Periprosthetic joint infection (PJI) is regarded as a critical factor contributing to the failure of primary and revision total joint arthroplasty (TJA). With the increasing prevalence of TJA, a significant increase in the incidence of PJI is expected. The escalating number of cases, along with the significant economic strain imposed on healthcare systems, place emphasis on the pressing need for development of effective strategies for prevention. PJI not only affects patient outcomes but also increases mortality rates, thus its prevention is a matter of vital importance. The longer-term survival rates for PJI after total hip and knee arthroplasty correspond with or are lower than those for prevalent cancers in older adults while exceeding those for other types of cancers. Because of the multifaceted nature of infection risk, a collaborative effort among healthcare professionals is essential to implementing diverse strategies for prevention. Rigorous validation of the efficacy of emerging novel preventive techniques will be required. The combined application of these strategies can minimize the risk of infection, thus their comprehensive adoption is important. Collectively, the risk of PJI could be substantially minimized by application of a multifaceted approach implementing these strategies, leading to improvement of patient outcomes and a reduced economic burden.

Background: Coronavirus disease 2019 (COVID-19) is often a mild disease, usually manifesting with respiratory complaints, and is sometimes mortal due to multiple organ failure. Hyperinflammation is a known COVID-19 component and is associated with organ dysfunction, disease severity and mortality. Controlling hyperinflammatory response is crucial in determining treatment direction. An important agent in providing this control is corticosteroids. This study aimed to determine whether dexamethasone and methylprednisolone, doses, administration time and duration in COVID-19 treatment are associated with improved treatment outcomes. Methods: This retrospective multicenter study was conducted with participation of 6 healthcare centers which collected data by retrospectively examining files of 1,340 patients admitted to intensive care unit due to COVID-19 between March 2020 and September 2021, diagnosed with polymerase chain reaction (+) and/or clinically and radiologically. Results: Mortality in the pulse methylprednisolone group was statistically significantly higher than that in the other 3 groups. Mortality was higher in older patients with comorbidities such as hypertension, diabetes mellitus, chronic kidney failure, coronary artery disease, and dementia. Pulse and mini-pulse steroid doses were less effective than standard methylprednisolone and dexamethasone doses, pulse steroid doses being associated with high mortality. Standard-dose methylprednisolone and dexamethasone led to similar effects, but standard dose methylprednisolone was more effective in severe patients who required mechanical ventilation (MV). Infection development was related to steroid treatment duration, not cumulative steroid dose. Conclusion Corticosteroids are shown to be beneficial in critical COVID-19, but the role of early corticosteroids in mild COVID-19 patients remains unclear. The anti-inflammatory effects of corticosteroids may have a positive effect by reducing mortality in severe COVID-19 patients. Although dexamethasone was first used for this purpose, methylprednisolone was found to be as effective at standard doses. Methylprednisolone administered at standard doses was associated with greater PaO 2 /FiO 2 ratios than dexamethasone, especially in the severe group requiring MV. High dose pulse steroid doses are closely associated with mortality and standard methylprednisolone dose is recommended.

Rationale: Endophthalmitis is an uncommon but serious ocular infection often resulting in probable visual loss. Bacteroides fragilis is a rare cause of endophthalmitis. Patient concerns: A 46-year-old male patient complained of eye pain and low vision after pars plana vitrectomy. Diagnosis: Bacteroides fragilis endophthalmitis after pars plana vitrectomy was diagnosed. Interventions: Pars plana vitrectomy and silicone oil implantation were performed. Outcomes: Early treatment and choice of tamponade in endophthalmitis after pars plana vitrectomy may possibly prevent evisceration and progression of endophthalmitis. Lessons: Bacteroides fragilis can be seen in cases of endophthalmitis after pars plana vitrectomy.

