Racial Disparities in Total Knee and Hip Arthroplasty in a Medically Underserved Community with a Diverse Population.

INTRODUCTION: Previous studies have demonstrated lower total joint arthroplasty utilization rates and worse postoperative outcomes among non-White patients. Our study examined whether these disparities exist in the setting of a diverse population. METHODS: This retrospective study included patients with a self-reported race who underwent total knee (TKA) or hip (THA) arthroplasty procedures in a racially diverse county. Patients who did not identify as White or Hispanic/Latino were excluded from the study due to small sample sizes. Demographic, intra and postoperative outcome differences were calculated. A multivariate logistic regression was developed to examine the association between patients' race and undesired postoperative outcomes. RESULTS: Five hundred fifty-five patients were included in our study with 490 identifying as non-Hispanic/Latino White (88.8%) and 65 as Hispanic/Latino (11.2%). Hispanic/Latino-identifying patients were significantly younger (61.9 ± 12.79 versus 68.58 ± 9.00 years), had lower Charlson Comorbidity Index scores, and were more likely to use non-Medicare/Medicaid insurance. We observed no differences between our cohorts in postoperative adverse events, emergency department visits, and hospital readmissions. Patients' self-identified race was not correlated with undesired postoperative outcomes. CONCLUSIONS: Although Hispanic/Latino-identifying patients constitute 50.2% of the county population of our study cohort, they accounted for only 11.2% of the patients in our study. This is noteworthy considering the lack of evidence suggesting a decreased prevalence of osteoarthritis among individuals of different races and ethnicities. Further, the demographic differences we observed suggest an exclusive Hispanic/Latino patient population utilizing TKA or THA procedures. Future studies controlling for risk factors and less invasive treatment options may explain these disparities.

Synthesis of propyl-functionalized hybrid monolithic silica capillaries and evaluation of their performances in nano-LC and CEC.

During the last decade, silica monolithic capillaries have focused more and more attention on miniaturized separation techniques like CEC, nano-LC, and chip electrochromatography owing to their unique chromatographic properties and to their possible in situ synthesis. Nevertheless, the preparation of conventional silica-based individual monolithic columns is time consuming, owing to the individual steps involved, including the synthesis of the silica matrix and its subsequent on-column chemical grafting. The hybrid organic-inorganic monoliths, whose synthesis is based on the polycondensation of siloxane with organosiloxane precursors, seems to be an attractive alternative since their direct synthesis leads to silica monoliths with organic moieties covalently linked to the inorganic silica matrix through hydrolytically stable Si-C bonds. This study describes the synthesis of hybrid monoliths using propyltrimethoxysilane (C3-TriMOS) as a new kind of silica coprecursor to subsequently increase the hydrophobicity of the stationary phase. The influence of several experimental parameters (pH, gelation temperature, relative proportion of the precursors) on the textural (skeleton and macropore size) and chromatographic properties (efficiency, retention, and electroosmotic mobility) of the obtained monoliths are discussed. The results show that the optimal coprecursor incorporation is obtained after a postgelation step during which the condensation of the C3-TriMOS coprecursor is favored by an increase in the pH medium. Thermal hydrolysis of urea previously added to the polymerization mixture allows this in situ pH increase. These hybrid monoliths present hydrophobic properties and allow the separation of test mixtures in the RP mode without any further modification. Moreover, they present excellent efficiencies since reduced plate height as low as 5 and 15 microm are obtained in the electrodriven mode (CEC) and in the hydrodynamic one (nano-LC), respectively.

An overview of SSR149415, a selective nonpeptide vasopressin V(1b) receptor antagonist for the treatment of stress-related disorders.

Vasopressin (AVP) and corticotropin-releasing factor (CRF) are key mediators in the organism's neuro-adaptive response to stress. Through pituitary and central vasopressin V(1b) receptors, AVP participates in the control of the hypothalamic-pituitary-adrenal axis (HPA) and is involved in various emotional processes. SSR149415 is the first selective, orally active vasopressin V(1b) receptor antagonist yet described. It is a competitive antagonist with nanomolar affinity for animal and human V(1b) receptors and displays a highly selective profile with regard to a large number of receptors or enzymes. In vitro, SSR149415 potently antagonizes functional cellular events associated with V(1b) receptor activation by AVP, such as intracellular Ca(2+) increase or proliferation in various cell systems. Pharmacological studies, performed by measuring ACTH secretion induced by various stimulants such as hormones (AVP or AVP + CRF) or physical stress (restraint or forced swimming stress and dehydration) in conscious rats or mice, confirm the antagonist profile of SSR149415 and its efficacy in normalizing ACTH secretion in vivo. SSR149415 is active by the oral route, at doses from 3 mg/kg, it potentiates CRF effect and displays a long-lasting oral effect in the different models. At 10 mg/kg p.o. its duration of action is longer than 4 h. This molecule also decreases anxiety and exerts marked antidepressant-like activity in several predictive animal models. The anxiolytic effects of SSR149415 have been demonstrated in various Generalized Anxiety Disorders (GAD) models (four-plate, punished drinking, elevated plus-maze, light dark, mouse defense test battery, fear-potentiated startle and social interaction tests). It is as effective as the benzodiazepine diazepam in the acute stress exposure test. SSR149415 has similar efficacy to the reference antidepressant drug, fluoxetine, in acute (forced-swimming) and chronic (chronic mild stress and subordination stress) situations in rodents. SSR149415 also reduces offensive aggression in the resident-intruder model in mice and hamsters. Depending on the model, the minimal effective doses are in the range of 1-10 mg/kg i.p. or 3-10 mg/kg p.o. SSR149415 is devoid of adverse effects on motor activity, sedation, memory or cognitive functions and produces no tachyphylaxis when administered repeatedly. It is well-tolerated in animals and humans and exhibits an adequate ADME profile. Thus, SSR149415 is a new dual anxiolytic/antidepressant compound, which appears to be free of the known side effects of classical anxiolytic/antidepressant drugs. Clinical trials are in progress, they will hopefully demonstrate its therapeutical potential for treating stress-related disorders.