Ospedale generale di zona San Camillo Treviso

Using fully cemented total hip arthroplasty (THA), involving both a cemented cup and stem, remains uncommon in several countries. This study aimed to evaluate the clinical and radiographic outcomes of fully cemented primary THA in an elderly population. This prospective, single-center, longitudinal cohort study enrolled patients in THA. Clinical assessments included the Harris Hip Score (HHS), the Timed Up-and-Go (TUG) test, and the Hip Disability and Osteoarthritis Outcome Score (HOOS). Radiographic evaluation was performed using anteroposterior and lateral X-rays to assess implant positioning and stability. Forty patients completed the 2-year follow-up (FU), with a mean age of 79.0±6.0 years. Clinical outcomes demonstrated significant improvements at 2-year FU: the mean HHS increased from 42±15 preoperatively to 93±9; TUG improved from 24±25s preoperatively to 8±3s; and HOOS improved from 35±14 preoperatively to 84±17. No intraoperative complications or implant-related adverse events were reported during the 2-year follow-up. This study highlights substantial improvements in functional outcomes, patient satisfaction, and radiographic evidence of good implant stability at 2-year follow-up. These findings support fully cemented THA as a safe and effective treatment option for elderly patients. IV.

PurposeLaparoscopic ventral mesh rectopexy (LVMR) is effective for the treatment of rectal prolapse. However, descending perineal syndrome may impair the outcomes of LVMR. The aim of this study was to assess the safety and functional outcomes of LVMR performed with and without transverse perineal support (TPS).MethodsThis was a retrospective study of 143 consecutive female patients treated with LVMR with or without TPS between 2018 and 2022. Patients with rectal prolapse and perineal descent who underwent surgery were included. Obstructed defecation syndrome and fecal incontinence were evaluated using the Cleveland Constipation Score (Wexner score) and St. Mark’s Incontinence Score, respectively. Perineal descent was defined using defecography. Biological meshes were utilized in all cases.ResultsNo significant differences were recorded between with- and without-TPS groups at baseline. TPS was performed in 110 patients (76.9%). Surgical morbidity was higher in the with-TPS group (12.7% vs. 0%, P=0.047), primarily due to seroma formation. Almost all complications were mild (Clavien-Dindo grades I–II). In both groups, digital aid for defecation (P<0.001), prolonged straining (P=0.004), and hematochezia (P<0.001) nearly disappeared postoperatively, though constipation and laxative/enema use persisted in 22.4%. Fecal incontinence significantly decreased from 43.4% to 11.2% (P<0.001). TPS appears to have a potentially favorable effect in reducing the constipation score. Both constipation and incontinence scores remained low up to 24 months after surgery. Operative time was significantly longer in the LVMR with-TPS group (P<0.001).ConclusionLVMR with TPS appears safe and feasible. TPS may provide better surgical outcomes compared to LVMR alone for patients with symptomatic rectoceles and descending perineum syndrome.

Osteoporosis is a common skeletal disease that leads to increased bone fragility, associated with increased risk of fracture and consequent significant morbidity and mortality, and is a global public health problem. It results from a chronic imbalance in bone remodeling, where bone resorption by osteoclasts exceeds bone formation by osteoblasts. Aging, hormonal changes, comorbidities, and drugs influence the process that leads to osteoporosis. In this review, we delve into the pathogenesis of primary and secondary osteoporosis after a summary of the normal physiology of bone homeostasis. Primary osteoporosis includes postmenopausal osteoporosis, driven largely by estrogen deficiency, and age-related (senile) osteoporosis, associated with reduced bone formation. An insight into male osteoporosis and osteoporosis treatment is also provided. Secondary osteoporosis can derive from underlying conditions, such as endocrine disorders, chronic inflammatory and genetic diseases, or prolonged use of glucocorticoids. Clinically, osteoporosis is often unacknowledged, underlining the importance of early risk assessment and diagnosis. A thorough understanding of the disease, its subtypes, and its underlying pathogenetic mechanisms is essential for early diagnosis and individualized treatment, all targeted to effective fracture prevention.

