<strong>Objective:</strong> <span style="font-family:Verdana;">To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydro...<strong>Objective:</strong> <span style="font-family:Verdana;">To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydroxychlo</span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">roquine and Azithromycin. </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> Prospective study. </span><b><span style="font-family:Verdana;">Setting:</span></b><span style="font-family:Verdana;"> Treatment centres of the city of Yaounde, Cameroon, from May 7</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> to 24</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2020. </span><b><span style="font-family:Verdana;">Participants:</span></b><span style="font-family:Verdana;"> We enrolled 51 consecutive confirmed COVID-19 on RT-PCR who having mild forms of COVID-19 and treated by hydroxychloroquine 200</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">mg twice daily during seven #days plus Azithromycin 500 mg the first day and 250 mg the remaining 4 days as per national standard. </span><b><span style="font-family:Verdana;">Main Outcomes Measures:</span></b><span style="font-family:Verdana;"> The</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">primary end-point was the change in QTc interval between day 0 (D0), day 3 (D3) and day 7 (D7). Secondary endpoints were changes in all other cardiac electrical conductivity patterns and the occurrence of clinical arrhythmic events during the course of treatment. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The population (29 men and 22 women) was aged 39 ± 11 years (range 17 to 61 years). Mean Tisdale score was 3.35 ± 0.48. No significant change from baseline (D0) of QTc was observed at D7 (429 ± 27 ms at D0 versus 396 ± 26 ms at D7;p = 0.27). A reduction of heart rate was observed between the D0 and D7 (75 ± 13 bpm versus 70 ± 13 bpm, p = 0.02) with increased QRS duration between D0 and D7 (95 ± 10 ms versus 102 ± 17 ms, p = 0.004). No symptomatic arrhythmic events occurred during the treatment course. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">No life-threatening modification of the QT interval was observed in non-severe COVID-19 patients treated ambulatory with hydroxychloroquine and azith</span></span><span style="font-family:Verdana;">romycin. Studies are needed in critical-ill and older patients.</span>展开更多
Infection after hip prostheses is a potentially devastating complication, and a serious medical and surgical challenge, especially when associated with Paprosky type III femoral bone loosening. Treatment is difficult ...Infection after hip prostheses is a potentially devastating complication, and a serious medical and surgical challenge, especially when associated with Paprosky type III femoral bone loosening. Treatment is difficult and options are limited. We report on a 2-stage revision of 15 patients undergoing femur reconstruction with massive allografts. Materials and methods: This was a prospective study which included 15 patients (10 men and 5 women) with infected hip prosthesis, associated with Paprosky type III femoral proximal massive bone loss. The median age of patients was 64 years with a preoperative functional status score of 6. The average number of procedures to the same hip after the first arthroplasty was 6. All patients benefited from a 2-step surgery with massive allografts and locking prosthesis. The average follow-up time was 36 months. Results: Infection was monomicrobial in 14 cases;and was polymicrobial in 4 cases. Methicillin-resistant Staphylococcus epidermidis was the main bacteria (n = 10). The average C-reactive protein level before the second procedure was 2.3 ± 3.4. It was normalized in 8 cases. We recorded 13 cases of primary consolidation without another surgery, 3 cases of relapse, 2 traumatic dislocations and 2 fractures of the allograft. Conclusion: Hip prosthesis infection is a potentially catastrophic complication with significant negative ramifications for both the patient and the healthcare system. Massive allografts use in Paprosky III femoral defect remains very attractive for bone stock restoration and hip function improvement.展开更多
文摘<strong>Objective:</strong> <span style="font-family:Verdana;">To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydroxychlo</span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">roquine and Azithromycin. </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> Prospective study. </span><b><span style="font-family:Verdana;">Setting:</span></b><span style="font-family:Verdana;"> Treatment centres of the city of Yaounde, Cameroon, from May 7</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> to 24</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2020. </span><b><span style="font-family:Verdana;">Participants:</span></b><span style="font-family:Verdana;"> We enrolled 51 consecutive confirmed COVID-19 on RT-PCR who having mild forms of COVID-19 and treated by hydroxychloroquine 200</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">mg twice daily during seven #days plus Azithromycin 500 mg the first day and 250 mg the remaining 4 days as per national standard. </span><b><span style="font-family:Verdana;">Main Outcomes Measures:</span></b><span style="font-family:Verdana;"> The</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">primary end-point was the change in QTc interval between day 0 (D0), day 3 (D3) and day 7 (D7). Secondary endpoints were changes in all other cardiac electrical conductivity patterns and the occurrence of clinical arrhythmic events during the course of treatment. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The population (29 men and 22 women) was aged 39 ± 11 years (range 17 to 61 years). Mean Tisdale score was 3.35 ± 0.48. No significant change from baseline (D0) of QTc was observed at D7 (429 ± 27 ms at D0 versus 396 ± 26 ms at D7;p = 0.27). A reduction of heart rate was observed between the D0 and D7 (75 ± 13 bpm versus 70 ± 13 bpm, p = 0.02) with increased QRS duration between D0 and D7 (95 ± 10 ms versus 102 ± 17 ms, p = 0.004). No symptomatic arrhythmic events occurred during the treatment course. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">No life-threatening modification of the QT interval was observed in non-severe COVID-19 patients treated ambulatory with hydroxychloroquine and azith</span></span><span style="font-family:Verdana;">romycin. Studies are needed in critical-ill and older patients.</span>
文摘Infection after hip prostheses is a potentially devastating complication, and a serious medical and surgical challenge, especially when associated with Paprosky type III femoral bone loosening. Treatment is difficult and options are limited. We report on a 2-stage revision of 15 patients undergoing femur reconstruction with massive allografts. Materials and methods: This was a prospective study which included 15 patients (10 men and 5 women) with infected hip prosthesis, associated with Paprosky type III femoral proximal massive bone loss. The median age of patients was 64 years with a preoperative functional status score of 6. The average number of procedures to the same hip after the first arthroplasty was 6. All patients benefited from a 2-step surgery with massive allografts and locking prosthesis. The average follow-up time was 36 months. Results: Infection was monomicrobial in 14 cases;and was polymicrobial in 4 cases. Methicillin-resistant Staphylococcus epidermidis was the main bacteria (n = 10). The average C-reactive protein level before the second procedure was 2.3 ± 3.4. It was normalized in 8 cases. We recorded 13 cases of primary consolidation without another surgery, 3 cases of relapse, 2 traumatic dislocations and 2 fractures of the allograft. Conclusion: Hip prosthesis infection is a potentially catastrophic complication with significant negative ramifications for both the patient and the healthcare system. Massive allografts use in Paprosky III femoral defect remains very attractive for bone stock restoration and hip function improvement.