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At least 595 records · Page 33Linked to original sources
PubMed1979

Review of methods for removing cast gold restorations.

Most techniques and devices described for crown removal, in one way or another, destroy the integrity of today's precision cast crowns. There were only three techniques described that do not require drilling a hole, cutting a notch or slot, clamping with claws or jaws, prying with instruments, or grasping with forceps and pliers. These are the copper band filled with cement, the coping of cold-curing acrylic resin, and the Richwil crown remover. The safest and least traumatic of all crown removal devices and techniques is to cut a slot and pry the crown loose. Although the crown is destroyed, damage to the tooth is avoided.

Acrylic Resins↗
PubMed1986

[Removal of an intrauterine device (IUD) and uterine curettage. A report of experiences].

It is reported on 180 patients in whom IUD were removed with simultaneous dilatation and curettage of the uterus because of menstrual irregularities or a long indwelling of the IUD. In addition to the indwelling the age of the patients and the parity are analysed and a survey of the histological findings is given. We explain our position about the necessity of simultaneous D and C, ist risks and economical aspects.

Adult↗
PubMed2006

Multicenter experience with failed and recalled implantable cardioverter-defibrillator pulse generators.

BACKGROUND: Despite the widespread and growing use of implantable cardioverter-defibrillators (ICDs), little information is available regarding their performance or the impact of advanced pacing functions on ICD reliability and longevity. OBJECTIVES: The purpose of this study was to examine the performance of contemporary ICD pulse generators that failed or were replaced because of manufacturers recalls. METHODS: ICD data were entered prospectively by nine participating centers. ICD pulse generator failure was defined as removal from service because the device was not functioning according to the manufacturer's specifications. A recalled ICD was a normally functioning pulse generator that was replaced as the result of a recall or advisory. RESULTS: From 1998 to 2005, 1,220 ICDs failed and 135 were recalled and replaced. The average implant time of failed ICDs was 4.4 +/- 1.5 years and of recalled ICDs was 1.7 +/- 0.8 years. The average implant time of single- and dual-chamber ICDs with rate responsive or cardiac resynchronization (CRT-D) pacing capabilities was significantly shorter than the average implant time of single- or dual-chamber devices without these features (P <.001). ICDs that provided rate responsive or CRT-D pacing failed earlier because of battery depletion (P <.001) and were significantly more prone to unexpected electronic or housing failure (9% vs 5%, P = .008) and recalls (25% vs 1%, P <.0001). Major adverse events included death (n = 2), failure to convert ventricular tachyarrhythmias (n = 6), and inappropriate shocks (n = 11). CONCLUSION: Based on our analysis of failed and recalled devices, the performance of contemporary ICDs has been adversely affected by premature battery depletion, electronic failure, and manufacturers' recalls. Additional studies are needed to precisely estimate ICD longevity and to determine the incidence of unexpected ICD failure.

Defibrillators, Implantable↗
PubMed1994

The North American experience with the UroLume endoprosthesis as a treatment for benign prostatic hyperplasia: long-term results. The North American UroLume Study Group.

OBJECTIVES: To determine the efficacy and safety of the UroLume endoprosthesis as a treatment for obstructive benign prostatic hyperplasia in healthy men. METHODS: One hundred twenty-six men were enrolled prospectively in a multicenter North American Clinical Trial. Ninety-five men (mean age 68 +/- 7 years) had moderate or severe prostatism, whereas 31 participants (mean age 76 +/- 8 years) were in urinary retention. Voiding function for all patients was assessed prior to stent placement and in follow-up at 1, 3, 6, 12, and 24 months with the Madsen-Iversen symptom questionnaire, peak urinary flow rate, postvoid residual urine volume, and cystoscopic examination. RESULTS: For the nonretention cohort at 24-month follow-up, the results were as follows: (1) total symptom score decreased from 14.3 +/- 0.5 preinsertion to 5.4 +/- 0.5 (p < 0.001); (2) peak urinary flow rate increased from 9.1 +/- 0.5 mL/s preinsertion to 13.1 +/- 0.7 mL/s (p < 0.001); and (3) postvoid residual urine volume decreased from 85 +/- 9 mL to 47 +/- 8 mL (p = 0.02). For the retention group, the total symptom score, peak urinary flow rate, and postvoid residual urine volume at 24 months were 4.1 +/- 0.5, 11.4 +/- 1.0 mL/s and 46 +/- 7 mL, respectively. By 12-month follow-up, most endoprostheses were completely covered with urothelium. Although significant long-term complications were minimal, 17 endoprostheses have been explanted for an overall removal rate of 13%. All devices were removed transurethrally without subsequent sequelae to the external urinary sphincter or urethra. CONCLUSIONS: The long-term results from this North American Clinical Trial suggest that the UroLume endoprosthesis can be an effective and safe treatment for properly selected healthy men with obstructive benign prostatic hyperplasia. Randomized clinical trials comparing this minimally invasive procedure with transurethral resection of the prostate are now underway to document further its efficacy and safety.

