A comparison of adverse short-term outcomes following forefoot amputation performed on an inpatient versus outpatient basis.

2021 ◽  
Author(s):  
Andrew J. Meyr ◽  
Jennifer Skolnik ◽  
Sara Mateen ◽  
Laura E. Sansosti
Keyword(s):  
Outpatient Basis ◽  
Short Term ◽  
Forefoot Amputation

ESTIMATION OF THE SAFETY OF LOW-INTENSITY LASER RADIATION IN TREATMENT OF PATIENTS WITH PROFESSIONAL POLYNEUROPATHIES OF THE UPPER LIMBS

2021 ◽  
Author(s):  
S.V. Grebenkov ◽  
◽  
N.Y. Malkova ◽  
O.A. Kochetova ◽  
Keyword(s):  
Laser Radiation ◽  
Side Effects ◽  
Upper Extremities ◽  
Projection Area ◽  
Outpatient Basis ◽  
Short Term ◽  
Low Intensity ◽  
Number Of Patients ◽  
Intensity Laser ◽  
Local Side

Abstract: The inclusion of low-intensity laser radiation in the complex treatment of professional polyneuropathies of the upper extremities, due to its numerous biological effects, contributes to a statistically significant reduction in pain in the hands of patients, and improves the conduction of nerve impulses along the peripheral nerves of the hands. In addition to describing the positive clinical and neurophysiological trends achieved during treatment, the issue of the safety of the developed therapy method is important. The aim of the study is to assess the safety of the proposed method of low-intensity laser therapy (LILT) in patients with professional polyneuropathies of the upper extremities. Material and methods: on the basis of the department of occupational pathology, 116 patients (60 men, 56 women) with occupational polyneuropathies of the upper extremities were treated using LILT. Therapeutic measures were carried out using a semiconductor laser apparatus for red spectrum radiation (650 nm) with fiber-optic light guides for percutaneous therapy "ALP-01-Laton" in the sitting position of patients. Diffuse scattered laser radiation of the red region of the spectrum with an energy illumination of 0.7-1.1 mW / cm2 directly affected the projection area of the exit of the median nerve from the carpal tunnel to the hand. There were 5-10 procedures per course, the energy exposure of laser radiation and the number of sessions were determined individually. Results: To ensure the safety of the therapy, patients were included in the study strictly in accordance with the developed inclusion and non-inclusion criteria. Patients were treated in a specially equipped room with the use of personal protective equipment; safety rules were followed during the operation of the device. During treatment, all 116 patients treated with LILT did not have systemic side effects. A number of patients developed short-term complaints associated with local reactions: short-term tingling sensations and "goose bumps" in the hands, warmth, slight burning sensation, etc. All recorded local side effects occurred directly during LILT-procedures and were completely stopped within 1-5 minutes after their completion. In general, LILT-exposure did not cause serious side effects and was well tolerated by patients. 13.5% of patients noted a decrease in pain in the arms directly during the LILT treatment procedures. Conclusion. The developed method of LILT of professional polyneuropathies of the upper extremities is simple and convenient for use in clinical practice: it is applicable both in a hospital and on an outpatient basis. LILT has a limited list of contraindications, and is generally well tolerated by patients with minimal local side effects.

Short-Term Results of Endoscopic Percutaneous Longitudinal Tenotomy for Noninsertional Achilles Tendinopathy and the Presentation of a Simplified Operative Method

2018 ◽  
Vol 12 (1) ◽  
pp. 73-78
Author(s):  
Michel Chraim ◽  
Hamza M. Alrabai ◽  
Sabine Krenn ◽  
Peter Bock ◽  
Hans-Jörg Trnka
Keyword(s):  
Achilles Tendon ◽  
Carpal Tunnel Release ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Operation Technique ◽  
Outpatient Basis ◽  
Short Term ◽  
Pain Visual Analog Scale ◽  
Postoperative Thrombosis

