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Bone & Joint Research
Vol. 9, Issue 8 | Pages 501 - 514
1 Aug 2020
Li X Yang Y Sun G Dai W Jie X Du Y Huang R Zhang J

Aims

Rheumatoid arthritis (RA) is a systematic autoimmune disorder, characterized by synovial inflammation, bone and cartilage destruction, and disease involvement in multiple organs. Although numerous drugs are employed in RA treatment, some respond little and suffer from severe side effects. This study aimed to screen the candidate therapeutic targets and promising drugs in a novel method.

Methods

We developed a module-based and cumulatively scoring approach that is a deeper-layer application of weighted gene co-expression network (WGCNA) and connectivity map (CMap) based on the high-throughput datasets.


The Bone & Joint Journal
Vol. 100-B, Issue 1_Supple_A | Pages 68 - 75
1 Jan 2018
Goel R Fleischman AN Tan T Sterbis E Huang R Higuera C Parvizi J Rothman RH

Aims

The aims of this study were to compare the efficacy of two agents, aspirin and warfarin, for the prevention of venous thromboembolism (VTE) after simultaneous bilateral total knee arthroplasty (SBTKA), and to elucidate the risk of VTE conferred by this procedure compared with unilateral TKA (UTKA).

Patients and Methods

A retrospective, multi-institutional study was conducted on 18 951 patients, 3685 who underwent SBTKA and 15 266 who underwent UTKA, using aspirin or warfarin as VTE prophylaxis. Each patient was assigned an individualised baseline VTE risk score based on a system using the Nationwide Inpatient Sample. Symptomatic VTE, including pulmonary embolism (PE) and deep vein thrombosis (DVT), were identified in the first 90 days post-operatively. Statistical analyses were performed with logistic regression accounting for baseline VTE risk.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 295 - 295
1 Sep 2005
Thompson G Florentino-Pineda I Poe-Kochert C Haber L Blakemore L Huang R
Full Access

Introduction and Aims: Evaluate the efficacy of epsilon aminocaproic acid (Amicar) in decreasing peri-operative blood loss in patients with idiopathic scoliosis.

Method: Thirty-six patients participated in this prospective, randomised, double blind, IRB-approved study. The patients who received Amicar were unknown until the completion of the study. All patients were 11–18 years of age, had idiopathic scoliosis, and underwent a posterior spinal fusion and segmental spinal instrumentation using standard hypotensive anesthesia. Factors analysed included age, gender, curve severity, number of vertebrae fused, operating time, hemoglobin and hematocrit pre-operatively and post-operatively, number of autologous units donated, pre-operative and post-operative fibrinogen levels, height, weight, estimated blood volume, estimated intra-operative blood loss, post-operative suction drainage, total peri-operative blood loss, and the autologous transfusion requirements.

Results: Nineteen patients received Amicar and 17 patients were controls. There was no statistical difference between the two groups pre-operatively. Total peri-operative blood loss was statistically less in the Amicar group (p=.036). This was 1,391±212ml in the Amicar group compared to 1,716±513ml in the control group. The decrease was predominantly in the post-operative suction drainage – 605±253ml compared to 939±455ml. The hemoglobin and hematocrits were higher postoperatively in the Amicar group. Interestingly, the fibrinogen levels rose post-operatively in the Amicar group. Total autologous blood transfusions were less in the Amicar group at 1.0±0.8 units compared to 1.7±1.2 units (p=.061). No patient required homologous blood. There were no post-operative complications.

Conclusions: Amicar is a safe, effective, and inexpensive pharmacologic agent that decreases peri-operative blood loss, particularly post-operative suction drainage, in patients with idiopathic scoliosis. This is probably due to increased fibrinogen levels. It results in a significantly decreased need for autologous blood donations pre-operatively and the associated costs.