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Mechanical Complications (mechanical + complications)
Selected AbstractsThe Role of Intraoperative Transesophageal Echocardiography in Heart TransplantationECHOCARDIOGRAPHY, Issue 7 2002Paval Romano M.D. The number of centers that perform heart transplants has increased rapidly in recent years. Although transthoracic and transesophageal echocardiography (TTE and TEE) are utilized frequently to diagnose and manage cardiac complications commonly found in this population postoperatively, little has been written about the routine use of intraoperative TEE. Intraoperative echo is ideally suited to identify acute complications during cardiac transplantation. This can include immediate signs of rejection, valvular abnormalities, and mechanical complications related to the surgical procedure. Many of these patients might require ventricular assist devices (VAD) to provide circulatory support, and intraoperative TEE can be used to verify correct positioning of the VAD hardware. In addition, many of the chronic complications that patients with heart transplants are at risk for may be serious yet asymptomatic. Therefore, a high quality, complete intraoperative echocardiographic study might serve as an important baseline to compare postoperative changes. [source] Biodegradable External Stents Inhibit Saphenous Vein Graft Thickening in the PigJOURNAL OF CARDIAC SURGERY, Issue 6 2002P Gadsdon Aim: External, non-restrictive, macro-porous stents prevent neointima formation in porcine vein grafts and have been proposed as a therapeutic approach to the prevention of late vein graft failure. Since these stents are non-biodegradable and therefore may elicit deleterious long-term, inflammatory, infective and mechanical complications the effect of external macro-porous biodegradable (polyglactin) stents on neointimal and medial thickening in porcine vein grafts was investigated. Methods: Bilateral vein saphenous vein-carotid artery interposition grafting was performed in Large White pigs (22,36 kg, n = 6) with external placement of 8 mm diameter polyglactin stents on one side, the contralateral side acting as a control. One month after surgery, graft wall dimensions were measured on histological sections using computer-aided planimetry and immunocytochemistry undertaken for selected parameters. Results: Polyglactin stents significantly reduced medial thickening compared to the All grafts were patent at explantation. Intimal thickness was significantly lower (p < 0.05) in the stented grafts (0.11 ± 0.01 mm) compared to the unstented controls (0.18 ± 0.01 mm). Similarly, medial thickness was significantly lower (p < 0.05) in the stented grafts (0.24 ± 0.03 mm) compared to the unstented controls (0.43 ± 0.04 mm) mm. Grafts externally supported with polyglactin had a pronounced increase in inflammatory cells (in particular, giant cells) around the biodegradable stent compared to both unstented controls and previously studied Dacron stented grafts. The space between graft and stent had become organised into a neo-adventitia with abundant microvessels which stained positively for VEGF and lectin (markers of micorvessels and endothelial cells). Conclusions: An over-size biodegradable stent reduces medial thickening, a component of late vein graft failure in experimental grafts. If subsequent studies confirm the preservation of this beneficial effect when the stent biodegrades completely, this form of stent may have an advantage over permanent stent material in the clinical use of external stenting to prevent vein graft thickening and failure. [source] Intermittent and Continuous Enteral Nutrition in Critically Ill Dogs: A Prospective Randomized TrialJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 3 2010M. Holahan Background: Malnutrition is a common problem in critically ill dogs and is associated with increased morbidity and mortality in human medicine. Enteral nutrition (EN) delivery methods have been evaluated in humans to determine which is most effective in achieving caloric goals. Objectives: To compare continuous infusion and intermittent bolus feeding of EN in dogs admitted to a critical care unit. Animals: Fifty-four dogs admitted to the critical care unit and requiring nutritional support with a nasoenteric feeding tube. Methods: Prospective randomized clinical trial. Dogs were randomized to receive either continuous infusion (Group C) or intermittent bolus feeding (Group I) of liquid EN. The percentage of prescribed nutrition delivered (PPND) was calculated every 24 hours. Frequencies of gastrointestinal (GI), mechanical, and technical complications were recorded and gastric residual volumes (GRVs) were measured. Results: PPND was significantly lower in Group C (98.4%) than Group I (100%). There was no significant difference in GI or mechanical complications, although Group C had a significantly higher rate of technical complications. GRVs did not differ significantly between Group C (3.1 mL/kg) and Group I (6.3 mL/kg) and were not correlated with the incidence