Technology and health care : official journal of the European Society for Engineering and Medicine
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Rotational malalignment following intramedullary nailing is a well-recognised problem. The threshold for clinically relevant malrotation has been established to be in the region of 15° whereas the incidence of significant malrotation following femoral nailing ranges from 22 to 43 percent. Many studies have been performed to address this issue with the major challenge acknowledged to be intraoperative control of femoral anteversion. ⋯ Statistically, there is no significant difference between the mean results for femoral antetorsion. The advantage of the method proposed in the current study, is the opportunity to enter the ventral femoral cortex during the surgical procedure without disturbing the process of femoral nailing. Thus, the surgeon can avail of continuous control of femoral rotation intra-operatively.
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Technol Health Care · Jan 2010
Prognostic value of procalcitonin (PCT) and/or interleukin-6 (IL-6) plasma levels after multiple trauma for the development of multi organ dysfunction syndrome (MODS) or sepsis.
Despite recent advances in treatment of severe injured patients, e.g. due to damage control orthopaedics, multi organ dysfunction syndrome (MODS) and sepsis are major complications in daily practice. During one year 94 patients were prospectively collected. ⋯ ISS 16, age 18-60 y, primary admission to our level-1 trauma center, survival > 48 hours after trauma. The development of MODS and sepsis were observed and different groups were formed (+/-). Demographic data revealed no significant differences between the subgroups. Comparing groups +MODS and -MODS significant differences on admission day were observed, when PCT showed first on day 2 after trauma differences. Regarding the development of sepsis PCT was advantageous to IL-6 showing significant higher plasma levels in group +sepsis from the first day after trauma. Serum levels of IL-6 and PCT could be useful in early identification of high risk patients to develop posttraumatic MODS. For sepsis PCT is the better prognostic factor.
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Technol Health Care · Jan 2009
ReviewWireless solutions for managing diabetes: A review and future prospects.
Diabetes is rapidly growing in prevalence worldwide. The number of people with diabetes was 171 million in 2000 and will grow to 366 million by 2030. One reason for this is a growing elderly population, but younger people are increasingly likely to develop diabetes due to an increase in mean weight and a decrease in exercise. ⋯ In this paper, the needs for information, change in lifestyle, health monitoring, and management of medication and complications in diabetes are analysed. They form a basis for following review of available wireless solutions for managing diabetes. Finally, future prospects of mobile management of diabetes are discussed.
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Technol Health Care · Jan 2009
3D visualized robot assisted reduction of femoral shaft fractures: evaluation in exposed cadaveric bones.
The main problems in intra-medullary nailing of femoral shaft-fractures are leg-length discrepancies and rotational differences with an incidence of 2-18% and 20-40% respectively. These may lead to severe postoperative sequelae such as additional correctional operations and difficult rehabilitation. Insufficient visualization can be considered the main reason for these complications. ⋯ Manipulation was controlled via a force-feedback joystick. This way, collisions of the fragments were transmitted back to the surgeon. At the end of the reduction the robot could rigidly retain the fragments' position.
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Technol Health Care · Jan 2009
Anaemia in older people with chronic heart failure: The potential cost.
Studies suggest benefits from correcting anaemia in heart failure using a combination of erythropoiesis-stimulating agents (ESAs) and intravenous iron. We set out to investigate the number of older patients who would require treatment of anaemia in a large teaching hospital in the United Kingdom and the cost implications. The prevalence of anaemia and chronic kidney disease (CKD) in patients 65 years and older with systolic dysfunction attending the local heart failure clinic was determined. ⋯ In our study of 86 heart failure patients, mean age 81 years, 34% have anaemia and 73% have stage III CKD with estimated glomerular filtration rate < 60 ml/min/1.73 cm2. At the haemoglobin threshold value of