury to treatment, the anatomopathological pattern of the lesion, and the patient's age and level of activity. Large defects present a particular reconstructive challenge, and there is no consensus on the optimal method of treatment. That being said, one of the options is an autograft using the semitendinosus hamstring tendon. We present a case of a 69-year-old woman who sustained a hyperflexion trauma to her left ankle. Three months later, ultrasound examination and a magnetic resonance imaging showed a complete tibialis anterior rupture with a gap of more than 10 cm. The patient was successfully treated with surgical repair. An autograft of the semitendinosus tendon was used to bridge the gap. The tibialis anterior rupture is a rare lesion that must be promptly diagnosed and treated, especially in physically active patients. Large defects pose particular challenges. Surgical management was found to be the treatment of choice. In the case of a lesion with a major gap, semitendinosus grafting can be successfully employed.
- Published
- 2023
- Full Text
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8. Antibiotic Resistance in Paediatric Febrile Urinary Tract Infections.
- Author
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Esposito S, Biasucci G, Pasini A, Predieri B, Vergine G, Crisafi A, Malaventura C, Casadio L, Sella M, Pierantoni L, Gatti C, Paglialonga L, Sodini C, La Scola C, Bernardi L, Autore G, Canto GD, Argentiero A, Cantatore S, Ceccoli M, De Fanti A, Suppiej A, Lanari M, Principi N, Pession A, and Iughetti L
- Subjects
- Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Child, Drug Resistance, Microbial, Humans, Antimicrobial Stewardship, Pediatrics, Urinary Tract Infections drug therapy, Urinary Tract Infections microbiology
- Abstract
Febrile urinary tract infection (UTI) is currently considered the most frequent cause of serious bacterial illness in children in the first 2 years of life. UTI in paediatrics can irreversibly damage the renal parenchyma and lead to chronic renal insufficiency and related problems. To avoid this risk, an early effective antibiotic treatment is essential. Moreover, prompt treatment is mandatory to improve the clinical condition of the patient, prevent bacteraemia, and avoid the risk of bacterial localization in other body sites. However, antibiotic resistance for UTI-related bacterial pathogens continuously increases, making recommendations rapidly outdated and the definition of the best empiric antibiotic therapy more difficult. Variation in pathogen susceptibility to antibiotics is essential for the choice of an effective therapy. Moreover, proper identification of cases at increased risk of difficult-to-treat UTIs can reduce the risk of ineffective therapy. In this review, the problem of emerging antibiotic resistance among pathogens associated with the development of paediatric febrile UTIs and the best potential solutions to ensure the most effective therapy are discussed. Literature analysis showed that the emergence of antibiotic resistance is an unavoidable phenomenon closely correlated with the use of antibiotics themselves. To limit the emergence of resistance, every effort to reduce and rationalise antibiotic consumption must be made. An increased use of antibiotic stewardship can be greatly effective in this regard., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
9. Retrospective 8-Year Study on the Antibiotic Resistance of Uropathogens in Children Hospitalised for Urinary Tract Infection in the Emilia-Romagna Region, Italy.
- Author
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Esposito S, Maglietta G, Di Costanzo M, Ceccoli M, Vergine G, La Scola C, Malaventura C, Falcioni A, Iacono A, Crisafi A, Iughetti L, Conte ML, Pierantoni L, Gatti C, Caminiti C, and Biasucci G
- Abstract
The development and spread of antibiotic resistance is an increasingly important global public health problem, even in paediatric urinary tract infection (UTI). In light of the variability in the data, it is necessary to conduct surveillance studies to determine the prevalence of antibiotic resistance in specific geographical areas to optimize therapeutic management. In this observational, retrospective, multicentre study, the medical records of 1801 paediatric patients who were hospitalised for UTI between 1 January 2012, and 30 June 2020, in Emilia-Romagna, Italy, were analysed. Escherichia coli was the most frequently detected pathogen (75.6%), followed by Klebsiella pneumoniae (6.9%) and Pseudomonas aeruginosa (2.5%). Overall, 840 cases (46.7%) were due to antimicrobial-resistant uropathogens: 83 (4.7%) extended spectrum beta-lactamase (ESBL)-producing, 119 (6.7%) multidrug resistant (MDR) and 4 (0.2%) extensively drug resistant (XDR) bacteria. Empirical antibiotic therapy failed in 172 cases (9.6%). Having ESBL or MDR/XDR uropathogens, a history of recurrent UTI, antibiotic therapy in the preceding 30 days, and empirical treatment with amoxicillin or amoxicillin/clavulanate were significantly associated with treatment failure, whereas first-line therapy with third-generation cephalosporins was associated with protection against negative outcomes. In conclusion, the increase in the resistance of uropathogens to commonly used antibiotics requires continuous monitoring, and recommendations for antibiotic choice need updating. In our epidemiological context, amoxicillin/clavulanate no longer seems to be the appropriate first-line therapy for children hospitalised for UTI, whereas third-generation cephalosporins continue to be useful. To further limit the emergence of resistance, every effort to reduce and rationalise antibiotic consumption must be implemented.