Purpose: This study was aimed to review the short-term results of endoscopic percutaneous longitudinal tenotomy for noninsertional Achilles tendinopathy using the Centerline Endoscopic Carpal Tunnel Release instrument (Arthrex). This method simplifies the operation technique, allows a good endoscopic visualisation of the Achilles tendon with very promising results. Methods: We performed multiple percutaneous longitudinal tenotomies under local anesthesia in 24 patients (25 tendons) with Achilles tendinopathy or peritendinitis that had failed conservative treatment between January 2013 and September 2016. All ambulatory procedures consisted of paratenon release and longitudinal tenotomies. The results were reviewed in 22 patients (23 tendons) at an average follow-up period of 22.5 months (range 10-36 months). Patients’ satisfaction and functional outcomes were evaluated using the Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaire, the pain visual analog scale (VAS), and the functional foot index. Results: Initial results are very promising with excellent results in 12 patients, good results in 9 patients, and fair result in 1 patient. One patient developed a postoperative thrombosis of the operated limb. Another patient developed a hypertrophic painful scar of the incision wound. The VAS for pain decreased drastically after the index procedure and averaged to 0.2 (SD 0.447). The VISA-A questionnaire score had improved from 42 ± 7.2 points preoperatively to 96.8 ± 14.3 points postoperatively (P = .004). The functional foot index decreased from 84 (SD 30.517) to 33.4 (SD 6.452) on the follow-up examination. Conclusions: The endoscopic-assisted longitudinal tenotomies procedure of the Achilles tendon is easily feasible and can be performed on an outpatient basis, produces minimal complications and shows excellent results. The described technique is recommended for all surgeons especially for those familiar with endoscopy of the Achilles tendon. Levels of Evidence: Therapeutic, Level IV: Case Series

Feasibility of a Short Term Severely Restricted Sodium Diet with Counselling Support

1989 ◽  
Vol 26 (4) ◽  
pp. 358-360 ◽  
Author(s):  
M Z Panos ◽  
Roger Williams
Keyword(s):  
Clinical Trials ◽  
Sodium Excretion ◽  
Urinary Sodium Excretion ◽  
Normal Diet ◽  
Urinary Sodium ◽  
Plasma Sodium ◽  
Outpatient Basis ◽  
Short Term ◽  
Sodium Diet ◽  
Metabolic Unit

For the purpose of short term clinical trials previous studies have made use of metabolic kitchens to provide severely restricted sodium diets. We evaluated the feasibility of administering a 5-day severely restricted (22 mmol) sodium diet on an outpatient basis with counselling support, outside a metabolic unit. In 13 highly-motivated volunteers, 24-h urinary sodium excretion fell from 128·5 ± 11·9 on a normal diet to 19·2 ± 2·88 mmol per day and plasma sodium dropped from 140 ± 0·41 to 137 ± 0·78 mmol/L, showing that such an approach is effective.

Short-Term Heroin Detoxification on an Outpatient Basis

1971 ◽  
Vol 6 (2) ◽  
pp. 241-264 ◽  
Author(s):  
George R Gay ◽  
Alan D Matzger ◽  
William Bathurst ◽  
David E Smith
Keyword(s):  
Outpatient Basis ◽  
Short Term

Safe and effective HeRO graft placement: Technique and results

2021 ◽  
pp. 112972982110080
Author(s):  
Karl A Illig ◽  
Mark J London ◽  
John Aruny ◽  
John R Ross
Keyword(s):  
Inferior Vena ◽  
Vena Cava ◽  
Outpatient Basis ◽  
Procedure Time ◽  
Infection Rates ◽  
Short Term ◽  
Graft Placement ◽  
Central Access ◽  
Inside Out ◽  
Placement Technique

