: Bangladesh is one of the most populous countries in the world at 160 million with 1/3 existing below the poverty line. With an annual birth rate of approximately 3.2 million, an estimated incidence of 1:900 live births, the country has approximately 5000 new cases of idiopathic congenital talipes equinovarus ...

BACKGROUND: Prolonged intensive care unit (ICU) stay is a surrogate for advanced morbidity or perioperative complications, and resource utilization may become an issue. It is our policy to continue full life support in the ICU, even for patients with a seemingly grim outlook. We examined the effect of duration of ...

OBJECTIVE: Benign biliary stricture of anastomotic stoma is frequent after biliary reconstruction. To prevent such a complication, a new paclitaxel-coated poly-L-lactide acid (PLLA) biodegradable biopolymer stent was designed. This original device was intended both to exert adequate mechanical support properties and to allow controlled drug delivery from the coating, with ...

OBJECTIVES: The purpose of this study was to evaluate the prevalence and significance of ventricular arrhythmias (VA) and the role of ICDs in patients supported by continuous-flow left-ventricular assist device (CF-LVADs). BACKGROUND: VAs are common in patients supported by CF-LVADs but prospective data to support the routine use of ICDs ...

Purpose/Objectives: To evaluate the effectiveness of ondansetron for the prevention of nausea and vomiting from dimethylsulfoxide (DMSO) during autologous stem cell transplantation (ASCT) infusion.Design: Nonrandomized cohort using historical control.Setting: Comprehensive cancer center outpatient infusion department.Sample: 50 patients receiving ASCT in the outpatient setting.Methods: Patients were assessed for nausea and vomiting ...

Noninvasive ventilation (NIV) has increasingly been used for the treatment of acute respiratory failure. Despite recommendations supporting its utilization in a limited group of patients, NIV is frequently relied on as a first line treatment. We conducted a retrospective study to assess whether the extended use of NIV is associated ...

Bleeding complications are frequent adverse events in patients supported with axial continuous-flow pumps. Previous retrospective studies demonstrated that bleeding events in patients with the HeartMate II (Thoratec Corp, Pleasanton, CA) were attributed to acquired von Willebrand syndrome. We sought to analyze the von Willebrand factor (VWF) profile in patients receiving ...

IMPORTANCE The effect of different rhinoplasty maneuvers on alar retraction remains to be elucidated. OBJECTIVE To determine the etiology and treatment of alar retraction based on a series of specific rhinoplasty maneuvers. DESIGN Retrospective review of a single surgeon's rhinoplasty digital photo database, examining preoperative alar retraction from January 1, ...

INTRODUCTION: Mortality of patients on extracorporeal membrane oxygenation (ECMO) remains high. The objectives of this study were to assess the factors associated with outcome of patients undergoing extracorporeal membrane oxygenation (ECMO) in a large ECMO referral centre and to compare veno-arterial ECMO (VA ECMO) as veno-venous ECMO (VV-ECMO). METHODS: We ...

OBJECTIVE: To report practice and outcomes in infants undergoing elective repair of tetralogy of Fallot. METHODS: A review of a retrospective cohort of elective complete repair of infants age 6 months or younger from 1995 to 2009 was performed. Patients were excluded because of previous interventions, hypercyanotic episodes, intensive care admissions, ...

BACKGROUND: Postoperative pancreatic fistula (POPF) is a major and serious complication after pancreaticoduodenectomy (PD). There have been no prospective randomized trials evaluating POPF rates in Roux-en-Y reconstruction (RYR) with isolated pancreatic drainage versus conventional loop reconstruction (CLR). The authors hypothesized that RYR decreases the incidence and severity of POPF in ...

OBJECTIVE: The objective of this study was to examine the incidence and clinical outcomes of residual lesions in postoperative pediatric cardiac surgery patients receiving extracorporeal membrane oxygenation (ECMO) support. METHODS: A retrospective observational study was undertaken at a pediatric heart institution. Postoperative pediatric cardiac surgery patients receiving ECMO support within ...

