Healing beyond the joint: Addressing mental health in periprosthetic joint infection in a prospective longitudinal study

OBJECTIVE

Periprosthetic joint infection (PJI) is a devastating complication following joint replacement surgeries. While the somatic impacts of PJI have been extensively explored, the influence on mental health remains understudied. This study aimed to longitudinally assess the psychological burden, quality of life, and expectations in individuals undergoing treatment for PJI.

METHODS

A prospective study was conducted at a German trauma center between January 2020 and December 2022. Patients diagnosed with PJI (n = 29, mean age 71.4 ± 8.8 years) were assessed at five timepoints, within one week before revision surgery, one month, three, six, and twelve months postoperatively. Outcomes included the ICD-10 symptom-rating (ISR), German Short-Form 36 (SF-36), European Quality of Life 5 Dimensions (EQ-5D), and an expectation questionnaire.

RESULTS

Psychological scores exhibited significant upward trends over time. The ISR score increased from 0.55 preoperatively to 0.87 at the 12-month follow-up (p = 0.002), surpassing the clinically relevant threshold. Depression and anxiety scores peaked at 6 months (1.6, p = 0.005) and 12 months (1.12, p = 0.001), respectively. Quality of life, measured by SF-36, showed stable physical component summary scores but declining mental component summary scores. Patients' expectations of returning to normal health consistently decreased (p = 0.009).

CONCLUSION

Patients undergoing treatment for PJI experience significant psychological burden, with implications for quality of life and expectations of recovery. The findings underscore the importance of addressing psychological well-being in the management of PJI and emphasize the need for comprehensive care strategies that encompass both somatic and psychological dimensions.

Reflektorische Atemtherapie bei Patienten mit idiopathischem Parkinson-Syndrom – Einarmige Pilotstudie

Hintergrund Beim idiopathischen Parkinson Syndrom (IPS) handelt es sich um die häufigste neurologische Erkrankung in Deutschland. Die Patienten haben ein erhöhtes Risiko, sekundär eine Störung der Lungenfunktion zu entwickeln. Die reflektorische Atemtherapie ist eine spezielle Form der Atemtherapie zur Behandlung von Lungenfunktionsstörungen.

Ziel Das Ziel dieser Pilotstudie war, die Anwendbarkeit der reflektorischen Atemtherapie bei Patienten mit IPS zu untersuchen.

Methode In der einarmigen interventionellen Pilotstudie erhielten die Probanden in der 3-wöchigen Interventionsphase 2 Behandlungen reflektorische Atemtherapie pro Woche. Die Verlaufsdokumentation erfolgte anhand des Parkinson’s Disease Questionnaire (PDQ) 39, der Spirometrie und des 6-Minuten-Gehtests. Zudem wurden die Zufriedenheit und der Studienabbruch der Studienteilnehmer erfasst und die Daten deskriptiv ausgewertet.

Ergebnisse Insgesamt wurden 10 Probanden eingeschlossen. Bei 9 Teilnehmern konnte die Therapie durchgeführt werden. Bei der Verlaufsdokumentation zeigten sich für eine Mehrheit der Patienten gleichbleibende bis positive Entwicklungen der krankheitsbezogenen Lebensqualität und der Gehstrecke. Die Zufriedenheit lag bei 9,44 (± 0,69) von 10 Punkten. Sowohl Drop-outs als auch Lost-to-Follow-up wurden erfasst.

Schlussfolgerung Bei Patienten mit IPS ist die reflektorische Atemtherapie eine ergänzende Behandlungsmethode. Die erfassten klinischen Daten können als Anhaltspunkte für nachfolgende wissenschaftliche Studien dienen.

The Validity of Rasterstereography: A Systematic Review

To investigate and monitor the progression of scoliosis and other spinal deformities in patients following idiopathic scoliosis (IS), non-invasive and radiation-free techniques are recommended because of the need for repeated radiographs. In a clinical setting, spine parameters can be quickly, cheaply and easily assessed using rasterstereography (RS). To assess the validity of the radiation-free technique RS based on surface topography compared with radiographs. MEDLINE, the Cochrane Library and EMBASE were systematically searched for studies which investigate the validity of rasterstereography compared with x-ray measurements. Studies published between January 1, 1990 and July 31, 2013 in English, German and French were included. Studies dealing with magnetic resonance imaging were excluded. Twelve studies with 570 patients were included; these articles were published between 1990 and 2013. The majority of studies investigated patients with IS, but other spinal pathologies included were thoracic hyperkyphosis and Scheuermann’s disease. With regard to the quality assessment criteria for the included studies, three out of twelve studies were evaluated using a twelve point scale and two used a scale with eleven points. We conclude that RS facilitates clinical practice by analysing the spinal column. It is completely radiation-free and could help to monitor scoliosis progression.

