Hip arthroplasty complete revision

Universitatea de Medicină şi Farmacie ”Iuliu Haţieganu”, Clinica de Ortopedie şi Traumatologie Cluj-Napoca, Secţia a II-a, Conferinţa a XI-a Naţională a ortopezilor-tramatologi din Republica Moldova “Politraumatisme – concepţii contemporane de diagnostic şi tratament”, 21 mai 2009, Chișinău, Republica MoldovaArtroplastia totală de şold este descrisă ca una dintre cele mai importante realizări în asigurarea stării de sănătate. Durata medie de viaţă a crescut, tot mai mulţi pacienţi dezvoltând leziuni degenerative ale articulaţiei şoldului care impun o intervenţie de artroplastie. În prezent un număr tot mai mare de pacienţi beneficiază de o artroplastie primară de şold, mulţi dintre ei sperând în continuare la menţinerea unui nivel ridicat de activitate. Din aceste motive chiar şi cu o rată de succes foarte mare a intervenţiilor chirurgicale primare, numărul reviziilor este în continuă creştere. Acest studiu face o analiză a cauzelor insuccesului artroplastiei primare şi ia în calcul şi posibilitatea efectuării artroplastiei şoldului cu o proteză de revizie şi în alte afecţiuni în afara coxartrozei, cum ar fi fracturile trohanteriene după eşecul fixării interne, cu pierdere mare de masă osoasă.Total hip arthroplasty is considered one of the most important achievements in healthcare. Life span has extended and thus more and more patients develop degenerative osteoarthritis lesions of the hip that require arthroplasty intervention. Nowadays a growing number of patients benefit from primary total hip replacement, many of them expecting to maintain an increased level of activity. Even with a high rate of success of the primary surgery, due to this reason the number of revisions is still growing. The present study analyses the causes of primary arthroplasty failure and discusses the possibility of using revision hip arthroplasty in other affections, for example in trochanteric fractures after failure of internal fixation with great bone mass loss

The current profile of the patient with atrial fibrillation

Abstract: Atrial fibrillation (AF) is the most common supraventricular arrhythmia, characterized by an irregular and extremely rapid atrial electrical activation that causes loss of atrial mechanical function and important hemodynamic consequences. AF classification is important in both the therapeutic approach and the prognosis. Several classifications based on the ECG patch, epicardial or endocavitary records have been performed over time, but no classification can take into account all the characteristics of AF and especially associated diseases, which may be both the cause and consequence of arrhythmia. Aim: The aim of the study is to establish the current profile of the patient with atrial fibrillation in the new era of oral anticoagulant therapy and sinus rhythm restoration. Material and methods: The trial was conducted on patients with atrial fibrillation hospitalized between 01.10.2014-31.03.2015 at Institute of Cardiovascular Diseases ”Prof. Dr. G. Georgescu”, Iasi. Patients included in the study were analyzed according to age and sex, criteria for the clinical and paraclinic definition for atrial fibrillation. Results: Atrial fibrillation is an extremely common cardiovascular pathology and is present in about one-third of patients admitted to our clinic. Cardiovascular diseases such as hypertension, ischemic coronary artery disease, and valvulopathy are common in patients with AF. Patients with AF are usually elderly patients with many associated diseases in whom sinus rhythm restoration treatment and anticoagulant therapy are difficult to establish. AF is one of the most common arrhythmias that complicates the evolution of acute myocardial infarction, association between dual antiplatelet therapy and anticoagulation treatment, increasing the risk of bleeding complications. Conclusions: Atrial fibrillation is an extremely common cardiovascular pathology and is present in about one-third of patients admitted to our hospital. The data obtained revealed that this arrhythmia occurs in a small number of cases as the only pathology of the patient, usually associated with numerous comorbidities. Cardiovascular diseases such as hypertension, ischemic coronary artery disease, valvulopathy are common in our practice. Patient with AF is a patient who requires long-term anticoagulant therapy and in whom sinus rhythm recovery therapy is dependent on the precocity of presentation to the physician, as well as on the therapeutic resources of current medicine

Green Synthesis and Characterization of Silver Nanoparticles Using a <i>Lythrum salicaria</i> Extract and In Vitro Exploration of Their Biological Activities

