scholarly journals The Application of Hemospray in Gastrointestinal Bleeding during Emergency Endoscopy

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Alexander F. Hagel ◽  
Heinz Albrecht ◽  
Andreas Nägel ◽  
Francesco Vitali ◽  
Marcel Vetter ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Salvage Therapy ◽  
Previous Treatment ◽  
Long Term Results ◽  
Emergency Endoscopy ◽  
Short Term ◽  
Long Term Effect ◽  
Short And Long Term ◽  
Lower Endoscopy

Introduction. Gastrointestinal bleeding represents the main indication for emergency endoscopy (EE). Lately, several hemostatic powders have been released to facilitate EE.Methods. We evaluated all EE in which Hemospray was used as primary or salvage therapy, with regard to short- and long-term hemostasis and complications.Results. We conducted 677 EE in 474 patients (488 examinations in 344 patients were upper GI endoscopies). Hemospray was applied during 35 examinations in 27 patients (19 males), 33 during upper and 2 during lower endoscopy. It was used after previous treatment in 21 examinations (60%) and in 14 (40%) as salvage therapy. Short-term success was reached in 34 of 35 applications (97.1%), while long-term success occurred in 23 applications (65.7%). Similar long-term results were found after primary application (64,3%) or salvage therapy (66,7%). Rebleeding was found in malignant and extended ulcers. One major adverse event (2.8%) occurred with gastric perforation after Hemospray application.Discussion. Hemospray achieved short-term hemostasis in virtually all cases. The long-term effect is mainly determined by the type of bleeding source, but not whether it was applied as first line or salvage therapy. But, even in the failures, patients had benefit from hemodynamic stabilization and consecutive interventions in optimized conditions.

scholarly journals Modelling large timescale and small timescale service variability

2019 ◽  
Vol 293 (1) ◽  
pp. 123-140
Author(s):  
Marco Gribaudo ◽  
Illés Horváth ◽  
Daniele Manini ◽  
Miklós Telek
Keyword(s):  
Service Time ◽  
Large Scale ◽  
Service Time Distribution ◽  
Efficient Computation ◽  
Short Term ◽  
Service Unit ◽  
Long Term Effect ◽  
Short And Long Term ◽  
Short Term Variability

Abstract The performance of service units may depend on various randomly changing environmental effects. It is quite often the case that these effects vary on different timescales. In this paper, we consider small and large scale (short and long term) service variability, where the short term variability affects the instantaneous service speed of the service unit and a modulating background Markov chain characterizes the long term effect. The main modelling challenge in this work is that the considered small and long term variation results in randomness along different axes: short term variability along the time axis and long term variability along the work axis. We present a simulation approach and an explicit analytic formula for the service time distribution in the double transform domain that allows for the efficient computation of service time moments. Finally, we compare the simulation results with analytic ones.

scholarly journals Short- and long-term results of chordal reconstruction using artificial suture material (polytetrafluoroethylene and polypropylene) in the dog

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Isamu Kanemoto ◽  
Tomonari Masumoto ◽  
Kiminari Ohara ◽  
Yusuke Kimura ◽  
Noboru Machida
Keyword(s):  
Suture Material ◽  
Long Term Results ◽  
Short Term ◽  
Suture Materials ◽  
Mitral Valve Plasty ◽  
Polypropylene Suture ◽  
Group 12 ◽  
Short And Long Term ◽  
Polypropylene Sutures

No previous reports have compared the suitability of expanded polytetrafluoroethylene (ePTFE) and polypropylene as artificial suture materials for chordal reconstruction in mitral valve plasty (MVP) in the dog. Twelve normal dogs were subjected to MVP using surfaceinduced deep hypothermia. In the short-term group (1.5-4 months after surgery), all ePTFE sutures were covered by a tissue sheath including the paired suture arms, which gave the appearance of native chordae from 2 months after surgery. In contrast, all polypropylene sutures were not covered by tissue, and appeared the same as the paired polypropylene suture arms at the operation. In the long-term group (12 months after surgery), all ePTFE sutures were covered by a tissue sheath, which appeared the same as that in the short-term group, and had flexibility without increased thickness with time. In contrast, although the polypropylene suture was covered completely by a tissue sheath in 1 dog, all the other polypropylene sutures were exposed except for both ends of the suture. ePTFE may be superior to polypropylene as an artificial suture material for chordal reconstruction in MVP.

