Treatment Failure Among Infected Periprosthetic Total Hip Arthroplasty Patients

Two-stage revision has been shown to be the most successful treatment in eradicating deep infection following total hiparthroplasty. We identified 62 patients treated by a two-stage revision. We defined “successful revision” as negative intraoperative cultures and no further infection-related procedure. We defined “eradication of infection” on the basis of negative cultures and clinical diagnosis at least one year after 2nd stage procedure. After a mean follow up of 2.7 years, eradication of the infection was documented in 91.1%, and a successful two-stage revision in 85.7% of patients. We observed no association between higher pre-reimplantation levels of ESR and C-reactive protein and lower likelihood of successful two-stage revision. We found an association between a history of another previous infected prosthetic joint and a failed 2nd stage procedure. Failure to achieve eradication of infection and successful two-stage revision occurs infrequently. Patients with prior history of a previous prosthetic joint infection are at higher risk of failure.Version of Recor

Treatment Failure Among Infected Periprosthetic Patients at a Highly Specialized Revision TKA Referral Practice

Deep infection is a serious and costly complication of total knee arthroplasty (TKA), which can increase patient morbidity and compromise functional outcome and satisfaction. Two-stage revision with an interval of parental antibiotics has been shown to be the most successful treatment in eradicating deep infection following TKA. We report a large series by a single surgeon with a highly specialized revision TKA referral practice. We identified 84 patients treated by a two-stage revision. We defined “successful two-stage revision” as negative intraoperative cultures and no further infection-related procedure. We defined “eradication of infection” on the basis of negative cultures and clinical diagnosis. After a mean follow up of 25 months, eradication of the infection was documented in 90.5% of the patients; some had undergone further surgical intervention after the index two-stage procedure. Successful two-stage revision (e.g. no I&D, fusion, amputation) was documented only in 63.5% of the patients. We also observed a trend between presence of resistant staphylococcus (MRSA) (p=0.05) as well as pre-revision surgical procedures (p=0.08) and a lower likelihood of successfully two-stage revision. Factors affecting the high failure rate included multiple surgeries prior to the two-stage revision done at our institution, and high prevalence of MRSA present among failed cases. The relatively high rate of failure to achieve a successful two-stage revision observed in our series may be attributed to the highly specialized referral practice. Thus increasing the prevalence of patients with previous failed attempts at infection eradication and delayed care as well as more fragile and immune compromised hosts

Paywalls

This commentary explores the ramifications of declining newspaper revenues due to a growing percentage of readers who use the internet to access news content. The author explores the ramifications of the New York Times, San Francisco Chronicle, Newsday and Popular Science adopting a paywall. He also discusses The Daily, a newspaper which exists exclusively on the iPad. Another model discussed is that of Apple’s iTunes and its potential for newspaper content distribution. Paywalls are put forward as a possible means of redress for this problem. ©Journal of Professional Communication, all rights reserved

Thesis Proposal and Project: Transplanted

This manuscript is a work of fiction in the mystery/thriller genre. Detective Joy Livingston is led to learn why God allows evil to exist in the world. Everything happens for a reason and this work seeks to represent loss, organ donation, and evil in a way that exhibits this

Seeing ecophobia on a vegan plate

There has been a sudden growth in the vegan industry, with meatless burgers garnering a profoundly positive consumer response and even people such as Arnold Schwarzenegger and Jackie Chan supportively entering the conversation. In some ways, companies such as Beyond MeatTM and Impossible FoodsTM and films such as The Game Changers are succeeding in doing what many political vegetarians and vegans, academics, and activists have long failed to do: to have a real effect on the animal agriculture business. Perhaps this is something to celebrate, especially since (despite the arguments, protests, and even veg-friendly businesses having steadily increased) the numbers of animals involved in the industry have consistently swollen. To rest much hope in the current vegan trends would be to fall victim to a deceptively sexist and ecophobic guiding narrative. While taking big steps toward shutting down the animal agriculture business, the great strides of the vegan industry follow a well-worn path. Putting veggie patties in the meat aisle and shunning words such as “vegetarian” and “vegan” engages in a disavowal of vegetal realities, and the fact that the meat aisle itself is so heavily gendered effectively re-genders the food itself. It may all seem harmless enough—even productive—until understood within the larger context of patriarchal “attempts,” to cite Laura Wright, “to reconceptualize veganism as an alternative untramasculine choice.” The Game Changers drips with such attempts, and, like the “meatless” products now enjoying such popularity, reeks of male self-delusionalism about having discovered a healthful, new diet. There is a lot more than veggies being served up with what we might call the new veganism, and there is not much chance of really effecting change unless we look at what’s really on the plate.Ha habido un repentino crecimiento en la industria vegana, con las hamburguesas sin carne consiguiendo una aceptacio n profundamente tentadora, e incluso gente como Arnold Schwarzenegger y Jackie Chan han ofrecido su apoyo al tema. De alguna manera, compan í as como Beyond MeatTM e Impossible FoodsTM y pelí culas como The Game Changers esta n teniendo e xito en lo que muchos vegetarianos y veganos polí ticos, acade micos, y activistas han fracasado durante mucho tiempo: tener un efecto real en el negocio de la agricultura animal. Quiza esto es algo a celebrar, especialmente ya que, a pesar del aumento constante de argumentos, protestas, e incluso de los negocios respetuoso con lo vegetariano, las cifras de animales implicadas en la industria han crecido continuamente. Poner muchas esperanzas en las tendencias veganas actuales serí a caer ví ctima de una narrativa influyente que es engan osamente sexista y ecofo bica. Mientras se dan grandes pasos hacia el cierre del negocio de la agricultura animal, las mayores zancadas de la industria vegana siguen un camino muy trillado. Poner hamburguesas veganas en el pasillo de la carne y evitar palabras como “vegetariano” o “vegano” conlleva la negacio n de la realidad vegetal, y el hecho de que el pasillo de la carne este tan orientado al ge nero hace que la comida se asocie a un ge nero a su vez. Parece algo bastante inofensivo—incluso productivo—hasta que se entiende dentro del contexto ma s amplio de “intentos” patriarcales, citando a Laura Wright: “reconceptualizar el veganismo como una eleccio n alternativa ultramasculina”. The Game Changers lo intenta a cuenta gotas y, como los productos “sin carne” gozan de tanta popularidad, apesta a autoengan o masculino sobre el hecho de haber descubierto una nueva dieta saludable. Se esta n sirviendo mucho ma s que veggies en lo que podemos llamar el nuevo veganismo, y no hay mucha oportunidad de realmente cambiar algo a menos que miremos lo que realmente esta en el plato

