Acetabular reconstruction for primary and revision total hip arthroplasty using Kerboull-type acetabular reinforcement devices—case–control study with factors related to poor outcomes of surgery

Kerboull-type acetabular support rings (KT) and allogenic bone graft were used for severe periacetabular bone loss with primary and revision total hip arthroplasty (THA). The purpose of this case–control study is to evaluate the risk factors related to poor outcomes of surgery. Sixty patients underwent primary THA and revision THA using allogenic bone graft with KT for large acetabular deficiency. These patients were retrospectively evaluated postoperatively and followed-up by radiograph. The minimum follow-up period was 4 years and averaged 7 years. A radiological failure was defined by the following criteria: substantial migration defined as change in the angle of inclination of more than 5 degrees or migration of more than 5 mm,breakage of the screw or device,acetabular revision due to aseptic loosening. Expected risk factors were defined as female, age>75 years, body mass index (BMI)>25%, medical history of hypertension, renal failure, liver steatosis, diabetes, hyperlipidemia, cardiac infarction, smoking, American Academy of Orthopedic Surgery (AAOS) classification III or IV, bleeding>500 mL, time of surgery>3hours, high hip center-type KT, inclination of KT>45 degrees, screw angle>25 degrees, morselized bone graft, Kawanabe's classification stage 3 or 4 and revision surgery. Nineteen hips (31.6%) revealed radiological failure according to our criteria, and revision THA was performed in 2 hips (3.3%). In the statistical analysis, morselized...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

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ConclusionIn this large observational study using a national clinical database, obese patients undergoing PD for head of pancreas cancer had increased risk of postoperative complications and mortality in comparison to controls.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
CONCLUSION: In this study, we could not detect an advantage in survival when SAVR or TAVR were utilized in intermediate to high surgical risk patients needing aortic valve replacement for severe aortic stenosis. PMID: 31596707 [PubMed - in process]
Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion: The results suggest that an immunosuppressive state develops at the terminal stage of severe leptospirosis with pulmonary hemorrhage and shock similar to that of patients with septic shock, with diffuse endothelial activation in the spleen, splenitis, and signs of disturbance in the innate and adaptive immunity in the spleen. The presence of leptospiral antigens in 73% of the spleens of the leptospirosis patients suggests the etiological agent contributes directly to the pathogenesis of the lesions. Our results support therapeutic approaches involving antibiotic and immunomodulatory treatments for leptospirosis...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
This study investigated if statins would similarly reduce postoperative arrhythmias in patients undergoing THA. METHODS:: We queried a large Medicare and private-payer database from 2005 to 2012 and identified 12,075 patients who were on a statin prior to THA. We then age and sex matched 34,446 non-statin users who underwent THA. Baseline comorbidities and postoperative complications were obtained and assessed via standard descriptive statistics. RESULTS:: The statin users had more preoperative comorbidities including congestive heart failure, valvular heart disease, pulmonary and renal disease, diabetes, hyperte...
Source: Hip International - Category: Orthopaedics Authors: Tags: Hip Int Source Type: research
ConclusionsBlack males undergoing radical cystectomy for cancer experienced higher complication rates than white males. Unexplained differences between the black and white males significantly contributed to the disparity in outcomes, which suggests that unmeasured factors, such as the quality of surgical or perioperative care, are playing a considerable role in the observed inequality.Supplement informationThis article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.
Source: American Journal of Preventive Medicine - Category: International Medicine & Public Health Source Type: research
​BY GREGORY TAYLOR, DO, &CHRISTOPHER COOLEY, DOA 66-year-old woman with a history of type 1 diabetes, hypertension, and end-stage renal disease (ESRD) on hemodialysis presented via EMS to the emergency department with altered mental status. She lived with her family, and they noted that she refused to go to dialysis for her past four sessions and had increasing lethargy for two days.She was afebrile, and her other vital signs were blood pressure 136/92 mmHg, heart rate 77 bpm, respiratory rate 20 bpm, and oxygen saturation 96% on room air. She was agitated and reaching for objects in the sky. Her cardiopulmonary exam...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
Discussion Liver gas gangrene is rare and has a high mortality rate. This case seems to have arisen from an immunosuppressive state after major surgery with biliary reconstruction for bile duct cancer and subsequent gastrointestinal bleeding, leading to gas gangrene of the liver.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This article is a review of stroke in patients with CKD and approach to managing it.
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research
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