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Biomedical subjects

G Spuntarelli

Publications and source records attributed to G Spuntarelli.

3 recordsLinked to original sources

Rigid external fixation and condylar remodeling.

Condylar fractures, instead of other mandibular fractures, play a primary importance role because their high incidence and the historic controversy existent in literature regarding their treatment. Recent studies prove that conservative treatment of condylar fractures, although not determining perfect alignment of the fractured segments, leads to a series of histologic and morphologic healing processes ending with consolidation of the fracture and functional recovery of the TMJ (temporo-mandibular joint). In this study, we observed long-term results of 2 cases of bicondylar fracture treated with surgical reduction and rigid external fixation. Rx orthopantomography control 1 year after surgery showed condylar remodeling bilaterally with good functional recovery. Our school affirms that semirigid fixation system allows optimal function between the articular head and the glenoid fossa, with good tridimensional repositioning of the fractured segments.

Adult↗

Mandibular distraction: evolution of treatment protocols in hemifacial microsomy.

Osteodistraction is currently used in those disorders presenting with osseus tissue deficit, excellent results having been obtained in the craniofacial complex. The factors contributing to the success of this procedure are a thin layer of subcutaneous tissue, minimum movement of the cutis, good vascularization of the soft tissues, and the good healing that ensues. The good plastic effects on the soft tissues and the possibility of constantly modulating the strength and monitoring the results have led to distraction osteogenesis gaining increasing consensus in the treatment of congenital and acquired deformities and in some selected cases, for the treatment of osseous deficits caused by trauma, postsurgical outcomes, or even severe alveolar deficits. Furthermore, in the last few years, this surgical technique has been successfully used in the treatment of pediatric deformities such as hemifacial microsomia, some severe class II skeletal deformities, and some syndromic cases, such as the treatment of temporomandibular ankylosis outcomes. In our opinion, guidelines in the indications for distraction are mandatory to select the procedure best suited to the pathologic situation of each individual patient.

Adolescent↗

HBV infection in chronic alcoholics. A survey on 287 cases.

Out of 287 chronic alcoholics, 21 of whom (7.32%) resulted HBsAg positive, 106 were tested for other serum HBV markers. An overall HBV prevalence of 55.66% was found. Cirrhotic patients were slightly older than non-cirrhotics (median age: 51 vs. 47), but the prevalence of both HBsAg and other HBV markers did not differ significantly between the two groups, neither among age classes. A relevant number of subjects (18.87%) had anti-HBc alone (or associated with anti-HBe) as the unique marker of HBV infection; this leads to some uncertainties in the evaluation of active viral disease. HBV positivity rate resulted significantly higher (p less than 0.01) in alcoholics than in two control groups, composed by health-care staff and open population (respectively 34% and 32.81% of positivity). Even if hepatitis B virus did not seem to affect directly the progress to liver cirrhosis in chronic alcoholics, a large number of patients seemed unable to clear the virus, whose importance in the development of chronic liver disease and hepatocellular carcinoma is well established. For these reasons, it seems advisable to include chronic alcoholics in high-risk groups that should be vaccinated against hepatitis B.

Adult↗