Acta bio-medica : Atenei Parmensis
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Acute kidney injury (AKI) is a common complication that occurs in a broad spectrum of clinical settings. Cardiac surgery-associated AKI continues to be a well-recognized complication of cardiac surgery with high morbidity and mortality. The lack of early biomarkers has for long prevented timely interventions to mitigate the effects of AKI. ⋯ Neutrophil gelatinase-associated lipocalin (NGAL) has been identified as a promising biomarker for early detection of AKI. Several studies have shown that NGAL levels significantly increase in AKI patients 24 to 48 hours before a detectable increase of serum creatinine. Recent studies also suggest that measurements of urinary NGAL levels in patients at risk for cardiac surgery-associated AKI may facilitate its early diagnosis and allow clinicians to implement therapeutic adjustments that have the potential to reverse renal cellular damage and minimize further kidney injury.
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Comparative Study
Comparison of percutaneous intramedullary Kirschner wire and interfragmentary screw fixation of displaced extra-articular metacarpal fractures.
the management of the displaced extra-articular metacarpal fractures is still a subject of debate in the literature. The purposes of this study were to report the outcomes of unstable extra-articular metacarpal fractures treated by using intramedullary Kirschner wires or inter-fragmentary screws and to determinate which techniques provide better clinical and radiographic results. ⋯ our results indicate that both procedures are effective in the treatment of displaced extra-articular metacarpal fractures. However, we believe K-wires represent the gold standard of treatment for displaced fractures of the metacarpal neck. Instead, screws are more effective for spiroid shaft fractures, while displaced fractures of the base may be treated with either screws or wires.
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2-Chloroprocaine is a local anesthetic with a very short half-life and a favorable evolution of spinal block for ultra-short outpatient procedures. The aim of this retrospective study is to evaluate the clinical impact of the introduction of spinal 1% 2-chloroprocaine compared to general anesthesia at the ARS Medica Clinic (Switzerland). ⋯ The right selection of the local anesthetic makes spinal anesthesia a suitable anesthetic technique for ultra-short outpatient procedures. If short acting local anesthetics are involved, spinal anesthesia could be competitive versus general anesthesia.