Introduction and Historical Overview

2015 ◽  
Author(s):  
John Goodfellow ◽  
John O'Connor ◽  
Hemant Pandit ◽  
Christopher Dodd ◽  
David Murray
Keyword(s):  
Common Sense ◽  
Large Body ◽  
Lateral Compartment ◽  
Partial Replacement ◽  
Osteoarthritis Of The Knee ◽  
Main Indication ◽  
Replacement Surgery ◽  
Common Causes ◽  
Bicompartmental Arthroplasty

Osteoarthritis of the knee is one of the most common causes of painful loss of mobility in middle-aged and elderly people in many populations and is the main indication for knee replacement surgery. From the early days of arthroplasty, it was recognised that arthritis was often limited to the medial (or lateral) compartment of the knee and, in the pioneering operation of MacIntosh 1 , metal spacers could be used in one compartment or both. Gradually, however, as the advantages of bicompartmental arthroplasty were appreciated, unicompartmental (or partial) replacement was less and less practised, and in some countries almost disappeared. With the introduction of tricompartmental replacement, a large body of surgical opinion concluded that osteoarthritis of the knee was a disease of the whole joint (like osteoarthritis of the hip) and that common sense required the replacement of all the articular surfaces to provide long-term relief of symptoms.

Mechanical Choices

2020 ◽  
Author(s):  
Michael S. Moore
Keyword(s):  
Common Sense ◽  
Legal Punishment ◽  
Common Causes ◽  
Moral Blame ◽  
The Brain ◽  
Common Sense Psychology

This book assays how the remarkable discoveries of contemporary neuroscience impact our conception of ourselves and our responsibility for our choices and our actions. Dramatic (and indeed revolutionary) changes in how we think of ourselves as agents and as persons are commonly taken to be the implications of those discoveries of neuroscience. Indeed, the very notions of responsibility and of deserved punishment are thought to be threatened by these discoveries. Such threats are collected into four groupings: (1) the threat from determinism, that neurosciences shows us that all of our choices and actions are caused by events in the brain that precede choice; (2) the threat from epiphenomenalism, that our choices are shown by experiment not to cause the actions that are the objects of such choice but are rather mere epiphenomena, co-effects of common causes in the brain; (3) the threat from reductionist mechanism, that we and everything we value is nothing but a bunch of two-valued switches going off in our brains; and (4) the threat from fallibilism, that we are not masters in our own house because we lack the privileged knowledge of our own minds needed to be such masters. The book seeks to blunt such radical challenges while nonetheless detailing how law, morality, and common-sense psychology can harness the insights of an advancing neuroscience to more accurately assign moral blame and legal punishment to the truly deserving.

Infective endocarditis in patients who use IV drugs: a single centre cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Alraddadi ◽  
A Alsagheir ◽  
S Gao ◽  
K An ◽  
H Hronyecz ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Long Term Outcomes ◽  
Replacement Surgery ◽  
Short Term Mortality ◽  
History Of ◽  
Short And Long Term ◽  
Baseline Characteristics

Abstract Background Managing endocarditis in intravenous drug use (IVDU) patients is challenging: unless patients successfully quit IVDU, the risk of re-infection is high. Clinicians often raise concerns with ethical and resource allocation principles when considering valve replacement surgery in this patient population. To help inform practice, we sought to determine the long-term outcomes of IVDU patients with endocarditis who underwent valve surgery in our center. Method After research ethics board approval, infective endocarditis cases managed surgically at our General Hospital between 2009 and 2018 were identified through the Cardiac Care Network. We reviewed patients' charts and included those with a history of IVDU in this study. We abstracted data on baseline characteristics, peri-operative course, short- and long-term outcomes. We report results using descriptive statistics. Results We identified 124 IVDU patients with surgically managed endocarditis. Mean age was 37 years (SD 11), 61% were females and 8% had redo surgery. During admission, 45% (n=56) of the patients had an embolic event: 63% pulmonary, 30% cerebral, 18% peripheral and 11% mesenteric. Causative organisms included Methicillin-Sensitive Staphylococcus Aureus (51%, n=63), Methicillin-Resistant Staphylococcus Aureus (15%, n=19), Streptococcus Viridans (2%, n=2), and others (31%, n=38). Emergency cardiac surgery was performed for 42% of patients (n=52). Most patients (84%) had single valve intervention: 53% tricuspid, 18% aortic and 13% mitral. Double valve interventions occurred in 15% (n=18). Overall, bioprosthetic replacement was most commonly chosen (79%, n=98). In-hospital mortality was 7% (n=8). Median length of stay in hospital was 13 days (IQR 8,21) and ICU 2 days (IQR 1,6). Mortality at longest available follow-up was 24% (n=30), with a median follow-up of 129 days (IQR 15,416). Valve reintervention rate was 11% (n=13) and readmission rate was 14% (n=17) at a median of 275 days (IQR 54,502). Conclusion Despite their critical condition, IVDU patients with endocarditis have good intra-hospital outcomes. Challenges occur after hospital discharge with loss of follow-up and high short-term mortality. IVDU relapse likely accounts for some of these issues. In-hospital and community comprehensive addiction management may improve these patients' outcomes beyond the surgical procedure. Annual rate 2009–2018 Funding Acknowledgement Type of funding source: None