Crescentic Proximal Metatarsal Osteotomy for Moderate to Severe Hallux Valgus: A Mean 12.2 Year Follow-Up Study

2001 ◽  
Vol 22 (10) ◽  
pp. 817-822 ◽  
Author(s):  
J.P. Veri ◽  
S.P. Pirani ◽  
R. Claridge
Keyword(s):  
Hallux Valgus ◽  
Long Term Results ◽  
Soft Tissue Reconstruction ◽  
Short Term ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
The Mean ◽  
Severe Hallux Valgus

The senior author's (R.C.) first 25 patients (37 feet) treated with a combination proximal crescentic osteotomy and distal soft-tissue reconstruction made up the patient cohort. All 25 patients were reviewed at a minimum of one year post-op (short-term follow-up) and 20/25 (31/37 feet) were reviewed again at a mean 12.2 years (range 11.4 to 13.0 yrs) post-op (long-term follow-up). This allowed for a comparison of short- and long-term results and led to a long-term follow-up rate of 84% (31/37 feet, mean 12.2 yrs). Clinical, radiographic and patient outcome measures were obtained and compared pre-op and at short- and long-term follow-up. The mean preoperative hallux valgus (HVA) and intermetatarsal angles (IMA) were 37° and 16° respectively. The mean HVA correction was 24° and IMA correction 10° at long-term follow-up with no tendency toward recurrence. Sesamoid position and first MTP subluxation was markedly improved postoperatively and the correction was maintained at long-term follow-up. Patients were asked about their satisfaction in terms of pain, appearance and motion. At long-term follow-up, more than 90% of patients were completely satisfied with pain and motion and greater than 80% with their appearance. Ninety-four percent of patients said they would have the operation again. The AOFAS clinical rating scale for the hallux was calculated retrospectively for pre-op and short-term follow-up and prospectively for long-term follow-up. The mean pre-op score was 37/100 (16 to 60) which significantly improved to 92/100 (67 to 100) at both follow-up periods, suggesting no evidence of decrease in outcome over time. Complications included two patients (5%) that were over-corrected into varus (one symptomatic, one asymptomatic), and four patients (11%) that were undercorrected, developing asymptomatic recurrences (>10° increase HVA) at long-term follow-up. In addition, two patients (5%) developed new transfer lesions postoperatively, likely related to technical error (one varus overcorrection, one dorsiflexion malunion). In conclusion, the long-term results, with a mean follow-up of 12.2 years, of the resection realignment procedure for moderate to severe hallux valgus are generally excellent and the complication rate is low and acceptable. Attention to detail, avoiding both undercorrection, which can lead to recurrence, and overcorrection, which can cause symptomatic varus, is essential.

scholarly journals The interactive effect of herbivory, nutrient enrichment and mucilage on shallow rocky macroalgal communities

2018 ◽  
Author(s):  
Sarah Caronni ◽  
Chiara Calabretti ◽  
Giulia Ceccherelli ◽  
Sandra Citterio ◽  
Maria Anna Delaria ◽  
...  
Keyword(s):  
Marine Protected Area ◽  
Interactive Effect ◽  
Term Effect ◽  
Short Term ◽  
Manipulative Experiment ◽  
Rocky Substratum ◽  
Long Term Effect ◽  
Short And Long Term ◽  
Macroalgal Assemblage

