111,899 research outputs found
Temporary epicardial pacing in an extremely low-birth-weight infant with congenital atrioventricular block
No full textCongenital atrioventricular block is a rare, but severe occurrence in the newborn can be related to various cardiac malformations or to maternal autoimmune diseases, particularly systemic lupus erythematosus. We report an extremely low-birth-weight infant affected by congenital heart block, due to positive anti-RO/SSA and anti-LA/SSB antibodies of the mother, with progressively increasing respiratory distress syndrome and heart failure. The infant was successfully treated with an external constant-current, single-chamber ventricular (VVI) temporary epicardial pacing, placed on the second day of life, at the weight of 810 g. After this treatment, cardiac failure resolved and respiratory assistance could be rapidly stopped. A single-chamber, rate-responsive, permanent pacemaker was placed at 3 months of life with steroid-eluting, epicardial-pacing leads. We emphasize that early extrathoracic temporary epicardial pacing is able to resolve heart failure in an extremely low-birth-weight infant. © 2007 The Authors; Journal compilation © 2007 Blackwell Publishing, Inc
SUPRA-ANNULAR MITRAL VALVE IMPLANTATION IN VERY SMALL CHILDREN
No full textObjective Mitral valve replacement (MVR) is a surgical option when mitral valvuloplasty is not feasible/successful. This study reviews our experience with MVR in very young children. Methods From July 2004 to January 2014, seven children (mean age 13.3-±-11.2 months; range 4 months to 35 months; mean body weight 6.0-±-2.2-kg) underwent MVR with a mechanical prosthesis in the supra-annular position. To provide better exposure in the left atrium, we performed in all but one case a biatrial transeptal incision according to Guiraudon. Six patients had congenital defects of the mitral valve and one had rheumatic. Six patients had undergone previous cardiosurgical procedures. Results All patients were implanted with a CarboMedics (CarboMedics, Austin, TX, USA) mechanical prosthesis. Mean prosthesis size was 19.0-±-3.1-mm (range 16 to 25). There were no cases of operative or late mortality. At follow-up (mean 67.1-±-34.8 months; range 25 to 108 months) two patients (28.6%) required reoperation both for thrombotic pannus formation over the disc at two and three months from first operation, respectively; only in one case was replacement necessary. Conclusion Supra-annular MVR may be considered a feasible secondary surgical option in children with a small annulus when mitral valvuloplasty is unsuccessful or unsuitable. Early and mid-term outcomes are acceptable but complications are not uncommon, especially related to thrombotic events
author-bios-SRD-19-0063.R1 – Supplemental material for The Network Structure of Police Misconduct
No full textSupplemental material, author-bios-SRD-19-0063.R1 for The Network Structure of Police Misconduct by George Wood, Daria Roithmayr and Andrew V. Papachristos in Socius</p
Low-Computational Cost Stitching Method in a Three-Eyed Endoscope
No full textAortic valve replacement is the only definitive treatment for aortic stenosis, a highly prevalent condition in elderly population. Minimally invasive surgery brought numerous benefits to this intervention, and robotics recently provided additional improvements in terms of telemanipulation, motion scaling, and smaller incisions. Difficulties in obtaining a clear and wide field of vision is a major challenge in minimally invasive aortic valve surgery: surgeon orientates with difficulty because of lack of direct view and limited spaces. This work focuses on the development of a computer vision methodology, for a three-eyed endoscopic vision system, to ease minimally invasive instrument guidance during aortic valve surgery. Specifically, it presents an efficient image stitching method to improve spatial awareness and overcome the orientation problems which arise when cameras are decentralized with respect to the main axis of the aorta and are nonparallel oriented. The proposed approach was tested for the navigation of an innovative robotic system for minimally invasive valve surgery. Based on the specific geometry of the setup and the intrinsic parameters of the three cameras, we estimate the proper plane-induced homographic transformation that merges the views of the operatory site plane into a single stitched image. To evaluate the deviation from the image correct alignment, we performed quantitative tests by stitching a chessboard pattern. The tests showed a minimum error with respect to the image size of 0.46 ± 0.15% measured at the homography distance of 40 mm and a maximum error of 6.09 ± 0.23% at the maximum offset of 10 mm. Three experienced surgeons in aortic valve replacement by mini-sternotomy and mini-thoracotomy performed experimental tests based on the comparison of navigation and orientation capabilities in a silicone aorta with and without stitched image. The tests showed that the stitched image allows for good orientation and navigation within the aorta, and furthermore, it provides more safety while releasing the valve than driving from the three separate views. The average processing time for the stitching of three views into one image is 12.6 ms, proving that the method is not computationally expensive, thus leaving space for further real-time processing