- Published
- 2021
- Full Text
- View/download PDF
10. First metatarsophalangeal fusion with dorsal plate: clinical outcomes.
- Author
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Restuccia G, Cosseddu F, Del Chiaro A, Ceccoli M, Lippi A, and Shytaj S
- Subjects
- Aged, Arthritis physiopathology, Female, Follow-Up Studies, Hallux Valgus surgery, Humans, Male, Retrospective Studies, Severity of Illness Index, Treatment Outcome, Weight-Bearing, Arthritis surgery, Arthrodesis methods, Bone Plates, Metatarsophalangeal Joint surgery
- Abstract
Background: First metatarsophalangeal joint (MTPJ) fusion is the most effective technique for the treatment of MTPJ primary arthritis, severe hallux valgus and failure of primary corrective surgery of these conditions. It can be achieved through different techniques. We evaluated the outcomes in a cohort of patients treated with dorsal plate arthrodesis., Materials and Methods: We treated 30 feet for 28 patients; the mean follow-up was 35 months. For each foot, we collected radiological and clinical assessment, with the visual analogue scale (VAS) for pain and the Manchester and Oxford Foot questionnaire (MOFQ). The technique consisted in a cup and cone arthrodesis with the application of a low profile dorsal plate. Patients were allowed for immediate weight bearing., Results: Consolidation was achieved in all cases; in 29 cases, radiographic union was recorded within 6 months from surgery, in one case after 9 months. Comparison between the preoperative and postoperative of VAS and MOXFQ values showed a statistically significant difference (p < 0.05). Only one case developed wound dehiscence as complication., Conclusions: Even if there is still a debate regarding the best system for MTPJ fusion, we believe cup and cone fusion with dorsal plating is an effective method. Moreover, the stability of the osteosynthesis obtained allows for immediate post-operative weight bearing, making patients able to return soon to their normal life., Trial Registration: We present a retrospective study; all patients enrolled were retrospectively registered.
- Published
- 2021
- Full Text
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11. All-Inside Arthroscopic Repair For Longitudinal Meniscal Tears: Clinical and Functional Results.
- Author
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Grossi S, Ipponi E, Bufalino E, Gariffo G, Filoni G, Ceccoli M, Simonetti M, Ciapini G, and Scaglione M
- Subjects
- Arthroscopy, Humans, Menisci, Tibial surgery, Retrospective Studies, Suture Techniques, Tibial Meniscus Injuries surgery
- Abstract
Meniscal injuries are a common challenge in orthopaedic surgery. Depending on their location and the patient's age and functional needs, they can be treated either conservatively or surgically. A surgical approach can consist of arthroscopic meniscectomy or meniscal suture. The latter is the treatment of choice in case of lesions involving the red-red or red-white areas of the meniscus, especially for young high-demanding patients. We report here our experience with the repair of longitudinal meniscal tears using the all-inside technique with the Fast-Fix™ 360 Meniscal Repair System (Smith & Nephew Endoscopy, Andover, MA). We retrospectively evaluated 20 consecutive cases of longitudinal meniscal tears. In 4 cases, concomitant ACL rupture was diagnosed and treated alongside the meniscal repair. All patients underwent periodic clinical evaluations. At the latest check-up, their functional outcomes were rated according to the Tegner-Lysholm Knee and KOOS scoring scales. The mean Tegner-Lysholm Knee score was 84.85 (44-100) and the mean KOOS score was 88.58. No failure or major complications were observed. Furthermore, a negative statistical association was observed between age at surgery and the post-operative Tegner-Lysholm Knee score (coef. = -1.01189 [-1.942073,-0.0817063], p = 0.035). This relation, independent of gender, meniscus involved, eventual associated ACL reconstruction, and chondral injury, suggests that functional outcomes worsen with increasing patient age. Our results suggest that the arthroscopic all-inside suture is both safe and effective in cases of longitudinal meniscal tear, considering the good post-operative functionality and low rates of local complications and surgical failures.
