Catheter systems for intrathecal drug delivery

1995 ◽  
Vol 83 (2) ◽  
pp. 215-217 ◽  
Author(s):  
Richard D. Penn ◽  
Michelle M. York ◽  
Judith A. Paice
Keyword(s):  
Medical Center ◽  
Intrathecal Catheter ◽  
Content Type ◽  
Steady Rate ◽  
Catheter Complications ◽  
The Mean ◽  
Thin Walled ◽  
A Prospective Study ◽  
Mean Time ◽  
Drug Pump

✓ A prospective study of intrathecal catheter reliability was performed at Rush-Presbyterian-St. Luke's Medical Center. All 102 patients who had baclofen administered chronically for spasticity via an implanted drug pump were included. Sixty percent of the patients had no catheter complications; the remaining patients had one to five complications over their course of treatment. Survival analysis demonstrated a steady rate of malfunction up to 80 months, with the mean time to first failure recorded at 20 months. Kinks, holes, breaks, dislodgments, and disconnections were the most common complications. On the basis of their research the authors conclude that the thin-walled silastic catheter does not perform well and that larger, thick-walled catheters should be used.

scholarly journals Time required to move cash through slot machines

2018 ◽  
Vol 21 (3) ◽  
pp. 376-384 ◽  
Author(s):  
Karen Kelly ◽  
Carl James Schwarz ◽  
Ricardo Gomez ◽  
Kim Marsh
Keyword(s):  
British Columbia ◽  
Slot Machines ◽  
Content Type ◽  
The Public ◽  
Average Value ◽  
The Mean ◽  
Time Required ◽  
Rest Breaks ◽  
Mean Time ◽  
Practical Implications

Purpose The purpose of this paper is to present an empirical study on the time needed to load and disburse cash using bill validators on slot machines and stand-alone cash dispensers in casinos in British Columbia under a Ticket In Ticket Out (TITO) system. Design/methodology/approach Testing took place over two days, using 18 machines. The results were extrapolated to estimate the approximate time required to process $1,000,000 with different average bill amounts in the cash mix and three different bill validator machines in common use. The average value per bill using the cash mix used by the public in the casino was $33.11 [standard error (SE) $2.11]. Findings The mean time/accepted note ranged from 4.12 to 9.65 s, depending on bill validator type. This implies that the time needed to load $1,000,000 onto credit slips using bill validators on slot machines ranges from 35 to 81 h, excluding rest breaks and other breaks. The time needed to redeem $1,000,000 is estimated to be 3 h. Practical/implications The implications of these finding for illicit actors to successfully launder large amounts of cash are discussed. Given the time needed to physically handle the cash, and other control systems currently in use in casinos in British Columbia, processing large amounts of cash using bill validators on slot machines would require a highly organized team that would find it difficult to elude detection. Originality/value The trial results provide a baseline estimate to be used going forward when investigating or proposing money laundering methodologies that include slot machines.

Ganglion cyst involvement of peripheral nerves

1997 ◽  
Vol 87 (3) ◽  
pp. 403-408 ◽  
Author(s):  
Kimberly S. Harbaugh ◽  
Robert L. Tiel ◽  
David G. Kline
Keyword(s):  
Peripheral Nerves ◽  
Ganglion Cyst ◽  
Medical Center ◽  
Case Reports ◽  
Motor Recovery ◽  
Neurological Deficits ◽  
Motor Deficit ◽  
Content Type ◽  
Ganglion Cysts ◽  
The Mean

✓ Despite their benign histological appearance and the current literature composed primarily of case reports with favorable outcomes, ganglion cysts involving peripheral nerves (GCPNs) can cause permanent neurological deficits. The authors present a 27-year Louisiana State University Medical Center (LSUMC) experience with the surgical management of GCPNs. From 1968 to 1995, 27 patients were surgically treated for 27 cysts that involved nerves at nine locations. Cysts of the peroneal nerve were the most common, comprising 52% of the cases. Motor deficit, pain, and sensory changes were present in 83%, 78%, and 48% of cases, respectively. A history of acute trauma was noted in 22%. The mean follow-up duration in these cases was 61 months. Motor recovery was good in only 58% of cases and was related to the severity of the preoperative motor deficit. Pain resolved or was significantly improved in 89% of cases. Five patients underwent nine procedures before referral to LSUMC for treatment of recurrence of their ganglion cysts. None of these patients suffered recurrence after undergoing surgery at LSUMC. However, four additional patients (17%) experienced a total of six recurrences after undergoing their initial procedure. The mean time to recurrence for the patient group as a whole was 16 months. On the basis of their experience, the authors conclude that GCPNs can behave in an aggressive fashion. Patients should be counseled preoperatively about the potential for limited motor recovery and a significant chance for recurrence.

