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- Rajan, S., et al.
(författare)
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The Niebauer-Cutter prosthesis in excision arthroplasty of the trapezium
- 1982
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Ingår i: Journal of Hand Surgery, European Volume. - : Sage Publications. - 1753-1934 .- 2043-6289. ; 14:3, s. 295-303
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Tidskriftsartikel (refereegranskat)abstract
- Sixteen patients had excision arthroplasty of the trapezium, using the Niebauer-Cutter prosthesis. The average period of postoperative follow-up was thirteen months. All patients had severe preoperative disabilities and the majority were relieved from resting pain and pain during active use of their hands. The postoperative range of motion with regard to the palmar and radial abduction was found to be satisfactory, while varying degrees of limitation of circumduction was the rule. There was no correlation between the patients' own judgment of the postoperative benefits and the objectively measured range of motion. One patient had a luxation of the prosthesis, while another had a subluxation when opposing the thumb. This frequency of luxation/subluxation seems to be less than that experienced with the other common type of prosthesis, the Swanson prosthesis. Although it is obvious that the ideal prosthesis for treatment of disabilities in the carpometacarpal joint of the thumb is still not available, it was concluded that the Niebauer-Cutter prosthesis is the best choice at the present.
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- Rubboli, Andrea, et al.
(författare)
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Esperienza iniziale sulluso di abciximab nel trattamento di salvataggio della trombosi coronarica acuta nel Laboratorio di Emodinamica [Initial experience with the use of abciximab in the salvage treatment of acute coronary thrombosis in the Hemodynamics Laboratory]
- 1998
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Ingår i: Cardiologia (Rome, Italy). - 0393-1978. ; 43:11, s. 1221-1229
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The optimal treatment of acute thrombotic complications in the Catheterization Laboratory has not been defined yet, due to the limited efficacy shown by various pharmacological regimens, even when associated to coronary angioplasty (PTCA). The aim of our study was therefore to evaluate the effects of abciximab (ReoPro), a new potent inhibitor of the platelet glycoprotein IIb/IIIa, when administered as a rescue treatment for acute thrombotic coronary occlusion during diagnostic or interventional procedures. Sixteen patients (12 males, 4 females, mean age 59.3 +/- 9.2 years, range 43-77 years), with unstable angina and consecutively treated with abciximab due to clinical instability attributable to coronary thrombosis angiographically proven during PTCA (9 cases) or diagnostic angiography (7 cases), were identified. The individual angiographic films and medical records were then reviewed in order to evaluate the effects of treatment on coronary flow, thrombus size and occurrence of in-hospital adverse events: death, non-fatal acute myocardial infarction (AMI), need for urgent myocardial revascularization and hemorrhage. The administration of abciximab, in association with PTCA (associated in turn with stent implantation in 8 cases), induced a significant increase of coronary TIMI flow grade (0.3 +/- 0.6 vs 2.4 +/- 0.9; p less than 0.05) and a significant decrease of thrombus score (size) 2.4 +/- 0.9 vs 1.3 +/- 0.6; p less than 0.01). No deaths nor need for urgent myocardial revascularization were observed; in 31% of cases (5 patients) evolution towards AMI occurred, while however 94% of cases (15 patients) had a coronary occlusion before treatment. No major hemorrhagic complications were observed, while in 12% of cases (2 patients) a groin hematoma associated with moderate hemoglobin drop, developed. In conclusion, the administration of abciximab, associated with the common rescue interventional procedures, in patients with acute thrombotic coronary occlusion in the Catheterization Laboratory, appears to be effective in restoring adequate coronary flow and reducing the thrombus size (limiting therefore the evolution towards AMI), and safe, not having been associated with significant hemorrhagic complications.
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- Öhlund, Carl, et al.
(författare)
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Calf compression for prevention of thromboembolism following hip surgery
- 1983
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Ingår i: Acta Orthopaedica. - : Informa Healthcare. - 1745-3674 .- 1745-3682 .- 0001-6470. ; 54:6, s. 896-899
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Tidskriftsartikel (refereegranskat)abstract
- A prospective, randomized trial of the effect of graded compression of the calf was done in 62 patients operated on electively for hip disease. After total hip arthroplasty, compression reduced the number of positive fibrinogen uptake tests by two-thirds, significant only in males, who seem to run a higher risk of thrombosis than females.
