Is hybrid fixation in revision TKA using LCCK prostheses reliable?

Introduction: The optimal technique for component fixation in revision total knee arthroplasty (rTKA) remains controversial: full cementation (FC) versus hybrid fixation (HF), which involves press-fit stem with cement fixation in the metaphyseal and epiphyseal zones. Previous series have either demonstrated the superiority of one or the other of these techniques or their equivalence. However, few studies have compared these 2 methods for rTKA using the Legacy® Constrained Condylar Knee (LCCK) prosthesis (Zimmer, Warsaw, Indiana, USA).

Apathetic hyperthyroidism in an elderly patient presenting with psychomotor retardation.

Hyperthyroidism in the elderly population is often associated with atypical, blunted, or nonspecific signs and symptoms, also known as apathetic hyperthyroidism (AH). The absence of the classical hyperkinetic clinical presentation can be confused with the normal aging process, or other diseases, and often leads to misdiagnosis, delayed treatment, and negative outcomes for elderly patients. We provide a case study of an elderly patient to illustrate the atypical presentation of AH.

Second victim phenomenon: Is 'just culture' a reality? An integrative review.

Background: Despite rigorous and multiple attempts to establish a culture of patient safety and a goal to decrease incidence of patient deaths in the health care, estimations of preventable mortality due to medical errors varied widely from 44,000 to 250,000 in hospital settings. This magnitude of medical errors establishes patient safety as being at the forefront of public concerns, healthcare practice and research. In addition to the potential negative impact on patients and the healthcare system, medical errors evoke intense psychological responses in health care providers' responses that threaten their personal and professional selves, and their ability to deliver high quality patient care.

Physiological stress markers during breath-hold diving and SCUBA diving.

This study investigated the sources of physiological stress in diving by comparing SCUBA dives (stressors: hydrostatic pressure, cold, and hyperoxia), apneic dives (hydrostatic pressure, cold, physical activity, hypoxia), and dry static apnea (hypoxia only). We hypothesized that despite the hypoxia induces by a long static apnea, it would be less stressful than SCUBA dive or apneic dives since the latter combined high pressure, physical activity, and cold exposure. Blood samples were collected from 12SCUBA and 12 apnea divers before and after dives.

Exploring the experience of nurse practitioners who have committed medical errors: A phenomenological approach.

Background And Purpose: To explore the experience of committing medical error from the perspective of nurse practitioners (NPs). Overall, the purpose of the study is to discern NPs' behaviors, perceptions, and coping mechanisms in response to having made a medical error.

Methods: Qualitative research based on two face-to-face audio-recorded semistructured interviews with 10 NPs who had made medical errors in practice.

Transplanted lungs and the "white plague": A case-report and review of the literature.

Rationale: Solid organ transplant recipients, especially after lung transplantation, are at increased risk for Mycobacterium tuberculosis pulmonary tuberculosis due to lifelong immunosuppression.

Patient Concerns: A 41-year-old woman underwent a second bilateral lung transplantation that was complicated by fatal pulmonary tuberculosis.

Diagnoses: Histological examination of a lung biopsy performed 6 weeks after retransplantation revealed a caseating granuloma and necrosis.

Cerebrospinal fluid lens-free microscopy: a new tool for the laboratory diagnosis of meningitis.

Cerebrospinal fluid cytology is performed by operator-dependant light microscopy as part of the routine laboratory work-flow diagnosis of meningitis. We evaluated operator-independent lens-free microscopy numeration of erythrocytes and leukocytes for the cytological diagnosis of meningitis. In a first step, prospective optical microscopy counts of leukocytes done by five different operators yielded an overall 16.

[Surgery of giant bullae of emphysema in adults].

Over a 20 years period 50 patients with giant emphysematous bullae (bilateral in 20 cases) were operated upon. Fifteen had been exposed to an occupational risk (coal mining, steel milling, chemicals); all were, or had been, tobacco smokers; 11 were in acute respiratory distress at the time of surgery. Respiratory function tests showed mixed restrictive and obstructive impairment.

[Surgical risk in the treatment of esophageal cancer. Apropos of 100 consecutive cases].

One hundred patients with cancer of esophagus, including approximately 30% of serious cases as a result of age or associated affections, were treated by surgery between 1978 and 1982. The operative mortality of 6% confirms the evolution observed currently in specialized departments throughout the world.

[Gastroesophageal reflux. Anatomical, physiological and surgical aspects. Apropos of 61 consecutive cases of peptic esophagitis surgically treated with the same procedure].

Based on a literature review and a personal series of cases treated, it is considered that gastroesophageal reflux results mainly from a mechanical process. The importance of the gastric musculature is emphasized, particularly the oblique fibers which form a thick belt encircling the esophagogastric function. Reflux is assumed to be almost exclusively due to loss of fixation of the point of attachment of this belt which, because of its particular texture, allows gastric dilatation to be propagated to the esophagogastric junction.

[Intrathoracic chemodectomas. A report on four observations (author's transl)].

Intrathoracic chemodectomas are extremely rare tumours, the number, published up to the present time being less than 50. We wish to report here four personal cases, all resected. The diagnosis was never made before surgery but solely by histopathology.

[Emergency reoperation for breakdown of sutures of an intrathoracic oeso-digestive anastomosis (author's transl)].

Unlabelled: The authors report five cases of emergency reoperation for breakdown of an intrathoracic oeso-digestive anastomosis.

Results: 1 death, 1 failure, new fistula formation but with spontaneous cure within 20 days, 3 primary cures. The success of these reoperations seems to us to depend narrowly: - on the rapidity of diagnosis, facilitated at present by early radiological examination; - on the absolute emergency of reoperation as soon as the breakdown is obvious radiologically and clinically, - on the strictness of surgical technic which should be the same as for a cold operation.