damage control orthopedics in the polytrauma patient

... corresponding delay in axon myelination [24] We have used lysolecithin-induced demyelination of the spinal cord to examine the possibility that ablation of NG2 also impedes repair of myelin damage in the ... were obtained using eriochrome cyanin staining to quantify the extent of myelin damage (data not shown) Thus, despite the initially larger extent of inflammation and loss of myelin in wild type ... of NG2 in multiple cell types during the processes of demyelination and remyelination Following microinjection of L-a-lysolecithin into the spinal cord white matter, we have investigated the activation,...

Ngày tải lên: 19/06/2014, 22:20

... of either warfarin, enoxaparin, or combination enoxaparin and warfarin therapy Most patients were discharged to home or to a rehabilitation facility on the 3rd or 4th postoperative day Indication ... ligament avulsions [18] In our series, there was a low overall rate of wound complications and infections, and there was no increase in this type of morbidity in patients undergoing the simultaneous ... Cefazolin (clindamycin if penicillin-allergic) antibiotic coverage was extended for 24 hours postoperatively Oral as well as parental narcotics were utilized for pain control in the majority of patients...

Ngày tải lên: 20/06/2014, 04:20

... at the anticipated crossing point of the nerve and the artery His right RLN was found not to follow the usual course of the nerve in the tracheaesophageal groove The dissection was advanced in ... anatomic finding Association of two anatomic variations has occurred in the same nerve, presenting the variation of the variation” Consent Written informed consent was obtained from the patient ... of the ILN in one patient is an extremely rare coincidence The prevalence of non-recurrent nerve has been reported below 1% [5-7] and increases the risk of ILN injury The laryngeal entry point...

Ngày tải lên: 10/08/2014, 23:21

... deactivates their inflammatory and antigen-presenting pathways In summary, the greater the inflammation and injury, the greater the counter-regulation Measurement of immune responsiveness During the ... preventing excessive inflammatory reactions in intensive care unit patients If the response is transient, then the beneficial effect dominates However, extensive systemic inflammation (e.g following ... cytokine profiling (differentiation of type 1/2 cytokine patterns by intracellular cytokine staining and flow cytometric analysis) have been developed Using standard operation procedures, interassay...

Ngày tải lên: 12/08/2014, 18:21

... References Diabetes Special Interest Group homepage [http://diabetes gha.org] Mesotten D: Tight glycaemic control in the intensive care unit: pitfalls in the testing of the concept Crit Care 2008, ... sweet debate: glycemic control in the intensive care unit Crit Care Med 2008, 36:3271-3272 Davidson PC, Steed RD, Bode BW: Glucommander A computer-directed intravenous insulin system shown to be ... Acknowledgments The authors gratefully acknowledge Joyce Reid and Kathy McGowan for their tireless work in support of the DSIG, the Georgia Hospital Association for its generous facilities and administrative...

Ngày tải lên: 13/08/2014, 16:20

... to perform the procedure on the corpses, although this was not needed, as no living humans were involved in the study Apart from packing swabs in the abdomen and removing them again, the procedure ... training and performed the procedure themselves Before the course, references [5-8] were handed out to the participants At the beginning of the session, the teacher briefly described the indications ... resulted in patients dying due to bleeding shock when they were transferred to the CT scanner training on the retroperitoneal packing procedure to other hospitals in our region, so trauma patients...

Ngày tải lên: 13/08/2014, 23:20

... utilizing their individual expertise This book outlines the principles of dealing with such patients including the preferences of techniques and the hardware available The text is divided into ... Acquisitions: Gina Almond Development: Beckie Brand Set in 10/13 Palatino by Newgen Imaging Systems (P) Ltd., Chennai, India Printed and bound in Singapore by COS Printers Pte Ltd For further information ... trunk into the superior vena cava Right: A left azygous (hemiazygous) vein drains blood from the lower trunk into a left superior vena cava and from there into the right atrium via the coronary sinus...

Ngày tải lên: 14/08/2014, 07:20

... occasion, the cephalic vein may break during lead insertion If the two leads cause a very tight fit in the vein, it may, as a consequence, invaginate the vein into the subclavian vein The torn ... sewing in the valve, the lead can be positioned on the endocardial surface of the ventricle, using the approach just described via the atrium The sewing ring of the valve will then cover the ... vein retained guide wire technique Left: Two leads are passed along an intact cephalic vein Right: The cephalic vein is torn with pushing of the second lead into the subclavian vein The vein...

Ngày tải lên: 14/08/2014, 07:20

... but rather proceed retrograde towards the arm in the axillary vein or up into the neck in the internal jugular vein (Figure 7.4) Although this can usually be prevented by not peeling the introducer ... annuloplasty ring to the apex of the right ventricle The other lead (white arrow) lies in the body of the right atrium The operation of the Locator® produces only a small change in the distal curvature ... (SelectSite® , Medtronic Inc.) At the distal end, four views of the catheter are shown demonstrating the range through which the catheter can be steered In the center is the thin 4.1F lumenless fixed...

Ngày tải lên: 14/08/2014, 07:20

... outside the vein in the pacemaker pocket has also been suggested The lead is secured to the tissues via the lead collar, using slowly absorbable suture material The lead can then be drawn into the intravascular ... vena cava will result in marked difficulties in trying to achieve left ventricular pacing The incidence of this abnormality draining into the coronary sinus is about 3–5% of patients with structurally ... Coronary sinus drains into left subclavian vein Univentricular heart Stenosis of the coronary sinus ostium Unroofed coronary sinus Wolff-Parkinson-White Coronary sinus diverticulum Interrupted inferior...