Objectives: Hemodialysis Reliable Outflow (HeRO) grafts are used when venous outflow is inadequate to support conventional access. These have been perceived as complex to implant and being associated with high risk. We have evolved a defined protocol for insertion that minimizes morbidity and maximizes efficiency. Methods: Our protocol includes staged intravenous access versus HeRO graft placement, reverse Trendelenburg positioning, subcutaneous access of the deep portion of the existing catheter, use of a stiff wire placed within the inferior vena cava, dilation of the tract to 8 mm, device lubrication, all insertion procedures directly visualized, and use of immediate access conduits with SuperHeRO connector. Results: From 7/1/18 to 8/13/19, 55 HeRO grafts were placed at our institution following this protocol, average age 58 ± 15 (26–86) years (mean ± SD, range). 53 (96%) had had prior ipsilateral central access (13 by means of “inside out” 2 weeks prior) the other two had on-table access. Mean procedure time was 70 ± 26 (38–148) min. Excluding seven “complex” cases, procedure time for our first 20 cases using this protocol was 72 ± 29 min, while that of the last 28 was 62 ± 18 min ( p < 0.05). One patient suffered acute CHF after unclamping; despite reclamping and ligation he died on POD 3 (mortality rate 2%). 71% were done as outpatients, and 47 of 53 evaluable patients (89%) had their grafts used within 36 h for dialysis. Only one patient (2%) has had an infection within 30 days (cellulitis). At a mean followup of 95 ± 105 (maximum 383) days, three additional patients have had graft infections requiring excision, for a total infection rate of 5/53 (9%). Conclusions: Our results suggest that HeRO graft placement can be performed with minimal morbidity and mortality on an outpatient basis. Short-term infection rates are low and 89% of patients have their grafts immediately accessed and are discharged without a catheter.

Conceptual short-term memory (CSTM) supports core claims of Christiansen and Chater

2016 ◽  
Vol 39 ◽  
Author(s):  
Mary C. Potter
Keyword(s):  
Working Memory ◽  
Rapid Serial Visual Presentation ◽  
Language Comprehension ◽  
Short Term Memory ◽  
Visual Presentation ◽  
Long Term Memory ◽  
Short Term ◽  
Term Memory ◽  
Use Of Knowledge

AbstractRapid serial visual presentation (RSVP) of words or pictured scenes provides evidence for a large-capacity conceptual short-term memory (CSTM) that momentarily provides rich associated material from long-term memory, permitting rapid chunking (Potter 1993; 2009; 2012). In perception of scenes as well as language comprehension, we make use of knowledge that briefly exceeds the supposed limits of working memory.

Ultrastructural Changes of Canine Kidneys During 24-Hour Perfusion on a LI-400 Preservation System

1971 ◽  
Vol 29 ◽  
pp. 316-317
Author(s):  
M. O. Magnusson ◽  
D. G. Osborne ◽  
T. Shimoji ◽  
W. S. Kiser ◽  
W. A. Hawk
Keyword(s):  
Electron Microscopy ◽  
Electrolyte Solution ◽  
Ultrastructural Changes ◽  
Midline Incision ◽  
Short Term ◽  
Pentobarbital Anesthesia ◽  
Pulsatile Perfusion

Short term experimental and clinical preservation of kidneys is presently best accomplished by hypothermic continuous pulsatile perfusion with cryoprecipitated and millipore filtered plasma. This study was undertaken to observe ultrastructural changes occurring during 24-hour preservation using the above mentioned method.A kidney was removed through a midline incision from healthy mongrel dogs under pentobarbital anesthesia. The kidneys were flushed immediately after removal with chilled electrolyte solution and placed on a LI-400 preservation system and perfused at 8-10°C. Serial kidney biopsies were obtained at 0-½-1-2-4-8-16 and 24 hours of preservation. All biopsies were prepared for electron microscopy. At the end of the preservation period the kidneys were autografted.

Polychlorinated biphenyl induced hepatocyte alterations

1987 ◽  
Vol 45 ◽  
pp. 716-717
Author(s):  
D.N. Collins ◽  
J.N. Turner ◽  
K.O. Brosch ◽  
R.F. Seegal
Keyword(s):  
Lipid Droplets ◽  
Wistar Rats ◽  
Homovanillic Acid ◽  
Polychlorinated Biphenyl ◽  
Corn Oil ◽  
Environmental Pollutants ◽  
Short Term ◽  
Pcb Congeners ◽  
Urinary Levels ◽  
The Brain

