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Understanding spinopelvic motion and the dynamic relationship of the hip, spine, and pelvis is essential in decreasing the risk of instability after total hip arthroplasty. The hip-spine relationship is complex, and a detailed analysis of each patient's spinopelvic mobility is warranted to help guide safe acetabular component positioning. Through the use of a standing anteroposterior pelvis X-ray, lateral spinopelvic radiographs in the standing and seated position, and advanced functional imaging, key spinopelvic parameters can be obtained. A systematic preoperative workup can help to identify hip-spine pathology that predisposes patients to instability, and can help in planning and establishing a patient-specific "safe zone." Based on the presence of concomitant hip-spine pathology, patients must be evaluated thoroughly with preoperative imaging to plan for the optimal target acetabular cup position. This paper guides readers through important parameters and imaging associated to spinopelvic motion as it relates to total hip arthroplasty stability.

Complications after total knee arthroplasty (TKA) are devastating for patients, and surgeons are held accountable in alternative payment models. Optimization of modifiable risk factors has become a mainstay in the preoperative period. We sought to evaluate the consequence of failure to optimize key risk factors in a modern cohort of patients who underwent TKA.

The American College of Surgeons National Surgical Quality Improvement Program database was searched to identify patients who underwent TKA in 2017-2018. Patients were considered optimized if they had a body mass index <40kg/m

, had albumin >3.5g/dL, were nonsmokers, and were nondiabetic. Patients were then grouped based on the previous 4 risk factors. Thirty-day readmission, infection, general complications, and mortality were analyzed and compared between the groups.

Overall, 84,315 patients were included in the study. A total of 31.6% of patients were not considered optimized. Body mass index >40kg/m

, albumin <3.5, smoking, and insulin-dependent diabetes were all found to be associated with postoperative infection, readmission, mortality, and complication in general (P < .05). When compared, the nonoptimized group was found to have significantly higher risk of readmission (5 vs 3%), infection (2 vs 1%), general complications (8 vs 5%), and mortality (0.35 vs 0.1%) (all P < .001). Logistic regression showed that those with albumin less than 3.5g/dL had 3.7-fold higher odds of infection and 7.2-fold higher odds of 30-day mortality.

Despite knowledge that modifiable risk factors significantly influence postoperative outcomes, surgeons continue to operate on patients who are not optimized. Among the modifiable risk factors analyzed, hypoalbuminemia appears to be the strongest risk factor for all complications evaluated. Special attention should be paid to preoperative nutritional optimization.

Retrospective cohort study, level IV.

Retrospective cohort study, level IV.

The aim of this study was to develop a surgical risk prediction model in patients undergoing anatomic lung resections from the registry of the Spanish Video-Assisted Thoracic Surgery Group (GEVATS).

Data were collected from 3,533 patients undergoing anatomic lung resection for any diagnosis between December 20, 2016 and March 20, 2018. We defined a combined outcome variable death or Clavien Dindo grade IV complication at 90 days after surgery. Univariate and multivariate analyses were performed by logistic regression. Internal validation of the model was performed using resampling techniques.

The incidence of the outcome variable was 4.29% (95% CI 3.6-4.9). The variables remaining in the final logistic model were age, sex, previous lung cancer resection, dyspnea (mMRC), right pneumonectomy, and ppo DLCO. The performance parameters of the model adjusted by resampling were C-statistic 0.712 (95% CI 0.648-0.750), Brier score 0.042 and bootstrap shrinkage 0.854.

The risk prediction model obtained from the GEVATS database is a simple, valid, and reliable model that is a useful tool for establishing the risk of a patient undergoing anatomic lung resection.

The risk prediction model obtained from the GEVATS database is a simple, valid, and reliable model that is a useful tool for establishing the risk of a patient undergoing anatomic lung resection.Genomic instability underlies genesis and the development of various types of cancer. During tumorigenesis, cancer initiating cells assume a set of features, which allow them to survive and proliferate. Different mutations and chromosomal alterations promote a selection of the most aggressive cancer clones that worsen the prognosis of the disease. Despite that caspase-2 was described as a protease fulfilling an initiator and an effector function in apoptosis, it has recently been discovered to play an important role in the maintenance of genomic integrity and normal chromosome configuration. This protein is able to stabilize p53 and affect the level of transcription factors, which activates cell response to oxidative stress. Here we focus on the discussion on the mechanism(s) of how caspase-2 regulates genomic stability and decreases tumorigenesis.The purpose of this study was to undertake a retrospective cross-sectional analysis to compare the frequency and characteristics of facial injury presentations at a UK and an Australian tertiary referral hospital during the implementation of COVID-19 social-distancing measures. The primary predictor variables were a heterogeneous set of factors grouped into logical categories demographics, injury mechanisms and site, and management. The primary outcome variable was the presentation of a hard or soft tissue facial injury. A descriptive statistical analysis was undertaken on the assembled data. The study found a clinical and statistically significant reduction in the frequency (absolute number) of facial injuries at each study site. In addition, a striking similarity common in both countries was an increase in the number of facial injuries due to falls and a reduction in facial injuries due to interpersonal violence. Conservative (non-operative) management of facial injury increased at both sites. selleck chemical The implementation of COVID-19 social-distancing public health measures, which aimed to limit community transmission of the coronavirus, had a secondary serendipitous effect of reducing the frequency of facial injury presentations and altering their epidemiological characteristics at both a UK and Australian tertiary referral hospital.