High Failure Rates of Locking Compression Plate Osteosynthesis with Transverse Fracture around a Well-Fixed Stem Tip for Periprosthetic Femoral Fracture

This study investigated the incidence of failure after locking compression plate (LCP) osteosynthesis around a well-fixed stem of periprosthetic femoral fractures (PFFs). We retrospectively evaluated outcomes of 63 Vancouver type B1 and C PFFs treated with LCP between May 2001 and February 2018. The mean follow-up duration was 47 months. Only patients with fracture fixation with a locking plate without supplemental allograft struts were included. We identified six periprosthetic fractures of proximal Vancouver B1 fractures with spiral pattern (Group A). Vancouver B1 fractures around the stem tip were grouped into seven transverse fracture patterns (Group B) and 38 other fracture patterns such as comminuted, oblique, or spiral (Group C). Vancouver C fractures comprised 12 periprosthetic fractures with spiral, comminuted, or oblique patterns (Group D). Fracture healing without complications was achieved in all six cases in Group A, 4/7 (57%) in Group B, 35/38 (92%) in Group C, and 11/12 (92%) in Group D, respectively. The failure rates of transverse Vancouver type B1 PFFs around the stem tip were significantly different from those of Vancouver type B1/C PFFs with other patterns. For fracture with transverse pattern around the stem tip, additional fixation is necessary because LCP osteosynthesis has high failure rates.

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FUNCTIONAL OUTCOME FOLLOWING ANATOMICAL LOCKING COMPRESSION PLATE BY OPEN TECHNIQUE AND MINIMAL INVASIVE PERCUTANEOUS OSTEOSYNTHESIS (MIPO) TECHNIQUE IN MID SHAFT CLAVICLE FRACTURE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i10.612 ◽

2019 ◽

Vol 3 (10) ◽

Author(s):

Dr. Rahul Bade ◽

Dr. Sanjay S. More ◽

Dr. Divyang Parmar

Keyword(s):

Operative Time ◽

Clavicle Fracture ◽

Minimal Invasive ◽

Locking Compression Plate ◽

Age Group ◽

Open Technique ◽

Compression Plate ◽

Group A ◽

The Mean ◽

Group B

INTRODUCTION: Clavicle fractures are common injuries in adults, accounting for 5% of all fractures and 44% of all shoulder fractures. Furthermore, there is an increasing incidence of complex fracture patterns after high-energy trauma. Incidence in males is usually highest in second and third decade which decreases thereafter as per age. Clavicles mid shaft fractures have classically been treated non-operatively. However, factors including severity of displacement, degree of comminution, and greater than 2 cm of shortening have been reported in the literature to predispose patients to unsatisfactory outcomes with non-operative treatment. Minimally invasive surgery is increasingly being used for the treatment of mid shaft clavicle fracture. The two most commonly used implant are titanium elastic nail (TEN) and locking compression plate (LCP). Minimally invasive percutaneous plate osteosynthesis (MIPPO) is widely used for long bone fracture. MATERIAL AND METHODS: The patients were selected randomly and were divided in the following two groups of 15 patients each: Group A: 15 patients treated by anatomical locking compression plate (LCP) by open technique. Group B: 15 patients treated by minimal invasive percutaneous osteosynthesis (MIPO) technique. Follow up period were 1 months, 2months and 6months. Functional outcome was evaluated using the constant shoulder score, which is scored from 0 to 100, with a lower score representing a higher level of functional disability. RESULTS: Majority of the patients (40%) in Group A were in the age group of 31-40 years followed by 26.7% in the age group of 21-30 years, 20% in the age group 41-50 years and 13.3% in the age group of 51-60 years. The mean age of the patients was 36.2 ± 9.09 years. Majority of the patients in both groups were male. There were 80% and 73.3% male patients in Group A and Group B respectively whereas female patients constituted 20% and 26.7% of the study group respectively. In Group A, 7 (46.7%) patients had operative time of 80-100 minutes whereas 6 (40%) and 2 (13.3%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 104.9 ± 13.52mins. In Group B, 6 (40%) patients had operative time of 80-100 minutes whereas 8 (53.4%) and 1 (6.6%) patients had operative time of 100-120 and 120-140 minutes respectively. The mean operative time was 106.5 ± 11.72mins. There was no significant association between the groups as per Student t-test (p>0.05). CONCLUSION: Operative treatment with a LCP for clavicle shaft fractures can be used to obtain stable fixation. Particularly, MIPPO of displaced mid shaft clavicular fractures resulted in a better cosmetic than conventional open reduction, although the functional outcomes were no different between the two groups.

