70 results on '"De Mauro, D."'
Search Results
2. Role of bariatric surgery in reducing periprosthetic joint infections in total knee arthroplasty. A systematic review and meta-analysis
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De Mauro, D., Balato, G., Festa, E., Di Cristo, A., Marasco, L., Loffredo, G., Di Lauro, P., Di Gennaro, D., Maccauro, G., and Rosa, D.
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- 2024
- Full Text
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3. Clinical Application of Adipose Derived Stem Cells for the Treatment of Aseptic Non-Unions: Current Stage and Future Perspectives—Systematic Review
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Smakaj, Amarildo, De Mauro, Domenico, Rovere, Giuseppe, Pietramala, Silvia, Maccauro, Giulio, Parolini, Ornella, Lattanzi, Wanda, Liuzza, Francesco, Smakaj A., De Mauro D., Rovere G., Pietramala S., Maccauro G. (ORCID:0000-0002-7359-268X), Parolini O. (ORCID:0000-0002-5211-6430), Lattanzi W. (ORCID:0000-0003-3092-4936), Liuzza F., Smakaj, Amarildo, De Mauro, Domenico, Rovere, Giuseppe, Pietramala, Silvia, Maccauro, Giulio, Parolini, Ornella, Lattanzi, Wanda, Liuzza, Francesco, Smakaj A., De Mauro D., Rovere G., Pietramala S., Maccauro G. (ORCID:0000-0002-7359-268X), Parolini O. (ORCID:0000-0002-5211-6430), Lattanzi W. (ORCID:0000-0003-3092-4936), and Liuzza F. more...
- Abstract
Fracture non-union is a challenging orthopaedic issue and a socio-economic global burden. Several biological therapies have been introduced to improve traditional surgical approaches. Among these, the latest research has been focusing on adipose tissue as a powerful source of mesenchymal stromal cells, namely, adipose-derived stem cells (ADSCs). ADSC are commonly isolated from the stromal vascular fraction (SVF) of liposuctioned hypodermal adipose tissue, and their applications have been widely investigated in many fields, including non-union fractures among musculoskeletal disorders. This review aims at providing a comprehensive update of the literature on clinical application of ADSCs for the treatment of non-unions in humans. The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Only three articles met our inclusion criteria, with a total of 12 cases analyzed for demographics and harvesting, potential manufacturing and implantation of ADSCs. The review of the literature suggests that adipose derived cell therapy can represent a promising alternative in bone regenerative medicine for the enhancement of non-unions and bone defects. The low number of manuscripts reporting ADSC-based therapies for long bone fracture healing suggests some critical issues that are discussed in this review. Nevertheless, further investigations on human ADSC therapies are needed to improve the knowledge on their translational potential and to possibly achieve a consensus on their use for such applications. more...
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- 2022
4. Preliminary data on the neurophysiological evaluation of male sexual dysfunction in patients with pelvic ring fractures: a multicenter retrospective study.
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ROVERE, G., FUSCO, A., SMAKAJ, A., DE MAURO, D., DE VITIS, R., PADUA, L., MECCARIELLO, L., FIDANZA, A., ERASMO, R., PERESSON, M., NOIA, G., MACCAGNANO, G., MACCAURO, G., and LIUZZA, F.
- Abstract
OBJECTIVE: Traumatic pelvic ring fractures include several comorbidities due to the close anatomical relationship between the skeletal system, pelvic organs, and neurovascular structures. In this retrospective multicenter study, we evaluated patients complaining of sexual dysfunction following pelvic ring fractures, assessed through different neuro-physiological examinations. PATIENTS AND METHODS: Patients were enrolled one year after the injury according to their reported ASEX scores and evaluated on the basis of the Tile's type of pelvic fracture. Lower limb and sacral somatosensory evoked potentials, pelvic floor electromyography, bulbocavernosus reflex and pelvic floor motor evoked potentials were recorded, according to the neurophysiological indications. RESULTS: A total of 14 male patients (mean age 50.4; 8 subjects Tile-type B and 6 Tile-type C) were enrolled. The ages between the Tile B group and the Tile C group of patients were not significantly different (p=0.187), while the ASEX scores were significantly different (p=0.014). In 57% of patients (n=8), no alterations in nerve conduction and/or pelvic floor neuromuscular responses were found. In 6 patients, electromyographic signs of denervation were revealed (2 patients), and alterations of the sacral efferent nerve component were detected in 4 patients. CONCLUSIONS: Sexual dysfunctions after a traumatic pelvic ring fracture are more common in Tile-type B. Our preliminary data did not reveal a significant association with neurogenic aetiology. Other causes could explain the complaining impairments. [ABSTRACT FROM AUTHOR] more...
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- 2023
5. Robotic-assisted unicompartimental knee arthroplasty performed with Navio system: a systematic review.
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ARE, L., DE MAURO, D., ROVERE, G., FRESTA, L., TARTARONE, M., ILLUMINATI, A., SMAKAJ, A., MACCAURO, G., and LIUZZA, F.
- Abstract
OBJECTIVE: Robotic-assisted arthroplasty is a relatively modern concept, quickly arising in its use. The aim of this systematic review is to assess, according to the existing literature, which are the functional and clinical outcomes and component positioning and implant survivorship of unicompartmental knee arthroplasty surgery performed using an image-free hand-held robotic system. Moreover, we analyzed whether there are significant differences and advantages compared to conventional surgery. MATERIALS AND METHODS: A systematic review has been performed on studies published between 2004 and 2021, on the electronic library databases, according to the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement. The inclusion criteria were all studies described as unicompartmental knee arthroplasty performed with the Navio robotic system. RESULTS: Fifteen studies were included, and 1,262 unicondylar knee arthroplasties were analyzed. These studies showed a satisfactory recovery of joint function, with a good range of motion (extension <5° and flexion which ranged from 105° to 130.3°) in patients of the NAVIO group. The revision rate was <2% while the infection rate <1%; no postoperative transfusion was needed in all UKA implanted. CONCLUSIONS: The use of a robotic tool for unicompartmental knee arthroplasty (UKA) could lead to a better implant positioning and joint alignment than conventional surgery. There is still limited evidence to support that the use of this robot in unicompartmental knee arthroplasty is a greater survivorship than other systems or conventional techniques; therefore, a longterm follow-up is needed. [ABSTRACT FROM AUTHOR] more...
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- 2023
6. Navigated percutaneous screw fixation of the pelvis with O-arm 2: two years' experience
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Ciolli G., Caviglia D., Vitiello C., Lucchesi S., Pinelli C., De Mauro D., Smakaj A., Rovere G., Meccariello L., Camarda L., Mac-Cauro G., Liuzza F., Ciolli G., Caviglia D., Vitiello C., Lucchesi S., Pinelli C., De Mauro D., Smakaj A., Rovere G., Meccariello L., Camarda L., Mac-Cauro G., and Liuzza F. more...
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Sacrum ,3D-fluoroscopic navigation ,Bone Screws ,Pelvis ,Iliosacral fixation ,Fracture Fixation, Internal ,Imaging, Three-Dimensional ,Surgery, Computer-Assisted ,O-arm Stealth Station S8 ,Fragility fracture of pelvis ,Humans ,Pelvic ring fractures ,Tomography, X-Ray Computed ,Retrospective Studies - Abstract
Aim To evaluate the case series of the patients operated with percutaneous fixation by the navigation system based on 3D fluo-roscopic images, to assess the precision of a surgical implant and functional outcome of patients. Methods A retrospective study of pelvic ring fractures in a 2-year period included those treated with the use of the O-Arm 2 in com-bination with the Stealth Station 8. Pelvic fractures were classifi-ed according to the Tile and the Young-Burgess classification. All patients were examined before surgery, with X-rays and CT scans, and three days after surgery with additional CT scan. The positioning of the screws was evaluated according to the Smith score, the outcome with the SF-36. Results Among 24 patients 18 were with B and six with C type fracture according to Tile, while eight were with APC, 10 LC, and six with VS type according to Young-Burgess classification. All patients were treated in the supine position, except two. A total of 41 iliosacral or transsacral screws and five anterior pelvic ring screws were implanted. The medium surgical time per screw was 41 minutes. There was a perfect correspondence of screw scores value from post-operative CT and intraoperative fluoroscopy. The mean screw score value was 0.92. There were no cases of poor positioning. The median follow-up was 17.5 months. The patients were satisfied with their health condition on SF-36. Conclusion The use of the O-arm guarantees great precision in the positioning of the screws and reduced surgical times with excellent clinical results in patients. more...
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- 2020
7. Cryptosporidiosis in a patient with Crohn's disease under anti-TNF treatment
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Miranda A, De Musis C, Sgambato D, De Mauro D, Picascia D, Avallone L, Romano L, D'Armiento FP, Romano M., Miranda, A, De Musis, C, Sgambato, D, De Mauro, D, Picascia, D, Avallone, L, Romano, L, D'Armiento, Fp, and Romano, M. more...
