To compare the new Olympus V-scope (VS) to conventional endoscopic retrograde cholangiopancreaticography (ERCP). Forty-nine patients with previous endoscopic papillotomy who were admitted for interventional ERCP for one of several reasons were included in this single-centre, prospective randomized study. Consecutive patients were randomized to either the VS group or to the ...

OBJECTIVES: Serum γ-glutamyl transferase (GGT) activity has been shown to be related to the development of atherosclerosis and cardiovascular events. The aim of this study was to evaluate the prognostic value of GGT in patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (PCI). PATIENTS AND ...

BACKGROUND: Restenosis after percutaneous transluminal angioplasty (PTA) of the superficial femoral artery (SFA) may occur in 45% of patients at 2 years follow-up. Paclitaxel-coated balloons have been found to reduce neointimal hyperplasia, and thus reduce restenosis. Recently, the Legflow(R) paclitaxel-coated balloon (Cardionovum Sp.z.o.o., Warsaw, Poland) (LPEB) has been introduced. This ...

Tenascin-C, a large oligometric glycoprotein of the extracellular matrix, increases the expression of matrix metalloproteinases that lead to plaque instability and rupture, resulting in acute coronary syndrome (ACS). We hypothesized that a high serum tenascin-C level is associated with plaque rupture in patients with ACS. Fifty-two consecutive ACS patients who ...

In Thailand, antibiotics are rampantly available in village groceries, despite the fact that it is illegal to sell antibiotics without a pharmacy license. This study implemented a multidisciplinary perspectives intervention with community involvement (MPI&CI), which was developed based on information obtained from focus groups that included multidisciplinary stakeholders. Community leaders ...

Introduction:The effect of nicotine withdrawal in smokers admitted to intensive care units (ICUs) is not well understood; therefore, the role of nicotine replacement therapy (NRT) in those patients is controversial.Objective:To demonstrate that NRT in ICU patients decreases need for sedatives/analgesics, number of days on ventilator, and total length of ICU ...

BACKGROUND: Iliocaval venous lesions produce a spectrum of symptoms ranging from mild swelling to venous ulcerations. In this study we examine the management and outcomes of these patients at our center. METHODS: In this study we performed a retrospective analysis of patients with symptomatic iliocaval venous stenoses, occlusions, or venous ...

BACKGROUND: The aim is to evaluate the efficacy of additional radiofrequency ablation (RFCA) for spontaneous dissociated pulmonary vein activity (DPV-spike) after PV isolation (PVI) in patients with paroxysmal atrial fibrillation (AF). METHODS: One hundred fifty-two consecutive patients with paroxysmal AF referred for RFCA were enrolled. When DPV-spike was documented after ...

BACKGROUND: Although various traction devices exist for endoscopic submucosal dissection (ESD), the effects of the material used in the devices on the human body has not been considered. Moreover, there has been no report on a device that facilitates dissection both on the oral and anal side of the lesion. ...

BACKGROUND: We sought to compare two synthetic injectable bulking agents, with known efficacy (PTQ™: a silicone biomaterial and Durasphere(®): pyrolytic carbon-coated beads), in the form of a randomised clinical trial. METHODS: Circumferential injection of either agent was performed under local anesthesia and sedation as a day-case procedure. The primary outcome ...

OBJECTIVE: To compare the malposition rates of endotracheal tubes (ETTs) when the insertional length (IL) is determined by a weight-based nomogram versus when IL is determined by palpation of the ETT tip. DESIGN: Open-label, randomized controlled trial (RCT). SETTING: Level III neonatal intensive care unit (NICU). SUBJECTS: All newborn babies ...

BACKGROUND: The efficacy of routine second-look endoscopy (SLE) to detect or prevent bleeding after gastric endoscopic submucosal dissection (ESD) has not yet been validated. OBJECTIVE: The aim of this study was to determine whether SLE affects clinical outcomes including bleeding and morbidity after gastric ESD. DESIGN: A prospective, randomized, controlled ...

BACKGROUND:The comparative clinical outcome of anatomic reconstruction of the medial patellofemoral ligament (MPFL) between the Y-graft technique and C-graft technique for chronic patellar instability is unknown. HYPOTHESIS:Anatomic reconstruction of the MPFL with a Y-graft technique (a Y-shaped graft: femoral fixation first with separate tensioning of the 2 bundles) would yield ...

