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Biomedical subjects

G Puddu

Publications and source records attributed to G Puddu.

62 records · Page 4Linked to original sources

Meniscal tears and associated anterior cruciate ligament tears in athletes: course of treatment.

Sixty-two athletes whose injured knees had negligible instability were found to have an absent or functionless anterior cruciate ligament (ACL) at the time of medial meniscectomy. After a mean of 52 months of followup, 51 patients were examined; 24 (47%) had returned to full sports activities, whereas 27 (53%) acknowledged incidents of the knee "giving way" or having completely given up sports because of instability. By analyzing the following variables, the jerk test, the type of meniscal lesion, and the type of sports engaged, we formulated a rating system to be used intraoperatively for determining the need for combining meniscectomy with a ligament reconstruction.

Adolescent↗

Evaluation of the results of extensor mechanism reconstruction.

One hundred sixteen patients underwent extensor mechanism reconstruction. Ninety-four returned at followup (3 to 11 years after surgery). Twenty-two patients were lost to followup. Subjectively, 74% of the patients had either an excellent or good result and 26% either a fair or poor result. We found retrospectively, that the patients with either fair or poor results had a stable or only mildly unstable patella preoperatively.

Adolescent↗

Chondromalacia and chronic anterior instabilities of the knee.

In this study, we surveyed a consecutive series of 500 patients who had undergone an open procedure for chronic anteromedial and/or anterolateral instabilities. Those patients who had an open arthrotomy were separated for analysis. All of the patients were examined before and during surgery. A knee sheet, based on the kind used at the Hughston Orthopaedic Clinic in Columbus, Georgia, was used to record all clinical findings. Chondromalacia of the articular surface of the femur was detected at surgery in 161 patients (32%). A statistical analysis showed that the variables directly influencing degenerative changes of the cartilage are: a previous surgery that did not sufficiently restore joint kinematics (chi square = 20.238, P less than 0.001) and a time lapse of more than 30 months between first trauma and surgery (chi square = 21.736; P = 0.001). A higher score on dynamic (jerk or pivot shift) and static (internal and external anterior drawer) tests, indicating instability, or a meniscal tear alone do not statistically correlate with chondromalacia, but together they influence degenerative changes of the cartilage.

Adult↗

[COX-2 inhibitors: a new treatment in rheumatic diseases].

Progressive increase of the average lifespan pushed up the number of the elderlies in the population. The subsequent spread of degenerative conditions such as osteoarthritis has inflated the request of NSAID despite their frequent toxicity. Side effects of NSAID are sometimes severe and mainly target gastrointestinal tract, renal and platelets function. It has been estimated that around 70% of the patients treated with NSAID develop some degree of gastric damage, ranging from aspecific dyspeptic syndromes to ulcerative diseases. Drugs are now available that selectively inhibit the cyclooxygenase-2: this enzyme is involved in the synthesis of prostaglandins during the inflammatory response. These new drugs have opened new perspectives in the treatment of arthritis; they allow COX-1 to work regularly, so that those prostaglandins that are involved in the maintenance of a regular function of the gastrointestinal tract mucosa and of the platelets. Celecoxib was the firstborn of these new drugs. Differently from FANS, COXIB has got less side effects on gastrointestinal tract and platelets function. Based on the evidence of the more recent clinical experience COXIB has to be recommended; in particular celecoxib, at a schedule of 200-400 mg/die, was shown to be highly effective in the symptomatic treatment of osteoarthritis and rheumatoid arthritis.

Aged↗