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Miniaturised extracorporeal

J H Amón Sesmero, M Cepeda Delgado, B de la Cruz Martín, J A Mainez Rodriguez, D Alonso Fernández, V Rodriguez Tesedo, D A Martín Way, J Gutiérrez Aceves
INTRODUCTION: The progressive reduction in the calibre of the tract in percutaneous kidney surgery to the point of miniaturisation has expanded its use to smaller stones that until now have been treated with extracorporeal shock wave lithotripsy (ESWL) and retrograde intrarenal surgery (RIRS). OBJECTIVE: To provide an update on the various techniques of small-calibre nephrolithotomy (SC-PCNL) analyse their efficacy, safety and indications and determine their degree of implantation at this time...
November 2017: Actas Urologicas Españolas
M Rumpler, J K Mader, J P Fischer, R Thar, J M Granger, F Deliane, I Klimant, F Aberer, F Sinner, T R Pieber, M Hajnsek
The combination of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion can be used to improve the treatment of patients with diabetes. The aim of this study was to advance an existing preclinical single-port system for clinical application by integrating the sensors of a phosphorescence based CGM system into a standard insulin infusion set. The extracorporeal optical phase fluorimeter was miniaturised and is now comparable with commercial CGM systems regarding size, weight and wear comfort...
February 15, 2017: Biosensors & Bioelectronics
Daniel Fudulu, Gianni Angelini
Paediatric heart surgery is associated with increased inflammation and the production of reactive oxygen species. Use of the extracorporeal cardiopulmonary bypass during correction of congenital heart defects generates reactive oxygen species by various mechanisms: haemolysis, neutrophil activation, ischaemia reperfusion injury, reoxygenation injury, or depletion of the endogenous antioxidants. The immature myocardium is more vulnerable to reactive oxygen species because of developmental differences compared to the adult heart but also because of associated congenital heart diseases that can deplete its antioxidant reserve...
2016: Oxidative Medicine and Cellular Longevity
Tim Femmer, Max L Eggersdorfer, Alexander J C Kuehne, Matthias Wessling
We describe a novel membrane based gas-liquid-contacting device with increased mass transport and reduced pressure loss by combining a membrane with a staggered herringbone static mixer. Herringbone structures are imposed on the microfluidic channel geometry via soft lithography, acting as mixers which introduce secondary flows at the membrane interface. Such flows include Dean vortices and Taylor flows generating effective mixing while improving mass transport and preventing concentration polarization in microfluidic channels...
August 7, 2015: Lab on a Chip
Markus Resch, Katrin Kurz, Wulf Schneider-Brachert, Kathrin Tintelnot, Christoph Birner, Thomas Schichtl, Matthias Lubnow, Christina Hart, Clemens Jilek, Simone Bertz, Michael Hilker, Günter A J Riegger, Andreas Luchner, Thomas Müller
In fulminant blastomycosis with multiorgan failure, the earliest diagnosis possible is crucial for successful treatment. If severe acute respiratory distress syndrome (ARDS) develops, miniaturised veno-venous extracorporeal membrane oxygenation (ECMO) might provide a unique and efficacious possibility to prolong the time frame for diagnosis and the beginning of treatment. This is the first report on a case of fatal blastomycosis in Germany. It reminds us to add exotic infections to the differential diagnosis in patients with refractory pneumonia in the era of worldwide tourism...
2009: BMJ Case Reports
Matthias Arlt, Alois Philipp, Sabine Voelkel, Leopold Rupprecht, Thomas Mueller, Michael Hilker, Bernhard M Graf, Christof Schmid
AIM OF THE STUDY: Death to trauma is caused by disastrous injuries on scene, bleeding shock or acute respiratory failure (ARDS) induced by trauma and massive blood transfusion. Extracorporeal membrane oxygenation (ECMO) can be effective in severe cardiopulmonary failure, but preexisting bleeding is still a contraindication for its use. We report our first experiences in application of initially heparin-free ECMO in severe trauma patients with resistant cardiopulmonary failure and coexisting bleeding shock retrospectively and describe blood coagulation management on ECMO...