scholarly journals Long-term Survival of Dialysis Patients With Bacterial Endocarditis Undergoing Valvular Replacement Surgery in the United States

Circulation ◽  
2013 ◽  
Vol 128 (4) ◽  
pp. 344-351 ◽  
Author(s):  
Maxwell D. Leither ◽  
Gautam R. Shroff ◽  
Shu Ding ◽  
David T. Gilbertson ◽  
Charles A. Herzog
Keyword(s):  
United States ◽  
The United States ◽  
Bacterial Endocarditis ◽  
Dialysis Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Replacement Surgery ◽  
Valvular Replacement

Urinary Diversions and Bladder Replacement Surgery: Evolution, Current Situation and Long-Term Outcomes

2012 ◽  
Vol 79 (19_suppl) ◽  
pp. 41-45
Author(s):  
Dario Fontana ◽  
Andrea Buffardi ◽  
Paolo Destefanis
Keyword(s):  
Current Situation ◽  
Long Term Outcomes ◽  
Replacement Surgery ◽  
Bladder Replacement

Long-Term Experience with Biocompatible Ossicular Implants

1986 ◽  
Vol 94 (6) ◽  
pp. 611-616 ◽  
Author(s):  
John R. Emmett ◽  
John J. Shea ◽  
William H. Moretz
Keyword(s):  
Chronic Otitis Media ◽  
Hearing Results ◽  
Common Causes ◽  
Ossicular Replacement ◽  
Stapes Prosthesis ◽  
Short And Long Term ◽  
Conductive Hearing ◽  
Long Term Experience

The senior author's 8-year personal experience with biocompatible ossicular implants is reviewed. Four hundred sixty-one consecutive operations, in which high-density polyethylene sponge ossicular replacement prostheses were used, are grouped according to the Bellucci classification of chronic otitis media. The prostheses used were the drum-to-footplate prosthesis (TORP, total) and the drum-to-stapes prosthesis (PORP, partial)*. Each group's short- and long-term hearing results are compared. Prosthesis extrusion and persistent or recurrent conductive hearing loss are the most common causes of operation failure. Failures within each group are analyzed, and techniques to prevent these complications are outlined.

Long-Term Results after Silicone Prosthesis Replacement of the Proximal Pole of the Scaphoid Bone in Advanced Scaphoid Nonunion

2002 ◽  
Vol 27 (5) ◽  
pp. 417-423 ◽  
Author(s):  
P. HAUSSMANN
Keyword(s):  
Scaphoid Fracture ◽  
Long Term Results ◽  
Partial Replacement ◽  
Scaphoid Bone ◽  
Proximal Fragment ◽  
Carpal Collapse ◽  
X Ray ◽  
Silicone Prosthesis ◽  
Prosthesis Replacement

The treatment of scaphoid fracture nonunion with a small proximal fragment with disturbed circulation and radioscaphoid arthrosis is difficult, and the result is often unsatisfactory. For this reason, in 1981 the replacement of the proximal fragment by a silicone lunate prosthesis was recommended for such cases. From 1980 to 1984, 11 patients (all male, average age 42 [range, 25–59] years) with the conditions described above were treated by silicone prosthesis partial replacement of the scaphoid. In one patient, the prosthesis had to be removed due to dislocation, and in another patient an arthrodesis of the wrist had to be carried out after 5 years due to increasing pain. All nine remaining patients were followed up after an average of 14 (range, 12–16) years, and were clinically and radiologically re-examined and assessed using the evaluation scheme proposed by Martini (1999) . The overall results were satisfactory. Specifically, the outcome was good in one case, satisfactory in six cases, and poor in two cases. Concerning the individual criteria, the best scores were observed in “subjective overall assessment” and in “work and sports”, whilst the worst were found in “movement” and “X-ray”. For all patients, X-ray examination revealed both postoperative arthrosis and extensive multiple cystoid osteolysis, presumably due to silicone synovitis. Nevertheless, most patients were free of symptoms. None of the patients felt that further treatment was necessary. Silicone prosthesis partial replacement of the scaphoid leads to long-term reduction in pain and adequate hand function. However, it is not capable of preventing carpal collapse and carpal arthrosis. Furthermore, since in several cases a progressive silicone synovitis developed, the method was rightly abandone d after 1984.

