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[PMID]:29505518
[Au] Autor:Zhang S; Huang Q; Xu B; Ma J; Cao G; Pei F
[Ad] Endereço:Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Título:Effectiveness and safety of an optimized blood management program in total hip and knee arthroplasty: A large, single-center, retrospective study.
[So] Source:Medicine (Baltimore);97(1):e9429, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Little has been published on blood management in total hip and knee arthroplasty (THA and TKA, respectively) patients focusing on both hematopoiesis and hemostasis. Our aim was to explore the effectiveness and safety of an optimized blood management program in THA and TKA patients in a large, single-center, retrospective study.We retrospectively reviewed consecutive primary unilateral THA and TKA patients' data at our institution through the National Health Database. They were divided into 3 groups according to an optimized blood management program: group A-combined use of intravenous and topical tranexamic acid (TXA); group B-use of recombinant human erythropoietin (rHuEPO) and iron supplements in addition to treatments in group A; group C-use of additional multiple boluses of TXA in addition to treatments in group B. The primary outcomes were hemoglobin (Hb) drop and calculated total blood loss (TBL). Other outcome measurements such as transfusion rate, postoperative length of stay (PLOS), venous thromboembolism (VTE), and mortality were also compared.From 2014 to 2016, a total of 1907 unilateral THA (986 in group A, 745 in group B, and 176 in group C) and 1505 unilateral TKA (795 in group A, 556 in group B, and 154 in group C) procedures were conducted at our institution. The Hb drop, calculated TBL, and PLOS in group C were significantly lower than those in groups A and B for THA and TKA patients. The transfusion rate in group C was also significantly less than in groups A and B for THA patients, while it was similar in groups A and B for TKA patients. No patients in group C received a transfusion. A significant difference was not detected in the incidence of deep vein thrombosis. No episode of symptomatic pulmonary embolism or all-cause mortality occurred within 30 days postoperatively.The current retrospective study suggests that for patients receiving primary unilateral THA or TKA, multiple boluses of intravenous TXA combined with topical TXA, rHuEPO, and iron supplements can reduce the calculated TBL, Hb drop, transfusion rate, and PLOS without increasing the incidence of VTE or mortality.
[Mh] Termos MeSH primário: Anemia/tratamento farmacológico
Antifibrinolíticos/administração & dosagem
Perda Sanguínea Cirúrgica/prevenção & controle
Eritropoetina/uso terapêutico
Ferro/uso terapêutico
Oligoelementos/uso terapêutico
Ácido Tranexâmico/administração & dosagem
[Mh] Termos MeSH secundário: Administração Intravenosa
Administração Tópica
Adulto
Idoso
Anemia/etiologia
Artroplastia de Quadril/efeitos adversos
Artroplastia do Joelho/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Proteínas Recombinantes/uso terapêutico
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 0 (Recombinant Proteins); 0 (Trace Elements); 11096-26-7 (Erythropoietin); 6T84R30KC1 (Tranexamic Acid); E1UOL152H7 (Iron)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009429


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[PMID]:29240467
[Au] Autor:Schultz K; Ewbank ML; Pandit HG
[Ad] Endereço:Medical Student, Indiana University School of Medicine, Indianapolis, USA.
[Ti] Título:Changing practice for hip arthroplasty and its implications.
[So] Source:Br J Nurs;26(22):1238-1244, 2017 Dec 14.
[Is] ISSN:0966-0461
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This overview provides insight into changes in clinical practice and the implications for nursing staff and clinicians who are involved in the management of patients undergoing primary total hip arthroplasty. The review highlights commonly used surgical approaches, their advantages, their associated risks and how to manage complications if they occur.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Padrões de Prática Médica/tendências
[Mh] Termos MeSH secundário: Artroplastia de Quadril/efeitos adversos
Seres Humanos
Enfermagem Ortopédica
Complicações Pós-Operatórias/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.12968/bjon.2017.26.22.1238


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[PMID]:28470463
[Au] Autor:Hoffmeister T; Schwarze F; Aschoff HH
[Ad] Endereço:Sana Kliniken Lübeck GmbH, Kronsforder Allee 71/73, 23560, Lübeck, Deutschland.