July 2010: Resuscitation
Hunaid A Vohra, Robert Whistance, Amit Modi, Sunil K Ohri
Conventional cardiopulmonary bypass can trigger a systemic inflammatory response syndrome similar to sepsis. Aetiological factors include surgical trauma, reperfusion injury, and, most importantly, contact of the blood with the synthetic surfaces of the heart-lung machine. Recently, a new cardiopulmonary bypass system, mini-extracorporeal circulation (MECC), has been developed and has shown promising early results in terms of reducing this inflammatory response. It has no venous reservoir, a reduced priming volume, and less blood-synthetic interface...
2009: Mediators of Inflammation
Krzysztof Mozol, Ireneusz Haponiuk, Andrzej Byszewski, Bohdan Maruszewski
BACKGROUND AND AIM: Miniaturisation of the extracorporeal circuit is a current trend in modern paediatric cardiac surgery. Many investigators stress that reduction of priming volume and artificial surface area of extracorporeal circulation could lead to clinical and economic benefits. The aim of this paper was to evaluate the costs of mini-circuit use in infants undergoing open heart surgery. METHODS: We assessed post-operative course and cost of treatment in 60 infants undergoing open heart surgery...
September 2008: Kardiologia Polska
Matthias Arlt, Alois Philipp, Markus Zimmermann, Sabine Voelkel, Michael Hilker, Jonny Hobbhahn, Christof Schmid
AIM: As a result of healthcare changes, interhospital transfer has become common in the care even of patients with severely deteriorated cardiopulmonary function. This study describes experience with the use of a specially downsized, lightweight extracorporeal circulation system (Emergency-MECC) which enables percutaneous cardiopulmonary bypass support in resistant cases of severe cardiac and cardiopulmonary failure. METHODS: Between March 2006 and June 2007, the Emergency-MECC system, consisting of a centrifugal pump and a membrane oxygenator, was used to facilitate interhospital transfer of five adults...
June 2008: Resuscitation
E C S Lai, M Fok, A S H Chan
OBJECTIVE: To evaluate the feasibility and safety of cholecystectomy using miniaturised instruments of 3 mm or less in diameter. DESIGN: Prospective study on patients with gallstones, with or without related complications. SETTING: Private hospital, Hong Kong. PATIENTS: From September 1997 to September 2002, 150 of the 180 consecutive patients managed were included in the present study. MAIN OUTCOME MEASURES: All patients were operated on with a standard four-port technique...
August 2003: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
S Lahme, K H Bichler, W L Strohmaier, T Götz
Stones of the renal pelvis can be treated either by extracorporeal shock wave lithotripsy (SWL) or percutaneous nephrolithotomy (PCNL). As a low-risk procedure with a longer treatment period, SWL often leads to persistent residual stone fragments, whereas conventional PCNL achieves a higher stone-free rate and allows a shorter treatment period albeit with a somewhat higher surgical risk. To reduce the invasiveness of conventional PCNL, the application of a miniaturised instrument for PCNL (MPCNL) was evaluated...
December 2001: European Urology
J Robin, F Tronc, A Curtil, F Sassolas, C Vedrinne, J Ninet, G Champsaur
Circulatory assistance in children and neonates has not been extensively reported. It poses specific problems related mainly to miniaturisation of systems. The authors report three cases of left ventricular assistance with the Biomedicus centrifugal pump followed by functional recovery in neonates operated for d-transposition of the great arteries. The assistance was installed by cannulation of the left atrial appendage and the ascending aorta, the canules being connected to the Biomedicus pump. The duration of assistance was 53, 116 and 120 hours respectively...
May 1997: Archives des Maladies du Coeur et des Vaisseaux
G Watson
The parameters of a laser which govern stone fragmentation are the pulse duration, wavelength and fibre diameter. The pulse duration is the most important parameter governing fibre transmission. The shorter the pulse duration the less tissue damage and the easier the plasma production at the stone surface but the greater the difficulty to transmit the laser energy through the fibre. At 1 microsecond pulse duration the laser wavelength is highly significant because it governs the degree of absorption at the stone surface necessary for plasma production...
1990: Annales Chirurgiae et Gynaecologiae
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