scholarly journals Bone cement implantation syndrome in cemented hip hemiarthroplasty—a persistent risk

2021 ◽  
Author(s):  
Karoline Weingärtner ◽  
Philipp Störmann ◽  
David Schramm ◽  
Sebastian Wutzler ◽  
Kai Zacharowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Bone Cement ◽  
Significant Risk ◽  
Cardiovascular Complications ◽  
Proximal Femur Fracture ◽  
Data Sets ◽  
Clinical Progression ◽  
The Mean ◽  
Bone Cement Implantation Syndrome

Abstract Background Every year, ~ 210,000 initial implantations of hip endoprostheses are carried out in Germany alone. The “bone cement implantation syndrome” (BCIS) is considered a severe peri- and early-postoperative complication when implanting cemented prostheses. The origin of the BCIS and its impact on the clinical outcome are still uncertain. This study investigates the clinical progression after BCIS cases in patients with cemented hemiarthroplasty. Risk factors for the occurrence of BCIS are evaluated. Material and methods Clinical data of all patients with a proximal femur fracture and which received a cemented hemiarthroplasty within a period of 9.5 years have been collected. BCIS (+) patients and BCIS (−) patients were compared with respect to their demographics and clinical outcome. Risk factors for the development of BCIS were identified. Results A total of 208 patients could be included with complete data sets. The mean age was 81.1 ± 10.0 years. Overall, 37% of the patients showed symptoms of BCIS. In comparison to BCIS (−) patients there was a significantly higher rate of cardiovascular complications (27.3% vs. 13.7%, p = 0.016) and a higher in-hospital mortality rate (15.6% vs. 4.6%, p = 0.006) in BCIS (+) patients. Age, absence of a femoral borehole and ASA status were identified as statistically significant risk factors of BCIS. Conclusion BCIS is frequently observed and in some cases severe complication. The therapy is exclusively symptomatic; identifying preventional measures might reduce the occurrence of BCIS.

Characterizing the Magnitude of and Risk Factors for Functional Limb Lengthening in Patients Undergoing Primary Total Knee Arthroplasty

2021 ◽  
pp. 155633162110091
Author(s):  
Brian P. Chalmers ◽  
Mark LaGreca ◽  
Jacqueline Addona ◽  
Peter K. Sculco ◽  
Steve B. Haas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Significant Risk ◽  
Primary Total Knee Arthroplasty ◽  
Limb Lengthening ◽  
Leg Lengthening ◽  
Total Knee ◽  
Plane Deformity ◽  
The Mean ◽  
Primary Total Knee

Background: There is little data on the magnitude and factors for functional leg lengthening after primary total knee arthroplasty (TKA). Questions/Purpose: We sought to determine the incidence of and risk factors for functional leg lengthening after primary TKA. Methods: We retrospectively reviewed consecutive unilateral primary TKAs at a single institution from 2015 to 2018. Of the 782 TKAs included, 430 (55%) were performed in women; the mean age was 66 years, and the mean body mass index was 29 kg/m2. Preoperatively, 541 (69%) knees were varus deformities and 223 (29%) were valgus deformities. Hip to ankle biplanar radiographs were obtained preoperatively and 6 weeks postoperatively for all patients. Two independent researchers measured leg length, coronal plane deformity, lateral knee flexion angle, and overall mechanical alignment on all preoperative and postoperative radiographs. Results: The mean overall ipsilateral functional leg lengthening was 7.0 mm. Seven hundred knees (90%) were overall functionally lengthened, including 462 (59%) knees lengthened >5 mm and 250 (31%) knees lengthened 10 mm or more. A valgus deformity and coronal plane deformity of 10° or more were significant risk factors for increased functional lengthening. Patients with severe valgus deformities (>10°) had the largest amount of functional lengthening, at a mean of 13.5 mm. Conclusion: After primary TKA, 90% of limbs are functionally lengthened, including roughly one-third over a centimeter. Valgus knee deformities and severe deformities (>10°) were significant risk factors for increased limb lengthening.