OBJECTIVES: To investigate the effectiveness of a comprehensive therapeutic algorithm including extracorporeal life support (ECLS) in high-risk acute pulmonary embolism (aPE) treated with pulmonary embolectomy. MATERIALS AND METHODS: This retrospective study included 25 consecutive patients of aPE treated with pulmonary embolectomy in a single institution between June 2005 and July ...

BACKGROUND: Little information exists to support that patients care about flexion beyond what is needed to perform activities of daily living (ADL) after Total knee arthroplasty (TKA). The purpose of this study was to investigate if the achievement of a higher degree of knee flexion after TKA would result in ...

Effective closure of the postpneumonectomy bronchopleural fistula (PBF) with the use of different techniques still remains a challenge for thoracic surgeons. The aim of this study was to evaluate the efficacy of modified method of PBF closure using pedicled pericardial flap (PPF) supported by fibrin glue (FG). The efficacy of ...

Early planned institution of temporary right ventricular assist device (RVAD) support with the CentriMag (Levitronix LLC, Waltham, MA, USA) in left ventricular assist device (LVAD) recipients was compared with permanent biventricular assist device (BVAD) or total artificial heart (TAH) support. Between 2007 and 2011, 77 patients (age range: 25-70 years) ...

OBJECTIVE: We hypothesized that ablation of recently described stable AF sources, either directly by Focal Impulse and Rotor Modulation (FIRM) or coincidentally when anatomical ablation passes through AF sources, may explain long term freedom of AF. BACKGROUND: It is unclear why conventional anatomical AF ablation can be very effective in ...

BACKGROUND:There is high interest but very little evidence to support labral reconstruction of the hip.Purpose/ HYPOTHESIS:The purpose of this study was to determine the clinical effectiveness of arthroscopic hip labral reconstruction using gracilis autograft in the multistep surgeries for femoroacetabular impingement (FAI). The hypothesis was that patients undergoing arthroscopic hip ...

BACKGROUND: Recent reports suggest worse outcomes in pediatric orthotopic heart transplantation (OHT) for congenital heart disease (CHD) and restrictive cardiomyopathy (RCM). We examined early outcomes in these diverse groups of patients in comparison with patients with dilatated cardiomyopathy (DCM). METHODS: From 2000 to 2011, 209 patients were included: 50 with ...

The Berlin Heart EXCOR is a first-generation paracorporeal, pneumatic ventricular assist device that creates pulsatile flow. It can be used for long-term support of the left and/or right ventricule during end-stage heart failure. The aim of this study was to share our clinical experience in 54 patients. Between April 2007 ...

Type 3 von Willebrand's disease (VWD) is a rare bleeding diathesis with complete or near complete deficiency of von Willebrand factor (VWF) and low factor VIII (FVIII) levels. In contrast, only FVIII is decreased in haemophilia A (HA). Both disorders are complicated by arthropathy. The purpose of this study was ...

BACKGROUND: There is insufficient information regarding patient-based outcomes after knee arthrodesis following infected total knee arthroplasty (TKA). The purpose of this study was to analyze outcomes in patients who underwent knee arthrodesis following infected TKA using clinical and radiographic measurements including a patient-based outcome measuring system. METHODS: We evaluated 8 ...

This pilot trial aims at gaining support for the optimization of acute burn resuscitation through noninvasive continuous real-time hemodynamic monitoring using arterial pulse contour analysis. A group of 21 burned patients meeting preliminary criteria (age range 18-75 years with second- third- degree burns and TBSA ≥10-75%) was randomized during 2010. ...

OBJECTIVE: Prominent fibrinogen cleavage by recombinant tissue plasminogen activator and formation of fibrinogen degradation products with anticoagulant properties was proposed to amplify the risk of thrombolysis-related bleeding complications, but supportive evidence mainly derived from studies on myocardial infarction. METHODS: This study included 547 consecutive stroke patients treated with recombinant tissue ...

