Early gain in pain reduction and hip function, but more complications following the direct anterior minimally invasive approach for total hip arthroplasty: a randomized trial of 100 patients with 5 years of follow up.

Background and purpose - The minimally invasive direct anterior (DA) approach for total hip arthroplasty (THA) is supposed to reduce surgical tissue trauma. We hypothesized that patients operated with the DA technique would have less postoperative pain and better hip function compared with a group operated with a conventional direct lateral (DL) approach. Patients and methods - 100 patients with hip osteoarthritis scheduled for THA were equally randomized to surgery through either DA or DL.

Adverse reaction to metal release from a modular metal-on-polyethylene hip prosthesis.

A 70-year-old man with an uncemented metal-on-polyethylene total hip prosthesis underwent revision arthroplasty 33 months later because of pain, swelling and recurrent dislocation. There appeared to be corrosion and metal release from the prosthetic head, resulting in pseudotumour formation and severe local soft-tissue destruction. The corrosion occurred at the junction between the titanium-molybdenum-zirconium-iron taper and the cobalt-chrome-molybdenum head, but the mechanism was unproven.

Heart rate variability and heat sensation during CT coronary angiography: Low-osmolar versus iso-osmolar contrast media.

Background: During computed tomography coronary angiography (CTCA) unexpected changes in heart rate while scanning may affect image quality.

Purpose: To evaluate whether an iso-osmolar contrast medium (IOCM, iodixanol) and a low-osmolar contrast medium (LOCM, iomeprol) affect heart rate and experienced heat sensation differently.

Material And Methods: One hundred patients scheduled for CTCA were randomized to receive either iodixanol 320 mgI/ml or iomeprol 400 mgI/ml.

Effects of induced hypothermia after soft-tissue injury.

Background: Hypothermia is occasionally employed to reduce the metabolic rate and to protect the brain in patients undergoing surgery, but it is controversial whether hypothermia (HT) is beneficial or harmful in trauma victims with soft-tissue injuries. For this purpose, we studied the acute effects of hypothermia induced after infliction of a standardized soft-tissue injury.

Methods: After a standardized high-energy gunshot wound to the right hind leg of 14 anesthetized piglets, the animals were randomized to normothermia or HT (30 degrees C) induced with a HT bed.

The effect of body mass and physical activity on the development of guinea pig osteoarthrosis.

We quantitatively evaluated the morphological and biochemical effects of body mass and physical activity on spontaneously developing guinea pig osteoarthrosis (OA). 6-month-old male guinea pigs were allocated to 3 groups: controls (C) living under standard laboratory conditions with food ad libitum; mobilized animals (M) allowed unrestricted motion in large rooms with food ad libitum; and a diet group (D) weight-matched with the M-group. At 9- and 12-months of age they were killed and the left proximal tibia was processed for quantitative histology and the right tibial articular cartilage for analyses of glycosaminoglycan (GAG).

Distribution of chondroitin 4-sulfate epitopes (2/B/6) in various zones and compartments of articular cartilage in guinea pig osteoarthrosis.

We studied changes in the morphology of tibial articular cartilage in early guinea pig osteoarthrosis (OA) at 6 and 12 months of age with quantitative light microscopy, and the distribution of chondroitin-4-sulfate with quantitative ultrastructural immunolabeling, using the 2/B/6 epitope. Labeling was correlated to previous chromatography findings concerning proteoglycan (PG) concentration in animals of the same age. The cell volume fraction had decreased at 12 months in the superficial zone of cartilage with OA (medial condyle) as well as in cartilage without OA (lateral condyle), being lower medially than laterally.

Mechanisms of shock wave induced endothelial cell injury.

Background And Objectives: Medical procedures, for example, laser angioplasty and extracorporeal lithotripsy as well as high-energy trauma expose human tissues to shock waves (SWs) that may cause tissue injury. The mechanisms for this injury, often affecting blood vessel walls, are poorly understood. Here we sought to assess the role of two suggested factors, viz.

Observer reliability in the arthroscopic classification of osteoarthritis of the knee.

We studied 19 videotaped knee arthroscopies in 19 patients with mild to moderate osteoarthritis (OA) of the knee in order to compare the intraobserver and interobserver reliability and the patterns of disagreement between four orthopaedic surgeons. The classifications of OA of Collins, Outerbridge and the French Society of Arthroscopy were used. Intraobserver and interobserver agreements using kappa measures were 0.

Induced hypothermia after high-energy soft-tissue injury and subsequent hemorrhagic shock.

Many cases of hypothermia (HT) occur in trauma victims subjected to soft tissue injury and hemorrhage. The aim of the present study was to study the effects of HT on the combination of these insults. A standardized gunshot wound was inflicted on the right hind leg of 14 anesthetized piglets.

[Telemedicine in diagnosis and treatment of occupational skin diseases].

Advances of new data transfer technologies in medicine enable distant consultations for far places residents. Scandinavian countries, especially Sweden, have accumulated significant experience with using television medicine in dermatology. Applying television medicine technologies in occupational dermatology is the most topical item for Nizhny Novgorod region.

Effect of load on articular cartilage matrix and the development of guinea-pig osteoarthritis.

Objective: To study the biochemical changes in the early development of primary guinea-pig knee osteoarthritis (OA) and its dependence on load.

