Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 6 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Diss. Linköping : Univ., 2006.

Thesis (doctoral)--Lund University, 1994. / Added t.p. with thesis statement inserted.

Thesis (doctoral)--Lund University, 1994. / Added t.p. with thesis statement inserted.

Introduction Alternative medicine has been employed in the treatment of several diseases. Listening to music after minor surgery has been beneficial regarding pain control. Aim The aim of this study was to determine the effect of music on intravenous patient-controlled (PCA) morphine consumption after hip or knee replacement. Methods This was an open label, randomized controlled trial. Forty (twenty per group) consecutive patients scheduled for arthroplasty were included. A standardized anaesthetic technique was used, consisting of propofol, sufentanil, rocuronium, and isoflurane. Postoperatively patients were allocated to one of two groups: Group M listened to music during the first 24 postoperative hours, while Group C did not listen to music. The PCA dose consisted of morphine 1.5 mg and droperidol 83.3 ìg with a lockout time on seven minutes. Rescue doses of morphine 15 ìg/kg intravenously every one-minute until the patient was pain free was administered by a nurse according to a visual descriptive pain score. Both groups received paracetamol 1 g intravenously six hourly. After 24 hours the total (PCA plus rescue) morphine dose was recorded. Morphine consumption in groups was analysed using the one-sided Student two-sample t test. The significance level was 0.05 and the power 0.95. Results Neither the PCA usage (p = 0.4138) nor the rescue doses of morphine (p = 0.9163) differed significantly between the groups. Conclusion Although a statistical difference could not be shown in this study, music during the postoperative period does offer a pleasant distraction from this overall undesirable experience. AFRIKAANS : Inleiding Alternatiewe medisyne word dikwels gebruik vir die hantering van verskeie siektetoestande. Daar is al aangetoon dat deur na musiek te luister voordelig is na geringer chirurgie ten opsigte van pynbeheer. Doel Die studie het ten doel gehad om die effek van musiek na heup- of knievervanging op intraveneuse pasiënt- beheerde morfienverbruik (PBA) te bepaal. Metodes Hierdie was ʼn enkel-blinde gerandomiseerde gekontroleerde studie. Veertig (twintig per groep) agtereenvolgende pasiënte geskeduleer vir gewrigsvervanging is by die studie ingesluit. ʼn Standaard narkosetegniek is gebruik, bestaande uit propofol, sufentaniel, rokuronium en isofluraan. Die pasiënte is postoperatief aan een van twee groepe toegedeel: Groep M het gedurende die eerste postoperatiewe 24 uur na musiek geluister terwyl Groep K nie na musiek geluister het nie. Die PBA-dosis het bestaan uit morfien 1.5 mg en droperidol 83.3 μg met ‘n uitsluitingstyd van sewe minute. Addisionele dosisse morfien is toegelaat. Dit is intraveneus deur die verpleegkundige volgens ʼn verbaal beskrewe pynskaal toegedien en het bestaan uit 15 μg/kg IV elke een minuut totdat die pasiënt volgens haar oordeel pynvry was. Beide groepe het ook sesuurliks parasetamol 1 g intraveneus ontvang. Vier en twintig uur na die operasie is die totale morfienverbruik (PBA plus bykomende dosisse) aangeteken. Die morfienverbruik in groepe is geanaliseer met behulp van die eenkantige tweesteekproef-t-toets. Die beduidenheidspeil was 0.05 en die onderskeidingsvermoë 0.90. Resultate Daar was tussen groepe geen beduidende verskil ten opsigte van die PBA (p = 0.4138) en die bykomende dosisse (p = 0.9613) morfien nie. Gevolgtrekking Alhoewel daar geen statisties beduidende verskil tussen groepe aangetoon is nie, bied musiek gedurende die postoperatiewe fase ʼn aangename afleiding van die andersins onaangename ondervinding. Copyright / Dissertation (MMed)--University of Pretoria, 2010. / Anaesthesiology / unrestricted

Presented master thesis focuses on comparison of total replacement with fixed polyethylene and replacement with dual mobility of trapeziometacarpal joint. Computational models consist of bones trapezium, trapezoid, first and second metacarpal and components of total replacements stem, neck, insert and cup. Replacements are compared on basis that how big force is transmitted from replacement to trapezium, contact pressures between neck and insert, equivalent elastic strains of bone tissue and lastly what is the influence of friction coefficient on results. Task was solved with finite element method in software ANSYS Workbench 19.2.

