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Burden of routine orthopedic implant removal a single center retrospective study

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World j.urnal of Orthopedics 2024年第2期15卷 139-146页

作者： Ammar K AlOmran Nader Alosaimi Ahmed A Alshaikhi Omar M Bakhurj. Khalid j.Alzahrani basil Ziyad Salloot Tamim Omar Alabduladhem Ahmed I AlMulhim Arwa Alumran Department of Orthopedic College of MedicineImam Abdulrahman Bin Faisal UniversityDammam 31441Saudi Arabia Health Information Management and Technology Department Imam Abdulrahman Bin Faisal UniversityDammam 31441Saudi Arabia

BACKGROUND Open reduction and internal fixation represent prevalent orthopedic procedures,sparking ongoing discourse over whether to retain or remove asymptomatic implants.Achieving consensus on this matter is paramount for orthopedic surgeons.This study aims to quantify the impact of routine implant removal on patients and healthcare facilities.A retrospective analysis of implant removal cases from 2016 to 2022 at King Fahad Hospital of the University(KFHU)was conducted and subj.cted to statistical scrutiny.Among these cases,44%necessitated hospitalization exceeding one day,while 56%required only a single day.Adults exhibited a 55%need for extended hospital stays,contrasting with 22.8%among the pediatric cohort.The complication rate was 6%,with all patients experiencing at least one complication.Notably,34.1%required sick leave and 4.8%exceeded 14 d.General anesthesia was predominant(88%).Routine implant removal introduces unwarranted complications,particularly in adults,potentially prolonging hospitalization.This procedure strains hospital resources,tying up the operating room that could otherwise accommodate critical surgeries.Clearly defined institutional guidelines are imperative to regulate this practice.AIM To measure the burden of routine implant removal on the patients and hospital.METHODS This is a retrospective analysis study of 167 routine implant removal cases treated at KFHU,a tertiary hospital in Saudi Arabia.Data were collected in the orthopedic department at KFHU from February 2016 to August 2022,which includes routine asymptomatic implant removal cases across all age categories.Nonroutine indications such as infection,pain,implant failure,malunion,nonunion,restricted range of motion,and prominent hardware were excluded.Patients who had external fixators removed or j.ints replaced were also excluded.RESULTS Between February 2016 and August 2022,360 implants were retrieved;however,only 167 of those who met the inclusion criteria were included in this study.The remaining implants were rej.cted due

关键词： Implant removal Healed fracture Orthopedic implant Complications Healthcare system

Extracellular sulfatase-2 is overexpressed in rheumatoid arthritis and mediates the TNF-α-induced inflammatory activation of synovial fibroblasts

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Cellular & Molecular Immunology 2022年第10期19卷 1185-1195页

作者： Ruby j.Siegel Anil K.Singh Paul M.Panipinto Farheen S.Shaikh j.dy Vinh Sang U.Han H.Mark Kenney Edward M.Schwarz Cynthia S.Crowson Sadik A.Khuder basil S.Khuder David A.Fox Salahuddin Ahmed Department of Pharmaceutical Sciences Washington State University College of Pharmacy and Pharmaceutical SciencesSpokaneWAUSA Department of Pathology and Laboratory Medicine University of Rochester Medical CenterRochesterNYUSA Center for Musculoskeletal Research University of Rochester Medical CenterRochesterNYUSA Department of Quantitative Health Sciences and Division of Rheumatology Mayo ClinicRochesterMNUSA Department of Medicine and Public Health University of ToledoToledoOHUSA Department of Pathology and Laboratory Medicine Phoenix Children’s HospitalPhoenixAZUSA Department of Medicine Division of Rheumatology and Clinical Autoimmunity Center of ExcellenceUniversity of Michigan Medical SystemAnn ArborMIUSA Division of Rheumatology University of Washington School of MedicineSeattleWAUSA

