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Daniel Gomez, Vicky Duffy, Diane Hersey, Carl Backes, Peter Rycus, Patrick McConnell, Jordan Voss, Mark Galantowicz, Clifford L Cua
Outcomes for extracorporeal membrane oxygenation (ECMO) have been described for patients with single ventricle physiology (SVP) undergoing cavopulmonary connection (Glenn procedure). An alternative surgical pathway for patients with SVP consists of an initial hybrid procedure followed by a comprehensive Stage II procedure. No data exist describing the outcomes of patients requiring ECMO after the comprehensive Stage II procedure. The goal of this study is to describe the outcomes for patients who required ECMO after the comprehensive Stage II procedure...
November 29, 2016: Artificial Organs
Catherine Heith, Gwenyth Fischer, Marie Steiner, Janet Hume
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
Peter Larsen, Henrik B Nielsen, Christoffer Lund, Daniel S Sørensen, Birgit T Larsen, Mark Matthews, Bill Vicenzino, Rasmus Elsoe
BACKGROUND: Assessment of ankle joint movement in a weight bearing position has important clinical implications. The lunge ankle dorsiflexion measurement device (LAD) has been developed with the aim of facilitating ease of and standardisation of the measurement of ankle joint movement. The literature lacks studies evaluating the reliability of weight bearing measurements of the ankle joint in study groups with ankle disabilities. The objective of this study was to examine the intra- and inter-tester reliability of ankle dorsiflexion measured with the novel LAD in patients following a fracture of the ankle...
December 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Cécile Aubron, Joris DePuydt, François Belon, Michael Bailey, Matthieu Schmidt, Jayne Sheldrake, Deirdre Murphy, Carlos Scheinkestel, D Jamie Cooper, Gilles Capellier, Vincent Pellegrino, David Pilcher, Zoe McQuilten
BACKGROUND: Bleeding is the most frequent complication associated with extracorporeal membrane oxygenation (ECMO) support in critically ill patients. Nonetheless, risk factors for bleeding have been poorly described especially those associated with coagulation anomalies and anticoagulant therapy during ECMO support. The aim of this study is to describe bleeding complications in critically ill patients undergoing ECMO and to identify risk factors for bleeding events. METHODS: We retrospectively analysed ICU charts of adults who received either veno-venous (VV) or veno-arterial (VA) ECMO support in two participating ICUs between 2010 and 2013...
December 2016: Annals of Intensive Care
Peter Larsen, Uffe Laessoe, Sten Rasmussen, Thomas Graven-Nielsen, Christian Berre Eriksen, Rasmus Elsoe
INTRODUCTION: Despite the high number of studies evaluating the outcomes following tibial shaft fractures, the literature lacks studies including objective assessment of patients' recovery regarding gait pattern. The purpose of the present study was to evaluate whether gait patterns at 6 and 12 months post-operatively following intramedullary nailing of a tibial shaft fracture are different compared with a healthy reference population. PATIENTS AND METHODS: The study design was a prospective cohort study...
September 28, 2016: Gait & Posture
Katherine Cashen, Roland L Chu, Justin Klein, Peter T Rycus, John M Costello
INTRODUCTION: Pediatric patients with hemophagocytic lymphohistiocytosis (HLH) may develop refractory respiratory or cardiac failure that warrants consideration for extracorporeal membrane oxygenation (ECMO) support. The purposes of this study were to describe the use and outcomes of ECMO in pediatric HLH patients, to identify risk factors for hospital mortality and to compare their ECMO use and outcomes to the ECMO population as a whole. METHODS: Pediatric patients (⩽ 18 years) with a diagnosis of HLH in the Extracorporeal Life Support Organization (ELSO) Registry were included...
September 13, 2016: Perfusion
Peter Larsen, Charles M Court-Brown, Julie Odgaard Vedel, Sabina Vistrup, Rasmus Elsoe
The literature lacks large-scale, up-to-date, population-based epidemiology studies on the incidence of patellar fractures based on complete populations. The purpose of this study was to provide up-to-date information concerning the incidence of patellar fractures in a large and complete population spanning a decade and to report on the distribution of fracture classification, trauma mechanisms, and patient baseline demographics. A retrospective review of clinical and radiological records of 756 patellar fractures treated between 2005 and 2014 was conducted...