To become a successful company today all costs, must be kept to a minimum. To make sure they are companies need to try new methods and policies to get closer to an optimum production. One of the things that need attention is the inventory of spare parts and the replacement of the same. The companies want their machines to have as many active hours as possible and therefore they need to replace components in them from time to time. This study will compare the current policy with a new one to see if it is economically justifiable to minimize the inventory of spare parts. This will be done by replacing two identical components in the same machine before they fail and production stops. We call it the proactive block replacement policy. To test this new policy a simulation based on historical data was made where the costs associated with the different replacements such as cost of component, cost o lost production and cost of the two types of replacements. All these costs were considered to see is the company could save money through this change. The result showed that the new policy was not suitable for this specific component because the cost of the component and the variation of lifetime on it was too high. Because of the big variation of lifetime, the time of the replacement had to be set after fewer hours of production which means more components will be used and the cost per active hour will be higher. This study is limited because only one specific component at a specific machine was studied and it is not possible to make any assumptions for other components from this study. This had to be done to get the most precise information from the company to get the best result. The conclusion of this study is that the company should keep their current replacement theory and not change into the new one. Though there might be possible ways of lowering the costs by only having one component in inventory instead of two. / För att bli ett framgångsrikt företag i dagens samhälle måste alla kostnader hållas till ett minimum. För att försäkra sig om detta måste företagen försöka hitta nya metoder och strategier för att komma närmare en optimal produktion. En av de saker som behöver undersökas är lagerhållningen av reservdelar och byten av de samma. Företagen vill att deras maskiner ska ha så många aktiva timmar som möjligt och därför behöver de ersätta komponenter i dem ibland. Denna undersökning kommer att jämföra den nuvarande strategin med en ny för att se om det är ekonomiskt fördelaktigt att minimera lagret av reservdelar. Detta görs genom att byta två identiska komponenter i samma maskin innan de hinner gå sönder och produktionen stannar. Vi kallar det för den proaktiva blockersättningspolicyn. För att testa den nya strategin gjordes en simulering baserad på historiska data där kostnaderna förknippade med de olika bytena, som till exempel komponentkostnad, kostnader och förlorad produktion och kostnad för de två typerna av byten. Alla dessa kostnader användes för att se om företaget kunde spara pengar genom att byta strategi. Resultatet visade att den nya strategin inte var lämplig för den specifika komponenten eftersom kostnaden för komponenten och variationen i livstiden, var för hög. På grund av den stora variationen i livslängden måste tiden för bytet planeras in efter färre timmars produktion, vilket betyder att fler komponenter kommer behöva köpas in och kostnaden per aktiv timme blir högre. Denna studie är avgränsad på så vis att endast en specifik komponent, på en specifik maskin, har studerats och det är inte möjligt att göra några generella antaganden för andra komponenter utifrån denna studie. För att få rättvisa och exakta resultat valdes att endast en komponent skulle undersökas för bästa resultat. Slutsatsen av denna studie är att företaget bör behålla sin nuvarande strategi för byten av komponenter och inte förändra till den nya. Trots detta kan det finnas möjliga sätt att sänka kostnaderna genom att bara ha en komponent i lager istället för två.

BACKGROUND: Tranexamic acid (TXA) has become highly utilized in total joint arthroplasties for its anti-fibrinolytic effect. Recently, intra-articular application of TXA has become popular for its avoidance of systemic distribution within the body. With a more direct application to the surgical site, there is interest to see if topical application will provide hemostasis without increasing rates of venous or arterial thrombotic events and infections. In particular, there is lack of published data describing the safety of TXA in patients who have a significant disposition towards thromboembolic events. METHODS: This study was a retrospective chart-review (RCR) to assess the safety and efficacy of intra-articular TXA (IA-TXA) in total knee and hip arthroplasty patients. IA-TXA 2g/50mL NS was administered to patients who were contraindicated for IV-TXA usage based on our hospital’s guidelines (history of VTE events, mitral or aortic valve replacement with additional risk factors for stroke, active cancer, genetic or acquired thrombophilia, significant cardiac disease, serum creatinine > 2.8 mg/dL). Primary efficacy outcomes were total blood loss on post-operative day 1 (POD1), overall perioperative blood loss, and changes in hemoglobin/hematocrit values over the hospital stay. Primary safety outcomes were the incidence of arterial or venous thrombosis and wound infections. The study compared patients who received IA-TXA (study group) to patients who did not receive TXA (control group). The study included TKA patients=156 (Control=72 Study=83), anterior THA patients=57 (Control=20 Study=37), and posterior THA patients=59 (Control=27 Study=32). RESULTS: TKA patients administered IA-TXA showed a significant decrease in POD1 blood loss compared to the control group [305.84 mL, p = 0.004]. Additionally, the control patients showed significantly lower levels of overall hematocrit than those who had received IA-TXA [0.9 units, p = 0.041]. However, IA-TXA did not cause a reduction in blood loss in either the anterior or posterior THA patients. No statistically significant differences existed between treatment and control groups for transfusion rates or post-operative complications (VTE events and infections). CONCLUSION: IA-TXA 2g/50mL is effective in reducing blood loss in TKA patients; however, further research is needed regarding IA-TXA use in THA patients. The lack of efficacy in THA may have been related to the dosage used, the volume instilled, the timing of administration, or technique of administration.