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Outcome of Dynamic Condylar Screw with Plate versus Distal Femoral Lock Compression Plate Fixation in Fracture of Distal Femur

Medicine Today ◽

10.3329/medtoday.v33i01.52159 ◽

2021 ◽

Vol 33 (1) ◽

pp. 45-49

Author(s):

Md Gulam Mustofa ◽

Chowdhury Foyzur Rob ◽

Md Kamrul Alam ◽

Akhlas Bhuiyan ◽

Habibur Rahman Chowdhury ◽

...

Keyword(s):

Functional Outcome ◽

Distal Femur ◽

Plate Fixation ◽

Lock Compression Plate ◽

Locking Compression Plate ◽

Plate Versus ◽

Dynamic Condylar Screw ◽

Compression Plate ◽

Group A ◽

Group B

Introduction: The dynamic compression screw with plate implant used to treat fractures of the distal femur. The distal femoral lock compression plate fixation is designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. The objective of the study is to compare the outcome of DF-LCP and DCS fixation in distal femoral fractures. Materials and Methods: This prospective comparative study was conducted in the Department of Orthopaedics, Sylhet MAG Osmani Medical College Hospital, Sylhet between January 2011 and December 2012. Thirty patients with AO type 33-B and 33-C fracture were selected and were divided randomly into group-A and group-B by odd and even number. Dynamic condylar screw (DCS) fixation was used in group-A and distal femoral locking compression plate (DF-LCP) fixation in group-B. Results: DCS group [9 male, 6 female; mean age, 44.9 ± 12.9 years] and DF-LCP group [10 male, 5 female; mean age, 42.6 ± 15.7) years] were similar in age (p=0.660) and sex (p=0.705). The total operation (minutes) [92.3 ± 7.5 versus 90.4 ± 6.9; p=0.484], length of postoperative hospital stay (days) [6.0 ± 0.9 versus 5.9 ± 0.9; p=0.695] and union time (weeks) [20.6 ± 5.0 versus 18.7 ±3.3 weeks; p=0.238] did not differ significantly between two groups. Total complications [6 (40.0%) versus 4 (26.7%); p=0.439] was also similar in both groups. Functional outcome was excellent in 13.3%, good in 33.3%, fair in 33.3% and poor in 20.0% cases in DCS group; while excellent in 53.3%, good in 20.0% fair in 6.7% and poor in 20.0% of cases in DF-LCP group; different was not significant (p=0.080). Conclusion: Dynamic condylar screw with plate and distal femoral locking compression plate fixation are equally effective for achieving satisfactory union and functional outcome in AO type 33-B, 33-C fracture distal femur. Medicine Today 2021 Vol.33(1): 45-49

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Survival of classic swine fever virus in hams made from the meat of pigs vaccinated with the PAV-250 strain and unvaccinated pigs

Revista Mexicana de Ciencias Pecuarias ◽

10.22319/rmcp.v10i3.4528 ◽

2019 ◽

Vol 10 (3) ◽

pp. 536-551

Author(s):

Heidi Amezcua Hempel ◽

María Salud Rubio Lozano ◽

Eliseo Manuel Hernández Baumgarten ◽

Pablo Correa Girón † ◽

Oscar Torres Ángeles ◽

...

Keyword(s):

