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https://www.readbyqxmd.com/read/28646360/does-the-risk-of-rerevision-vary-between-porous-tantalum-cups-and-other-cementless-designs-after-revision-hip-arthroplasty
#1
Inari Laaksonen, Michelle Lorimer, Kirill Gromov, Ola Rolfson, Keijo T Mäkelä, Stephen E Graves, Henrik Malchau, Maziar Mohaddes
BACKGROUND: Earlier results with porous tantalum acetabular cups in revision THA generally have been favorable. Recently there has been some evidence presented that porous tantalum cups might decrease the risk of rerevision in the setting of revision hip surgery performed owing to prosthetic joint infection (PJI). As the data supporting this assertion come from a study with a limited study population, examining this issue with a large registry approach may be enlightening. QUESTIONS/PURPOSES: By combining results from two large, national registries, we asked: (1) Do porous tantalum cups show improved survival after revision THA compared with other cementless designs? (2) Does the use of porous tantalum cups influence survivorship when rerevision for PJI is the endpoint? METHODS: A total of 2442 first-time THA revisions with porous tantalum cups and 4401 first-time revisions with other uncemented cups were included in this collaborative study between the Australian and Swedish national joint registries...
June 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28645466/the-scottish-enhanced-staphylococcus-aureus-bacteraemia-surveillance-program-the-first-18-months-data-in-children
#2
F Murdoch, J Danial, A K Morris, E Czarniak, J L Bishop, E Glass, L J Imrie
BACKGROUND: National enhanced surveillance of Staphylococcus aureus Bacteraemia (SAB) commenced on the 1(st) of October 2014 to gain a more in-depth understanding of the epidemiology of SAB within Scotland. Children under 16 were analysed separately from adults because previous studies had demonstrated differences in the epidemiology. AIM: The aim was to identify risk factors and patient populations most at risk to allow focused improvement plans to be developed...
June 20, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28645272/prosthetic-joint-infection-caused-by-granulicatella-adiacens-a-case-series-and-review-of-literature
#3
Fanny Quénard, Piseth Seng, Jean-Christophe Lagier, Florence Fenollar, Andreas Stein
BACKGROUND: Bone and joint infection involving Granulicatella adiacens is rare, and mainly involved in cases of bacteremia and infectious endocarditis. Here we report three cases of prosthetic joint infection involving G. adiacens that were successfully treated with surgery and prolonged antimicrobial treatment. We also review the two cases of prosthetic joint infection involving G. adiacens that are reported in the literature. CASE PRESENTATION: Not all five cases of prosthetic joint infection caused by G...
June 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28643095/-local-antibiotic-therapy
#4
REVIEW
Klaus-Dieter Kühn, Nora Renz, Andrej Trampuz
The treatment of superficial wound infections with local antibiotics is considered to be problematic as it is accompanied by an increased risk of resistance development and ineffectiveness in deeper regions. On the contrary, the local application of antibiotics is useful in arthroplasty and necessary if implants are utilized. The reason for this is the prevention of a rapid biofilm formation on foreign implants and a resulting infection may remain undiscovered until it becomes chronic. Apart from exogenous material, necrotic tissue (e...
June 22, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28642256/revision-for-prosthetic-joint-infection-following-hip-arthroplasty-evidence-from-the-national-joint-registry
#5
E Lenguerrand, M R Whitehouse, A D Beswick, S A Jones, M L Porter, A W Blom
OBJECTIVES: We used the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) to investigate the risk of revision due to prosthetic joint infection (PJI) for patients undergoing primary and revision hip arthroplasty, the changes in risk over time, and the overall burden created by PJI. METHODS: We analysed revision total hip arthroplasties (THAs) performed due to a diagnosis of PJI and the linked index procedures recorded in the NJR between 2003 and 2014...
June 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28640088/safety-of-tumor-necrosis-factor-alpha-inhibitors-for-treatment-of-ankylosing-spondylitis-a-meta-analysis
#6
Zeren Ma, Xiaoping Liu, Xiaosheng Xu, Jie Jiang, Jian Zhou, Jia Wang, Dewang Chen, Song Luo
BACKGROUND: Ankylosing spondylitis (AS) is a chronic immune-mediated disease affecting the sacroiliac joints and the spine, manifesting with new bone formation and osteopenia. Five tumor necrosis factor-alpha (TNF-α) inhibitors (infliximab, etanercept, adalimumab, certolizumab, and golimumab) are available for the treatment of AS, however, the results for the safety of TNF-α inhibitors in the treatment of AS are not consistent. METHODS: In this study, we conducted a meta-analysis to determine the safety of TNF-α inhibitors compared with placebo in reducing pain, swelling, and inflammation of AS patients...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639846/antibiotic-prophylaxis-is-not-indicated-prior-to-dental-procedures-for-prevention-of-periprosthetic-joint-infections
#7
Willem M H Rademacher, Geert H I M Walenkamp, Dirk Jan F Moojen, Johannes G E Hendriks, Theo A Goedendorp, Frederik R Rozema
Background and purpose - To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question: can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015...
