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Coralie Alexandre, Stéphane Baillard, Julien Tavet, Oliver Nüsse
No abstract text is available yet for this article.
October 2016: Médecine Sciences: M/S
Hans Kristian Pilegaard
The Nuss procedure is now the preferred operation for surgical correction of pectus excavatum (PE). It is a minimally invasive technique, whereby one to three curved metal bars are inserted behind the sternum in order to push it into a normal position. The bars are left in situ for three years and then removed. This procedure significantly improves quality of life and, in most cases, also improves cardiac performance. Previously, the modified Ravitch procedure was used with resection of cartilage and the use of posterior support...
September 2016: Annals of Cardiothoracic Surgery
Donald Nuss, Robert J Obermeyer, Robert E Kelly
Historically, pectus excavatum (PE) was reported to be congenital, but in our experience only 22% are noticed in the first decade of life. Thus far, genetic studies support an autosomal recessive heritability, which coincides with only 40% of our patients having some positive family history, but is also contradictory given a constant sex ratio of 4:1 in favor of males. This inconsistency may be explained by the effect of more than one pectus disease-associated allele. Once the deformity is noticed, it tends to progress slowly until puberty, when rapid progression is often seen...
September 2016: Annals of Cardiothoracic Surgery
Marie Maagaard, Johan Heiberg
Patients with pectus excavatum (PE) often describe improvements in exercise stamina following corrective surgery. Studies have investigated the surgical effect on physiological parameters; still, no consensus has yet been reached. Therefore, the aim of this literature review was to describe the cardiac outcome after surgical correction, both at rest and during exercise. In February 2016, a detailed search of the databases PubMed, Medline, and EMBASE was performed. We assessed clinical studies that described cardiac outcomes both before and after surgical correction of PE...
September 2016: Annals of Cardiothoracic Surgery
Jose Ribas Milanez de Campos, Miguel Lia Tedde
The correction of deep pectus excavatum, with the Nuss procedure, frequently require a series of maneuvers that is inherently dangerous. Herein we describe 10 technical modifications to prevent potential complications. These modified techniques have certain advantages and according to the authors, with these maneuvers the risk of pericardial sac, cardiac injury, bar displacement and complications during the removal of the bar could be markedly reduced.
September 2016: Annals of Cardiothoracic Surgery
Robert E Kelly, Robert J Obermeyer, Donald Nuss
BACKGROUND: Recently, technical improvement in the ability to measure lung function and the severity of chest deformity have enabled progress in understanding the mechanism of limitations of lung function in pectus excavatum. METHODS: After establishing that most patients with pectus excavatum do have symptoms of exercise intolerance, easy fatigability, and shortness of breath with exertion, lung function has been evaluated by a variety of methods in different centers...
September 2016: Annals of Cardiothoracic Surgery
Hans Kristian Pilegaard
BACKGROUND: Pectus excavatum (PE) is the most frequent anomaly of the anterior chest wall. Before 2001, all patients in Denmark were referred to the plastic and reconstructive surgeon for implantation of a subcutaneous silicone prosthesis, because the modified Ravitch procedure was not used. Since 2001, all patients have been treated with a modified Nuss procedure, which today has become the gold standard for correction of PE. METHODS: From September 2001 to March 2016, 1,713 patients have been operated by a modified Nuss procedure using the short bar at Aarhus University Hospital with a male-female ratio 6:1...
September 2016: Annals of Cardiothoracic Surgery
Frank-Martin Haecker, Sergio Sesia
BACKGROUND: For specific therapy to correct pectus excavatum (PE), conservative treatment with the vacuum bell (VB) was introduced more than 10 years ago in addition to surgical repair. Preliminary results using the VB were encouraging. We report on our 13-year experience with the VB treatment including the intraoperative use during the Nuss procedure and present some technical innovations. METHODS: A VB with a patient-activated hand pump is used to create a vacuum at the anterior chest wall...
September 2016: Annals of Cardiothoracic Surgery
Donald Nuss, Robert J Obermeyer, Robert E Kelly
Repair of pectus excavatum began at the beginning of the 20(th) century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support...
September 2016: Annals of Cardiothoracic Surgery
Aran Kanagaratnam, Steven Phan, Vakhtang Tchantchaleishvilli, Kevin Phan
BACKGROUND: Pectus excavatum is the most common congenital chest wall deformity. The two most common surgical techniques for its correction are the modified Ravitch technique and the minimally invasive Nuss technique. Despite both procedures being used widely, data comparing them are scarce. METHODS: We conducted a systematic review and meta-analysis of comparative studies to evaluate these procedures. A systematic search of the literature was performed from six electronic databases...
September 2016: Annals of Cardiothoracic Surgery
Benjamin A Keller, Sandra K Kabagambe, James C Becker, Y Julia Chen, Laura F Goodman, Julianna M Clark-Wronski, Kenneth Furukawa, Rebecca A Stark, Amy L Rahm, Shinjiro Hirose, Gary W Raff
BACKGROUND: Multimodal pain management strategies are used for analgesia following pectus excavatum repair. However, the optimal regimen has not been identified. We describe our early experience with intercostal cryoablation for pain management in children undergoing the Nuss procedure and compare early cryoablation outcomes to our prior outcomes using thoracic epidural analgesia. METHODS: A multi-institutional, retrospective review of fifty-two patients undergoing Nuss bar placement with either intercostal cryoablation (n=26) or thoracic epidural analgesia (n=26) from March 2013 to January 2016 was conducted...