Prevalence and risk factors of root resorption of adjacent teeth in maxillary canine impaction, among untreated children and adolescents

2018 ◽  
Vol 41 (5) ◽  
pp. 447-453 ◽  
Author(s):  
Frédéric Rafflenbeul ◽  
Catherine-Isabelle Gros ◽  
François Lefebvre ◽  
Sophie Bahi-Gross ◽  
Raphaëlle Maizeray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Children And Adolescents ◽  
Root Resorption ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Data Sets ◽  
Maxillary Canine ◽  
3D Data ◽  
Potential Risk Factors ◽  
Associated Risk Factors

Summary Objectives The aim of this retrospective study was to assess in maxillary canine impaction cases both the prevalence of root resorption of adjacent teeth among untreated children and adolescents, and its associated risk factors. Subjects and methods Sixty subjects (mean age 12.2 years; SD 1.9; range 8–17 years) with 83 displaced maxillary canines and without any past or ongoing orthodontic treatment were included in this study. The presence of root resorption was evaluated on images from a single cone beam computed tomography (CBCT) unit. Potential risk factors were measured on the CBCT images and on panoramic reconstructions of the 3D data sets. The sample was characterized by descriptive statistics and multiple logistic regressions were performed to predict root resorption. Results Root resorption of at least one adjacent tooth was detected in 67.5 per cent of the affected quadrants. It was found that 55.7 per cent of the lateral incisors, 8.4 per cent of the central incisors, and 19.5 per cent of first premolars were resorbed. Of the detected resorptions, 71.7 per cent were considered slight, 14.9 per cent moderate, and 13.4 per cent severe. Contact between the displaced canine(s) and the adjacent teeth roots was the only identified statistically significant risk factor, all teeth being considered (odds ratio [OR] = 18.7, 95% confidence interval: 2.26–756, P < 0.01). An enlarged canine dental follicle, a peg upper lateral, or an upper lateral agenesis were not significantly associated with root resorption of adjacent teeth, nor were age nor gender. Conclusions Root resorption of adjacent teeth was detected in more than two-thirds of a sample of sixty untreated children and adolescents.

scholarly journals Differences in Risk Factors for Retinopathy of Prematurity Development in Paired Twins: A Chinese Population Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Gordon S. K. Yau ◽  
Jacky W. Y. Lee ◽  
Victor T. Y. Tam ◽  
Stan Yip ◽  
Edith Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retinopathy Of Prematurity ◽  
Very Low Birth Weight ◽  
Significant Risk ◽  
The Mean ◽  
Record Review ◽  
Chinese Twins ◽  
Retrospective Medical Record Review

Purpose.To determine the differences in risk factors for retinopathy of prematurity (ROP) in paired twins.Methods.A retrospective medical record review was performed for all paired twins screened for ROP between 2007 and 2012. Screening was offered to very low birth weight (≤1500 grams) and preterm (≤32 weeks) neonates. Twins 1 and 2 were categorized based on the order of delivery. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP.Results.In 34 pairs of Chinese twins, the mean gestational age (GA) was 30.2 ± 2.0 weeks. In Twin 1, smaller GA (OR = 0.44,P=0.02), higher mean oxygen concentration (OR = 1.34,P=0.03), presence of thrombocytopenia (OR = 1429.60,P<0.0001), and intraventricular hemorrhage (OR = 18.67,P=0.03) were significant risk factors for ROP. For Twin 2, a smaller GA (OR = 0.45,P=0.03) was the only risk factor. There were no significant risk factors for ROP in Twin 1 or Twin 2 on multivariate analysis.Conclusion.In Chinese twin pairs, smaller GA was the only common risk factor for ROP while Twin 1 was more susceptible to the postnatal risks for ROP.

Abstract 2877: Ultra-early Endovascular Embolization Of Ruptured Cerebral Aneurysms Increases The Risk Of Hematoma Growth Unrelated To Aneurysmal Rebleeding

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Yusuke Egashira ◽  
Shinichi Yoshimura ◽  
Yukiko Enomoto ◽  
Kiyofumi Yamada ◽  
Takahiko Asano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Cerebral Aneurysms ◽  
Female Gender ◽  
Endovascular Embolization ◽  
Anterior Circulation ◽  
Hematoma Growth ◽  
Group 3 ◽  
The Mean ◽  
Systemic Anticoagulation

