scholarly journals Adverse Events due to Lack of Precision in Total Hip Arthroplasty: The Potential of Provocation-Based CT for Diagnosis of Implant Loosening

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Olof Sandberg ◽  
Henrik Olivecrona ◽  
Pelle Gustafson
Keyword(s):  
Retrospective Study ◽  
Adverse Events ◽  
Software Tool ◽  
Special Focus ◽  
Analysis Tool ◽  
Implant Loosening ◽  
X Ray ◽  
Total Hip ◽  
Mechanical Complications ◽  
National Patient

Adverse events in total hip replacement (THR) may have several origins, one being lack of precision in diagnosis and/or during surgery. This study describes the pattern and frequency of avoidable injuries in THR and the potential value of a new tool for early diagnosis of implant loosening. This retrospective study was based on all (n = 1 456) settled claims regarding THR in the Swedish National Patient Insurance database from 2010 to 2017. The claims and medical records were analyzed for root causes, with special focus on adverse events where lack of precision could be the cause. In a second stage, we assessed in 10 patients (20 implants) the diagnostic precision of a new software tool based on provocation-CT. These were all patients where the implant loosening diagnosis was deemed as inconclusive after a first plain X-ray. The findings from the provocation-CT and plain X-ray were compared to the surgical findings at revision. While 3 of 20 implants were correctly diagnosed with plain X-ray, for dynamic CT, this number was 14 of 20 implants. The retrospective study showed that the most common types of injuries were infections (34%), nerve injury (29%), mechanical problems (14.5%), dislocation (6%), and miscellaneous complications (16.5%). Of the patients with mechanical complications, one-third had aseptic implant loosening. Statement of clinical significance: we estimated that almost 200 patients in our registry study had mechanical complications after THR, mainly implant loosening. A third of these could potentially have been diagnosed and treated if CT examination with a dedicated image analysis tool to assess implant loosening after THR had been available.

Predicting early post-chemotherapy adverse events in patients with hematological malignancies: a retrospective study

2016 ◽  
Vol 24 (6) ◽  
pp. 2727-2733
Author(s):  
Xiaoming Fei ◽  
Fang Lei ◽  
Haifeng Zhang ◽  
Hua Lu ◽  
Yan Zhu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Adverse Events ◽  
Hematological Malignancies

scholarly journals GCT-08. PROTON BEAM RADIOTHERAPY FOR PEDIATRIC AND YOUNG-ADULT PATIENTS WITH INTRACRANIAL GERM CELL TUMOR

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii329-iii329
Author(s):  
Minako Sugiyama ◽  
Takayuki Hashimoto ◽  
Takashi Mori ◽  
Kazuya Hara ◽  
Yukayo Terashita ◽  
...  
Keyword(s):  
Young Adult ◽  
Adverse Events ◽  
Germ Cell ◽  
Cell Count ◽  
Proton Beam ◽  
Adult Patients ◽  
Short Term ◽  
Intracranial Germ Cell Tumor ◽  
X Ray ◽  
Proton Beam Radiotherapy

Abstract BACKGROUND To reduce treatment-related adverse events in pediatric and young-adult patients with brain tumors, proton beam radiotherapy (PBT) has recently been performed instead of conventional X-ray radiotherapy. However, whether PBT is as effective as X-ray radiotherapy has not been sufficiently investigated, especially in patients receiving whole-ventricular irradiation. METHODS We report a retrospective observation of 15 patients with intracranial germ cell tumors (GCT), who received PBT at our institution from April 2014 to September 2019. We evaluated their clinical course, short-term adverse events, and prognosis. RESULTS/ CONCLUSION Fifteen patients (9 males and 6 females; median age 13 years) who received PBT following induction chemotherapy were analyzed. Nine patients received 23.4–27.0 GyE of whole-ventricular irradiation due to GCT in the pituitary gland, pineal body, or hypothalamic area. Three patients received 23.4 GyE of whole-brain irradiation: one of them had boost irradiation for basal ganglia. Three patients received 30.6 GyE of craniospinal irradiation (CSI). Six of the 15 patients experienced nausea (grade 2, according to the CTCAE version 4.0). Four patients, including two who received CSI, showed myelosuppression: decrease in white blood cell count, lymphocyte cell count, and neutrophil count (grade 3). No other severe short-term adverse events of >grade 2 was observed in any of the patients. At a median follow-up of 21 months (2-62 months) after irradiation. all patients are alive without recurrence. Our results may be encouraging and further investigations with a larger scale is warranted.

