Two-year results of the Moovis trapeziometacarpal joint arthroplasty with focus on early complications

2020 ◽  
pp. 175319342092130
Author(s):  
Lene Dremstrup ◽  
Janni Kjærgaard Thillemann ◽  
Lone Kirkeby ◽  
Lotte Priess Larsen ◽  
Torben Bæk Hansen ◽  
...  
Keyword(s):  
Polyethylene Wear ◽  
Intraoperative Complications ◽  
Special Focus ◽  
Early Complications ◽  
Trapeziometacarpal Joint ◽  
Level Of Evidence ◽  
Early Results ◽  
Prolonged Immobilization ◽  
Cemented Cup ◽  
New Generation

In this prospective study, we aimed to analyse the early results of 200 consecutive total trapeziometacarpal joint arthroplasties using the Moovis cup, a new generation, dual-mobility, uncemented conical cup, with special focus on early complications. At the 24-month follow-up, we found clinically relevant improvement of function and comfort. Among intraoperative complications were nine intraoperative trapezial fractures, which were treated by screw osteosynthesis; prolonged immobilization; and conversion to cemented cup fixation or primary or secondary trapeziectomy. One was left untreated as the loose cup did not cause notable symptoms. There were three implants with polyethylene wear and two with liner dislocation. We conclude that early outcomes of this new-generation implant are favourable, but its surgery is challenging and associated with important intraoperative and early postoperative complications related to the learning curve. Attentive reaming of the trapezium and careful cup impaction are crucial steps to avoid trapezial fracture and early cup failure. Level of evidence: II

scholarly journals Tetraconatan phylogeny with special focus on Malacostraca and Branchiopoda: highlighting the strength of taxon-specific matrices in phylogenomics

2018 ◽  
Vol 285 (1885) ◽  
pp. 20181524 ◽  
Author(s):  
Martin Schwentner ◽  
Stefan Richter ◽  
D. Christopher Rogers ◽  
Gonzalo Giribet
Keyword(s):  
Amino Acid ◽  
Analytical Methods ◽  
Special Focus ◽  
Evolutionary Models ◽  
Phylogenomic Analyses ◽  
New Generation ◽  
Analytical Approaches ◽  
Internal Relationships ◽  
Complete Matrix ◽  
Phylogenomic Study

Understanding the evolution of Tetraconata or Pancrustacea—the clade that includes crustaceans and insects—requires a well-resolved hypothesis regarding the relationships within and among its constituent taxa. Here, we assembled a taxon-rich phylogenomic dataset focusing on crustacean lineages based solely on genomes and new-generation Illumina-generated transcriptomes, including 89 representatives of Tetraconata. This constitutes, to our knowledge, the first phylogenomic study specifically addressing internal relationships of Malacostraca (with 26 species included) and Branchiopoda (36 species). Seven matrices comprising 81–684 orthogroups and 17 690–242 530 amino acid positions were assembled and analysed under five different analytical approaches. To maximize gene occupancy and to improve resolution, taxon-specific matrices were designed for Malacostraca and Branchiopoda. Key tetraconatan taxa (i.e. Oligostraca, Multicrustacea, Branchiopoda, Malacostraca, Thecostraca, Copepoda and Hexapoda) were monophyletic and well supported. Within Branchiopoda, Phyllopoda, Diplostraca, Cladoceromorpha and Cladocera were monophyletic. Within Malacostraca, the clades Eumalacostraca, Decapoda and Reptantia were well supported. Recovery of Caridoida or Peracarida was highly dependent on the analysis for the complete matrix, but it was consistently monophyletic in the malacostracan-specific matrices. From such examples, we demonstrate that taxon-specific matrices and particular evolutionary models and analytical methods, namely CAT-GTR and Dayhoff recoding, outperform other approaches in resolving certain recalcitrant nodes in phylogenomic analyses.

