How severity and classification of pulmonary hypertension affect pregnancy outcomes: a systematic review and timeline.

Women with pulmonary hypertension (PH) have increased mortality during pregnancy and the peripartum period. An increasing number of publications suggest improvements in maternal outcomes, so we conducted a systematic review focusing on disease severity and maternal survival. After screening 9097 potential studies from 1967 to 2021, we identified 66 relevant publications. Outcomes improved continuously over time and mortality fell from 11.6% in studies published before 2015 to 8.2% in studies published after 2015. Mortality was lower in patients with mild disease (0.8%) than in those with Eisenmenger syndrome (26.2%) or idiopathic pulmonary arterial hypertension (7.4-24.0%). One major drawback of the published studies is that they define severity using echocardiographic-estimated pulmonary artery pressures, without considering more contemporary parameters. This systematic review provides new insights for preconception counseling on pregnancy risks related to PH and suggests that PH classification and severity should be carefully considered in determining an individual's pregnancy-associated risk.

CETP gene polymorphisms and haplotypes are explanatory variables for HDL cholesterol level in sickle cell disease.

Variations in lipid profile have been observed in sickle cell disease (SCD) and understanding their relationship with disease severity is crucial. This study aimed to investigate the association of polymorphisms of the CETP gene and laboratory markers of disease severity with lipid profile in a pediatric population with SCD. Biochemical and anthropometric analyses and CETP and alpha-thalassemia genotyping were performed. The study included 133 children and adolescents with sickle cell anemia (SCA) or hemoglobin SC disease (SCC), in steady-state. The SCA and no hydroxyurea (no HU) groups had higher values of ApoB, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) compared to the SCC and HU groups. However, there were no significant differences in ApoA1 and HDL-C levels between the groups based on genotype. Furthermore, the groups with altered levels of ApoA1, HDL-C, and the triglyceride/HDL ratio exhibited lower hemoglobin (Hb) levels and higher white blood cell counts. Hb level was associated to HDL-C levels. Analysis of CETP gene variants showed that the minor alleles of rs3764261 (C>A), rs247616 (C>T), and rs183130 (C>T), as well as the TTA haplotype, are explanatory variables for HDL-C levels. These findings suggested that dyslipidemia in SCD, specifically related to HDL-C levels, may be influenced by individual genetic background. Additionally, further investigation is needed to determine if clinical manifestations are impacted by CETP gene variants.

CETP gene polymorphisms and haplotypes are explanatory variables for HDL cholesterol level in sickle cell disease

Variations in lipid profile have been observed in sickle cell disease (SCD) and understanding their relationship with disease severity is crucial. This study aimed to investigate the association of polymorphisms of the CETP gene and laboratory markers of disease severity with lipid profile in a pediatric population with SCD. Biochemical and anthropometric analyses and CETP and alpha-thalassemia genotyping were performed. The study included 133 children and adolescents with sickle cell anemia (SCA) or hemoglobin SC disease (SCC), in steady-state. The SCA and no hydroxyurea (no HU) groups had higher values of ApoB, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) compared to the SCC and HU groups. However, there were no significant differences in ApoA1 and HDL-C levels between the groups based on genotype. Furthermore, the groups with altered levels of ApoA1, HDL-C, and the triglyceride/HDL ratio exhibited lower hemoglobin (Hb) levels and higher white blood cell counts. Hb level was associated to HDL-C levels. Analysis of CETP gene variants showed that the minor alleles of rs3764261 (C>A), rs247616 (C>T), and rs183130 (C>T), as well as the TTA haplotype, are explanatory variables for HDL-C levels. These findings suggested that dyslipidemia in SCD, specifically related to HDL-C levels, may be influenced by individual genetic background. Additionally, further investigation is needed to determine if clinical manifestations are impacted by CETP gene variants.

Pterygium surgery with lyophilized versus cryopreserved amniotic membrane graft.