Polychlorinated biphenyls (PCBs) are a ubiquitous class of environmental pollutants with toxic and hepatocellular effects, including accumulation of fat, proliferated smooth endoplasmic recticulum (SER), and concentric membrane arrays (CMAs) (1-3). The CMAs appear to be a membrane storage and degeneration organelle composed of a large number of concentric membrane layers usually surrounding one or more lipid droplets often with internalized membrane fragments (3). The present study documents liver alteration after a short term single dose exposure to PCBs with high chlorine content, and correlates them with reported animal weights and central nervous system (CNS) measures. In the brain PCB congeners were concentrated in particular regions (4) while catecholamine concentrations were decreased (4-6). Urinary levels of homovanillic acid a dopamine metabolite were evaluated (7).Wistar rats were gavaged with corn oil (6 controls), or with a 1:1 mixture of Aroclor 1254 and 1260 in corn oil at 500 or 1000 mg total PCB/kg (6 at each level).

Acetaminophen: Macula densa hypersecretory activity by induced hepatotoxicity

1987 ◽  
Vol 45 ◽  
pp. 934-935
Author(s):  
S.S. Poolsawat ◽  
C.A. Huerta ◽  
S.TY. Lae ◽  
G.A. Miranda
Keyword(s):  
Cell Proliferation ◽  
Liver Function ◽  
Chronic Inflammation ◽  
Foam Cell ◽  
Term Effect ◽  
Short Term ◽  
Drug Induced ◽  
Experimental Induction ◽  
Tissue Alterations ◽  
Toxic Responses

Introduction. Experimental induction of altered histology by chemical toxins is of particular importance if its outcome resembles histopathological phenomena. Hepatotoxic drugs and chemicals are agents that can be converted by the liver into various metabolites which consequently evoke toxic responses. Very often, these drugs are intentionally administered to resolve an illness unrelated to liver function. Because of hepatic detoxification, the resulting metabolites are suggested to be integrated into the macromolecular processes of liver function and cause an array of cellular and tissue alterations, such as increased cytoplasmic lysis, centrilobular and localized necroses, chronic inflammation and “foam cell” proliferation of the hepatic sinusoids (1-4).Most experimentally drug-induced toxicity studies have concentrated primarily on the hepatic response, frequently overlooking other physiological phenomena which are directly related to liver function. Categorically, many studies have been short-term effect investigations which seldom have followed up the complications to other tissues and organs when the liver has failed to function normally.

Ultrastructural investigations of MDL 19,660-induced effects on the canine platelet and megakaryocyte

1990 ◽  
Vol 48 (3) ◽  
pp. 374-375
Author(s):  
D.E. Loudy ◽  
J. Sprinkle-Cavallo ◽  
J.T. Yarrington ◽  
F.Y. Thompson ◽  
J.P. Gibson
Keyword(s):  
Antidepressant Drug ◽  
Beagle Dogs ◽  
Long Term Effects ◽  
Short Term ◽  
Platelet Counts ◽  
Toxicological Studies ◽  
Induced Aggregation ◽  
Internal Architecture

Previous short term toxicological studies of one to two weeks duration have demonstrated that MDL 19,660 (5-(4-chlorophenyl)-2,4-dihydro-2,4-dimethyl-3Hl, 2,4-triazole-3-thione), an antidepressant drug, causes a dose-related thrombocytopenia in dogs. Platelet counts started to decline after two days of dosing with 30 mg/kg/day and continued to decrease to their lowest levels by 5-7 days. The loss in platelets was primarily of the small discoid subpopulation. In vitro studies have also indicated that MDL 19,660: does not spontaneously aggregate canine platelets and has moderate antiaggregating properties by inhibiting ADP-induced aggregation. The objectives of the present investigation of MDL 19,660 were to evaluate ultrastructurally long term effects on platelet internal architecture and changes in subpopulations of platelets and megakaryocytes.Nine male and nine female beagle dogs were divided equally into three groups and were administered orally 0, 15, or 30 mg/kg/day of MDL 19,660 for three months. Compared to a control platelet range of 353,000- 452,000/μl, a doserelated thrombocytopenia reached a maximum severity of an average of 135,000/μl for the 15 mg/kg/day dogs after two weeks and 81,000/μl for the 30 mg/kg/day dogs after one week.

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