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Emilie M Flament, Keith R Berend, Jason M Hurst, Michael J Morris, Joanne B Adams, Adolph V Lombardi
BACKGROUND: In past decades, polyethylene wear was a major cause of failure in total knee arthroplasty (TKA). Polyethylene for use in arthroplasty has been vastly improved in recent years, with improved materials as well as manufacturing and sterilization processes. Testing has shown that infusion of vitamin E prevents oxidative degradation of polyethylene without remelting, allowing the material to maintain mechanical properties and wear resistance over time. The purpose of this study is to review the early result of patients undergoing primary TKA with vitamin E antioxidant-infused polyethylene inserts...
October 26, 2016: Surgical Technology International
John R Miklos, Orawee Chinthakanan, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
STUDY OBJECTIVE: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal. DESIGN: This was a retrospective study...
October 26, 2016: Surgical Technology International
Orawee Chinthakanan, John R Miklos, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
INTRODUCTION AND HYPOTHESIS: 1) Evaluate the most common indication for sling removal in patients with synthetic mesh slings; 2) identify the location of pain for each of the three types of synthetic sling procedures including retropubic (RP) sling, transobturator (TOT) sling, and single incision slings (SIS), and 3) describe the surgical approach to each of the above and its associated complications. MATERIALS AND METHODS: A retrospective chart review of all patients who underwent surgical removal of a sling due to a mesh-related complications from 2011 to 2013 at three referral centers...
October 26, 2016: Surgical Technology International
Roger S McIntyre, Ioana Florea, Brigitte Tonnoir, Henrik Loft, Raymond W Lam, Michael Cronquist Christensen
OBJECTIVE: This post hoc analysis investigates the effect of vortioxetine on cognitive functioning and depressive symptoms in working adults with major depressive disorder (MDD). METHODS: Population data from FOCUS, a double-blind, randomized, placebo-controlled study investigating the efficacy of vortioxetine versus placebo on cognitive functioning and depression in patients with MDD, were used to analyze mean change from baseline scores for the Digit Symbol Substitution Test (DSST), Trail Making Test A/B (TMT-A/B), Stroop, and Perceived Deficits Questionnaire (PDQ)...
October 25, 2016: Journal of Clinical Psychiatry
Robert Westermann, Chris A Anthony, Kyle R Duchman, Yubo Gao, Andrew J Pugely, Carolyn M Hettrich, Ned Amendola, Brian R Wolf
Infection following anterior cruciate ligament reconstruction (ACLR) is rare. Previous authors have concluded that diabetes, tobacco use, and previous knee surgery may influence infection rates following ACLR. The purpose of this study was to identify a cohort of patients undergoing ACLR and define (1) the incidence of infection after ACLR from a large multicenter database and (2) the risk factors for infection after ACLR. We identified patients undergoing elective ACLRs in the American College of Surgeons National Surgical Quality Improvement Program database between 2007 and 2013...
October 25, 2016: Journal of Knee Surgery
Ching-Wen Pan, Meng-Hsien Chen, Lien-Siang Chou, Hsing-Juh Lin
Indo-Pacific humpback dolphins (Sousa chinensis) have attracted considerable attention due to their critically endangered status and related conservation issues, but their trophic relationships and ecological significance in coastal ecosystems are poorly understood. For instance, this species is noticeably more abundant in the Xin-Huwei River Estuary (Ex) of Western Taiwan than in the nearby Zhuoshui River Estuary (Ez), though it is unclear why the distribution shows such partitioning. To explore this topic, we conducted field surveys seasonally for two years from 2012 to 2013 and constructed Ecopath models of Ex, Ez, and an offshore site (Dm) to compare energy flow within the food webs...
2016: PloS One
Karen H Keddy, Arvinda Sooka, Anthony M Smith, Alfred Musekiwa, Nomsa P Tau, Keith P Klugman, Frederick J Angulo
BACKGROUND: Typhoid fever remains an important disease in Africa, associated with outbreaks and the emerging multidrug resistant Salmonella enterica serotype Typhi (Salmonella Typhi) haplotype, H58. This study describes the incidence of, and factors associated with mortality due to, typhoid fever in South Africa, where HIV prevalence is high. METHODS AND FINDINGS: Nationwide active laboratory-based surveillance for culture-confirmed typhoid fever was undertaken from 2003-2013...
2016: PloS One
Ramnath Subbaraman, Ruvandhi R Nathavitharana, Srinath Satyanarayana, Madhukar Pai, Beena E Thomas, Vineet K Chadha, Kiran Rade, Soumya Swaminathan, Kenneth H Mayer
BACKGROUND: India has 23% of the global burden of active tuberculosis (TB) patients and 27% of the world's "missing" patients, which includes those who may not have received effective TB care and could potentially spread TB to others. The "cascade of care" is a useful model for visualizing deficiencies in case detection and retention in care, in order to prioritize interventions. METHODS AND FINDINGS: The care cascade constructed in this paper focuses on the Revised National TB Control Programme (RNTCP), which treats about half of India's TB patients...