In this paper the results of a manipulative experiment aimed to evaluate the interactive short- and long-term effect of three different stressors, herbivory, nutrient and mucilage, on a macroalgal assemblage are presented. The experiment was conducted in Tavolara Punta Coda Cavallo Marine Protected Area during a bloom of the benthic mucilage-producing microalga Chrysophaeum taylorii Lewis and Bryan (Pelagophyceae), recently spreading in the Mediterranean Sea. On a rocky substratum, 18 plots 20x20 cm in size were prepared and, according to different treatments, nutrients were added in some of them to simulate eutrophication, macroalgae were removed to simulate clearings produced by grazers and mucilage was manually removed to simulate mucilage-free conditions. Differences in the composition of macroalgal assemblages were found when considering the short term effect of the considered stressors, and also the response of the most abundant taxa (DFA, ECA, Dictyotales, Laurencia spp. and Padina pavonica) varied among treatments, proving that a combined effect of such stressors on the recovery of macroalgae was present. On the contrary, the effect of treatments was neither highlighted on the most abundant algae nor on the whole structure of the macroalgal assemblage.

scholarly journals The interactive effect of herbivory, nutrient enrichment and mucilage on shallow rocky macroalgal communities

2018 ◽  
Author(s):  
Sarah Caronni ◽  
Chiara Calabretti ◽  
Giulia Ceccherelli ◽  
Sandra Citterio ◽  
Maria Anna Delaria ◽  
...  
Keyword(s):  
Marine Protected Area ◽  
Interactive Effect ◽  
Term Effect ◽  
Short Term ◽  
Manipulative Experiment ◽  
Rocky Substratum ◽  
Long Term Effect ◽  
Short And Long Term ◽  
Macroalgal Assemblage

In this paper the results of a manipulative experiment aimed to evaluate the interactive short- and long-term effect of three different stressors, herbivory, nutrient and mucilage, on a macroalgal assemblage are presented. The experiment was conducted in Tavolara Punta Coda Cavallo Marine Protected Area during a bloom of the benthic mucilage-producing microalga Chrysophaeum taylorii Lewis and Bryan (Pelagophyceae), recently spreading in the Mediterranean Sea. On a rocky substratum, 18 plots 20x20 cm in size were prepared and, according to different treatments, nutrients were added in some of them to simulate eutrophication, macroalgae were removed to simulate clearings produced by grazers and mucilage was manually removed to simulate mucilage-free conditions. Differences in the composition of macroalgal assemblages were found when considering the short term effect of the considered stressors, and also the response of the most abundant taxa (DFA, ECA, Dictyotales, Laurencia spp. and Padina pavonica) varied among treatments, proving that a combined effect of such stressors on the recovery of macroalgae was present. On the contrary, the effect of treatments was neither highlighted on the most abundant algae nor on the whole structure of the macroalgal assemblage.

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Short- and Long-Term Results of the Surgical Management of Frontobasal Fractures

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Boštjan Lanišnik ◽  
Vojko Didanovič ◽  
Bogdan Čizmarevič
Keyword(s):  
Surgical Management ◽  
Long Term Results ◽  
Short And Long Term

Transapical versus Conventional Aortic Valve Replacement�A Propensity-Matched Comparison

2012 ◽  
Vol 15 (1) ◽  
pp. 4 ◽  
Author(s):  
David M. Holzhey ◽  
William Shi ◽  
A. Rastan ◽  
Michael A. Borger ◽  
Martin H�nsig ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Survival Rates ◽  
Long Term Results ◽  
Term Survival ◽  
Kaplan Meier ◽  
Risk Patients ◽  
Short And Long Term ◽  
Good Treatment Option ◽  
Matched Comparison

<p><b>Introduction:</b> The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).</p><p><b>Patients and Methods:</b> All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.</p><p><b>Results:</b> The 30-day mortality rate was 10.8% and 8.4% (<i>P</i> = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, <i>P</i> = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, <i>P</i> = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).</p><p><b>Conclusion:</b> Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.</p>

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