222 research outputs found

    ΠŸΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ‚ΠΎΠ² с Π°Π½Ρ‚ΠΈΠ±Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½Ρ‹ΠΌ ΠΏΠΎΠΊΡ€Ρ‹Ρ‚ΠΈΠ΅ΠΌ Π² ΠΎΡ€Ρ‚ΠΎΠΏΠ΅Π΄ΠΈΠΈ ΠΈ Ρ‚Ρ€Π°Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ: соврСмСнноС состояниС ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹

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    Current prophylactic and hygienic measures notwithstanding, implant-related infection remains among leadingΒ reasons for failure in orthopaedics and trauma surgery, resulting in extremely high social and economic costs. VariousΒ antibacterial coating technologies have been proven safe and effective both in preclinical and in clinical settings andΒ able to reduce post-surgical infections up to 90%, depending on the type of the coating and on the experimental setup.Β In spite of this findings, the widespread use of these technologies is still limited by several factors. After reviewingΒ the latest evidence on currently available antibacterial coatings, an algorithm is proposed to calculate the impactΒ of the delayed introduction of these technologies in the clinical practice. When applied to joint arthroplasties, ourΒ calculator shows that each year of delay to implement an antibacterial coating, able to reduce post-surgical infectionΒ by 80% at a final user’s cost price of €600, causes an estimated 35 200 new cases of periprosthetic joint infection inΒ Europe and additional annual hospital costs of approximately €440 million. Faster and more affordable regulatoryΒ pathways for antibacterial coating technologies and an adequate reimbursement policy for their clinical use appear aΒ feasible solution to mitigate the impact of implant-related infections and may benefit patients, healthcare systems,Β and related research.All patients provided written informed consent.Competing interests: the authors declare that there are no competing interests.НСсмотря Π½Π° соврСмСнныС достиТСния ΠΏΡ€ΠΎΡ„ΠΈΠ»Π°ΠΊΡ‚ΠΈΠΊΠΈ ΠΈ Π³ΠΈΠ³ΠΈΠ΅Π½Ρ‹, ΠΈΠΌΠΏΠ»Π°Π½Ρ‚-ассоциированная инфСкция остаСтся ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· основных ΠΏΡ€ΠΈΡ‡ΠΈΠ½ Π½Π΅ΡΠΎΡΡ‚ΠΎΡΡ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² ортопСдичСских ΠΈ Ρ‚Ρ€Π°Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΡ‡Π΅ΡΠΊΠΈΡ…Β Π²ΠΌΠ΅ΡˆΠ°Ρ‚Π΅Π»ΡŒΡΡ‚Π², Ρ‡Ρ‚ΠΎ ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΡ‚ ΠΊ Ρ‡Ρ€Π΅Π·Π²Ρ‹Ρ‡Π°ΠΉΠ½ΠΎ высоким ΡΠΎΡ†ΠΈΠ°Π»ΡŒΠ½Ρ‹ΠΌ ΠΈ экономичСским ΠΈΠ·Π΄Π΅Ρ€ΠΆΠΊΠ°ΠΌ. Π Π°Π·Π»ΠΈΡ‡Π½Ρ‹Π΅Β Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π°Π½Ρ‚ΠΈΠ±Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ покрытия ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ‚ΠΎΠ² Π·Π°Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄ΠΎΠ²Π°Π»ΠΈ сСбя ΠΊΠ°ΠΊ бСзопасноС ΠΈ эффСктивноС Ρ€Π΅ΡˆΠ΅Π½ΠΈΠ΅ ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹ инфицирования Π² процСссС ΠΊΠ°ΠΊ доклиничСских исслСдований, Ρ‚Π°ΠΊ ΠΈ Π² клиничСской практикС, Ρ‡Ρ‚ΠΎ способствуСт сниТСнию частоты послСопСрационной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Π΄ΠΎ 90% Π² зависимости ΠΎΡ‚ типа покрытия ΠΈ условий использования. НСсмотря Π½Π° Ρ‚Π°ΠΊΠΈΠ΅ Π²Ρ‹Π²ΠΎΠ΄Ρ‹, ΡˆΠΈΡ€ΠΎΠΊΠΎΠ΅ Π²Π½Π΅Π΄Ρ€Π΅Π½ΠΈΠ΅ ΠΏΠΎΠ΄ΠΎΠ±Π½Ρ‹Ρ… Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ ΠΏΠΎ-ΠΏΡ€Π΅ΠΆΠ½Π΅ΠΌΡƒ ΠΎΠ³Ρ€Π°Π½ΠΈΡ‡Π΅Π½ΠΎ нСсколькими Ρ„Π°ΠΊΡ‚ΠΎΡ€Π°ΠΌΠΈ. Π˜Π·ΡƒΡ‡ΠΈΠ² Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π°ΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½Ρ‹Π΅ Π΄Π°Π½Π½Ρ‹Π΅ ΠΏΠΎ Π΄ΠΎΡΡ‚ΡƒΠΏΠ½Ρ‹ΠΌΒ Π°Π½Ρ‚ΠΈΠ±Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½Ρ‹ΠΌ покрытиям, Π°Π²Ρ‚ΠΎΡ€Ρ‹ ΠΏΡ€Π΅Π΄Π»Π°Π³Π°ΡŽΡ‚ Π°Π»Π³ΠΎΡ€ΠΈΡ‚ΠΌ для расчСта влияния нСсвоСврСмСнного внСдрСния Ρ‚Π°ΠΊΠΈΡ… Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ Π² ΠΊΠ»ΠΈΠ½ΠΈΡ‡Π΅ΡΠΊΡƒΡŽ ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΡƒ. ΠŸΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΡ€Π΅Π΄Π»Π°Π³Π°Π΅ΠΌΠΎΠ³ΠΎ ΠΊΠ°Π»ΡŒΠΊΡƒΠ»ΡΡ‚ΠΎΡ€Π° ΠΊ опСрациям по ΡΠ½Π΄ΠΎΠΏΡ€ΠΎΡ‚Π΅Π·ΠΈΡ€ΠΎΠ²Π°Π½ΠΈΡŽ суставов дСмонстрируСт, Ρ‡Ρ‚ΠΎ ΠΊΠ°ΠΆΠ΄Ρ‹ΠΉ Π³ΠΎΠ΄ отсрочки внСдрСния Π°Π½Ρ‚ΠΈΠ±Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½Ρ‹Ρ…Β ΠΏΠΎΠΊΡ€Ρ‹Ρ‚ΠΈΠΉ, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΉ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» Π±Ρ‹ ΡΠ½ΠΈΠ·ΠΈΡ‚ΡŒ частоту послСопСрационной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Π½Π° 80% ΠΏΡ€ΠΈ стоимости для конСчного ΠΏΠΎΠ»ΡŒΠ·ΠΎΠ²Π°Ρ‚Π΅Π»Ρ Π² Ρ€Π°Π·ΠΌΠ΅Ρ€Π΅ 600 Π΅Π²Ρ€ΠΎ, ΠΏΡ€ΠΈΠ²Π΅Π΄Π΅Ρ‚ ΠΏΡ€ΠΈΠΌΠ΅Ρ€Π½ΠΎ ΠΊ 35 200 Π½ΠΎΠ²Ρ‹Ρ… случаСв возникновСния ΠΏΠ΅Ρ€ΠΈΠΏΡ€ΠΎΡ‚Π΅Π·Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Π² странах Π•Π²Ρ€ΠΎΠΏΡ‹ ΠΈ ΠΊ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ Π΅ΠΆΠ΅Π³ΠΎΠ΄Π½Ρ‹ΠΌ Π³ΠΎΡΠΏΠΈΡ‚Π°Π»ΡŒΠ½Ρ‹ΠΌ расходам Π² Ρ€Π°Π·ΠΌΠ΅Ρ€Π΅Β ΠΎΠΊΠΎΠ»ΠΎ 440 ΠΌΠ»Π½ Π΅Π²Ρ€ΠΎ. УскорСнныС ΠΈ Π±ΠΎΠ»Π΅Π΅ доступныС с Ρ‚ΠΎΡ‡ΠΊΠΈ зрСния Π·Π°Ρ‚Ρ€Π°Ρ‚ процСссы Π½ΠΎΡ€ΠΌΠ°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ рСгулирования Π² ΠΎΡ‚Π½ΠΎΡˆΠ΅Π½ΠΈΠΈ Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ Π°Π½Ρ‚ΠΈΠ±Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ покрытия ΠΈΠΌΠΏΠ»Π°Π½Ρ‚Π°Ρ‚ΠΎΠ², Π° Ρ‚Π°ΠΊΠΆΠ΅ адСкватная политика возмСщСния расходов ΠΏΠΎ клиничСскому использованию Ρ‚Π°ΠΊΠΈΡ… Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ ΠΏΡ€Π΅Π΄ΡΡ‚Π°Π²Π»ΡΡŽΡ‚ΡΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½Ρ‹ΠΌ Ρ€Π΅ΡˆΠ΅Π½ΠΈΠ΅ΠΌ для сниТСния частоты ΠΈΠΌΠΏΠ»Π°Π½Ρ‚-ассоциированной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ, ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡ качСства лСчСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², сниТСния Π½Π°Π³Ρ€ΡƒΠ·ΠΊΠΈ Π½Π° систСму здравоохранСния ΠΈ для стимулирования Π½Π°ΡƒΡ‡Π½Ρ‹Ρ… изысканий

