Introduction: There have been reported adverse reactions in patients with large head metal-on-metal hip arthroplasty, therefore metal particle debris are a cause for concern. The aim of this study was to evaluate the release trend of metal ions and the correlated variables. Methods: 54 patients were prospectively enrolled into the study from 2004 to 2006. All patients had 36-mm metal head, Pinnacle acetabular component, Summit stem and Ultamet CoCr alloy liner (Depuy Inc.), and underwent clinical and radiological management. The haematic concentration of Cr-Co at 0, 6, 12, 24, 60 and 120 months after the implantation was analysed in a sub-cohort of 34 patients. Results: 10-year revision rate for each case was 8.9%. The average concentration of Co at 120 months was 3.12 μg/L (median 2.20) with 53% values >2 μg/L and 1 >7 μg/L. After 6 months the median levels of Cr and Co were higher than time 0 (p < 0.0001); no significant differences were found between 6 and 24 months; while Co had significant increase between 60 and 120 months (p = 0.002). Overweight, University of California at Los Angeles (UCLA) >9 and <50 years old patients have significantly higher circulating metal ions. Discussion: This is 1 of the few prospective studies on the argument. The revision rate is conforming to records. Our data shows ionic concentration is not predictive of revision or adverse reaction to metals. We described a 3-phase trend for Co probably due to the loss of integrity of the surfaces.

No abstract

This article consists in a preliminary theoretical refl ection on integration policies for immigrants. Before conceiving, elaborating and carrying out specifi c policies in a complex fi eld such as the one related to immigration, it is important to know well the concept and the objectives of integration itself. Such a refl ection is necessary in order to assess and then command the several aspects of integration, as well as its consequences, sparing those who promote and implement the integration policy from the disappointment of failures in achieving what was planned. Therefore, this essay is an effort to clarify the meaning and scope of the word 'integration', by investigating its three most important concepts: identity, social cohesion and citizenship.

The Muslim community in Italy does not benefit from official recognition, which could, among other things, provide it with access to state funding. Nor does its fragmented nature favour a process of aggregation leading to the formation of a single representative body delegated to dialogue with the institutions. The government initiative establishing the Council of Italian Islam (Consulta) sought to encourage an original course in this direction, but it seems that the body is unlikely to solve the problem. The solutions adopted in various European countries and the proposals put forward by experts suggest that legal recognition cannot sidestep the question of representation and therefore calls for a process of cultural mediation

No abstract