Extracellular sulfatase-2(Sulf-2)influences receptor-ligand binding and subsequent signaling by chemokines and growth factors,yet Sulf-2 remains unexplored in inflammatory cytokine signaling in the context of rheumatoid arthritis(RA).In the present study,we characterized Sulf-2 expression in RA and investigated its potential role in TNF-α-induced synovial inflammation using primary human RA synovial fibroblasts(RASFs).Sulf-2 expression was significantly higher in serum and synovial tissues from patients with RA and in synovium and serum from hTNFtg mice.RNA sequencing analysis of TNF-α-stimulated RASFs showed that Sulf-2 siRNA modulated~2500 genes compared to scrambled siRNA.Ingenuity Pathway Analysis of RNA sequencing data identified Sulf-2 as a primary target in fibroblasts and macrophages in RA.Western blot,ELISA,and qRT‒PCR analyses confirmed that Sulf-2 knockdown reduced the TNF-α-induced expression of ICAM1,VCAM1,CAD11,PDPN,CCL5,CX3CL1,CXCL10,and CXCL11.Signaling studies identified the protein kinase C-delta(PKCδ)and c-j.n N-terminal kinase(j.K)pathways as key in the TNF-α-mediated induction of proteins related to cellular adhesion and invasion.Knockdown of Sulf-2 abrogated TNF-α-induced RASF proliferation.Sulf-2 knockdown with siRNA and inhibition by OKN-007 suppressed the TNF-α-induced phosphorylation of PKCδand j.K,thereby suppressing the nuclear translocation and DNA binding activity of the transcription factors AP-1 and NF-κBp65 in human RASFs.Interestingly,Sulf-2 expression positively correlated with the expression of TNF receptor 1,and coimmunoprecipitation assays demonstrated the binding of these two proteins,suggesting they exhibit crosstalk in TNF-αsignaling.This study identified a novel role of Sulf-2 in TNF-αsignaling and the activation of RA synoviocytes,providing the rationale for evaluating the therapeutic targeting of Sulf-2 in preclinical models of RA.

关键词： Sulfatase-2 TNF-α Rheumatoid arthritis Synovial fibroblasts Signal transduction

Image j.Analysis of Six Different Annealed Temperatures of 0.17% C of HSLA Steels

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World j.urnal of Engineering and Technology 2020年第4期8卷 617-629页

作者： Ngozi Grace Emordi Iweriolor Sunday Onyekpe basil Obimma Department of Metallurgical Engineering Delta State Polytechnic Ogwashi Uku Nigeria Department of Mechanical Engineering Delta State Polytechnic Ogwashi Uku Nigeria Department of Mechanical Engineering University of Benin Benin Nigeria

Annealing is a heat treatment procedure in which the mechanical properties of a material are being altered, and such alterations cause changes in its properties such as strength and hardness. It is usually carried out to improve ductility and toughness, to reduce hardness and to remove carbides. This study deals with the use of image analysis processing method for the measurement of structure of six annealed samples of 0.17% High Strength Low Alloy (HSLA) Steels (840°C - 990°C) with 30°C interval and 30 minutes soaking time. From the optical microscope images using Image j.program, some parameters like calculation of area, pixel value statistics, distances and angles measurements, edge detection, such as the circularity, ferret angle, solidity and perimeter, average area and the percentage area were examined. The annealed sample of 960°C gave the highest grain count of 543 with a perimeter of 41.518;standard deviation 7.057 and a mean of 28.722 which shows that annealing greatly improved the fatigue life of the steel. From the mechanical analysis result, the annealed sample at 840°C has a highest hardness value of 129.4 BHN and gave the lowest impact value of 58.75 j. This study shows a significant decrease in the hardness value as the annealing temperature increased which signifies that annealing temperature enhanced the fatigue property and tensile strength (wear strength) of the steel in study.

关键词： High Strength Low Alloy Steel Microstructure Image j

Ventricular Arrhythmia-Free Survival Following Therapeutic Hypothermia in Patients with Sudden Cardiac Death Due to Ventricular Tachycardia or Fibrillation

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International j.urnal of Clinical Medicine 2017年第5期8卷 293-305页

作者： basil M. Saour Yong H. j. Edward F. Philbin Henry T. Tan Duy T. Nguyen j.mes j. O’Brien Mandeep S. Sidhu David A. Steckman Mikhail T. Torosoff Division of Cardiology Department of Medicine Albany Medical College Albany USA Loma Linda University Medical Center Loma Linda USA University of Colorado Medical Center Aurora USA

Background: The potential benefits of implantable cardioverter-defibrillator (ICD) therapy in patients with sudden cardiac death (SCD) treated with therapeutic hypothermia (TH) have not been well studied. Methods: Incidence of recurrent non-sustained ventricular arrhythmia, ICD therapy, and death were ascertained in 64 consecutive survivors of SCD due to ventricular fibrillation or tachycardia, who were treated with TH. Follow-up was 31.5 +/- 3.3 months in 41 ICD recipients and 36.3 +/- 3.9 months in 23 patients who did not receive an ICD due to the presence of a reversible cause of cardiac arrest, an acute myocardial infarction in 87%. Results: Combined incidence of ventricular arrhythmia, ICD therapy, or death in patients who underwent ICD placement (21.9%) were similar to overall mortality in the patients who did not receive an ICD (21.7%, p = 0.752). ICD placement was associated with a significant mortality benefit;95.1% survival in ICD recipients vs. 78.3% in the no-ICD group (p = 0.038). Electrocardiographic findings of ST segment elevation on admission were associated with increased event rate in ICD recipients (p = 0.039) and increased mortality in SCD patients who did not receive an ICD (p Conclusions: SCD survivors treated with TH are at increased risk for recurrent arrhythmic events and derive significant mortality benefit from ICD implantation. Increased mortality in revascularized SCD patients with acute coronary syndrome, thought to have a reversible cause of cardiac arrest, calls for prospective trials investigating utility of ICD in this vulnerable patient population.