November 1, 2016: Orthopedics
Joseph E Tonna, Nicholas J Johnson, John Greenwood, David F Gaieski, Zachary Shinar, Joseph M Bellezo, Lance Becker, Atman P Shah, Scott T Youngquist, Michael P Mallin, James Franklin Fair, Kyle J Gunnerson, Cindy Weng, Stephen McKellar
PURPOSE: To characterize the current scope and practices of centers performing extracorporeal cardiopulmonary resuscitation (eCPR) on the undifferentiated patient with cardiac arrest in the emergency department. METHODS: We contacted all US centers in January 2016 that had submitted adult eCPR cases to the Extracorporeal Life Support Organization (ELSO) registry and surveyed them, querying for programs that had performed eCPR in the Emergency Department (ED ECMO)...
October 2016: Resuscitation
Peter Larsen, Charlotte B Goethgen, Sten Rasmussen, Annika B Iyer, Rasmus Elsoe
INTRODUCTION: Most studies of polytrauma examined highly mixed patient groups. The objective of the present study was to report the development of patient-reported quality of life (QOL), in a patient group with musculoskeletal polytrauma, excluding patients with major thoracic, abdominal, and brain injuries. MATERIALS AND METHODS: The study design was a 1-year cohort follow-up study. Recordings of injury severity were measured with the ISS and NISS. Patient-reported QOL was measured with the questionnaires Eq5d-5L and SF-36 and compared to age-matched reference populations...
November 2016: Archives of Orthopaedic and Trauma Surgery
Peter Larsen, Rasmus Elsoe, Uffe Laessoe, Thomas Graven-Nielsen, Christian Berre Eriksen, Sten Rasmussen
INTRODUCTION: To evaluate the development in patient-reported quality of life (QOL) and muscle strength in the period from surgery to 12 months postoperatively after intramedullary nailing of a tibial shaft fracture. MATERIALS AND METHODS: The design was a prospective, follow-up cohort study. QOL was measured with the questionnaire Eq5D-5L and compared to norm data from a reference population. Recordings of pain and contralateral muscle strength (isometric maximal voluntary contraction (MVC) for knee flexion and extension were collected at 6 weeks, 3, 6, and 12 months postoperatively...
October 2016: Archives of Orthopaedic and Trauma Surgery
Peter Larsen, Rasmus Elsoe, Michael S Rathleff
BACKGROUND: Displaced stress fractures of the femoral shaft are very uncommon. The proportion of middle-aged and older age groups participating in long-distance running, triathlon and other high intensity sports is increasing. As a consequence stress fracture of the femoral shaft may be on the rise in the future. CASE PRESENTATION: The patient was 43 years old male caucasian triathlete. The authors met the patient after he was admitted with a displaced femoral shaft fracture...
May 2016: Physical Therapy in Sport
Anne Hilgendorff, Christian Apitz, Damien Bonnet, Georg Hansmann
Persistent pulmonary hypertension of the newborn (PPHN) is the most common neonatal form and mostly reversible after a few days with improvement of the underlying pulmonary condition. When pulmonary hypertension (PH) persists despite adequate treatment, the severity of parenchymal lung disease should be assessed by chest CT. Pulmonary vein stenosis may need to be ruled out by cardiac catheterisation and lung biopsy, and genetic workup is necessary when alveolar capillary dysplasia is suspected. In PPHN, optimisation of the cardiopulmonary situation including surfactant therapy should aim for preductal SpO2between 91% and 95% and severe cases without post-tricuspid-unrestrictive shunt may receive prostaglandin E1 to maintain ductal patency in right heart failure...
May 2016: Heart: Official Journal of the British Cardiac Society
María Florencia Beer, Fernanda Maria Frank, Orlando Germán Elso, Augusto Ernesto Bivona, Natacha Cerny, Gustavo Giberti, Emilio Luis Malchiodi, Virginia Susana Martino, María Rosario Alonso, Valeria Patricia Sülsen, Silvia Ines Cazorla
Context Chagas' disease and leishmaniasis produce significant disability and mortality with great social and economic impact. The genus Stevia (Asteraceae) is a potential source of antiprotozoal compounds. Objective Aerial parts of four Stevia species were screened on Trypanosoma cruzi. Stevia satureiifolia (Lam.) Sch. Bip. var. satureiifolia (Asteraceae) dichloromethane extract was selected for a bioassay-guided fractionation in order to isolate its active compounds. Additionally, the antileishmanial activity and the cytotoxicity of these compounds on mammalian cells were assessed...
October 2016: Pharmaceutical Biology
Luiz Fernando Canêo, Rodolfo A Neirotti
As Marcelo Giugale published in the Financial Times, Latin America, on the whole, has not excelled at innovation - doing the same things in a new and better way or at doing new things. It has been slow to acquire, adopt and adapt technologies by this time available in other places[1]. Although extracorporeal membrane oxygenation (ECMO) is not a new technology, its use in Latin America is not widespread as needed. Furthermore, we still have a number centers doing ECMO, not reporting their cases, lacking a structured training program and not registered with the extracorporeal life support organization (ELSO)...
