Amperometric Biosensors Based on Direct Electron Shift Digestive enzymes

Reverse shoulder arthroplasty (RSA) is a common treatment of a variety of disabling shoulder conditions. The purpose of this study was to determine revision-free survivorship after RSA using a medialized glenoid and lateralized onlay-type humerus implant and to identify etiologies of revision.
All RSAs performed using the Comprehensive
Reverse Shoulder System (Zimmer Biomet, Inc.; Warsaw, IN, USA) at one institution from 2008 to 2014 were identified through a retrospective review. Charts were reviewed to determine whether the RSA was a primary or revision surgery. Patients were contacted by telephone, and survivorship was defined as no subsequent surgery after RSA. Of the 526 RSAs performed, responses were obtained from 403 patients (77%). A Kaplan-Meier analysis was performed to determine survivorship over time. A
test was used to determine differences between revision rates after RSA.
Minimum follow-up was 3years, and average follow-up was 4.83 ± 1.60years. Survivorship was 96% at 2years and 93% at 5years after RSA. Revisions were performed for instability (
=8), humeral tray-taper junction failure (
=5), acute fracture (
= 4), infection (
=3), glenoid loosening (
=3), osteolysis (
=1), or notching (
=1). Fourteen of the 151 patients (9.2%) who had surgery prior to RSA required revision after RSA. Having shoulder surgery prior to RSA was associated with higher rates of subsequent revision after RSA.
Overall, survivorship after RSA using a medialized glenoid and lateralized onlay-type humerus RSA is high, and prostheses implanted in native shoulders have lower rates of revision at midterm follow-up. Instability (1.9%) was the most common reason for revision.
Overall, survivorship after RSA using a medialized glenoid and lateralized onlay-type humerus RSA is high, and prostheses implanted in native shoulders have lower rates of revision at midterm follow-up. Instability (1.9%) was the most common reason for revision.
In primary total hip arthroplasty (THA), evidence supports the use of tranexamic acid (TXA) as an effective strategy for reducing blood loss, but scant evidence supports its use in revision THA.
We aimed to evaluate whether the use of topical TXA in revision THA is associated with less blood loss and lower transfusion rates and to assess its safety, specifically as it relates to thromboembolic complications.
In this retrospective comparative study, two groups who underwent revision THA between 2005 and 2017 were defined 98 patients who received 3g of topical TXA (study group) and 475 patients who did not receive TXA (control group). Subjects were divided into subgroups according to the type of revision. see more Hemoglobin and hematocrit levels, blood loss, and transfusions were recorded. The follow-up period was 6weeks.
Median estimated blood loss, hidden blood loss, hemoglobin drop, and transfusion rates were significantly lower in the study group. The rates of post-operative thromboembolism were similar in the two groups. According to subgroup analysis, patients with revision of the femoral component, both components, and staged exchange revisions showed significantly lower rates of transfusion.
Topical TXA administration during revision THA effectively reduced direct and indirect blood loss, including hidden losses, without increasing the rates of thromboembolic events. This effect appeared to be enhanced when thefemoral component was revised.
Topical TXA administration during revision THA effectively reduced direct and indirect blood loss, including hidden losses, without increasing the rates of thromboembolic events. This effect appeared to be enhanced when the femoral component was revised.
The ideal local anesthetic for use in ambulatory spinal anesthesia is safe, with minimal adverse effects, and of aduration that does not impede post-anesthesia care unit (PACU) discharge. Since itsapproval for use in spinal anesthesia in Europe in 2012, chloroprocaine has seen a resurgence. Recent studies have investigated the safety and efficacy of preservative-free chloroprocaine for use in spinal anesthesia, but few provide the incidence of adverse events such as urinary retention and transient neurologic symptoms.
We sought to assess the safety of chloroprocaine for spinal anesthesia, including the incidence of adverse events and the duration and quality of its use, in the initial 6months of its use at our institution. We hypothesized that chloroprocaine would provide effective spinal anesthesia for orthopedic cases of short duration, with a low rate of complications.
We conducted a retrospective chart review of all patients from June to December 2016 at our institution who had ambulatory knee arthral anesthesia for short orthopedic procedures, with no incidence of transient neurologic symptoms, neuropraxia, or urinary retention.
To curb costs at the state level, improve care quality, and promote access to care, certificate-of-need (CON) laws were established in many states in 1974. It is not known how CON regulations have affected the provision of knee arthroscopy, one of the most common orthopedic procedures performed in the USA.
We sought to characterize the effects of CON regulations on knee arthroscopy in the national Medicare population by examining trends in procedure volumes, comparing trends in procedure charges, evaluating distribution of procedure volumes between high-, mid-, and low-volume facilities, and comparing adverse event and complication rates after knee arthroscopy between states with and without CON regulations.
States with CON regulations covering both inpatient and outpatient operating rooms formed the study group (
 = 25 states) and were compared with states without CON laws or laws that did not cover operating rooms during the study period (
 = 20 states). The 100% Medicare Standard Analytical Files f arthroscopy.
CON regulations appear to have achieved several of their intended goals for knee arthroscopy. Further research is needed to determine if CON regulations affect the quality and sustainability of care provided to patients undergoing knee arthroscopy.