关键词： Sudden Cardiac Death Therapeutic Hypothermia Implantable Cardiac Defibrillator

复杂并发症产生在简单并且 polycystic 肝包囊

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World j.urnal of Hepatology 2012年第12期4卷 406-411页

作者： Christian Macutkiewicz Ricci Plastow Melissa Chrispij. Rafik Filobbos basil A Ammori David j.Sherlock j.ost PH Drenth Derek A O’Reilly Department of HepatoPancreato-Biliary Surgery North Manchester General HospitalManchester M8 5RBUnited Kingdom Department of Gastroenterology and Hepatology Radboud University Nijmegen Medical CenterPO Box 9101Code 455 NijmegenThe Netherlands Department of Radiology North Manchester General HospitalManchester M8 5RBUnited Kingdom The University of Manchester Manchester Academic Health Science CentreManchesterUnited Kingdom

Liver cysts are common,affecting 5%-10% of the population.Most are asymptomatic,however 5% of patients develop symptoms,sometimes due to complications and will require intervention.There is no consensus on their management because complications are so uncommon.The aim of this study was to perform a collected review of how a series of complications were managed at our institutions.Six different patients presenting with rare complications of liver cysts were obtained from Hepatobiliary Units in the United Kingdom and The Netherlands.History and radiological imaging were obtained from case notes and computerised radiology.As a result,1 patient admitted with inferior vena cava obstruction was managed by cyst aspiration and lanreotide;1 patient with common bile duct obstruction was first managed by endoscopic retrograde cholangiopancreatography and stenting,followed by open fenestration;1 patient with ruptured cysts and significant medical co-morbidities was managed by percutaneous drainage;1 patient with portal vein occlusion and varices was managed by open liver resection;1 patient with infected cysts was treated with intravenous antibiotics and is awaiting liver transplantation.The final patient with a simple liver cyst mimicking a hydatid was managed by open liver resection.In conclusion,complications of cystic liver disease are rare,and we have demonstrated in this series that both operative and non-operative strategies have defined roles in management.The mainstays of treatment are either aspiration/sclerotherapy or,alternatively laparoscopic fenestration.Medical management with somatostatin analogues is a potentially new and exciting treatment option but requires further study.

关键词： Liver Cysts Complications Polycystic

Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics?A systematic review and narrative synthesis

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Bone Research 2022年第4期10卷 661-678页

作者： Anj. R.Zelmer Renj. Nelson Katharina Richter Gerald j.Atkins Centre for Orthopaedic and Trauma Research Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSA 5000Australia Department of Infectious Diseases Central Adelaide Local Health NetworkAdelaideSA 5000Australia Royal Adelaide Hospital AdelaideSA 5000Australia Richter Lab Department of SurgeryBasil Hetzel Institute for Translational Health ResearchUniversity of AdelaideAdelaideSA 5011Australia

Approximately 40%of treatments of chronic and recurrent osteomyelitis fail in part due to bacterial persistence.Staphylococcus aureus,the predominant pathogen in human osteomyelitis,is known to persist by phenotypic adaptation as small-colony variants(SCVs)and by formation of intracellular reservoirs,including those in maj.r bone cell types,reducing susceptibility to antibiotics.Intracellular infections with S.aureus are difficult to treat;however,there are no evidence-based clinical guidelines addressing these infections in osteomyelitis.We conducted a systematic review of the literature to determine the demonstrated efficacy of all antibiotics against intracellular S.aureus relevant to osteomyelitis,including protein biosynthesis inhibitors(lincosamides,streptogramins,macrolides,oxazolidines,tetracyclines,fusidic acid,and aminoglycosides),enzyme inhibitors(fluoroquinolones and ansamycines),and cell wall inhibitors(beta-lactam inhibitors,glycopeptides,fosfomycin,and lipopeptides).The PubMed and Embase databases were screened for articles related to intracellular S.aureus infections that compared the effectiveness of multiple antibiotics or a single antibiotic together with another treatment,which resulted in 34 full-text articles fitting the inclusion criteria.The combined findings of these studies were largely inconclusive,most likely due to the plethora of methodologies utilized.Therefore,the reported findings in the context of the models employed and possible solutions for improved understanding are explored here.While rifampicin,oritavancin,linezolid,moxifloxacin and oxacillin were identified as the most effective potential intracellular treatments,the scientific evidence for these is still relatively weak.We advocate for more standardized research on determining the intracellular effectiveness of antibiotics in S.aureus osteomyelitis to improve treatments and patient outcomes.

