Alumina ceramic-on-ceramic bearings have gained popularity in hip arthroplasty because of their properties of low wear and chemical inertness. In a previous study, we reported the excellent clinical results in a series of cementless ceramic-on-ceramic primary total hip arthroplasties at a minimum of five years of follow-up. The purpose of ...

Summary.  In the last three decades there have been dramatic improvements in the availability and quality of treatment for people with inherited coagulation disorders. Indeed, the improvement of methods of purification and viral inactivation for plasma-derived coagulation factor concentrates first and then the development of products utilizing recombinant DNA technology ...

Objectives:  To determine minimum airflow rate required for olfactory stimulation in successfully rehabilitated laryngectomised patients after learning the polite yawning technique (PYT) and to confirm the hypothesis that sense of smell is rehabilitated once the nasal airflow is re-established. Study design:  Prospective open interventional trial. Setting:  Tertiary academic hospital. Participants:  ...

OBJECTIVE:Diffusion tensor imaging (DTI) analysis was performed on patients with tuberous sclerosis complex (TSC) to investigate potential changes in normal-appearing white matter after treatment with everolimus, a mammalian target of rapamycin (mTOR) inhibitor. METHODS:Recently, a phase I/II trial of everolimus demonstrated significant reductions in subependymal giant cell astrocytoma (SEGA) volume ...

Background: Warfarin and aspirin (ASA) are the most commonly used anticoagulant and antiplatelet drugs in the treatment of cardiovascular disease. Objectives: To provide a pooled estimate of the bleeding risk from randomized controlled trials (RCTs) comparing warfarin and ASA at the dose ranges recommended in evidence-based guidelines. Patients/Methods: Ovid MEDLINE, ...

Background: Delayed correction of blood clotting times as measured by the international normalized ratio (INR) is associated with adverse outcomes among certain patients with warfarin-related major bleeding. However, there are limited data on the association between INR correction and mortality. Objective: This study assessed factors associated with 30 day mortality ...

Study Type - Therapy (RCT) Level of Evidence 1b What's known on the subject? and What does the study add? Photovaporization of the prostate (PVP) is now challenging TURP as the standard treatment for lower LUTS caused by BPH. The learning curve for PVP is short and the main advantages of ...

ABSTRACT: Study Design. Propensity-matched case control study.Objective. To evaluate the two year clinical outcomes of patients that have undergone instrumented spinal fusions complicated by deep wound infections and compare them to a propensity-matched control group who did not have infectionsSummary of Background Data. Postoperative infection following instrumented spinal fusion is ...

Study Design. Prospective, longitudinal cohort (non-randomized).Objective. To compare thoracoplasty (Th), direct vertebral body derotation (DVBD), and Th/DVBD with respect to correction of the rib prominence and SRS self-image scores in patients undergoing surgery for adolescent idiopathic scoliosis (AIS).Summary of Background Data. Rib prominence correction is one of the main goals ...

Symptomatic venous thromboembolism (VTE) after total or partial knee arthroplasty (TPKA) and after total or partial hip arthroplasty (TPHA) are proposed patient safety indicators, but its incidence prior to discharge is not defined. To establish a literature-based estimate of symptomatic VTE event rates prior to hospital discharge in patients undergoing ...

Objectives. Compare the survival and the complication rates of 2 comparable groups of patients who underwent either endoscopic or transfacial resection of a sinonasal adenocarcinoma.Study Design. Historical cohort study.Setting. Tertiary referral center.Subjects and Methods. Twenty-four patients with sinonasal adenocarcinomas who recently underwent an endoscopy (the ENDO group, 1999-2009) were compared ...

PURPOSE: The purpose of this study was to determine the optimal decision between autograft and allograft for patients undergoing anterior cruciate ligament (ACL) reconstruction. METHODS: An expected-value decision analysis with sensitivity analysis was performed to systematically quantify the clinical decision. We evaluated 100 randomly selected individuals aged 16 to 70 ...