scholarly journals AB0799 REAL-WORLD EXPERIENCE OF SECUKINUMAB FOR PSORIATIC ARTHRITIS WITH AXIAL INVOLVEMENT.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1699.3-1699
Author(s):  
M. Martin Lopez ◽  
B. Joven-Ibáñez ◽  
J. L. Pablos
Keyword(s):  
Psoriatic Arthritis ◽  
Adverse Events ◽  
Real World ◽  
Spinal Pain ◽  
Tender Joint Count ◽  
P Value ◽  
X Ray ◽  
Activity Assessment ◽  
Real World Setting ◽  
Axial Involvement

Background:Evidence on the efficacy of biologics in the treatment of psoriatic arthritis (PsA) patients with axial manifestations affecting 30-70% of PsA patients is limited. Secukinumab (SEC) has provided significant and sustained improvement in the signs and symptoms of active PsA and ankylosing spondylitis.Objectives:This study aims to analyze the experience of using SEC for PsA patients with axial involvement in real-world setting.Methods:Multicentric observational, longitudinal, retrospective study conducted in a tertiary hospital between January 2016 and December 2019. Patients with PsA (CASPAR criteria) and clinical and/or image diagnosis of axial involvement receiving at least one dose of SEC were included. Patients with non-pathological sacroiliacs x-ray and MRI had to have spinal pain VAS ≥4/10 after failure to NSAIDs, prior to the onset of SEC, to be included. Medical records were reviewed to collect demographic and clinical data, features of PsA (manifestations, treatments and activity assessment). Descriptive statistics and then a comparative analysis with the Studentt-test to analyze the effectiveness of SEC were performed.Results:Of 98 PsA patients treated with SEC, 58 (59.2%) had axial involvement, of which 41 (71%) female. Mean age was 54 y.o (SD 10) and average duration of the disease was 10 years (SD 8). All 58 patients had peripheral disease (33% joint erosions), 55 (95%) had psoriasis, 20 (34%) showed dactilitis and 39 (67%) had enthesitis. Sacroiliacs x-ray was damaged in 38 (66%) patients (grade I-IV) and 23 (40%) pathological MRI, with HLAB27+ at 8 (14%) patients. Average BMI was 29 (SD 8), with an obesity rate of 33% (19 pt). Observed comorbidities were hypertension (27 pt, 47%), diabetes mellitus (6 pt, 10%), dyslipidemia (23 pt, 40%), active smoking (18 pt, 31%) and malignancy (6 pt, 10%). Regarding previous treatments, 90% had received cDMARDs, particularly methotrexate (86%) and 40 (69%) had been exposed to at least one bDMARD (15 pt to one, 9 to two, 6 to three and 10 to four or more). 7 patients were on 300 mg dose and 51 patients on 150 mg dose (dose escalation to 300 mg was performed in 16 patients and 44% respond and maintain SEC). Average drug survival time was 1.4 (SD 1) years. At 6 months of SEC therapy, tender and swollen joint count, spinal pain VAS, CRP, ASDAS-CRP and DAPSA had significantly decreased (Table 1). 29 (50%) patients suspended SEC during follow-up due to primary ineffectiveness (8), secondary ineffectiveness (16), adverse events (3), latex allergy (1) and remission (1). Adverse events do not differ from those reported in clinical trials.Table 1.Disease activity assessment at 6 months of secukinumab therapy.Baseline6 months after SECMean differenceP valueSJC4,8±5,41,9±3,1-2,8 (IC95% -3,9 a -1,7)p<0,0001TJC7,7±5,83,9±4,1-3,8 (IC95% -5,1 a -2,4)p<0,0001Spinal pVAS6,1±3,24,2±2,9-1,9 (IC95% -2,4 a -1,4)p<0,0001CRP (mg/L)7,7±9,94,9±5,9-2,9 (IC95% -4,5 a -1,2)p=0,0009ASDAS-CRP2,5±1,91,8±1,3-0,7 (IC95% -0,9 a -0,4)p<0,0001DAPSA27,7±12,116,7±10,4-11 (IC95% -15,3 a -6,8)p<0,0001SJC: swollen joint count, TJC: tender joint count, Spinal pVAS: spinal pain visual analog scale, CRP: C-reactive protein, SEC: secukinumab.Conclusion:Secukinumab in real-world setting provided improvements in the axial and peripheral manifestations of PsA, using both the 150 mg and 300 mg doses.Disclosure of Interests:MARIA MARTIN LOPEZ: None declared, Beatriz Joven-Ibáñez Speakers bureau: Abbvie, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, José Luis Pablos: None declared