Early return to work following highly selective vagotomy

1990 ◽  
Vol 76 (1) ◽  
pp. 39-42
Author(s):  
D. N. Tulloch ◽  
E. P. Dewar
Keyword(s):  
Duodenal Ulcer ◽  
Ulcer Recurrence ◽  
Royal Navy ◽  
Selective Vagotomy ◽  
Highly Selective Vagotomy ◽  
Early Return ◽  
The Mean ◽  
A Prospective Study ◽  
Return To Duty ◽  
Mean Time

SummaryIn the Royal Navy, after surgery, the time that servicemen spend away from work and the level of duty to whch they return are decisions made by the surgeon, not the general practitioner.In a prospective study, we have thus been able to assess the acceptability of return to full duty at decreasing intervals after highly selected vagotomy (HSY).Seventy-eight service men who underwent HSY for duodenal ulcer were studied in three periods, 1978–1980, 1981–1982, 1983–1986, each with a shorter interval to return to duty.There were no differences in the rates of ulcer recurrence, incisional hernia, or ability to perform full duties.After HSY the mean time to return to full duties for each group was 29.3, 16.4, and 4.2 weeks, respectively. Every patient returned to full duties at 28 days was able to perform any assigned task whether at sea or ashore.

scholarly journals Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients

2017 ◽  
Vol 44 (1) ◽  
pp. 41-45 ◽  
Author(s):  
MAURO PRADO DA SILVA ◽  
CHRISTIANO MATSUI ◽  
DANIEL DONGIOU KIM ◽  
JOAQUIM EDSON VIEIRA ◽  
CARLOS ALBERTO MALHEIROS ◽  
...  
Keyword(s):  
Neuromuscular Blockade ◽  
Obese Patients ◽  
Minimum Effective Dose ◽  
Nerve Stimulator ◽  
Peripheral Nerve Stimulator ◽  
Complete Reversal ◽  
The Mean ◽  
A Prospective Study ◽  
Mean Time ◽  
Grade Iii

ABSTRACT Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. Results: we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. Conclusion: the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg.

scholarly journals Evaluation of functional outcome following ORIF of bimalleolar fractures of the ankle-A prospective study of 30 patients

2020 ◽  
Vol 11 (4) ◽  
pp. 6051-6055
Author(s):  
Yeshwanth subash ◽  
Vishnu S ◽  
Damodharan
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Surgical Intervention ◽  
Early Mobilization ◽  
Foot And Ankle ◽  
The Mean ◽  
American Orthopaedic ◽  
A Prospective Study ◽  
Mean Time

Bimalleolar fractures are common injuries, and stable fracture patterns can be treated conservatively, while complicated, unstable fractures would require surgical intervention. This study aimed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of these fractures. This was a study of 30 patients with bimalleolar fractures who presented between January 2013 to January 2016 treated with ORIF with a follow-up period of 3 years. Functional outcome was performed with the AOFAS (American Orthopaedic Foot and ankle society) score. The mean age of the patients was 41.6 years. There was a female preponderance seen in our study with the left side being more commonly affected. The mean time to fracture union was 12.13 weeks, and we had excellent outcomes in 18 patients, good in 10, while two patients had a fair result. We did not lose any of our patients to follow up. All of our patients were happy with the functional outcome achieved. No significant complications were seen in our study. ORIF in bimalleolar fractures enables restoration of the ankle mortise to an anatomical position and facilitates early mobilization of the ankle resulting in good functional outcomes.

