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Opis: Background and Objectives: Increased revision rate of dual-modular (DM) femoral stems in primary total hip arthroplasty (THA) because of modular-neck breakage and adverse local tissue reactions (ALTRs) to additional junction damage products is well established and some designs have been recalled from the market. However, some long-term studies of specific DM stems did not confirm the inferiority of these stems compared to standard single-modular (SM) stems, and a head-to-head comparison THA is missing. The objectives of this multicentre study were to determine the survivorship and complication rates of a common DM stem design compared to a similar SM stem. Materials and Methods: In a time frame from January 2012 to November 2015, a cohort of 807 patients (882 hips) consecutively underwent primary cementless THAs at two orthopaedic centres. 377 hips were treated with a Zweimüller-type DM stem THA system and 505 hips with a similar SM stem THA system, both including a modern press-fit acetabulum. Kaplan-Meier survivorship and complication rates were compared between both groups in a median follow-up of 9.0 years (maximum, 9.9 years). Results: The 9-year survivorship of the DM stem THA system (92.6%, 95% CI 89.9–95.3) was significantly lower than that of the SM stem THA system (97.0%, 95% CI 95.2–98.8). There were no differences in revision rates for septic loosening, dislocation, and periprosthetic fractures between the two groups. One ceramic inlay and one Ti-alloy modular neck breakage occurred in the DM stem THA system group, but the main reason for revision in this group was aseptic loosening of components. Conclusions: The survivorship of the DM stem THA system was lower than the similar SM stem THA system in a comparable clinical environment with long-term follow-up. Our results confirmed that no rationale for stem modularity exists in primary THAs.
Ključne besede: total hip arthroplasty, modular necks, exchangeable necks, survival rate, complications, revision rate, primary hip replacement, prosthesis, Ti-alloy
Objavljeno v DKUM: 18.03.2024; Ogledov: 320; Prenosov: 4
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Opis: Aim The aim of this review is to examine the effectiveness of artificial intelligence in predicting multimorbid diabetes-related complications. Background In diabetic patients, several complications are often present, which have a significant impact on the quality of life; therefore, it is crucial to predict the level of risk for diabetes and its complications. Evaluation International databases PubMed, CINAHL, MEDLINE and Scopus were searched using the terms artificial intelligence, diabetes mellitus and prediction of complications to identify studies on the effectiveness of artificial intelligence for predicting multimorbid diabetes-related complications. The results were organized by outcomes to allow more efficient comparison. Key issues Based on the inclusion/exclusion criteria, 11 articles were included in the final analysis. The most frequently predicted complications were diabetic neuropathy (n = 7). Authors included from two to a maximum of 14 complications. The most commonly used prediction models were penalized regression, random forest and Naïve Bayes model neural network. Conclusion The use of artificial intelligence can predict the risks of diabetes complications with greater precision based on available multidimensional datasets and provides an important tool for nurses working in preventive health care. Implications for Nursing Management Using artificial intelligence contributes to a better quality of care, better autonomy of patients in diabetes management and reduction of complications, costs of medical care and mortality.
Ključne besede: artificial intelligence, prediction models, diabetes, prediction of diabetes complications
Objavljeno v DKUM: 03.10.2023; Ogledov: 375; Prenosov: 80
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Opis: Biomaterials and biotechnology are increasing becoming an important area in modern medicine. The main aim in this area is the development of materials, which are biocompatible to normal tissue. Tissue-implant interactions with molecular, biological and cellular characteristics at the implant-tissue interface are important for the use and development of implants. Implantation may cause an inflammatory and immune response in tissue, foreign body reaction, systemic toxicity and imminent infection. Tissue-implant interactions determine the implant life-period. The aims of the study are to consider the biological response to implants. Biomaterials and host reactions to implants and their mechanisms are also briefly discussed.
Ključne besede: host versus graft disease, GVHD, biomaterial, wound healing, transplant, tissue, prosthetic, implants, biological response, complications
Objavljeno v DKUM: 03.08.2017; Ogledov: 1466; Prenosov: 206
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Opis: Namen: Stresna inkontinenca urina je pri moških relativno redka in se pojavi kot posledica večjega operativnega posega, drugi vzroki stresne inkontinence urina se pri moških pojavljajo izjemoma. Ne glede na relativno majhno število prizadetih takšno uhajanje urina obolelim predstavlja velik medicinski in tudi socialni problem, saj se odpovejo normalnim dnevnim aktivnostim in se vse bolj omejujejo na domače okolje. Metode: Ena izmed možnosti zdravljenja stresne urinske inkontinence pri moških je tako imenovani InVance Male Sling sistem. Gre za minimalno invazivno kirurško metodo, pri kateri se na spodnjo stran pubične kosti z vijaki pritrdi poliesterska mrežica, ki tesni sečnico. V principu gre za sling operacijo. Rezultati: Na našem oddelku smo med letoma 2004 in 2007 z omenjeno prometodo zdravili osemintrideset bolnikov. Pri štiriintridesetih je šlo za stanje po radikalni odstranitvi prostate, pri štirih pa za stanje po transuretralni resekciji prostate. Čas spremljanja po posegu je pri vseh daljši od dveh let. Osemindvajset bolnikov navaja popolno ozdravitev (brez uporabe predlog), šest bolnikov navaja blago stresno inkontinenco (ena predloga dnevno), pri štirih bolnikih pa ni prišlo do izboljšanja. Pri nobenem bolniku nismo opažali zastoja urina ali na novo nastalih težav pri uriniranju, smo pa pri treh bolnikih srečali podaljšano gnojno izcejanje iz postoperativne rane in še pri treh kasno zavrnitev mrežice, zato smo pri teh bolnikih morali mrežico odstraniti. Imeli smo tudi bolnika z erozijo sečnice osem mesecev po posegu. Zaključek: Glede na naše rezultate lahko zapišemo, da je Invance sling operacija uspešna metoda zdravljenja moške stresne inkontinence urina z minimalnimi pooperativnimi zapleti.
Ključne besede: male urinary stress incontinence, sling procedure, minimally invasive procedure, treatment results, postoperative complications
Objavljeno v DKUM: 10.07.2015; Ogledov: 2173; Prenosov: 37
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