Tibiofemoral Contact Measures During Standing in Toe-In and Toe-Out Postures

2021 ◽  
pp. 1-7
Author(s):  
Michael A. Hunt ◽  
Christopher K. Cochrane ◽  
Andrew M. Schmidt ◽  
Honglin Zhang ◽  
David J. Stockton ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Contact Area ◽  
Lateral Compartment ◽  
Neutral Position ◽  
Joint Loading ◽  
Tibiofemoral Joint ◽  
Magnetic Resonance Scanner ◽  
Short And Long Term ◽  
Healthy Participants

Knee osteoarthritis is thought to result, in part, from excessive and unbalanced joint loading. Toe-in and toe-out gait modifications produce alterations in external knee joint moments, and some improvements in pain over the short- and long-term. The aim of this study was to probe mechanisms of altered joint loading through the assessment of tibiofemoral contact in standing with toe-in and toe-out positions using an open magnetic resonance scanner. In this study, 15 young, healthy participants underwent standing magnetic resonance imaging of one of their knees in 3 foot positions. Images were analyzed to determine contact in the tibiofemoral joint, with primary outcomes including centroid of contact and contact area for each compartment and overall. The centroid of contact shifted laterally in the lateral compartment with both toe-in and toe-out postures, compared with the neutral position (P < .01), while contact area in the medial and lateral compartments showed no statistical differences. Findings from this study indicate that changes in the loading anatomy are present in the tibiofemoral joint with toe-in and toe-out and that a small amount of lateralization of contact, especially in the lateral compartment, does occur with these altered lower limb orientations.

Modernity and the classical Theory of Democracy

2007 ◽  
Vol 28 (1) ◽  
pp. 9-38
Author(s):  
Raymond Boudon
Keyword(s):  
Classical Theory ◽  
Common Sense ◽  
Adam Smith ◽  
Good Sense ◽  
General Will ◽  
Impartial Spectator ◽  
Political Consensus ◽  
Theory Of Democracy

The classical theory of democracy starts from a model where good sense and common sense play a major role, as the notions of the “impartial spectator" (Adam Smith) or the “general will” (Jean-Jacques Rousseau) show, among others. These notions are indispensable to explain many social and political phenomend of our time: phenomena of political consensus on given issues or of short, mid and long-term moral, political, institutional and social evoltion.

Long-term fasting and realimentation in hypogean and epigean isopods: a proposed adaptive strategy for groundwater organisms

2002 ◽  
Vol 205 (14) ◽  
pp. 2079-2087 ◽  
Author(s):  
Frédéric Hervant ◽  
David Renault
Keyword(s):  
Metabolic Response ◽  
Large Body ◽  
Adaptive Strategy ◽  
Energy System ◽  
Adaptive Responses ◽  
Rapid Restoration ◽  
Surface Dwelling ◽  
Unpredictable Environment ◽  
Lipid Stores

SUMMARYThe effects of long-term fasting and subsequent refeeding on digestive physiology and energy metabolism were investigated in a subterranean aquatic crustacean, Stenasellus virei, and in a morphologically similar surface-dwelling species, Asellus aquaticus. Metabolic response to food deprivation was monophasic in A. aquaticus, with an immediate,large decrease in all energy reserves. In contrast, S. vireidisplayed three successive periods of phosphageno-glucidic, lipidic and,finally, proteo-lipidic-dominant catabolism over the course of the nutritional stress. To represent the responses of subterranean crustaceans to food stress and renutrition, a sequential energy strategy was hypothesized, suggesting that four successive phases (called stress, transition, adaptation and recovery) can be distinguished. Based on these results, a general adaptive strategy for groundwater organisms was proposed. Their remarkable resistance to long-term fasting may be partly explained by (1) a depressed metabolism,during which they mainly subsist on lipid stores, (2) a prolonged state of glycogen- and protein-sparing, (3) low energetic requirements and (4) large body stores. In addition, these groundwater species displayed high recovery abilities during refeeding, showing an optimal utilization of available food and a rapid restoration of their body reserves. These adaptive responses might be considered for numerous subterranean organisms as an efficient energy-saving strategy in a harsh and unpredictable environment where fasting(and/or hypoxic) periods of variable duration alternate with sporadic feeding events (and/or normoxic periods). Therefore, food-limited and/or hypoxia-tolerant groundwater species appear to be good examples of animals representing a low-energy system.

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