PURPOSE: To evaluate surgical outcomes (recurrence rate, aesthetics and symptoms) of pterygium surgery with two different amniotic membrane preservation approaches - lyophilized (LAM) and cryopreserved (CAM). METHODS: Primary pterygium patients were randomized to either LAM or CAM surgery. Demographic data, ocular surface disease index (OSDI), aesthetic grading (1 to 4), recurrences and complications were recorded over a 6-month follow-up period. RESULTS: Twenty-nine patients were recruited. Recurrence at month 6 was detected in 11 cases (37.9%) and was more prevalent with CAM grafts, without reaching statistical significance (P=0.196). Aesthetic outcome grading showed no differences between LAM and CAM at month 6 (P=0.124). Aesthetic results were mostly unsatisfactory (grade 3 and 4) without statistical differences between groups (P=0.514). Baseline OSDI was similar in both groups (P=0.888), and it significantly decreased by the last follow-up visit (P<0.001) for both the LAM and CAM groups. This decrease did not significantly differ between amniotic membrane preservation approach surgery groups (P=0.714). CONCLUSION: LAM might be considered a legitimate alternative to CAM, showing no inferiority in outcomes, since clinical and aesthetic outcomes were similar for both groups.

Stabilization of biomass ash granules using accelerated carbonation to optimize the preparation of soil improvers.

After the revision of the Fertilizer Regulation (EC 2019/1009), biomass ash can be used as component material for soil improvers to be placed on the EU market. This provides opportunities for large scale recycling of biomass ash. However, this material cannot be directly applied to soil without stabilization by carbonation, which also creates an opportunity for CO2 capture and storage. Here, accelerated carbonation in an atmospheric fixed-bed reactor (AFR) was applied to prepare ash granules (AG). Relative humidity of gas, temperature, reaction time and CO2 concentration were optimized and further tested in a closed high-pressure reactor (HPR). Materials resulting from both reactors were compared with those obtained after 1-year of carbonation under atmospheric conditions. This study showed that AFR accelerated tests resulted in a significant reduction of the reaction time than HPR to achieve a similar pH adjustment. Also, under 100 vol.% CO2 atmospheric conditions, pH and electrical conductivity reached target values faster than under 15 vol.% CO2 conditions. Based on results obtained here we recommend AFR operating at 25 °C and 100 vol.% CO2 for 20 h, as the optimal procedure for stabilization of AG. In this study we provide evidence that accelerated carbonation enables a much faster and cost-efficient preparation of potentially valuable soil additives than natural carbonation. Also, leaching tests revealed that plant nutrient availability (B, Mg, Mn, Mo and P) was increased under accelerated carbonation compared to natural carbonation. The present work paves the way towards the development of optimized protocols to effectively recycle biomass ashes for soil recovery.

Improving keratoconus management with central cor neal regularization and corneal collagen cross-linking protocol treatment.

Purpose: To evaluate safety and efficacy of customized central corneal regularization (CCR), together with simultaneous accelerated corneal collagen cross-linking (A-CXL) - CCR-CXL protocol, to treat keratoconus-related corneal ectasia. Design: Retrospective, comparative observational case series. Methods: Patients that had undergone combined CCR-CXL protocol. Main inclusion criteria were keratoconus visual acuity deterioration and contact lens intolerance. All patients underwent complete ophthalmological evaluation, corrected distance visual acuity (CDVA) and Scheimpflug-corneal tomography. Central corneal regularization was performed by ablation using flying spot laser. Subsequently, the stroma was saturated with 0.17% riboflavin-5-phosphate added every 2 minutes, followed by A-CXL 9 mW/cm2 for 10 minutes. CDVA, medium keratometry value (Kmed), and total corneal morphological irregularity index (CMI) of patients were analyzed before surgery and after 1, 3 and 12 months. A P value of .05 or less was considered statistically significant. Results: 46 eyes of 39 keratoconus patients were treated. At 1 month, the mean CDVA (LogMar) increased from 0.19 ± 0.02 to 0.12 ± 0.02 (P < .05), and the difference remained stable at month 12. Kmax decrease was statistically significant from 57.02 ± 5.65 to 50.21 ± 4.48 (P < .05). CMI decreased significantly from 47.8 ± 2.84 to 30.1 ± 2.4 (P < .01). Conclusions: CCR-CXL protocol is safe and effective in arresting keratectasia progression and increasing corneal optic regularity in keratoconus. These findings showed a significant improvement in CDVA, keratometry values and corneal optical aberrations after being treated with the CCR-CXL protocol.

Use of Nicergoline as Adjunctive Treatment of Neurotrophic Keratitis in Routine Clinical Practice: A Case Series.

