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Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: Developmental Medicine and Child Neurology
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: Operative Orthopadie und Traumatologie
September/22/2020
Abstract
Aim of surgery: The placement of an external elbow fixator can be statically carried out as temporary stabilization or as a hinged movement fixator. As a hinged movement fixator a functional follow-up treatment is possible due to control of the joint guidance and reduction of the compromising forces on the osteoligamentous structures.
Indications: As a temporary stabilization of the elbow, the external fixator is used as a damage control method. As a movement fixator it is used as an additional protection and movement control after complex osteoligamentous interventions and persisting tendency to dislocation of the joint and also as a standalone procedure. In some cases, the procedure is also used in distraction arthrolysis of stiff elbows and as a salvage procedure in patients with relevant comorbidities as part of fracture treatment.
Contraindications: Inexperience in relation to the procedure as well as a local acute infection at the level of the intended pin locations should specifically be mentioned as contraindications. In addition, compliance and patient understanding of the procedure are essential for the success of treatment.
Surgical technique: Soft tissue preparation for pin placement should be preferred over percutaneous incisions to enable a safe bone exposure. Knowledge of the course of neurovascular structures (particularly the radial nerve) is essential. When placing a hinge, knowledge of the position and detection of the idealized center of rotation is of fundamental importance.
Postoperative management: The type of postoperative management required essentially depends on the underlying injury. When placing a hinged fixator, the aim is to enable movement as early as possible. Nevertheless, blocking of the hinged fixator may be useful for a short period of time. Adequate pin care over the duration of the treatment is essential in order to prevent complications.
Results: Good functional results have been reported for the treatment of unstable elbows after primary and secondary placement of a hinged external fixator. Good functional scores and improvement in the range of motion were also recorded in the context of an arthrolysis (additive for open arthrolysis or distraction arthrolysis); however, in contrast a significant number of complications associated with this surgery are likely to emerge. As a definitive salvage procedure, satisfactory results were obtained in a small case series of a selected older patient group with relevant comorbidities.
Keywords: Damage control procedure; Distraction arthrolysis; Hinged external fixator; Salvage procedure; Temporary stabilization.
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Publication
Journal: Journal of Nephrology
September/22/2020
Abstract
A combined kidney and pancreas transplant is a therapeutic option for patients with type 1 diabetes and end-stage renal disease. After successful transplantation, fertility is rapidly restored, allowing women of childbearing age to have spontaneous pregnancies and men to father pregnancies. These pregnancies are at increased risk for maternal and neonatal adverse outcomes due to immunosuppressive therapy, comorbidities, previous type 1 diabetes and previous transplant surgery, although the majority ends with the birth of a live and healthy offspring. Hypertension, miscarriages, diabetes, infections, graft rejections, preterm delivery and low birth weight may complicate pregnancies after pancreas-kidney transplantation. Since not all immunosuppressive drugs can be safely used in pregnancy, it is important to review immunosuppressive treatment before conception. Adequate pre-conception counseling is important to inform women and their partners about potential risks for the pregnancy and the grafts and the advantages of pregnancy planning. These pregnancies should be managed within a multidisciplinary team, comprising a transplant physician, an endocrinologist, a nephrologist, an obstetrician and a neonatologist. Last but not least, it is very important to continue collecting data on the pregnancies in pancreas-kidney transplantation with the aim to improve knowledge and to generate evidence-based guidelines for the care of women after pancreas-kidney transplants who are considering a pregnancy.
Keywords: Immunosuppressive therapy; Kidney transplantation; Pancreas transplantation; Pregnancy after transplantation; Pregnancy in kidney donor; Pregnancy planning.
Publication
Journal: Current Hypertension Reports
September/22/2020
Abstract
Purpose of review: To present the evidence that describes what is being measured by upper-arm cuff blood pressure (BP) and the level of accuracy compared with invasive central aortic and brachial BP. Potential causes of inaccuracy and emerging methods are also discussed.
Recent findings: On average cuff systolic BP systematically underestimates invasive brachial systolic BP, although in a given individual it may substantially under- or over-estimate central aortic systolic BP. Such errors may affect individual health management outcomes and distort population level data on hypertension prevalence and control. Oscillometric cuff BP is particularly susceptible to inaccuracy in people with high arterial stiffness and with pathophysiological BP waveform shapes. Emerging cuff-less BP methods will be susceptible to inaccuracy if oscillometric cuff BP is used for calibration. The original purpose of cuff BP was to estimate central aortic BP. Recent evidence has shown substantial inaccuracy of oscillometric cuff BP exists for the measurement of invasive central aortic and brachial BP. Thus, development of more accurate BP methods, through better understanding of oscillometric and BP waveform morphology, is needed to improve health outcomes related to high BP.
Keywords: Aortic blood pressure; BP; BP management; Blood pressure cuff; Brachial blood pressure; Hypertension.
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
Publication
Journal: MMW Fortschritte der Medizin
September/22/2020
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