Aged↗
PubMed2002

Uptake pharmacokinetics of the Fentanyl Oralet in children scheduled for central venous access removal: implications for the timing of initiating painful procedures.

BACKGROUND: The Fentanyl Oralet (Abbott Laboratories, Abbott Park, IL, USA) is an oral transmucosal drug delivery system. We previously examined pharmacokinetic parameters of children who had completed consumption of the Fentanyl Oralet. The present study was designed to clarify pharmacokinetic parameters during the consumption phase to determine if there is an optimal administration time before painful procedures. METHODS: Patients, aged 3-10 years, who were scheduled for elective removal of central venous access devices under general anaesthesia, received a Fentanyl Oralet (fentanyl 10-15 microg x kg(-1)). Plasma fentanyl concentrations were measured by radioimmunoassay. Data from blood samples obtained during and after consumption of the Fentanyl Oralet from 17 patients in the present study were combined with data from our previous study to better characterize both the consumption and postconsumption concentration versus time profiles. RESULTS: Estimated fentanyl bioavailability (mean +/- SD) was low (36.1 +/- 0.4%), as were peak plasma concentrations (1.03 +/- 0.31 ng.ml-1), suggesting that many children swallowed a large fraction of the dose. This led to a relatively late and variable peak concentration time of 53 +/- 40 min. In addition, because of the apparently large degree of gastrointestinal absorption, concentration versus time curves were wide and flat. CONCLUSIONS: The wide and flat concentration versus time profile may allow flexibility in the timing of a painful procedure following Fentanyl Oralet administration. However, the variability of the time to peak concentration makes it difficult to suggest a minimum interval between Fentanyl Oralet consumption and the start of a painful procedure.

Administration, Buccal↗
PubMed1976

Surgical treatment of acromioclavicular dislocation.

The results of surgical treatment of 17 patients with complete acrominoclavicular dislocation are presented. The operative procedure described is technically easy, gives good results, has few complications which often follow operations using metallic fixation devices. A second operation to remove fixation devices is avoided.

Acromioclavicular Joint↗
PubMedDate not supplied

Evaluation of a polymer implanted port access device.

UNLABELLED: The implanted port vascular access system has provided many patients with safe and reliable vascular access. Its implanted design provides improved body image, reduced maintenance and a better quality of life. The Huber needle has been the standard means of accessing the implanted port system. Because of the problems associated with the Huber needle system, current standards recommend that the Huber needle be changed every 7 days. This evaluation examines the use of a polymer cannula to access the implanted port system. This polymer cannula eliminates many of the problems associated with the Huber needle and provides longer dwell times without increased complications. Seventy nine patients were accessed for a total of 1533 days with the mean dwell time being 19.4 days with no increase in complications associated with port access. OBJECTIVE: To establish implanted port access times of greater than 7 days without increased complications. DESIGN: A multicenter voluntary enrollment evaluation of a medical device. PATIENTS: Patients were offered the opportunity to participate in the evaluation if they had an implanted port and were going to be accessed for therapy for periods of 7 days or more. MEASUREMENTS: Patients were observed for adverse cutaneous reactions at the insertion site and any port access complications such as sepsis, leakage, changes in portal chamber integrity, and implant pocket integrity. RESULTS: From October 1994 through November 1995, 79 L-Cath for Ports (Luther Medical Products) polymer catheter port access devices (Illustration 1) were inserted in 54 patients. This polymer port access device was used instead of a rigid metal Huber needle for port access. The total number of access days was 1533 days with the mean duration of access being 19.4 days. Two patients experienced blood stream infections while they were accessed with the polymer port access device. These infections ensued with fever of unknown origin as the presenting symptom during neutropenic episodes after chemotherapy treatment. The port access device was removed and the port access device tip was cultured with culture results being negative. No other patients experienced complications related to the port access device. CONCLUSION: The polymer port access device provided a safe and effective means of extending port access times. This reduced the number of restarts for the patients and could extend portal septum life by exposing the portal septum to fewer accesses.

Catheters, Indwelling↗
PubMed2006

Efficacy of intrauterine lidocaine for removal of a "lost" intrauterine device: a randomized, controlled trial.