- Published
- 2021
- Full Text
- View/download PDF
12. Image-guided Cryotherapy for Musculoskeletal Tumors.
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Scandiffio R, Bozzi E, Ezeldin M, Capanna R, Ceccoli M, Colangeli S, Donati DM, and Colangeli M
- Subjects
- Cryotherapy, Humans, Bone Neoplasms therapy, Osteoblastoma, Osteoma, Osteoid, Soft Tissue Neoplasms therapy
- Abstract
Background: This article represents a review of the use of image-guided cryotherapy in the treatment of musculoskeletal tumor lesions. Cryotherapy is able to induce a lethal effect on cancer cells through direct and indirect mechanisms. In this manuscript, we combined our experience with that of other authors who have published on this topic in order to provide indications on when to use cryotherapy in musculoskeletal oncology., Discussion: Image-Guided percutaneous cryotherapy is a therapeutic method now widely accepted in the treatment of patients with musculoskeletal tumors. It can be used both for palliative treatments of metastatic bone lesions and for the curative treatment of benign bone tumors, such as osteoid osteoma or osteoblastoma. In the treatment of bone metastases, cryotherapy plays a major role in alleviating or resolving disease-related pain, but it has also been demonstrated that it can have a role in local disease control. In recent years, the use of cryotherapy has also expanded for the treatment of both benign and malignant soft tissue tumors., Conclusion: Percutaneous cryotherapy can be considered a safe and effective technique in the treatment of benign and malignant musculoskeletal tumors. Cryotherapy can be considered the first option in benign tumor lesions, such as osteoid osteoma, and a valid alternative to radiofrequency ablation. In the treatment of painful bone metastases, it must be considered secondarily to other standard treatments (radiotherapy, bisphosphonate therapy, and chemotherapy) when they are no longer effective in controlling the disease or when they cannot be repeated (for example, radiotherapy)., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2021
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13. Grisel's Syndrome in Children: Two Case Reports and Systematic Review of the Literature.
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Pini N, Ceccoli M, Bergonzini P, and Iughetti L
- Abstract
Background and Objective . Grisel's syndrome is a rare syndrome characterized by nontraumatic rotatory subluxation of the atlantoaxial joint. It usually affects children and typically presents with torticollis after ear, nose, and throat (ENT) surgery or head and neck infections. In the pediatric literature, there is only a small amount of available data; moreover, no systematic review has been previously done with focus on the pediatric population. We report our experience of two cases, and we provide a systematic review on Grisel's syndrome in children in order to offer a deeper insight about its clinical presentation, its current diagnosis, and principles of treatment. Case Reports and Review . We describe two boys of 9 and 8 years old, who developed atlantoaxial subluxation after adenoidectomy. Considering the early diagnosis, a conservative treatment was chosen, with no recurrence and no sequelae at follow-up. We identified 114 case reports, of which 90 describe children, for a total of 171 pediatric patients. Of the 154 cases in which cause was reported, 59.7% presented a head and neck infection and 35.7% had previous head and neck surgery. There is no sex prevalence (49.7% males versus 50.2% females). Mean delay in diagnosis is 33 days. Eight % of the patients had neurological impairment of the 165 cases which mentioned treatment, 96% underwent a conservative treatment, of whom the 8.8% recurred with the need of surgery. As a whole, 12% underwent surgery as a first- or second-line treatment. 3 6% of the patients whose follow-up was reported developed a sequela, minor limitation of neck movement being the most frequent. Conclusion . Grisel's syndrome should be suspected in children with painful unresponsive torticollis following ENT procedures or head and neck inflammation. CT scan with 3D reconstruction is the gold standard for diagnosis, allowing the identification of the subluxation and the classification according to the Fielding-Hawkins grading system. Surgical treatment is indicated in case of high-grade instability or failure of conservative treatment. Review of the literature shows how early diagnosis based on clinical and radiological evaluation is crucial in order to avoid surgical treatment and neurologic sequelae., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Nicole Pini et al.)
- Published
- 2020
- Full Text
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14. Born with a solitary kidney: at risk of hypertension.