    Two-bands effect on the superconducting fluctuating diamagnetism in MgB&#8322

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    The field dependence of the magnetization above the transition temperature Tc in MgB₂ is shown to evidence a diamagnetic contribution consistent with superconducting fluctuations reflecting both the σ and π bands. In particular, the upturn field Hup in the magnetization curve, related to the incipient effect of the magnetic field in quenching the fluctuating pairs, displays a double structure, in correspondence to two correlation lengths. The experimental findings are satisfactorily described by the extension to the diamagnetism of a recent theory for paraconductivity, in the framework of a zero-dimensional model for the fluctuating superconducting droplets above Tc

    Effect of two gaps on the flux lattice internal field distribution: evidence of two length scales from muSR in Mg1-xAlxB2

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    We have measured the transverse field muon spin precession in the flux lattice (FL) state of the two gap superconductor MgB2 and of the electron doped compounds Mg1-xAlxB2 in magnetic fields up to 2.8T. We show the effect of the two gaps on the internal field distribution in the FL, from which we determine two coherence length parameters and the doping dependence of the London penetration depth. This is an independent determination of the complex vortex structure already suggested by the STM observation of large vortices in a MgB2 single crystal. Our data agrees quantitatively with STM and we thus validate a new phenomenological model for the internal fields.Comment: now in press Phys. Rev. Lett., small modifications required by the edito

    Phenotypic and genomic identification of Staphylococcus epidermidis GOI1153754-03-14 isolated from an infected orthopedic prosthesis

