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41.
Russell A. Faust Adrien J. Kant Attila Lorincz Abbas Younes Elizabeth Dawe Michael D. Klein 《Journal of robotic surgery》2007,1(1):75-83
Minimally invasive surgery is rapidly becoming the desired surgical standard, especially for pediatric patients. Infants and
children are a particular technical challenge, however, because of the small size of target anatomical structures and the
small surgical workspace. Computer-assisted robot-enhanced surgical telemanipulators may overcome these challenges by facilitating
surgery in a small workspace. We studied the feasibility of performing robotic endoscopic neck surgery on a porcine model
of the human infant neck. The study design was a prospective, feasibility pilot study of a small cohort for proof of concept
and for a survival model. Sixteen non-survival piglets weighing 4.5–10 kg were used to develop the surgical approach and operative
technique. Eight piglets aged 3–6 weeks old and weighing 4.0–9.1 kg underwent survival thyroidectomy by a cervical endoscopic
approach using the Zeus surgical robot, which includes the Aesop endoscope holder and “Microwrist” microdissecting instruments.
We succeeded in performing endoscopic robotic neck surgery on a piglet as small as 4 kg, in an operative pocket as small as
2 cm3. Total incision length for all three ports was ≤23 mm. There were no major complications, no major robotic instrument malfunctions
or breakages, and no procedures required conversion to open surgery. These results support the feasibility of robotic endoscopic
neck surgery on a neck the size of a human infant’s.
Electronic supplementary material The online version of this article (doi: ) contains supplementary material, which is available to authorized users. 相似文献
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Wearable monitors for patients following discharge from an intensive care unit: practical lessons learnt from an observational study 下载免费PDF全文
44.
Nagaraja Moorthy DM Rajiv Ananthakrishna DM Dattatreya P. V. Rao DM Satvic C. Manjunath DM Manjunath C. Nanjappa DM 《Echocardiography (Mount Kisco, N.Y.)》2018,35(3):388-390
Intermittent dysfunction of mechanical mitral valve prosthesis is an uncommon condition. It carries serious clinical implications if unrecognized. Here, we present a case of a 28‐year‐old female with a history of rheumatic multivalvular disease, for which she had undergone double valve replacement and tricuspid annuloplasty. Six months later, she presented with heart failure. Clinical examination revealed intermittent loss of closing clicks followed by a pansystolic murmur at the apex, suggestive of mitral prosthetic valve dysfunction. We highlight the echocardiographic findings of paroxysmal mitral valvular regurgitation secondary to prosthetic valve malfunction secondary to prosthetic valve thrombosis. 相似文献
45.
False positive retroaortic left circumflex coronary artery in a patient with atrial septal defect 下载免费PDF全文
Saurabh Kumar Gupta MD DM Anunay Gupta MD DM Sivasubramanian Ramakrishnan MD DM Shyam S. Kothari MD DM 《Echocardiography (Mount Kisco, N.Y.)》2017,34(5):799-801
Retroaortic course of coronary artery is a relative contraindication for device closure of an atrial septal defect. In this brief report, we demonstrate, for the first time, inferior aortic recess mimicking retroaortic left circumflex coronary artery in a patient with atrial septal defect. This distinction is important to avoid spurious diagnosis of anomalous coronary artery denying patient a chance of nonsurgical closure of atrial septal defect. 相似文献
46.
Roopali Khanna MD DM Pujan Shah MD Mousam Dey MD Pravin K. Goel MD DM Puneet Goyal MD DM Shantanu Pandey MD McH 《Echocardiography (Mount Kisco, N.Y.)》2017,34(7):1107-1109
Sinus of Valsalva aneurysm is a rare congenital cardiac abnormality and is usually diagnosed when it ruptures. An asymptomatic 55‐year‐old male of unruptured sinus of Valsalva aneurysm of noncoronary cusp was on medical follow‐up. At 2‐year follow‐up, there was thrombus formation in the aneurysm, mimicking right atrium tumor on 2D transthoracic echocardiography. Cardiac computed tomography showed filling defect in the aneurysm suggestive of thrombus. Considering the high risk of systemic emboli surgery was performed, and aneurysm was repaired with Dacron patch. 相似文献
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48.
Lora Humphrey Beebe Robin Faust Harris 《International journal of mental health nursing》2013,22(5):430-436
This study describes physical activity level in outpatients with schizophrenia spectrum disorders (SSD) using extended‐wear pedometers. Demographic data, body fat and body mass index (BMI) measures were obtained from 24 outpatients. Participants were provided extended‐wear pedometers and instructed to wear them during waking hours for 1 week. More than 79% of subjects met Centres for Disease Control (CDC) obesity criteria. Participants wore pedometers, on average, 6 days during the week. Men walked more steps, walked longer distances, and burned more calories each day; differences were statistically significant for steps and distance on days 3 (t = 2.12, P = 0.045) and 5 (t = 2.19, P = 0.04). Higher percent body fat and BMI were significantly associated with fewer steps walked on most days. Extended‐wear pedometers are an easy‐to‐use, cost‐effective way to document physical activity and evaluate efforts to help this vulnerable group achieve activity‐related health improvements. 相似文献
49.
Streptococcus pneumoniae is an important pathogen worldwide. Accurate sampling of S. pneumoniae carriage is central to surveillance studies before and following conjugate vaccination programmes to combat pneumococcal disease. Any bias introduced during sampling will affect downstream recovery and typing. Many variables exist for the method of collection and initial processing, which can make inter-laboratory or international comparisons of data complex. In February 2003, a World Health Organisation working group published a standard method for the detection of pneumococcal carriage for vaccine trials to reduce or eliminate variability. We sought to describe the variables associated with the sampling of S. pneumoniae from collection to storage in the context of the methods recommended by the WHO and those used in pneumococcal carriage studies since its publication. A search of published literature in the online PubMed database was performed on the 1st June 2012, to identify published studies that collected pneumococcal carriage isolates, conducted after the publication of the WHO standard method. After undertaking a systematic analysis of the literature, we show that a number of differences in pneumococcal sampling protocol continue to exist between studies since the WHO publication. The majority of studies sample from the nasopharynx, but the choice of swab and swab transport media is more variable between studies. At present there is insufficient experimental data that supports the optimal sensitivity of any standard method. This may have contributed to incomplete adoption of the primary stages of the WHO detection protocol, alongside pragmatic or logistical issues associated with study design. Consequently studies may not provide a true estimate of pneumococcal carriage. Optimal sampling of carriage could lead to improvements in downstream analysis and the evaluation of pneumococcal vaccine impact and extrapolation to pneumococcal disease control therefore further in depth comparisons would be of value. 相似文献
50.
Saline contrast echocardiography for the detection of anomalous origin of pulmonary artery from aorta 下载免费PDF全文
Saurabh Kumar Gupta MD DM Abhishek Gupta MD 《Echocardiography (Mount Kisco, N.Y.)》2017,34(1):145-146
Saline contrast echocardiography is a well‐established modality for the diagnosis of right‐to‐left shunt lesions. In this brief report, we demonstrate, for the first time, its usefulness in the diagnosis of anomalous origin of right pulmonary artery from aorta. 相似文献