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  1. Article ; Online: Common inflammatory markers in the screening of knee arthroprosthesis infections.

    Conteduca, Jacopo / Filipponi, Marco / Pichierri, Paolo / Casto, Alberto / Meccariello, Luigi / Rollo, Giuseppe

    Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina

    2024  Volume 21, Issue 1, Page(s) 203–207

    Abstract: Aim To evaluate the sensitivity and specificity of serum C-reactive protein (CRP) in early and late total knee arthroplasty (TKA) infections. Methods Blood tests to determine CRP levels (cut-off 10 mg/L)were conducted before surgery, at 1st day, 7th day ... ...

    Abstract Aim To evaluate the sensitivity and specificity of serum C-reactive protein (CRP) in early and late total knee arthroplasty (TKA) infections. Methods Blood tests to determine CRP levels (cut-off 10 mg/L)were conducted before surgery, at 1st day, 7th day and 15th day after surgery and at 1, 3, 6,12, 24 and 36 months. Patients had routine follow-up visits and radiological evaluations at 14 days and at 1, 3, 6, 12, 24 and 36 months. Infections were recorded and classified according to Widmer classification. The χ2 test or Fisher (in subgroups smaller than 10 patients) exact test was used to compare categorical variables. The statistical significance was set at p <0.05. Results A total of 19 infections were diagnosed during the followup. According to Widmer, five were classified as early post-operative and 14 as late chronic. All patients with early infections had suspected symptoms such as fever, swelling and pain. During the first month, 59 patients who had high CRP level but negative microbiological culture were considered as false positive representing a CRP sensitivity of 80% and a specificity of 67.6%. Fourteen patients had late chronic infection. Conclusion This study suggests that a synovial fluid aspiration should be performed in patients with persistent inflammation symptoms with or without radiographic signs of loosening. Moreover, it recommends the use of different serum and synovial tests for periprosthetic joint infection (PJI) diagnosis.
    Language English
    Publishing date 2024-02-01
    Publishing country Bosnia and Herzegovina
    Document type Journal Article
    ZDB-ID 2378942-6
    ISSN 1840-2445 ; 1840-2445
    ISSN (online) 1840-2445
    ISSN 1840-2445
    DOI 10.17392/1688-23
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A staged use of tourniquet does not influence the fast-track recovery after total knee arthroplasty: a prospective randomized study.

    Salari, Paolo / Balato, Giovanni / Cavallo, Giuseppe / Strigelli, Vanni / Meccariello, Andrea / Baldini, Andrea

    Archives of orthopaedic and trauma surgery

    2024  

    Abstract: Introduction: Upper-tight tourniquet is widely used in Total Knee Arthroplasty in different modalities. However, it has been associated with a negative impact on post-operative muscle strength end pain. This study aimed to investigate the effect of ... ...

    Abstract Introduction: Upper-tight tourniquet is widely used in Total Knee Arthroplasty in different modalities. However, it has been associated with a negative impact on post-operative muscle strength end pain. This study aimed to investigate the effect of tourniquet on post-operative pain and recovery in enhanced recovery joint surgery.
    Materials and methods: In this prospective randomized study, we included 116 patients undergoing to TKA. Surgery was performed with a staged use of tourniquet in Group A (58 patients) and without tourniquet in Group B. In the former group a low-pressure tourniquet was deflated after bone cuts to allow hemostasis of posterior recess and re-inflated for cementation. For all patients a multimodal fast-track recovery protocol was used. Time to reach rehabilitation milestones was recorded as primary endpoint. Range of motion, pain, hemarthrosis, total blood loss, surgical field visualization, Knee Score (KS) and Oxford Knee Score (OKS) were considered as secondary outcomes.
    Results: . No statistically significant differences were found (group B: average 1.3 ± 0.6 day; group A: average 1.2 ± 0.5 day). Group A had a shorter mean surgical time and a clearer surgical field visualization. Group B had a larger estimated blood loss and hemoglobin drop without a statistically significant difference in the transfusion rate. No differences between the groups were seen in the KS, OKS and range of motion (ROM) and post-operative joint swelling. Pain score was similar between cohorts and recorded thigh pain was surprisingly greater in group B.
    Discussion: The use of tourniquet in TKA surgery helps to minimize intraoperative blood loss and improves surgical field visualization. Its application with a modern and staged protocol does not affect the functional outcomes (OKS, KSS, ROM) of the early post operative period without compromising the fast-track recovery.
    Language English
    Publishing date 2024-04-03
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 80407-1
    ISSN 1434-3916 ; 0003-9330 ; 0344-8444
    ISSN (online) 1434-3916
    ISSN 0003-9330 ; 0344-8444
    DOI 10.1007/s00402-024-05300-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: What ENT doctors should know about COVID-19 contagion risks.

