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1.
JBJS Case Connect ; 12(4)2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36563172

RESUMO

CASE: A 70-year-old woman presented with severe trunk deformity, gait disturbance, and bilateral hip pain. Radiography and magnetic resonance imaging revealed severe spinal kyphosis, bilateral osteoarthritis of the hip joints, and lumbar canal stenosis. A 2-stage corrective surgery for the treatment of spinal kyphosis was performed. Subsequently, the spinopelvic alignment changed remarkably. The spinal symptoms and radiographic parameters improved postoperatively, and bilateral hip pain and range of motion also showed improvement. CONCLUSION: Corrective surgery for the treatment of degenerative spinal kyphosis affected the spinopelvic alignment, and the symptoms of simultaneous coxarthrosis also improved after the corrective surgery.


Assuntos
Cifose , Osteoartrite do Quadril , Feminino , Humanos , Idoso , Osteoartrite do Quadril/cirurgia , Coluna Vertebral/cirurgia , Pelve , Cifose/cirurgia , Dor
2.
J Knee Surg ; 33(12): 1238-1242, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31284321

RESUMO

A longer surgical time will lead to postoperative complications in orthopaedic surgery. According to previous reports, surgeon volume affects a surgical time in anterior cruciate ligament (ACL) reconstruction. However, little attention has been paid to difference of a surgical time between high- and low-volume surgeons in ACL reconstruction. The purpose of the present study was to investigate the surgical time for both high- and low-volume surgeons and to clarify technical obstacles as well as the important technique to reduce the surgical time in ACL reconstruction. A total of 103 knees in 103 patients with ACL tear were enrolled. All the procedures were performed by 13 different surgeons. The surgeons were divided into two surgeon groups (high- and low-volume groups) based on the number of annual cases. The operative technique was divided into the same five steps to perform comparisons of step-by-step surgical time between the surgeon groups of different volumes. The statistical comparison was done between high- and low-volume groups in terms of surgical time in each step. Total operation times were 87.8 ± 17.6 and 129.9 ± 42.9 minutes in high- and low-volume group, respectively. Low-volume surgeons took much time in tendon harvesting and bone tunnel creation using arthroscopy. Low-volume surgeons took more time for primary ACL reconstruction, especially in tendon harvesting, compared with high-volume surgeons. Tendon harvesting was extremely important, as well as bone tunnel creation, for low-volume surgeons to reduce surgical time in primary ACL reconstruction.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Competência Clínica , Duração da Cirurgia , Cirurgiões Ortopédicos , Adolescente , Adulto , Lesões do Ligamento Cruzado Anterior/epidemiologia , Reconstrução do Ligamento Cruzado Anterior/métodos , Reconstrução do Ligamento Cruzado Anterior/normas , Reconstrução do Ligamento Cruzado Anterior/estatística & dados numéricos , Artroscopia/efeitos adversos , Artroscopia/métodos , Artroscopia/normas , Artroscopia/estatística & dados numéricos , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Feminino , Humanos , Masculino , Cirurgiões Ortopédicos/normas , Cirurgiões Ortopédicos/estatística & dados numéricos , Ortopedia/normas , Ortopedia/estatística & dados numéricos , Adulto Jovem
3.
Int J Clin Pharmacol Ther ; 56(6): 255-262, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29595122

RESUMO

OBJECTIVE: This study was designed to clarify the factors affecting the efficacy, adverse events, and pharmacokinetics of fondaparinux in Japanese patients undergoing artificial knee replacement surgery. MATERIALS AND METHODS: Fondaparinux (1.5 mg/d) was administered subcutaneously to patients (n = 30) at 24 hours after surgery, and blood samples were taken at various time points thereafter. Venous thromboembolism (VTE), presence of bleeding, and pharmacokinetics were evaluated. Multivariate analysis and population pharmacokinetic analysis were performed to detect factors that necessitated withdrawal of fondaparinux and individual differences in its pharmacokinetics. RESULTS: VTE was observed in 9 patients (3 for whom administration was continued and 6 for whom withdrawal was necessary). The maximum plasma concentration of fondaparinux was found to be a significant factor determining withdrawal of the drug. Population pharmacokinetic analysis demonstrated that individual renal function and body weight were significant factors associated with apparent clearance and volume of distribution, respectively. CONCLUSIONS: A high maximum plasma concentration of fondaparinux may result in subcutaneous hemorrhage, necessitating withdrawal of fondaparinux administration. The patient's kidney function and body weight also contribute to individual differences in pharmacokinetics. We recommend considering an adjustment to the dose of fondaparinux based on body weight in patients undergoing artificial knee replacement surgery.
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Assuntos
Artroplastia do Joelho , Inibidores do Fator Xa/farmacocinética , Polissacarídeos/farmacologia , Polissacarídeos/farmacocinética , Idoso , Idoso de 80 Anos ou mais , Feminino , Fondaparinux , Humanos , Masculino , Pessoa de Meia-Idade , Tromboembolia Venosa/prevenção & controle
4.
Biomed Chromatogr ; 32(6): e4213, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29451685