[Ti] Título:[The endo-exo prosthesis treatment concept : Improvement in quality of life after limb amputation].
[Ti] Título:Das Endo-Exo-Prothesen-Versorgungskonzept : Verbesserung der Lebensqualität nach Extremitätenamputation..
[So] Source:Unfallchirurg;120(5):371-377, 2017 May.
[Is] ISSN:1433-044X
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Osseointegrated, percutaneous implants as the force bearer for exoprosthetics after limb amputation have been used in individual cases for clinical rehabilitation of amputees during the past years. Most experience in this field in Germany has been accumulated at the Sana Klinik in Lübeck with the so-called endo-exo prosthesis (EEP) system. The two-step implantation procedure can now be considered as reliable. Following a well-documented learning curve initial soft tissue problems concerning the cutaneous stoma can now be regarded as exceptions. The retrospective examination of the results concerning by now more than 100 patients provided with an endo-exo femoral prosthesis (EEFP) showed a very satisfying outcome concerning objective as well as subjective values, such as duration of daily use and wearing comfort of the exoprosthesis. Regaining the ability of osseoperception due to the intraosseous fixation is described by the patients as a great advantage. The step from a socket prosthesis to an EEP is felt to be a big increase in quality of life by nearly all patients included into the follow-up. Nearly all of the patients questioned would choose an endo-exo prosthesis again. Meanwhile, the success of the EEP resulted in the broadening of indications from above-knee amputations to transtibial as well as transhumeral amputations. The results are likewise encouraging. The use of EEP for the upper limbs leads to substantial improvement in the range of motion of the shoulder joint with the intramedullary anchored percutaneous implant. Furthermore, new pathbreaking possibilities in the fixation of myoelectrically controlled arm prostheses may arise from the EEP technique.
[Mh] Termos MeSH primário: Cotos de Amputação/cirurgia
Amputação/reabilitação
Artroplastia de Quadril/instrumentação
Exoesqueleto Energizado
Prótese de Quadril
Perna (Membro)/cirurgia
Qualidade de Vida/psicologia
[Mh] Termos MeSH secundário: Amputação/psicologia
Artroplastia de Quadril/métodos
Artroplastia de Quadril/psicologia
Membros Artificiais
Terapia Combinada/instrumentação
Terapia Combinada/métodos
Terapia Combinada/psicologia
Seres Humanos
Osseointegração
Desenho de Prótese
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1007/s00113-017-0350-1


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[PMID]:29341066
[Au] Autor:Yu Y; Zhang K; Zhang L; Zong H; Meng L; Han R
[Ad] Endereço:Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantan Xili, Beijing, China, 100050.
[Ti] Título:Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults.