Background and purpose: Hematoma growth unrelated to aneurysmal rebleeding has been poorly studied, but is not a rare complication following endovascular embolization of ruptured cerebral aneurysms. The aim of this study is to elucidate the possible risk factors for this phenomenon. Methods: We included 101 consecutive patients with subarachnoid hemorrhage (SAH) who underwent endosaccular embolization at our institution within 72 hours of symptom onset in this study. All endovascular procedures were conducted under intraprocedural systemic anticoagulation. Age, gender, hypertension, diabetes, preoperative antiplatelet or anticoagulation use, neurological grade, Fisher computed tomography group, location and size of the aneurysm, the grade of aneurysm occlusion, and timing of endovascular procedure were retrospectively analyzed to find the risk factors for hematoma growth. Results: This series included 32 men (31.7%) and 69 women (68.3%), and the mean age ± SD was 65.5 ± 14.0 years. The mean time ± SD from onset to endovascular procedure was 12.1 ± 14.0 hours. Following the procedure, hematoma growth unrelated to aneurysmal rebleeding occurred in 14 patients (13.9%), and 10 of the 14 patients required surgical removal of hematoma and/or ventriculostomy to control intracranial pressure. All 14 patients had an anterior circulation aneurysm and had Fisher group 3 or 4 SAH. Ultra-early embolization (conducted within 6 hours after onset), female gender, history of hypertension, and poor neurological grade (WFNS grades 4 and 5) were significant risk factors of hematoma growth (p < 0.05 for all) by the univariate logistic analysis. In multivariate analysis, ultra-early embolization (OR, 18.0; 95% CI, 3.26-338; p = 0.0002), and female gender (OR, 9.83; 95% CI, 1.73-187; p = 0.0067) were independent risk factors for this phenomenon. Anterior circulation aneurysm and Fisher group 3 or 4 SAH did not suit for the logistic regression model, but were found to be significant risk factors by chi-square test (p = 0.018 and 0.022, respectively). Conclusions: Ultra-early endovascular embolization for ruptured cerebral aneurysm under systemic anticoagulation increases the risk of growth of hematomas unrelated to aneurysmal rebleeding. In addition, women with anterior circulation aneurysm presenting with dense focal SAH or intracerebral hematoma are at higher risk for this phenomenon.

scholarly journals 2272. Evaluation of Clinical Features, Carbapenem Resistance and Risk Factors of Klebsiella Species: A 4-Year Retrospective Study in Turkey

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S777-S778
Author(s):  
Zuhal Umit ◽  
Zumrut Sahbudak Bal ◽  
Gizem Guner ◽  
Gulhadiye Avcu ◽  
Duygu Bozkurt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Significant Risk ◽  
Carbapenem Resistance ◽  
Steroid Use ◽  
Carbapenem Resistant ◽  
Vitek 2 ◽  
The Mean ◽  
Klebsiella Spp ◽  
Klebsiella Infections

Abstract Background Gram-negative-resistant bacterial infections are increasing due to widespread use of antibiotics. Infections caused by Klebsiella spp. are an important part of healthcare-associated infections and cause morbidity and mortality. The aim of this study was to determine the epidemiological, clinical features, carbapenem resistance rates and risk factors of bloodstream infections of children with Klebsiella spp. Methods In this retropective study, medical records of 85 episodes of 75 patients caused by with Klebsiella spp. bacteriaemia who admitted to Ege University Faculty of Medicine, Pediatric Hospital in Turkey between 2014 and 2017 were evaluated. Conventional biochemical methods were performed using the automated systems of MALDİ-TOFF MS / VITEK 2 (Biomerieux, France). According to EUCAST recommendations, VITEK 2 (Biomerieux, France) automated microdilution method was used in sensitivity tests. Results The mean age of 85 episodes included in the study was 3.49 (±5.4) years. 58% of the patients were male and 42% were female. 18.8% of the patients were premature. The most common service was newborn service (30.6%). Neutropenia was 26% and thrombocytopenia was 55% at the time of diagnosis. Klebsiella pneumonia was 93% and Klebsiella oxytoca was 7%. Carbapenem resistance rate was found to be 30.6% in Klebsiella spp. Carbapenem resistance was found 18% in 2014, 38% in 2015, 42% in 2016 and 25% in 2017. In patients who developed carbapenem-resistant Klebsiella infection, the duration of pre-hospitalization ≥14 days (P = 0.034), the absolute neutrophil count < 100 (P = 0.048) and steroid use (P = 0.025) were statistically significant risk factors. The mean length of hospital stay was 107 (±103) days. Klebsiella spp. attributable mortality due to infection was 14% and crude mortality was 15%. No statistically significant difference was found in patients who developed resistant and susceptible infections. Conclusion Carbapenem resistance in Klebsiella infections was increased. Prolonged hospital stay, neutropenia and steroid use in the last 3 months were identified as significant risk factors for carbapenem-resistant Klebsiella infections. Disclosures All authors: No reported disclosures.

scholarly journals Extrusion of Femtosecond Laser-Implanted Intrastromal Corneal Ring Segments in Keratoconic Eyes: Prevalence, Risk Factors, and Clinical Outcomes

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Amr Mounir ◽  
Mahmoud Mohamed Farouk ◽  
Marwa Mahmoud Abdellah ◽  
Engy Mohamed Mostafa
Keyword(s):  
Risk Factors ◽  
Femtosecond Laser ◽  
Corneal Thickness ◽  
Significant Risk ◽  
Sun Exposure ◽  
Vernal Keratoconjunctivitis ◽  
Conjunctival Hyperemia ◽  
Intrastromal Corneal Ring ◽  
The Mean ◽  
Belo Horizonte

