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At least 631 records · Page 35Linked to original sources
PubMed2003

[Long term experience with the LifeSite hemodialysis device].

We present the first report on the long term use of the LifeSite hemodialysis access system in patients who have no possibility of arteriovenous fistula creation. This system consist of a titanium alloy valve and silicone catheter which is placed in a central vein. Conventionally two devices are placed for optimal blood draw and return but single needle dialysis is possible using only one device. We have used this system in six patients since February 1999. Four patients continue to use the LifeSite for dialysis while one patient transferred to peritoneal dialysis because of hemodynamic instability during dialysis and one patient died of mesenteric infarction. Blood flow using two devices is excellent (300-345 ml/min). The infection rate is low (about 1.7 episodes per 1,000 days) and most patients were successfully treated without the need to remove the device. Two patients required temporary removal of one device because of local infection. While this, they were dialysed via a single needle using the remaining device. In our experience the LifeSite system appears a useful alternative in patients in whom a native fistula is not possible and it is able to provide effective dialysis for at least three years.

Adult↗
PubMed2006

Safety study of the Cochlear Nucleus 24 device with internal magnet in the 1.5 Tesla magnetic resonance imaging scanner.

OBJECTIVES: To evaluate the effect of the 1.5 Tesla magnetic resonance imager (MRI) on the Cochlear Nucleus 24 Device without removing the internal magnet. To determine whether device fixation using a compression dressing could prevent internal magnet displacement in the MRI scanner and potentially obviate the need for surgical removal of the internal magnet. STUDY DESIGN: Prospective cadaveric study. METHODS: Four cadaver heads were implanted bilaterally with the Nucleus device with the internal magnet in place and placed into the 1.5 Tesla MRI scanner. The devices were then explanted after interaction with the MRI and evaluated for displacement of the internal magnet. Conditions tested include device fixation with a commercially available compression dressing and no fixation (worst-case scenario). Magnet strength was measured before and after each of the test conditions. RESULTS: Moderate to severe displacement of the magnet from the internal device occurred in 14 of 16 (87%) implants when no compression dressing was placed. Displacement occurred in 0 of 16 (0%) implants when the compression dressing was applied. No decrease in the strength of the implant magnet was found with the initial or subsequent MRI/implant interactions. CONCLUSIONS: Use of the 1.5 Tesla MRI on subjects with Cochlear Nucleus 24 implants did not result in any significant demagnetization of the internal magnet and did not cause displacement of the magnet when an external compression dressing was applied. Surgical removal of the internal magnet before scanning with the 1.5 Tesla MRI may not be necessary if a compression dressing is applied.

Cadaver↗
PubMed1998

Intra-aortic balloon counterpulsation in patients with severe cardiac dysfunction undergoing abdominal operations.

OBJECTIVE: To assess the effectiveness of intra-aortic balloon counterpulsation (IABC) as adjunctive treatment in patients undergoing abdominal operations. DESIGN: Retrospective review of patient medical records to determine the incidence of mortality following abdominal surgery and the incidence of complications from IABC. SETTING: University-based, tertiary care hospital. PATIENTS: Sixty-eight patients who underwent an abdominal operation and IABC during the same hospitalization were divided into the following groups: Group 1, IABC initiated prior to operation to enhance perioperative cardiac function; group 2, IABC used to treat cardiogenic shock in a patient who subsequently required an operation while undergoing IABC; and group 3, IABC device inserted and removed for treatment of cardiogenic shock in a patient who subsequently required an operation within 30 days of removal of the device. MAIN OUTCOME MEASURES: The incidence of mortality in IABC-supported patients and IABC-related complications. RESULTS: In group 1, excluding 3 patients who died following emergency operation, 26 patients underwent nonemergency procedures and had a 12% mortality rate. In group 2, 5 of 6 patients who underwent emergency operations died, whereas 3 of 4 patients who required only urgent operations survived. In group 3, 18 (62%) of 29 patients who underwent urgent or emergent operations died postoperatively. Thirteen patients experienced complications related to IABC; there were no deaths and no limbs were lost to ischemia. CONCLUSIONS: This is the largest reported series looking at the utility of IABC as adjunctive treatment for patients undergoing abdominal operations. The outcome for those patients requiring emergency operations remains poor, but it is likely that more liberal use of IABC in patients with severe cardiac dysfunction who require nonemergency operations may improve patient outcome.