    Meccariello, Giuseppe / Gallo, Oreste

    Head & neck

    2020  Volume 42, Issue 6, Page(s) 1248–1249

    MeSH term(s) Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Otolaryngology ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-04-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645165-2
    ISSN 1097-0347 ; 0148-6403 ; 1043-3074
    ISSN (online) 1097-0347
    ISSN 0148-6403 ; 1043-3074
    DOI 10.1002/hed.26190
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Transoral robotic styloidectomy for Eagle syndrome: A systematic review.

    Campisi, Ruggero / Caranti, Alberto / Meccariello, Giuseppe / Stringa, Luigi Marco / Bianchini, Chiara / Ciorba, Andrea / Pelucchi, Stefano / Vicini, Claudio

    Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

    2024  Volume 49, Issue 3, Page(s) 293–298

    Abstract: Objectives: The aim of the study is to conduct a systematic review of the existing literature on styloidectomy performed through transoral robotic surgery (TORS) in Eagle syndrome (ES).: Design and setting: Two independent reviewers (RC and AC) ... ...

    Abstract Objectives: The aim of the study is to conduct a systematic review of the existing literature on styloidectomy performed through transoral robotic surgery (TORS) in Eagle syndrome (ES).
    Design and setting: Two independent reviewers (RC and AC) conducted a systematic review of PubMed and Embase databases, seeking articles on TORS performed for ES treatment. The search was conducted in July 2023. The review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
    Participants: The review included a total of 17 adult patients, comprising 12 females and 5 males, with an average age of 52.2 years, all diagnosed with ES.
    Main outcome measures: For each patient, we assessed the overall length of the styloid process, the affected side, total intervention duration, hospitalization duration, pre and postoperative Visual Analogue Scale (VAS) scores, and the presence of minor and major complications.
    Results: We identified 4 articles describing 17 instances of TORS as a surgical treatment for ES in the literature, totaling 18 styloidectomies. The mean age of the patients was 52.2 years, with 12 females and 5 males. The average operation time, inclusive of the docking phase, was 68.8 minutes. Sixteen patients (94.1% of the total) experienced complete symptom disappearance or near-complete resolution after surgery. One patient (5.9%) showed improvement categorized as 'non-meaningful.' Only one case of minor complication was reported among the 17 procedures (5.9%).
    MeSH term(s) Adult ; Male ; Female ; Humans ; Middle Aged ; Robotic Surgical Procedures/methods ; Ossification, Heterotopic/surgery ; Temporal Bone/surgery ; Temporal Bone/abnormalities ; Hospitalization
    Language English
    Publishing date 2024-01-30
    Publishing country England
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2205891-6
    ISSN 1749-4486 ; 1749-4478 ; 0307-7772 ; 1365-2273
    ISSN (online) 1749-4486
    ISSN 1749-4478 ; 0307-7772 ; 1365-2273
    DOI 10.1111/coa.14145
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Oncological features and outcomes of laryngeal cancer surgery: a multicentric study.