Reference Strain ◽

Clinical Signs ◽

Classical Swine Fever ◽

Fever Virus ◽

Direct Immunofluorescence ◽

Biometric Analysis ◽

Treatment Groups ◽

Group A ◽

Group B ◽

Group D

The study was to determine the presence of Classical Swine Fever virus (CSFv), in the meat of vaccinated pigs with the PAV-250 strain and then challenged using the same strain. Five treatment groups were established (each with four pigs). Group A: Pigs thatwere fed with processed hams from negative animals; Group B: Pigs that were fed with processed hams from commercial pigs inoculated with the ALD (reference strain) (titre of 104.0/ml); Group C: Pigs fed with processed hams from pigs infected with the virulent ALD strain (titre of 102.5/ml); Group D: Pigs fed with processed hams from pigs vaccinated with the PAV-250 strain and challenged with the ALD strain (titre of 101.1/ml); and Group E: Pigs fed with processed hams from pigs vaccinated with two doses of the PAV-250 strain and challenged with the ALD strain (negative). Blood samples were taken at d 1, 5, 10, 15 and 20 for biometric analysis. Groups B, C and D manifested clinical signs of CSFv: 40 °C temperature, anorexia, paralysis, vomiting, diarrhea, tremor, hirsute hair and cyanosis. Pigs were slaughtered and necropsies performed to identify lesions in tissues. Results of direct immunofluorescence testing of tissues were positive and the virus was recovered. Under these study conditions, it was found that CSFv resisted the cooking method at 68 °C for 40 min in hams from unvaccinated pigs, and that the virus was able to transmit the disease to healthy unvaccinated pigs, whereas the hams from the vaccinated animals did not transmit the virus.

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The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽

10.1159/000517180 ◽

2021 ◽

pp. 1-9

Author(s):

Serdar Sahin ◽

Havva Sezer ◽

Ebru Cicek ◽

Yeliz Yagız Ozogul ◽

Murat Yildirim ◽

...

Keyword(s):

Clinical Outcomes ◽

Health Care Providers ◽

Study Groups ◽

Normal Weight ◽

Overweight And Obesity ◽

Care Providers ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D

Introduction: The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. Methods: We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. Results: There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). Conclusion: COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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AB0422 LEFT VENTRICULAR ABNORMALITIES IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS FOLLOWED BY SEQUENTIAL ECHOCARDIOGRAPHY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1941 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1510.1-1511

Author(s):

T. Kuga ◽

M. Matsushita ◽

K. Tada ◽

K. Yamaji ◽

N. Tamura

Keyword(s):

Lupus Erythematosus ◽

Systolic Dysfunction ◽

Left Ventricular ◽

Monocyte Count ◽

Lv Dysfunction ◽

Group A ◽

Group B ◽

Lv Diastolic Dysfunction ◽

Group D

Background:Cardiovascular disease (CVD) is detected in up to 50% of systemic lupus erythematosus (SLE) patients1and major cause of death2. Even clinically silent SLE patients can develop left ventricular (LV) diastolic dysfunction3. Proper echocardiographic follow up of SLE patients is required.Objectives:To clarify how the prevalence of LV abnormalities changes over follow-up period and identify the associated clinical factors, useful in suspecting LV abnormalities.Methods:29 SLE patients (24 females and 5 men, mean age 52.8±16.3 years, mean disease duration 17.6±14.5 years) were enrolled. All of them underwent echocardiography as the baseline examination and reexamined over more than a year of follow-up period(mean 1075±480 days) from Jan 2014 to Sep 2019. Patients complicated with pulmonary artery hypertension, deep venous thrombosis or pulmonary embolism and underwent cardiac surgery during the follow-up period were excluded. Left ventricular(LV) systolic dysfunction was defined as ejection fraction (EF) < 50%. LV diastolic dysfunction was defined according to ASE/EACVI guideline4. LV dysfunction (LVD) includes one or both of LV systolic dysfunction and LV diastolic function. Monocyte to HDL ratio (MHR) was calculated by dividing monocyte count with HDL-C level.Prevalence of left ventricular abnormalities was analysed at baseline and follow-up examination. Clinical characteristics and laboratory data were compared among patient groups as follows; patients with LV dysfunction (Group A) and without LV dysfunction (Group B) at the follow-up echocardiography, patients with LV asynergy at any point of examination (Group C) and patients free of LV abnormalities during the follow-up period (Group D).Results:At the baseline examination, LV dysfunction (5/29 cases, 13.8%), LV asynergy (6/29 cases, 21.7%) were detected. Pericarditis was detected in 7 patients (24.1%, LVD in 3 patients, LV asynergy in 2 patients) and 2 of them with subacute onset had progressive LV dysfunction, while 5 patients were normal in echocardiography after remission induction therapy for SLE. At the follow-up examination, LV dysfunction (9/29 cases, 31.0%, 5 new-onset and 1 improved case), LV asynergy (6/29 cases, 21.7%, 2 new-onset and 2 improved cases) were detected. Though any significant differences were observed between Group A and Group B at the baseline, platelet count (156.0 vs 207.0, p=0.049) were significantly lower in LV dysfunction group (Group A) at the follow-up examination. Group C patients had significantly higher uric acid (p=0.004), monocyte count (p=0.009), and MHR (p=0.003) than Group D(results in table).Conclusion:LV dysfunction is progressive in most of patients and requires regular follow-up once they developed. Uric acid, monocyte count and MHR are elevated in SLE patients with LV asynergy. Since MHR elevation was reported as useful marker of endothelial dysfunction5, our future goal is to analyse involvement of monocyte activation and endothelial dysfunction in LV asynergy of SLE patients.References:[1]Doria A et al. Lupus. 2005;14(9):683-6.[2]Manger K et al. Ann Rheum Dis. 2002 Dec;61(12):1065-70.[3]Leone P et al. Clin Exp Med. 2019 Dec 17.[4]Nagueh SF et al. J Am Soc Echocardiogr. 2016 Apr;29(4):277-314.[5]Acikgoz N et al. Angiology. 2018 Jan;69(1):65-70.Numbers are median (interquartile range), Mann-Whitney u test were performed, p value less than 0.05 was considered statistically significant.Disclosure of Interests: :None declared

