Cemented and screw-retained implant reconstructions: a systematic review of the survival and complication rates

To assess the 5-year survival rates and incidences of complications of cemented and screw-retained implant reconstructions.

Climate forcing reconstructions for use in PMIP simulations of the Last Millennium (v1

We update the forcings for the PMIP3 experiments for the Last Millennium to include new assessments of historical land use changes and discuss new suggestions for calibrating solar activity proxies to total solar irradiance.

The Impact of Uncertainty in the AIDS Incubation Period on Reconstructions of the HIV Epidemic

Backcalculation is the primary method used to reconstruct past human immunodeficiency virus (HIV) infection rates, to estimate current prevalence of HIV infection, and to project future incidence of acquired immunodeficiency syndrome (AIDS). The method is very sensitive to uncertainty about the incubation period. We estimate incubation distributions from three sets of cohort data and find that the estimates for the cohorts are substantially different. Backcalculations employing the different estimates produce equally good fits to reported AIDS counts but quite different estimates of cumulative infections. These results suggest that the incubation distribution is likely to differ for different populations and that the differences are large enough to have a big impact on the resulting estimates of HIV infection rates. This seriously limits the usefulness of backcalculation for populations (such as intravenous drug users, heterosexuals, and women) that lack precise information on incubation times.

Are there accurate predictors of long-term vital and functional outcomes in cardiac surgical patients requiring prolonged intensive care?

BACKGROUND AND OBJECTIVE: The decision to maintain intensive treatment in cardiac surgical patients with poor initial outcome is mostly based on individual experience. The risk scoring systems used in cardiac surgery have no prognostic value for individuals. This study aims to assess (a) factors possibly related to poor survival and functional outcomes in cardiac surgery patients requiring prolonged (> or = 5 days) intensive care unit (ICU) treatment, (b) conditions in which treatment withdrawal might be justified, and (c) the patient's perception of the benefits and drawbacks of long intensive treatments. METHODS: The computerized data prospectively recorded for every patient in the intensive care unit over a 3-year period were reviewed and analyzed (n=1859). Survival and quality of life (QOL) outcomes were determined in all patients having required > or =5 consecutive days of intensive treatment (n=194/10.4%). Long-term survivors were interviewed at yearly intervals in a standardized manner and quality of life was assessed using the dependency score of Karnofsky. No interventions or treatments were given, withhold, or withdrawn as part of this study. RESULTS: In-hospital, 1-, and 3-year cumulative survival rates reached 91.3%, 85.6%, and 75.1%, respectively. Quality of life assessed 1 year postoperatively by the score of Karnofsky was good in 119/165 patients, fair in 32 and poor in 14. Multivariate logistic regression analysis of 19 potential predictors of poor outcome identified dialysis as the sole factor significantly (p=0.027) - albeit moderately - reducing long-term survival, and sustained neurological deficit as an inconstant predictor of poor functional outcome (p=0.028). One year postoperatively 0.63% of patients still reminded of severe suffering in the intensive station and 20% of discomfort. Only 7.7% of patients would definitely refuse redo surgery. CONCLUSIONS: This study of cardiac surgical patients requiring > or =5 days of intensive treatment did not identify factors unequivocally justifying early treatment limitation in individuals. It found that 1-year mortality and disability rates can be maintained at a low level in this subset of patients, and that severe suffering in the ICU is infrequent.