PURPOSE: To describe the effectiveness and safety of nicergoline in patients with epithelial corneal defect or corneal ulcer due to neurotrophic keratitis (NK). METHODS: A prospective case series review was performed in 14 patients with NK who started treatment with nicergoline as an off-label prescription from January to November 2020. Patients with a epithelial defect or corneal ulcer due to NK were treated with oral nicergoline. RESULTS/SERIAL CASES: Complete corneal healing was observed in 10 (71.4%) of the 14 patients after 25.6 ± 26.60 days (range 7-90) with nicergoline. In three (21.5%) patients wound healing was not achieved, and one patient (7.1%) was lost to follow-up. The mean time between diagnosis and the starting of nicergoline was 10.92 ± 8.85 days (0-28). No adverse effects of nicergoline were observed. CONCLUSION: Nicergoline as an adjunctive treatment for NK showed a potential use in the healing of epithelial defect in real-life clinical practice.

First spatially resolved measurements of the D-3He α-particle source with the upgraded JET gamma-ray camera.

The Joint European Torus (JET) gamma-ray camera has been recently upgraded with the installation of new gamma-ray detectors, based on LaBr3(Ce) scintillation crystals, which add spectroscopic capability to the existing system allowing measurements with good energy resolution (5% at 0.622 MeV), a dynamic range from hundreds of keV up to about 30 MeV, and high counting rate capabilities of MCps. First gamma-ray measurements during the C38 campaign of the JET have been successfully carried out, in particular, in D-3He plasmas from three-ion ion cyclotron resonance heating experiments, where the detection of 16.4 MeV γ-rays from D + 3He → γ + 5Li reactions with the gamma-ray camera upgrade allowed determining the spatial profile of alpha particles born in D + 3He fusion reactions.

Cellular blue nevus tumor presenting as a submandibular lymph node in a 16-year-old.

The cellular blue nevus tumor is a type of dendritic melanocytic nevus that is typically benign and exceedingly rare. The incidence of all blue nevi is about 1%, usually affecting the adult population and appearing on the extremities, sacrococcygeal or gluteal regions. There have only been a handful of case reports cited in the literature where cellular blue nevi present in the head and neck region, usually affecting the scalp and young adult population (7, 8). As such, it is exceedingly rare to encounter a cellular blue nevus tumor in the neck or infiltrating into neck lymph nodes. Here we report a rare case of a cellular blue nevus tumor presenting as a right neck mass in a pediatric 16-year-old patient, shown to invade into the submandibular lymph node and surrounding soft tissue. It is important to be aware of the cellular blue nevus tumor as a differential diagnosis in pediatric neck masses. Histological evaluation is necessary to determine tumor aggression and malignant potential which can guide further treatment in pediatric patients.

Highly cross-linked arabinoxylans microspheres as a microbiota-activated carrier for colon-specific insulin delivery.

In vivo evaluation of arabinoxylans (AX) microspheres showed to protect insulin from degradation in the upper gastrointestinal tract and carrier insulin to colon. Insulin-loaded AX microspheres (50 UI/kg) decreased blood glucose level by 39% in diabetic rats with a maximum effect at 18 h post-administration, indicating that insulin remains bioactive. The continuous administration (4 days) of insulin-loaded AX microspheres improved the polyuria and increased the production of short-chain fatty acids, as well as Bifidobacterium and Bacteroides in diabetic rats compared to untreated diabetic rats. AX microspheres are a potential microbiota-activated carrier for colon-specific drug delivery and could be useful as a complementary treatment for diabetes.

Atención a mujeres en situación de aborto en el Hospital San José (2016-2019) / Attention to woman in abortion situation at San José Hospital (2016-2019)

Objetivo: evaluar la incorporación de elementos de calidad de atención a mujeres en situación de aborto (MSA) en la Unidad de Salud Sexual y Salud Reproductiva del Hospital San José, entre 2016 y 2019. Métodos: utilizando los datos recabados en el Sistema Informático Perinatal (SIP), se realizó un análisis descriptivo de las características sociodemográficas y se evaluó la implementación de la Unidad de Salud Sexual y Reproductiva a través de indicadores de atención de calidad. Resultados: las variables sociodemográficas que caracterizan nuestra población están definidas por una alta proporción de mujeres extranjeras (44,5%), que cuentan con un nivel educacional medio (63,8% educación secundaria y 26% universitaria), y una alta proporción de necesidades insatisfechas de métodos anticonceptivos (70,3%), representando características sociodemográficas similares a los diferentes centros de salud pública de la región. La tendencia de los indicadores de calidad de atención en las mujeres en situación de aborto del Hospital San José mejoró posterior a la implementación de la Unidad de Salud Sexual y Reproductiva y el modelo de atención postaborto (APA) al disminuir los métodos de evacuación uterina no recomendados y aumentar la cobertura en anticoncepción inmediata postaborto. Conclusión: la implementación de una unidad especializada en salud sexual y reproductiva mejora los indicadores de calidad a la MSA. (AU)

