Perioperative infection in the patient with rheumatic disease

Antimicrobial cellulose hydrogels preparation with RIF loading from bamboo parenchyma cells: A green approach towards wound healing

Wound healing is a challenged and complicated process due to the bacterial infections and frequent replacement in healing process. Hydrogels with properties of visibility and biocompatibility provided convenient and effective treatment during the wound healing process. Bamboo parenchyma cells have a great potential utilized on cellulosic materials fabrication for their high specific surface area and accessibility of chemical reagents. Herein, we present a simple and facile manufacture of transparent wound dressing from bamboo parenchymal cellulose via dissolution in DMAc/LiCl system. Rifampicin (RIF) was loaded on the hydrogel through immersion method. The result exhibited that the maximum drug loading efficiency of cellulose hydrogels was 82.13%. Hydrogel loaded RIF (HLR) showed that the inhibition zones against Gram-negative and Gram-positive bacteria were 19.11 mm and 36.93 mm, respectively. It was observed that the wound was healed more than 60% at 11th day in murine wound models. Meanwhile, RIF provided an exceptionally antibacterial property to hydrogels and promoted proliferation of epidermis cells in wound. As a result of observations, HLR demonstrating potential application in visual wound dressing materials for their excellent transparency, antibacterial effect, wound healing, and biocompatibility.

[Safety aspects of the treatment with glucocorticoids for rheumatoid arthritis]

Glukokortikoide (GC) werden für die initiale Therapie der RA nach wie vor empfohlen – zeitlich befristet und in geringstmöglicher Dosierung. Ihre komplexe Wirkweise geht mit Nebenwirkungen einher, die v. a. in der Dauertherapie oberhalb von 5 mg Prednisolon pro Tag eine Rolle spielen. In diesem Dosisbereich begünstigen sie Osteoporose, Diabetes/Hyperglykämie, kardiovaskuläre Ereignisse und Infektionen und tragen damit zu einer vermehrten Frühsterblichkeit bei. Dabei sind die Risiken der GC-Therapie von patientenbezogenen Faktoren abhängig wie Alter, Komorbidität und Begleitmedikation. Ein negativer Einfluss sehr niedriger Steroiddosen auf das Gesamtüberleben ist möglicherweise bei hoher kumulativer Dosis nachweisbar, die Datenlage ist hier jedoch widersprüchlich. Das Monitoring einer GC-vermittelten Toxizität mithilfe eines validierten Index sollte in Zukunft dazu beitragen, die Vorteile einer steroidsparenden Behandlungsstrategie besser zu beschreiben. Selektiver wirkende Substanzen könnten in Zukunft eine Abkopplung der erwünschten Wirkungen von den Nebenwirkungen ermöglichen.

Practical Pearls About Current Rheumatic Medications

New and existing rheumatic disease is frequently encountered in the primary care setting. The number of medications used to treat various rheumatic conditions continues to increase. Some medications have very specific indications, whereas others have increasing off-label uses. Regardless of the indication, the medications used in rheumatology have variable dosing recommendations, significant side effects, recommended monitoring parameters, and potential medication interactions. Clinicians need to be aware of the potential uses as well as possible pitfalls associated with medications used in rheumatology.

An Insight into Methods and Practices in Hip Arthroplasty in Patients with Rheumatoid Arthritis

Total hip arthroplasty (THA) has improved the quality of life of patients with hip arthritis. Orthopedic community is striving for excellence to improve surgical techniques and postoperative care. Despite these efforts, patients continue facing postoperative complications. In particular, patients with rheumatoid arthritis display a higher risk of certain complications such as dislocation, periprosthetic infection, and shorter prosthesis durability. In this review we present the current knowledge of hip arthroplasty in patients with rheumatoid arthritis with more insight into common practices and interventions directed at enhancing recovery of these patients and current shortfalls.