Articles: surgery.
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The da Vinci tele-robot necessitates the acquisition of new skills and surgical educators must develop standardized training programmes. It is possible that virtual reality (VR) computer simulation maybe used and it is necessary to define whether a simulator is an appropriate tool. ⋯ Practice sessions on a VR simulator improve technical performance. The simulator enables surgeons to mount the early part of the learning curve within a laboratory environment, which may lead to a more effective training programme.
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Evaluation of a reduction is currently a static procedure. The purpose of this study was to evaluate a model for analyzing the whole dynamic component of the reduction path up to the final result: the optimal reduction. The entire reduction procedure should be able to be retrospectively analyzed, both qualitatively and quantitatively. ⋯ Using the presented model the paths in a reduction process can be achieved as data in a simple manner. These data are supplied in a second work procedure of an automated evaluation. Thus, multiple possibilities result for retrospective analysis of the data regarding the dynamic process of a reduction.
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Innovations (Phila) · May 2008
Preoperative hemoglobin a1c predicts sternal wound infection after coronary artery bypass surgery with bilateral versus single internal thoracic artery grafts.
: Bilateral internal thoracic artery (BITA) grafting during coronary artery bypass (CABG) improves long-term and event-free survival but may carry a higher risk of wound complications. It is unknown whether preoperative hemoglobin A1c (HbA1c), a measure of long-term glucose control, predicts deep sternal wound infection (DSWI) after BITA grafting. ⋯ : Elevated preoperative HbA1c and BITA grafting were significant predictors of DSWI after CABG. Elevated HbA1c level should be considered in the risk/benefit analysis when selecting patients for BITA grafting.
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Journal of neurosurgery · May 2008
Natural history of unruptured intracranial aneurysms: probability of and risk factors for aneurysm rupture.
The authors conducted a study to investigate the long-term natural history of unruptured intracranial aneurysms and the predictive risk factors determining subsequent rupture in a patient population in which surgical selection of cases was not performed. ⋯ Cigarette smoking, size of the unruptured intracranial aneurysm, and age, inversely, are important factors determining risk for subsequent aneurysm rupture. The authors conclude that such unruptured aneurysms should be surgically treated regardless of their size and of a patient's smoking status, especially in young and middle-aged adults, if this is technically possible and if the patient's concurrent diseases are not contraindications. Cessation of smoking may also be a good alternative to surgery in older patients with small-sized aneurysms.