[So] Source:Cochrane Database Syst Rev;1:CD010947, 2018 Jan 17.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay). SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 12), Embase (1974 to 20 December 2016) and MEDLINE (PubMed) (1975 to 20 December 2016). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing studies on 20 December 2016. We updated this search in November 2017, but these results have not yet been incorporated in the review. We imposed no language restriction. SELECTION CRITERIA: We included all relevant randomized controlled trials (RCTs) dealing with the use of cerebral NIRS in the perioperative setting (during the operation and within 72 hours after the operation), including the operating room, the postanaesthesia care unit and the intensive care unit. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies, assessed risk of bias and extracted data. For binary outcomes, we calculated the risk ratio (RR) and its 95% confidence interval (CI). For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. As we expected clinical and methodological heterogeneity between studies, we employed a random-effects model for analyses and we examined the data for heterogeneity (I statistic). We created a 'Summary of findings' table using GRADEpro. MAIN RESULTS: We included 15 studies in the review, comprising a total of 1822 adult participants. There are 12 studies awaiting classification, and eight ongoing studies.None of the 15 included studies considered the paediatric population. Four studies were conducted in the abdominal and orthopaedic surgery setting (lumbar spine, or knee and hip replacement), one study in the carotid endarterectomy setting, and the remaining 10 studies in the aortic or cardiac surgery setting. The main sources of bias in the included studies related to potential conflict of interest from industry sponsorship, unclear blinding status or missing participant data.Two studies with 312 participants considered postoperative neurological injury, however no pooled effect estimate could be calculated due to discordant direction of effect between studies (low-quality evidence). One study (N = 126) in participants undergoing major abdominal surgery reported that 4/66 participants experienced neurological injury with blinded monitoring versus 0/56 in the active monitoring group. A second study (N = 195) in participants having coronary artery bypass surgery reported that 1/96 participants experienced neurological injury in the blinded monitoring group compared with 4/94 participants in the active monitoring group.We are uncertain whether active cerebral NIRS monitoring has an important effect on the risk of postoperative stroke because of the low number of events and wide confidence interval (RR 0.25, 95% CI 0.03 to 2.20; 2 studies, 240 participants; low-quality evidence).We are uncertain whether active cerebral NIRS monitoring has an important effect on postoperative delirium because of the wide confidence interval (RR 0.63, 95% CI 0.27 to 1.45; 1 study, 190 participants; low-quality evidence).Two studies with 126 participants showed that active cerebral NIRS monitoring may reduce the incidence of mild postoperative cognitive dysfunction (POCD) as defined by the original studies at one week after surgery (RR 0.53, 95% CI 0.30 to 0.95, I = 49%, low-quality evidence).Based on six studies with 962 participants, there was moderate-quality evidence that active cerebral oxygenation monitoring probably does not decrease the occurrence of POCD (decline in cognitive function) at one week after surgery (RR 0.62, 95% CI 0.37 to 1.04, I = 80%). The different type of monitoring equipment in one study could potentially be the cause of the heterogeneity.We are uncertain whether active cerebral NIRS monitoring has an important effect on intraoperative mortality or postoperative mortality because of the low number of events and wide confidence interval (RR 0.63, 95% CI 0.08 to 5.03, I = 0%; 3 studies, 390 participants; low-quality evidence). There was no evidence to determine whether routine use of NIRS-based cerebral oxygenation monitoring causes adverse effects. AUTHORS' CONCLUSIONS: The effects of perioperative active cerebral NIRS monitoring of brain oxygenation in adults for reducing the occurrence of short-term, mild POCD are uncertain due to the low quality of the evidence. There is uncertainty as to whether active cerebral NIRS monitoring has an important effect on postoperative stroke, delirium or death because of the low number of events and wide confidence intervals. The conclusions of this review may change when the eight ongoing studies are published and the 12 studies awaiting assessment are classified. More RCTs performed in the paediatric population and high-risk patients undergoing non-cardiac surgery (e.g. neurosurgery, carotid endarterectomy and other surgery) are needed.
[Mh] Termos MeSH primário: Encéfalo/metabolismo
Hipóxia-Isquemia Encefálica/diagnóstico
Consumo de Oxigênio/fisiologia
Espectroscopia de Luz Próxima ao Infravermelho
[Mh] Termos MeSH secundário: Abdome/cirurgia
Adulto
Artroplastia de Quadril
Artroplastia do Joelho
Criança
Transtornos Cognitivos/prevenção & controle
Seres Humanos
Vértebras Lombares/cirurgia
Monitorização Intraoperatória
Complicações Pós-Operatórias/prevenção & controle
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010947.pub2


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Registro de Ensaios Clínicos
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[PMID]:29466159
[Au] Autor:Anderson DR; Dunbar M; Murnaghan J; Kahn SR; Gross P; Forsythe M; Pelet S; Fisher W; Belzile E; Dolan S; Crowther M; Bohm E; MacDonald SJ; Gofton W; Kim P; Zukor D; Pleasance S; Andreou P; Doucette S; Theriault C; Abianui A; Carrier M; Kovacs MJ; Rodger MA; Coyle D; Wells PS; Vendittoli PA
[Ad] Endereço:From the Departments of Medicine (D.R.A.), Surgery (M.D.), and Community Health and Epidemiology (P.A.), Dalhousie University, and the Nova Scotia Health Authority (S. Pleasance, S. Doucette, C.T., A.A.), Halifax, the Department of Surgery, University of Toronto, Toronto (J.M.), the Departments of M
[Ti] Título:Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty.