The association of Raynaud's syndrome with cisplatin-based chemotherapy - a meta-analysis

BACKGROUND

Vasospastic disorders of the digital circulation such as the Raynaud's syndrome (RS) are known side-effects of treatment of cisplatin-based chemotherapy. The prevalence of RS in patients during treatment with cisplatin-based chemotherapy is not well-defined.

OBJECTIVE

The objective of this paper was to assess the prevalence of RS in patients receiving cisplatin-based chemotherapy - a meta-analysis of published data was performed.

MATERIAL AND METHODS

The PubMed database of the National Library of Medicine and ISI Web of Knowledge was used for studies dealing with RS and patients receiving cisplatin-based chemotherapy. The studies provided sufficient data to estimate the prevalence of RS in patients receiving cisplatin-based chemotherapy. A forest plot was determined by the revealed prevalences. Statistical analysis was based on methods for a random effects meta-analysis and a finite mixture model for proportions. Publication bias was investigated with the linear regression test (Egger's method). A meta-regression was conducted by the year of publication and latitude.

RESULTS

24 eligible studies, contributing data on 2749 subjects, were included in this meta-analysis. For RS in patients receiving cisplatin-based chemotherapy a pooled prevalence of 24% and 95% CI (0.175, 0.313) was obtained. A mixture model analysis found four latent classes. Statistically, publication bias was not present (p-value 0.74). The meta-regression indicated that the odds ratio increased when the latitude increased, too (p-value 0.011).

CONCLUSION

Despite some heterogeneity there is a possible indication of an association between RS and patients receiving cisplatin-based chemotherapy.

Association of Raynaud's syndrome with interferons. A meta-analysis

AIM

Vasospastic disorders of the digital circulation such as the Raynaud's syndrome (RS) are known side-effects of treatment of interferons. The prevalence of RS in patients during treatment with interferons agents is not well-defined. The objective of this paper was to assess the prevalence of RS in patients receiving interferons - a meta-analysis of published data was performed.

METHODS

The PubMed database of the National Library of Medicine and ISI Web of Knowledge was used for studies dealing with RS and patients receiving interferons. The studies provided sufficient data to estimate the prevalence of RS in patients receiving interferons. A forest plot was determined by the revealed prevalences. Statistical analysis was based on methods for a random effects meta-analysis and a finite mixture model for proportions. Publication bias was investigated with the linear regression test (Egger's method). A meta-regression was conducted by the year of publication.

RESULTS

Six eligible studies, contributing data on 183 subjects, were included in this meta-analysis. For RS in patients receiving interferons a pooled prevalence of 13.6% and 95% CI (95% CI 0.026, 0.313) was obtained. A mixture model analysis found three latent classes. Statistically, publication bias was not present (p-value 0.335).

CONCLUSION

Despite some heterogeneity there is a possible indication of an association between RS and patients receiving interferons.

The Association of Raynaud Syndrome With β-Blockers

Vasospastic disorders of the digital circulation such as the Raynaud syndrome (RS) are known side effects of treatment of β-adrenergic blockade. The prevalence of RS in patients during treatment with β-blockers is not well defined. The objective of this meta-analysis is to assess the prevalence of RS in patients receiving β-blockers. A literature search was performed for studies dealing with RS and patients receiving β-blockers. The studies provided sufficient data to estimate the prevalence of RS in patients receiving β-blockers. A total of 13 eligible studies, contributing data on 1012 individuals, were included in this meta-analysis. For RS in patients receiving β-blockers, a pooled prevalence of 14.7% (95% confidence interval 0.076-0.236) were obtained. Statistically publication bias was not present ( P = .877). Despite some heterogeneity, there is a possible indication of an association between RS and patients receiving β-blockers.

The association of Raynaud syndrome with thromboangiitis obliterans--a meta-analysis

Thromboangiitis obliterans (TAO) has traditionally been included among the diseases associated with Raynaud syndrome (RS). The prevalence of RS in patients with TAO is not well defined. The objective of this meta-analysis is to assess the prevalence of RS in patients with TAO. A literature search was performed for the studies dealing with RS and TAO. The studies provided sufficient data to estimate the prevalence of RS in patients with TAO. A total of 8 eligible studies, contributing data on 851 patients, were included in this meta-analysis. For TAO, a pooled prevalence of 28.1% and 95% confidence interval ([CI] = 0.158, 0.423) were obtained. Statistically publication bias was not present (P = .232). Despite some heterogeneity, there is a possible indication of an association between RS and patients with TAO.