Browsing by Subject "knee"

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  • Saku, S. A.; Linko, R.; Madanat, R. (2020)
    Background and Aims: Emergency Response Teams have been employed by hospitals to evaluate and manage patients whose condition is rapidly deteriorating. In this study, we aimed to assess the outcomes of triggering the Emergency Response Teams at a high-volume arthroplasty center, determine which factors trigger the Emergency Response Teams, and investigate the main reasons for an unplanned intensive care unit admission following Emergency Response Team intervention. Material and Methods: We gathered data by evaluating all Emergency Response Team forms filled out during a 4-year period (2014-2017), and by assessing the medical records. The collected data included age, gender, time of and reason for the Emergency Response Teams call, and interventions performed during the Emergency Response Teams intervention. The results are reported as percentages, mean +/- standard deviation, or median (interquartile range), where appropriate. All patients were monitored for 30 days to identify possible intensive care unit admissions, surgeries, and death. Results: The mean patient age was 72 (46-92) years and 40 patients (62%) were female. The Emergency Response Teams was triggered a total of 65 times (61 patients). The most common Emergency Response Team call criteria were low oxygen saturation, loss or reduction of consciousness, and hypotension. Following the Emergency Response Team call, 36 patients (55%) could be treated in the ward, and 29 patients (45%) were transferred to the intensive care unit. The emergency that triggered the Emergency Response Teams was most commonly caused by drug-related side effects (12%), pneumonia (8%), pulmonary embolism (8%), and sepsis (6%). Seven patients (11%) died during the first 30 days after the Emergency Response Teams call. Conclusion: Although all 65 patients met the Emergency Response Teams call criteria, potentially having severe emergencies, half of the patients could be treated in the arthroplasty ward. Emergency Response Team intervention appears useful in addressing concerns that can potentially lead to unplanned intensive care unit admission, and the Emergency Response Teams trigger threshold seems appropriate as only 3% of the Emergency Response Teams calls required no intervention.
  • Mustonen, Anne-Mari; Käkelä, Reijo; Joukainen, Antti; Lehenkari, Petri; Jaroma, Antti; Kaariainen, Tommi; Kroger, Heikki; Paakkonen, Tommi; Sihvo, Sanna Pauliina; Nieminen, Petteri (2021)
    Simple Summary Anomalies of fatty acid metabolism characterize osteoarthritis and rheumatoid arthritis in the knee joint. No previous study has investigated the synovial fluid fatty acid manifestations in these aging-related inflammatory diseases in the shoulder. The present experiment compared the fatty acid alterations between the shoulder and knee joints in trauma controls and in patients with end-stage osteoarthritis or end-stage rheumatoid arthritis. The fatty acid signatures in the synovial fluid of trauma controls were mostly uniform in both anatomical locations. Shoulders with rheumatoid arthritis were characterized by elevated percentages of arachidonic acid and docosahexaenoic acid and with reduced proportions of oleic acid. The fatty acid profiles of knees with osteoarthritis or rheumatoid arthritis were relatively uniform and displayed lower proportions of linoleic acid, docosahexaenoic acid and total n-6 polyunsaturated fatty acids. The results indicate location- and disease-dependent differences in the synovial fluid fatty acid composition. These alterations may affect joint lubrication, synovial inflammation and pannus formation as well as cartilage and bone degradation and contribute to the pathogeneses of inflammatory joint diseases. Anomalies of fatty acid (FA) metabolism characterize osteoarthritis (OA) and rheumatoid arthritis (RA) in the knee joint. No previous study has investigated the synovial fluid (SF) FA manifestations in these aging-related inflammatory diseases in the shoulder. The present experiment compared the FA alterations between the shoulder and knee joints in patients with end-stage OA or end-stage RA. SF samples were collected during glenohumeral or knee joint surgery from trauma controls and from OA and RA patients (n = 42). The FA composition of SF total lipids was analyzed by gas chromatography with flame ionization and mass spectrometric detection and compared across cohorts. The FA signatures of trauma controls were mostly uniform in both anatomical locations. RA shoulders were characterized by elevated percentages of 20:4n-6 and 22:6n-3 and with reduced proportions of 18:1n-9. The FA profiles of OA and RA knees were relatively uniform and displayed lower proportions of 18:2n-6, 22:6n-3 and total n-6 polyunsaturated FAs (PUFAs). The results indicate location- and disease-dependent differences in the SF FA composition. These alterations in FA profiles and their potential implications for the production of PUFA-derived lipid mediators may affect joint lubrication, synovial inflammation and pannus formation as well as cartilage and bone degradation and contribute to the pathogeneses of inflammatory joint diseases.