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- Aspelin, P., et al.
(författare)
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Cost-effectiveness of iodixanol in patients at high risk of contrast-induced nephropathy
- 2005
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 149:2, s. 298-303
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Forskningsöversikt (refereegranskat)abstract
- Background: Acute renal failure after contrast-induced nephropathy is a clinically important and costly complication after the use of iodine-based contrast media. We investigated the cost and cost-effectiveness of 2 contrast media in patients at high risk of contrast-induced nephropathy. Methods: The analyses were based on a randomized, prospective, multinational clinical study comparing the nephrotoxic effects of an isosmolar nonionic contrast medium, iodixanol, with those of a low-osmolar nonionic contrast medium, iohexol. Resource utilization data were obtained from the study and from a retrospective review of patients' hospital records. Swedish, German, and French unit prices were applied to resources used. Between-group differences in average costs were analyzed using a nonparametric bootstrap method. Results: Resource utilization data for 125 patients were analyzed. Seven contrast media-related serious adverse reactions, of which 6 were acute renal failures, were noted in 6 patients receiving iohexol. Two patients in the iodixanol group had 1 nonserious reaction each. The mean hospitalization cost per patient was €489, €573, and €393 lower after iodixanol than after iohexol using Swedish, German, and French unit prices, respectively. The mean per-patient costs of treating adverse drug reactions were €371, €399, and €445 lower after iodixanol than after iohexol, using the respective unit prices (P = 0.01). Iodixanol was cost-effective compared with iohexol, with both lower costs and better effects related to fewer adverse drug reactions. Conclusions: The isosmolar contrast medium iodixanol appears to be cost-effective when compared with a low-osmolar contrast medium, iohexol, in diabetic patients with renal impairment undergoing angiography. © 2005, Elsevier Inc. All rights reserved.
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- Aspelin, P, et al.
(författare)
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Nephrotoxic effects in high-risk patients undergoing angiography
- 2003
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 348:6, s. 491-499
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of iodinated contrast medium can result in nephropathy. Whether iso-osmolar contrast medium is less nephrotoxic than low-osmolar contrast medium in high-risk patients is uncertain. METHODS: We conducted a randomized, double-blind, prospective, multicenter study comparing the nephrotoxic effects of an iso-osmolar, dimeric, nonionic contrast medium, iodixanol, with those of a low-osmolar, nonionic, monomeric contrast medium, iohexol. The study involved 129 patients with diabetes with serum creatinine concentrations of 1.5 to 3.5 mg per deciliter who underwent coronary or aortofemoral angiography. The primary end point was the peak increase from base line in the creatinine concentration during the three days after angiography. Other end points were an increase in the creatinine concentration of 0.5 mg per deciliter or more, an increase of 1.0 mg per deciliter or more, and a change in the creatinine concentration from day 0 to day 7. RESULTS: The creatinine concentration increased significantly less in patients who received iodixanol. From day 0 to day 3, the mean peak increase in creatinine was 0.13 mg per deciliter in the iodixanol group and 0.55 mg per deciliter in the iohexol group (P=0.001, the increase with iodixanol minus the increase with iohexol, -0.42 mg per deciliter [95 percent confidence interval, -0.73 to -0.22]). Two of the 64 patients in the iodixanol group (3 percent) had an increase in the creatinine concentration of 0.5 mg per deciliter or more, as compared with 17 of the 65 patients in the iohexol group (26 percent) (P=0.002, odds ratio for such an increase in the iodixanol group, 0.09 [95 percent confidence interval, 0.02 to 0.41]). No patient receiving iodixanol had an increase of 1.0 mg per deciliter or more, but 10 patients in the iohexol group (15 percent) did. The mean change in the creatinine concentration from day 0 to day 7 was 0.07 mg per deciliter in the iodixanol group and 0.24 mg per deciliter in the iohexol group (P=0.003, value in the iodixanol group minus the value in the iohexol group, -0.17 mg per deciliter [95 percent confidence interval, -0.34 to -0.07]). CONCLUSIONS: Nephropathy induced by contrast medium may be less likely to develop in high-risk patients when iodixanol is used rather than a low-osmolar, nonionic contrast medium.
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