- Author
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La Scola C, Marra G, Ammenti A, Pasini A, Taroni F, Bertulli C, Morello W, Ceccoli M, Mencarelli F, Guarino S, Puccio G, and Montini G
- Subjects
- Adolescent, Blood Pressure Monitoring, Ambulatory, Case-Control Studies, Child, Female, Humans, Male, Masked Hypertension etiology, Retrospective Studies, Risk Assessment, Solitary Kidney complications, Masked Hypertension diagnosis, Solitary Kidney congenital
- Abstract
Background: Subjects with a congenital solitary kidney (CSK) are believed to be at risk of hypertension due to their low number of nephrons. However, as CSK is a congenital abnormality of the kidney or urinary tract (CAKUT), subtle dysplastic changes contributing to hypertension cannot be excluded., Methods: We retrospectively compared office blood pressure (OBP) and ambulatory blood pressure monitoring (ABPM) between two groups of children with CAKUT, aged 6-18 years: Group A with a CSK and Group B with two kidneys. All had normal renal parenchyma on scintigraphy and normal renal function. OBP and mean systolic and diastolic 24-h, daytime and nighttime ambulatory BP records were analyzed. The distribution of OBP and APBM as continuous values and the prevalence of hypertension (ambulatory/severe ambulatory or masked hypertension) in the two groups were compared., Results: There were 81 patients in Group A and 45 in Group B. Median OBP standard deviation scores were normal in both groups, without significant differences. Median ABPM standard deviation scores, although normal, were significantly higher in Group A and the prevalence of hypertension was higher (ambulatory/severe ambulatory or masked) (33.3 vs. 13.3%, p = 0.019), mainly because of the greater occurrence of masked hypertension., Conclusions: Our data show that a CSK per se can be associated with an increased risk of hypertension from the pediatric age. Therefore, ABPM, which has proved valuable in the screening of hypertension, is warranted in children with a CSK, even if laboratory and imaging assessment is otherwise normal.
- Published
- 2020
- Full Text
- View/download PDF
15. One-Step Reconstruction with Custom-made 3D-printed Scapular Prosthesis After Partial or Total Scapulectomy.
- Author
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Grossi S, D'Arienzo A, Sacchetti F, Ceccoli M, Cosseddu F, Neri E, Colangeli S, Parchi PD, Andreani L, and Capanna R
- Subjects
- Humans, Printing, Three-Dimensional, Prostheses and Implants, Prosthesis Design, Prosthesis Implantation, Orthopedic Procedures, Scapula
- Abstract
En bloc scapulectomy with covering muscles was historically considered the only procedure available for surgical treatment of bone and soft tissue tumors of the scapula. When possible, reconstruction with scapular allograft is the gold standard, and gives satisfactory functional, cosmetic, and oncological outcomes. While good results have recently been reported with 3D-printed prostheses for reconstruction of bone loss, there is little information available in the medical literature regarding scapula reconstruction with a 3D-printed prosthesis. Between 2016 and 2018, we performed four scapular resections (two total and two involving the superior 1/3) followed by reconstruction with a 3D-printed prosthesis made of a porous titanium alloy (Ti-6Al-4V, diameter between 100 and 400 mm), using computer-aided design (CAD) and patient-specific implants (PSI) with previously acquired CT-MR fusion images. At 2 years follow-up, the patients with partial scapulectomy had an MSTS score of 76%, no local or systemic recurrence, good clinical results and no pain. At 1 year 6 months follow-up, the patients with total scapulectomy had an MSTS score of 46%, no local or systemic recurrence, fair clinical results and no pain. Thus, custom-made 3D-printed prostheses appear to be valuable in orthopedic surgery. However, a larger cohort and longer-term analysis are needed to evaluate the scapular 3D-printed prosthesis as a reliable reconstruction technique.
- Published
- 2020
16. Cryotherapy efficacy and safety as local therapy in surgical treatment of musculoskeletal tumours. A retrospective case series of 143 patients.
