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Introduction/Objective. Pathologic fractures are devastating complications in metastatic bone disease. Treatment of these condition varies, and includes systemic therapies and surgical interventions. Lack of evidence still exists for standardized care. The aim of this study is to analyze radiological healing response and clinical outcomes after intramedullary nailing (IMN) and adjuvant radiotherapy in complete pathologic fractures of femur or humerus Methods. A total of 19 patients who presented with pathological fracture were retrospectively reviewed. Data regarding demographic characteristics, clinical outcomes and radiologic images were obtained from hospital records. All patients in this cohort were treated with closed, unreamed IMN and adjuvant radiation treatment. Results. Pain relief and full range of motion was obtained in all patients. The mean postoperative Musculoskeletal Tumor Society scores at last follow-up were 69% (range 50–85). All patients demonstrated complete radiographic healing between 2 and 6 months. Only one patient required reoperation for refracture at the tip of the nail which was revised with a longer nail. Conclusion. Our study demonstrated that pathologic fractures managed with closed unreamed IMN and adjuvant multifractional 20 Gy dose radiotherapy yielded good clinical outcomes with complete radiologic response regardless of patient’s life expectancy, adjuvant treatments and overall condition. Closed unreamed IMN was also associated with decreased surgical time in these high-risk patients.

Introduction/Objective. Sciatica is a disabling pathology with variable etiologies. The most common pathologies arise from discogenic or non-discogenic causes. Mass lesions are a rare cause of extraspinal sciatica, which have been commonly overlooked, leading to unnecessary spinal surgeries, delay in diagnosis or inadequate treatment. There is no standard surgical approach and functional outcomes after surgical treatment of these lesions are not well-known. The aim of this study is to evaluate clinical outcomes after surgical treatment of mass lesions causing sciatica in different locations. Methods. Data were obtained by a retrospective review from 2015 to 2020. The mean duration of symptoms at the time of surgery was 10.3 months (3–48 months). The mean age of patients at the time of surgery was 43.8 years (14–73 years). The mean follow-up was 19.5 months (4–50 months). In total, 14 cases had an extrapelvic localization distal to sciatic notch. The other three cases had lesions in the intrapelvic area, including left sciatic notch (1), right acetabulum (1), sacroiliac and lumbosacral region (1). None of the patients had palpable masses. Transgluteal, infragluteal, lateral, and posteromedial approach were used depending on location and size of the lesion. Results. At the final follow-up, all patients recovered with pain relief. The median musculoskeletal tumor society score was 90% (70–100). There was no recurrence at the latest follow-up. Conclusion. Our study demonstrated that early detection by neurological examination and radiological work-up can avoid unnecessary surgeries, enable early surgical treatment of tumoral mass with satisfactory clinical outcomes. The surgical approach should be individualized according to location and size of the lesion.

The CLEANKER (CLEAN clinKER production by calcium looping process) project got EC support from October 2017 to September 2021 under the Horizon 2020 call LCE 29 – 2017. CLEANKER (www.cleanker.eu) aims at demonstrating at TRL7 (Technology Readiness Level) the Calcium Looping (CaL) concept in a configuration highly integrated with the cement production process, making use of entrained flow reactors. There are currently no feasible methods to produce clinker, and thus cement, without releasing CO2 from CaCO3, and, given the lifetime of a cement plant, the technologies to be developed have to be retrofittable. In addition to oxyfuel combustion and post-combustion solvent-based capture technologies, which have attracted most of the research efforts up to now, Calcium Looping is recognized as another very promising emerging technology for CO2 capture in cement plants. The core activity of the project is the design, construction and operation of a CaL demonstration system including the entrained-flow carbonator (the CO2 absorber) and the entrained-flow oxyfuel calciner (the sorbent regenerator). This demonstration system, connected to the Buzzi Unicem kiln of the Vernasca cement plant (Italy), will capture the CO2 from a portion of the flue gases of the kiln, using as CO2 sorbent the same raw meal that is used for clinker production. The CLEANKER implementation plan spans four years from October 2017 to September 2021.The project is in its crucial phase: the erection of the demo plant is going to be completed by the end of August 2020 and the experimental campaigns will start immediately after.

