88 research outputs found
Healing of surgical site after total hip and knee replacements show similar telethermographic patterns
BACKGROUND: Isolated reports indicate the efficacy of infrared thermography for
monitoring wound healing and septic complications, but no long-term analysis has
ever been performed on this, and there are no data on the telethermographic
patterns of surgical site healing after uncomplicated total hip prosthesis and
after knee prosthesis.
MATERIALS AND METHODS: In this prospective, observational, nonrandomized cohort
study, two groups with forty consecutive patients each, who were operated on
respectively for total hip and for total knee replacements, underwent
telethermographic examination of the operated and contralateral joints prior to
and at fixed intervals for up to 1\ua0year after uncomplicated surgery. A digital,
portable telethermocamera and dedicated software were used for data acquisition
and processing.
RESULTS: No thermographic difference was observed preoperatively between the
affected side and the contralateral side in both groups. After the intervention,
a steep increase in the temperature of the operated joint was recorded after
total hip replacement and after knee replacement, with a peak mean differential
temperature measured three days postoperatively between the operated and
unoperated joint of 3.1\ua0\ub1\ua00.8\ub0C after total hip replacement, and 3.4\ua0\ub1\ua00.7\ub0C
after total knee replacement. Thereafter, the mean differential temperature
declined slowly to 0.7\ua0\ub1\ua01.1\ub0C and to 0.5\ua0\ub1\ua01.3\ub0C at 60\ua0days, and to 0.0\ua0\ub1\ua01.0\ub0C
and -0.1\ua0\ub1\ua01.1\ub0C 90\ua0days post-operatively, respectively. No further changes were
observed for up to 1\ua0year after surgery. Results were similar when comparing the
average telethermographic values of an elliptical area where the main axis
corresponded to the surgical wound.
CONCLUSIONS: The surgical sites after uncomplicated total hip or total knee
replacement show similar telethermographic patterns for up to 1\ua0year from
surgery, and can easily be monitored using a portable, digital, telethermocamera
Bone and joint infections in adults: a comprehensive classification proposal
Ten currently available classifications were tested for their ability to describe a continuous cohort of 300 adult patients affected by bone and joint infections. Each classification only focused, on the average, on 1.3\u2009\ub1\u20090.4 features of a single clinical condition (osteomyelitis, implant-related infections, or septic arthritis), being able to classify 34.8\u2009\ub1\u200924.7% of the patients, while a comprehensive classification system could describe all the patients considered in the study. RESULT AND CONCLUSION: A comprehensive classification system permits more accurate classification of bone and joint infections in adults than any single classification available and may serve for didactic, scientific, and clinical purposes
Prevention of implant-related infections by a resorbable, antibacterial-loaded coating: a new approach
Currently studied antibacterial coatings are far from having large-scale applications, due to various limitations. A recently developed fast resorbable, antibacterial-loaded, hydrogel coating may provide a new approach to offer an effective antibacterial and antibiofilm protection to orthopedic implants
Adherence to routine use of pharmacological prophylaxis of heterotopic ossification after total hip arthroplasty: results from an Italian multicenter, prospective, observational survey
Single-level anterior cervical discectomy and interbody fusion using PEEK anatomical cervical cage and allograft bone
BACKGROUND: In an effort to avoid the morbidity associated with autogenous bone graft harvesting, cervical cages in combination with allograft bone are used to achieve fusion. The goal of the current study was to assess the reliability and efficacy of anterior cervical discectomy and interbody fusion (ACDF) using a PEEK anatomical cervical cage in the treatment of patients affected by single-level cervical degenerative disease.
METHODS AND MATERIALS: Twenty-five patients affected by single-level cervical degenerative pathology between C4 and C7 were enrolled in this study. The clinical findings were assessed using the Neck Disability Index and the Visual Analog Scale. Surgical outcomes were rated according to Odom's criteria at last follow-up. Fusion was graded as poor, average, good or excellent by assessing the radiographs. Cervical spine alignment was evaluated by sagittal segmental alignment and sagittal alignment of the whole cervical spine preoperatively, 6 months postoperatively and at the last follow-up.
RESULTS: Twenty-five patients underwent ACDF using a PEEK anatomical cervical cage. All patients had a minimum 2 years of follow-up. The operative levels were C4-C5 in 5 patients, C5-C6 in 12 patients and C6-C7 in 8 patients. Preoperatively, average NDI was 34, 13 at 6 months, and 10 at latest follow-up. The mean preoperative VAS was 7; the mean postoperative VAS at latest follow-up was 3. Good or excellent fusion was achieved in all patients within 10 months (mean 5 months). Preoperatively, average sagittal segmental alignment (SSA) was 0.2\ub0 and average sagittal alignment of the cervical spine (SACS) 15.8\ub0. Six months after surgery, average SSA was 1.8\ub0 and average SACS 20.9\ub0, and at last follow-up, average SSA was 1.6\ub0 and average SACS 18.5\ub0.
CONCLUSION: Anterior cervical discectomy and interbody fusion using PEEK anatomical cervical cages can be considered a safe and effective technique to cure cervical disc herniation with intractable pain or neural deficit in cases where conservative treatment failed
Prosthetic joint infection caused by Pasteurella multocida: a case series and review of literature
What is the evidence base to guide surgical treatment of infected hip prostheses? systematic review of longitudinal studies in unselected patients
Hepatitis E virus infection in patients with acute non-A, non-B, non-C hepatitis in Central Brazil
An updated view of hypothalamic-vascular-pituitary unit function and plasticity
The discoveries of novel functional adaptations of the hypothalamus and anterior pituitary gland for physiological regulation have transformed our understanding of their interaction. The activity of a small proportion of hypothalamic neurons can control complex hormonal signalling, which is disconnected from a simple stimulus and the subsequent hormone secretion relationship and is dependent on physiological status. The interrelationship of the terminals of hypothalamic neurons and pituitary cells with the vasculature has an important role in determining the pattern of neurohormone exposure. Cells in the pituitary gland form networks with distinct organizational motifs that are related to the duration and pattern of output, and modifications of these networks occur in different physiological states, can persist after cessation of demand and result in enhanced function. Consequently, the hypothalamus and pituitary can no longer be considered as having a simple stratified relationship: with the vasculature they form a tripartite system, which must function in concert for appropriate hypothalamic regulation of physiological processes, such as reproduction. An improved understanding of the mechanisms underlying these regulatory features has implications for current and future therapies that correct defects in hypothalamic–pituitary axes. In addition, recapitulating proper network organization will be an important challenge for regenerative stem cell treatment
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