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- Glasbey, JC, et al.
(författare)
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- 2021
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swepub:Mat__t
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- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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| 7. |
- Lawes, Simon D. A., et al.
(författare)
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Performance of fullerene-like CNx coatings for automotive valve-train applications
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The design of internal combustion engines is evolving in order to provide greater efficiency and lower harmful emissions. There has been a move to lower component masses, higher engine temperatures, lower viscosity oils and low SAPS (sulphated ash, phosphor and sulphur) oils. With the transition to low density, low hardness materials and new lubrication conditions, come issues of component wear. Surface engineering techniques such as thin-film coating technologies present a possible solution. Thin-film coating development in recent years has often focused on achieving a high hardness, which often leads to high elastic modulus. However, there are potential benefits of less stiff and more elastic coatings. A number of wear mechanism are directly related to the ratio of hardness (H) and elastic modulus (E) and higher H/E ratios can be beneficial. This work therefore investigates the potential for using a highly elastic, experimental fullerene-like carbon nitride (FL-CNx) coating in a valve-train environment. Two FL-CNx coatings of differing nitrogen content were investigated using microscopy, wear testing, nanoindentation testing and in an experimental cam-tappet testing rig. The two FL-CNx coatings had similar adhesion to the substrate and hardness. The FL-CNx coating with the higher value of H/E also showed greater durability in the valve-train testing.
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| 10. |
- Shin, Hainsworth Y., et al.
(författare)
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Dependence of macrophage superoxide release on the pulse amplitude of an applied pressure regime : A potential factor at the soft tissue-implant interface
- 2016
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Ingår i: Journal of Tissue Engineering and Regenerative Medicine. - : Hindawi Limited. - 1932-6254. ; 10:3, s. 227-238
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Tidskriftsartikel (refereegranskat)abstract
- Failure of soft tissue implants has been largely attributed to the influence of biomaterial surface properties on the foreign body response, but some implant complications, e.g. macrophage accumulation and necrosis, are still not effectively addressed with surface treatments to minimize deleterious biomaterial effects. We explored an alternative explanation for implant failure, linking biocompatibility with implant micromotion-induced pressure fluctuations at the tissue-biomaterial interface. For this purpose, we used a custom in vitro system to characterize the effects of pressure fluctuations on the activity of macrophages, the predominant cells at a healing implant site. Initially, we quantified superoxide production by HL60-derived macrophage-like cells under several different pressure regimes with means of 5-40 mmHg, amplitudes of 0-15 mmHg and frequencies of 0-1.5 Hz. All pressure regimes tested elicited significantly (p2=0.74; p
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