June 22, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28639163/agr-functionality-affects-clinical-outcomes-in-patients-with-persistent-methicillin-resistant-staphylococcus-aureus-bacteraemia
#8
C K Kang, Y K Kim, S-I Jung, W B Park, K-H Song, K-H Park, P G Choe, H-C Jang, S Lee, Y-S Kim, Y G Kwak, K T Kwon, S Kiem, C-J Kim, E S Kim, H B Kim
Methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) often persists despite appropriate antibiotic therapy. It is unclear what microbiological factors contribute to poor clinical outcomes in persistent MRSAB (pMRSAB). We aimed to identify clinical and microbiological risk factors for in-hospital mortality in pMRSAB. We analysed MRSAB cases prospectively collected between 2009 and 2016 at 11 hospitals in Korea, defining cases of pMRSAB as MRSAB lasting ≥5 days despite administration of effective antibiotics...
June 21, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28638695/pre-rheumatoid-arthritis-and-its-prevention
#9
REVIEW
Binoy J Paul, Hemanth Illath Kandy, Vinod Krishnan
Pre-rheumatoid arthritis (pre-RA) is the preclinical period of the disease that precedes the onset of clinically apparent RA. It includes the interaction between genetic and environmental risk factors and development of disease-related autoantibodies and joint symptoms and signs, which may be considered nonspecific or unclassified for RA. A better understanding of the pre-RA stage will be useful in developing screening programs for early detection of RA. Identifying and modifying risk factors such as smoking, periodontitis, obesity, viral infections, and hormonal or dietary factors will be useful in preventing RA in susceptible population...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28638686/rheumatoid-arthritis-are-psychological-factors-effective-in-disease-flare
#10
Volkan Yılmaz, Ebru Umay, İbrahim Gündoğdu, Zeliha Özgür Karaahmet, Arif Erhan Öztürk
OBJECTIVE: Rheumatoid arthritis (RA) is clinically an undulant disease, and reasons for flare or remission vary. We aimed to identify factors potentially associated with disease flare and remission. MATERIAL AND METHODS: Two hundred and seventy-four patients with RA who were admitted to our center between January 2010 and January 2016 were included. Disease activity was evaluated using disease activity score 28 (DAS 28); functional status was evaluated using the modified Health Assessment Questionnaire (m-HAQ), a questionnaire that comprises flare or remission domains such as psychological stress and mood status, physical trauma, nutrition regimen, infection, antibiotic use, and seasonal weather changes...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28637910/excellent-diagnostic-characteristics-for-ultra-fast-gene-profiling-of-defa1-il1b-ltf-in-the-detection-of-prosthetic-joint-infections
#11
Regina Fillerova, Jiri Gallo, Martin Radvansky, Veronika Kraiczova, Milos Kudelka, Eva Kriegova
The timely and exact diagnosis of prosthetic joint infection (PJI) is crucial for surgical decision-making. Intra-operatively, delivery of the result within an hour is required. Alpha-defensin lateral immunoassay of joint fluid (JF) is precise in the intra-operative exclusion of PJI, however in patients with a limited amount of JF and/or when the JF is bloody this test is unhelpful. Important information is hidden in the periprosthetic tissues that could much better reflect the current status of implant pathology...
June 21, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28637307/sparing-carbapenem-usage
#12
A Peter R Wilson
Background: Carbapenem resistance in Gram-negative bacteria is increasing in many countries and use of carbapenems and antibiotics to which resistance is linked should be reduced to slow its emergence. There are no directly equivalent antibiotics and the alternatives are less well supported by clinical trials. The few new agents are expensive. Objectives: To provide guidance on strategies to reduce carbapenem usage. Methods: A literature review was performed as described in the BSAC/HIS/BIA/IPS Joint Working Party on Multiresistant Gram-negative Infection Report...
June 15, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#13
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28633901/patient-ethnicity-and-causative-species-determine-the-manifestations-of-anti-interferon-gamma-autoantibody-associated-nontuberculous-mycobacterial-disease-a-review
#14
REVIEW
Isano Hase, Kozo Morimoto, Takuro Sakagami, Yoshiki Ishii, Jakko van Ingen
Nontuberculous mycobacteria (NTM) infections involving anti-interferon-gamma (IFN-γ)-neutralizing autoantibodies have been described in previously immunocompetent adults. To investigate the factors underlying various disease manifestations, we reviewed 35 articles published between January 2004 and November 2016 and identified 111 NTM patients with anti-IFN-γ autoantibodies. Rapidly growing mycobacteria (RGM) accounted for 53% of the isolated species. RGM were predominant among the NTM species isolated from Thai (73%), Chinese (58%) and Filipino (56%) patients, whereas M...
