Peculiarities of knee replacement in patients with rheumatoid arthritis

Introduction. Rheumatoid arthritis (RA), as a steadily progressive disease leading to joint destruction and functional instability of the knee joints, often requires orthopedic correction.The aim. Of the review was to analyze the surgery strategy and technical features of knee arthroplasty and replacement in patients with RA.Basic provisions. RA is characterized by a number of abnormalities not only due to erosive arthritis and active persistent synovitis, but also caused by a decrease in bone mineral density, damage to the periarticular structures and patella, the formation of bone defects, as well as a high risk of postoperative complications. All these factors should be taken into account while choosing relevant surgical treatment and knee replacement technique. The article presents the optimal approaches for performing knee replacement in RA patients, taking into account the peculiarities of the existing structural and functional disorders.Conclusion. TEC in patients with RA requires a personalized approach based on evaluation of disease-associated risk factors affecting the results of orthopedic correction and the likelihood of complications.

P-L17 Post-liver transplant inferior vena cava stenosis in a large volume UK centre

Background Inferior vena cava stenosis (IVCS) is a rare complication of liver transplantation with a reported incidence rate of 3%. Limited clinical consensus exists on the management of IVCS. We report the management and outcomes of patients with IVCS at our transplant centre. Methods Relevant data were collected from adult patients who underwent liver transplantation at our centre between October 2014 and August 2020. These included demographics, investigation and management details with regards to IVCS. Values presented as % of total and median with interquartile range (IQR). Results A total of 636 liver transplants were performed during the study period, of which 48 (7.6%) patients were investigated for possible IVCS. Of those, 14 (2.2% of total) were found to have IVCS, 85.7% (n = 12) were female. Only 2/14 were re-transplants and pre-transplant portal vein thrombus was present in 3 cases (21.4%). 10 livers (71.4%) were DBD donors. Normothermic machine perfusion was used in 4/14 patients. All 14 recipients found to have IVCS had had an implantation using a modified piggyback cavocavostomy technique. The IVCS was identified at a median of 25.5 days (19.7-30.8 days) following transplantation within the suprahepatic IVC in 92.9% (n = 13). Hemi-azygos collateralisation was seen in 4 cases (28.6%). 8 of the 14 recipients underwent intervention for IVCS, 6 patients were managed with balloon venoplasty, 1 patient required an IVC stent and 1 was managed surgically. Six of the recipients with IVCS died, 4 of whom had an intervention for their stenosis and 3 of these were within 90 days of their transplant. Pressures measured at the anastomotic stricture were higher in those who succumbed (median of 21 Vs 12.5 mmHg; p=.017). Conclusions At our centre, cava-replacement technique was not associated with IVCS. Patients with more significant strictures (as evidenced by higher pressures at the anastomotic stenosis) may have an increased mortality risk.

Nearly Reversible ECG Steganography based on Polar Coordinate System with Digital Replacement Technique

In this paper, we present a nearly reversible data hiding for electrocardiogram (ECG) hosts. Based on the polar coordinate system domain, medical diagnosis and personal data can be embedded in an ECG signal by the simple digital replacement technique. Simulations revealed that the restored ECG with near lossless quality can be obtained by the proposed method at receiver site. In addition, the perceived quality of the marked ECG is very good with a high payload size. Moreover, the resultant signal-to-noise ratio (SNR), peak SNR, and payload of the proposed method outperforms those of existing techniques. Since the computation cost is low, the proposed method can be used in portable biometrics or ECG measuring instruments.

Scientific insights of electrochemical replacement approach to describe the origin of Pre-Columbian Peruvian gilded copper-based objects

Pre-Columbian Peruvian goldsmiths developed gilded copper-based objects by ancient techniques that require identification to propose conservation strategies. Lechtman H, conducted experiments to suggest that the electrochemical replacement was the gilding technique used by the Moche and Vicus cultural groups. Despite her remarkable achievement, the quantitative data provided by her is still open to discussion. This work focused on obtaining experimental data to recreate her protocol by introducing less gold precursor. Polished copper pieces were plated with an adherent gold film of up to 7.5 µm after immersing them into an electrolytic solution for 3 min and 6 min at 80 °C. Our results demonstrated that the electrochemical replacement technique gives rise to anodic regions in the plated objects. Further studies around the corrosion process that undergoes these heritage objects in burial and environmental conditions are suggested to determine their deterioration rate. Moreover, electroless and galvanic techniques should be explored in order to improve current approaches.