Abdomen↗
PubMed1996

Reproductive performance of lactating dairy cows following oestrus synchronisation with progesterone, oestradiol and prostaglandin.

The ability to synchronise onset of oestrus, and hence the time of breeding and calving, offers potential economic and management benefits to dairy farmers, especially in herds with seasonally concentrated calving patterns. A trial involving 2681 cows in 11 seasonal herds was conducted to evaluate the reproductive performance of lactating dairy cows following oestrus synchronisation with a combination of progesterone, oestradiol and prostaglandin. Cows were randomly assigned within herds to synchronised and control groups, balanced for age, date of calving, body condition and breed. Cows in the synchronised group were treated with an intravaginal progesterone-releasing device containing 1.9 g of progesterone and a gelatin capsule containing 10 mg of oestradiol benzoate 10 days prior to the planned start of the breeding season (Day 0). The device was removed 8 days later on Day -2 and a luteolytic dose of prostaglandin F2alpha was administered 2 days prior to removal of the progesterone-releasing device. Returns to service for cows in the synchronised group were synchronised by inserting a previously used intravaginal device during Days 16-21 after the start of the breeding season. Cows in the control group were left untreated. The percentage of cows being inseminated during the first 5 days was 89.0% for the synchronised group compared to 29.7% for the control group. Compared to cows in the control group, those in the synchronised group had a lower conception rate to the first insemination (52.9% v. 64.3%, p<0.001), a lower conception rate to the second insemination (51.8% v. 62.5%, p<0.001), a higher percentage of empty cows at the end of the breeding season (7.3% v. 5.1%, p<0.05), and more insemination services per pregnancy to artificial insemination (2.0 v. 1.6, p<0.001). There was no difference between the synchronised and control groups in the percentage of cows pregnant to artificial insemination (81.8% v. 85.5%, p>0.10). The mean day of conception from the start of the breeding season was advanced (p>0.0 1) by 1.3 days in synchronised cows (19.9 +/- 0.7 days; mean +/- SEM) compared to control cows (21.2 +/- 0.5 days). It is concluded that the oestrus synchronisation regime used in the present study caused a reduction in fertility, which reduced the potential gains from using such a programme to increase reproductive efficiency in dairy cows.

Journal Article↗
PubMed2006

Removing well-fixed total knee arthroplasty implants.

UNLABELLED: Revision total knee arthroplasty requires the removal of one or all of the prior knee components. Thoughtful and careful removal of well-fixed total knee components can preserve host bone stock and facilitate subsequent reconstructive efforts. The tools and techniques for knee component removal include simple osteotomes, saws, extraction devices, ultrasonic devices, and frequently a combination of some or all of the above. It is the unique nature of each revision arthroplasty, which presents the surgeon with such challenge. Each of the techniques discussed in this review reflects the anecdotal experience acquired in over 800 revision total knee arthroplasties performed at our center. We review our empiric bias regarding the individual applicability of these techniques. LEVEL OF EVIDENCE: Therapeutic studies, Level V (expert opinion). See Guidelines for Authors for a complete description of Levels of Evidence.

Arthroplasty, Replacement, Knee↗
PubMed1982

Studies on uterine tract infections and the IUCD with special reference to actinomycetes.