    Migliorelli, Andrea / Caranti, Alberto / Ferrarini, Luca / Meccariello, Giuseppe / Cammaroto, Giovanni / Ciorba, Andrea / Vicini, Claudio / Pelucchi, Stefano / Bianchini, Chiara

    Minerva surgery

    2024  Volume 79, Issue 2, Page(s) 140–146

    Abstract: Background: Laryngeal cancer (LC) is among of the most frequent head and neck cancers, associated to a high social impact and mortality. Unfortunately, the current treatment outcomes of LC are often scant, with different factors affecting patient's ... ...

    Abstract Background: Laryngeal cancer (LC) is among of the most frequent head and neck cancers, associated to a high social impact and mortality. Unfortunately, the current treatment outcomes of LC are often scant, with different factors affecting patient's prognosis (i.e., advanced age, advanced disease stage, lymph node involvement, tumor pathological features, type of intervention). The aims of the present study were: 1) to evaluate the epidemiological and clinical features of patients affected by LC; and 2) to focus on tumor risk factors affecting patient's overall survival (OS) and recurrences.
    Methods: A retrospective analysis of all patients affected by LC and surgically treated at two different hospital settings has been performed.
    Results: Two hundred twenty-five patients were enrolled in the present study; of these 189 were males (84%) and 36 (16%) were females. The most frequently performed surgery was total laryngectomy. Thirty-two (14.2%) patients experienced local recurrence, while 15 patients (6.6%) had regional recurrence and 15 distant metastases. Multivariate analysis showed that locoregional recurrence was associated to the occurrence of distant metastases (P=0.002, HR=25,35). Analyzing OS, the only statistically significant factor that correlated with an increased risk of mortality (P<0.015, HR=2,45) was locoregional recurrence.
    Conclusions: The present study confirms the literature data about age and sex distribution of LC, about tumors localization, lymph nodes metastasis and distant metastasis incidence and OS rate, based on T and N stage. Interestingly, within this series, the presence of locoregional recurrence or distant metastasis is related to a worst prognosis and a lower overall survival rate.
    MeSH term(s) Male ; Female ; Humans ; Laryngeal Neoplasms/epidemiology ; Laryngeal Neoplasms/surgery ; Retrospective Studies ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Larynx/pathology ; Head and Neck Neoplasms/pathology
    Language English
    Publishing date 2024-01-24
    Publishing country Italy
    Document type Multicenter Study ; Journal Article
    ZDB-ID 3067899-7
    ISSN 2724-5438
    ISSN (online) 2724-5438
    DOI 10.23736/S2724-5691.23.09950-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Reoperation in Chiari-1 Malformations.

    Talamonti, Giuseppe / Picano, Marco / Fragale, Maria / Marcati, Eleonora / Meccariello, Giulia / Boeris, Davide / Cenzato, Marco

    Journal of clinical medicine

    2023  Volume 12, Issue 8

    Abstract: 1) Background: The issue of unsuccessful surgery for Chiari-1 malformation (CM-1), as well as its potential causes and possible solutions, remains poorly documented and studied. (2) Methods: From a retrospective review of a personal series of 98 ... ...

    Abstract (1) Background: The issue of unsuccessful surgery for Chiari-1 malformation (CM-1), as well as its potential causes and possible solutions, remains poorly documented and studied. (2) Methods: From a retrospective review of a personal series of 98 patients undergoing treatment for CM-1 during the past 10 years, we created two study groups. Group 1: 8 patients (8.1%) requiring additional surgeries owing to postoperative complications (7 cerebrospinal fluid leakage, 1 extradural hematoma); 7 patients (7.1%) undergoing reoperations for failed decompression during the follow-up. Group 2: During the same period, we also managed 19 patients who had previously been operated on elsewhere: 8 patients who required adequate CM-1 treatment following extradural section of the filum terminale; 11 patients requiring reoperations for failed decompression. Failed decompression was managed by adequate osteodural decompression, which was associated with tonsillectomy (6 cases), subarachnoid exploration (8 cases), graft substitution (6 cases), and occipito-cervical fixation/revision (1 case). (3) Results: There was no mortality or surgical morbidity in Group 1. However, one patient's condition worsened due to untreatable syrinx. In Group 2, there were two cases of mortality, and surgical morbidity was represented by functional limitation and pain in the patient who needed revision of the occipitocervical fixation. Twenty patients improved (58.8%), 6 remained unchanged (32.3%), 1 worsened (2.9%) and 2 died (5.9%). (4) Conclusions: The rate of complications remains high in CM-1 treatment. Unfortunately, a certain rate of treatment failure is unavoidable, but it appears that a significant number of re-operations could have been avoided using proper indications and careful technique.
    Language English
    Publishing date 2023-04-13
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12082853
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Subcutaneous emphysema as a complication of otorhinolaryngological surgical procedures.

