Gefäßersatz bei infiziertem aortobifemoralen Bypass

The treatment of a long lasting infection of an infrarenal aorto-bifemoral graft in a 68 year old male is reported. The infected dacron prosthesis was replaced by a composite graft bypass using a short knitted Microvel double velour vascular graft bonded with a collagen/rifampicin release system and autogenous saphenous veins in the aorto-biiliacal position applying biprofundal anastomosis. The aortic prosthetic graft was covered in an omental pouch. The postoperative period was without complications. The laboratory findings normalized within a short time. The 6 months follow up was uneventful, the walking distance increased to 600 mtrs.     

Risk of bleeding after dentoalveolar surgery in patients taking anticoagulants

To avoid increasing the risk of thromboembolic events, it is recommended that treatment with anticoagulants should be continued during dentoalveolar operations. We have evaluated the incidence of bleeding after dentoalveolar operations in a prospective study of 206 patients, 103 who were, and 103 who were not, taking anticoagulants. Seventy-one were taking thrombocyte aggregation inhibitors and 32 vitamin K antagonists. Patients were treated according to guidelines developed at the Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. The operations studied included surgical extraction (when the surgeon had to incise the gingiva before extraction), non-surgical extraction, apicectomy, and placement of implants. Patients were given standard postoperative care and those taking vitamin K antagonists used tranexamic acid mouthwash postoperatively.     

Light and sound- emerging imaging techniques for inflammatory bowel disease

Patients with inflammatory bowel disease are known to have a high demand of recurrent evaluation for therapy and disease activity. Further, the risk of developing cancer during the disease progression is increasing from year to year. New, mostly non-radiant, quick to perform and quantitative methods are challenging, conventional endoscopy with biopsy as gold standard. Especially, new physical imaging approaches utilizing light and sound waves have facilitated the development of advanced functional and molecular modalities. Besides these advantages they hold the promise to predict personalized therapeutic responses and to spare frequent invasive procedures. Within this article we highlight their potential for initial diagnosis, assessment of disease activity and surveillance of cancer development in established techniques and recent advances such as wide-view full-spectrum endoscopy, chromoendoscopy, autofluorescence endoscopy, endocytoscopy, confocal laser endoscopy, multiphoton endoscopy, molecular imaging endoscopy, B-mode and Doppler ultrasound, contrast-enhanced ultrasound, ultrasound molecular imaging, and elastography.     

Effect of Improved access to Antiretroviral Therapy on clinical characteristics of patients enrolled in the HIV care and treatment clinic,at Muhimbili National Hospital (MNH), Dar es Salaam,Tanzania

Background  

Sub-Saharan Africa has been severely affected by the HIV and AIDS pandemic. Global efforts at improving care and treatment has included scaling up use of antiretroviral therapy (ART). In Tanzania, HIV care and treatment program, including the provision of free ART started in 2004 with a pilot program at Muhimbili National Hospital in Dar es Salaam. This study describes the socio-demographic and clinical features of patients enrolled at the care and treatment clinic at MNH, Dar es Salaam, Tanzania.     

Comparative efficiency of contrast-enhanced colour Doppler ultrasound targeted versus systematic biopsy for prostate cancer detection

Objective  

To compare the efficiency of contrast-enhanced colour Doppler ultrasound (CECD-US) targeted biopsy versus systematic biopsy (SB) for PCa detection in 1,776 men.     

The Obesity Paradox in Heart Failure: What Is Real Obesity in Heart Failure?

The obesity is a conventional cardiovascular risk factor. Obesity has detrimental effects on heart failure, but has been found to be paradoxically associated with improved survival. The obesity paradox remains controversial in the literatures. There are various underlying mechanisms to explain the obesity paradox in heart failure. Epidemiologic, biochemical, animal studies revealed this unexpected phenomenon, which was described as an obesity paradox. BMI does not provide information body composition and cardiopulmonary fitness status, which can be related to obesity paradox. Still, the obesity paradox is controversial; therefore, intentional weight gaining may not be recommended. Many researches related to obesity paradox have been introduced and further research needs to be done in the future.     

A New Accurate 3D Measurement Tool to Assess the Range of Motion of the Tongue in Oral Cancer Patients: A Standardized Model

In oral cancer treatment, function loss such as speech and swallowing deterioration can be severe, mostly due to reduced lingual mobility. Until now, there is no standardized measurement tool for tongue mobility and pre-operative prediction of function loss is based on expert opinion instead of evidence based insight. The purpose of this study was to assess the reliability of a triple-camera setup for the measurement of tongue range of motion (ROM) in healthy adults and its feasibility in patients with partial glossectomy. A triple-camera setup was used, and 3D coordinates of the tongue in five standardized tongue positions were achieved in 15 healthy volunteers. Maximum distances between the tip of the tongue and the maxillary midline were calculated. Each participant was recorded twice, and each movie was analysed three times by two separate raters. Intrarater, interrater and test–retest reliability were the main outcome measures. Secondly, feasibility of the method was tested in ten patients treated for oral tongue carcinoma. Intrarater, interrater and test–retest reliability all showed high correlation coefficients of >0.9 in both study groups. All healthy subjects showed perfect symmetrical tongue ROM. In patients, significant differences in lateral tongue movements were found, due to restricted tongue mobility after surgery. This triple-camera setup is a reliable measurement tool to assess three-dimensional information of tongue ROM. It constitutes an accurate tool for objective grading of reduced tongue mobility after partial glossectomy.