Objective: to evaluate the incorporation of elements of quality of care for women in abortion situation (WAS) in the Sexual Health and Reproductive Health Unit of the San José Hospital, between 2016 and 2019. Methods: using the data collected in the Perinatal Information System (SIP), a descriptive analysis of the sociodemographic characteristics was carried out and the implementation of the Sexual and Reproductive Health Unit was evaluated through quality care indicators. Results: the sociodemographic variables that characterize our population are defined by a high proportion of foreign women (44.5%), who have a medium educational level (63.8% secondary education and 26% university), and a high proportion of unmet needs for contraceptive methods (70.3%), representing sociodemographic characteristics similar to the different public health centers in the region. The trend of the quality of care indicators for women in abortion at the San José Hospital improved after the implementation of the Sexual and Reproductive Health Unit and the postabortion care model (PAC) by reducing non- recommended uterine evacuation methods. and increase coverage in immediate postabortion contraception. Conclusion: the implementation of a specialized unit in sexual and reproductive health improves the quality indicators of the WSA. (AU)

Immersive virtual reality and antigravity treadmill training for gait rehabilitation in Parkinson's disease: a pilot and feasibility study. / Entrenamiento antigravitatorio e inmersivo de realidad virtual para la rehabilitación de la marcha en la enfermedad de Parkinson: estudio piloto y de viabilidad.

INTRODUCTION: Treadmill training is considered an effective intervention to improve gait ability in patients with Parkinson's disease (PD). In parallel, virtual reality shows promising intervention with several applications in the inpatient medical setting. AIM: To evaluate the feasibility and preliminary efficacy of mechanical gait assistance combined with immersive virtual reality in patients with PD. PATIENTS AND METHODS: This pilot and feasibility study followed a pre-post study design. The intervention consisted of 12 sessions of 30 minutes, distributed regularly over four consecutive weeks. Participants walked on a treadmill with a body-weight support system set at approximately 20% of body weight and equipped with a virtual reality helmet controlled by a two-handed joystick. Feasibility and intervention outcomes were collected at baseline and after four weeks of intervention. RESULTS: Twelve participants of 60 patients were finally enrolled. Nine of them (75%) completed the treatment intervention with an adherence rate of 97%. Two participants left the study, one of them due to sickness associated with virtual reality and another because of a lack of motivation. There were significant differences associated with small-medium effect sizes when comparing the pre and post values for walk distance, walk speed, balance, and quality of life. CONCLUSIONS: The present study provided preliminary evidence supporting the feasibility of the combination of antigravity treadmill and immersive virtual reality system for the rehabilitation of patients with PD.

TITLE: Entrenamiento antigravitatorio e inmersivo de realidad virtual para la rehabilitación de la marcha en la enfermedad de Parkinson: estudio piloto y de viabilidad.Introducción. El entrenamiento en tapiz rodante se considera una intervención eficaz para mejorar la capacidad de la marcha en pacientes con enfermedad de Parkinson (EP). Paralelamente, la realidad virtual se muestra como una intervención prometedora con diversas aplicaciones en el entorno médico hospitalario. Objetivo. Evaluar la viabilidad y la eficacia preliminar de la asistencia mecánica para la marcha combinada con la realidad virtual inmersiva en pacientes con EP. Pacientes y métodos. Este estudio piloto y de viabilidad siguió un diseño pre-post. La intervención consistió en 12 sesiones de 30 minutos, distribuidas regularmente durante cuatro semanas consecutivas. Los participantes deambularon sobre un tapiz rodante con un sistema de descarga del peso corporal establecido aproximadamente en el 20% del peso corporal y equipados con un casco de realidad virtual controlado por un joystick para cada mano. Las mediciones de viabilidad y tratamiento se recopilaron al inicio del estudio y después de cuatro semanas de intervención. Resultados. De un total de 60 pacientes, se reclutó finalmente a 12 participantes. Nueve de ellos (75%) completaron el tratamiento, con una tasa de adhesión del 97%. Dos participantes abandonaron el estudio, uno debido a náuseas asociadas con la realidad virtual y otro por falta de motivación. Hubo diferencias significativas asociadas con un tamaño del efecto pequeño-mediano al comparar los valores pre y post para la distancia recorrida, velocidad de la marcha, equilibrio y calidad de vida. Conclusiones. El estudio proporcionó evidencia preliminar que apoya la viabilidad de la combinación de un tapiz rodante antigravitatorio y un sistema de realidad virtual inmersivo para la rehabilitación de pacientes con EP.