- Published
- 2019
8. Treatment options for proximal periprosthetic femoral fractures in Total Hip Arthroplasty: a single center experience.
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MARINO, S., GIULIANI, A., DE MAURO, D., ROVERE, G., SMAKAJ, A., SASSARA, G. M., ARE, L., MACCAURO, G., and LIUZZA, F.
- Abstract
OBJECTIVE: Proximal periprosthetic femoral fractures (PPFFs) are gradually increasing and surgical management is often associated with high risk of complications, due to elderly population and associated comorbidities. PATIENTS AND METHODS: We retrospectively assessed 39 patients at least at 2-years follow-up. We identified two study groups, similar for demographic data. Group A included patients surgically treated without involving prosthetic implants, whereas Group B included patients in which an implant revision was performed. RESULTS: Data were recorded from January 2017 to February 2020, and 39 patients were included: 30 females (76.9%) and 9 males (23.1%), with a confirmed diagnosis of periprosthetic fracture of the proximal femur. 23 (58.9%) patients were treated with Open Reduction and Internal Fixation (ORIF), 12 (30.7%) with revision surgery and 4 (10.3%) were treated by modular megaprosthesis. CONCLUSIONS: The treatment options considered in the study, revision arthroplasty and internal fixation had shown no significant differences as a matter of clinical outcomes and post-operative complications. [ABSTRACT FROM AUTHOR] more...
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- 2022
9. Medial gastrocnemius flap for the treatment of infected knee prostheses.
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ROVERE, G., SMAKAJ, A., DE MAURO, D., MARINO, S., VITIELLO, R., MESCHINI, C., ZIRANU, A., LIUZZA, F., MACCAURO, G., and PATAIA, E.
- Abstract
OBJECTIVE: Muscular flaps may represent a valid treatment option for prosthetic infection after knee arthroplasty. PATIENTS AND METHODS: We present the results of 20 consecutive patients treated with the use of medial gastrocnemius flap for the management of different types of injuries or integumentary defects after total knee arthroplasty. Tissue necrosis or dehiscence occurred within 1 and 2 months after arthroplasty. The mean follow-up was 23.4 (12-60) months. Clinical outcome was evaluated according to the infection control rate and post-operative Knee Society Score (KSS). RESULTS: Prosthesis salvage and complete restoration of skin coverage were achieved in all patients. Functional assessment was performed using the KSS score. The final knee KSS score was classified as excellent (score: 80-100) in 0 patients, good (score: 70-79) in 17 patients, fair (score: 60-69) in 2 patients, and poor (score: 60) in 1 patient. Residual Extension Deficit: 0-20°; Very Satisfactory in 17 patients. 30-70° Satisfactory in 2 patients, 80-90° Unsatisfactory in 1 patient. Patients who successfully underwent flap treatment experienced a much greater increase in both components of the KSS score. CONCLUSIONS: The results highlight the effectiveness of medial gastrocnemius muscular flap for the treatment of prosthetic knee infection, in terms of function, limb salvage, cost-effectiveness and post-surgery quality of life. Further larger studies may consolidate these findings. [ABSTRACT FROM AUTHOR] more...
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- 2022
10. Cryptosporidiosis in a patient with Crohn's disease under anti-TNF treatment.
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Miranda, A., De Musis, C., Sgambato, D., De Mauro, D., Picascia, D., Avallone, L., Romano, L., Francesco, P., D'Armiento, and Romano, M.
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- 2019
11. Lavorazioni particolari del solfuro di carbonio. Presentazione di una casistica di pregressa esposizione
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Loi, F, Maiorano, M, Vertugno, T, Memìnicacci, F, Patacchini, E, Motolese, Eduardo, Calfa, C, and De Mauro, D.
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- 1983
12. Bone alterations in inflammatory bowel diseases
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Giovanni Iolascon, Lorenzo Romano, Domenico De Mauro, Giuseppe Toro, Marco Romano, D. Sgambato, Agnese Miranda, Emanuele Ferrante, Antimo Moretti, Francesca Gimigliano, Cristiana De Musis, Sgambato, D., Gimigliano, F., De Musis, C., Moretti, A., Toro, G., Ferrante, E., Miranda, A., De Mauro, D., Romano, L., Iolascon, G., and Romano, M. more...
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Crohn’s disease ,Bone density ,Osteoporosis ,Population ,Review ,Inflammatory bowel diseases ,Inflammatory bowel disease ,Bone resorption ,Metabolic bone disease ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Bone mineral density ,education ,Bone mineral ,education.field_of_study ,Crohn's disease ,business.industry ,Osteopenia ,Bone alterations ,General Medicine ,medicine.disease ,digestive system diseases ,Ulcerative colitis ,030220 oncology & carcinogenesis ,Immunology ,Bone alteration ,030211 gastroenterology & hepatology ,business - Abstract
Inflammatory bowel diseases (IBDs) are characterized by a multifactorial partially unknown etiology that involves genetic, immunological and environmental factors. Up to 50% of IBD patients experience at least one extraintestinal manifestation; among them is the involvement of bone density which is referred to as metabolic bone disease (MBD), including osteopenia and osteoporosis. Bone alterations in IBDs population appear to have a multifactorial etiology: Decreased physical activity, inflammation-related bone resorption, multiple intestinal resections, dietary malabsorption of minerals and vitamin D deficiency, genetic factors, gut-bone immune signaling interaction, steroid treatment, microbiota and pathogenic micro-organisms interaction, and dietary malabsorption of minerals, that, all together or individually, may contribute to the alteration of bone mineral density. This review aims to summarize the prevalence and pathophysiology of metabolic bone alterations in IBD subjects outlining the main risk factors of bone fragility. We also want to underline the role of the screening and prophylaxis of bone alterations in Crohn's disease and ulcerative colitis patients and the importance of treating appropriately MBD. more...
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- 2019
13. Differences in microorganism profile in periprosthetic joint infections of the hip in patients affected by chronic kidney disease.
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Stimolo D, Budin M, De Mauro D, Suero E, Gehrke T, and Citak M
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- Humans, Male, Female, Retrospective Studies, Aged, Hip Prosthesis adverse effects, Hip Prosthesis microbiology, Aged, 80 and over, Middle Aged, Risk Factors, Prosthesis-Related Infections microbiology, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic microbiology, Arthroplasty, Replacement, Hip adverse effects
- Abstract
Background: Patients affected by chronic kidney disease (CKD) are at increased risk of periprosthetic joint infection (PJI) after total hip arthroplasty (THA). This patient population has a higher risk of recurrent infections and hospitalization. The aim of this study is to compare the profile of microorganisms in patients with CKD and PJI of the hip versus controls and to individuate potentially unusual and drug-resistant microorganisms among the causative bacteria., Materials and Methods: A total of 4261 patients affected by PJI of the hip were retrospectively studied. Patients affected by CKD in this population were identified and compared with a control group of patients with PJI but without CKD. Data on patient characteristics and comorbidities were collected. The microorganisms responsible for PJI were identified and compared between both groups., Results: The CKD group included 409 patients, 54.3% male, mean age of 73.8 ± 8.9 years, a higher body mass index (BMI) than the general population (29.88 ± 5.90 kg/m
2 ), and higher age-adjusted CCI of 6.15 ± 2.35. Overall, 70 different isolates of microorganisms were identified, including 52 Gram-positive spp., 28 Gram-negative spp., 3 fungi, and 1 mycobacterium. Polymicrobial infections were more common in CKD group than controls (47.9% versus 30.9%; p < 0.0001). Staphylococcus spp. were the most common bacteria in both groups, followed by Gram-negative Enterobacteriaceae and Streptococcus spp. CKD group showed a higher risk of developing infections caused by Staphylococcus aureus (p = 0.003), Gram-negative bacteria, and Candida (p = 0.035)., Conclusions: Renal failure exposes patients who undergo THA to PJI caused by microorganisms that are potentially more drug resistant, leading to a higher risk of treatment failure. Knowing in advance the different microorganism profiles could help to plan a different surgical strategy., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval for this study was obtained from the Ethik-Komission der Arztekammer Hamburg, Hamburg, Germany (2024–300431-WF). The study adhered to the principles outlined in the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: One of the authors (T.G.) certifies receipt of personal payments or benefits, during the study period, in an amount of less than USD 10,000 from W. Link & Co KG, outside the submitted manuscript. One of the authors (T..G) certifies receipt of personal payments or benefits, during the study period, in an amount of less than USD 10,000 from Zimmer Biomet Inc; and in an amount of less than USD 10,000 from CeramTec Co, all outside the submitted manuscript. One or more of the authors (M.C.) certifies receipt of personal payments or benefits, during the study period, in an amount of less than USD 10,000 from W. Link & Co KG, outside the submitted manuscript., (© 2024. The Author(s).) more...- Published
- 2024
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14. Can a 1.5-Stage Revision Be an Effective Alternative for Chronic Periprosthetic Hip and Knee Infections? A Systematic Review and Meta-Analysis.
