Increased Risk of New-Onset Rheumatoid Arthritis Among Osteoarthritis Patients Received Total Knee Arthroplasty: a global federated health network analysis.

Background: Complications of total knee arthroplasty (TKA) had been widely discussed. However, whether TKA influence risk of rheumatoid arthritis (RA) in osteoarthritis patients remained uncertain. We intend to evaluate the risk of RA in osteoarthritis patients underwent TKA. Methods: In this retrospective cohort study, data was retrieved from the US collaborative networks in TriNetX research network. Within the study period between 2005 and 2017, osteoarthritis patients underwent TKA were enrolled as case cohort whereas osteoarthritis patients never underwent TKA were enrolled as control cohort. Covariates were matched via propensity score matching. Risk of RA in TKA patients were valuated under various follow-up time and sensitivity models. Results: Under 1-year, 3-year and 5-year of follow-up, TKA patients were associated with significantly elevated risk of RA, especially under 1-year follow-up (HR=1.74; 95% CI, 1.39-2.18). Subgroup analysis demonstrated a significant increase in the risk of RA following TKA in the female subgroup (HR=1.42; 95% CI, 1.24-1.63), the subgroup aged 18-64 years (HR=1.48; 95% CI, 1.11-1.97), and the subgroup aged greater than 65 years old (HR=1.38; 95% CI, 1.21-1.58) based on 5-year follow-up. Conclusion: Clinicians should be concerned about uncharted association between TKA and RA reported our current study. Additional prospective studies and in-depth mechanistic inquiries were warranted to determine the causation.

Cerebrospinal fluid predictors of shunt-dependent hydrocephalus after hemorrhagic stroke: a systematic review and meta-analysis.

Hydrocephalus is a common complication of hemorrhagic stroke and has been reported to contribute to poor neurological outcomes. Herein, we aimed to investigate the validity of cerebrospinal fluid (CSF) data in predicting shunt-dependent hydrocephalus (SDHC) in patients with hemorrhagic stroke. PubMed, CENTRAL, and Embase databases were searched for relevant studies published through July 31, 2021. The 16 studies with 1505 patient included those in which CSF data predicted risk for SDHC and reports on CSF parameters in patients in whom SDHC or hydrocephalus that was not shunt-dependent developed following hemorrhagic stroke. We appraised the study quality using Newcastle-Ottawa Scale and conducted a meta-analysis of the pooled estimates of the CSF predictors. The meta-analysis revealed three significant CSF predictors for shunt dependency, i.e., higher protein levels (mean difference [MD] = 32.09 mg/dL, 95% confidence interval [CI] = 25.48-38.70, I2 = 0%), higher levels of transforming growth factor ß1 (TGF-ß1; MD = 0.52 ng/mL, 95% CI = 0.42-0.62, I2 = 0%), and higher ferritin levels (MD = 108.87 µg/dL, 95% CI = 56.68-161.16, I2 = 36%). The red blood cell count, lactate level, and glucose level in CSF were not significant in predicting SDHC in patients with hemorrhagic stroke. Therefore, higher protein, TGF-ß1, and ferritin levels in CSF are significant predictors for SDHC in patients with hemorrhagic stroke. Measuring these CSF parameters would help in the early recognition of SDHC risk in clinical care.

Intracranial solitary fibrous tumor/hemangiopericytoma - A case series.

BACKGROUND: Intracranial solitary fibrous tumor/hemangiopericytoma (HPC) is a rare and aggressive tumor. We conducted this retrospective study to investigate the outcome of patients after treatment, the efficacy of postoperative adjuvant radiotherapy, and the factors not conducive to total resection. METHODS: We conducted a retrospective review of the medical records of patients harboring fresh intracranial solitary fibrous tumor/HPC treated from January 2009 to December 2019 in our hospital. We reviewed their clinical presentations, radiologic appearances, tumor size and location, extent of resection, estimate intraoperative blood loss, treatment modalities and results, and duration of follow-up. RESULTS: There were seven consecutive patients (three males and four females). The ages of the patients at the time of diagnosis ranged from 35 to 77 years (mean: 52.86 years). Five patients (71.43%) got tumor bigger than 5 cm in dimension and only 1 patient (14.29%) underwent gross total tumor resection in the first operation without complication. Five patients (71.43%) underwent postoperative adjuvant radiotherapy. Follow-up period ranged from 4.24 to 123.55 months and the median follow-up period was 91.36 months. Three patients had favorable outcome with Glasgow Outcome Scale (GOS) equal to 4; four patients had unfavorable outcome with GOS equal to 2 or 3. No mortality was happened. CONCLUSION: Gross total tumor resection in the initial surgery is very important to achieve a better outcome. Massive intraoperative bleeding and venous sinus or major vessels adjoining are factors not conducive to total resection. Radiotherapy can be administered as adjuvant therapy for cases showing an aggressive phenotype or not treated with gross total resection.

Particulates and particulates-bound mercury (Hg(p)) sizes (PM18, PM10, PM2.5, PM1, PM<1) distributions study by using MOUDI sampler at a complex sampling site.

