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1.
Isolated patellofemoral arthritis is an increasingly recognized entity, and is usually associated with previous patellofemoral dysplasia or instability. Patellofemoral arthroplasty (PFA) has evolved significantly in recent years, both in terms of implant design and importantly in the understanding of appropriate patient selection. This review outlines the indications and investigations for PFA, provides a brief history of the development of contemporary implants, and presents the clinical outcomes for the prostheses most commonly used in the UK. In addition, it provides a detailed surgical technique for implantation of an onlay implant, with tips on how to optimize patellofemoral biomechanics and thus achieve a consistently good outcome. 相似文献
2.
John G. Wirtz 《Health marketing quarterly》2020,37(1):22-40
AbstractThis study tested whether the effect of self-referencing in a health-marketing message was amplified or attenuated when combined with message framing and narrative. Hispanic adults (N?=?146) were randomly assigned to read and respond to an obesity prevention message. Self-referencing messages generated greater cognitive elaboration but only when placed in a narrative. Conversely, self-referencing messages highlighting health risks of obesity produced higher levels of involvement and intention to increase physical activity and healthy eating. Health marketing professionals can use these findings to enhance the effectiveness of obesity prevention messages that target Hispanic adults. 相似文献
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Hendrik Kohlhof Frank S. Fröschen Thomas M. Randau Gunnar Hischebeth Michael Kehrer Dieter C. Wirtz Frank A. Schildberg Tim P. Kaminski 《Journal of orthopaedic research》2020,38(6):1359-1364
Periprosthetic joint infection is among the most common and severe complications in total joint arthroplasty. Today, a combination of different methods is used for diagnosis because no single method with sufficient sensitivity and specificity is available. In this study, we explored the usability of single-molecule microscopy to characterize synovial fluid samples from periprosthetic joint infections. Patients (n = 27) that needed revision arthroplasty underwent the routine diagnostic procedures for periprosthetic joint infection of the University Hospital in Bonn. Additionally, the diffusion rate of two probes, dextran and hyaluronan, was measured in small volumes of periprosthetic synovial fluid samples using single-molecule microscopy. To evaluate the suitability of single-molecule microscopy to detect PJI the AUC for both markers was calculated. The diffusion rate of hyaluronan in periprosthetic synovial fluid from patients with septic loosening was faster than in samples from patients with aseptic loosening. Single-molecule microscopy showed excellent diagnostic performance, with an area under the receiver operating characteristic curve of 0.93, and allowed the detection of periprosthetic joint infection in patients that would be challenging to diagnose with current methods. For the first time, single-molecule microscopy was used to detect periprosthetic joint infection. Our results are encouraging to study the value of single-molecule microscopy in a larger patient cohort. The speed and accuracy of single-molecule microscopy can be used to further characterize synovial fluid, potentially allowing intraoperative diagnosis of periprosthetic joint infections in the future. 相似文献
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Monitoring for undertransfusion 总被引:1,自引:0,他引:1
BACKGROUND: Most published reviews and audits of blood and blood component transfusion have focused on the issue of overtransfusion and on the inappropriate use of red cell components. There is growing concern that efforts to curb unnecessary transfusions may result in a trend toward undertransfusion of patients. There is little published information that addresses this issue or the magnitude of this practice. STUDY DESIGN AND METHODS: Undertransfusion was evaluated by examining the transfusion records from a 3-month period for 55 patients who met the study criteria of having either a hemoglobin level < 7 g per dL or a platelet count of < 10 × 10(9) per L. If the identified patient did not receive a transfusion within 24 hours of the reported hemoglobin level or platelet count, the medical record was reviewed by a resident physician. RESULTS: A total of 213 individual hemoglobin levels and platelet counts, representing the 55 patients, met our transfusion criteria. All except 8 of the identified patients received red cells and/or platelet transfusions. Reasons for not transfusing red cells included the patient's response to nutritional support and iron supplementation, refusal of blood, and noncompliance. Reasons for not transfusing platelets included falsely low platelet count because of platelet clumping in vitro, contraindication based on clinical diagnosis (e.g., immune thrombocytopenic purpura), and the patient's death before transfusion. CONCLUSION: Red cell and platelet transfusions were appropriately ordered for all patients who met the transfusion criteria. Undertransfusion is not a problem at this institution according to the criteria established. It is recommended that other institutions expand their blood utilization audits to include investigation for evidence of undertransfusion. Further research regarding the issue of undertransfusion is warranted and could be expanded to include other components. 相似文献
10.
Seaton RA; Naraqi S; Wembri JP; Warrell DA 《QJM : monthly journal of the Association of Physicians》1996,89(6):423-428
In Papua New Guinea, <it>Cryptococcus neoformans</it> var.
<it>gattii</it> meningitis has a high fatality rate even in
immunocompetent patients. Our retrospective study attempted to identify
marker of poor prognosis. Of 88 immunocompetent patients, 30 (34.1%) died,
usually soon after admission, and mortality was higher in men
(<it>p</it> = 0.025) and older patients (<it>p</it>
= 0.039). Death was associated with altered consciousness
(<it>p</it><0.001), a history of convulsions prior to
treatment (<it>p</it> = 0.002) and a maximum systolic blood
pressure of >150 mmHg (<it>p</it> = 0.017). These data
suggest that death results from raised intracranial pressure and subsequent
tentorial herniation. However, CSF opening pressure measured on admission
was raised in 29/36 (81%) patients and did not predict outcome. In
survivors, relapse was uncommon and was not predicted by discharge serum
cryptococcal antigen titres, which were frequently raised on completion of
therapy in asymptomatic patients. Mortality may be reduced if efforts are
made to lower intracranial pressure in those patients who present with
markers of poor prognosis.
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