Publications by authors named "A A Hegewald"

Objective: The purpose of this study is to investigate the efficacy of the GAID-Protocol, a bundle of intra- and postoperative infection prevention measures, to reduce implant-associated infections in patients undergoing posterior spinal fusion with instrumentation. These preventive measures are organized into a protocol that includes recommendations for four critical areas of implant protection (acronym GAID): Gloves, Antiseptics: sodium hypochlorite/hypochlorous acid (NaOCl/HOCl), Implants and Drainage-use in large wounds.

Methods: We performed a single-site retrospective review of cases undergoing posterior spinal fusion with instrumentation for primarily degenerative spinal diseases before and after implementation of the GAID-Protocol that was specifically designed to protect against implant-associated infections.

View Article and Find Full Text PDF
Article Synopsis
  • During the COVID-19 pandemic, the percentage of patients with high frailty in spine care increased significantly compared to pre-pandemic levels.
  • A decrease in low frailty patients was noted, coinciding with changes in surgery rates; low frailty patients experienced an increase in spine surgeries, while high frailty patients saw a decrease.
  • High frail patients showed a larger increase in comorbidities during the pandemic, but changes in in-hospital mortality rates were not linked to frailty levels.
View Article and Find Full Text PDF

Background:  The full impact of the COVID-19 pandemic on surgical spine care is difficult to assess due to a lack in nationwide evidence from more recent phases of the pandemic. We aimed to describe changes in in-hospital processes associated with spinal fusion procedures in the treatment of spinal infections (SI) during different phases of the pandemic.

Methods:  In this retrospective observational study, we examined the in-hospital prevalence and outcomes of spinal fusion procedures for SI (along with patient characteristics, rates of transfer to intensive care units, and mortality rates) during the first four waves of the pandemic compared with the corresponding prepandemic periods in 2019.

View Article and Find Full Text PDF

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial inflammation and joint destruction. Cell-derived small extracellular vesicles (sEV) mediate cell-to-cell communication in the synovial microenvironment by carrying microRNAs (miRs), a class of small non-coding RNAs. Herein, we report that sEV from synovial fluid promote osteoclast differentiation which is attributed to high levels of extracellular miR-574-5p.

View Article and Find Full Text PDF

Extracellular microRNAs (miRs) have been proposed as important blood-based biomarkers for several diseases. Contrary to proteins and other RNA classes, miRs are stable and easily detectable in body fluids. In this respect, miRs represent a perfect candidate for minimal invasive biomarkers which can hopefully become a complement for invasive histological examinations of tumor tissue.

View Article and Find Full Text PDF