October 2016: PLoS Medicine
Chiung-Ying Huang, Szu-Ying Lee, Chung-Wei Yang, Szu-Chun Hung, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
BACKGROUND: Low lean body mass (LBM) is an indicator of malnutrition inflammation syndrome, which is common in hemodialysis (HD) patients. The creatinine index (CI) has been validated as a reliable method to estimate LBM and evaluate the protein-energy status of HD patients. However, the traditional creatinine index formula was complex. We sought to investigate the impact of CI derived from a new simple formula on Chinese HD patient outcomes. METHODS: In this retrospective cohort study, we enrolled 1269 patients who initiated HD between February 1981 and February 2012 and followed them until the end of February 2013...
2016: PloS One
Joanne Elizabeth Hegarty, Jane Elizabeth Harding, Gregory David Gamble, Caroline Anne Crowther, Richard Edlin, Jane Marie Alsweiler
BACKGROUND: Neonatal hypoglycaemia is common, affecting up to 15% of newborns, and can cause brain damage. Currently, there are no strategies, beyond early feeding, to prevent neonatal hypoglycaemia. Our aim was to determine a dose of 40% oral dextrose gel that will prevent neonatal hypoglycaemia in newborn babies at risk. METHODS AND FINDINGS: We conducted a randomised, double-blind, placebo-controlled dose-finding trial of buccal dextrose gel to prevent neonatal hypoglycaemia at two hospitals in New Zealand...
October 2016: PLoS Medicine
Henrik Møller, Katherine Henson, Margreet Lüchtenborg, John Broggio, Jackie Charman, Victoria H Coupland, Elizabeth Davies, Ruth H Jack, Richard Sullivan, Peter Vedsted, Kieran Horgan, Neil Pearce, Arnie Purushotham
BACKGROUND: In the re-organisation of cancer registration in England in 2012, a high priority was given to the recording of cancer stage and other prognostic clinical data items. METHODS: We extracted 86 852 breast cancer records for women resident in England and diagnosed during 2012-2013. Information on age, ethnicity, socio-economic status, comorbidity, tumour stage, grade, morphology and oestrogen, progesterone and HER2 receptor status was included. The two-year cumulative risk of death from any cause was estimated with the Kaplan-Meier method, and univariate and multivariate Cox proportional hazards regressions were used to estimate hazard ratios (HR) and their 95% confidence intervals (95% CI)...
October 25, 2016: British Journal of Cancer
Firas Zahr Eldeen, Garrett R Roll, Carlos Derosas, Rajashankar Rao, Muhammad S Khan, Bridget K Gunson, James Hodson, Hynek Mergental, Ben-Hur Ferraz-Neto, John Isaac, Paolo Muiesan, Darius F Mirza, Asim Iqbal, M Thamara P R Perera
BACKGROUND: Whilst causes of hepatic artery thrombosis (HAT) after liver transplantation (LT) are multifactorial, early HAT (E-HAT) remains pertinent complication impacting on graft and patient survival. Currently there is no screening tool that would identify patients with increased risk of developing E-HAT. METHODS: We analyzed the native procoagulant state of LT recipients, identified through pretransplant thromboelastographic (TEG) data among other known risk factors, to identify risk factors for E-HAT...
November 2016: Transplantation
Marek Krawczyk, Michał Grąt, Rene Adam, Wojciech G Polak, Jurgen Klempnauer, Antonio Pinna, Fabrizio Di Benedetto, Franco Filipponi, Norbert Senninger, Aksel Foss, Sebastian Rufián-Peña, William Bennet, Johann Pratschke, Andreas Paul, Utz Settmacher, Giorgio Rossi, Mauro Salizzoni, Carlos Fernandez-Selles, Santiago T Martínez de Rituerto, Miguel A Gómez-Bravo, Jacques Pirenne, Olivier Detry, Pietro E Majno, Petr Nemec, Wolf O Bechstein, Michael Bartels, Silvio Nadalin, Francois R Pruvot, Darius F Mirza, Luigi Lupo, Michele Colledan, Giuseppe Tisone, Jan Ringers, Jorge Daniel, Ramón Charco Torra, Enrique Moreno González, Rafael Bañares Cañizares, Valentin Cuervas-Mons Martinez, Fernando San Juan Rodríguez, Sezai Yilmaz, Piotr Remiszewski
BACKGROUND: Liver transplantation is the most extreme form of surgical management of patients with hepatic trauma, with very limited literature data supporting its use. The aim of this study was to assess the results of liver transplantation for hepatic trauma. METHODS: This retrospective analysis based on European Liver Transplant Registry comprised data of 73 recipients of liver transplantation for hepatic trauma performed in 37 centers in the period between 1987 and 2013...
