[Risk profiling of postoperative complications in 17,644 total knee replacements]. / Identifizierung von Risikofaktoren postoperativer Komplikationen in der primären Knieendoprothetik.

AIM: Postoperative complications following primary total knee replacement performed between 2000 and 2002 were assessed to determine perioperative patient- and procedure-related risks associated with the procedure. METHODS: For this analysis, the data collected during postoperative hospitalization for 17,644 total knee arthroplasties were assessed. The analysis included two steps. First, using logistic regression, we identified and quantified significant risk factors for the occurrence of general postoperative complications. Second, univariate analysis was utilized to qualitatively and quantitatively analyze the influence of these significant risk factors on the occurrence of major complications (hematoma, cardiovascular complication, deep venous thrombosis, pulmonary embolism, joint infection, and pneumonia). RESULTS: General postoperative complications were reported in 11.3%. Major postoperative complications occurred in 7.2% with hematoma in 2.9%, cardiovascular complications in 1.8%, deep venous thrombosis in 1.2%, pulmonary embolism in 0.2%, joint infection in 0.8%, and pneumonia in 0.3%. Patient-related risk factors such as age, surgery time, gender, high ASA classification as well as procedure-related risk factors such as allogeneic blood transfusions and lateral release significantly increased the rate of postoperative complications. Males were more prone to hematoma, joint infection, and pneumonia in the immediate postoperative course than females, who were more in danger of developing deep venous thrombosis. Allogeneic blood transfusions increased the risk for postoperative hematoma, infection, and cardiovascular complication. Regional anesthesia was shown to decrease the risk for the occurrence of postoperative deep venous thrombosis and pulmonary embolism. CONCLUSIONS: Postoperative complications in total knee replacement are increased in males and elder patients. Increased time of surgery and allogeneic blood transfusions also represent important risk factors for postoperative complications following primary total knee replacement.

[Intestinal Chlamydia psittaci infection of cattle: frequency and technical aspects of the cultural detection of the agent]. / Die intestinale Chlamydia psittaci-Infektion des Rindes: Häufigkeit sowie technische Aspekte des kulturellen Erregernachweises.

With the purpose to evaluate the prevalence of latent chlamydial infections in cattle, 190 animals were examined for fecal shedding of chlamydiae. From the feces of 42 animals (22.1%) Chlamydia (C.) psittaci was grown either in the yolk sac of chicken embryos and/or in coverslip cultures of BGM-cells. The cell culture proved to be of lower susceptibility to chlamydial infections. In comparison with the chicken egg technique a sixfold quantity of chlamydial particles was required to initiate detectable intracellular growth. With the chicken embryo technique as a standard cell culture with a sensitivity range of 31.6% was not satisfactory for isolating chlamydiae from bovine feces. Attempts to recover chlamydiae from feces of two experimentally infected heifers in embryonated chicken eggs provided evidence that at least four randomly subsequent isolation trials are required to detect asymptomatic chlamydial infections of the bovine gut with a 95% confident level. Based on this fact, the positivity rate of 22.1% obtained by single fecal specimen examination indicates a wide spread occurrence of chlamydial infections in cattle.