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Festa E, Ascione T, De Mauro D, Di Gennaro D, Baldini A, and Balato G
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Background: A 1.5-stage revision could be an alternative to a 2-stage revision for treating hip and knee chronic periprosthetic infections, guaranteeing the maintenance of joint function and infection control and preventing infection-free patients from undergoing further surgery. Our systematic review aimed to answer several questions about the indication, the infection eradication rate, and the long-term functional outcome of 1.5-stage revisions used to treat chronic periprosthetic infections of the hip and knee., Methods: A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including studies dealing with the use of 1.5-stage and two-stage surgery for chronic periprosthetic joint infection following total knee arthroplasty or total hip arthroplasty The Coleman Methodology Score and the Methodological Index for Nonrandomized Studies score were used to assess the quality of the studies. A meta-analysis was performed to evaluate the infection eradication rate using either the 1.5-stage revision or the 2-stage technique. A total of 494 patients (111 hips and 385 knees) who underwent 1.5-stage with a mean age of 69 years (range, 61 to 82) were identified in the ten included studies., Results: The most common cause of reoperation was the conversion to the definitive prosthesis, followed by aseptic loosening. Infection control was reached in 84.6% of the 1.5-stage and 76.1% of the two-stage cohorts. The infection recurrence rate was higher in the two-stage cohort than the 1.5-stage group (21.8 versus 14.3%)., Conclusions: The 1.5-stage technique represents a valid treatment option in selected patients who have chronic periprosthetic joint infection who cannot undergo further surgeries, adding together the benefits of the 1- and 2-stage procedures. Furthermore, the 1.5-stage showed a better success rate in the infection resolution than the 2-stage technique., (Copyright © 2024 Elsevier Inc. All rights reserved.) more...
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- 2024
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15. Treatment options for unstable posterior pelvic ring lesions: A multicenter retrospective cohort study of the Italian Society for the Traumatology of the Pelvis.
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De Mauro D, Aprato A, Bove F, Mezzadri U, Giorgi PD, Casiraghi A, Galante C, Erasmo R, Santolini F, Formica M, Smakaj A, Rovere G, Ceccarelli M, Fidanza A, Faugno L, Balagna A, Fabbro M, Are L, Moretti F, Marino S, Maccauro G, Massè A, and Liuzza F more...
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- Humans, Retrospective Studies, Female, Male, Adult, Middle Aged, Treatment Outcome, Italy, Radiography, Pelvic Bones injuries, Pelvic Bones surgery, Pelvic Bones diagnostic imaging, Fracture Fixation, Internal methods, Fractures, Bone surgery, Fractures, Bone diagnostic imaging, Quality of Life, Bone Screws
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Purpose: Posterior pelvic ring lesions are a common finding in patients with pelvic trauma, representing a challenging condition for trauma surgeons. Surgical options are different and there is not yet evidence about the best option. Aim of the study are: (i) to compare Lumbopelvic fixation (LPF) and ilio-sacral screw fixation (ISS) regarding clinical and radiological outcome in unstable posterior pelvic ring injuries, both as whole population and single similar fracture types according to Tile classification (C1vsC1, C2vsC2, C3vsC3); (ii) to analyze clinical outcomes and complications in lumbopelvic fixation group, comparing open and closed reduction technique., Methods: A retrospective multicenter study was performed. Data of the patients were collected. Inclusion criteria were: (i) unstable posterior ring lesions Tile C type, (ii) surgically treated either through ISS (Group A) or LPF (Group B), (iii) minimum follow-up 12 months. Radiological evaluation was made through plain radiographs in Antero-posterior (AP), inlet and outlet views. Last clinical evaluation at 12 months was assessed through Majeed Score, and quality of life (QoL) through SF-12., Results: Group A was represented by 76 patients, and Group B by 42. Group B had better result in Majeed score for non-workers (average 60.1 ± 21.6 vs 65.0 ± 15.6, p = 0.016*). Comparing only C3-type lesions, Group A showed a higher rate of implants breakage (p = 0.032*). Other differences had p > 0.05. Comparing patients underwent open (ORIF) or closed (CRIF) reduction in Group B, CRIF group had shorter hospitalization (47.2 vs 23.4 days, p = 0.020*), an earlier full weight-bearing recovery (4.1 vs 2.6 months, p = 0.035*) and a better Majeed score in workers patients (70.3 vs 82.8, p = 0.019*). Better results for CRIF group were also recorded in quality of life (QoL), both in mental (45.1 vs 55.2, p = 0.040*) and physical outcome (31.9 vs 50.7, p < 0.001*)., Conclusion: ISS and LPF represent both good choices in posterior pelvic ring lesions, however some significant differences were noted. LPF seems to be preferable if the patient did not work before the trauma, due to better clinical outcome. In Tile C3 lesions, LPF have lower breakage rates. If LPF is chosen, CRIF provides better clinical outcomes, QoL and lower hospitalization., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.) more...
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- 2024
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16. A comparison between 3D printed models and standard 2D planning in the use of metal block augments in revision knee arthroplasty.
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Balato G, De Matteo V, Guarino A, De Mauro D, Baldi D, Cavaliere C, Salvatore M, Citak M, and Mariconda M
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- Humans, Female, Male, Aged, Middle Aged, Aged, 80 and over, Tomography, X-Ray Computed, Prosthesis Design, Tibia surgery, Tibia diagnostic imaging, Femur surgery, Femur diagnostic imaging, Prosthesis-Related Infections surgery, Arthroplasty, Replacement, Knee methods, Arthroplasty, Replacement, Knee instrumentation, Printing, Three-Dimensional, Reoperation, Knee Prosthesis
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Objectives: The study focused on the ability to predict the need and size of femoral and tibial augmentation using standard two-dimensional (2D) templates and models created with three-dimensional (3D) printing in surgical planning., Patients and Methods: This observational cohort study included 28 consecutive patients (22 females, 6 males; mean age: 71±7.3 years; range, 54 to 82 years) with periprosthetic joint infection recruited between March 2021 and September 2023 undergoing revision total knee arthroplasty revision (TKA). Standard planning was made using calibrated X-ray images. The 3D planning started with computed tomography scans to generate a 3D template of the distal femur and proximal tibia. The model was exported to a 3D printer to produce a patient-specific phantom. The surgery was then simulated on the 3D phantom using revision knee arthroplasty instrumentation to evaluate the appropriate augmentation to use until a correct alignment was obtained., Results: Three-dimensional planning predicted the need for femoral and tibial augments in 22 (78.6%) cases at both the tibial and femoral components, while 2D planning correctly predicted the need for augmentation in 17 (60.7%) for the tibial side and 18 (64.3%) for the femoral side. The Cohen's kappa demonstrated a significant agreement between the 3D planning for the femoral metal block and the intraoperative requirement (kappa=0.553), whereas 2D planning showed only nonsignificant poor agreement (kappa=0.083). In contrast, the agreement between 2D or 3D preoperative planning for tibial augment and the intraoperative requirement was nonsignificant (kappa=0.130 and kappa=0.158, respectively). On the femoral side, 2D planning showed only a fair nonsignificant correlation (r=0.35, p=0.069), whereas 3D planning exhibited substantial agreement with the actual thickness of the implanted augment (r=0.65, p<0.001). On the tibial side, 3D and 2D planning showed substantial agreement with the actual size of implanted augments (3D planning, r=0.73, p<0.001; 2D planning, r=0.69, p<0.001)., Conclusion: Prediction based on 3D computed tomography segmentation showed significant agreement with the intraoperative need for augmentations in revision TKA. The results suggest that planning with 3D printed models represents a stronger aid in this kind of surgery rather than standard 2D planning, providing greater accuracy in the prediction of the required augmentation in revision TKA. more...
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- 2024
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17. Evaluating Treatment Outcomes for Pelvic Insufficiency Fractures: A Systematic Review.
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Sassara GM, Smakaj A, De Mauro D, Righini R, Arnone A, Rovere G, El Ezzo O, Farsetti P, Tarantino U, and Liuzza F
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Background : Pelvic insufficiency fractures (PIF) are typical in geriatric populations with reduced bone quality, most commonly in elderly postmenopausal women. These fractures are usually caused by low-energy forces over the bones during ordinary life and cause disabling pain. Treatment options range from conservative to operative. The aim of this study is to assess the outcomes of treatments for pelvic insufficiency fractures, determining optimal approaches between surgical intervention and conservative management. Methods : This literature review systematically examines articles focusing on patients with PIF, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and using PubMed, Medline, and the Cochrane Library database. We took into account only full-text articles in indexed journals with available English abstracts, considering data about patient demographics, surgery, and outcomes. Results: After screening 128 articles, this study reviewed 20 manuscripts involving 1499 patients, mostly elderly females and focusing on sacrum fractures. Common treatments included conservative methods and sacroplasty, with a few complications reported. Osteoporosis was the prevalent comorbidity, and the survival rate post-treatment was high at 92.3%. Mobility outcomes varied, with some patients experiencing significant autonomy loss. The average follow-up period was over 17 months. Conclusions : This study found a cautious approach to surgery (timing of three weeks), which is reserved only for specific patterns, and it leads to increased autonomy and a lower risk of mortality. Due to the lack of pre- and postoperative scores as well as conflicting results, it is imperative to undertake further studies and research to be able to compare the alternative treatments efficiently. more...