September 28, 2016: Journal of Pediatric Surgery
Sâmia Georgia Dantas Linhares, João Carlos Das-Neves Pereira, Paulo Manuel Pêgo Fernades, José Ribas Milanez de Campos
PURPOSE: The aim of this study was to compare the functional exercise capacity and the lung function among patients undergoing early rehabilitation with those submitted to the conventional care after pectus excavatum repair using the Nuss procedure. METHOD: Patients were randomly allocated to the early rehabilitation group (ERG) who started rehabilitation after surgery and the group of the conventional care (CG) received routine care of the institution. They were evaluated before surgery (preoperative) and in hospital discharge day (postoperative)...
October 13, 2016: Pediatric Surgery International
Florian Mäsing, Xi Wang, Harald Nüsse, Jürgen Klingauf, Armido Studer
A facile light-mediated preparation of small palladium nanoparticles (PdNPs) with a diameter of 1.3 nm and low dispersity by using low-priced and readily prepared photoactive polymers is presented. These polymers act as reagents for the photochemical reduction of Pd ions and they are also stabilizers for the PdNPs generated in situ. The PdNP-polymer hybrid materials prepared by this reliable approach are efficient hydrogenation catalysts that show high activity and Z-selectivity in the semi-hydrogenation of alkynes...
October 13, 2016: Chemistry: a European Journal
Anne Hseu, Mykayla Sandler, Dawn Ericson, Nohamin Ayele, Kosuke Kawai, Roger Nuss
INTRODUCTION: Although dyspnea with exercise in the pediatric population can be multifactorial, the diagnosis of paradoxical vocal fold motion disorder (PVFMD) in this group is not well characterized. The objective of this study is to review the multiple causes of dyspnea with exercise in children, including the prevalence of PVFMD within this study population. METHODS: A retrospective review was conducted of patients seen at a tertiary pediatric hospital for exercise-induced dyspnea suspected to be related to PVFMD between January 2007 and July 2015...
November 2016: International Journal of Pediatric Otorhinolaryngology
Karl Nuss
Diseases of the bovine digit remain the major cause of painful lameness in cattle and commonly constitute a diagnostic and therapeutic challenge for clinicians. Prompt surgical wound revision is critical in acute injuries. Deep infections may be treated with debridement, resection of tendons, synovioscopy, joint lavage, arthrotomy and facilitated joint ankylosis. Postoperative care is more involved, lameness persists longer, and cost of treatment is higher after salvage techniques than after amputation of the digit...
November 2016: Veterinary Clinics of North America. Food Animal Practice
C Tessier, K Sweers, A Frajerman, H Bergaoui, F Ferreri, C Delva, N Lapidus, A Lamaziere, J P Roiser, M De Hert, P Nuss
Schizophrenia is a severe mental condition in which several lipid abnormalities-either structural or metabolic-have been described. We tested the hypothesis that an abnormality in membrane lipid composition may contribute to aberrant dopamine signaling, and thereby symptoms and cognitive impairment, in schizophrenia (SCZ) patients. Antipsychotic-medicated and clinically stable SCZ outpatients (n=74) were compared with matched healthy subjects (HC, n=40). A lipidomic analysis was performed in red blood cell (RBC) membranes examining the major phospholipid (PL) classes and their associated fatty acids (FAs)...
October 4, 2016: Translational Psychiatry
M K Arevalo, J C Prieto, N Cost, G Nuss, B J Brown, L A Baker
INTRODUCTION: Symptomatic pediatric ureterocele has diverse manifestations, making evidence-based management impractical. Thus, detailed visualization of ureterocele anatomy prior to first surgical incision is invaluable. Retrograde ureterocelogram (RUC) is a simple, underutilized radiologic technique that can be performed during cystoscopy. This study sought to determine whether RUC changes surgical management by more accurately depicting the complex ureteral and ureterocele anatomy, compared with renal ultrasound (US) and voiding cystourethrography (VCUG)...
September 17, 2016: Journal of Pediatric Urology
Kyle M Loh, Renée van Amerongen, Roel Nusse
There were multiple prerequisites to the evolution of multicellular animal life, including the generation of multiple cell fates ("cellular diversity") and their patterned spatial arrangement ("spatial form"). Wnt proteins operate as primordial symmetry-breaking signals. By virtue of their short-range nature and their capacity to activate both lineage-specifying and cell-polarizing intracellular signaling cascades, Wnts can polarize cells at their site of contact, orienting the axis of cell division while simultaneously programming daughter cells to adopt diverging fates in a spatially stereotyped way...
September 26, 2016: Developmental Cell
Mansi Shah, Richard Frye, Amy Marzinsky, Michael R Phillips, William Adamson, Sean E McLean
No abstract text is available yet for this article.
September 2016: American Surgeon
Aaron M Nuss, Ann Kathrin Heroven, Petra Dersch
A large repertoire of RNA-based regulatory mechanisms, including a plethora of cis- and trans-acting noncoding RNAs (ncRNAs), sensory RNA elements, regulatory RNA-binding proteins, and RNA-degrading enzymes have been uncovered lately as key players in the regulation of metabolism, stress responses, and virulence of the genus Yersinia. Many of them are strictly controlled in response to fluctuating environmental conditions sensed during the course of the infection, and certain riboregulators have already been shown to be crucial for virulence...
September 17, 2016: Trends in Microbiology
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