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- Skari, H, et al.
(författare)
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Congenital diaphragmatic hernia: a survey of practice in Scandinavia
- 2004
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Ingår i: Pediatric Surgery International. - : Springer Science and Business Media LLC. - 1437-9813 .- 0179-0358. ; 20:5, s. 309-313
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Tidskriftsartikel (refereegranskat)abstract
- There is no consensus on the treatment of congenital diaphragmatic hernia (CDH), and practice seems to vary between centres. The main purpose of the present study was to survey current practice in Scandinavia. Thirteen paediatric surgical centres serving a population of about 22 million were invited, and all participated. One questionnaire was completed at each centre. The questionnaire evaluated management following prenatal diagnosis, intensive care strategies, operative treatment, and long-term follow-up. Survival data (1995-1998) were available from 12 of 13 centres. Following prenatal diagnosis of CDH, vaginal delivery and maternal steroids were used at eight and six centres, respectively. All centres used high-frequency oscillation ventilation (HFOV), nitric oxide (NO), and surfactant comparatively often. Five centres had extracorporeal membrane oxygenation (ECMO) facilities, and four centres transferred ECMO candidates. The majority of centres (7/9) always tried HFOV before ECMO was instituted. Surgery was performed when the neonate was clinically stable (11/13) and when no signs of pulmonary hypertension were detected by echo-Doppler (6/13). The repair was performed by laparotomy at all centres and most commonly with nonabsorbable sutures (8/13). Thoracic drain was used routinely at seven centres. Long-term follow-up at a paediatric surgical centre was uncommon (3/13). Only three centres treated more than five CDH patients per year. Comparing survival in centres treating more than five with those treating five or fewer CDH patients per year, there was a tendency towards better survival in the higher-volume centres (72.4%) than in the centres with lower volume (58.7%), p =0.065.
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| 3. |
- Bock G., Roberts R.G., Kissling E., Achauer A., Alingahi J., Bruneton M., Friedrich W., Grad M. Guterch A., Hjelt S-E., Hyvönen T., Ikonen J-P., Komminaho K., Korja A, Heikkinen P., Kozolovaskaya E., Nevsky M.V., Pavlenkova N., Pedersen H., Plomerova J.
(författare)
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Seismic probing of Archean and Proterozoic Lithosphere in Fennoscandia.
- 2001
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Ingår i: EOS Transactions American Geophysical Union. - : American Geophysical Union. ; 82, s. 621,628-629
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Bringman, S., et al.
(författare)
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Is a dissection balloon beneficial in totally extraperitoneal endoscopic hernioplasty (TEP)? A randomized prospective multicenter study
- 2001
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Ingår i: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 15:3, s. 266-270
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Tidskriftsartikel (refereegranskat)abstract
- Background: Laparoscopic hernioplasty has been criticized because of its technical complexity and increased costs. Disposable dissection balloons can be used to facilitate the creation of the initial working space in totally extraperitoneal endoscopic hernioplasty (TEP), but their use adds to the cost of the operation. Methods: A total of 322 men with unilateral, primary, or recurrent inguinal hernias were randomized to undergo TEP with or without a dissection balloon. Results: In the group with the balloon, three of 161 patients (2.5%) required conversion to transabdominal preperitoneal hernioplasty (TAPP), or open herniorraphy, whereas 17 of 161 patients (10.6%) were converted to TAPP or open herniorraphy in the group without the balloon (p = 0.002). The mean operation time was 55 min in the group with the balloon and 63 min in the group without the balloon (p = 0.004). There was no difference between them in postoperative morbidity, and there were no major complications in either group. The recurrence rate was 3.1% in the group with the balloon and 3.7 % in the group without the balloon (p = 0.8). Conclusion: The use of a dissection balloon in TEP reduces the conversion rate and may be especially beneficial early in the learning curve.
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| 9. |
- Heikkinen, T, et al.
(författare)
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Hemiarthroplasty or osteosynthesis in cervical hip fractures: matched-pair analysis in 892 patients
- 2002
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Ingår i: Archives of Orthopaedic and Trauma Surgery. - : Springer Science and Business Media LLC. - 1434-3916 .- 0936-8051. ; 122:3, s. 143-147
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Tidskriftsartikel (refereegranskat)abstract
- Our aim was to compare hemiarthroplasty (HA) and osteosynthesis (OS) in the treatment of cervical hip fractures using matched-pair analysis, especially with regard to different age groups. Data concerning all hip fractures (excluding pathological fractures) at the University Hospitals of Lund in Sweden, where osteosynthesis with LIH hook-pins was used exclusively, and of Oulu in Finland, using mainly cementless Austin-Moore hemiarthroplasty, were registered during 1989-1996 using the same standardized hip fracture forms filled in preoperatively and at 4 months follow-up. Altogether 446 pairs matched for age, sex, place of residence and walking ability at the time of fracture were found. Patients aged 55-80 years seemed to benefit more, with regard to function, from OS than older patients. At 4 months follow-up, 38% of HA and 48% of OS patients lived in their own homes, 16% and 27% were able to walk alone outdoors, and 11% versus 16% were able to walk without any aids, respectively. At I year follow-up, mortality was significantly lower among the OS patients, but the reoperation rate was significantly higher. In conclusion, OS is associated with a better function and lower mortality than HA, especially in younger patients, and it is recommended as the primary treatment for cervical hip fractures in patients younger than 80 years and with good ambulatory capacity, whereas the oldest patients can also be safely treated by HA.
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| 10. |
- Noterdaeme, J. M., et al.
(författare)
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Heating, current drive and energetic particle studies on JET in preparation of ITER operation
- 2003
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 43:3, s. 202-209
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Tidskriftsartikel (refereegranskat)abstract
- This paper summarizes the recent work on JET in the three areas of heating, current drive and energetic particles. The achievements have extended the possibilities of JET, have a direct connection to ITER operation and provide new and interesting physics. Toroidal rotation profiles of plasmas heated far off axis with little or no refuelling or momentum input are hollow with only small differences on whether the power deposition is located on the low field side or on the high field side. With LH current drive the magnetic shear was varied from slightly positive to negative. The improved coupling (through the use of plasma shaping and CD4) allowed up to 3.4 MW of PLH in internal transport barrier (ITB) plasmas with more than 15 MW of combined NBI and ICRF heating. The q-profile with negative magnetic shear and the ITB could be maintained for the duration of the high heating pulse (8 s). Fast ions have been produced in JET with ICRF to simulate alpha particles: by using third harmonic He-4 heating, beam injected He-4 at 120 kV were accelerated to energies above 2 MeV taking advantage of the unique capability of JET to use NBI with 4 He and to confine MeV class ions. ICRF heating was used to replicate the dynamics of alpha heating and the control of an equivalent Q = 10 `burn' was simulated.
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