RESUMEN
BACKGROUND: In a retrospective study, we compared the results of different surgical therapies in 30 patients who had an early-onset infection after implantation of a hip hemiarthroplasty. MATERIAL AND METHODS: Patients were divided into two groups: In group 1 (n=16, deep infection), we changed the polyethylene inlay as well as the femoral head. In group 2 (n=14, deep infection), an acetabular component was also implanted. RESULTS: In group 1, successful treatment was achieved in 37.5% of patients 6 months after the last operation, compared with 71.4% in group 2 (p=0.019). All patients were supported with antibiotics. In group 1, three patients died from septic multiorgan failure. Two patients in group 1 and one patient in group 2 received a Girdlestone operation. CONCLUSIONS: These results suggest that aggressive surgical treatment with soft tissue revision, lavage, and implantation of an acetabular component in combination with antibiotics is a useful technique for treating early-onset infection.
Asunto(s)
Antibacterianos/administración & dosificación , Artroplastia de Reemplazo de Cadera/efectos adversos , Desbridamiento/métodos , Técnicas de Apoyo para la Decisión , Infecciones Relacionadas con Prótesis/etiología , Infecciones Relacionadas con Prótesis/terapia , Irrigación Terapéutica/métodos , Algoritmos , Femenino , Prótesis de Cadera/efectos adversos , Humanos , Masculino , Cuidados Posoperatorios/métodos , Reoperación/métodos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
AIMS: To describe the course of low back pain (LBP) among nurses across eight years. METHODS: A longitudinal study was performed with a follow up at 1 and 8 years among nurses employed by a large university hospital in Switzerland. A modified version of the Nordic Questionnaire was distributed to obtain information about demographic data, occupational activities, and various aspects of LBP. A clinical examination and several functional tests were used to overcome the problems associated with subjective pain reporting. Nurses having answered the questionnaire on all three occasions (n = 269) were classified into subgroups according to their pain intensity. For each subgroup the course of LBP was recorded. RESULTS: LBP was highly prevalent with an annual prevalence varying from 73% to 76%. A large percentage (38%) indicated the same intensity of LBP on all three occasions. The proportion of nurses reporting repeated increase of LBP (19%) was approximately as large as the proportion who complained about repeated decrease of LBP (17%). CONCLUSION: It became evident that LBP poses a persistent problem among nurses. Over an eight year period almost half of the nurses indicated the same intensity of LBP, thus supporting a recurrent rather than a progressive nature of LBP.