The torsion angle of the patellar tendon. A new CT parameter used for classification and treatment planning in femoropatellar syndrome.

The authors report a study conducted on 107 CT scans taken between January and December 2001 in 76 patients affected with femoropatellar pain, that did not benefit from physiotherapy. It is the purpose of this study to present a new CT scan parameter denominated torsion angle of the patellar tendon (TAPT) and to define an algorithm of treatment for this complex pathology based on the changes revealed by CT scan according to the Lyonese protocol. CT scan based on the Lyonese protocol provides an explanation of the symptoms and the objectivity via traditional parameters in 59.63% of patients. Thanks to the introduction of this new parameter (TAPT), which allows us to reveal the presence of an extrarotation of the proximal metaphysis of the tibia, the percentage of sensitivity with CT scan has been increased to 83.92%.

[The effect of a territorial health emergency service on the delay in the hospitalization of patients with an acute myocardial infarct]. / Effetto di un servizio per l'emergenza sanitaria territoriale sul ritardo di ricovero dei pazienti con infarto miocardico acuto.

In July 1987 a prehospital emergency medical service (EMS) was activated in Verona (Italy) and a broad educational campaign was introduced. Prehospital care is delivered by emergency physicians and/or qualified nursing staff, who travel by ambulance or helicopter and have radio contact with the hospital alarm centre. During a 1-year period before the activation of the EMS, 476 patients with acute myocardial infarction (AMI) were admitted to the coronary care unit (CCU) of Verona, with a median delay time of 4 hours. In the period between July 1990 and June 1991, 412 patients were admitted, with a median delay time of 3 hours. Age, gender, previous AMI and infarct location were not related to delay time. In the second period, 34% patients used the EMS, while 66% used their own transport. In patients who used the EMS, median delay time was 2 hours (1 hour and 20 min shorter, p < 0.01, than in patients who did not). The time between symptoms onset and reaching the decision that medical care should be sought (1 hour and 18 min) was the longest component of the total delay time. The time from EMS call to hospital arrival was 25 min and the time which elapsed in the Emergency Department before reaching the CCU was 15 min. In these patients, decision time and Emergency Department time were significantly shorter (p < 0.01) than in patients who did not use the EMS. We conclude that the EMS is effective in reducing delay time in patients with AMI.