Efficiency of two-stage revision arthroplasty in management of periprosthetic knee and hip joint infection

This technique involves removal of implant components, debridement of the purulent focus and installation of a cement spacer which is subsequently replaced with a permanent implant after 3–9 months. Purpose To evaluate mid-term results of two-stage surgical treatment of patients with chronic periprosthetic infection of the knee and hip joints. Materials and methods Treatment outcomes of 172 patients with periprosthetic infection who underwent two-stage revision arthroplasty in the period from 2011 to 2015 were assessed. Among them, 113 patients developed infection after hip replacement and 59 patients had infected knee joint. The average follow-up period was 4 ± 1.58 years (range: 2 to 6 years). Results Out of 113 two-stage procedures of hip joint revision, 102 (90.2 %) cases showed an arrest of infection. Four (3.6 %) patients with recurrence of the purulent process underwent resection arthroplasty, another four (3.6 %) rejected to replace the spacer with an implant, and three (2.6 %) had a two-stage re-revision. Out of 60 (59 patients) procedures of a two-stage knee joint revision, infection was arrested in 50 (83.3 %) cases; eight (13.4 %) had recurrence and underwent knee arthrodesis. One (1.6 %) refused to replace a spacer for an implant, and one more (1.6 %) had a two-stage repeated revision. Conclusions Two-stage knee and hip revision arthroplasty using a cement spacer is an effective option for treatment of chronic periprosthetic infection. It provides infection control in 86.7 % (83.3 % for knee and 90.2 % for hip joints) of cases in the mid-term follow-up period up to 5 years. However, the rate of re-infection remains significant and reaches 13.3 % (9.8 % for hip and 16.7 % for knee joints)

Formation of normative-methodical maintenance of quality and safety of campsites

Organization of campsites construction for auto tourists in Russia is an effective means of ensuring their rest and sleep during travel. Formation of normative and methodological support of campsites fire safety should take into account not only security, but also meet consumers' motivation to visit them. The authors examine conditions and requirements for the infrastructure of campsites and their localization, as well as methods of fire risk assessment in camping. They propose camping localization techniques and expert evaluation of fire risk in them

Formation of normative-methodical maintenance of quality and safety of campsites

Organization of campsites construction for auto tourists in Russia is an effective means of ensuring their rest and sleep during travel. Formation of normative and methodological support of campsites fire safety should take into account not only security, but also meet consumers' motivation to visit them. The authors examine conditions and requirements for the infrastructure of campsites and their localization, as well as methods of fire risk assessment in camping. They propose camping localization techniques and expert evaluation of fire risk in them

Analysis of the economic and clinical effectiveness of one- and two-stage revisions in the treatment of periprosthetic infection of the hip joint (literature review)

Introduction Infection is a devastating complication of joint replacement surgery and is associated with significant medical costs of treatment and rehabilitation. This review is based on the analysis of modern domestic and foreign literature and demonstrates the problem of periprosthetic joint infection (PJI) in terms of etiology, pathogenesis, diagnosis and surgical treatment options for PJI, as well as economic costs in different countries. Currently, two-stage revision arthroplasty is the most used treatment method in the world. At the same time, the number of publications on the effectiveness of one-stage revision arthroplasty in PJI has been increasing every year. Purpose Analysis of the clinical and economic efficiency of one- and two-stage revision arthroplasty interventions for suppression of the purulent inflammatory process and their medical costs Materials and methods The literature search was carried out in open electronic databases of scientific literature PubMed, eLIBRARY and Scopus. The search depth was 22 years. Sixteen articles were selected for economic analysis in which the expenditures on PJI management in developed and developing countries were reported. Also, there were 15 studies on evaluating the effectiveness of two-stage revisions and 26 articles on evaluating the effectiveness of one-stage revisions and 15 articles on analyzing the functional state of the affected limb according to the Harris Hip Score. The following inclusion criteria were used: systematic reviews, literature reviews, cohort studies on the topic of periprosthetic infection. Results The rate of PJI arrest with one-stage method was 89.5 % (Me-88.6; Q1-86 Q3-94) and the average mortality was 2.23 ± 2.24 (Me-1.2 Q1-0.8 Q3 -2.7). The rate of PJI suppression by two-stage method averaged 91.4 % (Me-93;Q1-88.2 Q3-96) with an average mortality rate of 3.2 %. The functional HHS after onestage replacement averaged 81.8 points, and after two-stage revision arthroplasty it was 77.4 points. The economic cost of treating one patient with PJI, according to various authors, varies from 6,500 to 150,000 dollars. Conclusions One-stage revision is cost-effective, has better functional parameters and lower mortality with comparable results in PJI arrest if strict adherence to indications is followed

Giant Asymmetry of Domain Walls Propagation in Pd/Co/Pd(111) Epitaxial Structures with Different Interface Roughness

The motion of domain walls (DWs) in magnetic nanoscale layered systems attracts a great deal of attention due to the possible chiral nature of the energy dissipation occurring because of the presence of strong spin–orbit coupling and the broken inversion symmetry. Here, we report on a giant asymmetry of DWs propagation in the creep regime in the Pd/Co/Pd epitaxial system under the influence of driving out-of-plane (OOP) and symmetry breaking in-plane (IP) magnetic fields. With an increase in the thickness of the bottom Pd layer, which in turn leads to growth of the interface roughness of the Pd/Co/Pd samples, the asymmetry of DWs propagation increases. The maximal reliably measured relation of the velocities of right-handed and left-handed propagating DWs in the Pd(12.5)/Co(0.7)/Pd(3) sample, where thickness is in nanometers, is equal to 6600, which means almost complete blocking of the propagation of DWs in the direction determined by the appropriate choice of a combination of the applied magnetic fields. The observed giant asymmetry of the propagation of DWs indicates the importance of nanoengineering the parameters of the interfaces to control the propagation of DWs in magnetic memory and logic devices