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Mid-term survival of the Optimys short stem: A prospective case series of 500 patients

World Journal of Orthopedics 2024年第3期15卷 257-265页

作者： Bryan Hamans Sheryl de Waard Sjoerd Kaarsemaker Esther R C Janssen Inger N Sierevelt Gino M M J Kerkhoffs Daniël Haverkamp Department of orthopaedic Surgery Xpert ClinicAmsterdam 1101EANetherlands Department of Orthopedic Surgery Amsterdam University Medical CenterAmsterdam 1105 AZNetherlands Esther R C Janssen Department of Orthopaedic SurgeryViecuri Medisch CentrumVenlo 5912 BLNetherlands Centre for orthopaedic Research Spaarne ZiekenhuisHoofddorp 2134 TMNetherlands Department of orthopaedic Surgery and Sports Medicine Amsterdam UMC-Location AMCAmsterdam 1105 AZNetherlands Department of Orthopedic Surgery Xpert Orthopedic Surgery ClinicAmsterdam 1101 EANetherlands

BACKGROUND In recent years,there has been an increase in the number of total hip arthroplasty procedures in the younger patient *** active group has higher expectations of their prosthesis in comparison to the older population,and there is a greater physical demand for the *** femoral stems were in-troduced to retain proximal bone stock and joint biomechanics and became more common to implant in this specific ***,the long-term survival and functional outcomes of various short stems are still being investigated in different *** To determine the 5-year survival of the Optimys hip *** This was a prospective multicenter cohort study of 500 patients conducted in two hospitals in the *** patients received the Optimys short stem(Mathys Ltd,Bettlach,Switzerland).The primary outcome measure was survival of the hip stem,with revision as the *** secondary outcome measurements included patient-reported outcome measures(PROMs).Kaplan-Meier analysis was used to calculate the 5-year survival ***-minus-log transformation was performed to calculate the 95%confidence interval(95%CI).Mixed model analyses were performed to assess the course of the PROMs during the 1st 2 years after *** were modeled separately for the 1st and 2nd years to calculate the yearly change in PROMs during both follow-up periods with accompanying 95%*** The mean age of the total 500 patients was 62.3 years(standard deviation:10.6)and 202 were male(40%).At a median follow-up of 5.5 years(interquartile range:4.5-6.7),7 patients were deceased and 6 revisions were registered,for infection(n=3),subsidence(n=2)and malposition(n=1).This resulted in an overall 5-year survival of 98.8%(95%CI:97.3-99.5).If infection was left out as reason for revision,a stem survival of 99.4%(95%CI:98.1-99.8)was *** questionnaires were completed by 471 patients(94%),317 patients(63%)completed the 1-year follow-up questionna

关键词： Total hip arthroplasty Femoral stem Short stem Optimys Survival 5-year survival Revision PROMs

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Radiofrequency ablation versus microwave ablation for colorectal liver metastases:long-term results of a retrospective cohort surgical experience

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Hepatobiliary Surgery and Nutrition 2024年第5期13卷 759-770,I0001页

作者： Ali Gunduz Sarioglu Chase J.Wehrle Ege Akgun Arturan Ibrahimli James F.Bena Eren Berber Department of Endocrine Surgery Cleveland ClinicClevelandOHUSA Department of General Surgery Cleveland ClinicClevelandOHUSA Department of Quantitative Health Sciences Cleveland ClinicClevelandOHUSA

Background:Ablation is an alternative treatment modality for selected patients with colorectal liver metastases(CRLMs).Although initially widely performed via radiofrequency ablation(RFA),more recently,microwave ablation(MWA)is being preferred due to its perceived superiority in creating the ablation *** aim of this study is to compare the long-term efficacy of these two modalities performed ***:Patients undergoing surgical liver ablation from 2005-2023 at a tertiary center by a single surgeon for CRLM were included in a retrospective institutional review board-approved *** were compared using Wilcoxon,Chi-square,Kaplan-Meier,and Cox multivariate regression *** data are presented as median(interquartile range).Results:There were a total of 242 *** RFA was done in 121 patients with 303 lesions and laparoscopic MWA in 121 patients with 300 *** was no difference between the groups regarding operative time(161 vs.147 minutes,respectively,P=0.4),perioperative morbidity(3%vs.8%,respectively,P=0.2)or hospital stay(1 vs.1 day,P=0.05).Local recurrence(LR)per lesion with at least 1 year of imaging follow-up was 29%in the RFA and 13%in the MWA group(P<0.001).Based on univariate survival analysis,tumor size,blood vessel proximity,ablation margin,and ablation modality were independent predictors of *** control these variables,direct matching was *** cohort included 189 ***-Meier analysis of these cohorts showed increased LR-free survival in the MWA group *** RFA group(P=0.005).Conclusions:This large study confirms our initial observation that local tumor control rate is better after MWA ***.

