Perivascular and Diffuse Lymphocytic Inflammation are not Specific for Failed Metal-on-metal Hip Implants

Several studies suggest that histologic findings from tissues obtained at revision arthroplasty for failed metal-on-metal (MOM) total hip implants may reflect an immune reaction to particles or ions in some patients. However, only a limited number of cases without MOM implants were reported as controls in those studies. The purpose of this study is to better define the extent and distribution of morphologic features attributed to an immune reaction in tissues sampled at revision surgery for failed nonMOM THA. As part of a multicenter, prospective study, we reviewed 612 capsular and interface tissues obtained from 130 patients at revision THA. The samples were selected from periacetabular regions (154 samples from 103 patients), femoral implant/cement-bone interface (154 samples from 79 patients), and from areas of the joint capsule that had an intraoperative gross appearance suggesting the possibility of either infection or metallosis (256 samples from 129 patients). All patients had more than one sample obtained. The extent and distribution of lymphocytes and plasma cells, acute inflammation, and visible particles of debris were graded using criteria similar to those described to grade inflammation around failed MOM implants. We identified perivascular lymphocytes in 111 biopsy samples taken from 65 (50%) of 130 patients, and in 87 specimens from 57 (53%) of 107 patients thought to have aseptic loosening. Diffusely distributed lymphocytes were identified in 86 (66%) of 130 patients, and in 66 (62%) of the 107 hips with aseptic loosening, although few had the highest grade of inflammation. Increasing extent of diffuse and perivascular lymphocytes correlated with increasing extent of metal particles. Mild lymphocytic inflammation, diffuse and especially perivascular, is common in tissues around failed nonMOM implants. Although extensive inflammation in an inflammatory pseudotumor pattern is rare, it does occur in some cases of failed metal-polyethylene hip arthroplasties. The importance of inflammation is unknown, but the extent of diffuse inflammation shows a positive correlation with metal debris, so it could reflect a reaction to particles or ions in some patients

Aplicação localizada de herbicidas para controle de alecrim-do-campo (Vernonia nudiflora) em pastagem natural.

Resumo: Para avaliar o controle de alecrim-do-campo (Vernonia nudiflora) com aplicação de herbicidas de contato, foi conduzido durante 353 dias, um experimento com delineamento de parcelas subdivididas, dispostas em blocos ao acaso, com três repetições em um arranjo fatorial (5x3)+1, sendo cinco herbicidas em três doses mais a testemunha. As parcelas corresponderam aos herbicidas, com doses de 1,5; 3,0 e 4,5 L ha-1 de Tordon, Aminol 806, Garlon, Grazon e Plenum. A abundância de V. nudiflora foi avaliada antes da aplicação e 60 e 353 dias após. A aplicação foi feita com ?roçadeira química? tratorizada, consistindo em uma plataforma com bandejas com altura regulável, que entra em contato somente com as plantas alvo. Os herbicidas não diferiram quanto à redução na abundância do alecrim e todos reduziram significativamente mais que a testemunha. Os tratamentos não interferiram na frequência na composição de espécies desejáveis no campo nativo. O uso do aplicador químico é eficaz para o controle, mesmo com baixas concentrações de herbicidas, tendo eficácia na redução do alecrim-do-campo e preservando as espécies desejáveis para a produção animal. [Located herbicide application to control alecrim-do-campo (Vernonia nudiflora) in natural grassland]. Abstract: To evaluate the control of alecrim-do-campo (Vernonia nudiflora) with contact herbicides, an experiment was conducted during 353 days, following a split plot block design, with three replicates in a (5x3)+1 factorial arrangement, being five herbicides in three doses and the control. The plots corresponded to the herbicides, with doses of 1.5, 3.0 and 4.5 L ha-1 of Tordon, Aminol 806, Garlon, Grazon e Plenum. The presence of V. nudiflora was evaluated prior to application and 60 and 353 days after. The application was made using a chemical applicator, which consists of a platform of adjustable height that contacts only the target plant. The herbicides did not differ in reducing the abundance of V. nudiflora and all of them reduced significantly more than the control. The chemical applicator was effective to control alecrim-do-campo, even with low herbicide concentrations, reducing the Vernonia abundance and not being harmful to the native desirable species

Controle de espécies indesejáveis e preservação de leguminosas de campo nativo com aplicação localizada de herbicidas.