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Prophylactic temporary abdominal aortic balloon occlusion for patients with pernicious placenta previa: a retrospective study

BMC Anesthesiology ◽

10.1186/s12871-021-01354-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fei Huo ◽

Hansheng Liang ◽

Yi Feng

Keyword(s):

Placenta Previa ◽

Balloon Occlusion ◽

Artery Embolism ◽

Abdominal Aortic ◽

Significant Difference ◽

Group A ◽

Group B ◽

Clinical Records ◽

Group D ◽

Central Placenta Previa

Abstract Background Pernicious placenta previa (PPP) can increase the risk of perioperative complications. During caesarean section in patients with adherent placenta, intraoperative blood loss, hysterectomy rate and transfusion could be reduced by interventional methods. Our study aimed to investigate the influence of maternal hemodynamics control and neonatal outcomes of prophylactic temporary abdominal aortic balloon (PTAAB) occlusion for patients with pernicious placenta previa. Methods This was a retrospective study using data from the Peking University People’s Hospital from January 2014 through January 2020. Clinical records of pregnant women undergoing cesarean section were collected. Patients were divided into two groups: treatment with PTAAB placement (group A) and no balloon placement (group B). Group A was further broken down into two groups: prophylactic placement (Group C) and balloon occlusion (group D). Results Clinical records of 33 cases from 5205 pregnant women underwent cesarean section were collected. The number of groups A, B, C, and D were 17, 16, 5 and 12.We found that a significant difference in the post-operative uterine artery embolism rates between group A and group B (0% vs.31.3%, p = 0.018). There was a significant difference in the Apgar scores at first minute between group A and group B (8.94 ± 1.43 vs 9.81 ± 0.75,p = 0.037),and the same significant difference between two groups in the pre-operative central placenta previa (29.4% vs. 0%,p = 0.044), complete placenta previa (58.8% vs 18.8%, p = 0.032),placenta implantation (76.5% vs 31.3%, p = 0.015). We could also observe the significant difference in the amount of blood cell (2.80 ± 2.68vs.10.66 ± 11.97, p = 0.038) and blood plasma transfusion (280.00 ± 268.32 vs. 1033.33 ± 1098.20, p = 0.044) between group C and group D. The significant differences in the preoperative vaginal bleeding conditions (0% vs 75%, p = 0.009), the intraoperative application rates of vasopressors (0% vs. 58.3%, p = 0.044) and the postoperative ICU (intensive care unit) admission rates (0% vs. 58.3%, p = 0.044) were also kept. Conclusions PTAAB occlusion could be useful in reducing the rate of post-operative uterine artery embolism and the amount of transfusion, and be useful in coping with patients with preoperative vaginal bleeding conditions, so as to reduce the rate of intraoperative applications of vasopressors and the postoperative ICU (intensive care unit) admission. In PPP patients with placenta implantation, central placenta previa and complete placenta previa, we advocate the utilization of prophylactic temporary abdominal aortic balloon placement.

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Biomechanical study of Tile C3 pelvic fracture fixation using an anterior internal system combined with sacroiliac screws

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02348-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Lin Liu ◽

Donggui Zeng ◽

Shicai Fan ◽

Yongxing Peng ◽

Hui Song ◽

...