Identification of hepatic progenitor cells in the canine fetal liver.

The liver plays essential roles in human and animal organisms, such as the storage, release, metabolism, and elimination of various endogenous or exogenous substances. Although its vital importance, few treatments are yet available when a hepatic failure occurs, and hence, the use of stem cells has arisen as a possible solution for both human and veterinary medicines. Previous studies have shown the existence of hepatic progenitor cells in human fetuses that were positive for EpCAM and NCAM. There is limited evidence, however, further identification and characterization of these cells in other species. Considering the similarity between dogs and humans regarding physiology, and also the increasing importance of developing new treatments for both veterinary and translational medicine, this study attempted to identify hepatic progenitor cells in canine fetal liver. For that, livers from canine fetuses were collected, cells were isolated by enzymatic digestion and cultured. Cells were characterized regarding morphology and expression of EpCAM, NCAM, Nestin, and Thy-1/CD90 markers. Our results suggest that it is possible to identify hepatic progenitor cells in the canine fetal liver; however, for therapeutic use, further techniques for cellular isolation and culture are necessary to obtain enriched populations of hepatic progenitors from the canine fetal liver.

Medidas para prevenir los riesgos asociados con la exposición a citostáticos en cirugía filtrante de glaucoma / Measures to prevent the risks associated with exposure to cytostatic drugs in glaucoma filtering surgery

INTRODUCCIÓN: El uso de medicamentos citostáticos como la mitomicina C y el 5-fluorouracilo es bien conocido en cirugía filtrante de glaucoma y en el manejo de sus complicaciones, no obstante, existe una falta de información en cuanto a las medidas preventivas a tomar por parte del profesional que maneja este tipo de sustancias. OBJETIVO: Concienciar al profesional sobre los riesgos asociados con el uso de medicamentos citostáticos sin la adecuada prevención. RESULTADOS: Revisión de la bibliografía y legislación disponible sobre medidas preventivas en el manejo de citostáticos en el ámbito médico y oftalmológico. CONCLUSIONES: La prevención y concienciación del profesional cualificado que maneja estas sustancias es la medida más importante para prevenir los posibles riesgos derivados. Es necesaria la coordinación con los equipos de Salud Laboral del Hospital y los profesionales y personal implicados en las distintas fases del proceso, desde la preparación en Farmacia Hospitalaria hasta su eliminación

INTRODUCTION: The use of cytostatic drugs such as Mitomycin C and 5-Fluorouracil is well-known in glaucoma filtering surgery, as well as the management of its complications. However, there is a lack of information regarding the preventive measures to be taken by the professional that handles these types of substances. OBJECTIVE: Raise awareness among professionals of the risks associated with the use of cytostatic drugs without adequate prevention measures. RESULTS: Review of the available literature and legislation on preventive measures in the management of cytostatic drugs in the medical and ophthalmological field. CONCLUSIONS: The prevention and awareness of the risks of the qualified professionals that handle these substances is the most important measure to prevent the possible risks. Coordination is necessary with the Occupational Health teams of the Hospital, as well as the professionals and staff involved in the different phases of the process, from the preparation in Hospital Pharmacy to its elimination

Measures to prevent the risks associated with exposure to cytostatic drugs in glaucoma filtering surgery. / Medidas para prevenir los riesgos asociados con la exposición a citostáticos en cirugía filtrante de glaucoma.

INTRODUCTION: The use of cytostatic drugs such as Mitomycin C and 5-Fluorouracil is well-known in glaucoma filtering surgery, as well as the management of its complications. However, there is a lack of information regarding the preventive measures to be taken by the professional that handles these types of substances. OBJECTIVE: Raise awareness among professionals of the risks associated with the use of cytostatic drugs without adequate prevention measures. RESULTS: Review of the available literature and legislation on preventive measures in the management of cytostatic drugs in the medical and ophthalmological field. CONCLUSIONS: The prevention and awareness of the risks of the qualified professionals that handle these substances is the most important measure to prevent the possible risks. Coordination is necessary with the Occupational Health teams of the Hospital, as well as the professionals and staff involved in the different phases of the process, from the preparation in Hospital Pharmacy to its elimination.