Recent Developments of Micropattern Detectors

2014 ◽  
pp. 156-194
Keyword(s):  
Large Hadron Collider ◽  
Visible Light ◽  
Parallel Plate ◽  
Hadron Collider ◽  
Special Focus ◽  
Large Area ◽  
Special Place ◽  
Recent Developments ◽  
New Generation ◽  
Detector Technology

In this chapter, the exciting developments in micropattern detectors in recent years are described. This includes GEM and MICROMEGAS detectors combined with micropixel readout, some peculiar designs of GEM and GEM-like detectors sensitive to UV and visible light, large area (>1m2) GEM and MICROMEGAS prototypes developed for the upgrades of the experiments at the large hadron collider, etc. A special focus is put on a new generation of spark-proof micropattern detectors, using resistive electrodes instead of traditional metallic ones. These detectors operate as ordinary micropattern detectors. However, in the case of occasional sparks, their current is limited by the resistivity of the electrodes so that the energy of the discharge is reduced by several orders of magnitude. Various designs of such detectors have been developed and successfully tested, including resistive GEM, resistive MICROMEGAS, resistive MSGC, etc. Among this family of detectors, a special place belongs to resistive parallel-plate micropattern detectors allowing one to achieve at the same time excellent spatial (38 µm) and time (77 ps) resolutions. Finally, the potential of multilayer detector technology for further optimization of the detector operation is discussed.

Perioperative complications and quality of life after radical retropubic prostatectomy

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 19-22
Author(s):  
F. Merlo ◽  
M. Mangano ◽  
P. Checchin ◽  
L. Maccatrozzo ◽  
A. Fandella ◽  
...  
Keyword(s):  
Social Life ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
Late Complications ◽  
Pelvic Lymphadenectomy ◽  
Radical Retropubic Prostatectomy ◽  
Point Of View ◽  
Early Complications ◽  
Retropubic Prostatectomy

— The Authors report their experience with perioperative complications in 128 patients after radical retropubic prostatectomy preceding bilateral pelvic lymphadenectomy for prostatic cancer. Patients were classified by anatomo-pathological stage; 25% were stage D1. Data relating to homologous transfusions (22%), intraoperative complications (1.6%), minor (16%) or major (7%) early complications and late complications (0.8%) are analysed. The latest group of patients has also been assessed from a sexual, psychological and social point of view. 84% of patients reported an erectile deficit, but only 4% suffered a psychological worsening reflecting on their social life.

scholarly journals A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Wilcke ◽  
Martin Roginski ◽  
Mikael Åström ◽  
Marianne Arner
Keyword(s):  
Ligament Reconstruction ◽  
Age Groups ◽  
Hand Surgery ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Special Focus ◽  
Trapeziometacarpal Joint ◽  
Patient Reported ◽  
Tendon Interposition ◽  
Joint Arthritis

Abstract Background The aim of the study was to evaluate patient reported outcome measures (PROM) before and after trapeziectomy with or without ligament reconstruction and tendon interposition for trapeziometacarpal joint arthritis with special focus on possible differences due to gender, age and surgical method. Methods Data from the Swedish quality registry for hand surgery (HAKIR) was analyzed preoperatively, 3 months and 1 year postoperatively for 1850 patients (mean age 63 years, 79% women). Results One year postoperatively, mean pain at rest was reduced from 50 to 12 of maximum 100. However, pain on load and weakness had not abated to the same extent (mean 30 and 34 of 100, respectively). The mean improvement in PROM did not differ between age groups or gender. The result was similar after trapeziectomy with ligament reconstruction and tendon interposition (86% of the patients) and simple trapeziectomy but few patients were operated with the latter method. Conclusion Pain on load and weakness remains to some extent 1 year after surgery for trapeziometacarpal joint arthritis. The result is similar after trapeziectomy with or without ligament reconstruction and tendon interposition and the same improvement can be expected after surgery regardless of age and gender.

scholarly journals SADI-S WITH RIGHT GASTRIC ARTERY LIGATION: TECHNICAL SYSTEMATIZATION AND EARLY RESULTS

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 85-90 ◽  
Author(s):  
Jordi Pujol GEBELLI ◽  
Amador Garcia Ruiz de GORDEJUELA ◽  
Almino Cardoso RAMOS ◽  
Mario NORA ◽  
Ana Marta PEREIRA ◽  
...  
Keyword(s):  
Duodenal Switch ◽  
Safe Procedure ◽  
Gastric Artery ◽  
Early Complications ◽  
Duodenal Stump ◽  
Surgical Time ◽  
Artery Ligation ◽  
Right Gastric Artery ◽  
Early Results ◽  
The Right