Keyword(s):

Minimally Invasive ◽

Steel Plate ◽

Standing Position ◽

Pelvic Fractures ◽

Internal Fixator ◽

Sacroiliac Joints ◽

Sacroiliac Screws ◽

Group A ◽

Group B ◽

Group D

Abstract Background How to perform minimally-invasive surgery on Tile C pelvic fractures is very difficult, and it is also a hot topic in orthopedic trauma research. We applied minimally-invasive treatment using an anterior internal fixator combined with sacroiliac screws. Objectives To compare the biomechanical properties of different fixation models in pelvic facture specimens, using an internal fixation system or a steel plate combined with sacroiliac screws. Methods Sixteen fresh adult cadaver pelvic specimens were randomly separated into four groups named A, B, C, and D. The four groups were respectively stabilized using a two-screwed, three-screwed, or four-screwed anterior internal fixator or a steel plate with sacroiliac screws. All models were tested in both standing and sitting positions. Vertical loads of 600 N were applied increasingly. Shifts of bilateral sacroiliac joints and pubis rupture were measured. Results The shifts in sacroiliac joints and pubis rupture in the standing position were all less than 3.5 mm, and the shifts in the sitting position were all less than 1 mm. In the standing position, the results of shifts in the sacroiliac joints were group C < group D < group B < group A. For comparisons between A:B and C:D, P > 0.05. For comparisons between A, B:C, and D, P < 0.05. The results of shifts in pubis ruptures were group D < group C < group B < group A. In the comparison between C:D, P > 0.05; for comparisons between A:B, A:C, A:D, B:C, and B:D, P < 0.05. In the sitting posture, the results of shifts in the sacroiliac joints were group C < group D < group B < group A, and the shifts in the pubis ruptures were group D < group C < roup B < group A. For comparison between C:D, P > 0.05. For comparisons between A:B, A:C, A:D, B:C, and B:D, P < 0.05. Conclusion Use of an anterior internal fixator combined with sacroiliac screws effectively stabilized Tile C3 pelvic fractures. The stability of specimens increased as the number of screws in the internal fixator increased.

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Hematological Features in Sheep with IgG and IgM Antibodies against Borrelia burgdorferi sensu lato

Pathogens ◽

10.3390/pathogens10020164 ◽

2021 ◽

Vol 10 (2) ◽

pp. 164

Author(s):

Labrini V. Athanasiou ◽

Victoria M. Spanou ◽

Eleni G. Katsogiannou ◽

Panagiotis D. Katsoulos

Keyword(s):

Borrelia Burgdorferi ◽

Rural Areas ◽

Blood Analysis ◽

Borrelia Burgdorferi Sensu Lato ◽

Igm Antibodies ◽

Group A ◽

Group B ◽

Group D ◽

Immunofluorescence Antibody

Exposure of sheep to Borreliaburgdorferi sensulato (s.I.) complex, the causative agent of Lyme borreliosis (LB), has been reported in tick-abundant areas worldwide, while no data have been reported in Greece. The aim of the study was to identify the hematological alterations in sheep with seropositivity against Borrelia burgdorferi (s.I.). Blood samples were obtained from 318 tick infested sheep for blood analysis and serological determination of IgG and IgM antibodies against B. burgdorferi by indirect immunofluorescence antibody (IFA) assay after exclusion of endo-ectoparasites and other tick-borne infections. A total number of 162 sheep met the inclusion criteria, allocated in four groups based on the presence or absence of IgG and/or IgM; sheep found negative for IgM and IgG (Group A), positive for IgM (Group B), positive for both IgM and IgG (Group C) and positive for IgG (Group D). Anemia, thrombocytopenia and normal or decreased leukocyte count, mainly due to lymphopenia were the main hematological features observed in seropositive sheep. The presence of these features raises the suspicion of Borrelia infection in tick infested sheep. The seropositivity of 23.58% in sheep raises concerns of Borrelia circulation, especially in rural areas and potential risk of transmission to humans.

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POS0563 THE NATURAL COURSE OF RHEUMATOID ARTHRITIS-ASSOCIATED INTERSTITIAL LUNG DISEASE FOCUSING ON LUNG PHYSIOLOGY AND DISEASE ACTIVITY: A PROSPECTIVE COHORT STUDY (PART 2)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3084 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 516.1-516

Author(s):