    Cerritelli, Luca / Caranti, Alberto / Ehsani, Diana / Moretti, Claudio / Meccariello, Giuseppe / Cammaroto, Giovanni / Pelucchi, Stefano

    Minerva surgery

    2023  Volume 78, Issue 4, Page(s) 401–412

    Abstract: Introduction: Subcutaneous emphysema (SE) represents, after bleeding and infections, a common complication in ENT surgery, given the intimate relationship between upper airways and anatomical area pertaining head and neck surgeon. Aim of this review is ... ...

    Abstract Introduction: Subcutaneous emphysema (SE) represents, after bleeding and infections, a common complication in ENT surgery, given the intimate relationship between upper airways and anatomical area pertaining head and neck surgeon. Aim of this review is to analyze its characteristics, method of diagnosis and treatment to provide the specialist a useful tool for its early recognition.
    Evidence acquisition: A narrative review was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. A total of 164 articles were collected and most of them were case reports.
    Evidence synthesis: Of 273 articles taken into consideration, only 164 met inclusion criteria. Review of all cases of SE in relation to surgical ENT procedures allow to classify each etiology on the surgical procedure that could be complicated with SE: laryngo-tracheal procedures, thyroid surgery, nasal and otological surgery, adenotonsillectomies. Moreover, traumatic orotracheal intubation, as well as alveolar rupture because of positive pressure ventilation or rupture of a preexisting abnormality, must be always taken into account.
    Conclusions: All ENT surgery can be complicated by SE. Diagnosis is simple and usually based only on physical examination, but correct and quick diagnosis is required. Treatment is in most of the time exclusively conservative, but SE could also represent a surgical emergency, given the possible evolution in pneumothorax/pneumomediastinum with serious consequences for patient's health.
    MeSH term(s) Humans ; Subcutaneous Emphysema/diagnostic imaging ; Subcutaneous Emphysema/etiology ; Otorhinolaryngologic Surgical Procedures/adverse effects ; Mediastinal Emphysema/diagnostic imaging ; Mediastinal Emphysema/etiology ; Trachea ; Intubation, Intratracheal/adverse effects
    Language English
    Publishing date 2023-03-23
    Publishing country Italy
    Document type Review ; Journal Article
    ZDB-ID 3067899-7
    ISSN 2724-5438
    ISSN (online) 2724-5438
    DOI 10.23736/S2724-5691.23.09855-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Surgical Treatment of Complex Craniofacial Fractures.

    Talamonti, Giuseppe / Fragale, Maria / Carrassi, Erika / Meccariello, Giulia / Pozza, Alessandro / Canzi, Gabriele

    World neurosurgery

    2023  Volume 183, Page(s) e462–e469

    Abstract: Objective: Severe craniofacial fractures may present different needs in treating intracranial lesions over facial injuries. This paper examines the results of our strategy, consisting of a single-stage combined neurosurgical-maxillofacial treatment.: ... ...