Since the advent of the plastic IUCD, an increasing number of patients with clinical pelvic actinomycosis have been reported in the literature and in a very much larger number of women, actinomycetes have been identified in cervical smears, either by Papanicolaou stain or specific immunofluorescence. After a 3-year study, we have concluded that actinomycetes can readily be cultured when the growth of more rapidly growing anaerobes is inhibited by metronidazole and anaerobic culture is continued for up to 14 days. We consider that actinomycetes form part of a polymicrobial anaerobic infestation developing in the presence of a foreign body. The organisms are found almost exclusively in women who have used all-plastic IUCDs for a long term and, from a continuing study, it is apparent that most disappear rapidly when the plastic device is removed or replaced by a copper device. Significant symptomatic evidence of infection is found in a small proportion of patients who are actinomycete-positive.

Actinomycetales↗
PubMed2002

Rescue balloon procedure for an emergency situation during coil embolization for cerebral aneurysms. Technical note.

In this article the authors describe a rescue balloon procedure for coil implantation in three cases. In each patient, the coil seemed likely to unravel. The coils stretched when attempts were made to remove the partially implanted but trapped device. The inflation of a nondetachable microballoon in front of the aneurysm orifice allowed the surgeons to complete implantation of the coil and to avoid a more forceful and potentially harmful retrieval. This rescue balloon method may be useful for emergency situations, such as coil stretching with or without migration.

Adult↗
PubMed2002

Ruptured intra-aortic balloon pump. A case report.

The intra-aortic balloon pump (IABP) is the gold standard for the mechanical assistance of failing heart. Balloon rupture is a potential complication that may result in a retained device. The operative removal by direct exposure of the femoral vessels has previously been described. We report the case of a retained IABP requiring laparotomy and direct aortic exposure for removal of the device.

Aged↗
PubMed2006

Laparoscopic transgastric removal of an eroded Angelchik prosthesis.

The Angelchik prosthesis is a silicone gel-filled implant historically placed around the gastroesophageal junction for the treatment of gastroesophageal reflux disease. Herein, we describe the laparoscopic transgastric removal of an Angelchik prosthesis that had eroded through the gastroesophageal junction of a patient 25 years after its placement. Under direct laparoscopic and endoscopic guidance, laparoscopic trocars were placed transabdominally, directly into the gastric lumen. Using 2-mm instrumentation, the prosthesis was transected, endoscopically snared, and removed perorally. The patient was discharged after a 3-day hospital stay. This is the first published description of a laparoscopic, transgastric approach to removal of a partially eroded prosthetic device to the stomach.

Aged↗
PubMed1993

[Removal of incarcerated intrauterine devices by combined methods].

Incarcerated IUDs are difficult to manage. Through clinical analysis of 41 cases with incarcerated IUDs, the value of X-ray, ultrasonographic and hysteroscopic examinations in combined use was assessed, especially in locating and describing the concrete shape of the incarcerated IUD before and during the removal operations. With the aid of these diagnostic methods 39 IUDs (95.12%) were removed through the vaginal route, while the remaining 2 (4.88%) were taken out by laparotomy, one had hyperplasia of the endometrium accompanied by retained broken pieces of the IUD, the other had uterine anomaly (uterus didelphys) with an incarcerated IUD. 40 out of the 41 IUDs were stainless steel rings, and only 1 was a Cu V IUD. The advantages and drawbacks of the three above-mentioned diagnostic were discussed as well as the effect of use. The different method of IUD removal were described.

Adult↗
PubMedDate not supplied

Perforation of the rectum by a Copper-T intra-uterine contraceptive device; a case report.

A case of a rare complication of a Copper-T intra-uterine contraceptive device (IUCD) producing uterine and rectal perforation is reported. The patient presented with the threads of the IUCD protruding through the anus and the device was removed from the rectum using a proctoscope. A review of the literature revealed only seven cases of perforation of the rectosigmoid by an IUCD in which the device was removed per rectum, and this report documents the first of such cases involving a Copper-T. Proctosigmoidoscopic evaluation is recommended whenever perforation of the rectosigmoid by an IUCD is suspected, since it may select those patients for whom rectal recovery of the IUCD is feasible, thus avoiding unnecessary surgical intervention.

