Outcomes of Shoulder Arthroplasty Performed for Postinfectious Arthritis.

Background: The purpose of this study was to evaluate the functional outcomes, infection rate, and complications associated with shoulder arthroplasty for sequelae of prior septic arthritis. Methods: This is a retrospective cohort study of 17 patients who underwent shoulder arthroplasty for sequelae of septic arthritis. Patients were analyzed for patient-reported outcomes, complications, and reoperations. Results: The 17 patients in this cohort were an average age of 65.4 ± 12.2 years old, were 58.8% male, and had an average body mass index of 27.9 ± 4.1 kg/m Conclusions: Shoulder arthroplasty after septic arthritis had inconsistent functional outcomes and high complication rates but no reinfection

Antibiotic Spacers in Shoulder Arthroplasty: Comparison of Stemmed and Stemless Implants.

Background: Antibiotic spacers in shoulder periprosthetic joint infection deliver antibiotics locally and provide temporary stability. The purpose of this study was to evaluate differences between stemmed and stemless spacers. Methods: All spacers placed from 2011 to 2013 were identified. Stemless spacers were made by creating a spherical ball of cement placed in the joint space. Stemmed spacers had some portion in the humeral canal. Operative time, complications, reimplantation, reinfection, and range of motion were analyzed. Results: There were 37 spacers placed: 22 were stemless and 15 were stemmed. The stemless spacer population was older (70.9 ± 7.8 years vs. 62.8 ± 8.4 years, p = 0.006). The groups had a similar percentage of each gender (stemless group, 45% male vs. stemmed group, 40% male; p = 0.742), body mass index (stemless group, 29.1 ± 6.4 kg/m2 vs. stemmed group, 31.5 ± 8.3 kg/m2; p = 0.354) and Charlson Comorbidity Index (stemless group, 4.2 ± 1.2 vs. stemmed group, 4.2 ± 1.7; p = 0.958). Operative time was similar (stemless group, 127.5 ± 37.1 minutes vs. stemmed group, 130.5 ± 39.4 minutes). Two stemless group patients had self-resolving radial nerve palsies. Within the stemless group, 15 of 22 (68.2%) underwent reimplantation with 14 of 15 having forward elevation of 109° ± 23°. Within the stemmed group, 12 of 15 (80.0%, p = 0.427) underwent reimplantation with 8 of 12 having forward elevation of 94° ± 43° (range, 30° to 150°; p = 0.300). Two stemmed group patients had axillary nerve palsies, one of which self-resolved but the other did not. One patient sustained dislocation of reverse shoulder arthroplasty after reimplantation. One stemless group patient required an open reduction and glenosphere exchange of dislocated reverse shoulder arthroplasty at 6 weeks after reimplantation. Conclusions: Stemmed and stemless spacers had similar clinical outcomes. When analyzing all antibiotic spacers, over 70% were converted to revision arthroplasties. The results of this study do not suggest superiority of either stemmed or stemless antibiotic spacers

Assessing the state of marine biodiversity in the Northeast Atlantic

The Northeast Atlantic, a highly productive maritime area, has been exposed to a wide range of direct human pressures, such as fishing, shipping, coastal development, pollution, and non-indigenous species (NIS) introductions, in addition to anthropogenically-driven global climate change. Nonetheless, this regional sea supports a high diversity of species and habitats, whose functioning provides a variety of ecosystem services, essential for human welfare. In 2017, OSPAR, the Northeast Atlantic Regional Seas Commission, delivered an assessment of marine biodiversity for the Northeast Atlantic. This assessment examined biodiversity indicators separately to identify changes in Northeast Atlantic biodiversity, but stopped short of determining the status of biodiversity for many species and habitats. Here, we expand on this work and for the first time, a semi-quantitative approach is applied to evaluate holistically the state of Northeast Atlantic marine biodiversity across marine food webs, from plankton to top predators, via fish, pelagic and benthic habitats, including xeno-biodiversity (i.e. NIS). Our analysis reveals widespread degradation in marine ecosystems and biodiversity, particularly for marine birds and coastal bottlenose dolphins, as well as for benthic habitats and fish in some regions. The poor biodiversity status of these ecosystem components is likely the result of cumulative effects of human activities, such as habitat destruction or disturbance, overexploitation, eutrophication, the introduction of NIS, and climate change. Bright spots are also revealed, such as recent signs of recovery in some fish and marine bird communities and recovery in harbour and grey seal populations and the condition of coastal benthic communities in some regions. The status of many indicators across all ecosystem components, but particularly for the novel pelagic habitats, food webs and NIS indicators, however, remains uncertain due to gaps in data, unclear pressure-state relationships, and the non-linear influence of some pressures on biodiversity indicators. Improving monitoring and data access and increasing understanding of pressure-state relationships, including those that are non-linear, is therefore a priority for enabling future assessments, as is consistent and stable resourcing for expert involvement

