[The Paci-Lorenz technic : poor record of the past (revision of 628 treated hips)].
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Biomedical subjects
Publications and source records attributed to R Olmi.
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A case is described of haemangioma of the proximal end of the humerus which simulated a giant cell tumour on radiography. An attempt at biopsy, carried out elsewhere, had failed because of severe haemorrhage from the tumour during operation. It was treated by en bloc resection and endoprosthesis with a good result after one year.
The results of fifteen cases of non-union of the humerus following treatment of the fracture by internal fixation are presented. In these cases there are skin, soft tissue and bone problems which complicate the treatment, which is therefore not free of complications. The authors advocate endomedullary nailing accompanied by bone grafting as the simplest and safest procedure.
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It is widely accepted that diabetic patients, above all poorly controlled ones, are more susceptible to infection. To verify whether diabetes might be considered a pro-infective risk factor in total hip replacement, 1,042 patients, who from 1969 to 1979 underwent an operation for arthropros thesis of the hip, were studied. The patients were subdivided into two groups according to whether they were diabetic or not. The diabetic patients, though well controlled by diet or by diet plus oral hypoglycemic agents, received insulin for at least two days before surgery. In the early post-operative phase they showed transient worsening of glycemic control rapidly corrected by increased insulin dosage. The patients of both groups were operated in low air exchange operating theaters, by the same staff and using standardized surgical techniques, and all received antibiotic coverage as preventive treatment against infections for a week after surgery. Infection and suppuration occurred in 11% of diabetic patients and only in 2% of non-diabetic patients (p less than 0.001); in these cases the prostheses were removed after unsuccessful antimicrobial treatment. Our study indicates that diabetes mellitus must be considered a proinfective risk factor in patients who undergo an operation for total hip replacement and suggests that a conservative approach is required in diabetic patients.
A method for the determination of the SAR distribution produced by an electromagnetic applicator for localized hyperthermia is described. The procedure for SAR evaluation consists of recording the time evolution of the temperature inside a polyacrylamide phantom by means of thermochromic liquid crystal sheets inserted in it. The technique allows a complete characterization of applicators in a very broad frequency range, using power levels of the order of those needed in real treatments. Criteria for the minimum phantom size and the maximum time duration of the characterization procedure are indicated, which allow a reliable determination of the effective field size and penetration depth of the applicator.
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