Mattia Manni

Tranexamic Acid in Pertrochanteric Femoral Fracture: Is it a Safe Drug or Not?

Abstract Background: There is a high incidence of blood transfusion following hip fractures in elderly patients. Aim: The aim of this study is to evaluate the effectiveness and complications of use of tranexamic acid in proximal femur nailing surgery. Materials and methods: Our sample group consisted of 90 patients suffering from pertrochanteric fractures surgically treated with osteosynthesis with SupernailGT(LimaCorporate). The classification system AO/OTA was used to divide the fractures into 31A1 (n=45) and 31A2 (n=45). The patients were divided into two groups: 47 patients were administered 15 mg of tranexamic acid per kg (group A) and 43 patients were administered placebo (group B). Blood counts were monitored daily to evaluate the rate of anemia. As a safety criterion, we monitored the possible occurrence of vascular events, symptomatic or not, over the 8 weeks post-surgery. Markers predicting mortality and deep venous thrombosis (DVE) were also monitored (fibrinogen D-dimer). Results: Blood loss occurring post-surgery can be influenced by numerous factors that are not linked to the use or non-use of tranexamic acid. While closely monitoring hemoglobin levels daily, we observed that 42% of the patients in group A required blood transfusion as opposed to 60% in group B. The results of the markers predicting mortality (alpha1-acid glycoprotein; albumin LDL) and those of DVE were not statistically significant between the two groups in this study (p>0.05). Conclusion: Based on this study, the use of tranexamic acid was statistically significant in reducing post-surgery blood loss.

Evaluation of the odor impact of some environmental gaseous pollutants: calibration of the methodology and preliminary results

During the last decades, it has been observed a growing interest on odor impact because of the frequenter social acceptability problems about energy plants handling and processing stored organic materials (e.g., biogas plants, landfills, farms, distilleries, etc.). In this context, the UNI EN 13725:2004 indicates the “dynamic olfactometry method” as validated, recognized, and adequate measurement procedure for estimating the odor concentration. This protocol is carried out by a panel of specifically trained and selected human receptors, but alternative analytical methodologies are currently under discussion. This work aims to describe the initial steps of a wider research toward the definition of a new analytical protocol for monitoring odor concentration. The alternative methodology is here presented through the implementation of a case study: stored organic materials exploited on an energy plant in Central Italy. The paper describes the preliminary activities related to the survey of the case study (i), the definition of alternative methods and devices for conducting emissions sampling (ii), and the adopted experimental approach (iii). Finally, preliminary results are also presented (iv). The resulting protocol, once validated, could be employed by local authorities to measure both the odor impacts and the effectiveness of specifically designed mitigation strategies.

CHRONIC COMPARTMENT SYNDROME OF LOWER LEG. AN UNUSUAL CASE IN NON ATHLETIC PATIENT

Chronic exertional anterior compartment syndrome is debilitating disease of the lower limb. Limited symptomology characterises the clinical picture at rest, pain during sporting activities, tumefaction, and contractures of the limb as well impotency by the pain of the entire forefoot and hypoesthesia. Usually, the most affected patients are athletes. We analyse a case of chronic post-traumatic compartment syndrome of the anterior tibial muscle in an unsportsmanlike patient.