Journal of clinical medicine
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Review
Single-Stage Revision Surgery in Infected Total Knee Arthroplasty: A PRISMA Systematic Review.
Periprosthetic joint infection in total knee arthroplasty is a significant complication that is a common reason for revision surgery. The current standard of care is two-stage revision surgery. There is however increasing evidence to support the use of single-stage revision surgery. ⋯ Although strict patient selection criteria have yielded successful results, good results were also reported when these criteria were not applied. The greater use of risk factors in identifying patients likely to have a successful outcome needs to be balanced with the practical benefits of performing a single stage procedure in higher risk patients. Future large clinical randomized control trials are required to confirm our results.
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Machine learning (ML) is a promising methodology for classification and prediction applications in healthcare. However, this method has not been practically established for clinical data. Hyperuricemia is a biomarker of various chronic diseases. We aimed to predict uric acid status from basic healthcare checkup test results using several ML algorithms and to evaluate the performance. ⋯ The ML model was superior to the CLR model for the prediction of hyperuricemia. Future studies are needed to determine the best-performing ML algorithms based on data set characteristics. We believe that this study will be informative for studies using ML tools in clinical research.
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This study investigated the effectiveness of a lighted stylet during tracheal intubation with direct laryngoscopy. The study randomly assigned 284 patients undergoing general anesthesia to either the simple stylet (Group S) or lighted stylet (Group L) groups. In both groups, stylet-assisted intubation was performed with direct laryngoscopy. ⋯ The incidence of mucosal bleeding was significantly higher in Group S (35 (25%) vs. 19 (13%), p = 0.011, Groups S and L, respectively). The total intubation time and degree of postoperative sore throat were not significantly different between the two groups. A lighted stylet increased the success rate of tracheal intubation during stylet-assisted tracheal intubation with direct laryngoscopy.
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Background: This study investigated the determinants (with a special emphasis on the role of diabetes app use, use of continuous glucose monitoring (CGM) device, and self-care behavior) of glycemic control of type 1 and type 2 diabetes mellitus (DM). Methods: A web-based survey was conducted using diabetes Facebook groups, online patient-forums, and targeted Facebook advertisements (ads). Demographic, CGM, diabetes app use, and self-care behavior data were collected. ⋯ Hyperglycemia in type 2 DM was increased by age (OR = 1.02, 95% CI: 1.00⁻1.04); high self-management concern (AOR = 2.59, 95% CI: 1.74⁻3.84); and poor confidence in self-management capacity (AOR = 3.22, 2.07⁻5.00). Conversely, diabetes app use (AOR = 0.63, 95% CI: 0.41⁻0.96) and "general diet" self-care (AOR = 0.84, 95% CI: 0.75⁻0.94), were significantly associated with the reduced odds of hyperglycemia. Conclusion: Diabetes apps, CGM, and educational interventions aimed at reducing self-management concerns and enhancing dietary self-care behavior and self-management confidence may help patients with diabetes to improve glycemic control.
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Sugammadex rapidly reverses muscle relaxation compared to acetylcholinesterase inhibitors. The long-term outcomes of sugammadex, however, are not well known. We compared 30-day postoperative outcomes following sugammadex and acetylcholinesterase inhibitor use in colorectal surgery patients. ⋯ We found no difference in 30-day postoperative outcomes following sugammadex and acetylcholinesterase inhibitor use. The only difference between these treatments was the associated incidence of delayed discharge, which was lower in group S.