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    Introduction: Staphylococcus epidermidis GOI1153754-03-14 is able to colonize orthopedic implants and to cause septic non-unions, as validated in a recent in vivo study (Lovati, 2016). To pore over the mechanisms leading to the biofilm formation on metallic implants, in the present study, we carried out the phenotypic and genotypic characterization of the clinical isolate S. epidermidis GOI1153754-03-14.Materials and Methods: The antimicrobial susceptibility and minimum inhibitory concentration (MIC) of the strain were evaluated through the Vitek2 System (Biomerieux), as well as its ability to form biofilm in vitro through a spectrophotometric assay (Stepanovich, 2000).The genomic DNA was extracted by Bacterial Genomic DNA Isolation Kit (Norgen Biotek Corp.). Libraries were prepared with the ThruPLEX DNA-seq (Rubicon Genomics) and then sequenced on the Illumina MiSeq platform through the MiSeq Reagent Kit v3 (600-cycles) to produce 300 bp paired-end reads (Illumina Inc.). Reads were quality-trimmed and gene annotated thanks to the RAST software (Aziz, 2008).Results: The antimicrobial susceptibility along with the MIC values are reported in Table 1. The outputs resulted in 51 contigs (Average = 50,720.6 Mb) with 396X fold average coverage. The total genome is 2,586,753 bp long with a GC content of 31.84% and an N50 value of 7 bp. The whole genome is composed by 2,467 protein-encoding genes and 64 RNAs (55 tRNAs and 9 rRNAs). The entire genome sequence has been deposited in the European Nucleotide Archive (ENA) under the accession no. FWCG01000000 (Bottagisio, 2017).Discussion: The genotypic and phenotypic characterization of the S. epidermidis GOI1153754-03-14 will enable a better comprehension of the mechanisms involved in the biofilm formation on orthopedic implants paving the way for innovative preventative and therapeutic strategies. Moreover, the sequence of this clinical strain is mandatory to develop dedicated proteomics analysis in order to highlight functional mechanism of biofilm formation

    Bone and joint infections in adults: a comprehensive classification proposal

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    Ten currently available classifications were tested for their ability to describe a continuous cohort of 300 adult patients affected by bone and joint infections. Each classification only focused, on the average, on 1.3\u2009\ub1\u20090.4 features of a single clinical condition (osteomyelitis, implant-related infections, or septic arthritis), being able to classify 34.8\u2009\ub1\u200924.7% of the patients, while a comprehensive classification system could describe all the patients considered in the study. RESULT AND CONCLUSION: A comprehensive classification system permits more accurate classification of bone and joint infections in adults than any single classification available and may serve for didactic, scientific, and clinical purposes

    Antibacterial Bioactive Glass, S53P4, for Chronic Bone Infections - A Multinational Study

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    Correction: Volume: 971 Pages: 115-116 DOI: 10.1007/5584_2017_13 Published: 2017 WOS:000446017300010Osteomyelitis is an infectious process in bone that occasionally leads to bone destruction. Traditionally, the surgical treatment procedure is performed in combination with systemic and local antibiotics as a two-stage procedure that uses autograft or allograft bone for filling of the cavitary defect. Bioactive glass (BAG-S53P4) is a bone substitute with proven antibacterial and bone bonding properties. One hundred and sixteen patients who had verified chronic osteomyelitis was treated using BAG-S53P4 as part of the treatment. Most of the patients had previously undergone numerous procedures, sometimes for decades. A register of patient data obtained from 11 centers from Finland, Italy, the Netherlands, Germany, Azerbaijan and Poland was set-up and continuously maintained at Helsinki University Central Hospital. The location of the osteomyelitis was mainly in the tibia followed by the femur and then the calcaneus. The median age of the patients was 48 years (15-87). The patients were either treated according to a one-stage procedure without local antibiotics (85 %) or by a two-stage procedure using antibiotic beads in the first procedure (15 %). The minimum follow-up was 1 year (12-95 months, median 31). The cure rate was 104/116, the total success rate 90 % and most of the patients showed a rapid recovery. The study shows that (BAG-S53P4) can be used in a one-stage procedure in treatment of osteomyelitis with excellent results.Peer reviewe

    Prevention of implant-related infections by a resorbable, antibacterial-loaded coating: a new approach

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    Currently studied antibacterial coatings are far from having large-scale applications, due to various limitations. A recently developed fast resorbable, antibacterial-loaded, hydrogel coating may provide a new approach to offer an effective antibacterial and antibiofilm protection to orthopedic implants
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