This research describes an eco-friendly green route for the synthesis of AgNPs using an aqueous extract of Lythrum salicaria. Taguchi design was used to optimize the synthesis method, taking into account various working conditions. The optimum parameters were established using a 3 mM AgNO3 concentration, a 1:9 extract:AgNO3 volume ratio, a pH value of 8, 60 ℃ temperature, and 180 min reaction time. The synthesized AgNPs were characterized using UV-Vis and FTIR spectroscopy, and TEM and EDX analysis. The SPR band at 410 nm, as well as the functional groups of biomolecules identified by FTIR and the EDX signals at ~3 keV, confirmed the synthesis of spherical AgNPs. The average AgNPs size was determined to be 40 nm, through TEM, and the zeta potential was −19.62 mV. The antimicrobial assay showed inhibition against S. aureus and C. albicans. Moreover, the results regarding the inhibition of lipoxygenase and of peroxyl radical-mediated hemolysis assays were promising and justify further antioxidant studies

Eco-Friendly Synthesis and Comparative In Vitro Biological Evaluation of Silver Nanoparticles Using <i>Tagetes erecta</i> Flower Extracts

The present study reports an eco-friendly synthesis method of silver nanoparticles (AgNPs) using two different extracts (aqueous and ethanolic) of Tagetes erecta flowers. When exposed to different biocompounds found in the plant, silver ions are reduced, thus, resulting in the green synthesis of nanoparticles. After performing the optimization of synthesis, the obtained AgNPs were characterized using various techniques. The UV–Vis spectrum of the synthesized nanoparticles showed maximum peaks at 410 and 420 nm. TEM analysis revealed that the particles were spherical with a size ranging from 10 to 15 nm, and EDX analysis confirmed the presence of silver metal. The average diameter value obtained through DLS analysis for the two types of AgNPs (obtained using aqueous and ethanolic extracts) was 104 and 123 nm. The Zeta potentials of the samples were −27.74 mV and −26.46 mV, respectively, which indicates the stability of the colloidal solution. The antioxidant and antimicrobial activities assays showed that nanoparticles obtained using the aqueous extract presented enhanced antioxidant activity compared to the corresponding extract, with both types of AgNPs exhibiting improved antifungal properties compared to the initial extracts

Beta-Blocker-Related Atrioventricular Conduction Disorders—A Single Tertiary Referral Center Experience

Background and Objectives: Drug-related bradyarrhythmia is a well-documented major adverse event among beta-blocker users and a potential cause for hospitalization or additional interventions. Whether beta-blocker use is associated with specific bradyarrhythmia presentations, and how this relates to other predisposing factors, is not well known. We aim to evaluate the association between beta-blocker use and the type of atrioventricular (AV) conduction disorder in patients with symptomatic bradycardia. Materials and Methods: We conducted a retrospective cohort study on 596 patients with a primary diagnosis of symptomatic bradyarrhythmia admitted to a single tertiary referral center. Of the cases analyzed, 253 patients were on beta-blocker treatment at presentation and 343 had no bradycardic treatment. We analyzed demographics, clinical and paraclinical parameters in relation to the identified AV conduction disorder. A multivariate regression analysis was performed to explore factors associated with beta-blocker use. Results: Of the 596 patients (mean age 73.9 ± 8.8 years, 49.2% male), 261 (43.8%) had a third-degree AV block, 92 (15.4%) had a second-degree AV block, 128 (21.5%) had slow atrial fibrillation, 93 (15.6%) had sick sinus syndrome and 21 (3.5%) had sinus bradycardia/sinus pauses. Beta-blocker use was associated with the female gender (p p p = 0.003), the lower left ventricular ejection fraction (p = 0.02), mitral stenosis (p = 0.009), chronic kidney disease (p = 0.02), higher potassium levels (p = 0.04) and QRS duration > 120 ms (p = 0.02). Slow atrial fibrillation (OR = 4.2, p p = 0.001) and sinus bradycardia/pauses (OR = 32.9, p Conclusions: Beta-blocker use is more likely to be associated with slow atrial fibrillation, sick sinus syndrome and sinus bradycardia/pauses, compared to a second- or third-degree AV block, after adjusting for other patient factors such as gender, admission type, ECG, comorbidities, cardiac function and lab testing