Functional and radiological outcomes of periacetabular osteotomy for hip dysplasia in patients under fifty years using a minimally invasive approach—a single surgeon series with a minimum follow up of two years

\ua9 The Author(s) 2024. Purpose: We conducted a retrospective analysis of prospectively collected data to evaluate (1) the extent of surgical correction following minimally invasive periacetabular osteotomy, (2) improvements in functional outcomes and any potential predictors for favourable outcome, and (3) complications after minimally invasive periacetabular osteotomy. Methods: A total of 352 minimally invasive periacetabular osteotomy procedures were performed on 312 hip dysplasia patients between 2013 and 2020. Radiological parameters such as lateral centre edge angle, acetabular index, and T\uf6nnis grade of arthritis were calculated. Patients also completed a range of patient reported outcome measures. Wilcoxon signed-rank tests were performed to assess for differences between patient reported outcome measures and radiological outcomes across the follow-up periods. Univariate linear regression and logistic regression were used to assess for predictors of change in functional outcome. Results: Patients had a significant correction in mean lateral centre edge angle from 17.2\ub0 to 35.3\ub0 (p < 0.001) and mean acetabular index from 13.2\ub0 to − 0.82\ub0. At one year follow-up all patient reported outcome measures were significantly greater than their baseline measurements and this improvement was maintained at two years. Changes in patient reported outcome measures were independent of radiological parameters such as change in the lateral centre edge angle and acetabular index, pre-operative T\uf6nnis grade, and patient factors such as age and sex. A total of 5.11% of patients developed post-operative complications, with four requiring posterior column fixation. Four patients (1.12%) needed a total hip replacement. Conclusion: Minimally invasive periacetabular osteotomy is a safe procedure that provides significant functional outcome improvements following surgery at six months which is maintained at two years. More than three-fourths of patients achieved improvement of iHOT-12 score beyond the minimal clinically important difference and more than half of the patients achieved substantial clinical benefit for iHOT-12 score

Factors influencing return to work after hip and knee replacement

Background: Return to employment is one of the key goals of joint replacement surgery in the working-age population. There is limited quantitative and qualitative research focusing on return to work after hip and knee replacement. It remains unclear why certain groups of patients are not able to achieve sufficient functional improvement to allow productive return to work while others can. Very little is known about the individual patient and employer perspectives in this regard. Aims: To review current evidence for the factors influencing employment outcomes in patients undergoing hip and knee replacement. Methods: Original articles and reviews in Medline, Embase and PsycINFO from 1987 to 2013 were included in the analysis. Results: Age, patient motivation, employment before surgery and type of job were found to be important factors in determining return to work following hip and knee replacement. Conclusions: There is a need for further qualitative work on how and why these factors influence employment outcomes. Keywords: Arthritis; joint replacement; occupational rehabilitation; qualitative

Radiolabeled humanized anti-CD3 monoclonal antibody visilizumab for imaging human T-lymphocytes

Visilizumab is an IgG2 humanized monoclonal antibody (mAb) characterized by non-FcγR binding and specific to the CD3 antigen, expressed on more than 95% of circulating resting T-lymphocytes and on activated T-lymphocytes homing in inflamed tissues. We hypothesized that the use of a radiolabeled anti-CD3 antibody might serve as a diagnostic tool for imaging T-cell traffic and lymphocytic infiltration of tissues and organs affected by autoimmune diseases. Here we describe the results of in vitro and animal experiments with 99mTc-succinimidyl-6-hydrazinonicotinate hydrochloride (SHNH)-visilizumab. Methods: For mAb labeling, we used a 2-step method with a heterobifunctional linker SHNH. Several titrations were performed to obtain the best labeling efficiency. In vitro quality controls included stability assay, cysteine challenge, sodium dodecyl sulfate polyacrylamide gel electrophoresis, binding assay, and immunoreactivity assay. In vivo studies by high-resolution images were performed at 6 and 24 h after the injection of 99mTc-SHNH-visilizumab. These included cell-targeting experiments in BALB/c mice xenografted subcutaneously with an increasing number of HuT78 cells in the leg and displaced with an excess of cold antibody. We also studied irradiated severe combined immunodeficient (SCID) mice reconstituted with human peripheral blood mononuclear cells (hPBMCs) and injected with 99mTclabeled visilizumab or control mAb. After dynamic imaging for 3 h, major organs were removed, counted, and processed for immunohistologic examination. Results: Visilizumab was labeled with HYNIC with high labeling efficiency (>90%) and high specific activity (SA; 10,360-11,100 MBq/mg), with retained biochemical integrity and in vitro binding activity to CD3-positive cells. The in vivo targeting experiment showed a proportional increase of specific uptake with the number of injected cells, both at 6 and at 24 h, and the in vivo competition study demonstrated more than 60% decreased uptake after an excess of unlabeled antibody. In SCID mice, hPBMCs in different tissues were detected by 99mTc-labeled visilizumab and confirmed by histology. Conclusion: Visilizumab can be efficiently labeled with 99mTc with high efficiency and SA and could be a valuable tool for the study of human T-lymphocyte trafficking and lymphocytic infiltration of tissues and organs. Copyright © 2009 by the Society of Nuclear Medicine, Inc

Increased respiratory symptoms following surgery in children exposed to environmental tobacco smoke

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75635/1/j.1460-9592.2003.01100.x.pd

Molecular imaging of rheumatoid arthritis by radiolabelled monoclonal antibodies: new imaging strategies to guide molecular therapies