关键词： Colorectal cancer liver metastasis liver ablation radiofrequency ablation(RFA) microwave ablation(MWA) local recurrence(LR)

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Comparison of fungal vs bacterial infections in the medical intensive liver unit:Cause or corollary for high mortality?

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World Journal of Hepatology 2024年第3期16卷 379-392页

作者： Sarah Khan Hanna Hong Stephanie Bass Yifan Wang Xiao-Feng Wang Omar T Sims Christine E Koval Aanchal Kapoor Christina C Lindenmeyer Department of Internal Medicine Cleveland ClinicClevelandOH 44195United States Cleveland clinic Lerner College of Medicine Cleveland ClinicClevelandOH 44195United States Department of Pharmacy Cleveland ClinicClevelandOH 44195United States Department of Quantitative Health Sciences/Biostatistics Section Cleveland ClinicClevelandOH 44195United States Department of Gastroenterology Hepatology and NutritionCleveland ClinicClevelandOH 44195United States Department of Infectious Disease Cleveland ClinicClevelandOH 44195United States Department of Critical Care Medicine Cleveland ClinicClevelandOH 44195United States

BACKGROUND Due to development of an immune-dysregulated phenotype,advanced liver disease in all forms predisposes patients to sepsis acquisition,including by opportunistic pathogens such as *** data exists on fungal infection within a medical intensive liver unit(MILU),particularly in relation to acute on chronic liver *** To investigate the impact of fungal infections among critically ill patients with advanced liver disease,and compare outcomes to those of patients with bacterial *** From our prospective registry of MILU patients from 2018-2022,we included 27 patients with culture-positive fungal infections and 183 with bacterial *** compared outcomes between patients admitted to the MILU with fungal infections to bacterial *** was extracted through chart *** All fungal infections were due to Candida species,and were most frequently blood *** among patients with fungal infections was significantly worse relative to the bacterial cohort(93%vs 52%,P<0.001).The majority of the fungal cohort developed grade 2 or 3 acute on chronic liver failure(ACLF)(90%vs 64%,P=0.02).Patients in the fungal cohort had increased use of vasopressors(96%vs 70%,P=0.04),mechanical ventilation(96%vs 65%,P<0.001),and dialysis due to acute kidney injury(78%vs 52%,P=0.014).On MILU admission,the fungal cohort had significantly higher Acute Physiology and Chronic Health Evaluation(108 vs 91,P=0.003),Acute Physiology Score(86 vs 65,P=0.003),and Model for End-Stage Liver Disease-Sodium scores(86 vs 65,P=0.041).There was no significant difference in the rate of central line use preceding culture(52%vs 40%,P=0.2).Patients with fungal infection had higher rate of transplant hold placement,and lower rates of transplant;however,differences did not achieve statistical *** Mortality was worse among patients with fungal infections,likely attributable to severe ACLF *** studies examinin

关键词： Fungal Infection Sepsis Acute on chronic liver failure Intensive care

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Standardization is needed in reporting risk and outcomes of machine perfusion in liver transplantation

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 709-714页

作者： Chase J.Wehrle Charles Miller Koji Hashimoto Andrea Schlegel Transplantation Center Department of SurgeryDigestive Disease InstituteCleveland ClinicClevelandOHUSA Department of Immunology Lerner Research InstituteCleveland ClinicClevelandOHUSA

We congratulate Yamamoto et *** their study“Impact of Portable Normothermic Machine Perfusion for Liver Transplantation from Adult Deceased Donors”(1).The surge of interest in normothermic machine perfusion(NMP)in the United States(US)has generated considerable *** authors present generally exciting results from their single-center analysis of 541 liver *** these,469 were from donors after brain dead(DBD);58(12.4%)received NMP and 411 static cold storage(SCS,87.6%).Seventy-two transplants were from donors after circulatory death(DCD);52(72.2%)received NMP(device-to-donor)vs.20 SCS(27.8%).

