Rapid recovery programs in arthroplasty: the money side.

The implementation of rapid recovery programs is the result of continuing efforts to achieve a shorter convalescing and faster "return-to-life" leading to higher quality and increased cost-effectiveness. The current traditional payment system stifles efficiency and the implementation of these programs. These payment systems incentivize "slowness" and longer lengths-of-stay.

[Metabolic syndrome risk assessment in children: use of a single score].

Objective:: To calculate a score of metabolic syndrome (MetS) in children and set a cutoff point of this score for the prediction of MetS risk.

Methods:: The study included a random sample of 348 children aged 8 and 9 years of Viçosa, Southeast Brazil. Factor analysis by principal components (PCA) was used to determine, among various risk factors, those with higher degrees of intercorrelation.

Foucault test: shadowgram modeling from the physical theory for quantitative evaluations.

The physical theory of the Foucault test has been investigated to represent the complex amplitude and irradiance of the shadowgram in terms of the wavefront error; however, most of the studies have limited the treatment for the particular case of nearly diffraction-limited optical devices (i.e., aberrations smaller than the wavelength).

Draft Genome Sequence of Colistin-Only-Susceptible Pseudomonas aeruginosa Strain ST235, a Hypervirulent High-Risk Clone in Spain.

We report the genome of colistin-only-susceptible Pseudomonas aeruginosa strain ST235 (PA_ST235). This isolate was obtained in the setting of an outbreak in a tertiary hospital in Spain. This clone was apparently associated with a significantly higher mortality rate.

Comparison of access to services in rural emergency departments in Quebec and British Columbia.

Introduction: Although emergency departments (EDs) in Canada's rural areas serve approximately 20% of the population, a serious problem in access to health care services has emerged.

Objective: The objective of this project was to compare access to support services in rural EDs between British Columbia and Quebec.

Methods: Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities.

Nontranscriptional role of Hif-1α in activation of γ-secretase and notch signaling in breast cancer.

γ-Secretase is composed of four proteins that are obligatory for protease activity: presenilin, nicastrin, Aph1, and Pen-2. Despite the progress toward understanding the function of these individual subunits, there is no information available pertaining to the modulation of γ-secretase in response to environmental changes in cells. Here, we show that hypoxia upregulates γ-secretase activity through a direct interaction with Hif-1α, revealing an unconventional function for Hif-1α as an enzyme subunit, which is distinct from its canonical role as a transcription factor.

Cadmium and lead in chocolates commercialized in Brazil.

Cadmium (Cd) and lead (Pb) concentrations and their relationship to the cocoa content of chocolates commercialized in Brazil were evaluated by graphite furnace atomic absorption spectrometry (GF AAS) after microwave-assisted acid digestion. Several chemical modifiers were tested during method development, and analytical parameters, including the limits of detection and quantification as well as the accuracy and precision of the overall procedure, were assessed. The study examined 30 chocolate samples, and the concentrations of Cd and Pb were in the range of <1.

Draft Whole-Genome Sequence of OXA-48-Producing Multidrug-Resistant Klebsiella pneumoniae KP_ST11_OXA-48.

We present the draft genome sequence of a blood culture isolate of OXA-48-producing Klebsiella pneumoniae (sequence type 11 [ST11]) obtained in the course of a hospital outbreak in Spain. Sequence analysis showed 121 genes related to antibiotic and antiseptic resistance, including blaOXA-48, which was located in an IncL/M plasmid.

What is the role of mental health in primary total knee arthroplasty?

Background: Psychological distress has been associated with inferior scores for pain after total knee arthroplasty (TKA). However, its relationships with scores and arthrofibrosis after TKA remain unclear.

Question/purposes: The objectives of this study were (1) to assess patient-reported outcomes (PROs), including Knee Society (KS) scores, of those patients who developed arthrofibrosis and underwent manipulation and compare them with a control group; and (2) in patients with arthrofibrosis who underwent manipulation, to determine PROs and KS scores of those with psychological distress and those without it.

Functionality of Varroa-resistant honey bees (Hymenoptera: Apidae) when used for western U.S. honey production and almond pollination.

Two types of honey bees, Apis mellifera L., bred for resistance to Varroa destructor Anderson & Trueman, were evaluated for performance when used for honey production in Montana, and for almond pollination the following winter. Colonies of Russian honey bees and outcrossed honey bees with Varroa-sensitive hygiene (VSH) were compared with control colonies of Italian honey bees.

Multiclonal spread of VIM-1-producing Enterobacter cloacae isolates associated with In624 and In488 integrons located in an IncHI2 plasmid.

Over a 6-year period (2007-2012), the emergence of Enterobacter cloacae isolates resistant to β-lactams and with reduced susceptibility to carbapenems was observed in Hospital Universitario 12 de Octubre (Madrid, Spain). To determine the possible role of metallo-β-lactamases (MBLs) in the resistance profile of these isolates, a molecular and clinical epidemiological study was performed, including determination of patients' clinical characteristics, genetic diversity of strains, resistance mechanisms to carbapenems, and the genetic environment of VIM-1. A total of 73 E.