Flow meters review and analysis / Srauto greičių matuoklių apžvalgos analizė

In the article dealt the speed-flow meters, they are classified according to the working of the principle, discussed the advantages, disadvantages, a comparative review. The examination of all possible flow measurement methods, they can be sort into five major groups. The aim was to review the different approaches used to measure the voltage amplitude value of a signal and to describe the capabilities of a projected instrument system. The most modern technological processes take measurement of flowing gas flow rate and flow. For this purpose, ultrasound, especially pulsed time are widely stared to apply. The most pulsed temporal method for measuring disadvantage is that a signal amplitude can vary only in strictly defined limits. Othewise, the signals may not be given or taken in wrong moment. Santrauka Kuriant naują srauto greičio matavimo metodą, pirmiausia ištiriame alternatyvių matavimo būdų privalumus, trūkumus ir veikimo principus. Straipsnyje nagrinėjami srautų greičio matuokliai. Jie klasifikuojami pagal veikimo principą, aptariami privalumai, trūkumai, atlikta palyginamoji apžvalga. Išnagrinėjus visus galimus srauto matavimo metodus, juos galima skirstyti į penkias stambias grupes. Raktiniai žodžiai: matavimų inžinerija, srauto matuoklis, greičio matuoklis, ultragarsinis matuoklis, tūrinis matuoklis, Doplerio matuokli

The effect of an orthopedic specialty hospital on operating room efficiency in shoulder arthroplasty

BACKGROUND: Operating room (OR) time is a major cost to the health care system. Therefore, increasing OR efficiency to save time may be a cost-saving tool. This study analyzed OR efficiency in shoulder arthroplasty at an orthopedic specialty hospital (OSH) and a tertiary referral center (TRC). METHODS: All primary shoulder arthroplasties performed at our OSH and TRC were identified (2013-2015). Manually matched cohorts from the OSH and TRC were compared for OR times. Three times (minutes) were recorded: anesthesia preparation time (APT; patient in room to skin incision), surgical time (ST; skin incision to skin closed), conclusion time (CT; skin closed to patient out of room). RESULTS: There were 136 primary shoulder arthroplasties performed at the OSH and matched with 136 at the TRC. OSH and TRC patients were similar in age (P = .95), body mass index (P = .97), Charlson Comorbidity Index (P = 1.000), sex (P = 1.000), procedure (P = 1.000), insurance status (P = .714), discharge destination (P = .287), and diagnoses (P = .354). These matched populations had similar ST (OSH: 110.0 +/- 26.6 minutes, TRC: 113.4 +/- 28.7 minutes; P = .307). APT (39.2 +/- 8.0 minutes) and CT (7.6 +/- 3.8 minutes) were shorter in the OSH patients than APT (46.3 +/- 8.8 minutes; P \u3c .001) and CT (11.2 +/- 4.7 minutes; P \u3c .001) in TRC patients. Total nonoperative time (sum of APT and CT) at the OSH (46.8 +/- 8.9 minutes) was shorter than at the TRC (57.5 +/- 10.4 minutes; P \u3c .001). CONCLUSIONS: Despite similar patient populations and case complexity, the OR efficiency at an OSH was superior to a TRC. Further analysis is needed to determine the financial implications of this superior OR efficiency