BACKGROUND: Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) have recently been suggested as diagnostic criteria for periprosthetic joint infection (PJI) diagnosis. Thresholds for these markers should be reexamined since they have been determined arbitrarily. QUESTIONS/PURPOSES: Based on recently defined criteria for PJI, we determined (1) whether there is a ...

Objective: To evaluate the clinical efficacy of levosimendan versus dobutamine in critically ill patients requiring inotropic support. Methods: Clinical trials were searched in PubMed, EMBASE, and the Cochrane Central Registry of Clinical Trials, as well as Web of Science. Studies were included if they compared levosimendan with dobutamine in critically ...

Critically ill patients have considerable oxidative stress. Glutamine and antioxidant supplementation may offer therapeutic benefit, although current data are conflicting. In this blinded 2-by-2 factorial trial, we randomly assigned 1223 critically ill adults in 40 intensive care units (ICUs) in Canada, the United States, and Europe who had multiorgan failure ...

INTRODUCTION: Sedation and pain management for mechanically ventilated critically ill surgical patients pose many challenges for the intensivist. Even though daily interruption of sedatives and opioids is appropriate in medical intensive care unit (ICU) patients, it may not be feasible in the surgical patients with pain from surgical incision or ...

The purpose of this study was to investigate the long-term effects of laparoscopic splenectomy (LS) for patients with chronic immune thrombocytopenia (ITP), and to identify predictive factors for promising hematological outcomes. We retrospectively analyzed the clinical records and follow-up data in patients who underwent LS for chronic ITP from November ...

BACKGROUND: Severe burns are associated with dramatic outcomes which are potentially detrimental. Nowadays the standard treatment for deep partial thickness and full-thickness burn is early excision and grafting, which is not always feasible this leads to chronicity and microbial colonization of burn wounds. Interesting properties of hydrogen peroxide 2% soaked ...

The differences in therapeutic effectiveness between sustained low-efficiency dialysis (SLED) and continuous blood purification (CBP) were investigated. In order to assess the different treatment methods, 56 critically ill patients were divided into two groups, the CBP group and the SLED group. A comparison was made between all the biochemical indicators, ...

Cavum septum pellucidum (CSP) and cavum Vergae (CV) are unusual variants and usually asymptomatic, but their expansion or inside lesions can produce symptoms by mass effect. A 46-year-old female Taiwanese worker presented with chronic daily headaches for eight years. Magnetic resonance imaging revealed coexistent CSP and CV. She declined surgical ...

The clinically appropriate duration of thromboprophylaxis in hospitalized patients with acute medical illnesses is unknown. In this multicenter, randomized, double-blind trial, we evaluated the efficacy and safety of oral rivaroxaban administered for an extended period, as compared with subcutaneous enoxaparin administered for a standard period, followed by placebo. We randomly ...

Only limited and conflicting data on the impact of preoperative chronic kidney disease (CKD) on outcomes after transcatheter aortic valve implantation (TAVI) are available. We retrospectively analyzed pooled data from the prospective TAVI databases of 4 centers (942 patients). Valve Academic Research Consortium end point definitions were used. The outcomes ...

BACKGROUND: Bacteraemia is an important cause of morbidity and mortality in critically ill children. Our objective was to assess whether daily bathing in chlorhexidine gluconate (CHG) compared with standard bathing practices would reduce bacteraemia in critically ill children. METHODS: In an unmasked, cluster-randomised, two-period crossover trial, ten paediatric intensive-care units ...

Context:Both critical illness and fasting induce low circulating thyroid hormone levels in the absence of a rise in TSH, a constellation-labeled nonthyroidal illness syndrome (NTI). The contribution of restricted nutrition during critical illness in the pathophysiology of NTI remains unclear.Objective:The objective of the study was to investigate the impact of ...

Abstract Background: Current discrepancies in the practice of artificial hydration therapy for terminally ill cancer patients have the potential to cause serious clinical problems. Purpose: The study's purpose was to explore the influence of hydration volume on the sings during the last three weeks of life in terminally ill cancer ...

AIM: To investigate plasma levels of the neutrophil-borne Heparin Binding Protein (HBP) in patients with induced hypothermia after cardiac arrest (CA), and to study any association to severity of organ failure, incidence of infection and neurological outcome. METHODS: This study included 84 patients with CA of mixed origin who were ...

BACKGROUND: During critical illness, the demand for glutamine may exceed that which can be mobilized from muscle stores. Infections increase mortality, morbidity, length-of-stay, antibiotic usage and the cost of care. This is a major health care issue. METHODS: RCTs were identified from the electronic databases: the Cochrane Library, MEDLINE, PubMed ...

PURPOSE: Delirium is a common complication in postoperative critically ill patients. Although abnormal melatonin metabolism is thought to be one of the mechanisms of delirium, there have been few studies in which the association between alteration of perioperative plasma melatonin concentration and postoperative delirium was assessed. MATERIALS: We conducted a ...

Venous thromboembolism (VTE), although a very common problem in everyday clinical practice, remains asymptomatic in most cases. Clinical diagnosis helps identify those who are going to have thromboembolic episode. A combination of clinical scoring systems like Wells' score and D-dimer assay provide a useful diagnostic tool. Trauma (surgical or accidental) ...

