Periprosthetic Femoral Fractures around Hip Arthroplasty: Current Concepts in their Management

2009 ◽  
Vol 19 (2) ◽  
pp. 75-86 ◽  
Author(s):  
Eleftherios Tsiridis ◽  
George Pavlou ◽  
Ram Venkatesh ◽  
Peter Bobak ◽  
Graham Gie
Keyword(s):  
Surgical Techniques ◽  
Femoral Fractures ◽  
Classification Systems ◽  
Anatomical Location ◽  
Bone Allografts ◽  
Current Classification ◽  
Revision Hip Surgery ◽  
Long Stem ◽  
Fracture Stability

Peri-prosthetic fractures (PFF) are complex management problems in orthopaedic surgery. Their treatment has evolved with advances in principles of internal fixation and revision hip surgery. Current classification systems look at anatomical location, prosthesis stability and Bone quality. Recent evidence highlights the importance of fracture stability in treatment planning, the weaknesses of single plating, the increasing role of long stem revision and also the importance of Bone allografts. We present the principles of management of both intra and post-operative PFFs, including surgical techniques and published outcomes.

Role of long stem revision knee prosthesis in periprosthetic and complex distal femoral fractures: A review of eight patients

Injury ◽  
2005 ◽  
Vol 36 (9) ◽  
pp. 1094-1102 ◽  
Author(s):  
Kuntrapaka Srinivasan ◽  
David A. Macdonald ◽  
Christopher C. Tzioupis ◽  
Peter V. Giannoudis
Keyword(s):  
Knee Prosthesis ◽  
Femoral Fractures ◽  
Distal Femoral Fractures ◽  
Stem Revision ◽  
Long Stem

scholarly journals Towards Personalized Medicine: Non-Coding RNAs and Endometrial Cancer

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 965
Author(s):  
Anna Franca Cavaliere ◽  
Federica Perelli ◽  
Simona Zaami ◽  
Roberto Piergentili ◽  
Alberto Mattei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Personalized Medicine ◽  
Early Stage ◽  
Classification Systems ◽  
Clinical Staging ◽  
Prediction Function ◽  
Current Classification ◽  
Non Coding Rnas

Endometrial cancer (EC) is the most frequent female cancer associated with excellent prognosis if diagnosed at an early stage. The risk factors on which clinical staging is based are constantly updated and genetic and epigenetic characteristics have recently been emerging as prognostic markers. The evidence shows that non-coding RNAs (ncRNAs) play a fundamental role in various biological processes associated with the pathogenesis of EC and many of them also have a prognosis prediction function, of remarkable importance in defining the therapeutic and surveillance path of EC patients. Personalized medicine focuses on the continuous updating of risk factors that are identifiable early during the EC staging to tailor treatments to patients. This review aims to show a summary of the current classification systems and to encourage the integration of various risk factors, introducing the prognostic role of non-coding RNAs, to avoid aggressive therapies where not necessary and to treat and strictly monitor subjects at greater risk of relapse.

SHOULDER GIRDLE RESECTION FOR BONE TUMORS, A MODIFICATION IN THE SURGICAL TECHNIQUES AND INTRODUCTION OF A NEW CLASSIFICATION SYSTEM

2019 ◽  
Vol 22 (01n02) ◽  
pp. 1950002
Author(s):  
Ahmed Shehadeh ◽  
Ahmad F. Ja’far ◽  
Anas Hamad
Keyword(s):  
Classification System ◽  
Bone Tumors ◽  
Surgical Techniques ◽  
Shoulder Girdle ◽  
Classification Systems ◽  
Surgical Approaches ◽  
Functional Score ◽  
Anatomical Location ◽  
Type I ◽  
New Classification

Background: Surgical techniques for resection of tumors at proximal humerus and scapula has been described in literature along with different classification systems, however, these techniques have not been revised for a while and the classification systems which are currently in use neither respect the difference between bone and soft tissue tumors nor the anatomical location humeral vs scapular. Material and Methods: The author operated on 32 patients with shoulder girdle tumors, all are bone tumors, Ewings sarcoma ([Formula: see text]), Osteosarcoma ([Formula: see text]), Metastatic tumors ([Formula: see text]), GCT ([Formula: see text]), Chondrosarcoma ([Formula: see text]). We assigned two separate classifications to humerus and scapula resection, since surgical approaches, techniques, and reconstruction options are totally different for the both sites. Resection of the humerus is classified into: Type I to Type IV, A: is added to the type when the majority of Deltoid is preserved, and B: when it is sacrificed. And we classify the scapula resection into: Type I to Type III, A: is added to the type when the majority of Deltoid is preserved, and B: when it is sacrificed. In extra articular humerus resection, we found that sacrificing the acromion and coracoid process is not necessary as part of routine resection. Preservation of these structures can improve the cosmetic appearance of the shoulder with at least equal functional outcome. Endoprosthesis was used in 26 patients for reconstruction, osteoarticular allograft was used in 2 patients, and Tichoff Lindberg technique for 4 patients. Results: At 30 month mean follow up period, 2 patients developed local recurrence (osteosarcoma [Formula: see text], Ewing Sarcoma [Formula: see text]), 2 patients had wound infection, and one patient developed stem loosening. The average MSTS functional score for all patients was 83%. Conclusion: The modification of surgical techniques saved structures which were unnecessarily resected, and kept the integrity of muscles and their attachments which were sacrificed in previously described techniques. This might lead to fewer restrictions during the rehabilitation process and resulted in preservation of the shoulder contour. The new classification system is realistic, separates the humeral resection from the scapular one, easy to be recalled and applicable to all patients.

scholarly journals Depression and schizophrenia

2012 ◽  
Vol 18 (4) ◽  
pp. 280-288 ◽  
Author(s):  
David Castle ◽  
Peter Bosanac
Keyword(s):  
Depressive Symptoms ◽  
Therapeutic Intervention ◽  
Evidence Base ◽  
Classification Systems ◽  
Clinical Implications ◽  
Confounding Factors ◽  
Current Classification

SummaryDepressive symptoms commonly occur in schizophrenia and have a significant impact on the distress and burden of the illness. Yet they are often overlooked, inadequately characterised by current classification systems and not consistently integrated into treatment. We discuss nosology, practical and clinical implications of symptom differentiation, and the role of causal and confounding factors, including iatrogenic, as targets for therapeutic intervention. The evidence base of psychosocial and psychotropic management is reviewed, with recommendations for the treatment of established syndromal depression in people with schizophrenia.