S. H. Chang ◽

J. S. Lee ◽

C. H. Park ◽

M. U. Kim ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Natural Course ◽

Annual Change ◽

Low Disease Activity ◽

Activity Group ◽

Lung Physiology ◽

Group A ◽

Group B ◽

Group D

Background:Interstitial lung disease (ILD) is a severe extra-articular manifestation of rheumatoid arthritis (RA). However, the effect of RA disease activity on the course of ILD is not yet known.Objectives:To assess the natural course of lung physiology of RA-ILD and the relation between arthritis activity and pulmonary physiology in patients with RA-ILD.Methods:The Korean Rheumatoid Arthritis ILd (KORAIL) cohort is the prospective observational cohort and aims to investigate the natural course of RAILD. Based on either 1987 or 2020 ACR criteria, patients diagnosed with RA and ILD based on CT scan were recruited from six tertiary medical hospitals in Korea since January 2015. RA disease activity was assessed using disease activity (DAS)28-ESR and CRP, annually. Pulmonary function tests (PFT), including FVC and DLCO were conducted annually. According to the transition of DAS28-ESR status, we classified patients into four groups: Group A. persistent remission or low disease activity, Group B. improvement, Group C. worsening, Group D. persistent moderate to high disease activity.Results:We analyzed 143 patients who completed a 2-year follow-up (visit 2) or had died with available PFT results at least twice. Mean duration since RA diagnosis and since ILD diagnosis was 7.6±8.0 and 2.7±3.1 years, respectively. Twenty-four patients were Group A, 33 Group B, 10 Group C and 30 Group D. The mean of FVC (mL) and % of the predicted value in FVC was significantly lower in Group D than in other groups (Table 1). The annual rate of decline in FVC was -42 (95% CI -93~10) mL·year-1 in Group B while -113 (95% CI -206~-21) mL·year-1 in Group C (Figure 1A). The annual decline rate in Group C was further exaggerated in patients with ≥ 80% of FVC predicted (-141, 95% CI -251~-32 mL·year-1). During two years of follow-up, patients ever experienced a relative decline of ≥10% from the enrollment in FVC predicted was 27.3%(n-9/33) in Group B whereas 30.0% (3/10) in Group C. The annual rate of decline in % of DLco predicted value was also the largest in Group C (-4.6 %·year-1, 95%CI -8.5~-0.7), which further exaggerated in patients with ≥ 80% of FVC predicted (-4.9%·year-1, 95 %CI -8.3~-1.5, Figure 1B). Of note, about half of patients with maintained not only low disease activity (Group A) but also moderate to severe disease activity (Group D) improved in DLco at least 10% or more from the enrollment of DLco predicted value (Group A: 54.2%, n=13/24, Group D: 46.7%, n=14/30).Conclusion:RA disease activity is associated with the change of lung physiology in patients with RA-ILD; worsening disease activity associated with a further decrease of annual change in FVC and maintaining low disease activity associated with a further increase of annual change in % of DLco predicted value.Table 1.The analysis of forced vital capacity (FVC) according to disease activity transition group.Group AGroup BGroup CGroup DFVC (mL), mean±SD2810.0±771.12528.8±735.32801.0±952.72048.3±575.7FVC % of predicted, mean±SD87.5±14.586.5±16.693.0±15.677.2±17.3Rate of FVC decline, mL·year-1 (95% CI)-52 (-112,7)-42 (-93,10)-113 (-206, -21)1 (-52, 54)A 10-point decline from V1 in predicted FVC value, n (%)29 (20.3)6 (25.0)6 (18.2)3 (30.0)Relative decline of 10% from the enrollment in predicted FVC value, n (%)35 (24.5)5 (20.8)9 (27.3)3 (30.0)Figure 1.The annual change of pulmonary physiology according to disease activity transition group.Acknowledgements:This work was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant no.HI14C1277).Disclosure of Interests:None declared

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Incidence of Bacteriuria after Urodynamic Study with or without Antibiotic Prophylaxis in Women with Urinary Incontinence

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0037-1604066 ◽

2017 ◽

Vol 39 (10) ◽

pp. 534-540 ◽

Cited By ~ 5

Author(s):

Elizabeth Hirakauva ◽

Ana Bianchi-Ferraro ◽

Eliana Zucchi ◽

Marcio Kajikawa ◽

Manoel Girão ◽

...

Keyword(s):

Urinary Incontinence ◽

Placebo Group ◽

Urinary Tract ◽

Antibiotic Prophylaxis ◽

Urine Culture ◽

Placebo Control ◽

Urodynamic Study ◽

Group A ◽

Group B ◽

Group D

Introduction The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study. Methods Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS. Results We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria. We didn't observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group. Conclusion The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.

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