ARTERIAL SWITCH OPERATION AND PLASMA BIOMARKERS: ANALYSIS AND CORRELATION WITH EARLY POSTOPERATIVE OUTCOMES
No full textThe aims of our study were to describe plasma brain natriuretic peptide (BNP), Troponin I (TnI), and Cystatin C (Cys-C) concentration kinetics in the postoperative period after arterial switch operation in neonate, and to test the correlation between the plasma biomarkers and early clinical outcomes. We prospectively enrolled 29 neonates who underwent ASO. All patients received Custodiol cardioplegia. Blood samples were collected preoperatively (one day before) and in the ICU immediately after admission, and then 6, 12, 24, and 48 h after surgery. TnI peak (mean 17.23 ± 7.0 ng/mL) occurred between the arrival in the ICU and the 6th hour, then we had a constant decrease. TnI had a good correlation with the inotropic support time (r = 0.560, p = 0.0015) and ICU time (r = 0.407, p = 0.028), less than with ventilation and Hospital stay (r = 0.37, p = 0.0451 and r = 0.385, p = 0.0404). BNP peak (mean 4773.79 ± 2724.52 ng/L) was in the preoperative time with a constant decrease after the operation and it had no significant correlations with clinical outcomes. The CyS-C had the highest preoperative values, which decreased during the operating phase, and then constantly increased upon arrival to the ICU with a peak at 48 h (mean 1.76 ± 0.35 mg/L). CyS-C peak had a good correlation with a plasmatic creatinine peak (r = 0.579, p = 0.0009) but not with other clinical outcomes. Our study demonstrated significant correlations between the Tnl peak and early clinical outcomes in neonates undergoing arterial switch operation. Other plasma biomarkers such as the BNP and CyS-C had no direct correlation
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
No full text“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
The role of endoscopy in the treatment of IV type laryngotracheal cleft complications after surgical repair
No full textLaryngotracheal cleft (LTC) is a rare congenital anomaly. Severe forms of LTC are usually treated surgically using extracorporeal circulation. Despite tremendous improvement of surgical techniques, postoperative complications are still frequent. We report a comprehensive description of an endoscopic approach to diagnosis, surgical repair and endoscopic treatment of complications after correction in a type IV LTC. © 2013 Elsevier Ireland Ltd
Aortic arch reconstruction in newborns with an autologous pericardial patch: contemporary results.
No full textThe incidence of recurrent aortic arch obstruction after Norwood procedure and other types of aortic arch reconstruction in newborns remains high. Biological and synthetic materials are used to enlarge the aorta. We report our experience using autologous pericardium to reconstruct the aortic arch in patients with hypoplastic left heart syndrome, aortic arch interruption and hypoplastic aortic arch.
A retrospective analysis of 39 consecutively operated patients evaluated after an initial Norwood and other types aortic arch repair was performed. The presence of recurrent arch obstruction (mean gradient >= 20 mmHg) and its management were noted. The mean weight of our patients was 3.2 +/- 0.7 kg.
The mean age at primary surgical correction was 7.4 +/- 6.8 (range 1-35 days). All patients were discharged without a significant residual gradient at the aortic arch except 4 who had a peak gradient of >= 30 mmHg. The overall incidence of recurrent arch obstruction was 28.2% (11 patients). Four (12.1%) patients had a distal obstruction, 1 (3%) had proximal obstruction and 1 had a mid-transverse arch obstruction. All patients underwent aortic arch reintervention consisting of balloon dilatation, and only after unsuccessful dilatation, 3 underwent surgical patch aortoplasties.
The use of autologous pericardium in aortic arch reconstruction procedure is effective and associated with an acceptable incidence of recurrent arch obstruction. Its availability and characteristics make it an attractive alternative to other materials
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