May 18, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28633772/omnidirectional-internal-fixation-by-double-approaches-for-treating-r%C3%A3-edi-allg%C3%A3-wer-type-iii-pilon-fractures
#15
Chong-Hua Dai, Jun Sun, Kun-Quan Chen, Hui-Bo Zhang
In the present study, we explored the effectiveness and complications of omnidirectional internal fixation using a double approach for treating Rüedi-Allgöwer type III pilon fractures. A retrospective analysis was performed of 19 cases of Rüedi-Allgöwer type III unilateral closed pilon fracture. With preoperative preparation and correct surgical timing, the reduction was performed using anteromedial and posterolateral approaches, and the fracture fragments were fixed by omnidirectional internal fixation...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28631728/acg-and-cag-clinical-guideline-management-of-dyspepsia
#16
Paul M Moayyedi, Brian E Lacy, Christopher N Andrews, Robert A Enns, Colin W Howden, Nimish Vakil
We have updated both the American College of Gastroenterology (ACG) and the Canadian Association of Gastroenterology (CAG) guidelines on dyspepsia in a joint ACG/CAG dyspepsia guideline. We suggest that patients ≥60 years of age presenting with dyspepsia are investigated with upper gastrointestinal endoscopy to exclude organic pathology. This is a conditional recommendation and patients at higher risk of malignancy (such as spending their childhood in a high risk gastric cancer country or having a positive family history) could be offered an endoscopy at a younger age...
June 20, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28631069/-s2-ala-iliac-screws-for-extended-pelvic-fixation-in-longer-lumbar-instrumentations-description-of-a-freehand-technique
#17
REVIEW
F Lattig, S Weckbach
OBJECTIVE: To reduce the rate of implant failures at the lumbosacral junction in polysegmental lumbar fusions. INDICATIONS: Spinal fusion with deformity correction including L5/S1, revision surgery for pseudoarthrosis L5/S1, screw pull-out and pedicle fractures in S1, and S1/S2 fractures after polysegmental fusions. CONTRAINDICATIONS: Osteosynthesis of complex pelvic ring fractures, tumors of the ilium. Relative contraindication: infection, to avoid contamination of the iliosacral joint...
June 19, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28630849/a-case-of-chronic-inflammation-of-the-ankle-joint-with-subtle-signs-of-inflammation-a-rare-presentation-of-tuberculosis-ankle
#18
Jeevan Pereira, S Anoop, George Joy Pettah
INTRODUCTION: Tuberculosis (TB) of the ankle is an uncommon presentation of extrapulmonary infection. The early diagnosis of TB arthritis of the ankle is difficult because of the uncommon site, the ability of TB to mimic other disorders and, all too common, lack of awareness of about this infection in ankle joint. CASE REPORT: A 30-year-old male presented with a 1-year history of right ankle pain and swelling. He denied any history of recent infection but had had recurrent ankle pain that had been treated accordingly...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630845/multi-foci-salmonella-enteritis-osteomyelitis-of-thoracic-spine-with-pleural-effusion-and-fatal-outcome-a-unique-case-presentation-and-review-of-the-literature
#19
Ioannis Papaioannou, Andreas Baikousis, Panagiotis Korovessis
INTRODUCTION: A case of thoracic vertebral osteomyelitis due to Salmonella enteritis (SE) in an immunocompetent patient is reported. This is the third case in the literature of SE thoracic vertebral osteomyelitis, but the first one with this multi-foci presentation and finally fatal outcome due to meningoencephalitis. Further data that makes our case unique are the absence of fever (body temperature: 37.4°C) and gastrointestinal disorders. CASE REPORT: A 57-year-old male patient initially presented with thoracic pain, dyspnea, and knee pain...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630839/septic-arthritis-of-the-hip-complicated-by-secondary-fungal-superinfection
#20
Scott Matthews, Sam Sloan, Daniel McCaffrey, Angel Ruiz
INTRODUCTION: Fungal joint infection can lead to serious consequences for those affected. It can often be a delayed diagnosis due to initial negative organism growth or lack of clinician awareness. Treatment should be early and aggressive to prevent patient morbidity and mortality. CASE REPORT: We present a case of staphylococcal septic arthritis of the native hip joint with secondary superinfection by Candida albicans in a young patient with no appreciable risk factors...
January 2017: Journal of Orthopaedic Case Reports
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