关键词： treatment finding synthesis

Global Pediatric Pulmonology Alliance recommendation to strengthen prevention of pediatric seasonal influenza under COVID-19 pandemic

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World j.urnal of Pediatrics 2020年第5期16卷 433-437页

作者： Kun-Ling Shen Leyla Namazova-Baranova Yong-Hong Yang Gary Wing Kin Wong Lanny j.Rosenwasser Lance E.Rodewald Anne Eng Neo Goh Eitan Kerem Chris O'Callaghan T.Bernard Kinane basil Elnazir Rina Triasih Rosemary Horne Anne B Chang j.m Buttery Ruth A.Etzel Kazunobu Ouchi Hilary Hoey Varinder Singh Genesis C.Rivera Spencer SLi Yu Guan Ling Cao Yue-j.e Zheng Lu-Zhao Feng Wu Zhong Zheng-De Xie Bao-Ping Xu Rong-j.n Lin Gen Lu Qiang Qin Chun-Mei Zhu Su-Yun Qian Gang Liu Cheng-Song Zhao Zhuang Wei Yu-Hong Zhao Global Pediatric Pulmonology Alliance(GPPA)Expert Panel on Infectious Diseases&COVID-19 China National Clinical Research Center of Respiratory Diseases Department of Respiratory Medicine of Beijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina Pediatrics and Child Health Research Institute Central Clinical HospitalRussian Academy of SciencesMoscowRussian Federation Department of Respiratory Shenzhen Children's HospitalShenzhenChina Chinese University of Hong Kong Hong Kong SARChina UMKC School of Medicine Kansas CityMOUSA National Immunization Program Chinese Center for Disease Control and PreventionBeijingChina K Women's and Children's Hospital SingaporeSingapore Department of Pediatrics Hadassah Hebrew University Medical CenterJerusalemIsrael UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital(GOSH)BRC University College LondonLondonUK Massachusetts General Hospital for Children BostonMAUSA Children's Health Ireland and Trinity College Dublin DublinIreland Department of Paediatric Faculty of MedicinePublic Health and NursingUniversitas Gadjah Mada/Dr.Sardjito HospitalYogyakartaIndonesia Monash University MelbourneAustralia Queensland Children's Hospital BrisbaneAustralia Monash Children's Hospital Menzies School of Health ResearchMelbourneAustralia George Washington University WashingtonDCUSA Department of Pediatrics Kawasaki Medical SchoolKurashiki-CityJapan Department of Pediatrics University of Dublin Trinity CollegeDublinIreland Lady Hardinge Medical College and Assoc Kalawati Saran Children's Hospital New DelhiIndia Center for Medical and Allied Health Sciences New Era UniversityQuezon Citythe Philippines Global Pediatric Pulmonology Alliance Hong Kong SARChina Department of Respiratory the Children's Hospital Affiliated to the Capital Institute of PediatricsBeijingChina School of Population Medicine and Public Health Chinese Academy of Medical Sciences/Peking Union Medical CollegeBeijingChina National Engineering Research Center for the Emergency Drug BeijingChina Nati

The World Health Organization(WHO)announced COVID-19 as a global pandemic in March of 2020[1].The COVID-19 pandemic may persist for a long period of time.Global prevention and control becomes a complex and challenging task,and such efforts should be sustained.Although general measures,such as social distancing,face masks,respiratory hygiene and hand sanitization,will bear fruits for decreasing spread of other respiratory illnesses including influenza,the specific prevention through vaccination is a key focus especially in the upcoming winter and spring seasons[2].

