scholarly journals Conservative Kinematic Alignment Strategies Report Higher Incidence of Mid-Term Pain Following TKA: a Retrospective Study

10.29007/h2mv ◽  
2019 ◽  
Author(s):  
Edgar Wakelin ◽  
Joshua Twiggs ◽  
Brett Fritsch ◽  
Michael Solomon ◽  
Brad Miles
Keyword(s):  
Retrospective Study ◽  
Patient Outcomes ◽  
Ct Scans ◽  
Kinematic Alignment ◽  
Mechanical Alignment ◽  
Coronal Alignment ◽  
Improved Outcomes ◽  
High Level ◽  
Postoperative Knee ◽  
State Score

Kinematic alignment (KA) aims to restore the pre-arthritic geometry of the joint and has been shown to produce similar or improved outcomes compared to mechanical alignment (MA). However, there are significant challenges when attempting to restore outlier joint anatomy. This study sought to investigate how achieved TKA alignment correlates with 12 month patient outcomes. The study considered three categories of achieved TKA alignments: KA, MA, or conservative KA (restricting coronal component alignments to within 5° and combined coronal alignment to within 3° of neutral). 369 patients were analysed; each patient had pre- and post-operative CT scans and a 12-month postoperative Knee Osteoarthritis & Outcome Score (KOOS). From CT scans, component positions were measured, and patients were categorized to one of the three categories. The conservative KA group were least likely (76%) to reach the threshold KOOS Pain score set by the Patient Acceptable State Score (PASS); the full KA group was most likely (95%) to reach the threshold, whilst the MA group was in between these two groups (88%). These results demonstrated an increase in pain when the achieved alignment formed a compromise between a restorative and a reconstructive approach, and further suggests that conservative approaches to kinematic alignment may require a high level of discretion.

scholarly journals Fluorescence-Guided Surgery in the Surgical Treatment of Gliomas: Past, Present and Future

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3508
Author(s):  
Rosa Sun ◽  
Hadleigh Cuthbert ◽  
Colin Watts
Keyword(s):  
Surgical Treatment ◽  
Surgical Resection ◽  
Patient Outcomes ◽  
Aminolevulinic Acid ◽  
Guided Surgery ◽  
Improved Outcomes ◽  
Fluorescence Guided Surgery ◽  
Central Nervous Systems ◽  
Extent Of Surgical Resection ◽  
Disease Free

Gliomas are central nervous systems tumours which are diffusely infiltrative and difficult to treat. The extent of surgical resection is correlated with improved outcomes, including survival and disease-free progression. Cancerous tissue can be directly visualised intra-operatively under fluorescence by administration of 5-aminolevulinic acid to the patient. The adoption of this technique has allowed surgeons worldwide to achieve greater extents of resection, with implications for improved prognosis. However, there are practical limitations to use of 5-aminolevulinic acid. New adjuncts in the field of fluorescence-guided surgery aim to improve recognition of the interface between tumour and brain with the objective of improving resection and patient outcomes.

EP.FRI.390 Improving care for patients with acute bowel obstruction: A closed loop audit

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Benjamin Clayphan ◽  
Anna Fairclough ◽  
Jeff Lim ◽  
Roderick Alexander
Keyword(s):  
Ct Scan ◽  
Patient Outcomes ◽  
Bowel Obstruction ◽  
Care Pathway ◽  
Imaging Modality ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Retrospective Audit ◽  
Raising Awareness ◽  
Time To Diagnosis

Abstract Aims Acute Bowel Obstruction (ABO) accounts for 10% of emergency surgical admissions and when surgery is required mortality can exceed 10%. Early diagnosis is associated with improved patient outcomes and timely acquisition of abdominal CT scans can help prevent delays. The NCEPOD 2020 report on ABO identified ‘delays in imaging’ as a key area for improvement in the care of these patients, with these delays being exacerbated if an abdominal X-ray (AXR) was performed as well as an abdominal CT. This study looks at ways to expedite the diagnosis of patients presenting with ABO.   Methods A retrospective audit of 77 patients admitted from A&E or SAU with ABO from April 2019 to February 2020 was conducted. Imaging modality, time-to-CT scan and time-to-diagnosis was recorded. Results and recommendations were presented locally and an evidence based ABO care pathway was implemented and publicised. 20 patients were audited prospectively, post care pathway implementation.  Results 70.1% of patients from the initial audit received a CT-scan and 42% of these patients received an AXR before their eventual CT-scan. The average wait for a definitive radiological diagnosis was 27.8hr. After implementation of the pathway only 18% of patients audited received both modes of imaging and the average time to diagnosis has been reduced to 10.7hr.  Conclusions Raising awareness of the appropriate and timely use of CT-scans in the diagnosis of ABO has reduced the number of concomitant AXR for these patients, expediting the making of a definitive diagnosis and improving patient outcomes. 

