208 research outputs found

    It's worth cleaning – The examination of the female taper could identify a particular cause of trunnionosis at revision 16 years after total hip arthroplasty

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    Adverse reaction to metal debris (ARMD) is an issue in metal-on-metal (MoM) total hip replacements (THR). It mainly affects large-head MoM THR, whereas 28–32 mm MoM pairings are associated with low long-term revision rates. However, the bearing surface is not necessarily the only cause of metal debris. This report documents with advanced analysis of the retrievals a particular cause of trunnionosis in late failure of a small diameter MoM THR and illustrates the importance of cleaning of the taper when seating the head in THR. A 65-year-old patient was revised due to ARMD 16 years after small diameter MoM THR. Debridement and exchange of the inlay and the head had been performed through an anterior approach. While the cup and the outer surface of the head were accessible to direct analysis by an optical coordinate measuring machine, the female taper had to be analysed indirectly by measuring an imprint. Wear from the cup and the head was within expected low ranges. The analysis of the female taper identified bone fragments, which contributed to trunnionosis. Failure due to ARMD after MoM THR is not necessarily caused by the bearing, but can be due to trunnionosis. Bone fragments within the taper contact in this case highlight the importance of meticulous cleaning of the taper before seating the head, to avoid trunnionosis

    „Research is unfolding again“ (Übersetzung)

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    A research project exemplifying the Collegium Helveticum’s transdisciplinary approach: historian Monika Dommann and artist Hannes Rickli talk to Barbara Bleisch about the project Digital Infrastructures and transdisciplinary ways of working

    Validierung der nichtinvasiven Messung der Gewebeoxygenierung bei Patienten mit herzchirurgischen Operationen und erweitertem hämodynamischem Monitoring

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    Validation of the non-invasive measurement of tissue-oxygenation in cardiothoracic patients with extended hemodynamic monitoring(by Katja Dommann)Monitoring of the hemodynamic values and oxygen supply of cardiothoracic patients in the perioperative period is of high importance in care. Invasive catheter-techniques and semi-optic systems such as the TEE (transesophageal echocardiography) are commonly used. Yet the interpretation and application of these devices requires a certain degree of experience.Based on the application of near-infrared-spectroscopy (NIRS) the InSpectra™ system by Hutchinson offers a non-invasive, continous and simple-to-interpret- monitoring system of the tissue-oxygenation in order to evaluate microperfusion.A study to validate the InSpectra™ system, which is already used to monitor patients other than in the cardiothoracic department, enclosed 40 patients undergoing cardiac surgery, who received a thenar sensor of the InSpectra™ system in addition to the commonly used hemodynamic monitoring. The sensor was placed before induction of anesthetics and remained on the thenar until the first postoperative day on the intensive-care-unit (ICU).During surgery (T1 – T2) and on the ICU (T3 – T5) hemodynamic parameters were taken, blood gases were drawn and the InSpectra™ results were taken.Results of the base-excess (BE) and the mixed-venous saturation (SvO2) did not recover during the course of the observation. Monitoring of the tissue-oxygenation (StO2) yet enabled a good documentation of postoperative reduction and further recovery of microcirculation with the course of time. When minimal StO2 <75% were found it developed to e a good predictor for elevation of serum-lactate, a reduced lactate-clearance and a negative base-excess until day 1 after cardiac surgery.StO2 < 75% seems to be benchmark because it is associated with an increases appearance of multi-organ-failure and death.In summary, the InSpectra™ monitoring system for non-invasive measurement of tissue-oxygenation after cardiac surgery is valid as a fast onset and continous monitoring method. Thou further studies are needed to determine the importance of NIRS in monitoring and therapeutic intervention of cardiosurgical patients

    Validierung der nichtinvasiven Messung der Gewebeoxygenierung bei Patienten mit herzchirurgischen Operationen und erweitertem hämodynamischem Monitoring

    No full text
    Validation of the non-invasive measurement of tissue-oxygenation in cardiothoracic patients with extended hemodynamic monitoring(by Katja Dommann)Monitoring of the hemodynamic values and oxygen supply of cardiothoracic patients in the perioperative period is of high importance in care. Invasive catheter-techniques and semi-optic systems such as the TEE (transesophageal echocardiography) are commonly used. Yet the interpretation and application of these devices requires a certain degree of experience.Based on the application of near-infrared-spectroscopy (NIRS) the InSpectra™ system by Hutchinson offers a non-invasive, continous and simple-to-interpret- monitoring system of the tissue-oxygenation in order to evaluate microperfusion.A study to validate the InSpectra™ system, which is already used to monitor patients other than in the cardiothoracic department, enclosed 40 patients undergoing cardiac surgery, who received a thenar sensor of the InSpectra™ system in addition to the commonly used hemodynamic monitoring. The sensor was placed before induction of anesthetics and remained on the thenar until the first postoperative day on the intensive-care-unit (ICU).During surgery (T1 – T2) and on the ICU (T3 – T5) hemodynamic parameters were taken, blood gases were drawn and the InSpectra™ results were taken.Results of the base-excess (BE) and the mixed-venous saturation (SvO2) did not recover during the course of the observation. Monitoring of the tissue-oxygenation (StO2) yet enabled a good documentation of postoperative reduction and further recovery of microcirculation with the course of time. When minimal StO2 <75% were found it developed to e a good predictor for elevation of serum-lactate, a reduced lactate-clearance and a negative base-excess until day 1 after cardiac surgery.StO2 < 75% seems to be benchmark because it is associated with an increases appearance of multi-organ-failure and death.In summary, the InSpectra™ monitoring system for non-invasive measurement of tissue-oxygenation after cardiac surgery is valid as a fast onset and continous monitoring method. Thou further studies are needed to determine the importance of NIRS in monitoring and therapeutic intervention of cardiosurgical patients

    Microfabricated Active Valves for Liquid and Gas Handling

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    SAMLABJury: H. Hügli (IMT-UniNE), A. Dommann (NTB, Buchs
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