Publications by authors named "MORANTE L"
Biologic graft infection (BGI) is one of the main complications in graft reconstructions. However, very little evidence exists regarding the epidemiology of BGI, as most of the data come from sparse reports. Moreover, most of the series did not detail the treatment and outcome of graft infections.
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- Periprosthetic joint infections (PJI) and fracture-related infections (FRI) of the distal femur can lead to significant bone loss, and a two-stage treatment protocol utilizing articulated silver-coated megaprosthesis was studied.
- A review of three institutions included 45 patients, showing an estimated 91.1% survival rate free from recurrence of infection two years after surgery, with complications primarily involving non-infection-related issues.
- Significant findings indicated that a longer resection length negatively impacted infection control, while the initial diagnosis (PJI or FRI) did not significantly affect outcomes, affirming the safety and effectiveness of this treatment approach.
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- Modular megaprostheses (MPs) are used for limb salvage after bone tumor resection and can also address massive bone defects in non-cancer cases, with a systematic review analyzing their epidemiology.
- The review examined 69 studies, discovering that a total of 2,598 MPs were used primarily for periprosthetic fractures, with the distal femur being the most frequently treated site, representing over 52% of cases.
- Complications occurred in nearly 20% of cases, with the most common being soft tissue failures and infections, highlighting that patients with significant bone loss or previous complications should be treated similarly to oncologic patients due to limited treatment options.
Purpose: A staged revision with placement of a temporary antibiotic-loaded cement spacer after removal of the implant is the "gold standard" for treatment of chronic prosthetic joint infection (PJI). It enables local delivery of antibiotics, maintenance of limb-length and mobility, easier reimplantation. However, bacterial colonization of spacers and mechanical complications can also occur.
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- The treatment of knee periprosthetic joint infection using a two-stage protocol with static and articulated spacers allows for local antibiotic delivery and preservation of knee function.
- A systematic review analyzed 87 studies and 4250 spacers, finding no significant difference in infection rates or complications between static and articulated spacers.
- However, articulated spacers were associated with significantly better knee flexion post-reimplantation (100.3° vs. 91.6°), though the review highlights potential biases due to the varying quality of the studies included.
Prosthetic joint infections (PJIs) occurring in multiple joints at the same time (synchronous PJI) are an extremely rare complication, frequently associated with bacteremia, and are associated with high mortality rates. The presence of three or more prosthetic joints, rheumatoid arthritis, neoplasia, bacteremia and immune-modulating therapy seem to be the recurring risk factors for synchronous PJI. In case of PJIs, all other replaced joints should be considered as potentially infected and investigated if PJI is suspected.
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- * Most current research is still in preclinical stages, with limited studies including lab experiments, animal models, and some in vitro and in vivo analyses.
- * Preliminary findings suggest that silver enhances antibacterial activity in bone substitutes, but more research is needed to understand its effectiveness and safety in clinical applications.
Article Synopsis
- This systematic review evaluates the mechanical complications associated with antibiotic-loaded spacers used during the staged revision of hip prosthetic joint infections (PJIs), highlighting the varying rates of complications which can reach up to 73%.
- The study analyzed 40 articles and found that standardized molded spacers had significantly higher mechanical complication rates (37.2%) compared to standardized preformed spacers (13.8%).
- The most common complication was spacer dislocation, and it was noted that the presence of metallic components did not significantly affect the complication rates, emphasizing the importance of careful patient selection for spacer implantation.
Oncoplastic breast surgery is an evolving field combining both breast aesthetic surgery and oncologic breast surgery. It aims to optimize cosmetic outcomes without interfering with oncologic safety. The superior hemimastectomy is a technique that can be considered for large upper-quadrant breast tumors or multifocal and multicentric breast tumors localized in the upper quadrants.
View Article and Find Full Text PDFThe main objective of this work was to study the effects of banana flour as energy sources on broiler performance. Seventy-five broilers were randomly distributed into five groups each with 15 broilers (n = 15 broilers/group). The broilers were grouped to maize-soybean meal diet as control, T : (5% of banana flour), T : (10% of banana flour), T : (15% of banana flour), and T : (20% of banana flour).
View Article and Find Full Text PDFThe influence of father-son relationships on adolescent personality and attitudes.
J Child Psychol Psychiatry
April 1963