Demand for low-cost, high-quality health care has forced the total joint replacement (TJR) industry to evaluate and mitigate high variable costs. Minimizing hospital stay can significantly reduce total cost of care. A shortened hospital stay does not compromise patient safety or satisfaction, and may reduce perioperative complications compared with multiple-day hospitalizations. Through the use of enhanced recovery clinical pathways, outpatient TJRs have progressively shortened hospitalizations. Successful ambulatory TJR can be accomplished through advances in surgical technique, presurgical patient education, opioid-sparing multimodal analgesia, anesthetic techniques that facilitate rapid recovery, and progressive rehabilitation.
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http://dx.doi.org/10.1016/j.anclin.2019.01.006 | DOI Listing |
Diabetologia
January 2025
MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Aims/hypothesis: UK standard care for type 2 diabetes is structured diabetes education, with no effects on HbA, small, short-term effects on weight and low uptake. We evaluated whether remotely delivered tailored diabetes education combined with commercial behavioural weight management is cost-effective compared with current standard care in helping people with type 2 diabetes to lower their blood glucose, lose weight, achieve remission and improve cardiovascular risk factors.
Methods: We conducted a pragmatic, randomised, parallel two-group trial.
Sci Rep
January 2025
Department of Respiratory medicine, Taian 88 Hospital, Taian, 271000, People's Republic of China.
Recent empirical investigations reinforce the understanding of a profound interconnection between metabolic functions and Obstructive Sleep Apnea-hypopnea Syndrome (OSAHS). This study identifies distinctive miRNA signatures in OSAHS with Metabolic Syndrome (Mets) patients from healthy subjects, that could serve as diagnostic biomarkers or describe differential molecular mechanisms with potential therapeutic implications. In this study, OSAHS with MetS patients showed significantly higher Apnea Hyponea Index(AHI), but lower oxygen desaturation index(ODI 4/h) and minimum pulse oxygen saturation(SpO).
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1/10, 40136, Bologna, Italy.
Introduction: Two-stage revision is considered the gold standard treatment in chronic periprosthetic joint infection (PJI) but no specific criteria or examination exist to determine infection eradication before reimplantation. This study aimed to assess the diagnostic performance of leukocyte scintigraphy after the first-stage procedure in two-stage revision for chronic PJI.
Material And Methods: Patients studied with leukocyte scintigraphy after cement spacer insertion for knee PJI from January 2012 to December 2021 were retrospectively included.
Sci Rep
January 2025
Department of Mechanical Engineering, College of Engineering, King Khalid University, Abha, 61421, Saudi Arabia.
Fault ruptures induced by earthquakes pose a significant threat to constructions, particularly underground structures such as pile foundations. Among various foundation types, batter pile foundations are widely used due to their ability to resist inclined forces. To gain new insights into the response of batter pile groups to fault ruptures caused by earthquakes, this study investigates the deformation and failure mechanisms of batter pile groups due to the propagation of normal and reverse fault ruptures using 3D numerical modeling.
View Article and Find Full Text PDFZhongguo Gu Shang
January 2025
Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China.
Tibial plateau fracture is a fracture involving the proximal articular surface of the tibia, and its injury mechanism is complex, the fracture morphology is different, and it is often accompanied by different degrees of soft tissue injury, which is difficult to diagnose and treat. In recent years, the research hotspot has focused on solving the reduction and fixation of the posterior lateral column of the tibial plateau, because it has been clinically found that the residual sagittal plane after tibial plateau fracture is insufficient reduction or loss of reduction leads to knee joint dysfunction. The posterior inclination angle of the tibial plateau is an important parameter to describe the sagittal alignment of the tibia.
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