Several characterizations of Bessel functions and their applications

The present work deals with the mathematical investigation of some generalizations of Bessel functions. The main motive of this paper is to show that the generating function can be employed efficiently to obtain certain results for special functions. The complex form of Bessel functions is introduced by means of the generating function. Certain enthralling properties for complex Bessel functions are investigated using the generating function method. By considering separately the real and the imaginary part of complex Bessel functions, we get respectively cosine-Bessel functions and sine-Bessel functions for which several novel identities and Jacobi–Anger expansions are established. Also, the generating function of degenerate Bessel functions is investigated and certain novel identities are obtained for them. A hybrid form of degenerate Bessel functions, namely, of degenerate Fubini–Bessel functions, is constructed using the replacement technique. Finally, the explicit forms of the real and the imaginary part of complex Bessel functions are established by a hypergeometric approach.

Settlement Analysis of Treated Soft Clay using LECA Replacement through Numerical Modelling

Soil replacement technique is the simplest and oldest way in improving the soft soil under the shallow foundations. The process started by taking or removing the un-wanted problematic part of soils and replacing it with other efficient materials. Therefore, this study conducted to analyse on the soft soil replacement using Lightweight Expanded Clay Aggregate (LECA) as a filling material instead of common aggregate. LECA has been widely used in geotechnical application as the materials were successfully recognized in minimising the dead loads by more than half. The settlement magnitude of treated soft soil with LECA replacement was analysed through finite element method by using PLAXIS 2D commercial software. The prediction graph for various internal friction angle has been developed for settlement estimation The graph was then validated using developed Settlement Prediction Model, analytical equations, and numerical analysis. Another finding from this study is a decrease in the magnitude of the settlement as the internal friction angle of LECA increases.

A clinical case of replacing an opacified intraocular lens in avitreal eye

Purpose. Using a clinical example, to analyze the possible causes of opacity of the Hydro-4 Aspheric IOL (Rumex, Great Britain). Materials and methods. Patient K., 32 years old, underwent the surgery for tractional retinal detachment in both eyes, which arose against the background of proliferative diabetic retinopathy of the retina. A history of type 1 diabetes mellitus from the age of 9. The visual acuity of both eyes before surgery was 0.03 n/k. Microinvasive (25G) vitrectomy with silicone oil tamponade of the vitreous cavity was performed. The second stage of surgical treatment is the removal of silicone oil from the vitreous cavity and phacoemulsification of cataract with partial excision of the posterior lens capsule with IOL implantation into the capsule bag of both eyes. A Hydro-4 Aspheric IOL (Rumex, UK) was implanted in the right eye, and Aspira-aAy (HumanOptic AG, Germany) – in the left one. After 3 months, on examination, attention was drawn to the diffuse opacity of the IOL of the right eye. The visual acuity was 0.01 n/k. The IOL replacement technique was as follows. Viscoelastic was injected into the anterior chamber and into the capsule bag through corneal paracentesis at 10 and 2 o'clock. The lens was dislocated into the anterior chamber and cut in half with vitreal scissors. The cut parts of the IOL were removed through a 2.2 mm tunnel at 12 o'clock. The Tecnis lens (AMO, USA) was chosen for implantation. Results and discussion. There was an increase in uncorrected visual acuity up to 0.4. There were no intra- and postoperative complications such as hemorrhagic, inflammatory, and also any from the cornea. The question remains open why, with the same tactics of the first two stages of surgical treatment of both eyes and implantation of lenses made of hydrophilic acrylic, only one IOL became cloudy. Accounting for the materials from which the IOL is made, which lens model is better to prefer to this day remains an urgent and unresolved problem for ophthalmic surgeons. Conclusion. The presence of a concomitant diabetes mellitus in the patient could influence the development of opacification of the hydrophilic acrylic IOL. Key words: IOL opacity, hydrophilic acrylic, IOL explantation, avitria.

Narrative interviews to assess quality of life in Peritoneal Dialysis

It has been found that people undergoing dialysis have a lower quality of life than the rest of the population. The aim of dialysis is to improve physical health, but also well-being. We were interested in the perception of the quality of life of patients undergoing Peritoneal Dialysis. We used the narrative interview method to collect their feelings, their daily experience, and their impressions about their care. We conducted four in-depth interviews, following the principle of theoretical data saturation, with adults treated at the Hospital of Nice. These interviews indicated that Peritoneal Dialysis rapidly improves physical and emotional health. Patients are satisfied with the technique, which allows them to return to a social, familial, and professional life. However, they regret that it does not relieve them of dietary restrictions, especially on salt. Patients appreciate the temporary support of a private nurse, which is systematically offered by our center at the beginning of treatment. They wish the involvement of peers to benefit from their experience, explanations and practical demonstrations. Quality of life is important to assess when choosing a renal replacement technique. Caregivers have to understand patients’ expectations and wishes in order to guide them towards the dialysis modality that suits their lifestyle and preferences best. This will improve treatment outcomes.