关键词： prevention influenza sustained

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博弈论的目标

Global Pediatric Pulmonology Alliance(GPPA)proposal for COVID-19 vaccination in children

理论经济学 2006年第11期 1-22页

作者：罗伯特·j.奥曼

本文分两个部分探讨了博弈论的核心任务。第一部分先对博弈论的科学属性进行了思辨性的探讨。作者认为，不能简单用“正确”或“错误”来评价博弈论；一个科学理论不应该试图去得到事实或者接近事实，而是要努力将人们的思想和观察用一... 详细信息

本文分两个部分探讨了博弈论的核心任务。第一部分先对博弈论的科学属性进行了思辨性的探讨。作者认为，不能简单用“正确”或“错误”来评价博弈论；一个科学理论不应该试图去得到事实或者接近事实，而是要努力将人们的思想和观察用一种简约的方式进行统一，从这个角度说博弈论不失为符合规范的科学理论。第二部分讨论了博弈论中若干“解”的概念，包括纳什均衡、核和夏普利值等等。作者认为这些概念必须根据它们的应用去加以理解，并且从它们应用的广泛程度和结果的质量进行评判。不同的“解”有不同的应用，每一种解都从某一侧面统一了交互性决策过程中的理性行为。正是基于这种对博弈解的理解，尽管博弈论是基于“理性人”的理论，但这并不妨碍它在解释“社会人”或“现代人”行为上取得引人注目的成功。

关键词：博弈论科学属性 “解”的概念

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World j.urnal of Pediatrics 2021年第5期17卷 458-461页

作者： Lance E.Rodewald Kun-Ling Shen Yong-Hong Yang Gary Wing-Kin Wong Leyla Namazova-Baranova Lanny j.Rosenwasser Adel S.Alharbi Anne B.Chang j.m Buttery basil Elnazir Ruth A.Etzel Anne Goh Hilary Hoey Rosemary Home Eitan Kerem Antonella Muraro Chris O’Callaghan Kazunobu Ouchi Varinder Singh j.u-Yao Wang Spencer Li Yu Guanon Yue-j.e Zheng Zhengde Xie Gen Lu Yi j.ang Xing-Wang Li Rong-Meng j.ang Xiao-Chuan Wang j.-Kui Deng Xiao-Xia Lu Bao-Ping Xu Zhuang Wei Lu-Zhao Feng Zheng-Yan Zhao the Global Pediatric Pulmonology Alliance(GPPA)Counci Global Pediatric Pulmonology Alliance(GPPA)Expert Panel on Infectious Diseases and COVID-19 National Immunization Program Chinese Center for Disease Control and Prevention.BeijingChina China National Clinical Research Center of Respiratory Diseases Department of RespiratoryBeijing Children's hospital.Capital Medical UniversityNational Center for Children's HealthBeijingChina Beij.ng Children's Hospital Capital Medical UniversityNational Center for Children's HealthBeijingChina Chinese University of Hong Kong.Hong Kong SAR China Pediatrics and Child Health Research Institute Central Clinical HospitalRussian Academy of SciencesMoscowRussian Federation University of Missouri-Kansas City School of Medicine Kansas CityMOUSA Prince Sultan Military Medical City(PSMMC) Ministry of DefenseRiyadhSaudi Arabia Queensland Children's Hospital.Brisbane Australia and Menzies School of Health ResearchDarwinAustralia Monash Children's Hospital Monash UniversityMelbourneAustralia Children's Health Ireland and Trinity College Dublin DublinIreland George Washington University WashingtonDCUSA KK Women’s and Children’s Hospital SingaporeSingapore Department of Pediatrics University of Dublin Trinity CollegeDublinIreland Monash University MelbourneAustralia Department of Pediatrics Hadassah Hebrew University Medical CenterJerusalem.Israel Food Allergy Referral Centre Veneto Region Padua University Hospital PaduaItaly UCL Great Ormond Street Institute of Child Health Great Ormond Street Hospital(GOSH)BRCUniversity College LondonLondonUK Department of Pediatrics.Kawasaki Medical School Kurashiki-cityJapan Lady Hardinge Medical College and Assoc Kalawati Saran Children's Hospital Bangla Sahib MargNew DelhiIndia College of Medicine National Cheng Kung UniversityTainan CityTaiwanChina VITUP International Hospital DalianLiaoningChina China Medicine Education Association Pediatric Committee BeijingChina Department of Respiratory Disease Shenzhen Children's Hospital.ShenzhenChina Research Unit of Critical Infection in Children Chinese Academy of Medical Sciences2019RU016National Clinical Rese

Coronavirus disease 2019(COVID-19)remains a global epidemic.As of August 18,2021,the number of reported cases has exceeded 207 million globally,with more than 4.3 million deaths.COVID-19 has brought devastating losses to human society.The overall crude mortality rate is 1-3%.Although pediatric deaths from COVID-19 are rare,they do occur,as over 9,000 children have died from COVID-19 globally to date[1].With the gradual and broad application of COVID-19 vaccines around the world,the rising proportion of cases among children and unvaccinated young adults demands attention.According to World Health Organization surveillance data.

关键词： mortality globally Alliance