Object The traditional methods for managing symptomatic chronic subdural hematoma (SDH) include evacuation via a bur hole or craniotomy, both with or without drain placement. Because chronic SDH frequently occurs in elderly patients with multiple comorbidities, the bedside approach afforded by the subdural evacuating port system (SEPS) is an attractive ...

PURPOSE: To compare automated administration of propofol and remifentanil guided by the Bispectral index (BIS) versus manual administration of short-acting drugs in critical care patients requiring deep sedation. The primary outcome was the percentage of BIS values between 40 and 60 (BIS(40-60)). METHODS: This randomized controlled phase II trial in ...

Protocolized sedation and daily sedation interruption are 2 strategies to minimize sedation and reduce the duration of mechanical ventilation and intensive care unit (ICU) stay. We hypothesized that combining these strategies would augment the benefits. To compare protocolized sedation with protocolized sedation plus daily sedation interruption in critically ill patients. ...

BACKGROUND: With a critical illness, intestinal complications are associated with high morbidity and mortality. METHODS: Operative findings and outcomes of 77 intensive care unit (ICU) patients treated with colectomy are described. RESULTS: Three conditions led to colectomy: sepsis (S group; n = 31), fulminant Clostridium difficile colitis (Cl group; n = 25), and cardiovascular ...

We performed clinico-pathological evaluations of 11 wild Agassiz's desert tortoises (Gopherus agassizii) from a translocation project in the central Mojave Desert, California, USA. Group 1 consisted of nine tortoises that were selected primarily due to serologic status, indicating exposure to Mycoplasma testudineum (seven) or both M. agassizii and M. testudineum ...

Drug-resistant chronic cluster headache (CH) is an unremitting illness with excruciatingly severe headaches that occur several times daily. Starting in 2000, a total of 19 patients with long-lasting chronic CH, with multiple daily attacks unresponsive to all known prophylactics, received stimulation of the posterior inferior hypothalamic area ipsilateral to the ...

ABSTRACT: BACKGROUND: Chronic lower limb ulcers constitute a major public health problem of great important all over the world and contribute significantly to high morbidity and long-term disabilities. There is paucity of information regarding chronic lower limb ulcers in our setting; therefore it was necessary to conduct this study to ...

Chronic, open, non healing wounds pose a continual challenge in medicine as the treatment is variable and there are no documented consistent responses. Although wound aetiologies vary and there are a number of factors that affect chronic wound pathogenesis, wound ischaemia and bacterial colonisation of wounds are the chief concerns ...

We evaluated the results of cases of chronic otitis media treated with mastoid obliteration surgery using bioactive glass S53P4. Twenty-five patients with chronic otitis media and 1 patient with cerebrospinal fluid leakage without chronic infection were treated with bioactive glass S53P4. Twenty patients had had previous surgery because of chronic ...

BACKGROUND: Silver-impregnated central venous catheters (CVCs) have been proposed as a means for preventing CVC colonization and related bloodstream infections (CRBSIs). AIM: To evaluate the efficacy of CVCs impregnated with silver nanoparticles in a large group of critically ill patients. METHODS: A prospective, randomized clinical trial was conducted in five ...

OBJECTIVES: The objectives of this study were to evaluate outcomes of pulmonary valve replacement (PVR) in patients with chronic pulmonary regurgitation (PR) and to better define the optimal timing of PVR. BACKGROUND: Although PVR is effective in reducing right ventricular (RV) volume overload in patients with chronic PR, the optimal ...

We encountered a 72-year-old woman with myasthenia gravis and thymoma who received glucocorticoid therapy for respiratory failure before undergoing thymectomy. After the antiacetylcholine receptor antibody titer was normalized, and the thymoma shrunk with prednisolone, the patient was free from symptoms. On pathological examination, the majority of the thymoma (type B2) ...

We report an open-label study comparing tadalafil and acetazolamide (n = 24) versus acetazolamide (n = 27) for prevention of high-altitude illness (HAI) at Mt. Kilimanjaro. Tadalafil group had lower rates of severe HAI compared with controls (4% vs 26%, p = 0.03), mostly because of decreased high-altitude pulmonary edema rates (4% vs 22%, p = 0.06).

BACKGROUND: Controlled-rate freezing and storage in nitrogen is the standard technique for cryopreservation of peripheral hematopoietic progenitor cells (PHPCs) but presents high cost and dimethyl sulfoxide (DMSO) toxicity. Cryopreservation at -80°C, by uncontrolled rate freezing with only 3.5% DMSO, preserves the functional capacities of PHPCs, produces successful engraftment, and reduces ...

BACKGROUND: Parenteral lipid emulsions (LEs) can influence leukocyte functions. The authors investigated the effect of 2 LEs on leukocyte death in surgical patients with gastrointestinal cancer. Material and METHODS: Twenty-five patients from a randomized, double-blind clinical trial (ID: NCT01218841) were randomly included to evaluate leukocyte death after 3 days of ...