November 2016: Transplantation
H Lu, K B Lua, Y J Lee, T T Lim, K S Yeo
This paper reports the results of combined experimental and numerical studies on the ground effect on a pair of three-dimensional (3D) hovering wings. Parameters investigated include hovering kinematics, wing shapes, and Reynolds numbers (Re). The results are consistent with the observation by another study (Gao and Lu, 2008 Phys. Fluids, 20 087101) which shows that the cycle-averaged aerodynamic forces generated by two-dimensional (2D) wings in close proximity to the ground can be broadly categorized into three regimes with respect to the ground clearance; force enhancement, force reduction, and force recovery...
October 25, 2016: Bioinspiration & Biomimetics
Daniel Gardner, Andrew Liman, Victoria Autelli, Casey O'Connell, Nicholas Testa, Glenn Ault
Improving patient safety is vital for all hospitals due to increasing public reporting and pay-for-performance reimbursement. Venous thromboembolism (VTE) remains a leading cause of preventable mortality accounting for 5 per cent of inpatient deaths. The purpose of this study was to outline the process of implementing standard VTE prophylactic order sets in a 600-bed academic safety net hospital and assess the resulting change in patient outcomes. Outcomes were assessed by comparing the rate that eligible inpatients receive VTE prophylaxis and the rate of preventable VTE's compared with total VTE's...
October 2016: American Surgeon
Valentina Bonev, Carlos Chavez De Paz Villanueva, Naveenraj Solomon, Maheswari Senthil, Mark E Reeves, Carlos Garberoglio, Sharon S Lum
When ductal carcinoma in situ (DCIS) is found on core needle biopsy, rates of upgrade to invasive cancer of 25 per cent and nodal positivity of 10 per cent have been reported. Sentinel lymph node dissection (SLND) is recommended when mastectomy is performed for DCIS. We investigated the role of SLND in DCIS patients undergoing partial and total mastectomy (TM). During the study period 2004 to 2013, 170 patients with DCIS were identified with a median age of 60 years (range 26-84 years). Of these, 58.2 per cent had partial mastectomy (PM) alone, 10...
October 2016: American Surgeon
Xuan-Binh D Pham, Jerry J Kim, Aaron B Parrish, Cynthia Tom, Ezinne J Ihenachor, David Mina, Christian de Virgilio
Prior studies have shown racial and gender differences with respect to maturation of arteriovenous fistulas. Women and minorities have lower maturation rates for unclear reasons. Small arterial diameter and high brachial artery bifurcation (HBB) are also implicated in reduced maturation rates. We sought to correlate differences in upper extremity arterial anatomy to race and gender. All upper extremity vascular mapping ultrasounds from 2013 to 2014 were retrospectively reviewed. A total of 509 arms in 284 patients were evaluated...
October 2016: American Surgeon
Jessica A Zagory, Jamie Golden, Kathleen Holoyda, Natalie Demeter, Nam X Nguyen
The optimal management of pilonidal disease in the pediatric population is still debated. We conducted a retrospective review of patients 21 years old and younger who underwent surgical management for pilonidal disease between 2009 and 2013 at a single pediatric institution. Sixty patients (41.7% male) were included in the analysis, with a mean age of 15.0 years (range, 13-20). Twelve (20%) had a prior drainage procedure for pilonidal abscess before the definitive operative treatment. After excision to the presacral fascia, 36 (60%) had primary closure, 17 (28...
October 2016: American Surgeon
Reza Fazl Alizadeh, Zhobin Moghadamyeghaneh, Matthew D Whealon, Mark H Hanna, Steven D Mills, Alessio Pigazzi, Michael J Stamos, Joseph C Carmichael
There are limited data regarding the association between body mass index (BMI) and colorectal surgery outcomes. We sought to evaluate the effect of BMI on short-term surgical outcomes in colon and rectal surgery patients in the United States. The American College of Surgeons National Surgery Quality Improvement Project database was used to identify all patients who underwent colon or rectal resection from 2005 to 2013. Multivariate regression analysis was used to assess the independent effect of BMI on outcomes...
October 2016: American Surgeon
Son Nguyen, Allen Zhu, William Toppen, Adeel Ashfaq, Jessica Davis, Richard Shemin, Abie H Mendelsohn, Peyman Benharash
Although the true incidence of postoperative dysphagia after cardiac surgery is unknown, it has been reported to occur in 3 to 21.6 per cent of patients. Historically, dysphagia has been associated with increased surgical complications and prolonged hospital stay. This study aimed to evaluate the costs and outcomes associated with dysphagia after cardiac surgery. Patients undergoing nonemergent, nontransplant cardiac operations between June 2013 and June 2014 were eligible for inclusion. Independent predictors of cost were identified through a multivariate linear regression model...
October 2016: American Surgeon
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