Unconstrained arthroplasty in type II valgus knees: posterior stabilized or cruciate retaining?

Purpose: Type II valgus knees are defined by medial collateral ligament laxity. This paper studies the results of posterior stabilized (PS) and cruciate retaining (CR) knee implants in type II valgus knees.

Methods: From 1999 to 2009, there were 100 type II valgus knees in 95 patients eligible for study (63 PS, 37 CR).

The performances of the Cockcroft-Gault, modification of diet in renal disease study and chronic kidney disease epidemiology collaboration equations in predicting gentamicin clearance.

Background: It is unclear which renal function equation, employing an isotope dilution mass spectrometry (IDMS)-aligned creatinine assay, best predicts gentamicin clearance.

Methods: The performances of the Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD) Study and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations for predicting gentamicin clearances were assessed retrospectively in 240 patients treated with gentamicin during 2011-2012, when the local creatinine assay was IDMS-aligned. Comparisons were based on the percentage within 30% of gentamicin clearance (P 30) and the root-mean-square error (RMSE) of each equation.

The radiological outcomes of patient-specific instrumentation versus conventional total knee arthroplasty.

Purpose: The aim of this study was to investigate the post-operative radiological outcomes of patient-specific instrumentation (PSI) surgery versus conventional total knee arthroplasty (TKA).

Methods: Sixty patients scheduled for a primary TKA were prospectively divided into PSI or conventional technique. Coronal and sagittal radiographic long limb films were taken post-operatively.

Preanalytical stringency: what factors may confound interpretation of thiopurine S-methyl transferase enzyme activity?

Background: Measurement of red blood cell thiopurine S-methyl transferase (TPMT) enzyme activity before commencing thiopurine therapy is recommended to avoid severe bone marrow suppression in TPMT-deficient patients. Patient's samples go through preanalytical transportation and storage steps before measurement. We studied patient's TPMT activity sample data to assess the effect of preanalytical variables including transportation time.

Biological variation of thiopurine methyltransferase enzyme activity: when has a significant change taken place?

Background: Thiopurine methyltransferase (TPMT) enzyme activity is measured before initiating thiopurine therapy to reduce the risk of severe drug-associated myelotoxicity in patients with low enzyme activity. TPMT activity may vary over time in relation to drug treatment and patient clinical condition. What constitutes a significant change in TPMT activity can be derived from biological variation and analytical imprecision.

The prostatic urethral lift for the treatment of lower urinary tract symptoms associated with prostate enlargement due to benign prostatic hyperplasia: the L.I.F.T. Study.

Purpose: We report the first multicenter randomized blinded trial of the prostatic urethral lift for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia.

Materials And Methods: Men at least 50 years old with AUASI (American Urological Association Symptom Index) 13 or greater, a maximum flow rate 12 ml per second or less and a prostate 30 to 80 cc were randomized 2:1 between prostatic urethral lift and sham. In the prostatic urethral lift group small permanent implants are placed within the prostate to retract encroaching lobes and open the prostatic urethra.

Simultaneous versus staged bilateral unicompartmental knee replacement.

We prospectively followed 171 patients who underwent bilateral unicompartmental knee replacement (UKR) over a period of two years. Of these, 124 (72.5%) underwent a simultaneous bilateral procedure and 47 (27.

Revision total knee arthroplasty: causes and outcomes.

Introduction: Local data on revision total knee arthroplasty (TKA) are limited. This study aims to assess the causes and outcomes of revision TKA in a single institution, with a 2-year follow-up.

Materials And Methods: A retrospective review of case records of patients who underwent revision TKA in 2008 and 2009 in the authors' institution was performed.

Optical imaging as an expansion of nuclear medicine: Cerenkov-based luminescence vs fluorescence-based luminescence.

Integration of optical imaging technologies can further strengthen the field of radioguided surgery. Rather than using two separate chemical entities to achieve this extension, hybrid imaging agents can be used that contain both radionuclear and optical properties. Two types of such hybrid imaging agents are available: (1) hybrid imaging agents generated by Cerenkov luminescence imaging (CLI) of β-emitters and (2) hybrid imaging agents that contain both a radioactive moiety and a fluorescent dye.

Dosing of dabigatran etexilate in relation to renal function and drug interactions at a tertiary hospital.

Background: Plasma concentrations of the anticoagulant dabigatran are correlated with clinical outcomes, and are affected by renal function, intestinal P-glycoprotein (P-gp) activity and stomach acidity.

Aims: To determine the adherence to dabigatran etexilate renal dosing guidelines, the frequency of co-prescription of potentially interacting drugs in patients on dabigatran, and how these related to dabigatran dosing.

Methods: A retrospective chart review of 204 patients discharged from a tertiary hospital on dabigatran etexilate over a 12-month period.

Hyperparasitaemic human Plasmodium knowlesi infection with atypical morphology in peninsular Malaysia.

