Comparison of different methods of femoral fixation anterior cruciate ligament reconstruction

The aim of this study is to compare three modes of femoral fixation, namely Aperfix, Rigidfix and Endobutton, in anterior cruciate ligament [ACL] reconstruction. 120 patients were randomly assigned to three groups, each consisting of 40 patients, and each group was treated by one of the above mentioned methods of femoral fixation. All patients were examined prior to and 24 months after surgery, and they were compared for anterior tibial displacement using the Lysholm score and KT-1000. The three modes of femoral fixation were not significantly different in terms of time of surgery. In the Endobutton group, the Lysholm score rose from 63.21 +/- 18.59 prior to ACL reconstruction to 90.64 +/- 9.47 after the surgery, while it rose from 65.72 +/- 18.74 to 96.22 +/- 5.35 in the Aperfix group and from 69.21 +/- 17.45 to 90.64 +/- 9.47 in the Rigidfix group. Anterior tibial displacement was 3.96 +/- 1.58 mm for Endobutton, 4.28 +/- 1.48 mm for Rigidfix and 4.03 +/- 1.79 mm for Aperfix. Aperfix was indicated to yield a better outcome in terms of instant stability and general results

Effect of door-to-antibiotic time on mortality of patients with sepsis in emergency department: a prospective cohort study

Sepsis constitutes an important cause of hospital admission with a high mortality rate. Appropriate antibiotic therapy is the cornerstone of therapy in patients with sepsis. Although numerous studies have recommended early antibiotic initiation in severe sepsis or septic shock stages of sepsis syndrome, its role in treatment of patients with sepsis who have not entered these stages remains to be investigated. The purpose of this study is to investigate the effect of door-to-antibiotic time in sepsis patients with various degrees of severity. This is a longitudinal prospective cohort study on adult patients admitted with sepsis to the emergency department. Sepsis was defined as presence of at least two criteria of systemic inflammatory response syndrome and procalcitonin levels >/= 2 micro g/l. Severity of sepsis was determined using the APACHE II [Acute Physiology and Chronic Health Evaluation II] scoring system. Time to antibiotic administration was recorded and its relationship with mortality was assessed. A total of 145 patients were eligible for enrollment. The mean age was 60.4 years and the mean APACHE score was 13.7. The overall in-hospital mortality was 21.4%, and the mean length of stay in hospital was 211.9 hours. The mean door-to-antibiotic time for our patients was 104.4 minutes. Antibiotic administration time and mortality in patients with APACHE scores of 21 or higher [P=0.05] were significantly related; whereas such a relationship was not observed for patients with APACHE scores of 11- 20 [P=0.46]. We observed early antibiotic initiation for patients in sepsis phase with higher severity scores was associated with significant improvement in survival rate