关键词： Liver transplantation machine perfusion normothermic machine perfusion(NMP) transplantation viability assessment

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Blood metal concentrations and cardiac structure and function in total joint arthroplasty patients

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World Journal of Orthopedics 2024年第8期15卷 773-782页

作者： Peter C Brennan Stephanie M Peterson Thomas J O'Byrne Mariana L Laporta Cody C Wyles Paul J Jannetto Garvan C Kane Maria Vassilaki Hilal Maradit Kremers Department of Orthopedic Surgery Mayo ClinicRochesterMN 55905United States Department of Quantitative Health Sciences Mayo ClinicRochesterMN 55905United States Department of Anesthesiology and Perioperative Medicine Mayo ClinicRochesterMN 55905United States Department of Laboratory Medicine and Pathology Mayo ClinicRochesterMN 55905United States Department of Cardiovascular Diseases Mayo ClinicRochesterMN 55905United States

BACKGROUND There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty(TJA)*** To determine the association of commonly used implant metals with echocardiographic measures in TJA *** The study comprised 110 TJA patients who had a recent history of high chromium,cobalt or titanium *** underwent two-dimensional,three-dimensional,Doppler and speckle-strain transthoracic echocardiography and a blood draw to measure metal *** and sex-adjusted linear and logistic regression models were used to examine the association of metal concentrations(exposure)with echocardiographic measures(outcome).RESULTS Higher cobalt concentrations were associated with increased left ventricular end-diastolic volume(estimate 5.09;95%CI:0.02-10.17)as well as left atrial and right ventricular dilation,particularly in men but no changes in cardiac *** titanium concentrations were associated with a reduction in left ventricle global longitudinal strain(estimate 0.38;95%CI:0.70 to 0.06)and cardiac index(estimate 0.08;95%CI,-0.15 to-0.01).CONCLUSION Elevated cobalt and titanium concentrations may be associated with structural and functional cardiac changes in some *** studies are warranted to better understand the systemic effects of metals in TJA patients.

关键词： Total joint arthroplasty Metal-on-metal Cardiotoxicity Heart failure Echocardiography Cobalt

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Does ischemia-free machine perfusion lead to early allograft dysfunction (EAD) free liver transplantation?

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 678-680页

作者： Hani M.Wadei Kristopher P.Croome Division of Kidney and Pancreas Transplant Department of TransplantMayo ClinicJacksonvilleFLUSA Division of Transplant Surgery Department of TransplantMayo ClinicJacksonvilleFLUSA

Normothermic machine perfusion(NMP)is an innovative technique used in solid organ transplantation that involves perfusing the organ with specialized solution or leukocyte depleted red blood cells at near-normal body temperature aiming at mimicking physiological conditions,and providing optimal conditions for organ preservation which leads to reduced risk of ischemia reperfusion injury(IRI)when compared to the standard static cold storage(SCS)(1).One of the key advantages of NMP is its ability to assess the quality of the organ in real-time and assessment of the organ performance prior to *** continuously monitoring parameters such as blood flow,oxygen consumption,and lactate production,clinicians can evaluate the viability of the organ and make more informed decisions about its suitability for *** real-time assessment can help reduce the risk of transplanting organs that may not function optimally or have a higher likelihood of complications ***,NMP may expand the pool of donor organs by allowing for the use of organs that may have been deemed marginal or unsuitable for transplantation using traditional methods(1,2).

关键词： Early allograft dysfunction(EAD) normothermic machine perfusion(NMP) liver transplant outcomes

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Toward less invasive coloproctology: The future is out there

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World Journal of Gastroenterology 2024年第3期30卷 199-203页

作者： Sameh Hany Emile Jonathan Ragheb Department of Colorectal Surgery Cleveland Clinic FloridaWestonFL 33331United States Department of Gastroenterology and Hepatology Cleveland Clinic FloridaWestonFL 33331United States

Medical care has undergone remarkable improvements over the past few *** of the most important innovative breakthroughs in modern medicine is the advent of minimally and less invasive *** trend towards employing less invasive treatment has been vividly shown in the field of gastroenterology,particularly *** to foregut interventions,colorectal surgery has shifted towards a minimally invasive ***,including both medical and surgical management of colorectal diseases,has undergone a remarkable paradigm *** treatment of both benign and malignant colorectal conditions has gradually transitioned towards more conservative and less inva-sive *** interesting paradigm shift was the trend to avoid the need for radical resection of rectal cancer altogether in patients who showed complete response to neoadjuvant *** trend of adopting less invasive appro-aches to treat various colorectal conditions does not seem to be stopping soon as further research on novel,more effective and safer methods is ongoing.

