两个阶段的修订:指示,技术和结果
Massimo Franceschini1, Leopoldo Pedretti1, Vincenzo Cerbone1
1Istituto Ortopedico "G. Pini", II Orthopaedic Clinic, University of Milan, Milan, Italy.
Annals of joint
|March 26, 2024
概括
周围假肢关节感染 (PJI) 管理需要精确的诊断和手术技术. 双阶段修复手术是复杂的PJI病例的关键方法,特别是当单阶段修复是禁忌时.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 生物医学工程 生物医学工程
背景情况:
- 周围假肢关节感染 (PJI) 在关节置换手术中提出了重大挑战.
- 在2018年国际共识会议 (ICM) 上提出了一个数值诊断工具.
- PJI对患者来说可能是毁灭性的,对外科医生来说可能是复杂的.
研究的目的:
- 概述PJI中两阶段修复手术的指示和方法.
- 为了突出单阶段修订的禁忌.
- 强调需要标准化PJI的诊断和治疗方案.
主要方法:
- 对Insall等人描述的两阶段假肢修改技术的审查.
- 对单阶段修订的禁忌的识别 (例如,软组织损害,耐药生物).
- 描述两阶段的过程:假肢摘除,脱bridement,间隔间隔器,抗生素,和延迟的重建.
主要成果:
- 当由于特定的患者或病原体因素而不能进行单阶段修订时,建议使用双阶段修订.
- 阶段之间的间隔可以从6周到几个月不等.
- 准确的手术前诊断和适当的技术对于成功的PJI治疗至关重要.
结论:
- 双阶段修复手术是管理复杂周围假肢关节感染的关键策略.
- 需要进一步的研究来优化PJI的时间,抗生素持续时间和诊断标准化.
- 有效管理PJI需要在诊断和手术干预方面的专业知识.
相关概念视频
Proofreading
Synthesis of new DNA molecules starts when DNA polymerase links nucleotides together in a sequence that is complementary to the template DNA strand. DNA polymerase has a higher affinity for the correct base to ensure fidelity in DNA replication. The DNA polymerase furthermore proofreads during replication, using an exonuclease domain that cuts off incorrect nucleotides from the nascent DNA strand.Errors during Replication Are Corrected by the DNA Polymerase EnzymeGenomic DNA is synthesized in...
Improving Translational Accuracy
Base complementarity between the three base pairs of mRNA codon and the tRNA anticodon is not a failsafe mechanism. Inaccuracies can range from a single mismatch to no correct base pairing at all. The free energy difference between the correct and nearly correct base pairs can be as small as 3 kcal/ mol. With complementarity being the only proofreading step, the estimated error frequency would be one wrong amino acid in every 100 amino acids incorporated. However, error frequencies observed in...
Guidelines and Strategies for Safe Computer Charting
The guidelines and strategies provided by the American Nurses Association (ANA) and the Canadian Nurses Association (CNA) offer essential principles for ensuring safe and secure computer charting systems in healthcare settings. Let's break down each recommendation:
Maintain Confidentiality and Security:
Maintain Confidentiality and Security:
Quality Control
Quality control is one of the three cyclical quality assurance activities that help keep a system under statistical control. Typical quality control activities include creating quality control charts, conducting proficiency testing, and documenting and archiving results.
Quality control helps track data, visualize trends, and identify variations, making it easier to detect deviations that may affect the accuracy of an analysis. One way to do this is by generating a quality control chart, which...
Quality control helps track data, visualize trends, and identify variations, making it easier to detect deviations that may affect the accuracy of an analysis. One way to do this is by generating a quality control chart, which...
Quality Assurance
Quality assurance is the overarching term used to describe the activities employed to ensure the proper performance of a system. These activities can be classified into three categories: quality control, quality assessment, and internal corrective measures. Typically, these activities work cyclically: quality control is performed before and during the analysis, while quality assessment occurs during and after the investigation. Internal corrective measures are implemented based on the findings...
FDA Approved Drugs: Changes to Approved Drugs
Post-approval, manufacturers may modify an approved new or generic drug product. Such modifications can encompass alterations in the Active Pharmaceutical Ingredient (API), manufacturing process, formulation, batch size, manufacturing site, and container closure system (FDA Guidance for Industry, April 2004). Often, a drug product may undergo multiple changes.These modifications require careful evaluation to determine their potential impact on the drug product's identity, strength, quality,...