Resumo: Para avaliar o efeito da aplicação localizada de herbicidas por contato, em Desmodium incanum, foi conduzido este estudo pelo período de 353 dias. O delineamento experimental foi de parcelas subdivididas, dispostas em blocos ao acaso, com três repetições em um arranjo fatorial [(5x3)+1], sendo cinco herbicidas mais a testemunha e três épocas de avaliação. As parcelas corresponderam aos herbicidas, locados na dose de 1,5 L ha-1 de Tordon, Aminol 806, Garlon, Grazon e Plenum, sendo compostas por oito quadros dispostos sobre uma transecta fixa. Realizou-se um levantamento prévio ao experimento, e dois levantamentos subseqüentes aos 60 e 365 dias apos a aplicação. A planta indesejável mais frequente era Vernonia nudiflora. Para aplicação dos herbicidas utilizou-se uma 'roçadeira química' tratorizada, consistindo em uma plataforma com bandejas com altura regulável, que entra em contato somente com as plantas alvo. O uso do aplicador químico foi eficaz para o controle de espécies indesejáveis além de não interferir na frequência do Desmodium incanum, sendo interessante a limpeza seletiva e preservação da flora nativa. [Weed control and preservation of native legumes species in natural grassland by herbicide localized application] Abstract: To evaluate the effect of localized application of herbicides by contact, in Desmodium incanum, this trial was conducted during a period of 353 days. The experimental design was a split plot arranged in a randomized block design with three replications in a factorial arrangement [(5x3) +1], five herbicides plus the control and three evaluation periods. The plots corresponded to herbicides, doses were locate: 1.5, 3.0 and 4.5 L ha -1 of Tordon, Aminol 806, Garlon, Grazon e Plenum, being composed by 8 tables arranged on a fixed line. Prior to application, was made a survey, another in 60 and 353 days after application. For the herbicides application, was used a chemical applicator, which consists in an adjustable height platform, and it is contact is only with the target plant. The use of chemical applicator was effective for controlling undesirable species besides not interfere on Desmodium incanum frequency besides being interesting for selective cleaning and preservation of the native vegetation

Controle de espécies indesejáveis e preservação de leguminosas de campo nativo com aplicação localizada de herbicidas

To evaluate the effect of localized application of herbicides by contact, in Desmodium incanum, this trial was conducted during a period of 353 days. The experimental design was a split plot arranged in a randomized block design with three replications in a factorial arrangement [(5x3) +1], five herbicides plus the control and three evaluation periods. The plots corresponded to herbicides, doses were locate: 1.5, 3.0 and 4.5 L ha -1 of Tordon, Aminol 806, Garlon, Grazon e Plenum, being composed by 8 tables arranged on a fixed line. Prior to application, was made a survey, another in 60 and 353 days after application. For the herbicides application, was used a chemical applicator, which consists in an adjustable height platform, and it is contact is only with the target plant. The use of chemical applicator was effective for controlling undesirable species besides not interfere on Desmodium incanum frequency besides being interesting for selective cleaning and preservation of the native vegetation.Para avaliar o efeito da aplicação localizada de herbicidas por contato, em Desmodium incanum, foi conduzido este estudo pelo período de 353 dias. O delineamento experimental foi de parcelas subdivididas, dispostas em blocos ao acaso, com três repetições em um arranjo fatorial [(5x3)+1], sendo cinco herbicidas mais a testemunha e três épocas de avaliação. As parcelas corresponderam aos herbicidas, locados na dose de 1,5 L ha-1 de Tordon, Aminol 806, Garlon, Grazon e Plenum, sendo compostas por oito quadros dispostos sobre uma transecta fixa. Realizou-se um levantamento prévio ao experimento, e dois levantamentos subseqüentes aos 60 e 365 dias apos a aplicação. A planta indesejável mais frequente era Vernonia nudiflora. Para aplicação dos herbicidas utilizou-se uma “roçadeira química” tratorizada, consistindo em uma plataforma com bandejas com altura regulável, que entra em contato somente com as plantas alvo. O uso do aplicador químico foi eficaz para o controle de espécies indesejáveis além de não interferir na frequência do Desmodium incanum, sendo interessante a limpeza seletiva e preservação da flora nativa