Afterword: reckoning with irreversibilities in biotic and political ecologies

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Humanizing Corporeal Spectacle: Humor and Resistance in Indra Sinha\u27s Animal\u27s People

This article examines Indra Sinha’s Animal’s People and the comments it makes about the long- term corporeal effects of environmental catastrophes. Sinha’s choice of a first person narrative strategy strongly sharpens the visceral impact of the story. The narrator is a lovably unlovable misfit who has been deformed and crippled by an industrial disaster that claimed thousands of lives. While the effects of the disaster play out through the body of the narrator himself (he calls himself “Animal” because he is so deformed), they are more than merely bodily effects: they are psychological, social, economic, developmental, sexual, and so on. Animal is a spectacle, and his very existence calls into question the boundary between what is human and what is not. The story he tells reveals the effects of capitalist racism and greed and raises questions about environmental justice issues and corporate responsibility. These are important questions that are inseparable from the material facts of Animal’s broken body. It is a deadly serious topic that Animal narrates, but he does it with humor (often self-deprecating), and it is precisely this humor that ultimately both humanizes him and intensifies the impact of the narrative itself

Post 9/11 and Narratives of Life Writing, Conflict, and Environmental Crisis

In his article Post 9/11 and Narratives of Life Writing, Conflict, and Environmental Crisis Simon C. Estok argues that there are four seemingly disparate and disconnected topics — war, migration, ecophobia, and life writing — which need to be discussed in tandem in order to produce deeper understandings of both the production and effects of post 9/11 narratives. Estok argues that narrative landscapes changed radically since the beginning of the twenty-first century and that this results in a combined effect both of terror reportage and of environmental crisis narratives. The pace and character of reportage blurred, erased, and expanded various boundaries and these changes will be increasingly central to discussions about life writing and its relation to environmental crisis writing

Book Review: Ecologies of a Storied Planet in the Anthropocene

Dr. Simon C. Estok is a full professor and Senior Research Fellow at Sungkyunkwan University (South Korea’s first and oldest university). He is editor of the A&HCI journal Neohelicon and is an elected member of The European Academy of Sciences and Arts. Estok teaches literary theory, ecocriticism, and Shakespearean literature. His award-winning book Ecocriticism and Shakespeare: Reading Ecophobia appeared in 2011 (reprinted 2014), and his much anticipated The Ecophobia Hypothesis (Routledge, 2018; reprinted with errata as paperback in 2020) has been translated into Turkish (tr. M. Sibel Dinçel) and is currently being translated into Chinese and Korean. He is coeditor of five books: Anthropocene Ecologies of Food (Routledge, April 2022), Mushroom Clouds: Ecological Approaches to Militarization and the Environment in East Asia (Routledge, March 2021), Landscape, Seascape, and the Eco-Spatial Imagination (Routledge, 2016), International Perspectives in Feminist Ecocriticism (Routledge, 2013), and East Asian Ecocriticisms (Macmillan, 2013). Estok has published extensively on ecocriticism and Shakespeare in such journals as PMLA, Mosaic, Configurations, English Studies in Canada, English Language Notes, and others. He is currently working on a book about slime in the Western cultural and literary imagination

The Hussites and Their Work of Reformation in Slovakia

In the middle of the fourteenth century central Europe was ripe for a reformation movement. a re-formation of the Church of the day. In consequence of the shameful debasement of the papacy and the deep corruption of the clergy and monks, the influence of the Church upon the moral and religious culture of the people, in spite of the ardent zeal of the homilists and catechists, was upon the whole much less than formerly. Reverence for the Church as it stood was indeed tottering, but was not yet completely overthrown