scholarly journals Are the First and Second Hip in Staged Bilateral Total Hip Arthroplasty Equal? A Hospital Adverse Event and Perioperative Risk Comparison

2021 ◽  
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Carlos A. Higuera ◽  
Juan C. Suarez ◽  
Preetesh D. Patel ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Adverse Events ◽  
Hip Arthroplasty ◽  
Retrospective Chart Review ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Exact Test ◽  
Total Hip ◽  
Discharge Disposition ◽  
The Mean

AbstractHospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second. Level of Evidence Level III.

scholarly journals 3D Ore Characterization as a Paradigm Shift for Process Design and Simulation in Mineral Processing

2021 ◽  
Author(s):  
Pratama Istiadi Guntoro ◽  
Yousef Ghorbani ◽  
Jan Rosenkranz
Keyword(s):  
Process Design ◽  
Paradigm Shift ◽  
Mineral Processing ◽  
Analysis Tool ◽  
Micro Computed Tomography ◽  
X Ray ◽  
Automated Mineralogy ◽  
Process Mineralogy ◽  
The Common ◽  
Ore Characterization

AbstractCurrent advances and developments in automated mineralogy have made it a crucial key technology in the field of process mineralogy, allowing better understanding and connection between mineralogy and the beneficiation process. The latest developments in X‑ray micro-computed tomography (µCT) have shown a great potential to let it become the next-generation automated mineralogy technique. µCT’s main benefit lies in its capability to allow 3D monitoring of the internal structure of the ore sample at resolutions down to a few hundred nanometers, thus excluding the common stereological error in conventional 2D analysis. Driven by the technological and computational progress, µCT is constantly developing as an analysis tool and successively it will become an essential technique in the field of process mineralogy. This study aims to assess the potential application of µCT systems, for 3D ore characterization through relevant case studies. The opportunities and platforms that µCT 3D ore characterization provides for process design and simulation in mineral processing are presented.

Refining Dual-Energy X-Ray Absorptiometry data to predict mortality among cirrhotic outpatients: A retrospective study

Nutrition ◽  
2020 ◽  
pp. 111132
Author(s):  
Lívia Alves Amaral Santos ◽  
Talles Bazeia Lima ◽  
Xingshun Qi ◽  
Sérgio Alberto Rupp de Paiva ◽  
Fernando Gomes Romeiro
Keyword(s):  
Retrospective Study ◽  
Dual Energy ◽  
X Ray

Tocilizumab in Giant Cell Arteritis: A Multicenter Retrospective Study of 34 Patients

2016 ◽  
Vol 43 (8) ◽  
pp. 1547-1552 ◽  
Author(s):  
Alexis Régent ◽  
Serge Redeker ◽  
Alban Deroux ◽  
Pierre Kieffer ◽  
Kim Heang Ly ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Adverse Events ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study ◽  
Efficacy And Safety ◽  
Severe Adverse Events ◽  
Retrospective Multicenter Study

Objective.To report the efficacy and safety of tocilizumab (TCZ) for giant cell arteritis (GCA).Methods.A retrospective multicenter study that included 34 patients receiving TCZ for GCA.Results.TCZ was effective in all but 6 patients, who still had mild symptoms. Mean glucocorticoid dose was tapered. One patient died and 3 patients had to stop TCZ therapy because of severe adverse events. Twenty-three patients stopped treatment; 8 of these experienced relapses after a mean of 3.5 ± 1.3 months.Conclusion.TCZ is effective in GCA. However, side effects occur. Whether this treatment has only a suspensive effect remains to be determined.

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