Soil is a depletable and non-renewable resource essential for food production, crop growth, and supporting ecosystem services, such as the retaining and cycling of various elements, including water. Therefore characterization and preservation of soil biological health is a key point for the development of sustainable agriculture. We conducted a comprehensive review of the use of Artificial Intelligence (AI) techniques to develop forecasting models based on soil microbiota data able to monitor and predict soil health. We also investigated the potentiality of AI-based Decision Support Systems (DSSs) for improving the use of microorganisms to enhance soil health and fertility. While available studies are limited, potential applications of AI seem relevant to develop predictive models for soil fertility, based on its biological properties and activities, and implement sustainable precision agriculture, safeguarding ecosystems, bolstering soil resilience, and ensuring the production of high-quality food.

The French Bulldog has become increasingly popular worldwide, but selective breeding for brachycephalic traits has increased its predisposition to several neurological disorders. Among these, intervertebral disc herniation (IVDH) is one of the most common causes of spinal cord compression, pain, and neurological deficits. Although genetic predisposition plays a key role, previous evidence suggests that gonadal hormones factors may also adversely affect skeletal development and spinal biomechanics, thus influencing risk of IVDH. The aim of this study is to evaluate the influence of gonadectomy and age at gonadectomy on the risk of developing IVDH in French Bulldogs. Medical records of 2,101 French Bulldogs were retrospectively reviewed. Dogs with complete clinical and reproductive histories were included and classified into two groups: affected (A group, with IVDH) and control (C group, without IVDH). Early-gonadectomized dogs (<12 months) showed a significantly higher risk of IVDH compared with intact dogs. Early-gonadectomized males were nearly twice as likely to develop IVDH (OR = 1.92) than intact males, while early-gonadectomized females exhibited an even stronger association (OR = 9.84) compared with late-gonadectomized (OR = 2.77) and intact females. The preliminary results of this study suggest a potential influence of gonadectomy and age at gonadectomy on the risk of developing IVDH in French Bulldog. Therefore, the age at which gonadectomy is performed should be carefully considered in this and other predisposed chondrodystrophic breeds. These findings highlight the importance of gonadal hormones and the need for further research to evaluate the differential effects of early age gonadectomy.

ObjectiveThe aim of this study was to report the outcomes of endovascular urgent thoracoabdominal aortic (TAAA) repair, using an off-the-shelf preloaded inner branch device (E-nside; Artivion). MethodsData from a physician-initiated national multicenter registry, including patients treated with E-nside endograft (INBREED) were prospectively collected (2020-2024); only urgent cases were included in this study. Primary outcomes were technical success and mortality at 30 days. Secondary outcomes were spinal cord ischemia rate, stroke rate, major adverse events (MAE) as also branch instability at 12 months. ResultsOf 185 patients enrolled in the INBREED, 64 (34.5%) were treated in a urgent setting and were included in the study. Reason for urgent repair was presence of aneurysm-related symptoms in 31 patients (48.4%), a contained rupture in eight (12.5%), and a large aneurysm >80 mm in 25 (39.1%). Extent of repair was I to III in 32 patients (50%) and IV in 32 (50%); 18 (28%) had a narrow (<25 mm) paravisceral aortic lumen. An adjunctive proximal thoracic endograft was deployed in 29 patients (45.3%); a distal bifurcated abdominal endograft was used in 33 (51.5%). Two hundred forty-nine target vessels (97.2%) were successfully incorporated through an inner branch from an upper arm (81.2%) or femoral (18.8%) access. A balloon expandable stent was used in 184 (75.7%) target vessels, a self-expandable stent in 59 (24.3%). Mean time for target vessel bridging was 39.9 ± 28.4 minutes per target vessel. Thirty-day cumulative major adverse event (MAE) rate was 28%, and mortality occurred in five patients (9.1%). There was one postoperative stroke (1.6%), and the spinal cord ischemia (SCI) rate was 8% (n = 5). For the 249 target vessels successfully incorporated through an inner branch, 1-year freedom from target vessel instability was 93% ± 3% after 1 year. ConclusionsThe E-nside represents a valid solution for the urgent treatment of TAAAs, including symptomatic and ruptured TAAAs, as well as large asymptomatic TAAAs that cannot wait for a custom-made device. The preloaded inner branches and available proximal and distal graft diameters might be useful in urgent settings and provided satisfactory early and 1-year results, in terms of both endograft and target vessel stability. Further studies are required to assess the clinical role of E-nside for urgent TAAA repair.