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- 2024
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18. Sex-related differences in periprosthetic joint infection research.
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De Mauro D, Meschini C, Balato G, Ascione T, Festa E, Bizzoca D, Moretti B, Maccauro G, and Vitiello R
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Introduction : Periprosthetic joint infections (PJIs) have emerged as a focal point in the realm of orthopedics, garnering widespread attention owing to the escalating incidence rates and the profound impact they impose on patients undergoing total joint arthroplasties (TJAs). Year after year, there has been a growing trend in the analysis of multiple risk factors, complication rates, and surgical treatments in the field. This study aims to illuminate the status of the sex-related differences in periprosthetic joint infections and advance research in this field. Methods : A systematic review was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The final reference list comprised longitudinal studies (both retrospective and prospective) and randomized controlled trials. A sex-based analysis was conducted to assess differences between males and females. Results : A total of 312 studies were initially identified through online database searches and reference investigations. Nine studies were subsequently included in the review. Eight out of nine studies examined the risk of developing PJI after total joint replacement. Notably, only half of these studies demonstrated a statistically significant value, with a p value < 0.05 , indicating a higher risk of infectious complications in males compared to females. Conclusion : According to the current literature, there appears to be a propensity for males to develop periprosthetic joint infection after total joint arthroplasty at a higher rate than the female population. Enhancing sex-related analysis in this field is imperative for gathering more robust evidence and insights., Competing Interests: The contact author has declared that none of the authors has any competing interests., (Copyright: © 2024 Domenico De Mauro et al.) more...
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- 2024
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19. Fragility Fractures in End-Stage Chronic Kidney Disease (CKD) Population: Patient-Related and CKD-Related Factor Analysis-A Single-Center Experience.
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De Mauro D, De Luca G, Marino S, Smakaj A, Rovere G, Liuzza F, Covino M, Fulignati P, Grandaliano G, and El Ezzo O
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Background: Chronic kidney disease (CKD) stands as a prevalent global health concern, and mineral and bone disease are among the most impactful consequences. A severe complication arising from mineral and bone disease is the occurrence of fragility fractures, which disproportionately affect individuals with CKD compared to the general population. The prevalence of these fractures impacts both survival rates and quality of life. The aims of this study are analyzing and identifying (i) patient-related risk factors and (ii) CKD-related risk factors to contribute to the development of preventive measures for fragility fractures for this population. Methods: A retrospective, single-center observational study was conducted, encompassing patient data from the years 2021 to 2023. Registry data were recorded, including patient-related and CKD-related data. Patients were interviewed about traumatological history, and their answers were recorded. Logistic regression analysis was employed to investigate the association between independent variables and dependent variables. Results: Eighty-four patients, with a mean age of 64.3 ± 15.2 years and a male percentage of 58.3%, were included in this study. Among them, 19.5% exhibited smoking habits. The mean Charlson Comorbidity Index was 3.06 ± 1.21. All patients were diagnosed with end-stage chronic kidney disease, with mean durations of 208 months from the diagnosis and 84.5 months from the beginning of dialysis. The logistic regression analysis, adjusted for age, sex, and CCI, revealed that smoking habits play a significant role as a risk factor for fragility fractures in lower limbs ( p: 0.011 *). The incidence of fragility fractures increases directly proportionally to the time since diagnosis ( p -value: 0.021 *) and the beginning of dialysis treatment ( p -value: 0.001 *). Conclusions: Among patient-related factors, smoking habits seem to significantly affect lower-limb fracture rates ( p < 0.05), whereas among CKD-related factors, time since CKD diagnosis and time since the beginning of dialysis treatment are directly related to higher risks of fragility fractures. No relevant correlations emerged in the studied treatments, except for a reduction in proximal femur fracture occurrence when patients underwent a combined treatment of a calcimimetic and a vitamin D analog. more...
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- 2024
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20. The Effect of Spacer Treatment of Infected Hip and Knee Arthroplasties on Patients' Mental Health: A Narrative Review of the Literature.
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Di Gennaro D, Coletta G, Festa E, De Mauro D, Rizzo M, Diana L, Balato G, and Mariconda M
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Background: The gold standard treatment for periprosthetic joint infections is the two-stage revision that includes the spacer placement before definitive reimplantation. The management of PJI affects patients' joint function and, subsequently, their mental health. Even though significant advances have been achieved, little to no attention has been paid to the psychological implications. So, based on standardized patient-reported outcome measures (PROMs), this study aimed to clarify the effect of spacer treatment of infected hip and knee arthroplasties on patients' mental health., Methods: We performed research on the literature on PJIs in the English language using the MEDLINE database with the search strings "spacer" OR "spacers" AND "hip" OR "knee" AND "SF-12" OR "SF-36" OR "EQ-5" OR "mental" OR "depression" OR "anxiety." The reference lists of selected articles were also hand-searched for any additional articles., Results: A total of 973 published papers were extracted, and 9 papers were finally included. A total of 384 patients who underwent spacer placement for PJI were identified. Of these 384 patients, 54% were female. The mean age ranged from 62 to 78.2 years. Of the11 papers identified for this review, 4 analyzed only hip spacers, including 119 patients; 4 only knee spacers, evaluating 153 patients; while a single study included 112 patients for both joints., Conclusions: Patients with the spacer are living in a state of mental upset, albeit better than the preoperative state. Clinical improvement with the review is not assured. The alteration of mental state turns out not to be transient for all the patients. more...
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- 2024
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21. Augmented Articulating Spacers in Infected Total Knee Arthroplasty: Surgical Technique.
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De Mauro D, Festa E, Di Gennaro D, Ascione T, Coletta G, Mariconda M, and Balato G
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Periprosthetic joint infections (PJIs) are a prominent subject of discussion in orthopedics and are frequently debated at conferences and congresses. In the context of PJIs affecting the knee, the decision between following a one-stage or two-stage treatment approach has historically been a pivotal consideration. The first option is limited by indications and potentially devastating complications in case of failure, whereas the second is widely accepted as the gold standard. Initially, the spacer was conceived solely to restore and maintain knee space after removal of the implant. An articulating spacer was introduced to mitigate patient limitations and improve knee function and quality of life. Two main types of articulating spacers are utilized in knee PJI treatment: the mold spacer and the metal-on-poly spacer. This text outlines a technique for metal-on-poly spacer implants. Based on our experience and the existing literature, this approach facilitates early full weight bearing and faster recovery of the knee's range of motion, ultimately improving the quality of life after surgery, thus allowing the spacer retention for an extended period, as suggested by the 1.5-stage revision. more...
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- 2024
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22. Triangular osteosynthesis and lumbopelvic fixation as a valid surgical treatment in posterior pelvic ring lesions: a systematic review.
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Rovere G, De Mauro D, Smakaj A, Sassara G, De Vitis R, Farsetti P, Camarda L, Maccauro G, and Liuzza F
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Objective: Unstable fractures of the sacrum often occur in patients with pelvic fractures and represent a real challenge for the orthopedic surgeon. Triangular osteosynthesis (TOS) and lumbopelvic fixation (LP) may represent a valid management option for the treatment of this condition. We present a systematic literature review about lumbopelvic fixation and triangular fixation as treatment option for unstable sacral fractures, to assess clinical and radiological outcomes after surgery and to evaluate appropriate indications and impact on the natural history of sacral fractures., Methods: The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 50 articles out of 108 titles, were considered eligible for the full-text analysis. Finally, 16 studies that met inclusion criteria were included in this review., Results: Overall, 212 patients (87 males, 58 females) with sacral fractures treated with TOS triangular fixation or LP lumbopelvic fixation were collected. The mean age was 37.6 years. Mean follow-up reported in all studies was 24.14 months., Conclusion: The results presented by the different authors, highlight the effectiveness of TOS triangular fixation and LP lumbopelvic fixation for the treatment of unstable sacral fractures associated with other pelvic fractures, in terms of function, stability, cost-effectiveness, and quality of life postoperatively., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Rovere, De Mauro, Smakaj, Sassara, De Vitis, Farsetti, Camarda, Maccauro and Liuzza.) more...
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- 2024
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23. Use of intra-operative fluorescence imaging in periprosthetic joint infection: State of the art and future perspectives.