[So] Source:N Engl J Med;378(8):699-707, 2018 02 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. METHODS: We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty. All the patients received once-daily oral rivaroxaban (10 mg) until postoperative day 5 and then were randomly assigned to continue rivaroxaban or switch to aspirin (81 mg daily) for an additional 9 days after total knee arthroplasty or for 30 days after total hip arthroplasty. Patients were followed for 90 days for symptomatic venous thromboembolism (the primary effectiveness outcome) and bleeding complications, including major or clinically relevant nonmajor bleeding (the primary safety outcome). RESULTS: A total of 3424 patients (1804 undergoing total hip arthroplasty and 1620 undergoing total knee arthroplasty) were enrolled in the trial. Venous thromboembolism occurred in 11 of 1707 patients (0.64%) in the aspirin group and in 12 of 1717 patients (0.70%) in the rivaroxaban group (difference, 0.06 percentage points; 95% confidence interval [CI], -0.55 to 0.66; P<0.001 for noninferiority and P=0.84 for superiority). Major bleeding complications occurred in 8 patients (0.47%) in the aspirin group and in 5 (0.29%) in the rivaroxaban group (difference, 0.18 percentage points; 95% CI, -0.65 to 0.29; P=0.42). Clinically important bleeding occurred in 22 patients (1.29%) in the aspirin group and in 17 (0.99%) in the rivaroxaban group (difference, 0.30 percentage points; 95% CI, -1.07 to 0.47; P=0.43). CONCLUSIONS: Among patients who received 5 days of rivaroxaban prophylaxis after total hip or total knee arthroplasty, extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT01720108 .).
[Mh] Termos MeSH primário: Artroplastia de Quadril
Artroplastia do Joelho
Aspirina/uso terapêutico
Inibidores do Fator Xa/uso terapêutico
Inibidores da Agregação de Plaquetas/uso terapêutico
Complicações Pós-Operatórias/prevenção & controle
Rivaroxabana/uso terapêutico
Tromboembolia Venosa/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Aspirina/efeitos adversos
Método Duplo-Cego
Inibidores do Fator Xa/efeitos adversos
Hemorragia/induzido quimicamente
Seres Humanos
Masculino
Meia-Idade
Inibidores da Agregação de Plaquetas/efeitos adversos
Fatores de Risco
Rivaroxabana/efeitos adversos
[Pt] Tipo de publicação:EQUIVALENCE TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Factor Xa Inhibitors); 0 (Platelet Aggregation Inhibitors); 9NDF7JZ4M3 (Rivaroxaban); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1712746


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[PMID]:29390269
[Au] Autor:Wang J; Wang D; Du J; Lin Z
[Ti] Título:A new strategy to reconstruct type III acetabular bone defect associated with inflammatory pseudotumor: combined medial and lateral acetabular bone grafting: A case report.
[So] Source:Medicine (Baltimore);96(50):e8777, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Inflammatory pseudotumor has been commonly reported in patients undergoing total hip arthroplasty (THA). PATIENT CONCERNS: We reported a patient who had a massive intra-pelvic pseudotumour and acetabular bone defect underwent two-stage revision THA. DIAGNOSES: A new surgical strategy for pseudotumor after THA is performed. INTERVENTIONS: Thorough debridement intra-pelvic pseudotumour via Smith-Petersen approach, bone grafting on iliac medial surface and plate-screw internal fixation were performed in the first stage, followed by revision of the loosened prosthesis to a cementless primary prosthesis in the second stage. OUTCOMES: A follow-up for 5 years showed satisfactory recovery of function. LESSONS: This surgical revision is less invasive than conventional methods, resulting in a stable and well-functioning hip joint after mid-term follow-up for 5 years.