November 2015: Brazilian Journal of Cardiovascular Surgery
Thomas Delong, Timothy A Wiles, Rocky L Baker, Brenda Bradley, Gene Barbour, Richard Reisdorph, Michael Armstrong, Roger L Powell, Nichole Reisdorph, Nitesh Kumar, Colleen M Elso, Megan DeNicola, Rita Bottino, Alvin C Powers, David M Harlan, Sally C Kent, Stuart I Mannering, Kathryn Haskins
T cell-mediated destruction of insulin-producing β cells in the pancreas causes type 1 diabetes (T1D). CD4 T cell responses play a central role in β cell destruction, but the identity of the epitopes recognized by pathogenic CD4 T cells remains unknown. We found that diabetes-inducing CD4 T cell clones isolated from nonobese diabetic mice recognize epitopes formed by covalent cross-linking of proinsulin peptides to other peptides present in β cell secretory granules. These hybrid insulin peptides (HIPs) are antigenic for CD4 T cells and can be detected by mass spectrometry in β cells...
February 12, 2016: Science
Peter Larsen, Rasmus Elsoe, Thomas Graven-Nielsen, Uffe Laessoe, Sten Rasmussen
OBJECTIVES:   Knee pain is accepted as a common complication to intramedullary nailing of tibial fractures. However, no studies have systematically studied the pain sequel following tibial fractures. The objective of this study was to assess pain and hyperalgesia from 6 weeks to 12 months postoperatively after intramedullary nailing of tibial shaft fracture. METHODS:   A total of 39 patients were included in this 12-month follow-up study. After 6 weeks, 3, 6, and 12 months postoperatively the pain intensity was measured on a visual analog scale (VAS) and the pressure pain sensitivity was assessed bilaterally by pain pressure thresholds (PPTs)...
June 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
B Frenckner
Extracorporeal membrane oxygenation (ECMO) is a method for providing long-term treatment of a patient in a modified heart-lung machine. Desaturated blood is drained from the patient, oxygenated and pumped back to a major vein or artery. ECMO supports heart and lung function and may be used in severe heart and/or lung failure when conventional intensive care fails. The Stockholm programme started in 1987 with treatment of neonates. In 1995, the first adult patient was accepted onto the programme. Interhospital transportation during ECMO was started in 1996, which enabled retrieval of extremely unstable patients during ECMO...
December 2015: Journal of Internal Medicine
Rasmus Elsøe, Peter Larsen, Sten Rasmussen, Hans Ager Hansen, Christian Berre Eriksen
INTRODUCTION: The outcomes and complications following surgical treatment of tibial plateau fractures have been widely reported. The objective of this study was to evaluate the quality of life (QoL), functional and radiological outcomes after lateral tibial plateau fractures, Arbeitsgemeinschaft für Osteosynthesefragen (AO) type 41-B2 and B3, treated with minimally invasive bone tamp reduction, allograft and percutaneous screw fixation. METHODS: This study was a cross-sectional study and a retrospective review and clinical evaluation of patients treated with minimally invasive bone tamp reduction, allograft and percutaneous screw fixation after lateral tibial plateau fractures between 2005 and 2010...
January 2016: Danish Medical Journal
P Larsen, L Koelner-Augustson, R Elsoe, J Petruskevicius, S Rasmussen
INTRODUCTION: The objective of the present study was to evaluate the relationship between clinical outcome and time of day of surgery and experience level of the surgeon. Secondly, we examined the relationship between the length of hospital stay and the time of day of surgery. METHODS: This retrospective cross-sectional cohort design study included patients treated with intramedullary nailing at Aalborg University Hospital from 1998 to 2008 after tibial shaft fractures (N = 294)...
December 18, 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Joseph Posluszny, Peter T Rycus, Robert H Bartlett, Milo Engoren, Jonathan W Haft, William R Lynch, Pauline K Park, Krishnan Raghavendran, Lena M Napolitano
OBJECTIVE: To examine the outcomes of prolonged (≥14 days) extracorporeal membrane oxygenation (P-ECMO) for adult severe respiratory failure and to assess characteristics associated with survival. BACKGROUND: The use of ECMO for treatment of severe respiratory adult patients is associated with overall survival rates of 50% to 70% with median ECMO duration of 10 days. No prior multi-institutional studies have examined outcomes of P-ECMO for severe respiratory failure...
March 2016: Annals of Surgery
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