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Heilbronn, Germany

Erken H.Y.,Anadolu Medical Center | Akmaz I.,Anadolu Medical Center | Takka S.,Academic Hospital | Kiral A.,Anadolu Medical Center
Journal of Hand Surgery: European Volume | Year: 2015

We performed a retrospective review of 12 patients with dorsal oblique and transverse amputations of the distal thumb who were treated with a volar cross-finger flap from the index finger. The mean patient follow-up period was 28 months postoperatively (range: 19-43 months). There were no instances of flap loss, infection, or donor site complication in our series. The mean Semmes-Weinstein monofilament testing scores on the injured thumb and the donor site were 0.65 g (range: 0.16-2 g) and 0.51 g (range: 0.16-1 g), respectively. The mean 2-point discrimination testing scores on the injured thumb and the donor site were 4.5 mm (range: 3-8 mm) and 4.3 mm (range: 3-7 mm), respectively. This study suggests that the volar cross-finger flap using the index finger is a reliable technique in repairing dorsal oblique and transverse amputations of the distal thumb.Type of study/level of evidence: Therapeutic IV © The Author(s) 2014.

Hofer S.,Innsbruck Medical University | Benzer W.,Academic Hospital | Oldridge N.,University of Wisconsin - Milwaukee | Oldridge N.,Rush University Medical Center
International Journal of Cardiology | Year: 2014

Aims Self-reported health-related quality of life (HRQL) and changes in HRQL have been shown to predict mortality and/or adverse events in patients with coronary artery disease. MacNew Heart Disease HRQL questionnaire scores were examined as predictors of 4-year all-cause mortality. Methods Following referral for angioplasty in 385 patients with coronary artery disease, data were analyzed for differences in all-cause mortality by MacNew Global and subscale baseline and 1- and 3-month change scores (deteriorated ≥ 0.50; unchanged (- 0.49 to + 0.49); and improved ≥ 0.50 points). Results Mean baseline, 1-month, and 3-month MacNew Global and subscale scores were similar in survivors and non-survivors. Mean 1- and 3-month Global and emotional subscale and mean 1-month social subscale change scores decreased more in non-survivors than survivors. Compared with patients whose Global MacNew HRQL scores improved at one month, 4-year all-cause mortality hazard ratio (HR) was higher in patients whose HRQL deteriorated (HR, 1.70, 95% CI, 1.09, 2.65; p = 0.021). Compared with patients whose Global MacNew HRQL improved at three months, 4-year all-cause mortality was higher in both patients whose HRQL had deteriorated (HR, 2.07, 95% CI, 1.29, 3.32; p = 0.003) and patients with unchanged HRQL (HR, 2.62, 95% CI, 1.11, 6.17; p = 0.028). Conclusions A deterioration of ≥ 0.50 points in MacNew HRQL Global scores at both one and three months is predictive of 4-year all-cause mortality. Serial HRQL information may be useful to identify patients at higher risk for adverse cardiac events and mortality and may have implications for determining follow-up frequency and treatment in individual patients. © 2014 Elsevier Ireland Ltd.

Mroczkowski P.,Otto Von Guericke University of Magdeburg | Ortiz H.,Public University of Navarra | Penninckx F.,Catholic University of Leuven | Pahlman L.,Academic Hospital
Colorectal Disease | Year: 2012