Hamstring lengthening commonly is performed for the treatment of flexed knee gait in patients with spastic diplegic cerebral palsy. Satisfactory short-term results after hamstring lengthening have been demonstrated in various studies. However, evidence for the effectiveness of hamstring lengthening to correct flexed knee gait is scant because of small and ...

OBJECTIVES: Erectile dysfunction (ED) is a common problem for elderly males. Higher serum lipid levels have important role in the pathogenesis, and in this prospective randomized trial, it is aimed to identify the effect of atorvastatin on erectile functions in comparison with regular tadalafil use. MATERIALS AND METHODS: 120 patients ...

BACKGROUND: Gait impairment is a common cause of disability in Parkinson disease (PD). Electromechanical devices to assist stepping have been suggested as a potential intervention. OBJECTIVE: To evaluate whether a rehabilitation program of robot-assisted gait training (RAGT) is more effective than conventional physiotherapy to improve walking. METHODS: A total of ...

Background: The clinical impact of stent edge dissection, tissue protrusion, and incomplete stent apposition (ISA) after stent implantation, detectable only on optical coherence tomography (OCT), is still unknown because the natural course has not been investigated. Methods and Results: All consecutive patients with angina pectoris in whom both intravascular ultrasound ...

Thienopyridines are among the most widely prescribed medications, but their use can be complicated by the unanticipated need for surgery. Despite increased risk of thrombosis, guidelines recommend discontinuing thienopyridines 5 to 7 days prior to surgery to minimize bleeding. To evaluate the use of cangrelor, an intravenous, reversible P2Y(12) platelet ...

PURPOSE: The purpose was to analyze the association between posterior tibial slope (PTS) and mucoid degeneration of the anterior cruciate ligament (ACL). METHODS: From October 1999 to May 2010, 84 arthroscopies were performed in 82 patients (18 men and 64 women) with mucoid degeneration of the ACL. The mean patient ...

Objective. To describe a series of children diagnosed with type I congenital laryngeal clefts (LC-I) and treated, due to various presentations, with endoscopic injection augmentation (IA).Study Design. Case series with chart review.Setting. Tertiary care academic children's hospital in Edmonton, Canada.Subjects. All pediatric patients diagnosed with LC-I and treated with IA ...

OBJECTIVES: To determine the diagnostic value for predicting cerebral hyperperfusion syndrome (CHS) by adding a transcranial Doppler (TCD) measurement in the early postoperative phase after carotid endarterectomy (CEA). DESIGN: Patients who underwent carotid endarterectomy between January 2004 and August 2010 and in whom both intra- and postoperative TCD monitoring were ...

PURPOSE: We determined the efficacy and potential complications of endoscopic incision and balloon dilation with double stenting for the treatment of primary obstructive megaureter in children. MATERIALS AND METHODS: We prospectively reviewed cases of primary obstructive megaureter requiring repair due to pyelonephritis, renal calculi and/or loss of renal function. A ...

PURPOSE: The use of traditional cutting guides during knee arthroplasty in some cases could be extremely difficult, if not impossible, because of angular deformities, IM sclerosis, long-stemmed hip implants, or hardware within the femoral canal that cannot be removed. In these difficult cases navigation-assisted knee arthroplasty should be considered as ...

Background. Complications in early onset mild gestational hypertension (GH) are predicted by Total Peripheral Vascular Resistance (TPVR)>1350 dyne more than by blood pressure levels. We therefore assessed the possible reduction of severe complications lowering TPVR with NO donors, oral fluids and standard antihypertensive therapy in women with early onset mild ...

BACKGROUND: Current data indicate that infliximab-given immediately after surgery-may be very effective in preventing postsurgical recurrence of Crohn's disease. However, it is unknown whether a similar benefit would result from early diagnosis and treatment, rather than prevention of endoscopic recurrence. AIMS: The primary outcome of this study was to clarify ...

We previously reported the ten to fourteen-year results for 311 Porous Coated Anatomic total hip replacements that had been inserted by two surgeons in 279 patients. The purpose of the present report is to update that study and to report the outcome beyond twenty years. The patients were followed prospectively ...