Purpose. To evaluate the prevalence, possible risk factors, and clinical results of femtosecond laser implanted intrastromal corneal ring segment (ICRS) extrusion in keratoconic eyes. Patients and Methods. This is a retrospective observational study evaluating 333 eyes of 269 patients who were subjected to femtosecond laser-implanted Keraring ICRS in the Sohag Refractive Center, Sohag, Egypt, from January 2014 to January 2019. The study included eyes with channels created by a femtosecond laser (60 kHz IntraLase femtosecond system; Advanced Medical Optics, Santa Ana, California, USA) with implantation of Keraring intrastromal corneal ring segments (Mediphacos, Belo Horizonte, Brazil). Patient data and causes of Keraring extrusions were identified as being those rings that migrated or showed melting of the cornea with no other reason which required segment removal. Results. Seven eyes were found to fit the criteria of ring extrusion (2.1%) out of the 333 eyes which had Keraring implantation. All extruded rings were from patients with keratoconus grade 3, with eccentric cones, and with femtosecond creation of the tunnel. Four eyes belonging to 3 patients (57.1%) had a history of vernal Keratoconjunctivitis, yet they did not show signs of activity at the time of implantation. They reported excessive rubbing just before they presented with conjunctival hyperemia and foreign body sensation. Five eyes (71.4%) showed chronic sun exposure. The mean minimal corneal thickness was 401.85 μm (range 384–420 μm), while the mean maximum keratometry was 61 D (range 55.18–68.96 D). Most of the extruded rings had large arcs. Six eyes had crosslinking (CXL) at the same session of the Keraring implantation. The simultaneous CXL treatment is considered as a possible significant risk factor for ring extrusion. Conclusion. ICRS is an effective reversible option for patients with keratoconus who are intolerant to hard contact lenses, yet the choice of cases and ring segments is mandatory for satisfactory results. Moreover, meticulous history taking and examination reduces the incidence of complications including extrusion.

Long Term Follow-Up of Pediatric Sickle Cell Disease Patients with Conditional Velocities on Transcranial Doppler (TCD).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2338-2338
Author(s):  
Lena Coïc ◽  
Suzanne Verlhac ◽  
Emmanuelle Lesprit ◽  
Emmanuelle Fleurence ◽  
Francoise Bernaudin
Keyword(s):  
Risk Factors ◽  
Color Doppler ◽  
Significant Risk ◽  
Biological Data ◽  
Treatment Intensification ◽  
Significant Difference ◽  
History Of ◽  
The Mean

Abstract Abnormal TCD defined as high mean maximum velocities &gt; 200 cm/sec are highly predictive of stroke risk and justify long term transfusion program. Outcome and risk factors of conditional TCD defined as velocities 170–200 cm/sec remains to be described. Patients and methods Since 1992, 371 pediatric SCD patients (303 SS, 44 SC, 18 Sß+, 6 Sß0) were systematically explored once a year by TCD. The newborn screened cohort (n=174) had the first TCD exploration between 12 and 18 months of age. TCD was performed with a real-time imaging unit, using a 2 MHz sector transducer with color Doppler capabilities. Biological data were assessed at baseline, after the age of 1.5 years and remotely of transfusion or VOC. We report the characteristics and the outcome in patients (n=43) with an history of conditional TCD defined by mean maximum velocities ranging between 170 and 200 cm/s in the ACM, the ACA or the ICA. Results: The mean follow-up of TCD monitoring was 5,5 years (0 – 11,8 y). All patients with an history of conditional doppler were SS/Sb0 (n=43). Mean (SD) age of patients at the time of their first conditional TCD was 4.3 years (2.2) whereas in our series the mean age at abnormal TCD (&gt; 200 cm/sec) occurrence was 6.6 years (3.2). Comparison of basal parameters showed highly significant differences between patients with conditional TCD and those with normal TCD: Hb 7g4 vs 8g5 (p&lt;0.001), MCV 82.8 vs 79 (p=0.047). We also had found such differences between patients with normal and those with abnormal TCD (Hb and MCV p&lt; 0.001). Two patients were lost of follow-up. Two patients died during a trip to Africa. Conditional TCD became abnormal in 11/43 patients and justified transfusion program. Mean (SD) conversion delay was 1.8 (2.0) years (range 0.5–7y). No stroke occurred. 16 patients required a treatment intensification for other indications (frequent VOC/ACS, splenic sequestrations): 6 were transplanted and 10 received HU or TP. Significant risk factors (Pearson) of conversion to abnormal were the age at time of conditional TCD occurrence &lt; 3 y (p&lt;0.001), baseline Hb &lt; 7g/dl (p=0.02) and MCV &gt; 80 (p=0.04). MRI/MRA was performed in 31/43 patients and showed ischemic lesions in 5 of them at the mean (SD) age of 7.1 y (1.8) (range 4.5–8.9): no significant difference was observed in the occurrence of lesions between the 2 groups. Conclusions This study confirms the importance of age as predictive factor of conditional to abnormal TCD conversion with a risk of 64% when first conditional TCD occured before the age of 3 years. TCD has to be frequently controled during the 5 first years of life.

