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61.
Kuerten David Fuest Matthias Walter Peter Mazinani Babac Plange Niklas 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2021,259(8):2251-2257
Graefe's Archive for Clinical and Experimental Ophthalmology - To investigate the relationship of ocular blood flow (via arteriovenous passage time, AVP) and contrast sensitivity (CS) in... 相似文献
62.
David J. Biau MD Kurt R. Weiss MD Rej S. Bhumbra FRCS PhD Darin Davidson FRCSC MSc Chris Brown FRCSC PhD Anthony Griffin MSc Jay S. Wunder FRCSC MSc Peter C. Ferguson FRCSC MSc 《Annals of surgical oncology》2013,20(6):1858-1864
Purpose
Local recurrence of a bone or soft-tissue sarcoma is a devastating complication. Minimizing the proportion of positive surgical margins, or tumor contamination, during resection is of paramount importance.Methods
Resections of sarcomas were prospectively evaluated and considered inadequate if unplanned microscopic or macroscopic positive surgical margins were identified or if inadvertent tumor contamination of the wound occurred. Monitoring of performance was continuously performed with a statistical process control method, the cumulative sum test, and regular meetings were held to discuss the reasons for failures. A target performance of 5 % inadequate procedures was chosen.Results
A total of 146 sarcomas—106 soft tissue and 40 bone—were resected during the monitoring period. Six (4 %) procedures were considered inadequate: three patients had inadvertent tumor contamination of the wound, two patients had unplanned microscopic positive margins, and one patient had both. Performance was considered to be adequate during the whole monitoring period.Conclusions
With adequate preoperative planning and surgical technique, the risk of an inadequate resection can be limited. Implementation of a statistical process control method allows for ongoing performance monitoring and ensures that quality remains adequate over time. 相似文献63.
Thomas Alserius Russell E. Anderson Niklas Hammar Tobias Nordqvist 《Scandinavian cardiovascular journal : SCJ》2013,47(6):392-398
Objective. To evaluate if glycosylated haemoglobin 1 (HbA1c) was associated with increased risk of infection and mortality after coronary artery bypass grafting (CABG). Design. Prospective observational study. Preoperative HbA1c concentrations were correlated to outcome in patients followed for an average of 3.5 years after CABG. Results. HbA1c was ≥6% in 68% of 161 patients with diabetes mellitus (DM) and in 3% of 444 patients without DM. Superficial sternal wound infection was observed in 13.9% if HbA1c ≥6% versus in 5.5% if <6% (p=0.007). Mediastinitis occurred in 4.9% if HbA1c≥6% and in 2.1% if HbA1c<6% (p=0.20) (Hazard ratio (HR) 1.9, 95% CI 0.6-5.9). Follow-up mortality was 18.9% in patients with HbA1c≥6% compared to 4.1% if HbA1c<6% (p<0.001) with HR 5.4, (95% CI 3.0-10.0) after multivariable adjustment. The risk of death was similar regardless of DM diagnosis. Conclusions. HbA1c ≥6% was associated with an increased risk of postoperative superficial sternal wound infections and a trend for higher mediastinitis rate and significantly higher mortality three years after CABG. 相似文献
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66.
Martina Bostr?m Marie Kalm Niklas Karlsson Nina Hellstr?m Erkenstam Klas Blomgren 《Journal of cerebral blood flow and metabolism》2013,33(6):935-943
We investigated the effects of ionizing radiation on microvessel structure and complexity in the hippocampus. We also assessed neurogenesis and the neurovascular niche. Postnatal day 14 male C57BL/6 mice received a single dose of 8 Gy to the whole brain and were killed 6 hours, 1 week, 7 weeks, or 1 year later. Irradiation decreased the total number of microvessels and branching points from 1 week onwards and decreased the total microvessel area 1 and 7 weeks after irradiation. After an initial increase in vascular parameter densities, concomitant with reduced growth of the hippocampus, the densities normalized with time, presumably adapting to the needs of the surrounding nonvascular tissue. Irradiation decreased the number of neural stem and progenitor cells in the hippocampus. The relative loss increased with time, resulting in almost completely ablated neurogenesis (DCX+ cells) 1 year after irradiation (77% decreased 1 week, 86% decreased 7 weeks, and 98% decreased 1 year after irradiation compared with controls). After irradiation, the distance between undifferentiated stem cells and microvessels was unaffected, and very few dying endothelial cells were detected. Taken together, these results indicate that the vasculature adjusts to the surrounding neural and glial tissue after irradiation, not vice-versa. 相似文献
67.