BACKGROUND: -Bleeding is an important cause of morbidity and mortality in patients with continuous-flow left ventricular assist devices (CF-LVADs). Reduced pulsatility has been implicated as a contributing cause. The aim of this study was to assess the effects of different degrees of pulsatility on the incidence of non-surgical bleeding. METHODS ...

OBJECTIVES/HYPOTHESIS: The majority of laryngectomy patients fail to use a hands-free valve on a daily basis, mainly due to fixation problems of the adhesive baseplate housing. To support adhesive housings during hands-free speech a new external neck brace (ENB 2.0) was developed. The effect of the brace was assessed in ...

Stroke is the most devastating complication of atrial fibrillation (AF), and the latter increases the risk of stroke by almost fivefold. AF elimination by catheter ablation should lower the risk of thromboembolic complications. Several studies support this hypothesis, demonstrating rates of stroke in AF patients similar to non-AF populations after ...

Object Although laminectomy is an effective surgical technique for the treatment of multilevel cervical stenotic lesions, postoperative kyphosis and neurological deterioration have been frequently reported after laminectomy. Hence, laminectomy without fusion is seldom performed nowadays. However, the clinical impression from the long-term follow-up of patients who had undergone laminectomy does ...

BACKGROUND: Inducibility of sustained tachycardia is preferred prior to cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT). METHOD: The Pediatric Electrophysiology Database of a single institution was retrospectively reviewed for patients with clinical sustained (≥30 seconds of symptoms) AVNRT documented by noninvasive means who underwent cryoablation for AVNRT to determine if ...

BACKGROUND: Major congenital heart disease (CHD) is seen in 10% to 15% of patients with congenital diaphragmatic hernia (CDH). Some neonates with CDH and major CHD are treated by surgery and some with extracorporeal membrane oxygenation (ECMO). Because of presumed poor survival, there is significant heterogeneity in management approaches for ...

BACKGROUND: Endocardial ablation approaches targeting the retroatrial cardiac ganglia to treat atrial fibrillation (AF) have been proposed. However, the potential value using this approach is unknown. Disruption of the autonomic inputs with orthotropic heart transplant (OHT) provides a unique opportunity to study the effects of autonomic innervation on AF genesis ...

The purpose of the study was to compare the recovery of knee mobility after two-stage revision of an infected total knee arthroplasty using a static or mobile spacer. At 12 months follow-up, none of the patients had a recurrent infection of their new prosthesis. Knee flexion was lower in the ...

AIM: To evaluate ex vivo the effectiveness of single-file instrumentation techniques compared with serial Ni-Ti rotary instrumentation with several irrigation regimens in reducing E. faecalis within root canals. METHODOLOGY: A total of 81 extracted human mandibular premolar teeth with a single root canal were infected with E. faecalis before and after canal ...

OBJECTIVE: To determine patient-derived weights or prioritisation for core outcome domains in chronic gout clinical studies. METHODS: Three patient groups participated in a conjoint decision making exercise using 1000Minds™ software that asked participants to make repeated judgements regarding which of two hypothetical patients with gout represented the best response to ...

OBJECTIVES: The aim of this study was to compare externally supported thin wall knitted polyester (P-EXS) and externally unsupported thin wall knitted polyester (P-non-EXS) for above-knee (AK) femoro-popliteal bypass grafting. DESIGN: A prospective multicenter randomised clinical trial. MATERIAL AND METHODS: Between 1999 and 2008, 265 AK femoro-popliteal bypass grafts (6 mm ...

The authors conducted a prospective, randomized, single-blind study to determine the degree of pulpal anesthesia obtained with a primary infiltration of 1 cartridge of articaine in the incisive/mental nerve region of the mandibular second premolar and to determine the anesthetic efficacy of a repeat articaine infiltration 20 minutes after the ...

PURPOSE: To assess the rotation and centration stability of the new design features of a 1-piece aspheric hydrophobic acrylic intraocular lens (IOL). SETTING: National Eye Hospital, Cairo, Egypt. DESIGN: Randomized clinical trial. METHODS: Patients in this study had implantation of a 1-piece Tecnis 1 ZCB00 IOL or a 3-piece Sensar ...