BACKGROUND: The currently recommended regimen for focal radiofrequency ablation (RFA) of Barrett's esophagus (BE) comprises 2 applications of energy, cleaning of the device and ablation zone, and 2 additional applications of energy. A simplified regimen may be of clinical utility if it is faster, easier, and equally safe and effective. ...

The use of glycoprotein IIb/IIIa receptor inhibitors (GPIs) in high-risk patients with acute coronary syndromes has been associated with reductions in ischemic events but increases in bleeding complications. The role of GPIs in patients who undergo primary percutaneous coronary intervention (PCI) by the transradial approach (TRA) is not well studied. ...

Erythropoiesis-stimulating agents (ESAs) have been used in orthopedic patients to reduce allogeneic blood transfusion (ABT). The purpose of this systematic review of randomized clinical trials is to evaluate the efficacy of preoperative administration of ESAs on hemoglobin level at discharge and frequency of ABT in patients undergoing hip or knee ...

BACKGROUND: Low-intensity warfarin is among the most frequently prescribed thromboprophylaxis regimens after major orthopedic surgery in the United States. This has been a source of controversy as the American College of Chest Physicians historically recommended standard intensity warfarin (INR 2-3) over low-intensity warfarin in this setting. The updated guidelines include ...

OBJECTIVE: To examinethe impact of a weight lossinterventionthat focused on daily self-weighing for self-monitoringas compared to a delayed control group among 91 overweight adults. DESIGN AND METHODS: The6-month intervention included a cellular-connected "smart"scale for daily weighing,web-based weight loss graph, and weekly emails with tailored feedbackand lessons.An objective measure of self-weighing ...

OBJECTIVE: To evaluate the efficacy of tezosentan in reducing the incidence of right ventricular (RV) failure and associated mortality in patients with pre-existing pulmonary hypertension. The primary endpoint was the proportion of patients with RV failure during weaning from cardiopulmonary bypass (CPB), assessed 30 min after the end of CPB. ...

OBJECTIVE:: To determine whether bacterial colonization of drains can be reduced by local antiseptic interventions. BACKGROUND:: Drains are a potential source of bacterial entry into surgical wounds and may contribute to surgical site infection after breast surgery. METHODS:: After institutional review board approval, patients undergoing total mastectomy and/or axillary lymph ...

BACKGROUND: Haemarthrosis and pain adversely affects the functional outcome of ACL reconstruction, especially in case of DB ACL reconstruction due to more extensive procedure. The purpose of the study was to evaluate the effect of haemarthrosis on the rehabilitation of DB ACL reconstruction versus SB ACL reconstruction. METHODS: 100 patients ...

Hypothermia, a body temperature of <36°C, has been shown to increase cardiac mortality, the incidence of postoperative infections, and the length of hospitalization following general surgery. However, studies assessing the incidence of hypothermia during primary total hip and total knee arthroplasty (THA and TKA) have not previously been demonstrated. In ...

PURPOSE:: To evaluate the anatomical closure rate and visual outcome in patients undergoing pars plana vitrectomy with internal limiting membrane peeling without dye enhancement and with indocyanine green or triamcinolone acetonide assistance. METHODS:: This is a retrospective, comparative interventional case series. The electronic charts of 435 eyes of 415 patients ...

BACKGROUND:Vancomycin is administered as antimicrobial prophylaxis to patients undergoing cardiac surgery, an intervention that usually requires cardiopulmonary bypass (CPB). Previous studies reported that CPB modifies vancomycin pharmacokinetic parameters.OBJECTIVE:To investigate intraoperative vancomycin pharmacokinetic changes in a large population of patients undergoing cardiac surgery with CPB (on-pump) and without CPB (off-pump).METHODS:In this ...

BACKGROUND: /st> A limitation of Bier's block or i.v. regional anaesthesia (IVRA) is tourniquet pain. We hypothesized that tourniquet placement on the forearm vs upper arm during IVRA for distal upper extremity surgery may result in less tourniquet pain, lower the need for analgesic interventions, and decrease post-anaesthesia care unit (PACU) ...

