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Neuropathic pain-like symptoms and pre-surgery radiographic severity contribute to patient satisfaction 4.8 years post-total joint replacement

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World Journal of Orthopedics 2017年第10期8卷 761-769页

作者： Sophie C Warner Helen Richardson Wendy Jenkins thomas kurien Michael Doherty Ana M Valdes Academic Rheumatology University of NottinghamClinical Sciences BuildingNottingham City Hospital Department of Cardiovascular Sciences University of Leicester and National Institute for Health Res-earchLeicester Cardiovascular Biomedical Research Unit Arthritis Research UK Pain Centre Academic Division of Trauma and Orthopaedics Queens Medical Centre

AIM To investigate a comprehensive range of factors that contribute to long-term patient satisfaction post-total joint replacement(TJR) in people who had undergone knee or hip replacement for *** Participants(n = 1151) were recruited from Nottinghamshire post-total hip or knee replacement. Questionnaire assessment included medication use, the pain-DETECT questionnaire(PDQ) to assess neuropathic pain-like symptoms(NP) and TJR satisfaction measured on average 4.8 years post-TJR. Individual factors were tested for an association with post-TJR satisfaction, before incorporating all factors into a full model. Data reduction was carried out using LASSO and receiveroperator characteristic(ROC) curve analysis was used to quantify the contribution of variables to post-TJR *** After data reduction, the best fitting model for post-TJR satisfaction included various measures of pain, history of revision surgery, smoking, pre-surgical X-ray severity, WOMAC function scores and various comorbidities. ROC analysis of this model gave AUC = 0.83(95%CI: 0.80-0.85). PDQ scores were found to capture much of the variation in post-TJR satisfaction outcomes: AUC = 0.79(0.75-0.82). Pre-surgical radiographic severity was associated with higher post-TJR satisfaction: OR_(satisfied) = 2.06(95%CI: 1.15-3.69), P = *** These results highlight the importance of pre-surgical radiographic severity, post-TJR function, analgesic medication use and NP in terms of post-TJR satisfaction. The PDQ appears to be a useful tool in capturing factors that contribute to post-TJR satisfaction.

关键词： Osteoarthritis Patient satisfaction Total joint arthroplasty Neuropathic pain Surgery outcomes

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Attributable cost of a nosocomial infection in the intensive care unit: A prospective cohort study

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World Journal of Critical Care Medicine 2017年第1期6卷 79-84页

作者： Binila Chacko kurien thomas Thambu David Hema Paul Lakshmanan Jeyaseelan John Victor Peter Medical ICU Division of Critical Care Christian Medical College Department of Medicine Pondicherry Institute of Medical Sciences Department of Medicine Ⅱ Christian Medical College Hospital Infection Control Committee Christian Medical College Department of Biostatistics Christian Medical College

AIM To study the impact of hospital-acquired infections(HAIs) on cost and outcome from intensive care units(ICU) in India. METHODS Adult patients(> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included. The impact of HAI on treatment cost and mortality was assessed. RESULTS The mean(± SD) age of the cohort(n = 499) was42.3 ± 16.5 years. Acute physiology and chronic health evaluation-Ⅱ score was 13.9(95%CI: 13.3-14.5); 86% were ventilated. ICU and hospital length of stay were 7.8 ± 5.5 and 13.9 ± 10 d respectively. Hospital mortality was 27.9%. During ICU stay, 76(15.3%) patients developed an infection(ventilator-associated pneumonia 50; bloodstream infection 35; urinary tract infections 3), translating to 19.7 infections/1000 ICU days. When compared with those who did not develop an infection, an infection occurring during ICU stay was associated with significantly higher treatment cost [median(inter-quartile range, IQR) INR 92893(USD 1523)(IQR 57168-140286) vs INR 180469(USD 2958)(IQR 140030-237525); P < 0.001 and longer duration of ICU(6.7 ± 4.5 d vs 13.4 ± 7.0 d; P < 0.01) and hospital stay(12.4 ± 8.2 d vs 21.8 ± 13.9 d; P < 0.001)]. However ICU acquired infections did not impact hospital mortality(31.6% vs 27.2%; P = 0.49).CONCLUSION An infection acquired during ICU stay was associated with doubling of treatment cost and prolonged hospitalization but did not significantly increase mortality.

关键词： Attributable cost Nosocomial infection Length of stay Mortality Intensive care

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Common polymorphisms of protein tyrosine phosphate non-receptor type 2 gene are not associated with risk of Crohn’s disease in Indian

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World Journal of Gastrointestinal Pathophysiology 2022年第4期13卷 114-123页

作者： Kaushik Chatterjee Amit Kumar Dutta Ashish Goel Rekha Aaron Vijayalekshmi Balakrishnan Ajith thomas Anoop John Rajeeb Jaleel Deepu David Reuben thomas kurien SD Chowdhury Ebby George Simon AJ Joseph Prasanna Premkumar Anna B Pulimood Department of Gastrointestinal Sciences Christian Medical College and HospitalVellore 632004Tamil NaduIndia Department of Gastroenterology Christian Medical CollegeVellore 632004Tamil NaduIndia Departments of Biostatistics Christian Medical CollegeVellore 632004Tamil NaduIndia

BACKGROUND Multiple genetic risk factors for Crohn’s disease(CD)have been ***,these observations are not consistent across different *** protein tyrosine phosphate non-receptor type 2(PTPN2)gene plays a role in various aspects of host defense including epithelial barrier function,autophagy,and innate and adaptive immune *** common polymorphisms in the PTPN2 gene(rs2542151 and rs7234029)have been associated with risk of CD in Western *** To evaluate the association of PTPN2 gene polymorphisms with risk of CD in Indian *** We conducted a prospective case-control *** with CD were recruited,and their clinical and investigation details were *** were patients without organic gastrointestinal disease or other comorbid *** common polymorphisms in the PTPN2 gene(rs2542151 and rs7234029)were *** was extracted from peripheral blood samples of cases and controls and target DNA was amplified using specific sets of *** amplified fragments were digested with restriction enzymes and the presence of polymorphism was detected by restriction fragment length *** frequency of alleles was *** frequencies of genotypes and alleles were compared between cases and controls to look for significant *** A total of 108 patients with CD(mean age 37.5±12.7 years,females 42.6%)and 100 controls(mean age 39.9±13.5 years,females 37%)were *** the single nucleotide polymorphism(SNP)rs7234029,the overall frequency of G variant genotype(AG or GG)was noted to be significantly lower in the cases compared to controls(35.2%vs 50%,P=0.05).For the SNP rs2542151,the overall frequency of G variant genotype(GT or GG)was noted to be similar in cases compared to controls(43.6%vs 47%,P=0.73).There were no significant differences in minor allele(G)frequency for both polymorphisms between the cases and *** the SNPs had no significant association with a

关键词： PTPN2 gene Crohn’s disease Genetic polymorphism Case-control study Asia Risk factor

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