Aim There have been initiatives to create a European audit project. This paper addresses the issue of differences in data collected by different registries. Method Patients with rectal cancer treated in 2008 and recorded in quality registries from Belgium, Germany/Poland, Spain and Sweden were analyzed. The comparison included number of patients, gender, age, American Society of Anesthesiology (ASA) classification, preoperative diagnostic and staging procedures, neoadjuvant therapy, surgical treatment and quality of surgery, postoperative complications and adjuvant treatment. Results The Belgian database consisted of 622 patients, the German/Polish database consisted of 3,393 patients, the Spanish database consisted of 1,641 patients and the Swedish database consisted of 1,826 patients. The percentage of patients in each ASA stage was highly variable. MRI use was highest in Spain and Sweden and very low in Germany/Poland. The percentage of cT4 stage tumours in Sweden was much higher than in all other countries. Sweden recorded the highest percentage of primary metastatic disease (20.3%) and Belgium recorded the lowest (10.2%). Neoadjuvant therapy in different protocols was administered to 41.2% patients in Germany/Poland, to 50.8% in Spain, to 55.2% in Belgium and to 62% in Sweden. Laparoscopic surgery (conversion rate) was performed for cure in 5% (28%) of patients in Sweden, in 20.8% (20.6%) in Spain, in 28.6% (15.2%) in Belgium and in 14.5% (8.9%) in Germany/Poland. The 30-day mortality for anterior resection, abdominoperineal excision and Hartmann's procedure in Sweden, Belgium and Spain was 2.0%, 2.3% and 3.1%, respectively. The German/Polish database reported an in-hospital mortality of 3.2%. Conclusion A European quality assurance project in rectal cancer is possible only after data collection is standardized. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Bourget P.,HU Necker Enfants malades | Amin A.,HU Necker Enfants malades | Vidal F.,HU Necker Enfants malades | Merlette C.,HU Necker Enfants malades | Lagarce F.,Academic Hospital
Journal of Pharmaceutical and Biomedical Analysis | Year: 2014

This study compares the performance of a reference method of HPLC to Raman spectroscopy (RS) for the analytical quality control (AQC) of complex therapeutic objects. We assessed a model consisting of a widely used anticancer drug, i.e., 5-fluorouracil, which was compounded in a complex medical device, i.e., an elastomeric portable infusion pump. In view of the main objective, the two methods provided excellent results for the analytical validation key criteria, i.e., trueness, precision and accuracy, ranging from 7.5 to 50mg/mL and in either isotonic sodium or 5% dextrose. The Spearman and Kendall correlation tests (p-value<1×10-15) and the statistical studies performed on the graphs confirm a strong correlation in the results between RS and the standard HPLC under the experimental conditions. The selection of a spectral interval between 700 and 1400cm-1 for both the characterization and quantification by RS was the result of a gradual process optimization, combining matrix and packaging responses. In this new application, we demonstrate at least eight benefits of RS: (a) operator safety, (b) elimination of disposables, (c) elimination of analysis waste, which contributes to the protection of the environment, (d) a fast analytical response of less than 2min, (e) the ability to identify the solubilizing phase, (f) reduction of the risk of errors because no intrusion or dilution are needed, (g) negligible maintenance costs and (h) a reduction in the budget dedicated to technician training. Overall, we indicate the potential of non-intrusive AQC performed by RS, especially when the analysis is not possible using the usual techniques, and the technique's high potential as a contributor to the safety of medication. © 2013 Elsevier B.V.

Bergqvist D.,Academic Hospital
Expert Review of Hematology | Year: 2013

Evaluation of: Beyer-Westendorf J, Lützner J, Donath L et al. Efficacy and safety of thromboprophylaxis with low-molecular-weight heparin or rivaroxaban in hip and knee replacement surgery. Findings from the ORTHO-TEP registry. Thromb. Haemost. 109(1), 154-163 (2013). From the ORTHO-TEP registry on joint replacement arthroplasty (hip and knee) from Dresden, Germany, three periods of different prophylactic regimens have been compared. In the present paper, results from low-molecular-weight heparin and rivaroxaban have been analyzed, with rivaroxaban showing a benefit concerning both effect and side effects. Clinical end points are used, the results being in line with published data from randomized studies. Inclusion in the registry of consecutive patients is important to illustrate generalizability of results obtained in randomized trials. This review discusses the problem with using historical comparisons to draw firm conclusions. © 2013 Expert Reviews Ltd.

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