STUDY DESIGN:: Retrospective radiographic analysis. OBJECTIVE:: To determine which lumbar interbody technique is most effective for restoring lordosis, increasing disc height, and reducing spondylolisthesis. SUMMARY OF BACKGROUND DATA:: Lumbar interbody fusions are performed in hopes of increasing fusion potential, correcting deformity, and indirectly decompressing nerve roots. No published study has ...

INTRODUCTION: The ideal measures to prevent postoperative delirium remain unestablished. We conducted this systematic review and meta-analysis to clarify the significance of potential interventions. METHODS: The PRISMA statement guidelines were followed. Two researchers searched MEDLINE, EMBASE, CINAHL and Cochrane Library for articles published in English before August 2012. Additional sources ...

The aim of this work was to determine whether the use of a newly developed methodology (Alg1) for AV and VV optimization improves cardiac resynchronization therapy (CRT) clinical and echocardiographic (ECHO) outcomes. In this single-center pilot clinical trial, 80 consecutive patients (79 % male; 70.1 ± 11.2 years) receiving CRT were randomly assigned to ...

OBJECTIVES: Few studies describe the trajectories of cognitive function for hip-fracture patients following hospital discharge and the treatment effects of interdisciplinary intervention on cognitive outcomes. The purpose of this study was to explore the 2-year postoperative trajectory for cognitive function of older hip-fracture patients and cognitive effects of an interdisciplinary ...

OBJECTIVE: To study the anatomic and visual outcomes of descemetopexy in Descemet's membrane detachment (DMD) after cataract surgery. DESIGN: Retrospective case series. PARTICIPANTS: Clinical notes of 60 patients who underwent DMD after cataract surgery between 2007 and 2011. METHODS: Descemetopexy was performed with air or 14% isoexpansile perfluoropropane (C3F8). MAIN ...

BACKGROUND: One of the best ways to control the transmission of malaria is by breaking the vector-human link, either by reducing the effective population size of mosquitoes or avoiding infective bites. Reducing house entry rates in endophagic vectors by obstructing openings is one simple way of achieving this. Mosquito netting ...

STUDY OBJECTIVE: To assess the effects on the endometrial surface of embryo transfer catheters using hysteroscopy with ultrasound guidance. DESIGN: Prospective descriptive study (Canadian Task Force classification III). SETTING: University-based clinical practice. PATIENTS: Twenty patients with a documented difficult trial transfer (TT). INTERVENTION: All patients underwent an intraoperative TT using ...

OBJECTIVES: To assess the impact of manual versus automated contrast injection on renal complications in patients undergoing PCI (percutaneous coronary intervention). BACKGROUND: Contrast volume is a major modifiable risk factor for contrast-induced nephropathy (CIN). Automated contrast injector systems (ACIS) are believed to be associated with a reduction in the total ...

OBJECTIVES:: In 2001, a randomized trial showed decreased mortality with early, goal-directed therapy in septic shock, a strategy later recommended by the Surviving Sepsis Campaign. Placement of a central venous catheter is necessary to administer goal-directed therapy. We sought to evaluate nationwide trends in: 1) central venous catheter utilization and ...

The aim of the present study was to determine the rate of myringosclerosis after radiofrequency (RF) myringotomy and ventilation tube (VT) insertion and compare it with that after the incisional myringotomy and VT insertion. Thirty children (60 ears), 2-16 years old (mean age 7.06 ± 2.77 years) who were planned to undergo surgical intervention ...

OBJECTIVES: This study sought to compare the efficacy and safety results after coronary implantation of a combined sirolimus-eluting CD34 antibody coated Combo stent (OrbusNeich Medical, Ft. Lauderdale, Florida) with the paclitaxel-eluting Taxus Liberté stent (PES) (Boston Scientific, Natick, Massachusetts). This report summarizes the first-in-man randomized, controlled multicenter REMEDEE trial (Randomized ...

Closed loop target-control infusion systems using a Bispectral (BIS) signal as an input (TCI Loop) can automatically maintain intravenous anesthesia in a BIS range of 40-60 %. Our purpose was to assess to what extent such a system could decrease anesthesia workload in comparison to the use of a stand alone ...

