Femoral neck fractures (FNF) is one of the most common traumatic events in elderly patients the choice of an appropriate treatment is necessary to decrease the related mortality and to achieve the best possible outcomes. Nowadays, it is still debated whether or not to cement the stem in hemiarthroplasty and above all, which stem to use to best respect the integrity of the elderly bone.

From January 2017 to December 2019, a bi-centric study utilizing prospectively collected databases of elderly patients with FNF treated with uncemented Korus stem hemiarthroplasty was performed. Patients were preoperatively classified according to ASA score. Patients’ clinical and X-ray follow-up was at 1, 3, 6, 12 months. Harris Hip Score (HHS) was used for analysed clinical improvement. On the X-rays, we analysed iatrogenic fractures, osteolysis area and radiolucent lines in the stem region during follow up.

233 patients were identified. Median follow-up was 12 months. Over time, 51 patients died (21.88%). Mean age was 89,56 ± 6,25. 75 patients had ASA score of 2 (32.3%), 102 patients a score of 3 (43.7%), 56 an ASA score of 4 (24,0%). The main Harris hip score was 68,66 ± 8.53 at 1 month of follow-up, 71,74 ± 9.65 after 3 months, 72,50 ± 10.66 at 6 months and 75,61 ± 9.63 at 12 months control.

Hydroxyapatite coated stem with an accurate design guarantee early fixation, good clinical and radiographic results, low rate of re-intervention and mortality rate and a satisfying return to pre-injury activities.

Hydroxyapatite coated stem with an accurate design guarantee early fixation, good clinical and radiographic results, low rate of re-intervention and mortality rate and a satisfying return to pre-injury activities.Background ad aim of workː the position of Italian law regarding participation of prophylactically treated hemophiliacs to organized sport trainings and competitions remains unclear and this study focuses on the eligibility of pediatric patients in particular. Methodsː 16 patients age 3 to 15 years old, with severe haemophilia and prophylaxis starting age of 20,2 ± 2,2 months were enrolled. Weight, height, body mass index (BMI) and joint status (Hemophilia Joint Health Score [HJHS] and Haemophilia Early Arthropathy Detection with UltraSound, HEAD-US score) of patients were evaluated at start (T0) and after 12 months (T12) of a HIITS sport activity program. Resultsː All patients qualified for Italian competitive sport medical certification. Their weight and height increased after 12 months, without an increase in BMI (T0= 17,2; T1= 18,7; p>0,05). HJHS score did not change significantly (T0 1.6 ± 1; T1 2.1 ± 1.3; p>0.05). All children were right-handed and atrophy for the muscles of the right elbow significantly decreased (no atrophy seen at T0 in 4 of 16 patients and at T1 in 8 of 16 patients; p=0.045). Conclusionsː Hemophilic children, prophylactically treated, are capable to be included in sport groups and physical activity programs.

to identify most frequent risk factors and to propose prevention strategies for the children admitted to Pediatric Emergency Department (PED) with acute poisoning.

We performed a retrospective study in a tertiary care hospital, describing the frequency and nature of pediatric poisoning, clinical management and outcome.

We collected data of 436 children admitted for acute poisoning. The mean age was 30 months and 51.1% were male. Most poisoning incidents (90.1%) were unintentional and drug ingestion (39.4%) was the leading cause of poisoning. Acute poisoning happened at home in 83,7% of cases and the mother was the most frequent caregiver during the event in 61.5%. No died were reported.

Our study showed that the two categories of patients at greatest risk for acute poisoning are children under 3 years and adolescents over 12 years. Adequate information campaigns about toxic substances are essential for children, adolescents and their parents.

Our study showed that the two categories of patients at greatest risk for acute poisoning are children under 3 years and adolescents over 12 years. Adequate information campaigns about toxic substances are essential for children, adolescents and their parents.The cause of pleural empyema is bacterial pneumonia and three stages has been described in the evolution of this disease exudative, fibrino-purulent and organizational phases. The first therapeutic intervention is the antibiotic therapy; where pharmacological therapy alone is not sufficient to eradicate the infection, it is also necessary a surgical treatment. Since the province of Piacenza having been in the epicenter area during the first Sars-Cov 2 pandemic wave in March 2020 and the number of patients with Covid-related pneumonia required invasive and non-invasive respiratory support, had a considerable organizational impact on pulmonology and respiratory unit, hindering an optimal treatment of the bacterial pneumonia both in community as well as in the hospital. Among the many „collateral” damages of the epidemiological wave of the infection with Sars Cov-2, we have been able to observe in our Hospital, also an increase of pulmonary empyemas diagnosed at an advanced stage for what we believe to be organizational and social causes directly related to the pandemic in order to cope with the emergency the Unit of Pneumology has been since March nearly uninterruptedly dedicated to the exclusive treatment of covid patients so the pneumologist has been removed due to the need from outpatient and residential management of general pneumology.Non-invasive pulmonary surfactant (SF) administration for neonatal respiratory distress syndrome (NRDS) is a development of administration of SF. Administration of SF via a supraglottic device (SGD) has been shown to be effective. Here the results of administration of SF in NRDS in infants requiring oxygen and nasal-CPAP (n-CPAP) via two types of SGDs, LMA® vs iGel®, in a second level Neonatal Unit are reported in a retrospective study. Results – Fourteen infants in the LMA®Group were matched with 21 comparable infants in the iGel® Group (g.a. ≥30 wks and b.w. ≥ 1,500 gr) presenting NRDS with fraction of inspired oxygen (FiO2) ≥ 0.25 – 0.6, requiring n-CPAP. All infants presented a significant improvement of PaO2/FiO2 ratio that was seen earlier in the iGel® Group vs the LMA® Group. There was no severe adverse effect during the maneuver with both SGDs. No baby died, No.2 required endotracheal intubation for a second dose of SF as by protocol, and No. 1 was transferred to a higher level of care. Conclusion – Non-invasive SF administration via SGD has been done effectively at a second level Neonatal Unit and very early in the course of the disease therefore limiting transfer of the baby without complications with both SGDs. Improvement in gas exchange was more rapid in the iGel®Group. This result needs confirmation. In our experience iGel® was easier to use than LMA®.