O artigo aborda o perfil sócio-demográfico e ocupacional do Programa Saúde da Família (PSF) do Estado de Mato Grosso, Brasil, apresentando os julgamentos avaliativos de médicos e enfermeiros das equipes sobre os seguintes aspectos: graus de concordância sobre os propósitos do programa; graus de uso de meios de planejamento e de implantação das ações de atenção básica. Trata-se de pesquisa avaliativa, que conduziu às seguintes conclusões: (1) o perfil dos profissionais confirma a tendência da feminilização da força de trabalho em saúde; prevalecem os contratos precários de trabalho e a rotatividade dos trabalhadores; os rendimentos são díspares entre as duas categorias profissionais; registraram-se esforços de capacitação para adequar o perfil de formação ao programa; (2) médicos e enfermeiros julgam que o programa alterou o modelo assistencial, favorecendo o controle social, a vigilância epidemiológica e a promoção à saúde; (3) eles julgam ser elevado o grau de implantação de várias ações de atenção básica previstas, e menor o das ações educativas, intersetoriais e de controle das doenças crônicas e endêmicas.

Abstract Background Respiratory Syncytial Virus (RSV) is the most important cause of severe respiratory infections in infants with seasonal epidemics. Environmental factors (temperature, humidity, air pollution) could influence RSV epidemics through their effects on virus activity and diffusion. Methods We conducted a retrospective study on a paediatric population who referred to our Paediatric Emergency Unit in order to analyze the correlation between weekly incidence of RSV positive cases during winter season in Bologna and meteorological factors and air pollutants concentration. Results We observed a significant correlation between the incidence of RSV infections and the mean minimum temperature registered during the same week and the previous weeks. The weekly number of RSV positive cases was also correlated to the mean PM10 concentration of the week before. Conclusions RSV epidemic trend in Bologna (Italy) is related to the mean minimum temperature, and the mean PM10 concentration.

Abstract We report the case of a parosteal osteosarcoma of the distal ulna, treated with wide resection without reconstruction. The patient developed lung metastasis and a mass in the interosseus membrane of the forearm proximally to the osteotomy. The lung mass was found to be a metastasis from parosteal osteosarcoma and the biopsy of the forearm mass revealed a myositis ossificans. The suspicion of a recurrence of parosteal osteosarcoma, already metastatic, led to a second wide resection with no reconstruction. A slice of the radial cortex was taken during this second procedure. From a histological point of view, good margins were achieved and diagnosis of myositis ossificans was confirmed. Two months later, a radius fracture occurred and a synthesis, with plate and screws, as added with poly(methyl methacrylate) (PMMA) to reconstruct the bone loss, was performed. Indication of the reconstructive technique and the complication after distal ulna resection in oncologic surgery are discussed in this paper.

Abstract Introduction We present a case of a patient with juxtaarticular hemangiohamartoma with a synovial extension associated with hemorrhagic synovitis and recurrent spontaneous hemarthrosis. Case presentation A 21-year-old Caucasian woman was admitted to our hospital complaining of pain and swelling at her knee for 6 months. In the magnetic resonance imaging, T2-weighted and fat-suppressed scans revealed a mass with high signal intensity just posterior to the patellar tendon. We performed an excisional biopsy of the mass through an anterior longitudinal incision. Excised material included arterial and venous vascular structures, which were found to be spread among the fat, connective and peripheral nerve tissues microscopically. Conclusion Although hemangiohamartomas are not true neoplasms, they may cause knee pain, swelling and hemarthrosis that warrant surgical resection. This lesion, although rare, should be considered in the differential diagnosis, especially in teenagers and young adults.