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Andrew Luu Fahd Syed Gowri Raman Anshul Bhalla Eavan Muldoon Susan Hadley Eric Smith Madhumathi Rao 《The Journal of arthroplasty》2013
Periprosthetic infections of hip and knee joints are now treated by two-stage revision arthroplasty with an infection control rate of 91%. The present systematic review studied the reported incidence of acute kidney injury (AKI) and infection recurrence from January 1989 to June 2012 to assess the risk–benefit ratio of antibiotic spacer use. Ten observational studies (n = 544 patients) with clinical outcomes showed an average incidence of AKI of 4.8%. The average reported persistence or recurrence rate of infection was 11% during a follow-up period that ranged from 13 to 108 months. The risk–benefit ratio presently favors treatment although there appears to be higher complication rates and incidence of AKI than previously reported. Marked heterogeneity in practice and lack of detail in reporting precluded more robust quantitative synthesis. Clinicians need to be aware of the potential risk of AKI, particularly in high-risk patients; practice patterns for the use of antibiotic spacers need to be standardized. 相似文献
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Paul A. Toste Brian E. Kadera Sergei F. Tatishchev David W. Dawson Barbara M. Clerkin Raman Muthusamy Rabindra Watson James S. Tomlinson Oscar J. Hines Howard A. Reber Timothy R. Donahue 《Journal of gastrointestinal surgery》2013,17(12):2105-2113
Background
The optimal surgical management of small nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) remains controversial. We sought to identify (1) clinicopathologic factors associated with survival in NF-PNETs and (2) preoperative tumor characteristics that can be used to determine which lesions require resection and lymph node (LN) harvest.Methods
The records of all 116 patients who underwent resection for NF-PNETs between 1989 and 2012 were reviewed retrospectively. Preoperative factors, operative data, pathology, surgical morbidity, and survival were analyzed.Results
The overall 5- and 10-year survival rates were 83.9 and 72.8 %, respectively. Negative LNs (p?=?0.005), G1 or G2 histology (p?=?0.033), and age <60 years (p?=?0.002) correlated with better survival on multivariate analysis. The 10-year survival rate was 86.6 % for LN-negative patients (n?=?73) and 34.1 % for LN-positive patients (n?=?32). Tumor size ≥2 cm on preoperative imaging predicted nodal positivity with a sensitivity of 93.8 %. Positive LNs were found in 38.5 % of tumors ≥2 cm compared to only 7.4 % of tumors <2 cm.Conclusions
LN status, a marker of systemic disease, was a highly significant predictor of survival in this series. Tumor size on preoperative imaging was predictive of nodal disease. Thus, it is reasonable to consider parenchyma-sparing resection or even close observation for NF-PNETs <2 cm. 相似文献84.
Chronic sinus formation using non absorbable braided suture following open repair of Achilles tendon
Raju Ahluwalia Charalambos Zourelidis Shigong Guo Raman Dega 《Foot and Ankle Surgery》2013,19(2):e7-e9
This study reports a case of a 34 year old man who sustained an Achilles tendon rupture which was surgically repaired using a non-absorbable suture that was complicated by a deep sinus and chronic infection. Despite antibiotics, surgical debridement and skin grafting, his condition did not resolve. Further imaging revealed a sinus leading to the core suture knot that was eccentrically placed but not buried within the healed tendon repair, and the offending suture was subsequently removed.This case highlights the importance of meticulous surgical technique when performing Achilles tendon repair and a high index of suspicion for early imaging when patients present with chronic wound infection post-operatively.The authors urge surgeons to use routinely use an absorbable non-braided suture, which remains buried within the core when performing Achilles tendon repair. 相似文献
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David R. Lynch MD PhD Massimo Pandolfo MD Jorg B. Schulz MD Susan Perlman MD Martin B. Delatycki MD PhD R. Mark Payne MD Robert Shaddy MD Kenneth H. Fischbeck MD Jennifer Farmer MS Paul Kantor MD Subha V. Raman MD Lisa Hunegs MSW MPH Joanne Odenkirchen MPH Kristy Miller MPH Petra Kaufmann MD MSC 《Movement disorders》2013,28(2):190-195