Comparison of two methods for obtaining and transporting corneal samples in suspected infectious keratitis.

BACKGROUND AND PURPOSE: The purpose of this study is to compare two alternative methods of collecting and transporting media for the diagnosis of corneal ulcers, as not all clinical settings have conventional culture materials and transport media available. METHODS: In this open-label, prospective, comparative, and randomized study, patients with clinical suspicion of infectious keratitis with high risk of loss of vision had corneal specimens collected using two methods and transport media: Eswab scraping with Amies transport medium and 23-gauge needle scraping in BACTEC Peds broth. The order of each collection method was randomized. The samples were processed by standard methods, comparing the positivity frequencies for both by parametric and nonparametric tests, according to normality criteria. RESULTS: Corneal infiltrates from 40 eyes of 40 patients were analyzed. Culture positivity rate was 50% for Eswab and 35% for 23-gauge needle (P=0.258). The overall growth rate of the two methods combined was not higher than with the swab alone. The results obtained with a swab were not influenced by the collection sequence (P=0.112); however, the positivity rate was significantly higher when the sample taken with the needle was performed first (P=0.046). CONCLUSIONS: The single sample Eswab method of collection and transportation for the diagnosis of high risk corneal ulcers is a valid alternative and can be used in cases in which, for various reasons, there is no access to the full set of traditional culture materials.

Molecular detection of Rickettsia species in ticks collected in the Mexico-USA transboundary region.

Zoonotic tick-borne diseases, including those caused by Rickettsia species, continue to have serious consequences for public health worldwide. One such disease that has emerged as a major problem in several countries of the American continent is the Rocky Mountain Spotted Fever (RMSF) caused by the bacterium Rickettsia rickettsii. Several tick species are capable of transmitting R. rickettsia, including Amblyomma cajennense, A. aureolatum, A. imitator, Rhipicephalus sanguineus, Dermacentor andersoni, D. variabilis and possibly A. americanum. Despite previous reports in Mexico linking new outbreaks of RMSF to the presence of these tick species, no robust measures have tackled transmission. In the present study, we amplified R. rickettsii from 109 test DNA samples extracted from ticks collected from several animals and humans of Tamaulipas, Mexico, between November 2015 and December 2017. Our analysis revealed the presence of R. rickettsii in six samples and these findings contribute to a spatial distribution map that is intended to minimize the risk of transmission to humans.

Achieving discharge within 24 h of robotic unicompartmental knee arthroplasty may be possible with appropriate patient selection and a multi-disciplinary team approach.

AIMS: There has been significant interest in day-case and rapid discharge pathways for unicompartmental knee replacements (UKR). Robotic-assisted surgery has the potential to improve surgical accuracy in UKR. However, to date there are no published studies reporting results of rapid-discharge pathways in patients receiving UKR using the NAVIO ◊ robotic system. METHODS: A retrospective analysis identified 19 patients who were safely discharged within 24 h following UKR using the NAVIO ◊ robotic system between June 2017 and October 2019. All patients went through a standardised UKR pathway protocol. Pre-operatively patients underwent education sessions and anaesthetic assessment, with selected patients undergoing occupational/physiotherapy assessment prior to surgery. All patients received a general anaesthetic with local anaesthetic infiltration prior to closure; nerve blocks were not used routinely. A multi-modal analgesic regime was utilised. Patients were discharged home once they were safe to mobilise on ward, had normal vital signs and pain was adequately controlled. Patients were discharged with outpatient physiotherapy referral and consultant follow up at 6 weeks. RESULTS: All patients were discharged within 24 h; there were no post-operative complications and no readmissions to hospital. The mean length of stay was 19.5 h (SD = 6.8), with patients seen twice on average by physiotherapy post-operatively. Active range of motion at 6 weeks was 105.8°, with all patients mobilising independently. The median 6-month post-operative Oxford Knee Score was 44 out of 48. CONCLUSION: This initial feasibility study suggests that patients may be safely discharged within 24 h of UKR using the NAVIO robotic system. Appropriate patient selection will ensure successful discharge. Further prospective studies are needed.