- Author
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Colangeli S, Parchi P, Andreani L, Beltrami G, Scoccianti G, Sacchetti F, Ceccoli M, Totti F, Campanacci DA, and Capanna R
- Subjects
- Giant Cell Tumors surgery, Giant Cell Tumors therapy, Humans, Neoplasm Recurrence, Local, Osteosarcoma surgery, Osteosarcoma therapy, Retrospective Studies, Treatment Outcome, Bone Neoplasms surgery, Bone Neoplasms therapy, Cryotherapy
- Abstract
Cryotherapy, also called Cryoablation (CA), is a technique that provides a local treatment to various pathological conditions. In Musculoskeletal tumours management, Cryoablation is well accepted and validated as a treatment in palliative cures for metastatic patients. Recently, CA has been proposed also as an alternative to radiofrequency ablation in osteoid osteoma and other benign tumour treatment with promising results. Cryotherapy with argon ice-balls as local adjuvant in open surgery is a tool that can provide enlargement of surgical margins if used properly. There is still not enough evidence supporting use of cryotherapy as local adjuvant in Musculoskeletal open surgery as the series cited above are very small and there is no comparative RCT between local adjuvant therapies including CA. One-hundred-and-eighty-three patients were treated with Cryoablation from 2000 and 2018 in the Musculoskeletal Tumours Surgery Unit of Careggi (Florence) and the University 2nd Clinic of Pisa. In our study group, 38 patients (26.6%) were affected by bone metastasis, 16 patients (11.1%) by aneurismal bone cysts or angiomas, 22 patients (15.4%) by low-grade malignant musculoskeletal tumours, 2 patients (1,4%) by fibromatosis, 63 patients (44.1%) by benign musculoskeletal tumours (principally Giant Cell Tumours-GCT) and 2 patients (1.4%) by Osteosarcomas. In 125 cases (87.4%), CA has been used as an adjuvant therapy, in 12 cases (8.4%) as a percutaneous ablation therapy and in 6 cases (4.2%) as adjuvant to remove tumoral lesions 'en bloc' or as a 'poor technique' for its sterilizing effect on previously resected bones. Mean follow-up was 10 years. Twenty-three patients (16%) were classified as Alive with Disease (AWD) due to local recurrence or tumour progression (14 metastases, 5 low-grade malignant bone tumours, 4 Giant Cell Tumours). Eight patients died due to the disease (6 metastases, 2 osteosarcomas), while 1 died from leukaemia. One-hundred-and-eleven patients (78%) were classified as Continues Disease Free (CDF). All patients reported decrease in pain-related symptoms after surgery and all surgeons reported better control of blood loss. Three cases (2%) of local skin necrosis or wound dehiscence were reported. No local recurrences were reported after fibromatosis ablation. Our results confirm that CA could be considered as a safe and effective technique to treat various conditions as adjuvant and palliative therapy. In particular, in open surgery, cryotherapy as an adjuvant treatment could lead to very low rates of recurrence in locally aggressive tumours like Giant Cell Tumours. These results could be generalized but a better understanding about indications and outcomes can be reached studying CA in specific populations with comparation to other adjuvant techniques.
- Published
- 2018
17. Ultrastructural characteristics and immune profile of equine MSCs from fetal adnexa.
- Author
-
Iacono E, Pascucci L, Rossi B, Bazzucchi C, Lanci A, Ceccoli M, and Merlo B
- Subjects
- Angiogenic Proteins metabolism, Animals, Biomarkers metabolism, Cell Adhesion, Cell Movement, Cell Proliferation, Cells, Cultured, Cellular Microenvironment, Chondrogenesis, Cytokines metabolism, Female, Horses, Mesenchymal Stem Cells metabolism, Microscopy, Electron, Transmission, Osteogenesis, Phenotype, Amnion cytology, Mesenchymal Stem Cells immunology, Mesenchymal Stem Cells ultrastructure, Wharton Jelly cytology
- Abstract
Both in human and equine species, mesenchymal stem cells (MSCs) from amniotic membrane (AM) and Wharton's jelly (WJ), may be particularly useful for immediate use or in later stages of life, after cryopreservation in cell bank. The aim of this study was to compare equine AM- and WJ-MSCs in vitro features that may be relevant for their clinical employment. MSCs were more easily isolated from WJ, even if MSCs derived from AM exhibited more rapid proliferation ( P < 0.05). Osteogenic and chondrogenic differentiation were more prominent in MSCs derived from WJ. This is also suggested by the lower adhesion of AM cells, demonstrated by the greater volume of spheroids after hanging drop culture ( P < 0.05). Data obtained by PCR confirmed the immunosuppressive function of AM and WJ-MSCs and the presence of active genes specific for anti-inflammatory and angiogenic factors (IL-6, IL 8, IL-β1). For the first time, by means of transmission electron microscopy (TEM), we ascertained that equine WJ-MSCs constitutively contain a very impressive number of large vesicular structures, scattered throughout the cytoplasm. Moreover, an abundant extracellular fibrillar matrix was located in the intercellular spaces among WJ-MSCs. Data recorded in this study reveal that MSCs from different fetal tissues have different characteristics that may drive their therapeutic use. These finding could be noteworthy for horses as well as for other mammalian species, including humans., (© 2017 Society for Reproduction and Fertility.)
- Published
- 2017
- Full Text
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