Notes

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In multiple regression analysis, however, only higher Crowe grade, intra-operative fracture, and post-operative acetabular offset less than 16mm were independent predictors of dislocation.

Dysplastic hips can be more prone to post-THA dislocation than those with primary OA. Higher grades of dysplasia, failure of offset restoration, and intra-operative fracture can increase the rate of dislocation in this group of patients.
Dysplastic hips can be more prone to post-THA dislocation than those with primary OA. Higher grades of dysplasia, failure of offset restoration, and intra-operative fracture can increase the rate of dislocation in this group of patients.
Re-operation after septic failure of a one-stage exchange for prosthetic joint infection (PJI) of the knee isa highly challenging procedure with concerns over residual bone stock, soft tissues, and stability. The associated changes in microbiology in cases of reinfection are still largely unknown.

A comprehensive analysis was performed of all patients treated at our tertiary institution between 2001 and 2017 who developed reinfection after a one-stage exchange for PJI of the knee. Prerequisites for inclusion were a certain diagnosis of PJI according to the ICM criteria and a minimum follow-up of threeyears. Data on comorbidities, previous surgical interventions, microbiological findings at the time of the initial one-stage exchange and at the time of reinfection, detection methods, and antibiotic resistance patterns were retrospectively studied.

Sixty-six patients were identified that met the inclusion criteria. Reinfection occurred after a mean time interval of 27.7months (SD ± 33.9, range 1-165). Ten e the complexity of subsequent procedures. Also, a longer follow-up of these patients than previously suggested seems in order.
Definitive treatment of distal extra-articular fractures of the tibia is challenging and both minimal invasive plate osteosynthesis (MIPO) and intramedullary nailing (IMN) are considered to be feasible surgical modalities with their own implant-specific merits and demerits. This retrospective study was designed to compare MIPO versus IMN in terms of fracture healing, complications, functional and radiological outcomes and to assess the efficacy of intra-operative alignment control to reduce the rate of malalignment after definitive fixation of distal extra-articular fractures of the tibia.

All consecutive adult patients with extra-articular distal meta- or diaphyseal tibia fractures that were treated between January 2012 and September 2019 either with MIPO or IMN were included. Outcome measures included fracture healing, complications (infection, malalignment, subsequent surgeries), functional and radiological outcomes. Intra-operative alignment control encompassed bilateral draping of the lower extremitinfection. The incidence of malalignment was surprisingly low endorsing the utility of the intra-operative alignment control.
To describe and compare the aortic-right atrial pressure (AoP-RAP) gradients and mean coronary perfusion pressures (CPPs) generated during open chest selective aortic arch perfusion (OCSAAP) with those generated during open cardiac massage (OCM) in hypovolemic swine.

Ten male Hanford swine utilized in a prior poly-trauma study were included in the study. selleck kinase inhibitor Animals were rendered hypovolemic via a 30% volume bleed. Upon confirmation of death, animals underwent immediate clamshell thoracotomy and aortic cross-clamping followed by 5min of OCM. A catheter suitable for OCSAAP was then inserted into the aorta and animals underwent 1min of OCSAAP at a rate of 10mL/kg/min. Aortic and right atrial pressures were recorded continuously using solid-state blood pressure catheters. Representative 10-s intervals from each resuscitation method were extracted. Hemodynamic parameters including AoP-RAP gradients and CPPs were calculated and compared.

At baseline, time from death to intervention was significantly shorter for OCM. However, mean CPPs and AoP-RAP gradients were significantly higher in animals undergoing OCSAAP. 98% of OCSAAP segments had a mean CPP > 15, compared to 35% of OCM intervals. While OCM had a significant negative correlation between time to intervention and maximum CPP, this correlation was not significant for OCSAAP.

OCSAAP generates favorable and potentially time-resistant pressure gradients when compared to those generated by OCM. Further investigation of the technique of OCSAAP is warranted, as it may have potential utility as a therapy during resuscitative thoracotomy (RT).
OCSAAP generates favorable and potentially time-resistant pressure gradients when compared to those generated by OCM. Further investigation of the technique of OCSAAP is warranted, as it may have potential utility as a therapy during resuscitative thoracotomy (RT).
To summarize unfavorable fracture patterns during sagittal split ramus osteotomy (SSRO) and investigate the association with influencing factors.

We conducted a retrospective analysis of 1007 patients with 2008 sides of SSRO and classified unfavorable fracture patterns into three types fracture lines involving the sigmoid notch, condylar process, or coronoid process (Type A); fracture lines extending from the posterior border of the mandibular ramus to the mandibular body or the anterior border of the ramus (Type B); and unfavorable fractures located in the anterior horn of the proximal segment with free fragment (Type C). Logistic regression analysis was used to evaluate factors influencing unfavorable fracture patterns, including sex, age at the time of operation, class of occlusion, presence of the third molar, uni- or bi-maxillary surgery, and the distance from the mandibular canal to the buccal cortex.