Background: The present study aimed to evaluate the effect of fossae lumbales laterales and pelvic incidence (PI) on transsacral corridors. Methods: Patients who underwent pelvic computed tomography (CT) during routine therapy in a single center between 2015 and 2020 were retrospectively reviewed. The patients’ age and sex were documented during CT examination. Measurements were performed for both the upper and second sacral segments. Height and weight of the patients were determined using appropriate tools and body mass index (BMI) was calculated. Transsacral corridors were identified in true coronal and true sagittal planes and their width was determined as the maximum gap measured so that no screws could come out of the transacral corridors. PI was measured. Results: Our study included 244 (57%) male and 184 (43%) female patients, who had a mean age of 49.3 ± 14.15 years (range, 18–89 years) and a mean BMI of 26.57 ± 2.38 kg/m 2 . No statistically significant correlation was found between the detection of the dimple sign in physical examination and the presence of an adequate corridor. The PI was statistically significantly higher in the patients with dimples (p < 0.001). PI of the female patients was higher than that of the male patients (p = 0.026). The correlation between PI and the existence of adequate corridors for S1 and S2 screws was not statistically significant (p = 0.858 and p = 0.129, respectively). On the relationship between the presence of adequate S1 and S2 corridors where transsacral screws could be sent, an inverse relationship was detected: if the S1 transsacral corridor was adequate, the S2 corridor was inadequate or vice versa. Conclusions We could not obtain meaningful results on the use of the dimples of Venus or PI instead of CT to evaluate the adequacy of transverse corridors. Nevertheless, we confirmed that an increased PI was associated with the presence of dimples of Venus.

Purpose: The main purpose of this study is to evaluate prognostic factors that affected the patients’ early (<30 days) and late (six months, one year, and overall) postoperative mortality following hip fracture surgery. Materials and Methods: This retrospective study included 515 patients older than 75 years old with surgically treated osteoporotic hip fracture. The demographic data, American Society of Anesthesiologists (ASA) classification, type of anesthesia, duration of hospital stay, and history of intensive care unit (ICU) stay were collected.An analysis of laboratory values was also performed to determine their relationship with mortality. The primary outcome was survival, determined as the time from the surgery to death or the end of the study. The patients were divided into four groups according to survival time: at the first month, six months, first year, and overall survival. An analysis of demographic and laboratory values was performed to determine their validity as prognostic factors for each group. Results: Postoperative C-reactive protein (CRP) level showed an independent association with a poor survival at the first month. ASA classification, admission to the ICU, and preoperative CRP levels showed an independent association with a poor survival for the first six months. Preoperative CRP level showed an independent association with a poor survival for the first year. ASA classification, admission to the ICU, and the preoperative CRP levels showed an independent association with a poor overall survival. Conclusion CRP level, a high ASA classification, and postoperative ICU admission were related to poorer overall survival rate following hip fracture surgery in the elderly.

Purpose: We investigated the effect of the time of secondary intraocular lens (IOL) implantation on final visual acuity and other causes affecting visual prognosis in cases left aphakic after open globe injury. Methods: The study included 62 eyes of 62 patients left aphakic after the repair of open globe injury between 2012 and 2019. Demographic characteristics, trauma zone, ocular trauma score, type of injury, time of secondary IOL implantation, final best-corrected visual acuity (BCVA), and complications were recorded for each patient. Results: The mean follow-up time of 62 patients was 25.05 ± 12.59 months. The preoperative BCVA was found to be 2.40 ± 0.86 logarithm of the minimum angle of resolution (logMAR), while the postoperative final BCVA was found to be 0.53 ± 0.70 logMAR (p < 0.01). The mean interval timing of secondary sulcus foldable IOL implantation was determined to be 3.79 ± 4.04 months. No correlation was observed between secondary IOL implantation time and final BCVA (r = 0.140, p = 0.319). Furthermore, when only pediatric patients were taken, an excellent positive correlation was found between the secondary IOL implantation time and final BCVA logMAR (r = 0.895, p < 0.01). Multiple linear regression on final BCVA with age, revealed a significant model explaining 48.0% of the variability with younger age and better final BCVA with as significant coefficients (p = 0.007). Conclusions Although time interval between primary repair and secondary IOL implantation to correct aphakia does not effect final BCVA in adult patients, earlier surgery should be considered for amblyopia management in pediatric patients.

Purpose: We investigated the effect of the time of secondary intraocular lens (IOL) implantation on final visual acuity and other causes affecting visual prognosis in cases left aphakic after open globe injury. Methods: The study included 62 eyes of 62 patients left aphakic after the repair of open globe injury between 2012 and 2019. Demographic characteristics, trauma zone, ocular trauma score, type of injury, time of secondary IOL implantation, final best-corrected visual acuity (BCVA), and complications were recorded for each patient. Results: The mean follow-up time of 62 patients was 25.05 ± 12.59 months. The preoperative BCVA was found to be 2.40 ± 0.86 logarithm of the minimum angle of resolution (logMAR), while the postoperative final BCVA was found to be 0.53 ± 0.70 logMAR (p < 0.01). The mean interval timing of secondary sulcus foldable IOL implantation was determined to be 3.79 ± 4.04 months. No correlation was observed between secondary IOL implantation time and final BCVA (r = 0.140, p = 0.319). Furthermore, when only pediatric patients were taken, an excellent positive correlation was found between the secondary IOL implantation time and final BCVA logMAR (r = 0.895, p < 0.01). Multiple linear regression on final BCVA with age, revealed a significant model explaining 48.0% of the variability with younger age and better final BCVA with as significant coefficients (p = 0.007). Conclusions Although time interval between primary repair and secondary IOL implantation to correct aphakia does not effect final BCVA in adult patients, earlier surgery should be considered for amblyopia management in pediatric patients.