In a hospital-based, prospective cohort study, the effects of the three standard treatment regimens for mild Clostridium difficile infection (CDI), oral (p.o.) metronidazole at 500 mg three times/day, intravenous (i.v.) metronidazole at 500 mg three times/day, and oral (p.o.) vancomycin at 250 mg four times/day, were compared with respect to ...

BACKGROUND: Endoscopic skull base surgery (ESBS) is considered a minimally-invasive surgical modality with less morbidity and patient discomfort. Quality-of-life (QOL) assessments provide a patient-reported estimate of well-being that may be clinically relevant. Although the sinonasal tract is integral to ESBS, the change in sinonasal-related QOL with ESBS has not been ...

INTRODUCTION: Total knee arthroplasty (TKA) is commonly used treatment method of severe primary knee osteoarthritis refractory to conservative treatment. Despite the presumed increase in the use of this treatment modality in younger patients, there is very little published data on this phenomenon. PATIENTS AND METHODS: We obtained data on performed ...

AIM: Atrial fibrillation is one of the most common postoperative arrhythmias following cardiac surgery. Despite many clinical studies, there is still no consensus on the most appropriate prevention strategy for atrial arrhythmia. A randomized prospective trial was conducted to determine the efficacy of intravenous landiolol administration in the early period ...

ABSTRACT: Delta neutrophil index (DN) is the immature granulocyte fraction provided by a blood cell analyzer (ADVIA 2120; Siemens Healthcare Diagnostics, IL), which is determined by subtracting the fraction of mature polymorphonuclear leukocytes from the sum of myeloperoxidase (MPO)-reactive cells. The purpose of this study is to define the role ...

BACKGROUND: The objective of this work was to obtain a controlled subjective and objective in vivo clinical comparison of the Passy-Muir, Shiley, and Ball speaking valves. METHODS: Ten patients free of laryngeal pathology but dependent on tracheotomy for respiration were tested with each of the speaking valves. Olfaction was assessed ...

To analyze the use of noninvasive ventilation (NIV) in respiratory failure after extubation in patients after cardiac surgery, the factors associated with respiratory failure, and the need for reintubation. Retrospective observational study. Intensive care unit in a university hospital. Patients (n = 63) with respiratory failure after extubation after cardiac ...

Abstract Continuous renal replacement therapy (CRRT) has emerged as the preferred dialysis modality for critically ill patients with acute kidney injury. The objectives of this retrospective study were to assess the effect of nafamostat on circuit patency of CRRT and the safety regarding bleeding complications in patients at high risk ...

PURPOSE: To assess the role of acromioplasty in the arthroscopic repair of small- to medium-sized rotator cuff tears. METHODS: A prospective randomized trial of 120 patients who had small- to medium-sized rotator cuff tears and various types of acromions without spurs were included. Sixty patients received arthroscopic rotator cuff repair ...

This study examined the clinical course of patients with asymptomatic severe aortic stenosis (AS) according to the new proposed aortic valve stenosis grading classification. The management of patients with asymptomatic severe AS remains controversial. Moreover, under the same denomination of severe AS, several entities might be identified according to transvalvular ...

OBJECTIVE: Emergency Endovascular Aortic Aneurysm Repair (eEVAR) is a rapidly evolving approach to ruptured Abdominal Aortic Aneurysms (rAAA). Yet longer-term outcomes following eEVAR remain unclear. This study compares mid-term outcomes of eEVAR and open rAAA. METHODS: A prospective database for all patients undergoing eEVAR and open rAAA from January 2006 ...

OBJECTIVES/HYPOTHESIS: To measure patient quality of life after rhinoplasty in regard to nose appearance and function with use of the modern structural and functional surgical approach. STUDY DESIGN: Retrospective chart review at a tertiary referral center. METHODS: We performed a retrospective chart review with prospective follow-up. All patients with rhinoplasty ...