ABSTRACT Background: Bariatric surgery is performed all over the world with close to 500.000 procedures per year. The most performed techniques are Roux-en-Y gastric bypass and sleeve gastrectomy. Despite this data, the most effective procedure, biliopancreatic diversion with or without duodenal switch, represents only no more than 1.5% of the procedures. Technical complexity, morbidity, mortality, and severe nutritional adverse effects related to the procedure are the main fears that prevent most universal acceptance. Aim: To explain the technical aspects and the benefits of the SADI-S with right gastric artery ligation as an effective simplification from the original duodenal switch. Methods: Were included all patients undergoing this procedure from the November 2014 to May 2016, describing and analysing aspects of this technique, the systematization and early complications associated with the procedure. Results: A series of 67 patients were operated; 46 were women (68.7%); mean age of the group was 44 years old (33-56); and an average BMI of 53.5 kg/m2 (50-63.5). Surgical time was 115 min (80-180). A total of five patients (7.5%) had any complication and two (2.9%) had to be reoperated. There were two patients with leak, one at the duodenal stump and other at the esophagogastric angle. There was no mortality. Patients stayed at the hospital a median of 2.5 days (1-25). Conclusions: SADI-S with right gastric artery ligation is a safe procedure with few preliminary complications. The technical variations introduced to the classical duodenal switch are reproducible and may allow this procedure to be more popular. All the complications in this series were not related to the ligation of the right gastric artery.

SNOW: Sitravatinib and nivolumab in oral cavity cancer (OCC) window of opportunity study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6569-6569
Author(s):  
Marc Oliva Bernal ◽  
Daniel Vilarim Araujo ◽  
Douglas Brian Chepeha ◽  
Amy Prawira ◽  
Anna Spreafico ◽  
...  
Keyword(s):  
Immune Cell ◽  
Intraoperative Complications ◽  
Clinical Stage ◽  
Standard Of Care ◽  
Response Assessment ◽  
Complete Response ◽  
Window Of Opportunity ◽  
Antitumor Effects ◽  
Post Surgery ◽  
Early Results

6569 Background: Sitravatinib (receptor TKI against TYRO3, AXL, MERTK and VEGF family of receptors) is predicted to increase M1-type tumor-associated macrophages (TAMs) and decrease MDSCs in the tumor microenvironment. SNOW is a window-of-opportunity study evaluating the immunogenic and antitumor effects of preoperative sitravatinib and nivolumab in patients (pts) with OCC. Early results demonstrated the combination was safe and active (Oliva et al, SITC 2019). Biomarker analyses and updated results are presented. Methods: Pts with untreated T2-4a, N0-2 or T1>1cm-N2 OCC are eligible. All pts receive oral sitravatinib 120mg daily from day (D) 1 up to 48h pre-surgery and 1 dose of Nivolumab 240mg on D15. Surgery planned between D23-D30. Standard of care adjuvant radiotherapy given based on clinical stage. Tumor pictures, fresh tumor biopsies, blood samples taken at baseline, D15 and pre-surgery. Tumor flow cytometry and multiplex immunofluorescence staining performed on all biopsies to study changes in immune-cell populations. Tumor whole-exome sequencing (WES) performed on baseline biopsies. Results: As of Jan 31st 2020, 10 out of 12 planned pts were enrolled. Study treatment was well-tolerated: only 1 pt had grade (G) >3 toxicity (hypertension) and 1 pt required surgery delay due to G2 thrombocytopenia. None had intraoperative complications. 1 pt had wound infection and tracheostomy bleeding 11 days post-surgery, possibly-related to study drugs. All pts had tumor reduction, 9/10 had pathological downstaging, including 1 complete response (Table). All had clear margins with no extranodal extension; none required adjuvant chemotherapy. All pts are alive with no recurrence (median follow-up= 69 weeks). Lower % of MDSCs and increased % of M1-TAMs and M1:M2 ratio trend was seen at D15 and pre-surgery, with stronger effect in major responders. Best responders (Pts S1-S2) had higher % of PD-L1+ TAMs at baseline. Tumor WES revealed an HRAS G12D mutation in pt S2 and a BLM mutation (DNA repair) in pt S6 (no downstaging). Conclusions: Pharmacodynamic analyses support the antitumor and immune effects of sitravatinib and nivolumab in OCC. Immune pathological response assessment and transcriptomics are on-going. Clinical trial information: NCT03575598 . [Table: see text]