The objectives of this study were to measure ambient air particles concentrations of different particulates sizes ranges (PM18, PM10, PM2.5, PM1, PM<1) at a complex (traffic, residential and commercial) site. Besides, particulates-bound mercury (Hg(p)) concentrations for various particulates sizes (PM18, PM10, PM2.5, PM1, PM<1) at mixed site were also studied. Finally, ambient air particulates and Hg(p) size distributions were also described at this complex sampling site. The results showed that the average PM18, PM10, PM2.5, PM1, PM<1 concentrations were 48.83, 41.78, 35.41, 19.89, and 11.86 µg/m3, respectively. And the average ambient air particulates-bound mercury (Hg(p)) which attached on PM18, PM10, PM2.5, PM1, PM<1 particles concentrations were 0.0838, 0.0867, 0.0790, 0.0546, and 0.0373 ng/m3, respectively, in the summer season. In addition, the average ambient air Hg(p) which attached on PM18, PM10, PM2.5, PM1, PM<1 particles concentrations were 0.0175, 0.0144, 0.0120, 0.0092, and 0.0057 ng/m3, respectively, in the autumn season. Finally, the average ambient air Hg(p) which attached on PM18, PM10, PM2.5, PM1, PM<1 particles concentrations were 0.0070, 0.0053, 0.0038, 0.0026, and 0.0014 ng/m3, respectively, in the winter season. And July has the average highest PM18 and PM10 concentrations. As for PM2.5, PM1 and PM<1 particulates, the average highest particulates concentrations all occurred in November. In addition, the highest average Hg(p) in PM18, PM10, PM2.5, PM1, and PM<1 concentrations all occurred in July. Moreover, the average particles and particulates-bound mercury m.m.d. values were ranged from 1.0 to 1.8 and 0.7 to 2.0 µm from July to December of 2018, respectively, at this mixed sampling site. As for monthly ambient air particles sizes distributions, the results further showed that the main peaks for July, September, and December all occurred in the sizes of 10-18 µm. The main peaks for October and November all occurred in the sizes of 2.5-10 µm. As for monthly Hg(p) sizes distributions, the results further showed that the main peaks for July occurred in the size of 0.3-1 µm. The main peak for September occurred in the size of 1-2.5 µm. The main peaks for October to December all occurred in the size of 10-18 µm. The above finding further concluded that the particulates-bound mercury (Hg(p)) was tended to be associated with the large particles sizes mode during the winter season. Finally, this study further shows that the Taichung Thermal Power Plant was responsible for the main emission source of Hg(p) especially in summer season of Central Taiwan.

Intraspinal tumors: analysis of 184 patients treated surgically.

BACKGROUND: Intraspinal tumors are rare central nervous system neoplasms. The reported clinical features of intraspinal tumors have varied in previous studies. We present here the cases of 184 patients with intraspinal tumors treated surgically in our hospital and a review of the literature. METHODS: We conducted a retrospective review of 184 patients with intraspinal tumors who underwent surgical treatment in our institution between 2002 and 2013. Their age, sex, initial presentation, tumor location, level of affected vertebral column, histological diagnosis, and primary origin of the metastatic tumor were reviewed and analyzed. RESULTS: Of these 184 patients, 97 (52.7%) were men and 87 (47.3%) were women. The mean age was 56.3 years (range 7-83 years). A total of 102 (55.4%) had primary tumors, while 82 (44.6%) patients had developed metastatic tumors. The histological diagnosis of the primary tumors included 55 (53.9%) schwannomas, 16 (15.7%) meningiomas, six (5.9%) ependymomas, five (4.9%) neurofibromas, three (2.9%) hemangiomas, two (2.0%) hemagioblastomas, and 15 (14.7%) other tumor types. The most common primary sites of the metastatic tumors were the lung and breast. CONCLUSION: Primary tumors were more numerous than metastastic tumors in our series of patients. For the primary tumors, our study showed a higher proportion of nerve sheath cell tumors (schwannomas and neurofibromas) and fewer meningiomas and neuroepithelial tumors compared with reports from non-Asian countries. In addition, the lung was the most common origin of the metastatic tumors and more than half of these tumors were located at the thoracic spine. Back pain and radicular pain were the most common presentations in patients with intraspinal tumors.

[Measurement of the reactive oxygen species and cytokines in the seminal plasma of leukocytospermic patients].

OBJECTIVES: To detect the levels of reactive oxygen species (ROS), superoxide dismutase(SOD) and interleukin 8(IL-8) in seminal plasma of infertile patients, and evaluate the possible relationship between those levels. METHODS: Semen was collected from normal donors (15 cases), infertile men without infection (16 cases), and infertile men with infection (leukocytospermia, 11 cases). The routine analysis of semen was accomplished, and then the levels of IL-8, malondialdehyde (MDA), SOD, and white blood cell (WBC) were examined. The correlative analysis between the level of ROS and other parameters in these populations was made. RESULTS: In leukocytospermic group, the levels of MDA, WBC, and IL-8 were higher than those in the other two groups (P < 0.001). Significantly positive correlation was observed between IL-8 and MDA (r = 0.852, P < 0.001) and between the levels of IL-8 and WBC. CONCLUSIONS: These findings suggest that increased oxidative stress in patients with leukocytospermia may cause the increase of IL-8(r = 0.818, P < 0.01). The increased oxidative stress may be due to defect in ROS scavenging system.