To assess the incidence of Type 1 Diabetes Mellitus (T1DM) during the period 2012-2017, the frequency and severity of ketoacidosis (DKA) at diabetes onset, and the factors associated with DKA in children and adolescents younger than 18 years old in the Abruzzo region, Italy.

All incident cases of T1DM (0-17 years old) diagnosed between January 2012 and December 2017 were included. Data about the patients were obtained from two independent sources; insulin prescriptions and medical records. Clinical data at diabetes onset, as well as demographic and non-demographic data, including center of first hospitalization, distance to regional reference center and number of pediatricians (per 1000 residents younger than 18 years) were collected and evaluated.

During 2012-2017 period, 177 patients were diagnosed with T1DM. In 2012, T1DM incidence was 15.6 per 100,000/year; in 2013, 16.4 per 100,000/year; in 2014, 11.6 per 100,000/year; in 2015, 14.2 per 100,000/year; in 2016, 16.2 per 100,000/year and in 2017, 12.2 per 100,000/year. DKA was present in 29.3% of patients, 6.9% with severe DKA. The DKA presence was correlated to age (p<0.02), ethnicity (p<0.04), being transferred to a specialist center instead of being directly admitted to one (p<0.002) and the number of pediatricians in the population (p<0.01). The DKA severity was associated with the delay of transfer (p<0.04).

Being admitted directly to a specialist center is very important and it could be expression of high alertness of pediatricians. Availability of well-trained pediatricians is necessary for the prevention of DKA. (www.actabiomedica.it).

Being admitted directly to a specialist center is very important and it could be expression of high alertness of pediatricians. Availability of well-trained pediatricians is necessary for the prevention of DKA. (www.actabiomedica.it).

Schwannomas of the lower limb are uncommon benign tumors and those arising from Tibial Nerve are particularly rare. We report our experience on the topic, with particular attention to clinical presentation and lower limbs overall functionality before and after treatment. Our aim is to assess clinical impairment caused by the tumor and evaluate the effectiveness of surgical treatment.

Time between symptoms outbreak and diagnosis, as well as pre- operative tumor size were evaluated for each case. Pre-operative and post-operative overall lower limb functionality were assessed using both MSTS and LEFS scores. Sensitive symptoms and muscular strength were also evaluated before and after surgery.

7 patients were included in our study. The mean follow-up was 22.9 months. Average diagnostic delay was 8 months and tumor size was 29.3mm. Before surgery each patient had positive Hoffmann-Tinel sign and an at least mild paresthesia, 57% of our cases had slight reduction of muscular strength. Pre-operative MSTS score was 24.4 and LEFS score was 64.7. Tumor size and diagnostic delay were associated with pre-operative functionality. No major local complication was recorded during or after surgery. Each patient with pre-operative sensitive or motorial deficit benefited the effects of surgical treatment.

Our cases suggest early diagnosis could reduce the impact of the disease on patients’ activities of daily living and quality of life. Surgery, for its part, represents a safe and reliable approach to Tibial Nerve schwannomas with good chances of clinical and functional remission.

Our cases suggest early diagnosis could reduce the impact of the disease on patients’ activities of daily living and quality of life. Surgery, for its part, represents a safe and reliable approach to Tibial Nerve schwannomas with good chances of clinical and functional remission.Platypnea-Orthodeoxia Syndrome (POS) is a clinical entity defined as positional dyspnoea (platypnea) and arterial desaturation (orthodeoxia) that occurs when sitting or standing up and usually resolves by lying down. Up to April 25th 2021, eleven cases of POS after SARS-CoV-2 pneumonia have been reported on Pubmed. Accordingly, SARS-CoV-2 infection may be considered as an emergent cause of POS due to an increase in ventilation/perfusion (V/Q) mismatch. In this article we provide an update on the patient with POS after fibrotic evolution of SARS-CoV-2 interstitial pneumonia, which we previously reported and we discuss the case reports of POS due to SARS-CoV-2 infection.