The New Generation Siemens Multiline Lithotripter Tube "M": Early Results in Ureteral Calculi

1996 ◽  
Vol 10 (5) ◽  
pp. 403-406
Author(s):  
H. GOETHUYS ◽  
B. WINNEPENNINCKX ◽  
H. Van POPPEL ◽  
L. BAERT
Keyword(s):  
Ureteral Calculi ◽  
Early Results ◽  
New Generation

The Early Results of the Brunelli Procedure for Trapeziometacarpal Instability

1998 ◽  
Vol 23 (6) ◽  
pp. 758-761 ◽  
Author(s):  
S. N. J. ROBERTS ◽  
J. N. BROWN ◽  
M. G. HAYES ◽  
A. SAIES
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Joint Surface ◽  
Carpometacarpal Joint ◽  
Trapeziometacarpal Joint ◽  
Independent Observer ◽  
Abductor Pollicis Longus ◽  
Early Results ◽  
The Mean

We report the results of Brunelli’s abductor pollicis longus transfer for symptomatic instability of the trapeziometacarpal joint in 15 hands (14 patients) at a mean follow-up of 21 months. Patients were assessed subjectively, and objectively by an independent observer. All but one of the patients were very satisfied with the result of the operation, including the six patients who had significant degeneration of the carpometacarpal joint surface preoperatively. Four patients said they had no pain and the mean pain score overall on a visual analogue scale was 1.2 (out of a maximum of 10). Overall the outcome was rated good or excellent in 11 of the 15 thumbs.

A comparison of surgical practice and operative outcomes between retroperitoneal and transperitoneal laparoscopic nephrectomies – 6 years of data from the BAUS Nephrectomy database

2021 ◽  
pp. 205141582110500
Author(s):  
James Jenkins ◽  
Christopher Foy ◽  
Kim Davenport
Keyword(s):  
Partial Nephrectomy ◽  
Surgical Approach ◽  
Intraoperative Complications ◽  
Careful Consideration ◽  
Perioperative Outcomes ◽  
Transfusion Rate ◽  
Volume Data ◽  
Level Of Evidence ◽  
Open Conversion ◽  
The Impact

Objectives: While the choice of surgical approach for laparoscopic nephrectomy is broadly split between transperitoneal and retroperitoneal options, the evidence for the impact of this decision on perioperative outcomes is built on relatively small volume data, with often inconsistent findings and conclusions. We aimed to assess the impact of operative approach on perioperative outcomes for laparoscopic radical, partial and simple nephrectomy and nephroureterectomy through analysis of the British Association of Urological Surgeons (BAUS) Nephrectomy database. Patients and methods: All patients added to the BAUS Nephrectomy database with laparoscopic surgery between 2012 and 2017 inclusively were included and subdivided by operation and surgical approach. Preoperative patient and tumour characteristics, as well as intraoperative and post-operative short-term outcomes, were assessed. Results: Overall, 26,682 operations were documented over the review window (81.6% transperitoneal). Small increases in blood loss ( p = 0.001), transfusion rate ( p = 0.02) and operative length ( p = 0.01) were seen for transperitoneal radical nephrectomies and longer hospital stays seen for retroperitoneal procedures (radical nephrectomy p = 0.00l; partial nephrectomy p = 0.04). Retroperitoneal procedures were associated with increased rates of conversion for simple nephrectomy ( p = 0.02), nephroureterectomy ( p = 0.03) and most notably partial nephrectomy (10.5% versus 4.4%; p = 0.001). No further variation in intraoperative complications, post-operative complications, tumour margin positivity rates, unintended ITU admission, or likelihood of death was identified related to surgical approach. Conclusion: Observed variations in perioperative outcomes were generally modest in nature, and little ground is seen to support a change in operative technique for those committed to one approach. A caveat to this exists with open conversion for retroperitoneal partial nephrectomies and requires careful consideration of patient selection by the individual surgeon. Level of evidence: 4

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