[Clinical relevance of drug interactions between nonsteroidal antiinflammatory drugs (NSAIDs) and antihypertensives].

Objective: To establish the clinical relevance of drug interactions between nonsteroidal antiinflammatory drugs (NSAIDs) and antihypertensives, based on the interaction severity and probability of occurrence.

Design: Systematic review.

Data Sources: A PubMed/Medline search was made using the MeSH terms: NSAIDs, Antihypertensive drugs, and Drug interactions.

Simultaneous determination of erlotinib and metabolites in human urine using capillary electrophoresis.

The purpose of this study was to develop a simple and sensitive CE-UV method to quantify erlotinib and metabolites in urine. Following liquid-liquid extraction, erlotinib, and metabolites were separated with a BGE whose composition was phosphate buffer (pH 2.5, 65 mM) with 0.

Use of limited proteolysis and mutagenesis to identify folding domains and sequence motifs critical for wax ester synthase/acyl coenzyme A:diacylglycerol acyltransferase activity.

Triacylglycerols and wax esters are synthesized as energy storage molecules by some proteobacteria and actinobacteria under stress. The enzyme responsible for neutral lipid accumulation is the bifunctional wax ester synthase/acyl-coenzyme A (CoA):diacylglycerol acyltransferase (WS/DGAT). Structural modeling of WS/DGAT suggests that it can adopt an acyl-CoA-dependent acyltransferase fold with the N-terminal and C-terminal domains connected by a helical linker, an architecture demonstrated experimentally by limited proteolysis.

A descriptive study of access to services in a random sample of Canadian rural emergency departments.

Objective: To examine 24/7 access to services and consultants in a sample of Canadian rural emergency departments (EDs).

Design: Cross-sectional study-mixed methods (structured interview, survey and government data bases) with random sampling of hospitals.

Setting: Canadian rural EDs (rural small town (RST) definition-Statistics Canada).

Draft Whole-Genome Sequence of VIM-1-Producing Multidrug-Resistant Enterobacter cloacae EC_38VIM1.

The VIM-1-producing multidrug-resistant strain Enterobacter cloacae was isolated from blood culture. The strain showed multiple resistances to clinically used antibiotics, including all β-lactams, fluoroquinolones, aminoglycosides, and sulfonamides. Sequence analysis showed the presence of 14 genes associated with resistance to antibiotics, including the metallo-β-lactamase VIM-1 gene, which was located in a class 1 integron.

Celecoxib and heterotopic bone formation after total hip arthroplasty.

We assessed the effectiveness of celecoxib in the prevention of heterotopic ossification (HO) following primary total hip replacement (THR). We studied 170 consecutive THRs. Sixty-three patients received celecoxib after surgery (200mg twice/daily) for 28 days and 84 did not.

Vitamin D insufficiency in patients with THA: prevalence and effects on outcome.

Background: The consequences of vitamin D insufficiency in the elderly remain controversial. The prevalence and potential effects of its chronic insufficiency on quality of life and physical function in patients undergoing THA have received little attention.

Question/purposes: We determined (1) prevalence of preoperative vitamin D insufficiency in patients undergoing THA and (2) relationships of insufficiency to patient-perceived outcomes (PPOs) and hip scores.

Clonal diversity among Burkholderia cepacia complex isolates from cystic fibrosis patients in a reference unit.

Introduction: The epidemiology of Burkholderia cepacia complex (Bcc) in cystic fibrosis (CF) is not widely known.

Methods: All CF patients with Bcc between 2002 and 2011 were reviewed, and a molecular analysis of isolates was performed.

Results: The prevalence of Bcc infection was 7.

Temporal activity in particular segments and transitions in the olympic triathlon.

The Olympic Triathlon is a combined endurance sport. It includes back-to-back swimming, cycling, running and the transition between events (T1 & T2). The aim of the current study was to analyse the possible relationship between the Lost Time T1 & T2 and overall performance.

Effect of cycling competition type on effort based on heart rate and session rating of perceived exertion.

Aim: The aim of this study was to compare the exercise intensity and competition load during Time Trial (TT), Flat (FL), Medium Mountain (MM) and High Mountain (HM) stages based heart rate (HR) and session rating of perceived exertion (RPE).

Methods: We monitored both HR and RPE of 12 professional cyclists during two consecutive 21-day cycling races (Vuelta a España) in order to analyze the exercise intensity and competition load (TRIMPHR and TRIMPRPE).

Results: The highest (P<0.

Readmission rates in the state of Florida: a reflection of quality?

Background: High readmission rates are viewed by the Centers for Medicare & Medicaid Services as a quality of care determinant but it is unclear whether readmission rates per se reflect quality and the drivers of readmissions after hip arthroplasty remain unclear.

Question/purposes: We therefore describe the effects of (1) insurance, discharge disposition, and mental health status as they relate to rates; (2) rehospitalization charges; and (3) reasons for readmissions.

Methods: We studied a cohort of all 27,019 patients who initially underwent hip arthroplasty in Florida (April 2009 to March 2010).