scholarly journals Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation

2013 ◽  
Vol 53 (1) ◽  
pp. 6
Author(s):  
Indah Nurhayati ◽  
Muhammad Supriatna ◽  
Kamilah Budhi Raharjani ◽  
Eddy Sudijanto
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Study ◽  
Pleural Effusion ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Patient Outcomes ◽  
Morbidity And Mortality ◽  
Chi Square ◽  
X Ray ◽  
Chest X Ray

Background Most infants and children admitted to the pediatricintensive care unit (PICU) have respiratory distress and pulmonarydisease as underlying conditions. Mechanical ventilation may beused to limit morbidity and mortality in children with respiratoryfailure.Objective To assess a correlation between chest x-ray findingsand outcomes of patients with mechanical ventilation.Methods This retrospective study was held in Dr. KariadiHospital, Semarang, Indonesia. Data was collected from themedical records of children admitted to the PICU from Januaryto December 2010, who suffered from respiratory distress andused mechanical ventilation. We compared chest x-ray findings tothe outcomes of patients. Radiological expertise was provided byradiologists on duty at the time. Chi-square and logistic regressiontests were used for statistical analysis.Results There were 63 subjects in our study, consisting of 28 malesand 35 females. Patient outcomes were defined as survived or died,43 subjects ( 68%) and 20 subjects (3 2%), respectively. Chest x-rayfindings revealed the following conditions: bronchopneumonia48% (P=0.298; 95%CI 0.22 to 1.88), pleural effusion 43%(P=0.280; 95%CI 0.539 to 4.837) , pulmonary edema 6%(P=0.622; 95%CI 0.14 to 14.62) and atelectasis 3% (P=0.538;95%CI 0.03 to 7 .62). None of the chest x-ray findings significantlycorrelated to patient outcomes.Conclusion Chest x-ray findings do not correlate to patientoutcomes in pediatric subjects with mechanical ventilation inthe PICU of Dr. Kariadi Hospital, Semarang, Indonesia.

scholarly journals Chest x-ray findings and outcomes of children with suspected ventilator .. associated pneumonia

2012 ◽  
Vol 52 (4) ◽  
pp. 233
Author(s):  
Neni Sumarni ◽  
Muhammad Sholeh Kosim ◽  
Mohammad Supriatna ◽  
Eddy Sudijanto
Keyword(s):  
Retrospective Study ◽  
Patient Outcomes ◽  
Pulmonary Infection ◽  
Ventilator Associated Pneumonia ◽  
Chi Square ◽  
X Ray ◽  
Chest X Ray ◽  
Hospital Acquired ◽  
Pediatric Icu ◽  
The Relationship

Background Ventilator􀁖associated pneumonia (VAP) is anosocomial infection in patients who have received mechanicalventilation (MV), either by endotracheal intubation ortracheostomy, for more than 48 hours. YAP represents 80% ofall hospital􀁖acquired pneumonias. VAP incidence varies from5.1 %􀁖33.3%. The modified clinical pulmonary infection scoreis a criteria for diagnosing suspected YAP and typically includesradiographic evidence. YAP is associated with significantmorbidity and mortality.Objective To determine the relationship between chest x􀁖rayfindings and outcomes in children Mth suspected VAP.Methods This retrospective study was held in Dr. Kariadi Hospitalfrom January - December 2010. Data was collected from medicalrecords of pediatric ICU (PICU) patients with suspected VAP.Chest x􀁖ray findings and patient outcomes were recorded. X􀁖rayfindings were assessed by the on􀁖duty radiologist. Chi square testwas used for statistical analysis.Results Subjects were 30 children consisting of 14 males and 16females. Patient outcomes were 23 patients survived and 7 patientsdied. Chest x􀁖ray findings were categorized into the followinggroups and compared to patient survivability: diffuse infiltrates76.7% (OR􀁗0.694; P􀁗0.532; 95% CI 0.102 to 4.717), localhedinfiltrates 13.3% (OR􀁗4.200; P􀁗 0.225; 95% CI 0.470 t037.49),and no infiltrates 10% (OR􀁗 1.222; P􀁗 0.436; 95% CI 0.593 to0.926). None of the x􀁖ray findings had a significant correlationto patient outcomes.Conclusion There was no significant relationship between chestx􀁖ray findings and outcomes in children with suspected VAP.[Paediatr rndones. 2012;52:233-8].

scholarly journals Peculiarities of pregnansy and childbirth in patients with a burdened gynecological anamnesis

2020 ◽  
Vol 5 ◽  
pp. 5-10
Author(s):  
T. P. Andriichuk ◽  
A. Ya. Senchuk ◽  
V. I. Chermak
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Pregnant Women ◽  
Postpartum Period ◽  
Control Group ◽  
Careful Monitoring ◽  
Pregnancy And Childbirth ◽  
History Of ◽  
High Level ◽  
Adaptive Reactions

