62 research outputs found
Management of toxic ingestions with the use of renal replacement therapy
Although rare, renal replacement therapy (RRT) for the treatment of the metabolic, respiratory and hemodynamic complications of intoxications may be required. Understanding the natural clearance of the medications along with their volume of distribution, protein binding and molecular weight will help in understanding the benefit of commencing RRT. This information will aid in choosing the optimal forms of RRT in an urgent setting. Overdose of common pediatric medications are discussed with suggestions on the type of RRT within this educational review
Association between bone mineral density and type 2 diabetes mellitus: a meta-analysis of observational studies
Type 2 diabetes mellitus (T2DM) influences bone metabolism, but the relation of T2DM with bone mineral density (BMD) remains inconsistent across studies. The objective of this study was to perform a meta-analysis and meta-regression of the literature to estimate the difference in BMD (g/cm2) between diabetic and non-diabetic populations, and to investigate potential underlying mechanisms. A literature search was performed in PubMed and Ovid extracting data from articles prior to May 2010. Eligible studies were those where the association between T2DM and BMD measured by dual energy X-ray absorptiometry was evaluated using a cross-sectional, cohort or case–control design, including both healthy controls and subjects with T2DM. The analysis was done on 15 observational studies (3,437 diabetics and 19,139 controls). Meta-analysis showed that BMD in diabetics was significantly higher, with pooled mean differences of 0.04 (95% CI: 0.02, 0.05) at the femoral neck, 0.06 (95% CI: 0.04, 0.08) at the hip and 0.06 (95% CI: 0.04, 0.07) at the spine. The differences for forearm BMD were not significantly different between diabetics and non-diabetics. Sex-stratified analyses showed similar results in both genders. Substantial heterogeneity was found to originate from differences in study design and possibly diabetes definition. Also, by applying meta-regression we could establish that younger age, male gender, higher body mass index and higher HbA1C were positively associated with higher BMD levels in diabetic individuals. We conclude that individuals with T2DM from both genders have higher BMD levels, but that multiple factors influence BMD in individuals with T2DM
Residual posterior femoral condyle osteophyte affects the flexion range after total knee replacement
We followed up 92 patients with total knee replacement and a pre-operative knee flexion of at least 90°. The patients were followed up regularly at 3 months, 6 months and 1 year. The outcome measured was the amount of maximum passive knee flexion at the end of 1 year after replacement. The potential factors affecting the final flexion range were investigated. After regression analysis, apart from pre-operative knee flexion (p<0.001), the most significant independent surgical factors that predict the amount of post-operative flexion were presence of residual posterior femoral condyle osteophyte (p=0.046) and overstuffing the patella by more than 2 mm during resurfacing of the patella (p<0.001)
Amélioration de la mobilité après prothèse totale de genou: Le patient la perçoit-il?
Influence of intra-operative parameters on postoperative early recovery of active knee flexion in posterior-stabilized total knee arthroplasty
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