Objectives: This study was conducted to evaluate the effects of traditional and contracted endodontic cavity (TEC and CEC) preparation with the use of Reciproc Blue (RPC B) and One Curve (OC) single-file systems on the amount of apical debris extrusion in mandibular first molar root canals. Materials and Methods: Eighty extracted mandibular first molar teeth were randomly assigned to 4 groups (n = 20) according to the endodontic access cavity shape and the single file system used for root canal preparation (reciprocating motion with the RCP B and rotary motion with the OC): TEC-RPC B, TEC-OC, CEC-RPC B, and CEC-OC. The apically extruded debris during preparation was collected in Eppendorf tubes. The amount of extruded debris was quantified by subtracting the weight of the empty tubes from the weight of the Eppendorf tubes containing the debris. Data were analyzed using 1-way analysis of variance with the Tukey post hoc test. The level of significance was set at p < 0.05. Results: The CEC-RPC B group showed more apical debris extrusion than the TEC-OC and CEC-OC groups (p < 0.05). There were no statistically significant differences in the amount of apical debris extrusion among the TEC-OC, CEC-OC, and TEC-RPC B groups. Conclusions RPC B caused more apical debris extrusion in the CEC groups than did the OC single-file system. Therefore, it is suggested that the RPC B file should be used carefully in teeth with a CEC.

Objectives: This study was conducted to evaluate the effects of traditional and contracted endodontic cavity (TEC and CEC) preparation with the use of Reciproc Blue (RPC B) and One Curve (OC) single-file systems on the amount of apical debris extrusion in mandibular first molar root canals. Materials and Methods: Eighty extracted mandibular first molar teeth were randomly assigned to 4 groups (n = 20) according to the endodontic access cavity shape and the single file system used for root canal preparation (reciprocating motion with the RCP B and rotary motion with the OC): TEC-RPC B, TEC-OC, CEC-RPC B, and CEC-OC. The apically extruded debris during preparation was collected in Eppendorf tubes. The amount of extruded debris was quantified by subtracting the weight of the empty tubes from the weight of the Eppendorf tubes containing the debris. Data were analyzed using 1-way analysis of variance with the Tukey post hoc test. The level of significance was set at p < 0.05. Results: The CEC-RPC B group showed more apical debris extrusion than the TEC-OC and CEC-OC groups (p < 0.05). There were no statistically significant differences in the amount of apical debris extrusion among the TEC-OC, CEC-OC, and TEC-RPC B groups. Conclusions RPC B caused more apical debris extrusion in the CEC groups than did the OC single-file system. Therefore, it is suggested that the RPC B file should be used carefully in teeth with a CEC.

OBJECTIVES: The aim of this study was to compare postoperative pain intensity after root canal treatment with One G (OG) vs. R-Pilot (RP) files used for glide path preparation. MATERIALS AND METHODS: Ninety-three single-canaled mandibular premolar teeth with asymptomatic non-vital pulp were randomly assigned into 3 groups (n = 31): OG, RP, or without glide path (WGP). After creating the glide path, the root canals were prepared using sequential Mtwo rotary files to size 30/0.05. One endodontic specialist carried out single-visit endodontic treatment. The patients were asked to rate the severity of postoperative pain on a visual analogue scale at 24, 48, and 72 hours after the visit. They were also asked to record their intake of prescribed analgesics taken. The data were analyzed using the χ2, Friedman, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS: In all 3 groups, postoperative pain decreased significantly at each time interval (p < 0.05). At 24 hours, the OG group had less postoperative pain than the WGP group (p < 0.05). However, no significant difference was found between the RP group and the others. No statistically significant difference was found among the WGP, OG, and RP groups in postoperative pain intensity at 48 or 72 hours or in analgesic tablet intake at the 3 assessed time intervals. CONCLUSIONS: The OG group had less postoperative pain than the WGP group in the first 24 hours. The OG and RP systems were similar regarding postoperative pain intensity and analgesic intake.
Analgesics ; Bicuspid ; Dental Pulp Cavity ; Endodontics ; Humans ; Pain, Postoperative ; Specialization ; Tooth