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De Mauro D, Salber J, Stimolo D, Florian E, and Citak M
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- Humans, Optical Imaging methods, Prosthesis-Related Infections diagnosis
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Background: In periprosthetic joint infections (PJIs), the surgeon's role becomes pivotal in addressing the infection locally, necessitating the surgical removal of infected and necrotic tissue. Opportunity to enhance the visualization of infected tissue during surgery could represent a game-changing innovation., Objective: The aim of this narrative review is to delineate the application of intraoperative fluorescence imaging for targeting infected tissues in PJIs., Methods: A systematic review, adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, was carried out. The search included multiple online database; MEDLINE, Scopus, and Web of Science. For data extraction the following were evaluated: (i) diagnosis of musculoskeletal infection; (ii) use of intraoperative fluorescence imaging; (iii) infected or necrotic tissues as target., Results: Initially, 116 studies were identified through online database searches and reference investigations. The search was narrowed down to a final list of 5 papers for in-depth analysis at the full-text level. Subsequently, 2 studies were included in the review. The study included a total of 13 patients, focusing on cases of fracture-related infections of the lower limbs., Conclusion: The primary and crucial role for orthopedic surgeons in PJIs is the surgical debridement and precise removal of necrotic and infected tissue. Technologies that enable clear and accurate visualization of the tissue to be removed can enhance the eradication of infections, thereby promoting healing. A promising avenue for the future involves the potential application of intraoperative fluorescence imaging in pursuit of this objective. more...
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- 2024
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24. Thoracic synovial cyst as cause of cord compression in a patient with Charcot-Marie-Tooth disease.
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De Mauro D, Cicia A, Meluzio MC, Grillo G, Smakaj A, Perna A, and Tamburrelli FC
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- Male, Humans, Aged, 80 and over, Laminectomy methods, Charcot-Marie-Tooth Disease complications, Spinal Cord Compression etiology, Spinal Cord Compression surgery
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An 80-year-old male patient affected by Charcot-Marie-Tooth (CMT) disease came to our attention in July 2020, for the occurrence of low back pain and lower limb weakness, and also saddle anesthesia, urinary and faecal retention were referred. His diagnosis of CMT is dated back to 1955 and through the years, the clinical picture slowly worsened but never got particularly severe. The quick symptoms outbreak and the presence of urinary disturbances were red flags, which lead us to direct the diagnostic orientation elsewhere. A Magnetic Resonance Imaging of the thoraco-lumbar spinal cord was then performed and it was suggestive for synovial cyst at T10-T11. The patient underwent a decompression with laminectomy and then stabilized through arthrodesis. In the very next days after the surgery, the patient showed a sudden and significant improvement of his condition. At the last visit, he showed a remarkable relief of the symptoms, walking by himself. more...
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- 2023
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25. Outcomes at 2 years follow-up of sacral fractures associated with unstable vertical pelvic ring injuries in obese patients: a multicentric retrospective study.
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Liuzza F, Smakaj A, Rovere G, De Mauro D, Rollo G, Erasmo R, Fidanza A, Gruobor P, and Meccariello L
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- Humans, Retrospective Studies, Follow-Up Studies, Quality of Life, Fracture Fixation, Internal, Treatment Outcome, Spinal Fractures complications, Spinal Fractures surgery, Fractures, Bone complications, Fractures, Bone surgery
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Background and Aim: Sacral fractures with concomitant unstable pelvic ring injuries are severe conditions which occur in patients involved in high-energy trauma. When operative treatment is required, high surgical experience on the field is mandatory, especially in a sub-polpulation of obese patients which have increased risk of complications. The aim of this multicentric retroscpective study was to describe and analyze clinical and radiological outcomes of sacral vertical fractures in obese patients with a minimum of 2 years follow-up. Methods: A total of 121 pelvic fractures admitted to Emergency Departments of three II level trauma centres from April 2015 to April 2021 were retrospectively reviewed. Demographics, injury mechanism, surgical data and complications were collected. The quality of life and the pelvic function were respectively measured by SF-12 questionnaires, Denis Work Scale and Majeed Score. The inter-rater agreement between the clinical scores and the Denis Work Scale was assessed. Results: A total of 19 patients were included in the study. The average follow up was 41.16 months. The average BMI was 38.63 and the mean abdominal circumference was 128.10 cm. The average Majeed and SF-12 scores were respectively 66.47 and 74.32. Five patients were able to return to their previous employment. The post traumatic life's quality and related dysfunctions are influenced by the high BMI. Conclusions: Faster recovery and early weight-bearing should be persued in order to minimize complications, expecially in obese patients. In these sample of patients, "triangular osteosynthesis" was the best treatment choice for sacral vertical fractures. more...
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- 2023
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26. Correlation between traumatic pelvic ring injuries and sexual dysfunctions: a multicentric retrospective study.
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Rovere G, Smakaj A, Perna A, De Mauro D, Are L, Meccariello L, Fidanza A, Erasmo R, Falez F, Maccauro G, and Liuzza F
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- Humans, Male, Female, Adult, Middle Aged, Retrospective Studies, Pelvis, Sexual Behavior, Sexual Dysfunction, Physiological epidemiology, Sexual Dysfunction, Physiological etiology, Pelvic Bones injuries, Fractures, Bone complications, Fractures, Bone surgery
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Purpose: Among the functional impairments associated with pelvic ring injuries (PRI), sexual dysfunction (SD) is a common clinical issue. The aim of this study is to investigate correlations between traumatic PRI, genitourinary, and sexual dysfunctions, for a proper multidisciplinary treatment., Methods: We performed an observational, multicentric study, from January 2020 to 2022. We conducted a follow-up after surgery at three, six, 12, and 24 months by measuring the Female Sexual Functioning Index (FSFI), the International Index of Erectile Function (IIEF), the Arizona Sexual Experience Scale (ASEX), the Majeed Score, and the SF-12. Descriptive statistics was conducted on T-test, Whelc's test, and one-way ANOVA which were performed when appropriate., Results: A total of 76 patients (mean age 42.17 ± 15 years) were included in the study and allocated into three groups (A, B, and C). Tile A group revealed good sexual outcomes, similar to that of healthy patients. Tile B group demonstrated worsen SD than the previous group. In Tile C group, there was a longer average duration of the orthopaedic surgery when compared to group B. However, in terms of SDs, statistical significance could not be demonstrated between groups C and B., Conclusions: We observed a progressive spontaneous recovery of sexual function, corresponding to each PRI group. Moreover, men classified as B2 had milder SDs than B1 male patients., (© 2023. The Author(s).) more...
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- 2023
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27. Spring Plates as a Valid Additional Fixation in Comminuted Posterior Wall Acetabular Fractures: A Retrospective Multicenter Study.
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De Mauro D, Rovere G, Are L, Smakaj A, Aprato A, Mezzadri U, Bove F, Casiraghi A, Marino S, Ciolli G, Cerciello S, Maccagnano G, Noia G, Massè A, Maccauro G, and Liuzza F
- Abstract
Background: The posterior wall fracture is the most frequent pattern of acetabular fractures. Many techniques of fixation have been described in the literature and involve plates, screws, or a combination of both. This study aims to investigate the clinical and radiological outcomes of spring plates in the treatment of comminuted posterior wall acetabular fractures. (2) Methods: A retrospective multicenter (four level I trauma centers) observational study was performed. Patients with a comminuted posterior wall acetabular fracture treated with a spring plate (DePuy Synthes, West Chester, PA) were included. Diagnosis was made according to the Judet and Letournel classification. Diagnosis was confirmed with plain radiographs in an antero-posterior view and Judet views, iliac and obturator oblique views, and thin-slice CT with multiplanar reconstructions. (3) Results: Forty-six patients (34 males and 12 females) with a mean age of 51.7 years (range 19-73) were included. The most common mechanism of injury was motor vehicle accident (34 cases). In all cases, spring plates were placed under an overlapping reconstruction plate. The mean follow-up was 33.4 months (range 24-48). The mean period without weight-bearing was 4.9 weeks (range 4-7), and full weight-bearing was allowed at an average of 8.2 weeks (range 7-11) after surgery. (4) Conclusions: According to the present data, spring plates can be considered a viable additional fixation of the posterior wall acetabular fractures. more...
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- 2023
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28. Outcomes of acetabular fractures treated with acute fix and replace versus open reduction and internal fixation in elderly population: a multicentric retrospective study.