Ngày tải lên: 14/08/2014, 07:20

... ventricular lead passing inferior without a bend as if into the floor of the right atrium and fits nicely with the accompanying schematic Depending on its position in the ventricle, the lead tip may ... permanent pacemaker implantation in a pregnant patient shrouded in lead from the diaphragm down Following physiologic pacing, in an otherwise normal female, there is no contraindication to pregnancy [123] ... leads requiring a thoracotomy is not indicated • In the adult, provided the patient is in sinus rhythm, reestablishment of atrioventricular synchrony is essential • In some centers, a single pass...

Ngày tải lên: 14/08/2014, 07:20

... show the ventricular lead emerging from the coronary sinus looping in the right atrium and then passing to the floor of the right ventricle The atrial lead (At) lies against the lateral wall of the ... to show the ventricular lead emerging from the coronary sinus, looping in the large right atrium and passing through the tricuspid valve to the floor of the right ventricle (white arrow) The atrial ... paradoxical embolism The decision would depend on the size of the shunt, age of the patient, previous emboli and the experience of the institution in closing such shunts The advent of transvenous...

Ngày tải lên: 14/08/2014, 07:20

... (RAO) showing dual chamber pacing in a patient with Ebstein’s anomaly The passive-fixation atrial lead lies in the atrial appendage The passive-fixation right ventricular lead lies in the atrialized ... the right subclavicular region to the superior vena cava and the stub of the right atrium It then proceeds behind the baffle into the anatomical left atrium, where it is attached to the roof In ... showing dual chamber pacing in a patient with the Mustard procedure In all views, the upper active-fixation lead is attached to the roof of the left atrium, but unlike in Figures 20.3 and 20.4, the...

Ngày tải lên: 14/08/2014, 07:20

... at the time of the original surgery As described earlier, the lead can be positioned in the ventricle, via the atrium and the sewing ring of the prosthetic tricuspid valve will then cover the ... operatively the coronary sinus may not drain directly into the right atrium The surgeon, in order to protect the conducting system may position the prosthetic tricuspid valve, so that the coronary sinus ... showing dual chamber pacing in a patient with the Mustard procedure In the PA view, active-fixation leads are attached to the roof of the left atrium and lateral wall of the left ventricle In the...

Ngày tải lên: 14/08/2014, 07:20

... portion of the single ventricle The two epimyocardial leads are on top of each other in the PA view which has been highlighted with a box In the L Lat view, a black arrow points to the two epimyocardial ... pacing There is both sensing and pacing in the atrium Ventricular pacing demonstrates a right bundle branch block configuration and a left axis deviation suggesting left ventricular pacing from the ... Prejean CA Pacing in the middle cardiac vein in a patient with tricuspid prosthesis PACE 2002; 25: 243–244 73 Bos HS, Pop GAM, Stel EA et al Dual site coronary sinus pacing in a patient with an...

Ngày tải lên: 14/08/2014, 07:20

... tract, 103 innominate vein, internal jugular approach, limitation, interrupted inferior vena cava, 41 intra-atrial baffle, 40, 89, 91 repair, 41 introducers, funnel introducer, 6, second introducer, ... LK et al Permanent pacing in patients with univentricular heart (Abstract) PACE 1994; 17: 806 251 Blackburn MEC, Gibbs JL Ventricular pacing from the coronary sinus in a patient with a Fontan ... al Transvenous ventricular pacing options in Ebstein’s anomaly Indian Heart J 1998; 50: 565–568 201 Andersen C, Oxhøj H, Justensen P Pacing in a patient with Ebstein’s anomaly PACE 1989; 12: 1586–1588...

Ngày tải lên: 14/08/2014, 07:20

... prognostic indicator in fulminant hepatitis in patients without encephalopathy upon admission [10,11] In the present study, we examined 11 proinflammatory genes in patients receiving therapy in the ... GPIb-IX-V Therefore, upregulated VWF may represent unstable hemostasis and reflect damage to endothelial megakaryocytes expressing VWF In the signaling pathway, VWF interacts with integrins in the ... functions in the complement and coagulation cascades, linking downstream to the inflammatory process or to B cell receptor signaling NAMPT is another indicator for prognosis It is the rate-limiting...

Ngày tải lên: 18/06/2014, 16:20

... and Cz-TMS in the OSAS patients, but not in the normal individuals In both groups the amplitudes of the MEPgg in response to AL-TMS and Cz-TMS increased during tongue protraction in comparison ... observed in the OSAS group, supporting the reality of OSAS-related changes in the corticomotor control of the genioglossus In this view, it is of importance to note that in the OSAS group the influence ... with the AHI In other words, the more severe was the OSAS and hence the instability of the upper airway, the more responsive was the genioglossus to TMS and hence, possibly, the higher the drive...

Ngày tải lên: 12/08/2014, 14:20

... control in only twothirds of ICU patients Continuous insulin infusion Most study protocols used continuous intravenous insulin infusion combined with intravenous bolus injections Sliding scale ... with continuous insulin infusion combined with frequent blood glucose determinations and the use of the last two blood glucose values to determine the insulin infusion rate Although there is ... 10 No Meijering et al we review the results of clinical trials using insulin/glucose algorithms in critically ill patients, focusing on the number of blood glucose determinations in the desired...

Ngày tải lên: 12/08/2014, 23:21

... of insulin [27,42] Total insulin prescribed by SPRINT is limited to U/hour to minimise saturation and the administration of ineffective insulin [23,29,30,43] Insulin is given predominantly in ... SPRINT, Specialised Relative Insulin Nutrition Tables Figure shows the average nutrition intake and insulin administration rate for the first days on the SPRINT protocol The average nutrition intake ... Porte D Jr, Kahn SE: The effect of insulin dose on the measurement of insulin sensitivity by the minimal model technique Evidence for saturable insulin transport in humans J Clin Invest 1996, 97:501-507...

Ngày tải lên: 13/08/2014, 10:20