RESUMO

Edoxaban was extracted from human plasma by simple protein precipitation with acetonitrile, followed by quantitative determination using a liquid chromatography-mass spectrometry method. The recoveries of edoxaban and the internal standard (ticlopidine) from human plasma were >85%, and the within- and between-day coefficients of variation were within 15%. The limit of quantification in human plasma was 1 ng/mL. The concentration of edoxaban in blood decreased at room temperature, but remained unchanged for 1 week at 4°C. On the other hand, the concentration in plasma at both -20 and -80°C remained unchanged for 5 months. These results indicated that blood samples should be centrifuged immediately or stored at 4°C, and that plasma samples should be stored below -20°C until analysis. This method was applied to human plasma obtained from four patients after total knee arthroplasty. Analysis of edoxaban pharmacokinetics demonstrated an absorption time lag of 4h, a maximum concentration of 110 ± 26 ng/mL and an oral clearance of 37 ± 16 L/h. The analytical methods established in this study will be suitable for determining the concentrations of edoxaban in human plasma.


Assuntos
Artroplastia do Joelho/efeitos adversos , Cromatografia Líquida/métodos , Inibidores do Fator Xa/sangue , Piridinas/sangue , Espectrometria de Massas em Tandem/métodos , Tiazóis/sangue , Idoso , Idoso de 80 Anos ou mais , Inibidores do Fator Xa/uso terapêutico , Feminino , Humanos , Modelos Lineares , Masculino , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/prevenção & controle , Piridinas/uso terapêutico , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Tiazóis/uso terapêutico , Tromboembolia/tratamento farmacológico , Tromboembolia/prevenção & controle
5.
Am J Sports Med ; 32(3): 781-6, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15090397

RESUMO

BACKGROUND: Low back pain is a common presenting symptom among players of American football. In Japan, however, skeletal disorders in football players, including low back problems, have been rarely studied, and management to prevent skeletal disorders has not been established. STUDY DESIGN: An epidemiological study with prospective observation. METHODS: The authors analyzed the relationship between lumbar spine abnormalities viewed through radiographs taken during the preparticipation physical examination, and the incidence of low back pain during a 1-year period in 171 high school and 742 college football players. Abnormalities assessed were spondylolysis, disc space narrowing, spinal instability, Schmorl's node, balloon disc, and spina bifida occulta. RESULTS: High school players with spondylolysis had a higher incidence of low back pain (79.8%) than those with no abnormal radiographic results (37.1%). College players with spondylolysis, disc space narrowing, and spinal instability had a higher incidence of low back pain (80.5%, 59.8%, and 53.5%, respectively) than those with no abnormal radiographs (32.1%), and college players with spondylolysis had a higher incidence of low back pain than those with disc space narrowing and spinal instability. CONCLUSIONS: The results of the present study suggest that an abnormality such as spondylolysis is the most significant risk factor for low back pain in high school and college football players, and that disc space narrowing and spinal instability are also significant risk factors for low back pain in athletes with greater athletic activity such as college football players.


Assuntos
Futebol Americano/lesões , Dor Lombar/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagem , Adolescente , Adulto , Distribuição de Qui-Quadrado , Humanos , Incidência , Japão/epidemiologia , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Masculino , Prevalência , Estudos Prospectivos , Radiografia , Doenças da Coluna Vertebral/complicações , Doenças da Coluna Vertebral/epidemiologia
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