The use of an antibacterial implant in the treatment of periprosthetic infection in an HIV-positive patient

Background: The frequency of occurrence of infectious complications after hip arthroplasty in HIV-infected patients is extremely high. Revision arthroplasty for periprosthetic infection is the leader (64%) among the causes of early revision interventions. The search for ways to increase the efficiency of the sanitizing stage of treatment due to antibacterial coatings of the endoprosthesis components continues.Objective: Demonstration of a clinical case of treatment of periprosthetic infection in an HIV-positive patient using a spacer and a femoral component of a hip joint endoprosthesis coated with linear Sp1 carbon chains and silver. 123 months after hip arthroplasty for stage 3 dysplastic coxarthrosis in HIV-positive patient of 42 years old developed an instability of the acetabular component with the growth of Staphylococcus aureus in punctates. A revision was performed with the removal of the endoprosthesis and the installation of an articulating spacer with the addition of antibiotics. 12 weeks later, a recurrence of periprosthetic infection occurred, and Enterococcus faecalis was detected in punctates. During re-endoprosthetics, there was an installation of an articulating spacer covered with a two-dimensionally ordered linear-chain carbon doped with silver, based on the Zimmer CPT femoral component and bone cement with antibiotics addition. After 3 months, the second stage of revision arthroplasty was performed with implantation of an individual acetabular component and a femoral component coated with two-dimensionally ordered linear-chain carbon doped with silver.Conclusion: 4 months after the operation the patient returned to work, 12 months later the functional results were satisfactory. The use of components coated with two-dimensionally ordered linear-chain carbon doped with silver in an HIV-positive patient with recurrent periprosthetic infection made it possible to stop the infectious process, improve limb function and the quality of life

Dopaminergic Polymorphisms Associated with Time-on-Task Declines and Fatigue in the Psychomotor Vigilance Test

Prolonged demands on the attention system can cause a decay in performance over time known as the time-on-task effect. The inter-subject differences in the rate of this decline are large, and recent efforts have been made to understand the biological bases of these individual differences. In this study, we investigate the genetic correlates of the time-on-task effect, as well as its accompanying changes in subjective fatigue and mood. N = 332 subjects performed a 20-minute test of sustained attention (the Psychomotor Vigilance Test) and rated their subjective states before and after the test. We observed substantial time-on-task effects on average, and large inter-individual differences in the rate of these declines. The 10-repeat allele of the variable number of tandem repeats marker (VNTR) in the dopamine transporter gene and the Met allele of the catechol-o-methyl transferase (COMT) Val158Met polymorphism were associated with greater vulnerability to time-on-task. Separately, the exon III DRD4 48 bp VNTR of the dopamine receptor gene DRD4 was associated with subjective decreases in energy. No polymorphisms were associated with task-induced changes in mood. We posit that the dopamine transporter and COMT genes exert their effects by increasing dopaminergic tone, which may induce long-term changes in the prefrontal cortex, an important mediator of sustained attention. Thus, these alleles may affect performance particularly when sustained dopamine release is necessary