Suchergebnisse

Outer ear infections (OE) affect millions of people annually with significant associated healthcare costs. Incorrect administration or non-compliance with the treatment regimen can lead to infection persistence, recurrence, antibiotic resistance, and in severe cases aggravation to malignant otitis externa. Such issues are particularly pertinent for military personnel, patients in nursing homes, the geriatric population, for patients with head or hand tremors and for those with limited or no access to proper healthcare. With the intent of using traditional material science principles to deconvolute material design while increasing relevance and efficacy, we developed a single application, cold-chain independent thixotropic drug delivery system. This can be easily applied into the ear as a liquid, then gels to deliver effective concentrations of antibiotics against bacterial strains commonly associated with OE. The system maintains thixotropic properties over several stress/no stress cycles, shows negligible swelling and temperature dependence, and does not impact the minimum inhibitory concentration or bactericidal effects of relevant antibiotics. Moreover, the thixogels are biocompatible and are well tolerated in the ear. This drug delivery system can readily translate into a user-friendly product, could improve compliance via a single application by the diagnosing health care provider, is expected to effectively treat OE and minimize the development of antibiotic resistance, infection recurrence or exacerbation.

One of the most controversial topics in total knee arthroplasty is rotation of the femoral component. The current gold-standard in total knee arthroplasty consists in positioning the femoral component in 3 degrees of external rotation to the epicondylar axis, having as reference the tangent to the posterior condyles. Achieving the correct rotation of the femoral components is one of the main goals during total knee arthroplasty. Multiple complications can result from internal femoral rotation, such as lateral patellar tilt, patellar subluxation or dislocation, mobilization with movement on pain, and low survival rates of the femoral components. Postoperative rotational assessment of protective components can only be performed correctly using computed tomography. The known evaluation methods are related to anteversion of the femoral neck, femoral trans-epicondylar line, insertion of the posterior cruciate ligament from the tibia and tibial tuberosity. The purpose of this study was to evaluate the rotation of the prosthetic components in the group of patients with the methods validated by studies and to find alternatives to evaluate the rotation of the femoral component. Thirty-four patients diagnosted with gonarthrosis, proposed for total knee arthroplasty, were included in the study. This is a prospective cohort study in which applied statistics consisted of analyzing data using frequency and percentage for qualitative and mean variables and standard deviation for quantitative variables

Metformin was a revelation in the treatment of patients with type 2 diabetes, being widely used, with remarkable outcomes. Lately, research has greatly expanded the indications of metformin treatment, which can be used not only in diabetes but also in many other conditions. Although still debatable, several studies have shown the beneficial effects of metformin treatment in patients with psoriasis. This article is a review of the latest data of scientific literature about the effects of metformin administration in patients with diabetes and psoriasis, but also in nondiabetic patients with psoriasis.

In an attempt to standardize the X-ray analysis and to create relevant correlations between it and the functional results, we present a pilot model of an artificial neural network based on a Bayesian belief network (BNN) designed for the automatic analysis of anteroposterior X-ray of the knee following total knee arthroplasty and more precisely the analysis of the tibial component. A prospective analysis was conducted in which 30 patients were analyzed and two groups resulted: the first was made up of 12 cases considered "normal" by the examiners (optimal positioning and cementation) and the second one, which was considered "pathological" (incorrect positioning or cementation) and included 16 cases. Based on 22 points established on the tibial component several geometric sizes (calculated parameters) were computed. Several parameters were compared and the results were up to 75% accuracy, 81.25% sensitivity, and 66.7% specificity. BBNs can be a solution for X-ray evaluation of total knee arthroplasty and can improve the understanding of its evolution. It needs confirmation in time, its accuracy rising with the number of patients introduced in the analysis algorithm.

Diabetes and increased body mass index are two of the most associated comorbidities in patients undergoing total knee arthroplasty. With the number of patients undergoing knee arthroplasty increasing and with the incidence of diabetes and increased BMI, we can expect that in the coming decades the association of the two comorbidities will be frequent. An ethical issue arises when the patients who are refused for total knee arthroplasty are instructed to change the risk factors, and they fail either because of a mental problem or because of a physical problem. This study analyzes the effects of controlled, uncontrolled, uncomplicated and complicated diabetes on the rates of postknee arthroplasty complications. The study proposes to evaluate obese patients in terms of functional outcomes and postoperative complications after total knee arthroplasty.