Total joint arthroplasty (TJA) including total hip arthroplasty (THA) and total knee arthroplasty (TKA) are performed for patients with primary osteoarthritis (OA). Also, there are patients who undergo TJA for management of inflammatory arthritis (IA), including patients with rheumatoid arthritis (RA), Spondyloarthritis (SPA) including ankylosing spondylitis (AS) and psoriatic arthritis (PSA) and systemic lupus erythematosus (SLE).
The purpose of this review was to evaluate the current knowledge about the risk of complications after TJA in patients with IA and perioperative management of antirheumatic drugs.
THA and TKA are orthopedic surgeries that help patients with arthritis restore function, mobility and reduce pain. Patients with inflammatory arthritis have systemic disorders that cause a high rate of complications associated with the surgery.
Patients with inflammatory arthritis, including RA, SPA, and SLE who need TJA have a higher risk of developing complications compared to patients with OA.
Information about cardiovascular risk factors and other comorbidities is important to better control and reduce the risk of postoperative complications.
TJA = total joint arthroplasty, THA = total hip arthroplasty, TKA = total knee arthroplasty, OA = osteoarthritis, SPA = spondyloarthritis, IA = inflammatory arthritis, RA = rheumatoid arthritis, AS = ankylosing spondylitis, PSA = psoriatic arthritis, SLE = systemic lupus erythematosus, DMARDs = Disease-modifying antirheumatic drugs, PJI = prosthetic joint infection, VTE = venous thromboembolism, HCQ = hydroxychloroquine, SSZ = sulfasalazine, TNF = tumor necrosis factor, GS = corticosteroids.
Background. Functional endoscopic sinus surgery may be indicated when certain anatomic variations impede the normal drainage of the paranasal sinuses through the ostiomeatal complex. We aimed at studying the drainage system of the maxillary sinus which consists of the maxillary infundibulum, the main ostium of the maxillary sinus, the ethmoidal infundibulum and the hiatus semilunaris inferior.
Material and methods. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 60 subjects (N=120 maxillary sinuses). The anatomical pattern of the maxillary sinus drainage was studied on coronal scans.
Results. As related to different morphological possibilities in the supero-lateral limit of the maxillary sinus drainage system, five different patterns were defined: in type I (55%) there was no pneumatization in that situs, in type II (18%) there was an infraorbital recess of the maxillary sinus placed above the sinus ostium, in type III (14%) an ethmoidal recess of the maxillary sinus was expanded within the ethmoid bone, above the ethmoidal infundibulum, in type IV (3%) there were Haller cells above the sinus ostium, while in type V (10%) there were non-infraorbital ethmoid air cells above and draining into the ethmoidal infundibulum.
Conclusion. It appears that CBCT is a reliable tool to make an anatomical distinction of the variable pattern of pneumatization impeding a normal drainage of the maxillary sinus, between maxillary sinus- and ethmoid-derived air-filled spaces.
Background: Osteoarthritis (OA) and rheumatoid arthritis (RA) can overlap and the presence of OA can interfere with the evaluation of patients with RA.
Objectives: The aim of this study was to evaluate the possible impact of OA on the clinical, laboratory and ultrasound parameters currently evaluated in patients with early RA (ERA).
Methods: We have evaluated the data obtained from patients with ERA referred to our Early Arthritis Research Center (EARC). Only data from patients who fulfilled EULAR/ ACR 2010 criteria for RA and had symptom duration of less than 12 months were analyzed. All patients underwent clinical examination, laboratory tests and ultrasound (US) examination.
Results: There was a clear predominance of women (62.8%). The mean age was 55.47±13.71 years. At baseline, 21 patients (48.8%) were diagnosed with OA. Hand OA did not influence the values of any of the parameters assessed (p>0.05). For patients with knee OA, significantly higher values were observed only for DAS28 at baseline (p=0.018) as well as after 12 months of observation (p=0.031).
Conclusions: Significantly higher values of DAS28 were observed in patients with ERA who associated knee OA, while the values of SDAI were not influenced, suggesting that SDAI may be superior to DAS28 in evaluating patients with ERA and knee OA. The values of patient’s VAS were not influenced by the presence of hand or knee OA suggesting that these types of OA do not influence the patients’ perception of the disease activity. Moreover, the values of ultrasound scores were not influenced by the presence of OA.
The paper referes to the possibility of using neural networks in selecting the “Research-Development” strategy, in the nonconventional technologies field. It presents a selection and the main key elements of the Research and Development (R & D) strategies, applicable in the nonconventional technologies (NT) field and, thus, the specific analytical elements of such a methodology. It also refers to the possibility of using neural networks (“NN”) up to the level of taking managerial decisions regarding the manufacturing processes. Research Objectives: Defining components from the neuron ‘s structure into the organizational systems, in order to select ptime strategies for the organizational management. Expected Results: Transposing the entire methodology in a software.
Since their publication in 1965, the Bradford Hill criteria for causality have been largely used as a framework for causal inference in epidemiology. We aim at employing this classical approach to shed new light onto the web of causation of childhood obesity. Although the fundamental cause of obesity is the long-term imbalance between energetic need and intake, this medical condition is multifactorial in its origin, influenced by genetic, behavioral, socioeconomic, and environmental factors. This imbalance leads to accumulation of excessive adipose tissue. Observational studies tend to mostly quantify association between dietary factors and accumulation of adipose tissue. On the other hand, multivariate analysis proved some of these associations to be spurious, therefore prospective trials are needed to demonstrate causality. Short term experimental studies have been conducted to identify unique dietary pattern changes on specific outcomes, but long term, community-based studies would offer more comprehensive answers on dietary pattern effects. We conducted a literature review on PubMed, Scopus, Web of Science, and Google Scholar. From a total of 323 papers identified at first stage, we further discuss the applicability of Bradford Hill criteria for 31 articles, by examples of dietary patterns and accumulation of excess body fat as exposure-response associations. We also put forward and analyzed the evidence prospective studies would bring, as foundation for future interventions.