[Mh] Termos MeSH primário: Acetábulo/transplante
Artroplastia de Quadril/efeitos adversos
Doenças Ósseas/cirurgia
Granuloma de Células Plasmáticas/cirurgia
Ossos Pélvicos/cirurgia
[Mh] Termos MeSH secundário: Adulto
Desbridamento
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008777


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[PMID]:29377951
[Au] Autor:Kruse C; Rosenlund S; Broeng L; Overgaard S
[Ad] Endereço:Department of Orthopaedic Surgery and Traumatology, Odense University Hospital and Institute of Clinical Research, University of Southern, Odense, Denmark.
[Ti] Título:Radiographic cup position following posterior and lateral approach to total hip arthroplasty. An explorative randomized controlled trial.
[So] Source:PLoS One;13(1):e0191401, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The two most common surgical approaches to total hip arthroplasty are the posterior approach and lateral approach. The surgical approach may influence cup positioning and restoration of the offset, which may affect the biomechanical properties of the hip joint. The primary aim was to compare cup position between posterior approach and lateral approach. Secondary aims were to compare femoral offset, abductor moment arm and leg length discrepancy between the two approaches. Eighty patients with primary hip osteoarthritis were included in a randomized controlled trial and assigned to total hip arthroplasty using posterior approach or lateral approach. Postoperative radiographs from 38 patients in each group were included in this study for measurement of cup anteversion and inclination. Femoral offset, cup offset, total offset, abductor moment arm and leg length discrepancy were measured on preoperative and postoperative radiographs in 28 patients in each group. We found that mean anteversion was 5° larger in the posterior approach group (95% CI, -8.1 to -1.4; p = 0.006), while mean inclination was 5° less steep (95% CI, 2.7 to 7.2; p<0.001) compared with the lateral approach group. The posterior approach group had a larger mean femoral offset of 4.3mm (95% CI, -7.4 to -1.3, p = 0.006), mean total offset of 6.3mm (95% CI, -9.6 to -3; p<0.001) and mean abductor moment arm of 4.8mm (95% CI, -7.6 to -1.9; p = 0.001) compared with the lateral approach group. We found a larger cup anteversion but less steep cup inclination in the posterior approach group compared with the lateral approach group. Femoral offset and abductor moment arm were restored after total hip arthroplasty using lateral approach but significantly increased when using posterior approach.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Articulação do Quadril/diagnóstico por imagem
Articulação do Quadril/cirurgia
[Mh] Termos MeSH secundário: Idoso
Artroplastia de Quadril/efeitos adversos
Fenômenos Biomecânicos
Feminino
Articulação do Quadril/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Radiografia
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191401


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[PMID]:29466152
[Au] Autor:Garcia D
[Ad] Endereço:From the Department of Medicine, University of Washington, Seattle.
[Ti] Título:Hybrid Strategy to Prevent Venous Thromboembolism after Joint Arthroplasty.
[So] Source:N Engl J Med;378(8):762-763, 2018 02 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Artroplastia do Joelho
Tromboembolia Venosa
[Mh] Termos MeSH secundário: Anticoagulantes
Artroplastia de Quadril
Seres Humanos
Complicações Pós-Operatórias
Trombose Venosa
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMe1716534


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[PMID]:29351915
[Au] Autor:White H; Barrett M; Gooding C
[Ad] Endereço:University of Cambridge, Cambridge, UK htw28@cam.ac.uk.
[Ti] Título:Chronic hip pain.