Aplicação localizada de herbicidas para controle de alecrim-do-campo (vernonia nudiflora) em pastagem natural

To evaluate the control of alecrim-do-campo (Vernonia nudiflora) with contact herbicides, an experiment was conducted during 353 days, following a split plot block design, with three replicates in a (5x3)+1 factorial arrangement, being five herbicides in three doses and the control. The plots corresponded to the herbicides, with doses of 1.5, 3.0 and 4.5 L ha-1 of Tordon, Aminol 806, Garlon, Grazon e Plenum. The presence of V. nudiflora was evaluated prior to application and 60 and 353 days after. The application was made using a chemical applicator, which consists of a platform of adjustable height that contacts only the target plant. The herbicides did not differ in reducing the abundance of V. nudiflora and all of them reduced significantly more than the control. The chemical applicator was effective to control alecrim-do-campo, even with low herbicide concentrations, reducing the Vernonia abundance and not being harmful to the native desirable species.Para avaliar o controle de alecrim-do-campo (Vernonia nudiflora) com aplicação de herbicidas de contato, foi conduzido durante 353 dias, um experimento com delineamento de parcelas subdivididas, dispostas em blocos ao acaso, com três repetições em um arranjo fatorial (5x3)+1, sendo cinco herbicidas em três doses mais a testemunha. As parcelas corresponderam aos herbicidas, com doses de 1,5; 3,0 e 4,5 L.ha-1 de Tordon, Aminol 806, Garlon, Grazon e Plenum. A abundância de V. nudiflora foi avaliada antes da aplicação e 60 e 353 dias após. A aplicação foi feita com “roçadeira química” tratorizada, consistindo em uma plataforma com bandejas com altura regulável, que entra em contato somente com as plantas alvo. Os herbicidas não diferiram quanto à redução na abundância do alecrim e todos reduziram significativamente mais que a testemunha. Os tratamentos não interferiram na frequência na composição de espécies desejáveis no campo nativo. O uso do aplicador químico é eficaz para o controle, mesmo com baixas concentrações de herbicidas, tendo eficácia na redução do alecrim-do-campo e preservando as espécies desejáveis para a produção animal

Inter-method reliability of the modified Rankin Scale in patients with subarachnoid hemorrhage

BACKGROUND AND OBJECTIVES: The modified Rankin Scale (mRS) is one of the most frequently used outcome measures in trials in patients with an aneurysmal subarachnoid hemorrhage (aSAH). The assessment method of the mRS is often not clearly described in trials, while the method used might influence the mRS score. The aim of this study is to evaluate the inter-method reliability of different assessment methods of the mRS. METHODS: This is a prospective, randomized, multicenter study with follow-up at 6 weeks and 6 months. Patients aged ≥ 18 years with aSAH were randomized to either a structured interview or a self-assessment of the mRS. Patients were seen by a physician who assigned an mRS score, followed by either the structured interview or the self-assessment. Inter-method reliability was assessed with the quadratic weighted kappa score and percentage of agreement. Assessment of feasibility of the self-assessment was done by a feasibility questionnaire. RESULTS: The quadratic weighted kappa was 0.60 between the assessment of the physician and structured interview and 0.56 between assessment of the physician and self-assessment. Percentage agreement was, respectively, 50.8 and 19.6%. The assessment of the mRS through a structured interview and by self-assessment resulted in systematically higher mRS scores than the mRS scored by the physician. Self-assessment of the mRS was proven feasible. DISCUSSION: The mRS scores obtained with different assessment methods differ significantly. The agreement between the scores is low, although the reliability between the assessment methods is good. This should be considered when using the mRS in clinical trials. TRIAL REGISTRATION: www.trialregister.nl; Unique identifier: NL7859. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-021-10880-4

Increasing risk of revision due to deep infection after hip arthroplasty: A study on 97,344 primary total hip replacements in the Norwegian Arthroplasty Register from 1987 to 2007

Background and purpose Over the decades, improvements in surgery and perioperative routines have reduced the incidence of deep infections after total hip arthroplasty (THA). There is, however, some evidence to suggest that the incidence of infection is increasing again. We assessed the risk of revision due to deep infection for primary THAs reported to the Norwegian Arthroplasty Register (NAR) over the period 1987–2007