关键词： Toward Less invasive Minimally invasive Coloproctology Future Colorectal surgery

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Peri-articular elbow fracture fixations with magnesium implants and a review of current literature: A case series

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World Journal of Orthopedics 2024年第3期15卷 215-229页

作者： Christopher Fang Antony Xavier Rex Premchand Derek Howard Park Dong Hao Toon Department of orthopaedic Surgery Khoo Teck Puat HospitalNational Healthcare GroupSingapore 768828Singapore

BACKGROUND In recent years,the use of Magnesium alloy implants have gained renewed popularity,especially after the first commercially available ConformitéEuropéenne approved Magnesium implant became available(MAGNEZIX®CS,Syntellix)in *** To document our clinical and radiographical outcomes using magnesium implants in treating peri-articular elbow *** Our paper was based on a retrospective case series ***-operatively,a standardized surgical technique was utilized for insertion of the magnesium ***–operatively,clinic visits were standardized and physical exam findings,functional scores,and radiographs were obtained at each *** complications were *** Five patients with 6 fractures were recruited(2 coronoid,3 radial head and 1 capitellum).The mean patient age and length of follow up was 54.6 years and 11 months *** fractures healed,and none exhibited loss of reduction or complications requiring revision *** patient developed synovitis of the elbow joint or suffered electrolytic reactions when titanium implants were used *** Although there is still a paucity of literature available on the subject and further studies are required,magnesium implants appear to be a feasible tool for fixation of peri-articular elbow fractures with promising results in our *** In recent years,the use of Magnesium alloy implants in orthopaedic surgeries have gained renewed *** from being bioabsorbable,negating the need for implant removal,magnesium also has good osteoconductive properties[1-4].Biomechanically,it exhibits greater biomechanical strength than any pre-existing polymers,and reduces the stress-shielding effect associated with titanium and steel implants as it has a Young’s modulus closer to bone[4].Currently,the main utility of magnesium implants in the orthopaedic community is within the foot and ankle community where satisfactory results have been reported

关键词： Magnesium screw Fracture Peri-articular Elbow

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Pro and anti-inflammatory diets as strong epigenetic factors in inflammatory bowel disease

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World Journal of Gastroenterology 2024年第27期30卷 3284-3289页

作者： Adele Rostami Kristen White Kamran Rostami Digestive Health clinic Palmerston North 4410New Zealand Digestive Health clinic&Kōtare Wellness Ltd Palmerston North 4410New Zealand Department of Gastroenterology Palmerston North HospitalPalmerston North 4442New Zealand

Inflammatory bowel disease(IBD)is the consequence of a complex interplay between environmental factors,like dietary habits,that alter intestinal microbiota in response to luminal antigens in genetically susceptible *** represents an auspicious area for the discovery of how environmental factors influence the pathogenesis of inflammation,prognosis,and response to ***,it relates to gene expression control in response to environmental *** increasing number of patients with IBD globally is indicative of the negative effects of a food supply rich in trans and saturated fats,refined su-gars,starches and additives,as well as other environmental factors like seden-tarism and excess bodyweight,influencing the promotion of gene expression and increasing DNA hypomethylation in *** many genetic variants are now associated with Crohn's disease(CD),new therapeutic strategies targeting modi-fiable environmental triggers,such as the implementation of an anti-inflammatory diet that involves the removal of potential food antigens,are of growing interest in the current ***,as a strong epigenetic factor in the pathogenesis of inflammatory disorders like IBD,provides novel insights into the pathophysio-logy of intestinal and extraintestinal inflammatory disorders.

关键词： Inflammatory bowel disease Epigenetic Anti-inflammatory diet Immunogenetics Microbiome Polymeric diet Elemental diet

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Effects of Tai Chi in diabetes patients: Insights from recent research

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World Journal of Diabetes 2024年第1期15卷 1-10页

作者： Hidetaka Hamasaki Department of Endocrinology and Metabolism Internal MedicineHamasaki ClinicKagoshima 890-0046Japan

Tai Chi,a practice that combines elements of both exercise and mindfulness,offers a wide range of health *** body of evidence concerning the impact of Tai Chi on diabetes has recently been *** editorial aims to provide a concise summary of the current state of evidence for Tai Chi's effects on individuals with type 2 diabetes(T2D).The review includes 3 randomized controlled trials(RCTs)and 5 systematic reviews and meta-analyses,all of which investigate the effectiveness of Tai Chi on various health outcomes in individuals with *** Chi demonstrates a significant effect to enhance glycemic control,lower blood pressure,improve serum lipid profiles,reduce insulin resistance,positively influence obesity-related indices,and improve overall quality of life in individuals with ***,it is noteworthy that recent RCTs have reported inconsistent findings regarding the effects of Tai Chi on glycemic control and insulin *** author also delves into potential mechanisms by which Tai Chi may exert its influence on the human ***,the editorial highlights the critical issues that warrant further exploration in the future.

关键词： Type 2 diabetes Tai Chi Exercise Mind-body exercise Chinese traditional exercise Randomized controlled trial Systematic review and meta-analysis

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