Mid-term outcomes of mobile-bearing lateral unicompartmental knee arthroplasty.

BACKGROUND: This research was undertaken to evaluate Oxford Domed Lateral unicompartmental knee replacement (UKR) survival and clinical and radiological outcomes. The study also considered the influence of body mass index (BMI) on results and proposed contralateral healthy knee anatomic femorotibial angle (AFTA) as a predictor of postoperative knee alignment. METHODS: A retrospective evaluation of 41 primary Oxford Domed Lateral UKR performed in 41 patients in the same institution was undertaken on a patient group comprising of 10 men and 31 women with a mean age of 63 years (range: 38-81 years). A minimum follow-up of two years was required. RESULTS: The total revision rate was one out of 41 patients (2.4%), with a mean follow-up of 49 months (range: 25-84 months). One patient presented with a traumatic medial dislocation of the bearing after 15 months (resulting in an overall dislocation rate of 2.4%). The visual analogue scale (VAS) and the Oxford knee score (OKS) demonstrated significant postoperative improvement (P < 0.001). Survival at five years, with revision for any reason as the endpoint, was 97.5%. No significant correlation was observed between BMI and postoperative flexion angle, radiologically measured parameters, or pre- and postoperative VAS and OKS. Significant correlation was found (r = 0.77, P < 0.001) between postoperative and contralateral healthy knee anatomic femorotibial angles. CONCLUSIONS: The Oxford Domed Lateral UKR presents a low dislocation rate and excellent mid-term clinical and functional results. Contralateral healthy knee AFTA appears to be a predictor of postoperative knee alignment.

Pharmacokinetics of ceftazidime administered to lactating and non-lactating goats.

The aim of this work was to determine the pharmacokinetics of intravenous (i.v.) and intramuscular (i.m.) ceftazidime administered to lactating (LTG; n=6) and non-lactating (NLTG; n=6) healthy Creole goats in 2 trials (T1 and T2). During T1 and T2, goats randomly received a single dose of i.m. or i.v. ceftazidime (10 mg/kg). Serum concentration of iv ceftazidime in NLTG and LTG goats is best described by 2 and 3 compartment models, respectively. The pharmacokinetic parameters of iv and im ceftazidime administered to LTG and NLTG showed statistically significant differences (P < 0.05) in the constants (lamda(z), T1 vs. T2 [i.v.] 0.5 +/- 0.1 vs. 0.3 +/- 0.1/h; T1 vs. T2 [i.m.] 0.5 +/- 0.2 vs. 0.3 +/- 0.1/h) and in the mean times (t(1/2), T1 vs. T2 [i.v.] 1.6 +/- 0.3 vs. 2.3 +/- 0.6 h; T1 vs. T2 [i.m.] 1.6 +/- 0.7 vs. 2.6 +/- 0.9 h) of elimination. The bioavailability of ceftazidime in LTG and NLTG was 113.0 +/- 17.8 and 96.0 +/- 18.0%, respectively. Ceftazidime concentration in milk at 2 h was: i.v. = 1.9 +/- 0.2 and i.m. = 2.4 +/- 0.5 microg/ml; the penetration in milk was i.v. = 18.3 +/- 13.5 and im = 14.3 +/- 10.6%. Ninety-six hours after i.v. and i.m. administration, residues of the drug were not found in milk. In conclusion, ceftazidime, when administered to goats, showed high concentration times in serum, good penetration into milk and a bioavailability that makes it suitable to be used by the i.m. route.

[Clinical and epidemiological spectrum of Mycoplasma pneumoniae infections at a pediatric hospital]. / Espectro clínico-epidemiológico de las infecciones por Mycoplasma pneumoniae en un hospital infantil.

OBJECTIVE: The objective of this study was to determine the epidemiology of Mycoplasma pneumoniae infections at our hospital and to evaluate the prescription of macrolides to empirically treat respiratory infections in children. PATIENTS AND METHODS: A one year prospective study was performed. To find out the prevalence of M. pneumoniae infections, we obtained blood samples of 519 children attending our hospital out-patient department to determine M. pneumoniae IgG levels. In order to establish the incidence, IgM antibodies against M. pneumoniae were measured in 255 children admitted to the hospital showing clinical pictures compatible with this infection. RESULTS: In the first years of life, prevalence of M. pneumoniae infection was low. According to our study, only 3.3% of 1 year-old patients had M. pneumoniae antibodies. Antibody levels increased in children of 5 years or older. The highest rates, between 58.5% and 63.3%, were detected in patients between 8 and 12 years of age. The incidence rate (6.7%) was low among the children admitted. The most frequent clinical entity was pneumonia (82%). The highest rate of infection was found in children of 8 to 10 years. Symtomatology was mainly sub-acute. Crioagglutinins provided the most significant predictive value for etiological diagnosis. CONCLUSIONS: M. pneumoniae infections gain significance in patients over 5 years of age. In our environment, incidence of acute symptomatic infection is low. We consider that both age and presentation of acute respiratory processes should be taken into account when establishing empirical macrolide treatment in children.