Rates and Predictors of Treatment Failure in Staphylococcus aureus Prosthetic Joint Infections According to Different Management Strategies: A Multinational Cohort Study—The ARTHR-IS Study Group

Introduction: Guidelines have improved the management of prosthetic joint infections (PJI). However, it is necessary to reassess the incidence and risk factors for treatment failure (TF) of Staphylococcus aureus PJI (SA-PJI) including functional loss, which has so far been neglected as an outcome. Methods: A retrospective cohort study of SA-PJI was performed in 19 European hospitals between 2014 and 2016. The outcome variable was TF, including related mortality, clinical failure and functional loss both after the initial surgical procedure and after all procedures at 18 months. Predictors of TF were identified by logistic regression. Landmark analysis was used to avoid immortal time bias with rifampicin when debridement, antibiotics and implant retention (DAIR) was performed. Results: One hundred twenty cases of SA-PJI were included. TF rates after the first and all surgical procedures performed were 32.8% and 24.2%, respectively. After all procedures, functional loss was 6.0% for DAIR and 17.2% for prosthesis removal. Variables independently associated with TF for the first procedure were Charlson >= 2, haemoglobin 30 kg/m(2) and delay of DAIR, while rifampicin use was protective. For all procedures, the variables associated with TF were haemoglobin < 10 g/dL, hip fracture and additional joint surgery not related to persistent infection. Conclusions: TF remains common in SA-PJI. Functional loss accounted for a substantial proportion of treatment failures, particularly after prosthesis removal. Use of rifampicin after DAIR was associated with a protective effect. Among the risk factors identified, anaemia and obesity have not frequently been reported in previous studies. [GRAPHICS]

«Accademie e Biblioteche d’Italia». Indici delle annate I (1927/28) - L (1982)

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The BACHD Rat Model of Huntington Disease Shows Specific Deficits in a Test Battery of Motor Function

Contains fulltext : 179621.pdf (publisher's version ) (Open Access

Use of local anaesthetic drugs in day surgery. the experience of two hospitals in Lombardia

This prospective observational study was designed in order to systematically detect in two Hospitals the therapeutic approach to surgical ambulatory patients, mainly concerning the anaesthetic choice, time of surgery and postoperative analgesic consumption, as well as to evaluate the patient and physician satisfaction. In two Hospitals, Legnano and Magenta, 203 patients were enrolled among those undergoing either genera! surgery (mainly hernioplasty and coccygeal cyst removal) or hand surgery (mainly carpal tunnel syndrome and Dupuytren disease). Loco-regional anaesthesia were of different types: plexal, troncular, or infiltration. High quality and safety of local anaesthesia were confirmed: 80% of patients not reporting any pain, local or generalized during surgery. Also the postoperative pain was well! controlled: nearly 10% of patients complaining local pain and only 1% generalized pain

Comparison between two therapeutic approaches to post-operative pain in urological surgery Psychological and pharmacological aspects

The post-operative analgesic therapy represents a target of quality and saving for a Hospital because it ensures a positive outcome for surgery-treated patients. From this point of view, it is important to use validated protocols in each specific clinical context and to pay attention to all the factors involved in the genesis of pain...In this study the analgesic benefit offered by different protocols of treatment of post-operative pain in 88 patients who underwent an operation of transurethral prostatectomy (TURP) has been evaluated. In addition to verifying the efficacy of different pharmacological therapies, we wanted to estimate the impact of providing the patients with detailed information before surgery on the following response to the analgesic therapy. Our present results demonstrate the validity of a therapeutic protocol based on the use of an opiate administered by continuous intravenous infusion and point out the importance of a multidisciplinary approach to the patient with post-operative pain

San Patrignano. Lessons from the Italian experience

This chapter focuses on a retention in treatment study carried out in San Patrignano (SanPa), Italy\u2019s largest therapeutic community (TC) working with drug addiction. Study outcomes are connected to some of this TC\u2019s characteristics which are also to be found in other Italian contexts. In the first part, after presenting some data on public and private services dealing with addictions, the authors outline an Italian TC model and its main characteristics. The second and third parts focus on SanPa\u2019s history and organization. The fourth and fifth parts introduce two independent follow-up studies promoted by SanPa as well as the aforementioned retention factor study, Community Outcome. Important results emerge on the ability of this TC to retain users and contribute to their complete recovery, as drug-free people reintegrated into society and the labor market

Validation of behavioral phenotypes in the BACHD rat model

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Aligning and Updating Cadaster Maps with Aerial Images by Multi-Task, Multi-Resolution Deep Learning

International audienceA large part of the world is already covered by maps of buildings , through projects such as OpenStreetMap. However when a new image of an already covered area is captured, it does not align perfectly with the buildings of the already existing map, due to a change of capture angle , atmospheric perturbations, human error when annotating buildings or lack of precision of the map data. Some of those deformations can be partially corrected, but not perfectly, which leads to misalignments. Additionally , new buildings can appear in the image. Leveraging multi-task learning, our deep learning model aligns the existing building polygons to the new image through a displacement output, and also detects new buildings that do not appear in the cadaster through a segmentation output. It uses multiple neural networks at successive resolutions to output a displacement field and a pixel-wise segmentation of the new buildings from coarser to finer scales. We also apply our method to buildings height estimation, by aligning cadaster data to the rooftops of stereo images. The code is available at https://github.com/Lydorn/mapalignment