The objective: to study the features of pregnancy, childbirth, postpartum period, fetal status and newborns in patients with a history of chronic salpingo-оophoritis.Materials and methods. Conducted a retrospective study of 150 birth histories and neonatal development maps. All patients were divided into two groups. The main group includes 100 patients with chronic salpingo-оophoritis, for which they received anti-inflammatory treatment from 1 to 3 times before pregnancy. The control group included 50 pregnant women who did not suffer from chronic salpingo-оophoritis.Results. Our analysis of pregnancy, childbirth, fetal and neonatal status in women with chronic salpingo-оophoritis indicates that such patients have a complicated obstetric and gynecological and somatic history, which forms an unfavorable basic condition of organs and systems, imperfect adaptation to pregnancy, high risk of failure of adaptive reactions. The result is a violation of the formation and development of the mother-placenta-fetus system and, as a consequence, a high level of complications during pregnancy, childbirth and perinatal pathology.Conclusion. Patients suffering from chronic salpingo-oophoritis should be considered at high risk of possible complications during pregnancy and childbirth. This category of women needs quality preconception training and careful monitoring during pregnancy.

scholarly journals Gene expression–based discovery of atovaquone as a STAT3 inhibitor and anticancer agent

Blood ◽  
2016 ◽  
Vol 128 (14) ◽  
pp. 1845-1853 ◽  
Author(s):  
Michael Xiang ◽  
Haesook Kim ◽  
Vincent T. Ho ◽  
Sarah R. Walker ◽  
Michal Bar-Natan ◽  
...  
Keyword(s):  
Gene Expression ◽  
Retrospective Study ◽  
Human Plasma ◽  
Patient Outcomes ◽  
Anticancer Agent ◽  
Plasma Concentrations ◽  
Anticancer Efficacy ◽  
Key Points

Key PointsThe FDA-approved drug atovaquone is a novel, clinically available inhibitor of STAT3 at standard human plasma concentrations. Atovaquone shows anticancer efficacy in vitro, in vivo, and in a retrospective study of AML patient outcomes after atovaquone treatment.

Family interventions in psychosis

2020 ◽  
pp. 531-537
Author(s):  
Juliana Onwumere ◽  
Elizabeth Kuipers
Keyword(s):  
Patient Outcomes ◽  
Family Involvement ◽  
Lived Experiences ◽  
Treatment Guidelines ◽  
Well Being ◽  
Evidence Base ◽  
Family Interventions ◽  
Improved Outcomes ◽  
The Impact

Families can play an important role in supporting individuals living with psychosis disorders and helping to facilitate their improved outcomes. This chapter, offered by Juliana Onwumere and Elizabeth Kuipers, provides an overview of the literature reporting on family involvement in the care of adults with lived experiences of psychosis, the impact of the caregiving role on carer well-being, and the predictive links between caregiving relationships and key patient outcomes including relapse. The chapter reports on the application of family interventions, the evidence base supporting its application and inclusion in treatment guidelines, and implementation issues.

scholarly journals Comparison of Kinematic Alignment and Mechanical Alignment in Total Knee Arthroplasty: A Meta‐analysis of Randomized Controlled Clinical Trials

2020 ◽  
Vol 12 (6) ◽  
pp. 1567-1578
Author(s):  
Zhi‐xiang Gao ◽  
Neng‐ji Long ◽  
Shao‐yun Zhang ◽  
Wei Yu ◽  
Yi‐xin Dai ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Kinematic Alignment ◽  
Mechanical Alignment ◽  
Controlled Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Total Knee

The Colectomy Improvement Project: Do Evidence-Based Guidelines Improve Institutional Colectomy Outcomes?

2016 ◽  
Vol 82 (9) ◽  
pp. 830-834 ◽  
Author(s):  
Danny Mammo ◽  
Claire Peeples ◽  
Marc Grodsky ◽  
Drew Honaker ◽  
Harry Wasvary
Keyword(s):  
Patient Outcomes ◽  
Educational Intervention ◽  
Best Practice ◽  
Improvement Project ◽  
Best Practice Guidelines ◽  
Improved Outcomes ◽  
Practice Parameters ◽  
Surgical Infections ◽  
Specific Practice ◽  
Evidence Based Guidelines

This study evaluates whether increased adherence to eight specific practice parameters leads to improved outcomes in patients undergoing elective colorectal resections. In addition, we analyzed whether physicians with better compliance achieved better patient outcomes. Compliance to practice parameters and subsequent outcomes were compared between two groups relative to an educational intervention promoting the eight best practice guidelines selected. A total of 485 patients were identified over a 4-year period and were separated into a pre- (n = 273) and post-education (n = 212) group. After the educational intervention, there was increased compliance in five of the eight practice parameters ( P < 0.05). When outcomes where examined, the readmission rate (2.4% vs 8.4%; P = 0.005) and the incidence of deep surgical infections (0% vs 1.8%; P = 0.01) were significantly decreased when comparing the posteducational group to that of the group before intervention. A lower rate of anastomotic leaks were identified in the posteducation group, but this did not reach significance (1.9% vs 5.1%; P = .09). When analyzed individually, the most compliant physicians achieved better patient outcomes than their peers. Education of the operative team improved adherence to practice parameters and this may have contributed to improving patient outcomes.

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