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27. Ankylosing spondylitis in patients undergoing total hip arthroplasty increases the risk of medical and implant-related complications: a case control analysis.

Author

Mekkawy, Kevin L, Rodriguez, Hugo C, Mercadal, Gino, Gosthe, Raul G, Khanuja, Harpal S, Corces, Arturo, and Roche, Martin W

Subjects
ANKYLOSING spondylitis, MYOCARDIAL infarction, PULMONARY embolism, URINARY tract infections, PNEUMONIA, TOTAL hip replacement, PROSTHESIS-related infections, COMPLICATIONS of prosthesis, PATIENT readmissions, VENOUS thrombosis, RETROSPECTIVE studies, ACUTE kidney failure, JOINT dislocations, MEDICAL records, ACQUISITION of data, SEPSIS, LENGTH of stay in hospitals, STROKE, SURGICAL site infections, BLOOD transfusion, ACCIDENTAL falls, COMORBIDITY, PERIPROSTHETIC fractures, DISEASE risk factors, DISEASE complications
Abstract

Introduction: Ankylosing spondylitis (AS) is an inflammatory spondyloarthropathy, often involving the spine and sacroiliac joints. Total hip arthroplasty (THA) has been shown to be effective in improving pain and function in patients with AS with hip involvement. However, extraskeletal manifestations and altered mechanics in those with AS leads to increased complications. Thus, the aims of this study were to assess the effects that AS has on medical and implant complications, falls, length of stay, and readmissions following THA. Methods: A retrospective review of the Mariner private insurance claims database was conducted from 2010 to 2020. All cases of THA and those with AS were identified using Current Procedural Terminology, and International Classification of Disease 9th and 10th revision codes. Patients who underwent THA with a diagnosis of AS were matched to non-AS patients 1:5 based on demographic and comorbidity profiles. 90-day medical complications, falls, and readmission rates, as well as 2-year implant complications were compared between cohorts. Results: A total of 6509 AS patients were matched to 32,489 control patients. The AS group had significantly higher rates of myocardial infarction, cerebrovascular accident, deep vein thrombosis, pulmonary embolism, urinary tract infection, wound complications, acute kidney injury, pneumonia, sepsis, transfusions, and falls when compared to the control group. The AS group had significantly higher rates of prosthetic joint infection, dislocation, mechanical loosening, and periprosthetic fracture (all p < 0.0001). Likewise, mean length of stay and readmissions were significantly greater in the AS group. Conclusions: Ankylosing spondylitis in patients undergoing THA is associated with significant risk of medical and implant complications, as well as fall risk, length of stay, and readmission rates. These findings may allow orthopaedic surgeons to be more attentive in identifying those patients at risk and allow for more educated patient counseling and perioperative planning. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Photobleaching Effect on the Sensitivity Calibration at 638 nm of a Phosphorus-Doped Single-Mode Optical Fiber Dosimeter.

Author

Fricano, Fiammetta, Morana, Adriana, Roche, Martin, Facchini, Alberto, Mélin, Gilles, Clément, Florence, Balcon, Nicolas, Mekki, Julien, Marin, Emmanuel, Ouerdane, Youcef, Boukenter, Aziz, Robin, Thierry, and Girard, Sylvain

Subjects
SINGLE-mode optical fibers, SEMICONDUCTOR lasers, DOPING agents (Chemistry), DOSIMETERS, RADIATION, FIBERS
Abstract

We investigated the influence of the photobleaching (PB) effect on the dosimetry performances of a phosphosilicate single-mode optical fiber (core diameter of 6.6 µm) operated at 638 nm, within the framework of the LUMINA project. Different irradiation tests were performed under ~40 keV mean energy fluence X-rays at a 530 µ Gy(SiO2)/s dose rate to measure in situ the radiation-induced attenuation (RIA) growth and decay kinetics while injecting a 638 nm laser diode source with powers varying from 500 nW to 1 mW. For injected continuous power values under 1 µW, we did not measure any relevant influence of the photobleaching effect on the fiber radiation sensitivity coefficient of ~140 dB km−1 Gy−1 up to ~30 Gy. Above 1 µW, the fiber radiation sensitivity is significantly reduced due to the PB associated with the signal and can decrease to ~80 dB km−1 Gy−1 at 1 mW, strongly affecting the capability of this fiber to serve as a dosimeter-sensitive element. Higher power values up to 50 µW can still be used by properly choosing a pulsed regime with periodic injection cycles to reduce the PB efficiency and maintain the dosimetry properties. Basing on the acquired data, a simple model of the photobleaching effect on a coil of the investigated fiber is proposed in order to estimate its sensitivity coefficient evolution as a function of the cumulated dose and its fiber length when injecting a certain laser power. Additional studies need to investigate the influence of the temperature and the dose rate on the PB effects since these parameters were fixed during all the reported acquisitions. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Solar Particle Event Detection With the LUMINA Optical Fiber Dosimeter Aboard the International Space Station

Author

Roche, Martin, Balcon, Nicolas, Clement, Florence, Cheiney, Pierrick, Morana, Adriana, Di Francesca, Diego, Jean-Christophe, Malapert, Kerboub, Nourdine, Oro Marot, Lourdes, Ricci, Daniel, Mekki, Julien, Canton, Remi, Marin, Emmanuel, Melin, Gilles, Robin, Thierry, de la Fuente, Gustavo, and Girard, Sylvain

Abstract

LUMINA, a fiber-based dosimeter, exploiting the radiation induced attenuation (RIA) phenomenon, has been operational inside the International Space Station (ISS) since August 2021. We discuss in this article its capability to detect the possible signatures of recent solar particle events (SPEs) through the related increase of the dose rate (DR) radiation level within the ISS. Our analysis over 699 days of operation shows that the two LUMINA channels, operating either in the visible or infrared (IR) domains, are able to detect the slight DR increase related to the solar flares (SFs), in particular, in the poles regions. The South Atlantic Anomaly (SAA) remains well detected by both LUMINA channels, but no significant increase of the DRs is noticable during the solar events in this region. These results were obtained at DRs close to the lower detection limit of our instrumentation, demonstrating the potential of fiber dosimeters, especially if less shielded, to detect the SFs and monitor the radiation environment.

Published
2024
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