The closing of the last century opened a wide variety of approaches for inflammation imaging and treatment of patients with rheumatoid arthritis (RA). The introduction of biological therapies for the management of RA started a revolution in the therapeutic armamentarium with the development of several novel monoclonal antibodies (mAbs), which can be murine, chimeric, humanised and fully human antibodies. Monoclonal antibodies specifically bind to their target, which could be adhesion molecules, activation markers, antigens or receptors, to interfere with specific inflammation pathways at the molecular level, leading to immune-modulation of the underlying pathogenic process. These new generation of mAbs can also be radiolabelled by using direct or indirect method, with a variety of nuclides, depending upon the specific diagnostic application. For studying rheumatoid arthritis patients, several monoclonal antibodies and their fragments, including anti-TNF-α, anti-CD20, anti-CD3, anti-CD4 and anti-E-selectin antibody, have been radiolabelled mainly with 99mTc or 111In. Scintigraphy with these radiolabelled antibodies may offer an exciting possibility for the study of RA patients and holds two types of information: (1) it allows better staging of the disease and diagnosis of the state of activity by early detection of inflamed joints that might be difficult to assess; (2) it might provide a possibility to perform ‘evidence-based biological therapy’ of arthritis with a view to assessing whether an antibody will localise in an inflamed joint before using the same unlabelled antibody therapeutically. This might prove particularly important for the selection of patients to be treated since biological therapies can be associated with severe side-effects and are considerably expensive. This article reviews the use of radiolabelled mAbs in the study of RA with particular emphasis on the use of different radiolabelled monoclonal antibodies for therapy decision-making and follow-up

Differences in tidal breathing between infants with chronic lung diseases and healthy controls

BACKGROUND: The diagnostic value of tidal breathing (TB) measurements in infants is controversially discussed. The aim of this study was to investigate to what extent the breathing pattern of sleeping infants with chronic lung diseases (CLD) differ from healthy controls with the same postconceptional age and to assess the predictive value of TB parameters. METHODS: In the age of 36–42 postconceptional weeks TB measurements were performed in 48 healthy newborns (median age and weight 7d, 3100 g) and 48 infants with CLD (80d, 2465 g)) using the deadspace-free flow-through technique. Once the infants had adapted to the mask and were sleeping quietly and breathing regularly, 20–60 breathing cycles were evaluated. Beside the shape of the tidal breathing flow-volume loop (TBFVL) 18 TB parameters were analyzed using ANOVA with Bonferroni correction. Receiver-operator characteristic (ROC) curves were calculated to investigate the discriminative ability of TB parameters. RESULTS: The incidence of concave expiratory limbs in CLD infants was 31% and significantly higher compared to controls (2%) (p < 0.001). Significant differences between CLD infants and controls were found in 11/18 TB parameters. The largest differences were seen in the mean (SD) inspiratory time 0.45(0.11)s vs. 0.65(0.14)s (p < 0.0001) and respiratory rate (RR) 55.4(14.2)/min vs. 39.2(8.6)/min (p < 0.0001) without statistically significant difference in the discriminative power between both time parameters. Most flow parameters were strongly correlated with RR so that there is no additional diagnostic value. No significant differences were found in the tidal volume and commonly used TB parameters describing the expiratory flow profile. CONCLUSION: The breathing pattern of CLD infants differs significantly from that of healthy controls. Concave TBFVL and an increased RR measured during quiet sleep and under standardized conditions may indicate diminished respiratory functions in CLD infants whereas most of the commonly used TB parameters are poorly predictive

Patotipos diarreagénicos emergentes de escherichia coli en colombia

La enfermedad diarreica es una importante causa de morbi-mortalidad en los niños menores de cinco años a nivel mundial. La frecuencia de los agentes etiológicos virales, bacterianos y parasitarios varía de acuerdo a la región geográfica. Las Escherichia coli patógenas son causas frecuentes de Enfermedad Diarreica Aguda (EDA) en niños menores de cinco años en países en vía de desarrollo. Siendo E. coli enterotoxigénica (ECET), enteropatogénica (ECEP) y enteroagregativa (ECEA) las cepas predominantes. Evidencia clínica y epidemiológica indica que cepas emergentes de E.coli con genotipos diferentes a las cepas clásicas se asocian a EDA moderada o severa, sin embargo, estudios sobre estas cepas son limitados y su frecuencia se desconoce en Colombia.El objetivo de este trabajo fue identificar cepas de E. coli emergentes en niños menores de 5 años con diarrea en Colombia.Para evaluar el papel de E. coli emergentes en EDA se diseñó estudio prospectivo de casos con diarrea y controles sanos en niños menores de 5 años en Bucaramanga, Colombia. El estudio fue aprobado por los comités de ética de cada institución participante. Heces fecales de casos y controles se evaluaron para la detección de patotipos de E. coli y otros agentes diarreagénicos, incluyendo virus, parásitos y bacterias.Los patotipos diarreagénicos de E. coli fueron identificados en 9.3% (29/311) de casos y en 10% (30/299) de controles. Todos los patotipos de E. coli con excepción de la E. coli productora de toxina Shiga se detectaron. Las diferencias entre los patotipos de E. coli de casos y controles no fue estadísticamente significativa. Se identificaron dos cepas de E. coli enteroinvasiva (EIEC) con adherencia agregativa y formación de biopelículas similares a E. coli enteroagregativa (ECEA). Adicionalmente, Rotavirus, Norovirus GI/GII, Astrovirus y Sapovirus fueron identificados en casos con frecuencias entre 0,3 a 9,6% y en controles de 0,7 a 2,3%. Salmonella, Campylobacter jejuni, Cryptosporidium parvum, Entamoeba histolytica y Giardia lamblia se detectaron tanto en casos y como en controles.Se concluye que los patotipos diarreagénicos de E. coli son frecuentes en niños con diarrea y sin diarrea. Se reportan ECEI emergentes con fenotipos de adherencia celular y formación de biopelículas similares a la ECEA