Objectives: Early acute periprosthetic joint infections (PJIs) treated with debridement, antibiotics and implant retention (DAIR) have failure rates ranging from 10% to 60%. We determined the efficacy of applying local gentamicin-impregnated beads and/or sponges during debridement in early PJI.
Methods: Patients with early acute PJI, defined as less than 21 days of symptoms and treated with DAIR within 90 days after index surgery, were retrospectively evaluated. Early failure was defined as PJI-related death, the need for implant removal or a second DAIR or antibiotic suppressive therapy owing to persistent signs of infection, all within 60 days after initial debridement. Overall failure was defined as implant removal at any timepoint during follow-up. A 1:1 propensity score matching was performed to correct for confounding factors.
Results: A total of 386 patients were included. Local gentamicin was applied in 293 patients (75.9%) and was withheld in 93 patients (24.1%). Multivariate analysis demonstrated that the use of local gentamicin was independently associated with early failure (OR = 1.97, 95% CI = 1.12-3.48). After propensity matching, early failure was 40.3% in the gentamicin group versus 26.0% in the control group (P = 0.06) and overall failure was 5.2% in the gentamicin group versus 2.6% in the control group (P = 0.40). These numbers remained when solely analysing the application of gentamicin-impregnated sponges.
Conclusions: Even after propensity score matching, failure rates remained higher if local gentamicin-impregnated beads and/or sponges were administered in early acute PJI. Based on these results, their use should be discouraged.
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http://dx.doi.org/10.1093/jac/dky354 | DOI Listing |
Eur J Haematol
January 2025
Venous Thromboembolism Unit, Internal Medicine Department, General University Hospital Gregorio Marañón, Madrid, Spain.
Introduction: Anticoagulant therapy is critical for venous thromboembolism (VTE) management, though bleeding remains a major concern, ranging from mild to fatal events. This study aimed to assess the predictive value of cytokines for major bleeding in patients with acute pulmonary embolism (PE).
Methods: In this prospective, observational study, patients aged ≥ 18 years with acute PE were enrolled from April 2021 to September 2022 and followed for 30 days.
Appl Neuropsychol Adult
January 2025
University Department of Neurology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
Unlabelled: Greater empirical and scientific attention is still put on patients with left brain hemisphere (LBH) damage where language impairments are common and expected. In patients with RBH damage, language assessment is therefore rarely done in the acute phase of stroke recovery.
Purpose: To investigate language impairments in the acute phase of stroke using a Croatian standardized language battery for the first time and compare patients with RBH stroke, LBH stroke and healthy individuals.
Support Care Cancer
January 2025
Department of Acute Medicine, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, UK.
Purpose: Management of patients with low-risk febrile neutropenia in an outpatient setting guided by the MASCC score is proven to be safe and effective. Most patients on ambulatory low-risk febrile neutropenia pathways are undergoing treatment for breast cancer. Recent data has shown benefit of the addition of immune checkpoint inhibitor therapy to cytotoxic chemotherapy in the neoadjuvant setting for patients with early triple-negative breast cancer.
View Article and Find Full Text PDFPancreatology
January 2025
Department of General Surgery, Pancreatic Disease Center, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:
Background: Post-pancreatectomy acute pancreatitis (PPAP) is an early acute inflammatory process of the pancreatic remnant that is associated with a series of downstream pancreas-specific complications. This study aimed to investigate the relationship between postoperative serum C-reactive protein (CRP) levels and the occurrence of PPAP after pancreaticoduodenectomy (PD).
Methods: Consecutive patients who underwent PD between January 1, 2020, and May 31, 2022, were retrospectively analyzed.
J Neurointerv Surg
January 2025
Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
Background: Post-stroke epilepsy (PSE) is a major complication of stroke. However, data about the predictors of PSE in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy are limited.
Objective: To evaluate the relationship between intraoperative angiographic signs and PSE risk in patients with anterior circulation AIS who underwent mechanical thrombectomy.
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