Niklas Sandström Bernard Yan Richard Dowling John Laidlaw Peter Mitchell 《Journal of clinical neuroscience》2013,20(9):1213-1218
Poor-grade (World Federation of Neurological Surgeons [WFNS] clinical grading scale grades IV and V) subarachnoid hemorrhage (SAH) is associated with significant morbidity and mortality. However, the correlation between the timing, modality of intervention (clipping or coiling) and the clinical outcome is not clear. This study aims to examine this correlation. Patients presenting with WFNS grades IV and V aneurysmal SAH between 1997 and 2008 to a single centre were studied. An aggressive policy of early intervention was followed, and the selection of endovascular versus microsurgical intervention was made according to angiographic rather than clinical features. Clinical outcomes were graded using the modified Rankin scale (mRS) at 6 month follow-up. One hundred and forty-three poor-grade patients (23.9% of all 598 aneurysmal SAH patients) were studied. Treatment was microsurgical in 83 (58.0%) and endovascular in 60 (42%) patients. Twenty patients (14.0%) were lost to follow-up. Good outcome (mRS 0-2) at 6 months was found in 45 microsurgical patients (63.3%) and 24 endovascular patients (46.1%). This trend towards better clinical outcomes in the microsurgical group was not statistically significant. With an aggressive early treatment policy more than half of the poor-grade SAH patients demonstrated a good clinical outcome. Microsurgery and endovascular treatment, when selected primarily according to angiographic features, were equally likely to achieve good outcome. 相似文献
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69.
Robert D. Beckett Alex N. Isaacs Kaitlin J. Montagano Amy H. Sheehan Darin C. Ramsey Tracy Sprunger 《American journal of pharmaceutical education》2020,84(12)
Objective. To determine the perceived value that pharmacy practice department chairs ascribe to pharmacy faculty candidates having completed a teaching and learning curriculum (TLC) program and related activities.Methods. An 18-item survey instrument was created that was intended to capture the overall impressions of pharmacy practice chairs regarding the value of TLC programs, relative importance compared to other accomplishments (eg, residency completion, board certification), and importance of specific activities. Following pilot testing and establishment of intra-rater reliability, invitations to complete the electronic survey instrument were sent to pharmacy practice chairs (or their equivalent) at accredited Doctor of Pharmacy (PharmD) programs in the United States.Results. Of the 127 pharmacy practice chairs invited, 53 completed the survey (response rate of 41.7%). The majority of respondents held a PharmD degree (90.6%), had been in their role of chair for zero to five years (60.4%), and represented a private institution (54.7%). The majority of respondents who answered the question (32 of 49) felt it was very important or important (16.3% and 49.0%, respectively) that teaching experiences be completed within a formal teaching and learning curriculum program. These programs were believed to be most important for candidates with less than five years of professional experience. Teaching and learning curriculum programs were not deemed to be more important than other accomplishments by most responders. The perceived most important TLC program activities were instruction on didactic and experiential teaching strategies, and experience developing learning objectives, developing examination items, evaluating examination results, and facilitating case conferences or practice laboratory activities.Conclusion. Teaching and learning curriculum programs may provide the foundational experiences needed for pharmacy graduates to stand out among other candidates, although department chairs’ perceptions of the value of teaching and learning curriculum experiences varied. 相似文献
70.
Christoph Kraus Darin Quach David M. Sholtes Erhan Kavakbasi Renske De Zwaef Maxine Dibué John Zajecka Bernhard T. Baune 《Neuromodulation》2022,25(3):316-326
BackgroundA substantial number of patients with major depressive disorder (MDD) do not sufficiently remit after the first lines of antidepressant treatments, making them vulnerable to poor clinical outcomes. Patients who have not had adequate resolution of their depressive symptoms after four antidepressant treatments and/or have been experiencing their current episode of MDD for two years or more (with insufficient responses to adequate antidepressant treatments) should be evaluated for antidepressant vagus nerve stimulation (VNS Therapy). Adjunctive VNS Therapy is a promising long-term treatment option for patients with difficult-to-treat depression (DTD), offering significantly improved remission rates in comparison with usual treatments. However, VNS Therapy requires specialized treatment centers to support patients.Materials and MethodsIn this narrative review, we aim to outline the necessary steps for setting up an antidepressant VNS Therapy service in an efficient manner.ResultsEstablishing a VNS Therapy service requires several high-level considerations: initiation of a collaborative multidisciplinary team of health care professionals; developing a surgical pathway for implantation; consideration of reimbursement and health care coverage; setting up a specialist clinic to identify optimal candidates for VNS Therapy; educating patients and their families about VNS Therapy; and training health care providers on patient-specific VNS Therapy treatment and long-term treatment management.ConclusionsAntidepressant VNS Therapy is a promising treatment option for the long-term treatment of patients with DTD. We have successfully initiated four VNS Therapy service centers for DTD in the United States, Austria, and Germany. Based on our experiences and lessons learned, herein, we have provided advice to psychiatric centers planning to set up a VNS Therapy service for their patients with DTD. 相似文献