The distance from the mandibular canal to the buccal cortex was significantly associated with unfavorable fracture patterns during SSRO. The presence of third molars was significantly associated with Type A fractures. The distance from the mandibular canal to the buccal cortex was significantly lower in Type B fractures.

We found that the influencing factors for unfavorable fracture patterns varied. Clinicians should pay specific attention to patients with factors for each unfavorable fracture pattern during SSRO.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .The European guidelines on cardiopulmonary resuscitation, which are divided into 12 chapters, have recently been published. In addition to the already known chapters, the topics "epidemiology" and "life-saving systems" have been integrated for the first time. For each chapter five practical key statements were formulated. In the present article the revised recommendations on basic measures and advanced resuscitation measures in adults as well as on postresuscitation treatment are summarized and commented on.
Construction worker health and safety is a primary concern for construction companies and researchers. Arabian Gulf region, like Saudi Arabia, has been experiencing extremely hot and humid (EHH) weather, which directly affects construction workers' health and safety. This study aims to address the problem of EHH weather conditions and their impacts on construction workers' physiological status.

This study assesses the impacts of EHH weather on construction workers' physiological status through the measurement of workers' physical body parameters (age, height, and weight); type of activities; and assigned tasks. Thirty-five multinational workers participated in the measurements, which were conducted in real construction site conditions A quantitative analysis was then applied to quantify the physiological impacts of the weather conditions. Several hypotheses were tested to identify the significant impacts of individual and working aspects on the workers' physiological responses.

The results provide empirical evidence that the recorded Heart Rate (HR) exceeded the acceptable physiological zones for construction workers exposed to extremely hot and humid weather conditions. Physical body parameters, work activities, and worker status significantly influence construction workers' physiological responses. This study recommends adopting a continuous monitoring approach as an early warning system under extremely hot and humid weather conditions.
The results provide empirical evidence that the recorded Heart Rate (HR) exceeded the acceptable physiological zones for construction workers exposed to extremely hot and humid weather conditions. Physical body parameters, work activities, and worker status significantly influence construction workers' physiological responses. This study recommends adopting a continuous monitoring approach as an early warning system under extremely hot and humid weather conditions.
Communicating about delusions is generally considered achallenging task.

Assuming that there are nevertheless avariety of communicative resources competently employed to meet this challenge, the authors present aconversation analytic study of two narrative interviews in which people talk about their experience of delusions.

It is shown that through pauses, breaks, reformulations, negotiations of the so-called common ground and the use of metaphoric speech, they succeed in conveying many aspects of the experience of delusions that cannot simply be described in terms of content.

These examples of communicative strategies can be aresource for others and encourage mental health professionals and users alike to engage in conversations on delusions.
These examples of communicative strategies can be a resource for others and encourage mental health professionals and users alike to engage in conversations on delusions.
Drug-coated balloons (DCBs) for femoropopliteal peripheral artery disease have been shown to be clinically superior and cost-effective compared to conventional percutaneous transluminal angioplasty (PTA). However, few studies enrolled patients with chronic limb-threatening ischemia (CLTI). Our objective was to study the cost-effectiveness of endovascular treatment with versus without DCB in CLTI patient populations in the Netherlands and Germany.

Target lesion revascularization (TLR) and major amputation rates were obtained from the CLTI subgroup of the IN.PACT Global study. Rates for "status quo" treatment involving PTA with primary or bailout stenting were derived from systematic literature search. Costs and cost-effectiveness were calculated using a decision-analytic Markov model considering, in the base case, a 2-year horizon, and strategy-specific quality-adjusted life year (QALY) gains calculated from survival and health state-specific utilities. A willingness-to-pay threshold of €50,000/QALY was assumed, and extensive sensitivity analyses were performed.

Model-projected 24-month probabilities of TLR were 26.2% and 32.8% for treatment with and without DCB, and probabilities for amputation were 2.8% and 11.9%, respectively. DCB added 0.017 QALYs while saving €1,030 in the Dutch setting and €513 in the German setting, respectively. DCB was found dominant or cost-effective across a wide range of assumptions.

Urea excipient drug-coated balloon therapy for treating CLTI from femoropopliteal artery disease is associated with improved patient outcomes and expected overall cost savings to payers in the Dutch and German healthcare systems, rendering it a cost-effective and likely dominant treatment strategy.
Urea excipient drug-coated balloon therapy for treating CLTI from femoropopliteal artery disease is associated with improved patient outcomes and expected overall cost savings to payers in the Dutch and German healthcare systems, rendering it a cost-effective and likely dominant treatment strategy.
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