Bench-top comparison of thermometers used in newborn infants

2020 ◽  
pp. fetalneonatal-2020-320123
Author(s):  
Emma A Dunne ◽  
Katie Cunningham ◽  
Colm Patrick Finbarr O'Donnell ◽  
Lisa K McCarthy
Keyword(s):  
Steady State ◽  
Prospective Study ◽  
Newborn Infants ◽  
Mean Difference ◽  
Continuous Mode ◽  
Control Temperature ◽  
Steady State Temperature ◽  
The Mean ◽  
A Prospective Study ◽  
Mean Time

We wished to determine the accuracy of thermometers used to measure temperature in newborn infants. We measured the temperature of a water bath with three types of thermometer set at 0.5°C increments between 32.5°C and 38.5°C and compared the values to a control. We recorded the time to display steady-state temperature. The Microlife thermometer most closely approximated control temperature (mean difference <0.1°C (SD<0.1°C)) and displayed a reading in a mean time of 29 s (SD 2 s). Used in ‘predictive’ (default) mode, the Welch Allyn SureTemp Plus 692 thermometer differed from the control by a mean of 0.6°C (SD 0.3°C), displaying a temperature at 15 s (SD 3 s). This device consistently overestimated temperature. In ‘continuous’ mode, the mean difference was <0.1°C (SD<0.1°C) at 5 min. The Phillips probe differed from the control by a mean of 0.4°C (SD 0.2°C). Thermometers used to measure temperature in newborn infants may underestimate hypothermia. A prospective study in newborn infants is needed.

Recurrent spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension: a prospective study

2003 ◽  
Vol 99 (5) ◽  
pp. 840-842 ◽  
Author(s):  
Wouter I. Schievink ◽  
M. Marcel Maya ◽  
Mary Riedinger
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypotension ◽  
Surgical Repair ◽  
Csf Leak ◽  
Content Type ◽  
Cerebrospinal Fluid Leaks ◽  
The Mean ◽  
A Prospective Study ◽  
Fine Print

Object. Intracranial hypotension due to a spontaneous spinal cerebrospinal fluid (CSF) leak is an increasingly recognized cause of postural headaches, but reliable follow-up data are lacking. The authors undertook a study to determine the risk of a recurrent spontaneous spinal CSF leak. Methods. The patient population consisted of a consecutive group of 18 patients who had been evaluated for consideration of surgical repair of a spontaneous spinal CSF leak. The mean age of the 15 women and three men was 38 years (range 22–55 years). The mean duration of follow up was 36 months (range 6–132 months). The total follow-up time was 654 months. A recurrent spinal CSF leak was defined on the basis of computerized tomography myelography evidence of a CSF leak in a previously visualized but unaffected spinal location. Five patients (28%) developed a recurrent spinal CSF leak; the mean age of these four women and one man was 36 years. A recurrent CSF leak developed in five (38%) of 13 patients who had undergone surgical CSF leak repair, compared with none (0%) of five patients who had been treated non-surgically (p = 0.249). The recurrent leak occurred between 10 and 77 months after the initial CSF leak, but within 2 or 3 months of successful surgical repair of the leak in all patients. Conclusions. Recurrent spontaneous spinal CSF leaks are not rare, and the recent successful repair of such a leak at another site may be an important risk factor.

scholarly journals Evaluation of renal function in patients with psoriasis using immunobiologicals

2013 ◽  
Vol 88 (4) ◽  
pp. 667-669 ◽  
Author(s):  
Sarah Suyanne Carvalho Melgaco ◽  
Geraldo Bezerra da Silva Junior ◽  
Amanda Maria Menezes Dantas ◽  
Ana Mirella Arcanjo Vasconcelos ◽  
Veronica Riquet de Siqueira ◽  
...  
Keyword(s):  
Renal Function ◽  
Prospective Study ◽  
Creatinine Clearance ◽  
The Mean ◽  
A Prospective Study ◽  
Mean Time

The aim of this study was to evaluate renal function in patients with psoriasis using immunobiologicals. A prospective study was conducted with 15 patients with confirmed diagnosis of psoriasis who were starting to use immunobiologicals. The mean age was 41±11 years, with 60% females. The mean time of disease was 11±6.6 years. Significant changes in creatinine and creatinine clearance were not observed in the course of the study. There was an increase in transaminases and a decrease in magnesium levels.

scholarly journals Comparison of the Clinical Characteristics and Outcomes Associated with Vancomycin-Resistant Enterococcus faecalis and Vancomycin-Resistant E. faecium Bacteremia