For many years, cardiac pacing has been based on the stimulation of right ventricular common myocardium to correct diseases of the conduction system. The birth and the development of cardiac resynchronization have led to growing interest in the correction and prevention of pacing-induced dyssynchrony. Many observational studies and some randomized clinical trials have shown that conduction system pacing (CSP) can not only prevent pacing-induced dyssynchrony but can also correct proximal conduction system blocks, with reduction of QRS duration and with equal or greater effectiveness than biventricular pacing. Based on these results, many Italian electrophysiologists have changed the stimulation target from the right ventricular common myocardium to CSP. The two techniques with greater clinical impact are the His bundle stimulation and the left bundle branch pacing. The latter, in particular, because of its easier implantation technique and better electric parameters, is spreading like wildfire and is representing a real revolution in the cardiac pacing field. However, despite the growing amount of data, until now, the European Society of Cardiology guidelines give a very limited role to CSP.

Significant alveolar bone resorption follows tooth extraction. Immediate implant placement alone is not sufficient to prevent this phenomenon. In this clinical case, a fractured upper first premolar was replaced by an immediate implant and a customized healing abutment designed on the perimeter of the extractive alveolus. After 3 months, the implant was restored. The facial and interdental soft tissue was maintained with appreciable success after 5 years. The pre- and 5-year-post-treatment CT scans showed no bone loss. The use of an interim customized healing abutment helps preventing hard and soft tissues collapse. This technique is very straightforward and might represent a smart preservation strategy when there is no indication for adjunctive hard or soft tissue grafting.

Behçet's disease (BD) is a heterogeneous multifactorial autoinflammatory disease characterized by a plethora of clinical manifestations. Cutaneous lesions are considered hallmarks of the disease. However, their evolution over time and a thorough description are scarcely reported in non-endemic regions. The aim of this study was to detail BD skin manifestations and their evolution over time in Italy, as well as the dermatological prognostic impact of specific cutaneous features in long-standing disease. Data were collected in a double fashion, both retrospectively and prospectively, from the AutoInflammatory Disease Alliance (AIDA) international registry dedicated to BD, between January 2022 and December 2022. A total of 458 Italian patients were included. When assessing skin manifestations course, the constant or sporadic presence or absence of cutaneous involvement between onset and follow-up was considered. Oral ulcers (OU) (88.4%) and genital ulcers (GU) (52.6%), followed by skin involvement (53.7%) represented the most common presenting mucocutaneous manifestations at disease onset. Up to the time of enrolment into the AIDA registry, 411 (93.8%) patients had suffered from OU and 252 (57.9%) from GU; pseudofolliculitis (PF) accounted for the most common skin manifestation (170 patients, 37.1%), followed by erythema nodosum (EN) (102 patients, 22.3%), skin ulcers (9 patients, 2%) and pyoderma gangrenosum (4 patients, 0.9%). A prospective follow-up visit was reported in 261/458 patients; 24/148 (16.2%) subjects with skin involvement as early as BD onset maintained cutaneous lesions for the entire period of observation, while 120 (44.1%) patients suffered from sporadic skin involvement. Conversely, 94/113 (83.2%) with no skin involvement at disease onset did not develop skin lesions thereafter. At follow-up visits, cutaneous involvement was observed in 52 (20%) patients, with a statistically significant association between PF and constant skin involvement (p = 0.031). BD in Italy is characterized by a wide spectrum of clinical presentations and skin manifestations in line with what is described in endemic countries. Patients with skin disease at the onset are likely to present persistent cutaneous involvement thereafter; mucocutaneous lesions observed at the onset, especially PF, could represent a warning sign for future persistent skin involvement requiring closer dermatological care.