OBJECTIVE: To evaluate the efficacy of intrauterine lidocaine instillation in reducing patient discomfort during the removal of a "lost" intrauterine device (IUD). METHODS: This double-blinded, randomized, placebo-controlled trial included 68 women who underwent removal procedure for a "lost" IUD. Thirty-four women were allocated to the lidocaine group and 34 to the saline group. The main outcome measure was the intensity of pain during, immediately after, and 20 minutes after the procedure, assessed by a visual analog scale. Statistical analysis was performed using the Friedman test with Bonferroni correction, Student t test, and chi2. RESULTS: There were no statistically significant differences between the study group and the control group in mean age, parity history of chronic pelvic pain and dysmenorrhea, history of curettage, education, socioeconomic status, menopausal status, breastfeeding, type of IUD, and duration of IUD. Pain scores demonstrated a significant difference between groups during the procedure (placebo 6.41 +/- 1.15, lidocaine 5.23 +/- 0.69, P < .01), immediately after procedure (placebo 6.05 +/- 1.01, lidocaine 4.94 +/- 0.60, P < .01), and 20 minutes after procedure (placebo 4.32 +/- 0.63, lidocaine 4.44 +/- 0.66, P < .01). The number needed to treat was 3 (95% confidence interval 2-9). CONCLUSION: Intrauterine lidocaine appears to be effective in decreasing pain in women undergoing the removal procedure of a "lost" IUD. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov, NCT00308841. LEVEL OF EVIDENCE: I.

Administration, Topical↗
PubMed2006

Management of acute respiratory distress syndrome using pumpless extracorporeal lung assist.

PURPOSE: To describe the use of a pumpless extracorporeal lung assist device in the treatment of severe acute respiratory distress syndrome (ARDS). CLINICAL FEATURES: A 15-yr-old girl developed severe post-traumatic ARDS. After all conventional treatment strategies failed, we inserted a pumpless extracorporeal lung assist device. This device consists of an arterial cannula inserted into the femoral artery, and a membrane oxygenator with a venous cannula that returns the oxygenated blood back to the patient's femoral vein. Since the driving force is the patient's blood pressure, a roller pump with its negative side effects is not needed. The device allowed removal of excessive PaCO(2) and, by applying minimal ventilation, minimization of further ventilator-induced lung injury. The pumpless extracorporeal lung assist device remained in situ for ten days without any adverse side effect. During this time, the lung recovered such that mechanical ventilation could be reinstalled cautiously. The device was then removed and, after a prolonged period of intensive care, the patient recovered without any sequelae. CONCLUSION: In this case of a severely damaged lung, an arteriovenous pumpless extracorporeal lung assist was a helpful device to remove elevated CO(2) and reduce mechanical stress by applying minimal ventilation. This device is simple to operate and has the potential of being used routinely in the treatment of severe ARDS.

Adolescent↗
PubMed1988

Ultrasound-guided intrauterine removal of intrauterine contraceptive devices in pregnancy.

The risk to the embryo and to the mother when pregnancy results with an intrauterine device (IUD) in the uterus is well documented. Current advice in such cases is to remove the IUD if the string is visible; proper management when the string is not accessible is controversial. In four such cases, we were able to remove the IUDs from inside the uterine cavity using a small alligator forceps guided by high-resolution ultrasound. All four pregnancies progressed successfully to term. Based on the literature and our own experience, we recommend removal of IUDs or therapeutic abortion when pregnancy occurs with an IUD in situ.

Adult↗
PubMed2003

Dynamic hip screw removal using a blade plate extraction device.

Dynamic hip screw implants are extracted by removing the side plate and compression screws. Occasionally, ingrown bone will prevent easy plate removal. A common solution is to use an osteotome as a levering device; however, the stress riser on the proximal femur caused by this maneuver could result in a catastrophic fracture. A blade plate extraction device fits into the dynamic hip screw side plate and allows relatively atraumatic removal of the implant, preventing the use of excessive force and decreasing the risk of an intraoperative fracture.

Bone Plates↗
PubMed1993

Complicated removal of the distal locking device of Brooker-Wills.

Fractures of the femur in two women, ages 17 and 27, were treated with Brooker-Wills nails. While the distal deployment device was inserted into the nail in one patient, the tip of the driver/inserter broke into the proximal end of the distal deployment device. This complicated the extraction of the nail and the distal locking device after healing of the fracture. In the other patient, removal of the distal locking device and the nail was complicated by inability to engage the tip of the driver inserter into the proximal end of the distal deployment device. The method described here facilitates removal of nails and the distal locks.

Adolescent↗
PubMed1997

Efficacy, cleaning ability and safety of different devices for gutta-percha removal in root canal retreatment.