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Smakaj A, Rovere G, Scoscina D, De Mauro D, Erasmo R, Battiato C, Maccauro G, and Liuzza F
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- Acetabulum injuries, Acetabulum surgery, Aged, Fracture Fixation, Internal adverse effects, Fracture Fixation, Internal methods, Humans, Retrospective Studies, Treatment Outcome, Arthroplasty, Replacement, Hip adverse effects, Fractures, Bone etiology, Fractures, Bone surgery, Hip Fractures etiology, Hip Fractures surgery, Spinal Fractures surgery
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Purpose: The optimal operative treatment for displaced acetabular fractures in elderly population is still object of debate. Acute fix and replace procedure, the so called "combined hip procedure" (CHP), was introduced because of the poor results of the open reduction and internal fixation (ORIF) alone. The aim of the study is to compare clinical outcomes of CHP and ORIF alone for the treatment of acetabular fractures in elderly patients., Methods: This is the largest multicentric retrospective analytical study, with a case-control design on the issue. Hospital records and clinical notes were reviewed to collect demographic, peri-operative, and clinical data., Results: A total of 45 patients met the inclusion criteria: 24 patients entered the CHP group whereas 21 entered the ORIF control group. The mean age was 69.5 + - 1.12 years in the ORIF group and 73.4 + - 1.84 in the control group. The most frequent traumatic mechanism was the fall from same level in both groups (37.5% CHP; 42.9% ORIF). Operating time was significantly lower in the CHP group compared to the ORIF group (207 + - 11.0 ORIF; 175 + - 9.16 CHP; p < 0.05). Moreover, full weight-bearing was allowed significantly earlier in the CHP group compared to ORIF alone (37.3 + - 1.59 ORIF; 32.5 + - 1.69 CHP; p < 0.05). Among the clinician-completed scores, the HHS at three months was higher in the CHP group (66.3 + - 1.83 ORIF;73.6 + - 2.09 CHP; p < 0.05). All the other clinical outcomes were similar in both study groups., Conclusion: CHP is desirable treatment option in elderly patients with acetabular fracture when there are poor expected outcomes in terms of joint survival with ORIF alone., (© 2022. The Author(s).) more...
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- 2022
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29. Use of muscular flaps for the treatment of knee prosthetic joint infection: A systematic review.
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Rovere G, Smakaj A, Calori S, Barbaliscia M, Ziranu A, Pataia E, Maccauro G, De Mauro D, and Liuzza F
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Deep periprosthetic infection after total knee arthroplasty is a serious and challenging complication for the orthopedic surgeon. Muscular flaps may represent a valid treatment option for the treatment of this condition. We present a systematic literature review about the use of muscular flaps for the treatment of knee prosthetic joint infection. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 70 articles, out of 589 titles, were considered eligible for the full-text analysis. Finally, 27 studies that met inclusion criteria were included in this review. Overall, 345 patients (139 males, 206 females) suffering from TKA infection treated with muscular flaps were collected. The mean age was 57.3 years. Mean follow-up, reported in all studies, was 30.1 months. The results presented by the different authors, highlight the effectiveness of muscular flaps for the treatment of periprosthetic infection, in terms of function, limb salvage, prevention of recurrences, cost-effectiveness, and quality of life postoperatively. Muscle flaps provide an excellent management option for patients with persistent infection after total knee arthroplasty., Competing Interests: The authors declare no potential conflict of interest more...
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- 2022
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30. Clinical Application of Adipose Derived Stem Cells for the Treatment of Aseptic Non-Unions: Current Stage and Future Perspectives-Systematic Review.
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Smakaj A, De Mauro D, Rovere G, Pietramala S, Maccauro G, Parolini O, Lattanzi W, and Liuzza F
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- Adipocytes, Cell- and Tissue-Based Therapy, Humans, Regenerative Medicine, Adipose Tissue, Mesenchymal Stem Cells
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Fracture non-union is a challenging orthopaedic issue and a socio-economic global burden. Several biological therapies have been introduced to improve traditional surgical approaches. Among these, the latest research has been focusing on adipose tissue as a powerful source of mesenchymal stromal cells, namely, adipose-derived stem cells (ADSCs). ADSC are commonly isolated from the stromal vascular fraction (SVF) of liposuctioned hypodermal adipose tissue, and their applications have been widely investigated in many fields, including non-union fractures among musculoskeletal disorders. This review aims at providing a comprehensive update of the literature on clinical application of ADSCs for the treatment of non-unions in humans. The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Only three articles met our inclusion criteria, with a total of 12 cases analyzed for demographics and harvesting, potential manufacturing and implantation of ADSCs. The review of the literature suggests that adipose derived cell therapy can represent a promising alternative in bone regenerative medicine for the enhancement of non-unions and bone defects. The low number of manuscripts reporting ADSC-based therapies for long bone fracture healing suggests some critical issues that are discussed in this review. Nevertheless, further investigations on human ADSC therapies are needed to improve the knowledge on their translational potential and to possibly achieve a consensus on their use for such applications. more...
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- 2022
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31. Anterior intrapelvic approach and suprapectineal quadrilateral surface plate for acetabular fractures with anterior involvement: a retrospective study of 34 patients.
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Ciolli G, De Mauro D, Rovere G, Smakaj A, Marino S, Are L, El Ezzo O, and Liuzza F
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- Acetabulum diagnostic imaging, Acetabulum surgery, Bone Plates, Fracture Fixation, Internal adverse effects, Humans, Middle Aged, Retrospective Studies, Treatment Outcome, Fractures, Bone diagnostic imaging, Fractures, Bone epidemiology, Fractures, Bone surgery, Hip Fractures
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Background: The purpose of the study is to evaluate the use of the suprapectineal quadrilateral surface (QLS) plates associated with the anterior intrapelvic approach (AIP) to the acetabulum in the surgical treatment of acetabular fractures with anterior involvement., Methods: We did a retrospective study of patients surgically treated with QLS plates and AIP for acetabular fractures with the involvement of the anterior column, between February 2018 and February 2020, in our Hospital. The following data were recorded: mechanism of injury, the pattern of fracture, presence of other associated injuries, the time before performing the surgery, surgical approach, position on operating table, time of surgery, intraoperative bleeding, hospitalization time, intraoperative and postoperative complications. Follow-ups were performed at 1, 3, 6, 12 months, then annually. The clinical-functional outcome was assessed with the Merle d'Aubigne Postel score (MAP) modified by Matta; while the radiological outcome with the Matta Radiological Scoring System (MRSS). A Chi-square test was utilized to examine associations between parametric variables., Results: We included 34 patients, mean age 62.1, with an average follow-up of 20.7 months. The most frequent traumatic mechanism was road trauma. There were 15 isolated anterior columns and 19 associated patterns. There were 5 cases of associated visceral injuries, and 10 cases of other associated skeletal fractures. All patients were in the supine position. The surgical approach used was the AIP in all cases, with the addition of the first window of the ilioinguinal approach in 16 cases and of the Kocher-Langenbeck approach in 2 cases. The average time before performing the surgery was 8.5 days. The mean time of the surgery and the mean length of stay after surgery were 227.9 min and 8.2 days, respectively. There weren't cases of intra-operative complications, while there were postoperative complications in 5 patients. The MRSS was judged anatomical in 26 cases, imperfect in 7 cases and poor in 1 case. The average MAP value was 15.2. We observed a significant relationship between the radiological outcome and the clinical outcome (p < 0.05)., Conclusions: The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement., (© 2021. The Author(s).) more...
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- 2021
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32. Use of muscular flaps for the treatment of hip prosthetic joint infection: a systematic review.
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Rovere G, De Mauro D, D'Orio M, Fulchignoni C, Matrangolo MR, Perisano C, Ziranu A, and Pataia E
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- Aged, Female, Hip Joint, Humans, Male, Persistent Infection surgery, Quality of Life, Arthritis, Infectious surgery, Arthroplasty, Replacement, Hip adverse effects, Hip Prosthesis adverse effects, Muscle, Skeletal transplantation, Surgical Flaps
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Background: Deep periprosthetic infection after total hip arthroplasty (THA) is a serious and challenging complication for the orthopedic surgeon. Muscular flaps may represent a valid management option for the treatment of this condition. We present a systematic literature review about the use of muscular flaps for the treatment of hip prosthetic joint infection., Methods: The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seventy-seven articles, out of 279 titles, were considered eligible for the full-text analysis. Finally 15 studies that met inclusion criteria were included in this review., Results: Overall, 210 patients (49% males, 48.6% females and 2.4% not reported) suffering from THA infection treated with muscular flaps were collected. The mean age was 69.6 years. Mean follow-up, reported in all studies, was 3.3 years. The results presented by the different authors, highlight the effectiveness of muscular flaps for the treatment of periprosthetic infection, in terms of function, limb salvage, prevention of the recurrences, cost-effectiveness, and quality of life postoperatively., Conclusions: Muscle flaps provide an excellent management option for patients with persistent infection after total hip arthroplasty., (© 2021. The Author(s).) more...
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- 2021
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33. Gibson approach and surgical hip dislocation according to Ganz in the treatment of femoral head fractures.