The aim of this study was to evaluate the results when the surgical concept of not accepting intraprocedural paravalvular leakage was applied for transcatheter aortic valve implantation (TAVI). The surgical strategy of conventional aortic valve replacement does not accept paraprosthetic leakage and requires immediate action to eliminate it. However, paravalvular ...

OBJECTIVE: To determine the incidence of urinary tract infection (UTI) after ureteral reimplantation (UR) for primary vesicoureteral reflux (VUR). MATERIALS AND METHODS: In this retrospective review, the pyelonephritis-free survival of patients with primary VUR who underwent open UR from January 1990 to December 2002 was assessed using a Cox proportional ...

BACKGROUND: VNS (Vagus Nerve Stimulation Therapy) is approved in the USA to treat refractory epilepsy as adjunctive to antiepileptic drugs (AEDs) in patients ≥12 years with complex partial seizures. AIMS: To evaluate clinical outcomes, quality-adjusted life years (QALY), and costs associated with VNS in pediatric patients with drug-resistant epilepsy in ...

Introduction: There is no definite data indicating which modality to use to assess the efficacy of SWL. Usually, PARs are recommended in PCNL afterwards and in the followup of asymptomatic stones whereas NCCT is recommended in case of residual fragments. We compared the efficacies of PAR and NCCT in terms ...

BACKGROUND AND AIMS: Gastric variceal obturation (GVO) therapy is the current treatment of choice for gastric variceal bleeding (GVB). However, the efficacy of non-selective ß-blockers (NSBB) in the secondary prevention of GVB is still debatable. This study aimed to evaluate the efficacy of additional NSBB to repeated GVO in the ...

Abstract Background: The aim of the study was to evaluated the primary and secondary (after reoperation) patency rates and some effect factors in fistula patency for hemodialysis patients. Material and methods: Over a 10-year period, 1529 arteriovenous fistulas (AVFs) were fashioned in 1003 (611 males, 392 females; median age range ...

The optimal degree of neck rotation during internal jugular vein (IJV) cannulation remains undetermined because previous studies suggested using sonography, but without puncturing the vein. We assessed whether a neutral position (NP) of the head (0 degrees) during ultrasound-guided cannulation of the IJV was safer than rotating the neck to ...

STUDY DESIGN:: A retrospective investigation. OBJECTIVE:: To clarify at which age and at what point in the postoperative period neurological deterioration occurs in patients with cervical spondylotic myelopathy. SUMMARY OF BACKGROUND DATA:: Inferior surgical outcomes tend to be seen with increasing age, however, the age threshold and the postoperative period ...

Background: The required acenocoumarol dose and the risk of underanticoagulation and overanticoagulation are associated with CYP2C9 and VKORC1 genotypes. However, the duration of the effects of these genes on anticoagulation is not yet known. Objectives: In this study, effects of these polymorphisms on the risk of underanticoagulation and overanticoagulation over ...

Background:Postoperative nausea and vomiting (PONV) remains the most common postoperative complication, and causes decreased patient satisfaction, prolonged postoperative hospital stays, and unanticipated admission. There are limited data that indicate that dextrose may reduce nausea and vomiting. In this trial, we attempted to determine whether the rate of PONV can be ...

The objective of the present study was to assess the efficacy of posterior reconstruction of Denonvilliers' musculofascial plate for restoring urinary continence after laparoscopic radical prostatectomy. A total of 48 consecutive patients who underwent laparoscopic radical prostatectomy were retrospectively reviewed. Of them, 23 underwent laparoscopic radical prostatectomy without posterior reconstruction ...

10-year survival rates after unicompartmental knee replacement (UKR) have been up to 97% in single-center studies, but they have been as low as 80% in studies from arthroplasty registers. Few studies have evaluated short-term functional outcome and its improvement with time. We determined the time course of functional outcome as ...

OBJECTIVE:To evaluate the effectiveness of intravenous immunoglobulin (IVIG) treatment of Kawasaki disease ≥10 days after illness onset.METHODS:We selected patients initially treated with IVIG on days 11 to 20 in the database of the 20th nationwide survey in Japan. We then selected pair-matched control subjects of the same gender and age, ...