As a result of the economic crisis of 2009-2010, the road traffic on the national road network, for the period 2011-2014, decreased considerably. Thus, the evolution coefficients, for the period 2020-2025, registered a trend of decrease in road traffic.
Based on the analysis of the results of the automatic traffic records, it was found that the average daily average traffic increased by about 4.7% in 2016 compared to 2015 (the year of the last general circulation census) and is in continuous growth, one of the reasons being removal of car registration tax. In 2015, for the development of evolution coefficients and the rates of evolution of traffic on the national road network, the linear regression method was used which took into account both the evolution of road traffic reported in 1995, 2000, 2005 and 2010, as well as the evolution of road traffic on the traffic counters network for the period 2010-2015.
The paper analyzes aspects of the efficiency of the method used until the present and the need to develop coefficients and rates of evolution based on more complex methods, based on several economic and social indicators, including the projected evolution of GDP.
BACKGROUND. Odontogenic rhinosinusal suppurations have a high potential for major ocular-orbital and cerebral complications because of the presence of anaerobic bacteria flora, with continuity, contiguity and haematogenous propagation mechanisms. This pathology is often diagnosed in other departments than ENT such as ophthalmology, neurosurgery or OMF surgery.
MATERIAL AND METHODS. We present three clinical cases of odontogenic rhinosinusal suppurations with major complications: a 36-year-old patient with odontogenic pansinusitis complicated with orbital phlegmon and cerebral frontal lobe abscess; a 19-year-old patient with complicated maxillary-ethmoidal-frontal sinusitis complicated with frontal subdural empyema and frontal bone osteomyelitis (with a history of craniofacial trauma one year before); a 66-year-old patient with odontogenic maxillary-ethmoidal sinusitis complicated with orbital apex syndrome.
RESULTS. The treatment was surgical, by external approach, with endoscopic nasal control, in interdisciplinary teams. We have associated massive antibiotic therapy. Surgical drainage for complicated rhinosinusitis should be done in emergency, within the first 24 hours after admission, according to guidelines. The bacteriological examination for aerobic and anaerobic flora can guide the diagnosis - two cases associated maxillo-ethmoidal aspergilloma lesions. The evolution of the cases was favourable.
CONCLUSION. Interdisciplinary teams have successfully solved these complicated odontogenic rhinosinusal suppurations. Two of the cases were admitted and cured within 2 weeks, in the context of very hot weather, which exacerbated dormant dental infections.
Seismic vulnerability for a structure represents the susceptibility to be affected by an event with a given intensity. The vulnerability of a structure can be influenced by the design methods or by different problems that may appear during the execution process.
This paper shows a case study for the vulnerability increase of a reinforced concrete frame structure in 2 different situations:
a) modification produced due to code changes, meaning P100-2006 respectively P100-2013;
b) modifications produced the structure taking into account the errors which have occurred during the execution process;
For both cases, capacity curves were plotted considering the nonlinear analysis, also called pushover. The numerical simulation was performed in SAP2000 software. These curves were compared with the response spectrum corresponding to the site conditions in order to obtain the performance point. For accurate results, fragility curves were plotted for both considered situations, according to previous research of the authors.
The paper emphasizes the importance of each stage during the execution of a structure. More over the differences in the vulnerability index show the importance on the overall behavior of the structure. Solution to increase strength and safety for the structure are also given at the end of the paper
Angiogenesis is a crucial event for tumor growth and it is regulated predominantly by several different growth factors. Vascular endothelial growth factor protein family (VEGF) and its receptors are probably the most important tissue factors responsible for angioblast differentiation and tube formation. VEGF protein family currently comprises several members: VEGF (or VEGF-A), VEGF-B, VEGF-C and VEGF-D, VEGF-F, placental growth factor (PlGF), and their receptors VEGFR-1, VEGFR-2 and VEGFR-3. VEGF is a key angiogenic growth factor and its level of expression is a critical marker for detection of the angiogenic diseases. The potent role of VEGF in tumor angiogenesis has been widely described in the past decade, being expressed in most types of nondigestive and digestive cancers. VEGF family members play an important role in the development of pancreatic cancer (especially VEGF-A, VEGF-C, VEGF-D, VEGFR-1 and VEGFR-2). VEGF-A is the most specific and prominent angiogenic factor among all family members and VEGFR-2 is the most important receptor in evaluating the angiogenesis in pancreatic cancer. Thus, VEGF overexpression may be considered as a diagnostic marker and as a poor prognostic factor of the disease.
Autophagy, a homeostatic process involved in nutrient regeneration and immune responses, may be involved in intracellular killing of M. tuberculosis. Several studies linked variation in autophagy genes with susceptibility to pulmonary tuberculosis, but others did not confirm these findings.
We genotyped single nucleotide polymorphisms (SNPs) in the ATG5 (rs2245214, c.574-12777G>C) and NOD2 (rs2066844, c.2104C>T) genes for 256 pulmonary tuberculosis patients and 330 unrelated healthy controls in Romania. Both SNPs have been reported as relevant for the autophagy process and potentially for susceptibility to active pulmonary tuberculosis.
In our study, the polymorphisms in ATG5 and NOD2 were not associated with tuberculosis. This suggests that the two genetic variants we focused on are not related to the risk for developing active TB in a Romanian population.