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De Mauro D, Rovere G, Smakaj A, Marino S, Ciolli G, Perna A, Battiato C, El Ezzo O, and Liuzza F
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- Acetabulum, Femur Head, Fracture Fixation, Internal adverse effects, Humans, Retrospective Studies, Treatment Outcome, Femoral Fractures, Hip Dislocation, Hip Fractures diagnostic imaging, Hip Fractures surgery
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Background: The purpose of the study is to evaluate clinical and radiological outcomes in those patients with femoral head fracture, treated with open reduction and internal fixation through Gibson approach and Ganz flip trochanter osteotomy. The treatment of Pipkin fractures is very challenging, especially for small trauma centers, because of the unusual fracture patterns and high-level surgical skills required., Case Presentation: Between 2017 and 2020, nine cases of Pipkin fractures came to the Emergency Department at the Trauma Center of our Hospital in Rome. Inclusion criteria were the diagnosis of femoral head fracture, the open reduction and internal fixation as surgical choice and at least 24 months follow-up. Patients older than 65 years and those treated through total hip replacement or combined hip procedure (CHP) were excluded. Thus, five patients were included in our case series. The clinical outcome was evaluated according to Western Ontario and McMaster Universities Arthritis Index, Vail Hip score, modified Harris Hip score and Merle D'Aubignè Postel score. Radiographic assessment was scored according to Epstein-Thompson classification and heterotopic ossification was assessed through Brooker classification. The mean follow-up was 24 months (range 12-24). Average modified Harris Hip score was 92.1 points (range 75.9-100), and the average Vail score was 81.8 (range 55-95). WOMAC score was assessed in three different subscales, pain (A), stiffness (B) and physical condition (C), with the following results: 1.4 A (range 0-7), 1.2 B (range 0-6) and 6.4 C (range 0-22). Merle d'Aubignè Postel score resulted excellent for four patients and good for one patient. According to Epstein-Thompson score of the radiological outcome, four patients showed a good result and one a fair result. No mechanical or infective complications occurred in the five patients., Conclusions: Gibson's approach and surgical hip dislocation through Ganz trochanteric flip osteotomy allow a good exposure of the femoral head and acetabulum, giving us the possibility to perform an anatomical reduction of the fracture. In our case series, satisfactory clinical and radiological short-term results were obtained without significant complications., (© 2021. The Author(s).) more...
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- 2021
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34. Newer generation straight humeral nails allow faster bone healing and better functional outcome at mid-term.
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Mocini F, Rovere G, De Mauro D, De Sanctis EG, Smakaj A, Maccauro G, and Liuzza F
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- Adolescent, Adult, Aged, Aged, 80 and over, Fracture Fixation, Intramedullary, Humans, Humeral Fractures diagnostic imaging, Humeral Fractures surgery, Humerus, Middle Aged, Nails, Shoulder Fractures, Treatment Outcome, Young Adult, Bone Nails
- Abstract
Purpose: Although proximal and diaphyseal humerus fractures are frequent, the optimal management remains controversial. Antegrade nailing prevents further damage to the soft tissues and to the vascularization, but it has been associated with postoperative shoulder pain and dysfunction. During the latest years a straight nail design was developed to minimize these problems., Methods: A total of 243 patients who had undergone surgery for antegrade intramedullary humeral nailing between January 2013 and July 2018 in A. Gemelli Trauma Center were divided into two groups according to the nail design used: straight nail group (S-group) and curvilinear nail group (C-group). Clinical data were collected using assessment forms (SF12-v2, Quick-DASH, ASES and Constant-Murley). Radiographic bone healing was assessed with RUST score at 30, 90 and 180 days after surgery., Results: The S-group was made up of 128 patients with a mean age of 59 ± 19 (range 18-97) and a mean follow-up of 46 ± 9 months. The C-group was made up of 115 patients with a mean age of 53 ± 16 (range 18-88) and a mean follow-up of 51 ± 8 months. The S-group had a mental component summary (MCS) score of 54.3 ± 7.7 and a physical component summary (PCS) score of 46 ± 10.2, the C-group had a MCS score of 50.9 ± 8.4 and a PCS score of 44.1 ± 7.4. Quick-DASH and ASES were respectively 18.8 ± 4.3 and 78.6 ± 8.2 in the S-group, 28.3 ± 11.6 and 72.1 ± 13.5 in the C-group with statistical significance. Constant-Murley score was 73.9 ± 9.1 in the S-group (76% of the contralateral healthy side) and 69.4 ± 10.4 in the C-group (73% of the contralateral healthy side). The radiographic union score in the S-group was 4.1 ± 0.3 at 30 days after surgery, 7 ± 0.8 at 90 days and 10 ± 1.2 at 180 days, while in the C-group it was 4.2 ± 0.4 at 30 days, 6.4 ± 0.7 at 90 days and 9 ± 0.9 at 180 days., Conclusion: Newer generation straight nails allow a faster bone healing and better functional outcome at mid-term follow up. Level of evidence III., (© 2021. The Author(s).) more...
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- 2021
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35. Epidemiology and aetiology of male and female sexual dysfunctions related to pelvic ring injuries: a systematic review.
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Rovere G, Perna A, Meccariello L, De Mauro D, Smimmo A, Proietti L, Falez F, Maccauro G, and Liuzza F
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- Causality, Female, Humans, Incidence, Lumbosacral Plexus, Male, Retrospective Studies, Fractures, Bone complications, Fractures, Bone epidemiology, Pelvic Bones
- Abstract
Introduction: Pelvic ring injuries, frequently caused by high energy trauma, are associated with high rates of morbidity and mortality (5-33%), often due to significant blood loss and disruption of the lumbosacral plexus, genitourinary system, and gastrointestinal system. The aim of the present study is to perform a systematic literature review on male and female sexual dysfunctions related to traumatic lesions of the pelvic ring., Methods: Scopus, Cochrane Library MEDLINE via PubMed, and Embase were searched using the keywords: "Pelvic fracture," "Pelvic Ring Fracture," "Pelvic Ring Trauma," "Pelvic Ring injury," "Sexual dysfunction," "Erectile dysfunction," "dyspareunia," and their MeSH terms in any possible combination. The following questions were formulated according to the PICO (population (P), intervention (I), comparison (C), and outcome (O)) scheme: Do patients suffering from pelvic fracture (P) report worse clinical outcomes (C), in terms of sexual function (O), when urological injury occurs (I)? Is the sexual function (O) influenced by the type of fracture (I)?, Results: After screening 268 articles by title and abstract, 77 were considered eligible for the full-text analysis. Finally 17 studies that met inclusion criteria were included in the review. Overall, 1364 patients (902 males and 462 females, M/F ratio: 1.9) suffering from pelvic fractures were collected., Discussion: Pelvic fractures represent challenging entities, often concomitant with systemic injuries and subsequent morbidity. Anatomical consideration, etiology, correlation between sexual dysfunction and genitourinary lesions, or pelvic fracture type were investigated., Conclusion: There are evidences in the literature that the gravity and frequency of SD are related with the pelvic ring fracture type. In fact, patients with APC, VS (according Young-Burgess), or C (according Tile) fracture pattern reported higher incidence and gravity of SD. Only a week association could be found between GUI and incidence and gravity of SD, and relationship between surgical treatment and SD. Electrophysiological tests should be routinely used in patient suffering from SD after pelvic ring injuries., (© 2021. The Author(s).) more...
- Published
- 2021
- Full Text
- View/download PDF
36. Navigated percutaneous screw fixation of the pelvis with O-arm 2: two years' experience.
- Author
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Ciolli G, Caviglia D, Vitiello C, Lucchesi S, Pinelli C, De Mauro D, Smakaj A, Rovere G, Meccariello L, Camarda L, Maccauro G, and Liuzza F
- Subjects
- Bone Screws, Fracture Fixation, Internal, Humans, Pelvis diagnostic imaging, Retrospective Studies, Sacrum, Tomography, X-Ray Computed, Imaging, Three-Dimensional, Surgery, Computer-Assisted
- Abstract
Aim To evaluate the case series of the patients operated with percutaneous fixation by the navigation system based on 3D fluoroscopic images, to assess the precision of a surgical implant and functional outcome of patients. Methods A retrospective study of pelvic ring fractures in a 2-year period included those treated with the use of the O-Arm 2 in combination with the Stealth Station 8. Pelvic fractures were classified according to the Tile and the Young-Burgess classification. All patients were examined before surgery, with X-rays and CT scans, and three days after surgery with additional CT scan. The positioning of the screws was evaluated according to the Smith score, the outcome with the SF-36. Results Among 24 patients 18 were with B and six with C type fracture according to Tile, while eight were with APC, 10 LC, and six with VS type according to Young-Burgess classification. All patients were treated in the supine position, except two. A total of 41 iliosacral or transsacral screws and five anterior pelvic ring screws were implanted. The medium surgical time per screw was 41 minutes. There was a perfect correspondence of screw scores value from post-operative CT and intraoperative fluoroscopy. The mean screw score value was 0.92. There were no cases of poor positioning. The median follow-up was 17.5 months. The patients were satisfied with their health condition on SF-36. Conclusion The use of the O-arm guarantees great precision in the positioning of the screws and reduced surgical times with excellent clinical results in patients., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.) more...
- Published
- 2021
- Full Text
- View/download PDF
37. COVID-19 pandemic: management of patients affected by SARS-CoV-2 in Rome COVID Hospital 2 Trauma Centre and safety of our surgical team.