[So] Source:BMJ;360:j5882, 2018 01 19.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Neoplasias Ósseas/secundário
Neoplasias da Mama/complicações
Articulação do Quadril/patologia
Dor/diagnóstico
[Mh] Termos MeSH secundário: Artroplastia de Quadril/métodos
Neoplasias Ósseas/complicações
Neoplasias da Mama/diagnóstico por imagem
Doença Crônica
Diagnóstico Diferencial
Feminino
Articulação do Quadril/diagnóstico por imagem
Articulação do Quadril/cirurgia
Seres Humanos
Meia-Idade
Recidiva Local de Neoplasia
Radiografia/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180121
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5882


  10 / 21886 MEDLINE  
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[PMID]:29254318
[Au] Autor:Vicenti G; Pesce V; Bizzoca D; Nappi V; Palmiotto F; Carrozzo M; Moretti B
[Ad] Endereço:School of Medicine, University of Bari Aldo Moro, AOU Consorziale Policlinico, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Orthopaedic and Trauma Unit, Bari, Italy.
[Ti] Título:Perioperative plasmatic presepsin levels in patients undergoing total hip or knee replacement: a preliminary study.
[So] Source:J Biol Regul Homeost Agents;31(4):1081-1086, 2017 Oct-Dec.
[Is] ISSN:0393-974X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Presepsin (sCD14-ST) is an emerging biomarker in the diagnosis of sepsis. In the field of orthopaedics, it could be useful in the diagnosis and management of periprosthetic joint infections (PJI). The aim of this study is to define the normal perioperative plasmatic levels of presepsin in patients undergoing primary cementless total hip replacement (THR) or primary cemented total knee replacement (TKR). For this purpose, 50 patients (19 male, 31 female, mean age= 64.04±8.88) were recruited. The patients were divided into two groups: Group A patients underwent cementless THR, whereas Group B patients underwent cemented TKR. On recruitment, anthropometric data, smocking status, osteoarthritis stage according to Kellgren and Lawrence, Harris Hip Score (HHS) for Group A patients and Knee Society Score (KSS) for Group B patients, drugs assumption and comorbidities were recorded. All the patients underwent serial blood tests, including complete blood count, presepsin (PS), C-reactive protein (CRP) and procalcitonin (PCT) 24 hours before arthroplasty (T0) and at 24 (T1), 48 (T2), 72 (T3) and 96 (T4) hours postoperatively. Body temperature (θ) was recorded every six hours in the time lapse T0-T4. Presepsin plasmatic concentration was comparable at baseline in both groups. After surgery, however, a significant increase of presepsin was observed in Group A, whereas in Group B no significant changes of presepsin were recorded. A comparable trend of this biomarker was found in the two groups, i.e. presepsin increased from T0 to T3, when it reached its maximum value, and its decrease started at T4. Finally, presepsin resulted more accurate than CRP in the evaluation of perioperative inflammatory response in patients undergoing THR or TKR. These data will be helpful in defining a reference interval for presepsin in patients with prosthetic joint implants, and a cut-off of this biomarker for the diagnosis of PJI.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Artroplastia do Joelho
Receptores de Lipopolissacarídeos/sangue
Osteoartrite do Quadril/sangue
Osteoartrite do Joelho/sangue
Fragmentos de Peptídeos/sangue
Sepse/sangue
[Mh] Termos MeSH secundário: Idoso
Biomarcadores/sangue
Proteína C-Reativa/metabolismo
Calcitonina/sangue
Feminino
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/complicações
Osteoartrite do Quadril/diagnóstico
Osteoartrite do Quadril/cirurgia
Osteoartrite do Joelho/complicações
Osteoartrite do Joelho/diagnóstico
Osteoartrite do Joelho/cirurgia
Período Perioperatório
Dados Preliminares
Sepse/complicações
Sepse/diagnóstico
Sepse/cirurgia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Lipopolysaccharide Receptors); 0 (Peptide Fragments); 0 (presepsin protein, human); 9007-12-9 (Calcitonin); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE



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