• Flanagan Harder posted an update 1 year, 5 months ago

    RESULTS There were no significant differences between hip and knee PJIs in overall survivorship (P = .71), or when stratified by irrigation and debridement (P = .39), or two-stage exchange arthroplasty (P = .59). There was also no difference by joint in the multivariate or sensitivity analysis. Survival rates had the most dramatic rates of decrease in the initial months after treatment of PJI but began to plateau after 1.09 years. CONCLUSION This study reveals no difference in treatment outcomes between knee and hip PJIs. In addition, given the difficulty with obtaining follow-up, we suggest that one-year follow-up is sufficient for an accurate reporting of treatment failure. BACKGROUND A contemporary, porous-coated acetabular implant designed for uncemented insertion was introduced in Europe and Australia in 2007. A similar previous acetabular system was found in several studies at 10 to 15-year follow-up to demonstrate accelerated polyethylene wear, osteolysis, and early failure. The current study was conducted to determine the midterm safety and effectiveness of this contemporary acetabular system using highly crosslinked polyethylene and ceramic liners at 5-year follow-up. METHODS A prospective, nonrandomized study was conducted at 8 sites in Canada and the United States. All 148 study participants received a contemporary acetabular shell with proprietary porous coating. The primary outcome was the requirement for revision surgery at 5 years postoperatively. Secondary outcomes included a survival analysis, patient-reported outcome measures, radiographic failure, and postoperative adverse events. RESULTS At 5-year follow-up there was 1 cup revised for deep infection. No cups were revised for loosening and none were found to be radiographically loose. The overall survival rate with reoperation for any reason was 97.1%. The success rate was 96.8% for polyethylene and 100% for ceramic with no difference in the success rate between either bearing surface (P = 1.0). The mean patient-reported outcome measures all improved significantly between preoperative and 5-year postoperative scores (P  less then .001). CONCLUSION Results from this 5-year, multicenter, prospective study indicate excellent survivorship for this acetabular system when used with crosslinked polyethylene or ceramic bearing surfaces. BACKGROUND Dilute povidone-iodine (PI) lavage, a simple disinfection method, could reduce postoperative infection risk. However, there is no clinical consensus regarding its efficacy in total joint arthroplasties (TJAs). This systematic review and meta-analysis evaluated PI lavage’s efficacy in preventing infection after TJA. METHODS MEDLINE, Embase, and the Cochrane Library were systematically searched for studies published before November 22, 2019, that compared postoperative infection rates in patients who underwent TJA with or without PI lavage before wound closure. Subgroup analyses were designed to identify the differences in infection site (overall or deep), type of surgery (total hip arthroplasty or total knee arthroplasty), time until diagnosis of infection (3 or 12 months postoperatively), and primary/aseptic revision arthroplasties. PF-02341066 RESULTS We included 7 studies with 31,213 TJA cases, comprising 8861 patients who received PI lavage and 22,352 who did not. Pooled odds ratio for overall infection rate for the PI and non-PI lavage groups was 0.67 (95% confidence interval, 0.38-1.19, P = .17) and for the deep infection rate was 0.90 (95% confidence interval, 0.27-2.98, P = .86). Subgroup analyses revealed no differences in postoperative infection rates between the PI and non-PI lavage groups in terms of total hip arthroplasty and total knee arthroplasty, diagnosis of infection at 3 and 12 months postoperatively, or primary and aseptic revision arthroplasties. CONCLUSION We detected no differences in the overall postoperative infection rates between the PI and non-PI lavage groups before wound closure in TJA including all studies in the subgroup analyses. We tested the effect of alcohol hand rub in eradicating Escherichia coli, and compared it with hand wash using ozonized tap water or soap and water. Alcohol eradicated all bacteria in 10 of 35 participants, but with an average (SD) of 2330 (4227) CFU/mL left after disinfection, while ozonized water removed all bacteria in 10 of 55 participants, with an average of only 538 (801) CFU/mL left (p=0.045). Soap washing was the most effective with total removal of bacteria in 6 of 20 participants, with an average of 98 (139) CFU/ml (p=0.048 and 0.018 versus ozonized water and alcohol, respectively). Since its discovery in 2006 by Oh-I and colleagues, NUCB2/nesfatin-1 encoded by nucleobindin-2 (NUCB2) has drawn sustained attention as reflected in over 500 publications. Among those, more than half focused on the alterations of food intake, body weight and metabolism (glucose, fat) induced by nesfatin-1 and/or NUCB2/nesfatin-1. In the current review we discuss the existing literature focusing on NUCB2/nesfatin-1’s influence on food intake, body weight and glucose as well as fat metabolism and highlight gaps in knowledge. Adult body size is determined by the quality and quantity of nutrients available to animals. In insects, nutrition affects adult size primarily during the nymphal or larval stages. However, measures of adult size like body weight are likely to also change with adult nutrition. In this study, we sought to explore the roles of nutrition throughout the life cycle on adult body weight and the size of two appendages, the wing and the femur, in the fruit fly Drosophila melanogaster. We manipulated nutrition in two ways by varying the protein to carbohydrate content of the diet, called macronutrient restriction, and by changing the caloric density of the diet, termed caloric restriction. We employed a fully factorial design to manipulate both the larval and adult diets for both diet types. We found that manipulating the larval diet had greater impacts on all measures of adult size. Further, macronutrient restriction was more detrimental to adult size than caloric restriction. For adult body weight, a rich adult diet mitigated the negative effects of poor larval nutrition for both types of diets.

Demos
Buy This Template
Recash test site
Logo
Register New Account