of vomiting or regurgitation. Conclusions and Clinical Importance: There was a statistically significant difference in the PPND between continuously and intermittently fed dogs, but this difference is unlikely to be clinically relevant. Critically ill dogs can be successfully supported with either continuous infusion or intermittent bolus feeding of EN with few complications. Increased GRVs may not warrant termination of enteral feeding. [source] A 3-Year Retrospective Study of Cresco Frameworks: Preload and ComplicationsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2005Lars Hjalmarsson DDS ABSTRACT Purpose: The aim of this retrospective clinical study was to evaluate the clinical outcome of fixed implant-supported complete prostheses on Astra or Brånemark implants when using either conventional cast frameworks or frameworks produced according to the Cresco Ti Precision method® (Cresco Ti Systems Sàri., Lausanne, Switzerland). Materials and Methods: Forty-six patients treated 3 years previously were divided into four groups according to implant system and framework design. Clinical examinations were performed and case records were scrutinized. The stability for each prosthesis retention screw was recorded as the torque profile and was monitored using the Osseocare® torque controller (Nobel Biocare AB, Göteborg, Sweden). Complications in association with implants and superstructures were registered. Patient opinions were recorded. The significance level was set to 5%. Results: The Astra-Cresco group demonstrated a lower degree of prosthesis retention screw stability compared with the Astra group. No differences among the four groups were seen regarding plaque, bleeding on probing, or marginal bone resorption. The Brånemark group (Brånemark System®, Nobel Biocare AB) demonstrated more mechanical complications than the Brånemark-Cresco group. Mobile prostheses were found in the Brånemark and the Astra-Cresco groups. Fracture of veneer was seen in 20% of the prostheses and was more frequently found in the groups with mobile prostheses. Sixty percent of the prostheses showed reactions in the surrounding soft tissues. The most common reaction was mucosal proliferation. No differences were detected in the patients' opinions. Conclusion: Within the limitations of this retrospective study, the following can be concluded: (1) compared with conventional frameworks, the Cresco distortion correction method does not provide a better clinical outcome after prosthesis connection in patients with fixed implant-supported complete prostheses; and (2) the two framework-producing methods behave differently on Astra implants compared with Brånemark implants concerning prosthesis retention screw stability, mechanical and biologic complications, and reactions in patients with fixed implant-supported complete prostheses. [source] Clinical Experiences of CNC-Milled Titanium Frameworks Supported by Implants in the Edentulous Jaw: 1-Year Prospective StudyCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2000Anders Örtorp LDS ABSTRACT Background: A new type of titanium framework has been introduced, but so far no clinical reports have been made in this treatment modality. Purpose: The aim of this study was to report the clinical performance of implant-supported prostheses with computer numeric controlled (CNC)-milled titanium frameworks in the edentulous jaw and to compare the results with prostheses provided with conventional cast frameworks during the first year of function. Material and Methods: A consecutive group of 65 patients with 67 prostheses were provided with CNC-milled titanium frameworks in 23 upper and 44 lower jaws. During the same period, 61 consecutive patients were treated on a routine basis with 31 upper and 31 lower conventional gold alloy casting prostheses. Clinical and radiographic 1-year data were collected for both the test and control groups. Results: A total of 14 of 729 inserted implants were lost during the follow-up period (1.9%). All prostheses were functioning after 1 year except a conventional prosthesis with a cast framework, which was replaced by an implant-supported over-denture due to implant loss. The 1-year cumulative survival rate (CSR) was 100% and 97.8% for CNC prostheses and implants, respectively. The corresponding CSR for the control group was 98.3% and 98.3%, respectively. Few problems were reported in both groups, and the clinical and the radiologic performances were similar for both groups. No mechanical complications except some resin veneer fractures (n = 6) were observed. The mean marginal bone loss for the test group during the first year in function was 0.4 mm (SD = 0.35) and 0.4 mm (SD = 0.33) in the upper and lower jaws, respectively. A similar pattern of bone reaction was also observed in the control group. Conclusion: CNC-milled titanium frameworks can be used as an alternative to conventional castings in the edentulous jaw, presenting similar clinical and radiologic performances as conventional cast frameworks during the first year of function. [source] | ||||||||||