Isolated meniscus injuries in skeletally immature children and adolescents: state of the art

2021 ◽  
pp. jisakos-2020-000496
Author(s):  
Gustavo Vinagre ◽  
Flávio Cruz ◽  
Khalid Alkhelaifi ◽  
Pieter D'Hooghe
Keyword(s):  
Children And Adolescents ◽  
State Of The Art ◽  
Surgical Techniques ◽  
Meniscal Repair ◽  
Management Plan ◽  
Anatomical Location ◽  
Return To Sports ◽  
Meniscal Tears ◽  
Geographical Differences ◽  
Meniscal Healing

The prevalence of isolated meniscal injuries in children and adolescents is low; however, we see an increase mainly due to intensified sports-related activities at an early age. A meniscal repair should be attempted whenever possible as children present with increased meniscal healing potential. The diagnosis and management of meniscal tears involve both patient factors and tear characteristics: size, anatomical location and associated injuries. Special attention should be given to the feature of discoid menisci and related tears as they require a specific management plan. This state-of-the-art review highlights the most recent studies on clinical evaluation, surgical techniques, tips and tricks, pitfalls, outcomes, return-to-sports, geographical differences and future perspectives related to meniscal injuries in children and adolescents.

scholarly journals Endovascular Considerations in Traumatic Injury of the Carotid and Vertebral Arteries

2021 ◽  
Vol 38 (01) ◽  
pp. 053-063
Author(s):  
Ananth K. Vellimana ◽  
Jayson Lavie ◽  
Arindam Rano Chatterjee
Keyword(s):  
Natural History ◽  
Clinical Presentation ◽  
Traumatic Injury ◽  
Classification Systems ◽  
Endovascular Techniques ◽  
Traumatic Injuries ◽  
Cerebrovascular Injury ◽  
Vertebral Arteries ◽  
Carotid And Vertebral Arteries

AbstractCervical carotid and vertebral artery traumatic injuries can have a devastating natural history. This article reviews the epidemiology, mechanisms of injury, clinical presentation, and classification systems pertinent to consideration of endovascular treatment. The growing role of modern endovascular techniques for the treatment of these diseases is presented to equip endovascular surgeons with a framework for critically assessing patients presenting with traumatic cervical cerebrovascular injury.

scholarly journals The Potential Association between the Risk of Post-Surgical Adhesion and the Activated Local Angiotensin II Type 1 Receptors: Need for Novel Treatment Strategies

2021 ◽  
pp. 1-8
Author(s):  
Mahmood Tavakkoli ◽  
Saeed Aali ◽  
Borzoo Khaledifar ◽  
Gordon A. Ferns ◽  
Majid Khazaei ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Molecular Mechanisms ◽  
Transforming Growth Factor ◽  
Therapeutic Potential ◽  
Angiotensin Receptor Blockers ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Transforming Growth Factor Β

<b><i>Background:</i></b> Post-surgical adhesion bands (PSABs) are a common complication after abdominal or pelvic surgeries for different reasons like cancer treatment. Despite improvements in surgical techniques and the administration of drugs or the use of physical barriers, there has only been limited improvement in the frequency of postoperative adhesions. Complications of PSAB are pain, infertility, intestinal obstruction, and increased mortality. The most important molecular mechanisms for the development of PSAB are inflammatory response, oxidative stress, and overexpression of pro-fibrotic molecules such as transforming growth factor β. However, questions remain about the pathogenesis of this problem, for example, the causes for individual differences or why certain tissue sites are more prone to post-surgical adhesions. <b><i>Summary:</i></b> Addressing the pathological causes of PSAB, the potential role of local angiotensin II/angiotensin II type 1 receptors (AngII/AT1R), may help to prevent this problem. <b><i>Key Message:</i></b> The objective of this article was to explore the role of the AngII/AT1R axis potential to induce PSAB and the therapeutic potential of angiotensin receptor blockers in the prevention and treatment of PSAB.

scholarly journals Non-Coding RNAs as Prognostic Markers for Endometrial Cancer

2021 ◽  
Vol 22 (6) ◽  
pp. 3151 ◽  
Author(s):  
Roberto Piergentili ◽  
Simona Zaami ◽  
Anna Franca Cavaliere ◽  
Fabrizio Signore ◽  
Giovanni Scambia ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Markers ◽  
Classification Systems ◽  
Prognostic Role ◽  
Protein Coding ◽  
Pathological Characteristics ◽  
Epigenetic Events ◽  
Cancer Types ◽  
Non Coding Rnas

Endometrial cancer (EC) has been classified over the years, for prognostic and therapeutic purposes. In recent years, classification systems have been emerging not only based on EC clinical and pathological characteristics but also on its genetic and epigenetic features. Noncoding RNAs (ncRNAs) are emerging as promising markers in several cancer types, including EC, for which their prognostic value is currently under investigation and will likely integrate the present prognostic tools based on protein coding genes. This review aims to underline the importance of the genetic and epigenetic events in the EC tumorigenesis, by expounding upon the prognostic role of ncRNAs.

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