OBJECTIVES: This study sought to compare clinical outcomes and angiographic findings using the Resolute zotarolimus-eluting stent (R-ZES; Medtronic, Santa Rosa, California) versus the Taxus Liberte paclitaxel-eluting stent (PES; Boston Scientific, Natick, Massachusetts) in an all-comer Chinese population. BACKGROUND: Concerns regarding restenosis risk led to new-generation drug-eluting stents (DES) designed for ...

I. BACKGROUND:: Autologous platelet-rich plasma (PRP) contains multiple growth factors. The aim of this randomized trial was to study the effect of an injection of PRP during random extension of an axial pattern flap procedure. II. METHODS:: Sixteen male New Zealand white rabbits were randomly assigned to two groups of ...

BACKGROUND: Instability of the second metatarsophalageal (MTP) joint is a common disorder of the forefoot and can be addressed operatively. The objective of this study was to compare a temporary K-wire fixation (tKW) to a postoperative strapping dressing (SD) after realignment surgery of second MTP instability in combination with correction ...

The European Group generally agrees with the American guidelines on the issue of the indications for additional surgery in patients with recurrence of medullary thyroid cancer. The discussions have been focused mainly on the postoperative follow-up, where some European experts feel that a postoperative calcitonin-stimulating test is of some importance ...

The aim of this study was to determine whether patients from the Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System in the Treatment of Patients With de Novo Native Coronary Artery Lesions (SPIRIT) IV trial who underwent percutaneous coronary intervention, who had target lesions with jailed side ...

CONTEXT: Current research has identified numerous safety risks related to patient handovers including postoperative handovers. During the postoperative handover and the recovery period, the patient is at risk of potential complications of surgery or anaesthesia. Furthermore, patients are subject to a downscale in monitoring and observation, which makes them vulnerable ...

INTRODUCTION: Primary angioplasty has improved survival as compared to thormbolysis. However, bleeding complications still represent the Achille's heel, mainly related to access site. Although the radial approach is getting larger consensus for elective percutaneous procedures, its safety and advantages in the setting of ST-segment elevation (STEMI) is controversial. Therefore, the ...

PURPOSE: To evaluate the stability of axis rotation, astigmatism correction, and improvement in uncorrected distance visual acuity (UDVA) up to 6 months postoperatively using an astigmatism-correcting intraocular lens (IOL) in a 25-gauge transconjunctival sutureless vitrectomy combined with cataract surgery. SETTING: Department of Ophthalmology, Kagawa University Faculty of Medicine, Kagawa, Japan. ...

OBJECTIVES: We developed and tested a training method for Basic Life Support incorporating defibrillator feedback during simulated cardiac arrest (CA) to determine the impact on the quality and retention of CPR skills. METHODS: 298 subjects were randomized into 3 groups. All groups received a 2-hour training session followed by a ...

Several concerns have emerged regarding the higher risk for stent thrombosis (ST) after drug-eluting stent (DES) implantation, especially in the setting of ST-segment elevation myocardial infarction (STEMI). Few data have been reported so far in patients with diabetes mellitus, which is associated with high rates of target vessel revascularization after ...

BACKGROUND: /st>There are controversies regarding the most efficient shoulder position during infraclavicular subclavian venous catheterization. We hypothesized that, regarding the success rate of subclavian venous catheterization, the neutral shoulder position would not be inferior to the retracted shoulder position. METHODS: /st>A total of 362 patients who underwent elective surgery were ...

Objective: To assess the outcomes of the hemodialysis reliable outflow (HeRO) device in a subset of hemodialysis access-challenged patients with central venous obstruction. Methods: Retrospective analysis of a series of patients in 2 centers who underwent placement of the HeRO device between September 2009 and November 2010. Patients' demographics, access ...

INTRODUCTION: Abdominal aortic aneurysm (AAA) is associated with hypercoagulability, evidenced by increased markers of coagulation activation, including thrombin-antithrombin complex (TAT), prothrombin fragments 1 and 2 (F1+2), and D-dimer. Our aim was to compare the effect of endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) on changes in coagulation activation ...