Methods: Load distribution was modified with below-knee amputation or femur valgus osteotomy in 9-month-old guinea-pigs. Soft tissue sham operated animals served as controls.

Acute hemodynamic effects of induced hypothermia in hemorrhagic shock: an experimental study in the pig.

Hypothermia (HT) is used in certain surgical procedures to reduce metabolism and protect the brain, but in trauma victims accidental HT is considered harmful. Recent animal studies indicate that HT has protective effects in hemorrhagic shock. The aim of the present study was to examine how induced HT modifies the hemodynamic pattern in hemorrhagic shock.

Laser-induced shock wave endothelial cell injury.

Background And Objective: Several laser procedures, extracorporeal lithotripsies (ESWL), and high-velocity missile trauma generate pressure transients that are transmitted through the tissues. Despite several publications demonstrating shock wave-induced tissue injury, little is known about its pathophysiology. This study introduces an in vitro model for studying shock wave effects on endothelial cell (EC) monolayers.

Psychotic disorders among inpatients with abuse of cannabis, amphetamine and opiates. Do dopaminergic stimulants facilitate psychiatric illness?

We have studied the occurrence of dual diagnoses (psychoses as well as abuse of either amphetamine, cannabis or opiates) during a 15-year period, among patients treated at Huddinge Hospital, Stockholm, Sweden. The purpose of the study is to evaluate if the different drugs were coupled to different rates of psychiatric co-morbidity. During the period in question, 461, 425 and 371 different patients respectively had been admitted at least once due to dependency on amphetamine, cannabis and opiates.

Patients with recurrent injuries--psychosocial characteristics and injury panorama.

Accidents are often considered to be a direct function of exposure to risk, but this study implies that there are subgroups of patients that expose themselves to more risks than others. Based on a consecutive series of moderately injured patients this study aimed to compare patients with repeated trauma episodes with patients with single trauma. The study showed that the former had experienced more violence during their lives, had a less favourable psychosocial situation and more often reported psychiatric problems and alcohol abuse compared with the latter, confirming the clinical knowledge that injury recurrence is associated with risk factors such as alcohol abuse, pre-existing psychopathology and a propensity towards violence.

Monobactams and carbapenems for treatment of intraabdominal infections.

During the last decade improved clinical and microbiological methods have resulted in the realization that most intraabdominal infections involve both aerobic and anaerobic bacteria. Papers on the use of different antimicrobial agents directed against the polymicrobial flora of the infected site have been published. In this paper the use of monobactams and carbapenems for treatment of intraabdominal infections is reviewed.

The significance of alcohol for violence and accidents.

For almost all types of accidents and violence, there is a causal relationship with alcohol intoxication or alcohol abuse. Alcohol may have significance as a risk factor for the perpetrator (culprit, car driver, etc.), as well as for the victim.

Acute metabolic and endocrine effects of induced hypothermia in hemorrhagic shock: an experimental study in the pig.

Background: Hypothermia is considered harmful in trauma patients. In surgery, hypothermia is occasionally used to reduce metabolism and protect the brain. Recent studies in animals have also shown protective effects of hypothermia in hemorrhagic shock.

Somatic morbidity among patients diagnosed with affective psychoses and paranoid disorders. A case-control study.

Several studies have shown an increased mortality rate among psychiatric patients. Morbidity, however, has been studied less often. In this study, the authors examined the number of hospitalizations with somatic diagnoses in 722 patients with affective psychoses and 472 with a paranoid disorder.

Accidental firearm injury in childhood--a predictor of social and medical outcome?

This paper reports register data on a consecutive series of 141 children and teenagers hospitalized due to firearm injuries during a 21-year period in a community with restrictive firearm laws. Most of the injuries were minor and hospitalization was short. Shot by an air gun resulting in an eye injury was the most frequent reason for hospitalization.

Somatic morbidity in schizophrenia--a case control study.

Several studies have stated that rates of premature mortality of schizophrenic patients are increased. Morbidity, however, is less often examined. In the present study we have compared the number of hospitalizations due to different somatic diseases in 775 schizophrenic patients with their sex- and age-matched controls.

Sensory and sympathetic block during interpleural analgesia.

Background And Objectives: Interpleural analgesia is an effective method for pain relief after upper abdominal surgery. To examine whether the analgesic effect is obtained by block of the intercostal nerves, we assessed the analgesic efficacy of the block, the skin sensitivity, and indices of sympathetic outflow over the trunk.

Methods: Interpleural analgesia was instituted at the end of open cholecystectomy in 20 patients 24-81 years of age (mean, 42 years).

Haemodynamics during inhalation of a 50% nitrous-oxide-in-oxygen mixture with and without hypovolaemia.

Background: Inhalation of a gas mixture containing 50% nitrous oxide in oxygen (N2O/O2) is widely used for pain relief in emergency situations, which may also be associated with blood loss. The aim of this study was to evaluate the haemodynamic effects of this gas mixture in normo- and hypovolaemic subjects.

Methods: Six healthy males were studied during inhalation of N2O/O2 before and after withdrawal of 900 ml of blood.

Central and regional hemodynamics during acute hypovolemia and volume substitution in volunteers.

Objectives: To study the central and regional hemodynamics and oxygen consumption during acute hypovolemia and volume replacement with crystalloid and colloid solutions.

Design: Prospective, randomized, laboratory investigation.

Setting: Clinical physiology department at a university hospital.