Adult↗
PubMed1993

A new protector device for safe endoscopic removal of sharp gastroesophageal foreign bodies in infants.

The accidental ingestion of sharp foreign bodies into the upper-gastrointestinal tract is not uncommon in children. Endoscopic extraction of these objects poses technical difficulties, and a number of dangerous complications can occur. We present two cases of successful retrieval of large, sharp gastroesophageal foreign bodies in small children using a new, commercially available endoscopic end protector hood that prevents exposure of the esophageal and pharyngeal wall to injuries and laceration by the foreign body. This device is simple to use, versatile, and effective and advances the safe endoscopic removal of a variety of gastroesophageal foreign bodies in pediatric patients.

Child, Preschool↗
PubMed2006

Evaluation of a vessel-sealing device for laparoscopic granulosa cell tumor removal in standing mares.

OBJECTIVE: To describe a laparoscopic technique for granulosa cell tumor removal using a vessel sealing device (LigaSuretrade mark) in standing mares. STUDY DESIGN: Retrospective study. ANIMALS: Eight mares (8-24 years old; weighing, 406-525 kg). METHODS: Before surgery, ovarian size and adjacent body wall thickness was determined by ultrasonography. Mares were sedated and after local anesthesia (inverted L and local infiltration), laparoscopic cannulation was performed without insufflation. The mesovarium was anesthetized and the LigaSure instrument applied to the mesovarium for hemostasis and resection to remove the affected ovary. Mares were hospitalized for 24 hours before discharge. RESULTS: Median ovarian diameter was 10.5 cm (range, 6-14 cm). Median surgery time was 75 minutes (range, 40-180 minutes). Hemostasis was achieved using the LigaSure device in all mares. Median length of the abdominal wall incision made to remove the ovary was 13 cm (range, 5-17 cm); no incisional complications occurred. CONCLUSIONS: The LigaSure vessel sealing device provided adequate hemostasis for removal of larger neoplastic ovaries in standing mares. CLINICAL RELEVANCE: Concerns of ligature placement can be alleviated by use of the LigaSure device and standing laparoscopic technique provides excellent observation of the surgical field ensuring hemostasis.

Animals↗
PubMed2003

Resynchrony of previously anoestrous cows and treatment of cows not detected in oestrus that had a palpable corpus luteum with prostaglandin F(2 alpha).