Membranous nephropathy leads to end-stage renal disease in more than 20% of patients. Although immunosuppressive therapy benefits some patients, trial evidence for the subset of patients with declining renal function is not available. We aimed to assess whether immunosuppression preserves renal function in patients with idiopathic membranous nephropathy with declining ...

Our aim was to investigate whether adding ω-3 polyunsaturated fatty acids (PUFAs) to parenteral nutrition (PN) could reduce inflammation and improve immune function in patients following esophageal cancer surgery. In this pilot study, 60 patients with esophageal cancer were divided into 2 groups (30 patients in each group). All patients ...

Limited work is available on the benefits of nutritional support enriched with arginine and n-3 fatty acids in surgical patients with head and neck cancer, particularly if well-nourished. We conducted a pilot study in these patients to examine effects on inflammatory markers and clinical outcome. Patients scheduled for radical resection ...

We report our experience with the Levitronix CentriMag (Levitronix LLC, Waltham, MA) in the setting of venoarterial extracorporeal membrane oxygenation (ECMO) system support as treatment for postcardiotomy cardiogenic shock. Between January 2007 and August 2011, 14 consecutive adult patients received CentriMag ECMO support after cardiac surgery procedures at our institution. ...

Total hip or knee arthroplasty is an elective procedure that is usually accompanied by substantial blood loss, which may lead to acute anemia. As a result, almost half of total joint arthroplasty patients receive allogeneic blood transfusions (ABT). Many studies have shown that post-operative auto-transfusion (PAT) significantly reduces the need ...

The contribution of cardiogenic shock to in-hospital mortality has not decreased significantly despite prompt revascularization, advances in medical therapy, and mechanical circulatory support. For patients in cardiogenic shock, mechanical circulatory support has been provided by a variety of devices. We report the outcome of the Impella device for acute mechanical ...

The purpose of this study was to analyse the outcomes of patients readmitted to ICU following initial recovery after oesophagectomy. Surgery for oesophageal cancer has significant morbidity and poor long-term outcomes. There is limited evidence concerning the long-term outcomes of patients who require readmission to the intensive care unit (ICU) ...

Acute kidney injury (AKI) is a common and life-threatening complication following coronary artery bypass graft (CABG). Neutrophil gelatinase-associated lipocalin (NGAL) and Cystatin C have shown to be good predictive factors for AKI. Recently, there has been a growing interest in the use of hypertonic saline in cardiac operations. The purpose ...

PURPOSE: The use of 'hinged' knee prostheses for primary knee arthroplasty procedures is increasing. This analysis reports the rates of implant survival, modes of failure, revision details and functional outcomes with particular reference to the primary indication for surgery for a cohort of patients treated with primary hinged knee replacement. ...

The aim of this study was to evaluate the effect of dietician-delivered intensive nutritional support (INS) on postoperative outcome in patients with esophageal cancer. Approximately 50-80% of patients with esophageal cancer are malnourished at the time of diagnosis. Malnutrition enhances the risk of postoperative complications, resulting in delay of postoperative ...

BACKGROUND: Significant aortic insufficiency (AI) after left ventricular assist device (LVAD) placement affects device performance and end-organ perfusion. This study examined the development and progression of AI after implantation of continuous-flow LVAD. METHODS: Seventy-nine patients undergoing Heart Mate II (Thoratec Corp, Pleasanton, CA) LVAD implantation for predominantly destination therapy (n ...

Three studies were done on the effects of ipsilateral location (same ovary) versus contralateral location (opposite ovaries) of the future ovulatory follicle and CL in heifers. The numbers of heifers for the ipsilateral and contralateral groups, respectively, were: experiment (Exp) 1 (N = 4 and 4), Exp 2 (N = ...

BACKGROUND: There is conflicting evidence on the utility of elective intra-aortic balloon pump (IABP) use during high-risk percutaneous coronary intervention (PCI). Observational series have indicated a reduction in major in-hospital adverse events although randomized trial evidence does not support this. A recent study has suggested a mortality benefit trend early ...