The purpose of this study was to evaluate the efficacy, cleaning ability and safety of five different devices and techniques to remove gutta-percha root canal fillings. One hundred and twenty extracted single-rooted anterior and premolar teeth were enlarged to ISO size 35 and obturated with laterally condensed gutta-percha using AH 26 as the sealer. Removal of gutta-percha was performed with the following devices and techniques: (a) Gates-Glidden and Hedstrom files, (b) only Hedstrom files, (c) Hedstrom files and chloroform, (d) the Endotec and Hedstrom files, and (e) the XGP drill and Hedstrom files. The following data were recorded: time taken to reach the desired working length, time required for the removal of the gutta-percha, and the amount of material extruded apically. The teeth were split longitudinally and photographed. Cleanliness of the root canal walls was scored using the projected slides with a total magnification of approximately 70x. The fastest technique to reach the working length was using the XGP drill (e), followed by the Gates-Glidden drills (a), Hedstrom files and chloroform (c), and the Endotec device (d). The use of Hedstrom files (b) without any additional support proved to be most time-consuming. Differences were statistically significant (U-test, P > 0.05) between the rotary devices and the manual techniques. Time for complete removal of gutta-percha was again shortest with the XGP drills (e), followed by the Gates-Glidden burs (a), the Endotec device (d), Hedstrom files with chloroform (c), and Hedstrom files alone (b). The XGP burs and the Gates-Glidden drills worked significantly faster than the other techniques. The amount of debris and filling material extruded apically in most cases did not exceed 0.1 mg. No significant differences could be detected between the groups (U-test, P > 0.05). Root canal cleanliness proved best following the use of Hedstrom files without additional support (b) and the Gates-Glidden drills (a), followed by Hedstrom files in combination with chloroform (c), the XGP-gutta-percha remover (e), and the Endotec device (d). When using the XGP two instrument fractures occurred in the apical parts of the root canals preventing further instrumentation to the apical foramen. When using the Gates-Glidden burs four instrument fractures occurred, but all fragments could be removed with forceps immediately. The results suggest that the XGP gutta-percha remover and the Gates-Glidden drills are efficient and time saving devices to remove gutta-percha but include a certain risk of instrument breakage and may leave some filling material inside the root canal. The best root canal cleanliness was achieved with Hedstrom files alone which, on the other hand, were shown to be the most time-consuming.

Evaluation Studies as Topic↗
PubMedDate not supplied

Intra-articular migration of a sutureless arthroscopic rotator cuff fixation device.

Rotator cuff tears are a common orthopaedic condition. Recent new advances in arthroscopic equipment and devices has allowed many rotator cuff tears to be repaired arthroscopically. Some of these newer devices allow sutureless repair of rotator cuff tears. We report a case of failure in intra-articular migration of such a fixation device. Displacement of the device was noted 4 months after surgery on magnetic resonance arthography. The device was removed arthroscopically with no long-term sequelae. Nevertheless, it is important to recognize that these devices have the potential for intra-articular migration. Due diligence is required in placing these devices. As with all arthroscopic procedures, there appears to be a learning curve associated with the use of sutureless rotator cuff repair fixation devices.

Aged↗
PubMed2004

Removal times and techniques of a viscoadaptive ophthalmic viscosurgical device.

PURPOSE: To analyze removal techniques for Healon5 (sodium hyaluronate 2.3%). SETTING: Center for Research on Ocular Therapeutics and Biodevices, Charleston, South Carolina, USA, and Department of Ophthalmology, Ruprecht-Karls-University, Heidelberg, Germany. METHODS: In a standardized laboratory setup, the Miyake-Apple posterior view video technique in human autopsy eyes was used to evaluate removal of an ophthalmic viscosurgical device (OVD) from capsular bags implanted with poly(methyl methacrylate), silicone, and acrylic intraocular lenses (IOLs). Healon5 was stained with fluorescein for better visualization. Open-sky preparation and an Alcon Legacy Series 20000 phaco machine with a flow rate of 25 mL/minute and a vacuum setting of +500 mm Hg (maximum irrigation/aspiration [I/A]) were used. With Technique 1, the I/A tip was placed on the center of the IOL and maximum aspiration was applied. With Technique 2 (modified rock 'n roll technique), the I/A tip was moved in quick circular movements on top of the IOL to break the OVD chains and facilitate aspiration. RESULTS: With Technique 1, the mean removal time was 59.0 seconds +/- 23.1 (SD) and with Technique 2, 23.6 +/- 10.3 seconds (P =.004). The removal time of Healon5 correlated with the IOL material. With Technique 2, removal was fastest with silicone IOLs (13.5 +/- 2.1 seconds) followed by PMMA IOLs (17.5 +/- 2.1 seconds). With acrylic IOLs, remnants of the OVD trapped behind the IOL optic resulted in a longer removal time of 34.1 +/- 1.2 seconds. CONCLUSIONS: Healon5 was completely removed from the capsular bag with the modified rock 'n roll technique. With acrylic IOLs, remnants can be trapped behind the optic and may be overlooked with an unstained OVD. Aspiration behind the optic is recommended with this IOL type.

Acrylic Resins↗