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Castel Guelfo di Bologna, Italy

Al-Atabi M.,Taylors University | Espino D.M.,Istituto Ortopedico Rizzoli di Bologna | Hukins D.W.L.,University of Birmingham
Journal of Biomechanical Science and Engineering | Year: 2010

This paper reports the first steps in determining the effects of fluid flow on the performance of the mitral valve of the heart that is relevant to surgical repair of the valve. In this paper, blood flow in idealised two-dimensional models of the mitral valve was studied using a numerical fluid-structure interaction (FSI) and experimental models and an experimental problem designed to validate the computational model. Both the experiments and simulation predicted a large vortex behind the anterior leaflet during inflow of blood into the left ventricle, in agreement with MRI scans available in the literature. Leaflet deformations agreed with results from experiments in the literature and with our previous experimental results. © 2010 by JSME. Source

Di Martino A.,Biomedical University of Rome | Merlini L.,Laboratory of Musculoskeletal Cell Biology | Faldini C.,Istituto Ortopedico Rizzoli di Bologna
Expert Opinion on Therapeutic Targets | Year: 2013

Introduction: The cause of low back pain and the pathophysiology of lumbar pain and sciatica have recently been reconsidered basing on current knowledge on cellular and molecular mediators of inflammation. Several cytokines have been considered as potential therapeutic targets to contrast sciatica in patients with disc herniation, and supportive studies suggest a leading role of TNF-α in this contest: therefore, clinical trials have tested TNF-α inhibitors in the clinical setting of the patient with radicular pain secondary to an herniated disc. Areas covered: The current review deals with the autoimmune theory of disc herniation and its role in determining radiculopathy and neuropathic pain. It also reports the recent evidences that led to the introduction of anti-TNF-α drugs into the clinical setting as a biological therapy for radiculopathy and disc herniation. Expert opinion: Targeting the TNF-α pathway has demonstrated controversial effects in the tested study population and available results only report a short-term follow-up. More confirmatory studies in terms of long-term clinical results, complications, more effective route of administration and cost-effective analysis are required to establish the real role of this biological therapy in the treatment of patients with disc herniation and neuropathy. © 2013 Informa UK, Ltd. Source

Frezza A.M.,University College London | Frezza A.M.,Biomedical University of Rome | Cesari M.,Istituto Ortopedico Rizzoli di Bologna | Baumhoer D.,University of Basel | And 21 more authors.
European Journal of Cancer | Year: 2015

Background Mesenchymal chondrosarcoma (MCS) is a distinct, very rare sarcoma with little evidence supporting treatment recommendations. Patients and methods Specialist centres collaborated to report prognostic factors and outcome for 113 patients. Results Median age was 30 years (range: 11-80), male/female ratio 1.1. Primary sites were extremities (40%), trunk (47%) and head and neck (13%), 41 arising primarily in soft tissue. Seventeen patients had metastases at diagnosis. Mean follow-up was 14.9 years (range: 1-34), median overall survival (OS) 17 years (95% confidence interval (CI): 10.3-28.6). Ninety-five of 96 patients with localised disease underwent surgery, 54 additionally received combination chemotherapy. Sixty-five of 95 patients are alive and 45 progression-free (5 local recurrence, 34 distant metastases, 11 combined). Median progression-free survival (PFS) and OS were 7 (95% CI: 3.03-10.96) and 20 (95% CI: 12.63-27.36) years respectively. Chemotherapy administration in patients with localised disease was associated with reduced risk of recurrence (P = 0.046; hazard ratio (HR) = 0.482 95% CI: 0.213-0.996) and death (P = 0.004; HR = 0.445 95% CI: 0.256-0.774). Clear resection margins predicted less frequent local recurrence (2% versus 27%; P = 0.002). Primary site and origin did not influence survival. The absence of metastases at diagnosis was associated with a significantly better outcome (P < 0.0001). Data on radiotherapy indications, dose and fractionation were insufficiently complete, to allow comment of its impact on outcomes. Median OS for patients with metastases at presentation was 3 years (95% CI: 0-4.25). Conclusions Prognosis in MCS varies considerably. Metastatic disease at diagnosis has the strongest impact on survival. Complete resection and adjuvant chemotherapy should be considered as standard of care for localised disease. © 2014 Elsevier Ltd. All rights reserved. Source

Faldini C.,University of Bologna | Martino A.D.,Biomedical University of Rome | Perna F.,University of Bologna | Martikos K.,Istituto Ortopedico Rizzoli di Bologna | And 2 more authors.
European Spine Journal | Year: 2014

Purpose To analyze changes in spino-pelvic parameters (SPPs) after surgery of high-grade lumbar isthmic spondylolisthesis (HDIS).Methods We analyzed 41 patients affected by HDIS operated upon by attempt of reduction and posterior spinal fusion with pedicle screw systems with or without interbody fusion. Pelvic tilt (PT), lumbar lordosis (LL), pelvic incidence (PI), and sacral slope (SS) were measured, and patients were further divided into balanced and unbalanced pelvis subgroups.Results SS passed from 46.8° ± 9.8° preoperatively to 50.1° ± 10.1° (p = 0.02). PT passed from 26.7° ± 6.7° preoperatively to 22.9° ± 7.5° (p = 0.003). Unbalanced patients showed significantly higher PT and lower SS compared to the balanced patients preoperatively, and these corrected after surgery. Patients with instrumentation failure (n = 5) had significant increase in PT values postoperatively (p = 0.018).Conclusions We confirmed the positive effect of surgery on the SPPs in patients affected by HDIS, which showed different patterns of corrections with surgery for balanced and unbalanced pelvis patients. © Springer-Verlag Berlin Heidelberg 2014. Source

Gagliotti C.,Agenzia Sanitaria e Sociale Regionale Emilia Romagna | Cappelli V.,Agenzia Sanitaria e Sociale Regionale Emilia Romagna | Carretto E.,Azienda Ospedaliera di Reggio Emilia | Marchi M.,Agenzia Sanitaria e Sociale Regionale Emilia Romagna | And 82 more authors.
Eurosurveillance | Year: 2014

Starting in 2010, there was a sharp increase in infections caused by Klebsiella pneumoniae resistant to carbapenems in the Emilia-Romagna region in Italy. A region-wide intervention to control the spread of carbapenemase-producing K. pneumoniae (CPKP) in Emilia-Romagna was carried out, based on a regional guideline issued in July 2011. The infection control measures recommended to the Health Trusts (HTs) were: phenotypic confirmation of carbapenemase production, active surveillance of asymptomatic carriers and contact isolation precautions for carriers. A specific surveillance system was activated and the implementation of control measures in HTs was followed up. A significant linear increase of incident CPKP cases over time (p<0.001) was observed at regional level in Emilia-Romagna in the pre-intervention period, while the number of cases remained stable after the launch of the intervention (p=0.48). Considering the patients hospitalised in five HTs that provided detailed data on incident cases, a downward trend was observed in incidence after the release of the regional guidelines (from 32 to 15 cases per 100,000 hospital patient days). The spread of CPKP in Emilia-Romagna was contained by a centrally-coordinated intervention. A further reduction in CPKP rates might be achieved by increased compliance with guidelines and specific activities of antibiotic stewardship. © 2014, European Centre for Disease Prevention and Control (ECDC). All rights reserved. Source

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