AIMS: To determine if resynchrony, using a progesterone (P4) / oestradiol benzoate (ODB) regime, of previously treated, anovulatory anoestrous (AA) cows would increase the probability of oestrus, conception and pregnancy compared to no resynchrony. Additionally, the effect of prostaglandin F2alpha (PG) treatment of cows not detected in oestrus, but in which a corpus luteum (CL) was palpable transrectally (NDO/CL+), was compared with no treatment. METHODS: Cows not detected in oestrus by 1 week before the start of the seasonal breeding programme were categorised as AA or NDO/CL+, based on absence or presence of a palpable CL, respectively. All AA cows were treated with an intravaginal device containing 1.36 g P4 (CIDR-B) for a period of 6 days, and with 1 mg ODB by intramuscular (I/M) injection 1 day after the device was removed (Day 0). Half the AA cows that were detected in oestrus between Days 0 and 3 were randomly assigned to be resynchronised by reinsertion of a clean used CIDR-B device on Day 15, for a period of 6 days, followed by an I/M injection of 0.5 mg ODB, 1 day after the device was removed (resynchrony, RS), while the other half were not resynchronised (no-RS). NDO/CL+ cows were alternately assigned to be either treated with 25 mg of the PG, dinoprost tromethamine, on Day 0 or left as untreated controls (Con). RESULTS: Resynchrony increased the percentage of cows detected in oestrus between Days 14 and 28 (212/282 = 75.2% vs 155/285 = 54.4%, for RS vs no-RS, respectively; p<0.001), but had no effect on conception rate to a service within the first 3 days of the mating period (146/397 = 36.8% vs 148/399= 37.1%, for RS vs no-RS cows, respectively; p>0.9), or to a service between Days 14 and 28 (84/159 = 52.8% vs 114/217 = 52.5%, for RS vs no-RS cows, respectively; p>0.9). Resynchrony increased the Day 28 pregnancy rate (264/432 = 61.1% vs 237/435 = 54.5%, for RS vs no-RS cows, respectively; p=0.03), but had no effect on the Day 56 or final pregnancy rates (p>0.1).Prostaglandin treatment of NDO/CL+ cows did not affect the percentage of cows detected in oestrus by Day 7 (43/106 = 40.6% vs 51/101 = 50.5%, for Con vs PG, respectively; p=0.15), or Day 28 (92/106 = 86.8% vs 91/101 = 90.1%, for Con vs PG, respectively; p>0.4). Treatment did not affect the Day 28 pregnancy rate (55/103 = 53.4% vs 54/98 = 55.1%, for Con vs PG, respectively; p>0.9), the Day 56 pregnancy rate (81/103 = 78.6% vs 74/98 = 75.5%, for Con vs PG, respectively; p>0.6), or the final pregnancy rate (98/103 = 95.1% vs 89/97 = 91.8%, for Con vs PG, respectively; p>0.3). CONCLUSIONS: Resynchrony of AA cows treated using the present protocol increased the proportion of non-pregnant cows detected in oestrus between Days 14 and 28 and increased the Day 28 pregnancy rate. This resynchrony protocol may be useful for increasing the proportion of the herd pregnant in the first month of the breeding programme, especially in herds that have a history of a low proportion of non-pregnant cows detected in oestrus between Days 14 and 28. There was no benefit in treating NDO/CL+ cows with PG compared to no treatment.

Journal Article↗
PubMed1986

Laparoscopic tubal sterilization combined with removal of an intrauterine contraceptive device. A report of 49 cases.

A retrospective study was done on 49 patients who underwent removal of an intrauterine device (IUD) and laparoscopic sterilization as a combined procedure during a 13-year period at Booth Memorial Medical Center, Flushing, New York. Five patients were given prophylactic antibiotic therapy, one was treated with postoperative antibiotic therapy for an asymptomatic actinomycosis infection of the endometrium, diagnosed on the curettings, and two patients developed postoperative infections requiring antibiotic therapy. Twenty-one patients had endometritis of various degrees diagnosed on the endometrial curettings, but only two developed clinical infections postoperatively. Elimination of those patients receiving prophylactic antibiotics from the study group left 43, of whom 41 (95%) had an uncomplicated postoperative course and did not develop clinical pelvic inflammatory disease even though 15 of them had endometritis diagnosed on curettage. It appears that removal of an IUD at the time of laparoscopic sterilization does not significantly affect the safety or postoperative morbidity of the sterilization procedure.

Adult↗
PubMed1997

Use of the ganciclovir implant for treating cytomegalovirus retinitis secondary to immunosuppression after bone marrow transplantation.

PURPOSE: To report a case in which we treated cytomegalovirus retinitis using an intravitreal ganciclovir sustained-release device in a patient negative for the human immunodeficiency virus, with a history of myeloproliferative syndrome with myelofibrosis and profound immunosuppression after allogeneic bone marrow transplantation. METHODS: Case report. Review of medical records and fundus photographs. RESULTS: After the ganciclovir device was implanted, the cytomegalovirus retinitis did not progress, and visual acuity improved. We removed the device 9 months after implantation. CONCLUSIONS: The ganciclovir sustained-release device may be useful for treating cytomegalovirus retinitis in patients without the acquired immunodeficiency syndrome who are profoundly immunosuppressed and fail conventional intravenous therapy. If immune suppression is of limited duration, the device can be removed.

Antiviral Agents↗