To reduce study start‐up time, increase data sharing, and assist investigators conducting clinical studies, the National Institute of Neurological Disorders and Stroke embarked on an initiative to create common data elements for neuroscience clinical research. The Common Data Element Team developed general common data elements, which are commonly collected in clinical studies regardless of therapeutic area, such as demographics. In the present project, we applied such approaches to data collection in Friedreich's ataxia (FRDA), a neurological disorder that involves multiple organ systems. To develop FRDA common data elements, FRDA experts formed a working group and subgroups to define elements in the following: ataxia and performance measures; biomarkers; cardiac and other clinical outcomes; and demographics, laboratory tests, and medical history. The basic development process included identification of international experts in FRDA clinical research, meeting by teleconference to develop a draft of standardized common data elements recommendations, vetting of recommendations across the subgroups, and dissemination of recommendations to the research community for public comment. The full recommendations were published online in September 2011 at http://www.commondataelements.ninds.nih.gov/FA.aspx . The subgroups′ recommendations are classified as core, supplemental, or exploratory. Template case report forms were created for many of the core tests. The present set of data elements should ideally lead to decreased initiation time for clinical research studies and greater ability to compare and analyze data across studies. Their incorporation into new, ongoing studies will be assessed in an ongoing fashion to define their utility in FRDA. © 2012 Movement Disorder Society 相似文献
88.
Neha Sharma Yash Gupta Meenakshi Bansal Snigdha Singh Prateek Pathak Mohd Shahbaaz Raman Mathur Jyoti Singh Mohammad Kashif Maria Grishina Vladimir Potemkin Vinoth Rajendran Poonam Prakasha Kempaiah Agam Prasad Singh Brijesh Rathi 《RSC advances》2020,10(58):35516
Malaria, a global threat to the human population, remains a challenge partly due to the fast-growing drug-resistant strains of Plasmodium species. New therapeutics acting against the pathogenic asexual and sexual stages, including liver-stage malarial infection, have now attained more attention in achieving malaria eradication efforts. In this paper, two previously identified potent antiplasmodial hydroxyethylamine (HEA) compounds were investigated for their activity against the malaria parasite''s multiple life stages. The compounds exhibited notable activity against the artemisinin-resistant strain of P. falciparum blood-stage culture with 50% inhibitory concentrations (IC50) in the low micromolar range. The compounds'' cytotoxicity on HEK293, HepG2 and Huh-7 cells exhibited selective killing activity with IC50 values > 170 μM. The in vivo efficacy was studied in mice infected with P. berghei NK65, which showed a significant reduction in the blood parasite load. Notably, the compounds were active against liver-stage infection, mainly compound 1 with an IC50 value of 1.89 μM. Mice infected with P. berghei sporozoites treated with compound 1 at 50 mg kg−1 dose had markedly reduced liver stage infection. Moreover, both compounds prevented ookinete maturation and affected the developmental progression of gametocytes. Further, systematic in silico studies suggested both the compounds have a high affinity towards plasmepsin II with favorable pharmacological properties. Overall, the findings demonstrated that HEA and piperidine possessing compounds have immense potential in treating malarial infection by acting as multistage inhibitors.Malaria, a global threat to the human population, remains a challenge partly due to the fast-growing drug-resistant strains of Plasmodium species. 相似文献
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Aurélie Mbeutcha Ilaria Lucca Vitaly Margulis Jose A. Karam Christopher G. Wood Michela de Martino Romain Mathieu Andrea Haitel Evanguelos Xylinas Luis Kluth Morgan Rouprêt Pierre I. Karakiewicz Alberto Briganti Michael Rink Malte Rieken Alon Z. Weizer Jay D. Raman Nathalie Rioux-Leclecq Christian Bolenz Karim Bensalah Yair Lotan Christian Seitz Mesut Remzi Shahrokh F. Shariat Tobias Klatte 《World journal of urology》2016,34(8):1155-1161