Plasmodium knowlesi is a potentially life-threatening zoonotic malaria parasite due to its relatively short erythrocytic cycle. Microscopic identification of P. knowlesi is difficult, with "compacted parasite cytoplasm" being one of the important identifying keys.

Diagnosis and management of Müllerian adenosarcoma of the uterine cervix.

Objective: To report on the diagnosis and management of Müllerian adenosarcoma of the uterine cervix at a gynecologic oncology unit in Singapore.

Methods: Nine cases (1992-2008) were identified from the unit registry. All hospital records were retrospectively analyzed.

Less outliers in pinless navigation compared with conventional surgery in total knee arthroplasty.

Purpose: The aim of this study was to investigate the effectiveness of a new pinless navigation system (BrainLAB(®) VectorVision(®) Knee 2.5 Navigation System) as an intra-operative alignment check in total knee arthroplasty using conventional cutting jigs.

Methods: 200 patients who underwent total knee arthroplasty using conventional technique or pinless navigation by a senior surgeon were included in the study and prospectively followed up.

Estimating time to disease progression comparing transition models and survival methods--an analysis of multiple sclerosis data.

This article reports an analysis that aims to quantify the effect of fingolimod, an oral treatment for relapsing remitting multiple sclerosis (MS), on disability progression. The standard approach utilizes survival analysis methods, which may be problematic for MS studies that assess disability at only a few time points and include as a cardinal feature both relapses and remissions. Instead, a Markov transition model, originally developed in the framework of longitudinal data, is fit, and its special probabilistic properties are used to estimate survival curves for time to disability progression.

Enhanced luminescence of Ag nanoclusters via surface modification.

Unlabelled: In this work we present a detailed study on the influence of surface modifications for luminescent silver (Ag) clusters. Ag clusters (25 atoms) capped with dihydrolipoic acid show a distinct absorbance spectrum with several sharp transitions, and relative broad deep red luminescence with a quantum yield of 5% combined with a remarkably long luminescence lifetime of ~3 μs at room temperature. Both pH and the presence of coordinating ligands influence the absorbance spectra and fluorescence intensity.

Joint line changes and outcomes in constrained versus unconstrained total knee arthroplasty for the type II valgus knee.

Purpose: The objective of this study was to compare the outcome of constrained and unconstrained primary total knee arthroplasty (TKA) in the management of the valgus deformity.

Methods: This is a retrospective review of patients with type II valgus knee who underwent primary TKA from 1999 to 2011. There were fifty patients in Group 1 who underwent varus-valgus constrained TKA.

Comparative demographics, ROM, and function after TKA in Chinese, Malays, and Indians.

Background: There is marked racial disparity in TKA use rates, demographics, and outcomes between white and Afro-Caribbean Americans. Comparative studies of ethnicity in patients undergoing TKAs have been mostly in American populations with an underrepresentation of Asian groups. It is unclear whether these disparities exist in Chinese, Malays, and Indians.

Comparing dose prediction software used to manage gentamicin dosing.

Background: Current Australian guidelines recommend initiating directed therapy of gentamicin if administration exceeds 48 h. Directed doses of gentamicin require the monitoring of plasma concentrations of gentamicin to determine the 24-h area under the time course of plasma gentamicin concentrations (AUC) and a dosage prediction program, for example TCIWorks or Aladdin. However, doses calculated by such programs have not been compared with an established program.

Simple novel bone bank storage: the Singapore General Hospital experience.

Introduction: Since 1981, the Singapore General Hospital (SGH) bone bank has proven to be a safe, reliable, and economical source of bone allografts. Femoral heads are used exclusively and are procured from patients undergoing hip arthroplasty. Screening for HIV, hepatitis B, and hepatitis C is carried out prior to surgery.

Multispectral visualization of surgical safety-margins using fluorescent marker seeds.

Optical guidance provided by luminescent marker seeds may be suitable for intraoperative determination of appropriate resection margins. In phantom studies we compared the tissue penetration of several organic dyes and inorganic particles (quantum dots; QDs) after incorporation in experimental marker seeds. The tissue penetration of (near infra-) red organic dyes was much better than the penetration of dyes and QDs with an emission in the visible range.

Evaluation of the relationship between anteroposterior translation of a posterior cruciate ligament-retaining total knee replacement and functional outcome.

The success of total knee replacement (TKR) depends on optimal soft-tissue balancing, among many other factors. The objective of this study is to correlate post-operative anteroposterior (AP) translation of a posterior cruciate ligament-retaining TKR with clinical outcome at two years. In total 100 patients were divided into three groups based on their AP translation as measured by the KT-1000 arthrometer.

Two-year outcome of early deep MRSA infections after primary total knee arthroplasty: a joint registry review.

The aim of this study is to determine the success rate in eradication of early methicillin-resistant Staphylococcus aureus (MRSA) prosthetic joint infection. Rate of prosthesis retention and functional outcome between patients with prosthesis retention and prosthesis revision were compared. All patients who underwent primary total knee arthroplasty between May 1998 and September 2008 at our institution developing early deep MRSA infection were included.