scholarly journals Novel Application of Statistical Methods to Identify New Urinary Incontinence Risk Factors

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Theophilus O. Ogunyemi ◽  
Mohammad-Reza Siadat ◽  
Suzan Arslanturk ◽  
Kim A. Killinger ◽  
Ananias C. Diokno
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Longitudinal Data ◽  
Statistical Methods ◽  
Repeated Measures ◽  
Significant Risk ◽  
Large Data ◽  
Data Sets ◽  
Predictive Index ◽  
Urine Loss

Longitudinal data for studying urinary incontinence (UI) risk factors are rare. Data from one study, the hallmark Medical, Epidemiological, and Social Aspects of Aging (MESA), have been analyzed in the past; however, repeated measures analyses that are crucial for analyzing longitudinal data have not been applied. We tested a novel application of statistical methods to identify UI risk factors in older women. MESA data were collected at baseline and yearly from a sample of 1955 men and women in the community. Only women responding to the 762 baseline and 559 follow-up questions at one year in each respective survey were examined. To test their utility in mining large data sets, and as a preliminary step to creating a predictive index for developing UI, logistic regression, generalized estimating equations (GEEs), and proportional hazard regression (PHREG) methods were used on the existing MESA data. The GEE and PHREG combination identified 15 significant risk factors associated with developing UI out of which six of them, namely, urinary frequency, urgency, any urine loss, urine loss after emptying, subject’s anticipation, and doctor’s proactivity, are found most highly significant by both methods. These six factors are potential candidates for constructing a future UI predictive index.

scholarly journals Early and Midterm Outcome of TEVAR for Thoracic Aortic Pseudoaneurysm

2021 ◽  
Author(s):  
Hui Wang ◽  
Tun Wang ◽  
Hao He ◽  
Xin Li ◽  
Yuan Peng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Cardiac Disease ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Aortic Pseudoaneurysm ◽  
Significant Difference ◽  
Independent Risk Factors ◽  
The Mean

Abstract Backgrounds: The prognosis of thoracic aortic pseudoaneurysm (TAP) after thoracic endovascular aortic repair (TEVAR) remains unclear. This study investigates the early and midterm clinical outcome as well as relevant risk factors of TAP patients following TEVAR therapy.Methods: From July 2010 to July 2020, 37 eligible TAP patients who underwent TEVAR were selected into our research. We retrospectively explored their baseline, perioperative and follow-up data. Fisher exact test and Kaplan-Meier method were applied for comparing difference between groups. Risk factors of late survival were discerned using Cox regression analysis.Results: There were 29 men and 12 women, with the mean age as 59.5±13.0 years (range, 30-82). The mean follow-up time was 30.7±28.3 months (range, 1-89). For early result, early mortality (≦30days) happened in 3(8.1%) zone 3 TAP patients versus 0 in zone 4 (p= 0.028); acute arterial embolism of lower extremity and type II endoleak respectively occurred in 1(2.7%) case. For midterm result, survival at 3 months, 1 year and 5 years was 88.8±5.3%, 75.9±7.5% and 68.3±9.9%, which showed significant difference between zone 2/3 versus zone 4 group (56.3±14.8% versus 72.9±13.2%, p= 0.013) and emergent versus elective TEVAR groups (0.0±0.0% versus 80.1±8.0%, p= 0.049). On multivariate Cox regression, lesions at zone 2/3 (HR 4.605, 95%CI 1.095-19.359), concomitant cardiac disease (HR 4.932, 95%CI 1.086-22.403) and emergent TEVAR (HR 4.196, 95%CI 1.042-16.891) were significant independent risk factors for worse late clinical outcome. Conclusions: TEVAR therapy is effective and safe with satisfactory early and midterm clinical outcome for TAP patients. Lesions at zone 2/3, concomitant cardiac disease and emergent TEVAR were independent risk factors for midterm survival outcome.

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