- Author
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De Mauro D, Rovere G, Smimmo A, Meschini C, Mocini F, Maccauro G, Falez F, Liuzza F, and Ziranu A
- Subjects
- Hospitals, Humans, Pandemics prevention & control, Patient Care Team, Rome, SARS-CoV-2, Trauma Centers, COVID-19
- Abstract
Background: SARS-CoV-2 pandemic left a deep mark in the health systems around the globe, leading to an important change in the way we intend the access to the healthcare and its fruition. Hospitals faced something unexpected, and they underwent a deep change and so did orthopaedic activity., Materials and Methods: In "A. Gemelli" University hospital new protocols were adopted for the safe management of patients affected by SARS-CoV-2. Among these patients, six had to be treated also for orthopaedic problems. The management of these patients, from the admission in the Emergency Room (E.R). to the operating room (O.R.), followed the protocols we developed for the coronavirus crisis., Results: Four among the six patients underwent surgical treatments. Two of them showed a change of their clinical status, due to a worsening of COVID-19 symptoms, so the surgical option was postponed. All of them were admitted to the Infectious Diseases Unit, rather than the Orthopaedic and Traumatology Unit, in order to provide the best measures to prevent the spread of the contagion and to ensure the best treatment for COVID-19. No O.R. staff was infected by SARS-CoV-2., Conclusions: More studies are needed to provide a higher statistical significance to the safety measures taken in order to contrast the spread of SARS-CoV-2 in the Surgical Room. Orthopaedic surgeons are more exposed to the contagion due to the particular tools set they use. A more sensible and specific quick test for novel Coronavirus is particularly needed, due to the lack of sensitivity of the serological rapid test. more...
- Published
- 2020
- Full Text
- View/download PDF
38. Foot metastasis: Current knowledge.
- Author
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Greco T, Cianni L, De Mauro D, Dughiero G, Bocchi MB, Cazzato G, Ragonesi G, Liuzza F, Maccauro G, and Perisano C
- Abstract
Foot metastasis are rare and often overlooked due to non-specifical symptoms. This often leads to misdiagnosis delaying the right diagnosis. Metastatic disease of the foot is rare. Foot pain and swelling may be the presenting symptom of an occult malignancy. If metastatic disease is not kept in the differential diagnosis of foot pain, diagnosis and treatment will be delayed. The purpose of this study was to analyze articles presenting cases of foot metastasis to provide a more accurate incidence of symptomatic foot acrometastasis as well as to review the clinical course and outcomes. Studies were searched on PubMed/Medline from the inception to February 2020. All studies included in the review presented foot metastasis either with or without a known primary tumor. Most of the articles were case reports, to which we added two case reports of foot acrometastasis produced by our Institute. Forty-three studies with a total of 45 patients were included in this review. The literature published mostly concerning case reports about old patients (average age: 63,2), in a late phase of their disease. Lung cancer appeared to be the most common primary tumor, followed by endometrial and breast cancer. In the 36% of the cases foot metastasis were found when the primary site was still unknown. Calcaneus and metatarsal bones were the most common bones involved. Surgical solution is rare, the chosen treatments are often of palliative care. Prognosis was often poor, death occurred within 2 years since the discovery of foot metastasis in about 50% of cases., Competing Interests: Conflict of interest: the authors declare no potential conflict of interest., (©Copyright: the Author(s).) more...
- Published
- 2020
- Full Text
- View/download PDF
39. Bone alterations in inflammatory bowel diseases.
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Sgambato D, Gimigliano F, De Musis C, Moretti A, Toro G, Ferrante E, Miranda A, De Mauro D, Romano L, Iolascon G, and Romano M
- Abstract
Inflammatory bowel diseases (IBDs) are characterized by a multifactorial partially unknown etiology that involves genetic, immunological and environmental factors. Up to 50% of IBD patients experience at least one extraintestinal manifestation; among them is the involvement of bone density which is referred to as metabolic bone disease (MBD), including osteopenia and osteoporosis. Bone alterations in IBDs population appear to have a multifactorial etiology: Decreased physical activity, inflammation-related bone resorption, multiple intestinal resections, dietary malabsorption of minerals and vitamin D deficiency, genetic factors, gut-bone immune signaling interaction, steroid treatment, microbiota and pathogenic micro-organisms interaction, and dietary malabsorption of minerals, that, all together or individually, may contribute to the alteration of bone mineral density. This review aims to summarize the prevalence and pathophysiology of metabolic bone alterations in IBD subjects outlining the main risk factors of bone fragility. We also want to underline the role of the screening and prophylaxis of bone alterations in Crohn's disease and ulcerative colitis patients and the importance of treating appropriately MBD., Competing Interests: Conflict-of-interest statement: No potential conflicts of interest. No financial support. more...
- Published
- 2019
- Full Text
- View/download PDF
40. Sexuality education 1990. A review of state sexuality and AIDS education curricula.
- Author
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De Mauro D
- Subjects
- Americas, Behavior, Developed Countries, Disease, North America, Sexual Behavior, United States, Virus Diseases, Acquired Immunodeficiency Syndrome, Condoms, Contraception, Curriculum, Education, Evaluation Studies as Topic, Family Planning Services, HIV Infections, Health Education, Homosexuality, Sex Education
- Published
- 1990
41. [Histogenesis of squamous cell carcinoma of the gallbladder. An anatomo-clinical case].
- Author
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Cintorino M, Cetta F, De Mauro D, Calfa C, Iudicone R, and Del Vecchio MT
- Subjects
- Aged, Humans, Male, Carcinoma, Squamous Cell pathology, Gallbladder Neoplasms pathology
- Published
- 1981
42. [Changes in the speed of lipid absorption after test meals in totally gastrectomized patients with esophago-jejuno-duodenal anastomosis].
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Tanzini G, Cetta F, de Mauro D, Calfa C, and Filippini F
- Subjects
- Feces analysis, Gastrectomy, Humans, Dietary Fats, Intestinal Absorption, Postgastrectomy Syndromes physiopathology
- Published
- 1977
43. [Effect of levamisole on the formation of lymphocyte rosettes in patients undergoing surgery. Clinical study].
- Author
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Di Perri T, Auteri A, Laghi Pasini F, Ciani D, Bilenchi R, Pasqui AL, and De Mauro D
- Subjects
- Adult, Aged, Antibody Formation drug effects, Double-Blind Method, Female, Humans, Immunity, Cellular drug effects, Immunity, Innate drug effects, Lymphocytes immunology, Male, Middle Aged, Levamisole immunology, Lymphocytes drug effects, Rosette Formation, Surgical Procedures, Operative
- Published
- 1981
44. [The viscoelastic properties and tonic adaptation of the intestine].
- Author
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Tanzini G, Cetta F, Salvestrini F, and de Mauro D
- Subjects
- Animals, Dogs, Elasticity, Female, Male, Muscle Contraction, Muscle Relaxation, Muscle Tonus, Muscle, Smooth physiology, Pressure, Intestines physiology
- Published
- 1978
45. [So-called eosinophilic cholecystitis].
- Author
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Miracco C, Cetta F, Leoncini L, and De Mauro D
- Subjects
- Adult, Aged, Cholecystitis diagnosis, Female, Humans, Middle Aged, Cholecystitis pathology, Eosinophilia pathology
- Published
- 1983
46. [Granular-cell myoblastoma. Histogenetic and clinical considerations on a case].
- Author
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De Mauro D, Calfa C, Tanzini G, and Cetta F
- Subjects
- Adult, Female, Humans, Middle Aged, Neoplasms, Muscle Tissue pathology, Skin Neoplasms pathology, Tongue Neoplasms pathology, Neoplasms, Muscle Tissue diagnosis, Skin Neoplasms diagnosis, Tongue Neoplasms diagnosis
- Published
- 1977
47. [The viscoelastic properties and tonic adaptation of the stomach].
- Author
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Tanzini G, Cetta F, Salvestrini F, and de Mauro D
- Subjects
- Animals, Dogs, Elasticity, Female, Gastric Emptying, Gastric Mucosa physiology, Male, Muscle Contraction, Muscle Relaxation, Muscle Tonus, Muscle, Smooth physiology, Pressure, Serous Membrane physiology, Stomach physiology
- Published
- 1978
48. [Modern trends in physiopathology of interstitial exchanges].
- Author
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De Mauro D, Giubbolini G, Tanzini G, and Romeo-Caparra S
- Subjects
- Animals, Blood Proteins, Humans, Osmosis, Osmotic Pressure, Water-Electrolyte Balance, Body Fluids metabolism, Extracellular Space physiopathology
- Published
- 1966
49. [Sphygmic wave velocity and vasomotor reactions in normal and pathological extremities].
- Author
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Giubbolini G, De Mauro D, and Romeo Caparra S
- Subjects
- Axilla, Fingers, Humans, Thigh, Arteries, Extremities, Pulse, Vascular Diseases physiopathology, Vasomotor System physiopathology
- Published
- 1966
50. [Neurography and nerve grafts].
- Author
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De Mauro D and Tanzini G
- Subjects
- Animals, Humans, Peripheral Nerve Injuries, Neurosurgery, Peripheral Nerves transplantation
- Published
- 1967
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