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Oliveira do Hospital, Portugal

Brinkert D.,University of Strasbourg | Ali M.,Orthopedic Unit | Naud M.,Montpellier University | Maire N.,University of Strasbourg | And 2 more authors.
International Wound Journal

Negative pressure wound therapy combined with timed, cyclical instillation (NPWTi) of topical wound solutions has been recently presented as a new adjunctive modality for treating wounds with signs of infection. Normal saline, antiseptics and antimicrobials all have been proposed in scientific and clinical studies as potentially effective when used with NPWTi for treating heavily infected wounds. This is a prospective clinical study of 131 patients with 131 wounds treated with NPWTi using saline between January 2012 and December 2012 in two orthopaedic centres and one surgical wound healing centre in France. Saline was exclusively used. Results were favourable: in 98% of the cases, the wounds could be closed after debridement and following the use of NPWTi. Mean duration of NPWTi was 12·19days. This does not preclude the need for treating the biofilm appropriately with more active antibacterial products when biofilm has been documented. © 2013 John Wiley & Sons Ltd and Medicalhelplines.com Inc. Source

Casale R.,Rehabilitation Institute of Zingonia | Atzeni F.,IRCCS Galeazzi Orthopedic Institute | Masala I.F.,Orthopedic Unit | Sarzi-Puttini P.,University of Milan
Best Practice and Research: Clinical Rheumatology

Abstract Complex regional pain syndrome (CRPS) encompasses a wide range of painful conditions, but it is characterised by continuing (spontaneous and/or evoked) limb pain that is seemingly disproportionate in time or degree to the usual course of any known trauma or other lesion. The pain is regional, with distal predominance usually but not related to a specific nerve territory or dermatome, and it is usually associated with abnormal sensory, motor, sudomotor, vasomotor and/or trophic findings. The complexity of the aetiopathogenetic factors making up the clinical picture of CRPS is mirrored by the inconsistency of almost all of the monotherapies used to treat it so far. Motor and sensory symptoms significantly interfere with the patients' daily function and quality of life, and almost all of them report substantial disability in their working and recreational activities, mood and mobility. © 2015 Elsevier Ltd. Source

Margiotta G.,University of Palermo | Sanfilippo A.,University of Palermo | Accardo F.M.,University of Palermo | Damiani P.,University of Palermo | And 2 more authors.
EuroMediterranean Biomedical Journal

In inflammatory bowel disease (IBD) the suspected etiological cause is a dysregulation of the intestinal immune system, in which it is possible to determine a cross-like immune reactivity against the resident microbiota; this mechanism explains the existence of Lesniowski-Crohn's disease, a variant of IBD in which patients manifest osteoarticular problems that may also be the primary manifestation of the disease. The aim of this study was to compare some cases encountered by our research group at the University of Palermo with others reported in international literature on osteoarticular manifestations in IBD. © EUROMEDITERRANEAN BIOMEDICAL JOURNAL 2012. Source

Lowery D.P.,Newcastle University | Wesnes K.,Cognitive Drug Research | Brewster N.,Orthopedic Unit | Ballard C.,Kings College London
International Journal of Geriatric Psychiatry

Objective To determine whether attentional impairments are reliable neuropsychological markers of sub syndrome delirium. Method A prospective cohort study with repeated assessment beginning pre-operatively and continuing through the first post-operative week. Computerized assessments of attention and the Mini-Mental State Examination were administered with one hundred patients admitted for elective orthopedic surgery, 70 years and over and free of dementia. Acute change of cognitive status was used to identify cases of sub syndrome delirium. Results There were significant differences of post-surgical performance between the 'no delirium' and 'sub-syndrome delirium' groups of reaction time, global cognition, accuracy and greater variability of reaction time (p < 0.041). There were significant within subject main effects on reaction time (p = 0.001), variability of reaction time (p = 0.022) and MMSE (p = 0.000) across the cohort; but no significant interaction effect of 'diagnosis' * 'time' on the computerized measures of attention (p > 0.195). Conclusion The distinction between people with sub syndrome delirium and no delirium is difficult to quantify but computerized measures of attention might provide a sensitive indicator. Sub syndrome delirium is an observable marker of a clinical abnormality that should be exploited to improve care management for vulnerable patients. © 2010 John Wiley & Sons, Ltd. Source

Sitati F.C.,Orthopedic Unit | Naddumba E.,Mulago Hospital | Beyeza T.,Kampala University
Tropical Doctor

In developing countries, sciatic nerve injury following gluteal intramuscular injection is a persistent problem. A study over 6 months involving 133 children seen in Mulago hospital with acute flaccid paralysis revealed 124 (93%) children with injection-induced sciatic nerve injury. The identity of the drug in 79 cases (59.4%) was quinine. It is recommended that the gluteal region should not be used as an intramuscular injection site in children. Source

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