2012 ◽  
Vol 56 (5) ◽  
pp. 2452-2458 ◽  
Author(s):  
Kayoko Hayakawa ◽  
Dror Marchaim ◽  
Emily T. Martin ◽  
Namita Tiwari ◽  
Adnan Yousuf ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Lower Risk ◽  
Clinical Characteristics ◽  
Medical Center ◽  
Blood Cultures ◽  
Study Cohort ◽  
Vancomycin Resistant Enterococcus ◽  
Content Type ◽  
The Mean ◽  
Vancomycin Resistant

ABSTRACTIn published studies, cohorts of patients with bacteremia due to vancomycin-resistantEnterococcus(VRE) have predominantly been infected withEnterococcus faecium. Little is known about the epidemiology and outcomes associated with bacteremia due to VREnterococcus faecalis. A retrospective study of isolates obtained from January 2008 to October 2010 was conducted at Detroit Medical Center (DMC). Unique patients with blood cultures positive for VRE were reviewed. Outcomes were analyzed using logistic regression. During the study period, 105 cases of bacteremia due to VRE. faecalisand 197 cases of bacteremia due to VRE. faeciumwere identified. The mean age in the study cohort was 61.5 ± 15 years; 162 subjects (53.6%) were male. After controlling for a propensity score, bacteremia due to VRE. faecaliswas associated with >2-fold-lower in-hospital mortality than bacteremia due to VRE. faecium. Interestingly, bacteremia due to VRE. faecaliswas associated with longer hospital stay after VRE isolation, although total length of stay was similar for groups with VRE. faecalisand VRE. faecium. Bacteremia due to VRE. faecaliswas associated with a >2-fold-lower risk for mortality than bacteremia due to VRE. faecium, possibly due to the availability of β-lactam therapeutics for treatment of VRE. faecalis.

scholarly journals Clinical and Microbiological Characteristics of Culture-Positive, Influenza-Associated Pulmonary Aspergillosis: A Single-Center Study in Southern Taiwan, 2016–2019

2022 ◽  
Vol 8 (1) ◽  
pp. 49
Author(s):  
Chi-Jung Wu ◽  
Cong-Tat Cia ◽  
Hsuan-Chen Wang ◽  
Chang-Wen Chen ◽  
Wei-Chieh Lin ◽  
...  
Keyword(s):  
Medical Center ◽  
Pulmonary Aspergillosis ◽  
Microbiological Characteristics ◽  
Single Center Study ◽  
All Cause Mortality ◽  
Southern Taiwan ◽  
The Mean ◽  
Antifungal Use ◽  
Mean Time ◽  
Culture Positive

This study delineated the characteristics of 24 (11.2%) culture-positive, influenza-associated pulmonary aspergillosis (IAPA) patients out of 215 patients with severe influenza during 2016–2019 in a medical center in southern Taiwan. Twenty (83.3%) patients did not have EORTC/MSG-defined host factors. The mean time from influenza diagnosis to Aspergillus growth was 4.4 days, and 20 (83.3%) developed IAPA within seven days after influenza diagnosis. All patients were treated in intensive care units and all but one (95.8%) received mechanical ventilation. Aspergillus tracheobronchitis was evident in 6 (31.6%) of 19 patients undergoing bronchoscopy. Positive galactomannan testing of either serum or bronchoalveolar lavage was noted in all patients. On computed tomography imaging, IAPA was characterized by peribronchial infiltrates, multiple nodules, and cavities superimposed on ground-glass opacities. Pure Aspergillus growth without bacterial co-isolation in culture was found in 17 (70.8%) patients. A. fumigatus (15, 62.5%), A. flavus (6, 25.0%), and A. terreus (4, 16.7%) were the major causative species. Three patients had mixed Aspergillus infections due to two species, and two had mixed azole-susceptible and azole-resistant A. fumigatus infection. All patients received voriconazole with an all-cause mortality of 41.6%. Of 14 survivors, the mean duration of antifungal use was 40.5 days. In conclusion, IAPA is an early and rapidly deteriorating complication following influenza that necessitates clinical vigilance and prompt diagnostic workup.

Sign in / Sign up

Export Citation Format

Share Document