The World Health Organization declared an influenza H1N1 global pandemic in June 2009, which resulted in a great deal of research. However, no studies have been published on incidence, characteristics and impact in rural emergency departments (EDs). Data were gathered from two rural EDs located in Southwestern Ontario. A retrospective ...

Assessed herein are the results of treating a total of 119 patients presenting with chronic critical ischaemia of the lower extremities accompanied by necrosis of distal portions of the foot. All patients underwent various successful operations of lower-limb revascularization, followed by evaluating the terms of healing of the wounds on ...

Debate continues about the optimal treatment modality of lupus nephritis (LN). We compared the efficacy and safety of intravenous cyclophosphamide (CYC) and mycophenolate mofetil (MMF) for LN treatment in Korea. After searching for systemic lupus erythematosus (SLE) patients diagnosed between 1998 and 2007 with the diagnostic code of ICD10, we ...

Systemic lupus erythematosus (SLE) belongs to a family of related autoimmune rheumatic disorders that are capable of affecting multiple organs, and they are all associated with a variety of autoantibodies. Henoch Schoenlein purpura (HSP) is a sort of systemic vasculitis that is not associated with auto-antibodies and can affect different ...

This study aimed to evaluate the benefits of microalbuminuria in preventing kidney damage in systemic lupus erythemathosus. This was a prospective study of 6 months has focused on 25 patients of both sexes aged over 14 with SLE whose diagnosis was based on the criteria of the American College of ...

The Charles procedure for late-stage lower limb lymphoedema (LLL) is often criticized for its unpredictable and poor results. We have adopted a systematic approach to optimize outcome of patients treated with this excisional surgery. From June 2004 to March 2009 we performed the Charles procedure on 1 lower limb of ...

Purpose: To describe a procedural technique involving a combined antegrade femoral and retrograde tibial approach for treatment of complex popliteal and infrapopliteal occlusions, and to determine the safety and efficacy of this technique. Materials and Methods: From May 2008 to March 2010, seven patients presenting with critical limb ischemia received ...

An active surgical strategy to save lower limbs of patients with critical leg ischemia includes not only infrainguinal bypass surgery but also repeated surgery when needed. A failed infrainguinal bypass often threatens viability of the patient's legs, at which point a redo bypass procedure with a new graft may be ...

Patients suffering from limb-threatening ischemia often have scarce or inadequate autogenous veins for complex lower limb revascularization. One option for such patients is to use conduit consisting of cadaver saphenous vein allograft (CSVA) as a final surgical option before limb amputation. This study reviewed retrospectively the patency of CryoVein CSVA ...

Up to 88% of cavernous malformations (CMs) of the central nervous system can become symptomatic and cause long-term disability. The aim of this study was to document the characteristics of CMs in the catchment area of our institution. We retrospectively analysed newly discovered CMs over a 20-year observation period, as ...

BACKGROUND: Wrong-site surgeries (including wrong-site, wrong-person and wrong-procedure errors) remain the number one problem among adverse events of health care delivery. Patients and/or family members should be involved when possible to help prevent such errors. AIMS: 1) Design an educational animation program about patient safety for patients and/or family members ...

To observe immediate and late results of catheter-directed endovascular thrombolytic treatment of acute ischaemia of the leg. DESIGN, MATERIAL AND METHODS: A total of 212 patients treated with Actilyse® at the University Hospital of North Norway because of acute arterial ischaemia of the leg during the period 01 January 2000-30 ...

Extracorporeal Life Support Organization Registry data confirm that the number of pediatric patients being supported by extracorporeal membrane oxygenation (ECMO) is increasing. To minimize the potential neurologic effects of carotid artery ligation, the common femoral artery (CFA) is frequently being used for arterial cannulation. The cannula has the potential for ...

Endovenous laser therapy (EVLT) for ablation of the great saphenous vein (GSV) is thought to minimize postoperative morbidity compared with high ligation and stripping (HL/S). Only a few randomized trials have reported early results. This prospective randomized trial compared EVLT (980 nm) and HL/S results at 1 and 2 years ...

Duplex ultrasound scanning (DUS) has benefit for intraoperative and subsequent evaluation of surgical bypasses in the lower extremities. The utility of DUS after endovascular revascularizations is not established. This study was performed to evaluate whether DUS findings after infrainguinal endovascular interventions for critical limb ischemia (CLI) were predictive of need ...

Fibular hemimelia is partial or total aplasia of the fibula; it represents the most frequent congenital defect of the long bones. It usually is associated with other anomalies of the tibia, femur, and foot. We reviewed 32 patients with Type III fibular hemimelia treated by successive lower limb lengthening and ...

To report our experience of long-term results of inframalleolar bypass. Retrospective analysis. We analysed 122 inframalleolar bypasses performed between January 1991 and June 2005 in 116 patients. Most patients were treated for critical ischaemia (97%). The indication for the use of podalic arteries was a lack of tibial arteries with ...

A survey was performed of U.K. lower-limb reconstruction services and the protocol for management of free flaps to the lower limb in the first postoperative week. The postoperative period is of vital importance in these patients due to the complex nature of microsurgical tissue transfer. A range of answers were ...