Articles: surgery.
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In addition to mortality, Health Related Quality of Life (HRQOL) has increasingly been claimed as an important outcome variable. The aim of this study was to assess HRQOL and independence in activities of daily living (ADL) six months after discharge from an Intensive Care Unit (ICU), and to study its determinants. ⋯ ASA-PS, age, type of surgery, ICU LOS and SAPS II could be seen as determinants of HRQOL.
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Drilling procedures are common in orthopedic surgery and are one specific task that may be aided by computer-assisted navigation. However, the inherent flexibility of drill bit bending may make this the limiting factor in achieving acceptable accuracy when using these systems. We designed an alignment device that was fit to a standard orthopedic drill that allowed an extension of the stabilizing point of a drill bit. ⋯ For the trails using the alignment device, the 2.5-mm drill bit was significantly less accurate than the three larger drills. Our results demonstrate that the use of external devices to augment drill bit stabilization can improve drilling accuracy. This may have particular importance when using navigation systems to drill into small anatomic confines.
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Journal of neurosurgery · Jul 2007
Case ReportsReal-time image-guided direct convective perfusion of intrinsic brainstem lesions. Technical note.
Recent preclinical studies have demonstrated that convection-enhanced delivery (CED) can be used to perfuse the brain and brainstem with therapeutic agents while simultaneously tracking their distribution using coinfusion of a surrogate magnetic resonance (MR) imaging tracer. The authors describe a technique for the successful clinical application of this drug delivery and monitoring paradigm to the brainstem. Two patients with progressive intrinsic brainstem lesions (one with Type 2 Gaucher disease and one with a diffuse pontine glioma) were treated with CED of putative therapeutic agents mixed with Gd-diethylenetriamene pentaacetic acid (DTPA). ⋯ Using this technique, CED can be used to safely perfuse targeted regions of diseased brainstem with therapeutic agents. Coinfused imaging surrogate tracers can be used to monitor and control the distribution of therapeutic agents in vivo. Patients with a variety of intrinsic brainstem and other central nervous system disorders may benefit from a similar treatment paradigm.
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Clin Podiatr Med Surg · Jul 2007
ReviewAdvanced plastic surgery techniques for soft tissue coverage of the diabetic foot.
Obtaining stable, durable, and functional wound closure of a diabetic foot wound or open pedal amputation through plastic surgical techniques is essential to limit the potential for repeated ulceration, infection, and "supra-pedal" amputation. Myriad conservative and surgical techniques can be used to obtain wound closure. The authors discuss their approach and present operative pearls for their most commonly employed plastic surgical techniques to provide adequate soft tissue coverage of diabetic foot wounds. Emphasis is placed on the techniques necessary to perform these procedures and the surgical thought process involved in closing diabetic foot wounds.