    Abstract Objective: Severe craniofacial fractures may present different needs in treating intracranial lesions over facial injuries. This paper examines the results of our strategy, consisting of a single-stage combined neurosurgical-maxillofacial treatment.
    Methods: A retrospective review was conducted of 33 consecutive patients with complex fractures of the anterior cranial fossa and facial skeleton, who required elective surgery for craniofacial reconstruction. Patients who required emergency surgery for intracranial clots or penetrating wounds were excluded. In all cases, all or almost all the anterior skull-base was injured with compound fractures of the frontal sinus, the orbital roofs, the lamina cribrosa, and the planum sphenoidale. In all cases, the prioritization of treatment was carefully discussed, and surgical timing and strategy were agreed.
    Results: There was 1 dead. Olfactory injuries were always found intraoperatively. There were no mucoceles, CSF-leak recurrences, cranial infections, or neurologic worsening. The functional and neurologic results were highly satisfactory.
    Conclusions: The one-stage surgical treatment of complex craniofacial fractures has numerous advantages, including the possibility of reducing facial fractures without the risk of CSF leaks. It also eliminates the need for repeated procedures in fragile patients, and the need to dismantle the facial reconstruction if the skull base repair is performed later. The main issue is the surgical timing, considering that the maxillofacial surgeon usually favors early facial repair, whereas the neurosurgeon generally prefers delayed manipulation of the contused frontal lobes. A timeframe of 10-14 days after trauma may be a good compromise for safe procedures with excellent neurologic and functional outcomes.
    MeSH term(s) Humans ; Skull Base/surgery ; Skull Fractures/surgery ; Ethmoid Bone/surgery ; Plastic Surgery Procedures ; Cranial Fossa, Anterior/surgery
    Language English
    Publishing date 2023-12-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2023.12.121
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Tracheal reconstruction: mini-review and anatomical study on the use of antero lateral thigh fascial flap for heterotopical transplantation.

    Sgarzani, Rossella / Meccariello, Giuseppe / Iannella, Giannicola / Stella, Franco / Negosanti, Luca

    Indian journal of thoracic and cardiovascular surgery

    2022  Volume 38, Issue 5, Page(s) 506–510

    Abstract: Background: The reconstructive tracheal options for extensive lesions still remain limited and although a valid substitute is required unfortunately, the biomechanical tracheal characteristics do not allow an easy replacement. In this study we reviewed ... ...

    Abstract Background: The reconstructive tracheal options for extensive lesions still remain limited and although a valid substitute is required unfortunately, the biomechanical tracheal characteristics do not allow an easy replacement. In this study we reviewed the described options and investigated, in human cadaver model, whether thigh fascia can be used, as an alternative to forearm fascia, as recipient site for trachea graft heterotopical allotransplantation.
    Anatomical study: In three fresh cadavers, 3 tracheal graft, 6 radial forearm (RF) fascial flaps and 6 antero-lateral thigh (ALT) fascial flaps were harvested. For each flap we simulated the heteretopical transplantation of the trachea in each fascial flap, and the harvesting of the composite graft as a free flap. The composite graft was finally decomposed at bench and the pedicle was injected to confirm fascial vascularization. The main measured outcomes were: flap fascia vascularization after pedicle injection, average time of flap harvesting, number of perforators included in ALT fascial flap and diameter of the vessels for anastomosis. Difficulties were noted, in order to compare RF flap and ALT flap.
    Results: Fascia vascularization was confirmed in all cases by pedicle injection. The main difficulty with radial flap was to harvest the fascial layer due to its thinness and its strong adherence to palmaris longus tendon, while the main difficulty with ALT flap was to prevent any traction on the perforators. The average time of flap harvesting and graft inset (by a junior plastic surgeon) was 1 h and 30 min for radial forearm flap and 2 h and 10 min for ALT flap.
    Conclusion: Despite many different techniques proposed in the literature, tracheal heterotopical allotransplantation still seemed the most promising, and ALT flap promised be a feasible alternative for heterotopical transplantation of trachea.
    Language English
    Publishing date 2022-04-04
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2164386-6
    ISSN 0973-7723 ; 0970-9134
    ISSN (online) 0973-7723
    ISSN 0970-9134
    DOI 10.1007/s12055-022-01354-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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