Procedural and one-year outcomes of the BASILICA technique in Europe: the multicentre EURO-BASILICA registry.

Background: The real-world outcomes of the use of the BASILICA (Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction) transcatheter technique in Europe have not been described.

Aims: We sought to evaluate the procedural and one-year outcomes of BASILICA in patients at high risk for coronary artery obstruction (CAO) undergoing transcatheter aortic valve implantation (TAVI) in a multicentre European registry (EURO-BASILICA).

Methods: Seventy-six patients undergoing BASILICA and TAVI at ten European centres were included.

Neglected Achilles tendon rupture with central insertional plantaris tendon hypertrophy: two cases.

A neglected Achilles tendon rupture is often characterized by muscle weakness and an overlengthened repair by scar tissue. Reconstructive surgery is usually performed taking into account the patient's required level of function. Two surgical cases of neglected Achilles tendon rupture are presented in this article.

A life without pain: a case report.

Congenital insensitivity to pain is a rare condition with an abnormality of interpretation of painful stimuli. This case report illustrates how a sequence of injuries after no or trivial trauma incapacitated a young boy. Especially the bilateral collapse and dislocation of the hip is an unusual sequela of this disorder.

Tibiotalocalcaneal arthrodesis using a reamed retrograde locking nail.

New techniques for tibiotalocalcaneal arthrodesis ideally should improve union rate and reduce the complication rate. The purpose of this study was to evaluate the union rate of tibiotalocalcaneal arthrodesis achieved using an intramedullary nail without formal debridement of the subtalar joint and open or percutaneous debridement of the ankle joint. Consolidation time, complication and satisfaction rates, American Orthopaedic Foot and Ankle Society ankle/hindfoot score, and shoe adaptation were assessed.

Acetabular augmentation ring for recurrent dislocation of total hip arthroplasty: 60% stability rate after an average follow-up of 74 months.

Between 1988 and 2002, 47 patients (50 hips) were treated with acetabular shell augmentation arthroplasty for recurrent idiopathic dislocation of their total hip arthroplasty. Apparent causes for dislocation such as deep infection, component malposition, or polyethylene wear were excluded. Follow-up averaged 74 months (range, 12-178 months), and clinically, 30 hips (60%) did not present a subsequent dislocation at most recent follow-up.

Stenting and abciximab in primary angioplasty: a review of current status.

Improvement of stent deployment techniques and advances in antiplatelet therapy have shown that stenting in the setting of ST-elevation myocardial infarction (STEMI) is safe and effective. Randomized trials have found that as compared to balloon angioplasty, coronary stenting does not reduce mortality and reinfarction, despite the reduction in target vessel revascularization. Furthermore, these benefits seem to be reduced when applied to unselected patients with STEMI.

Unsuccessful reperfusion in patients with ST-segment elevation myocardial infarction treated by primary angioplasty.

Background: Several studies have shown that patency of the epicardial vessel does not guarantee optimal myocardial perfusion in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI). The aim of the current study was to identify clinical and angiographic correlates of unsuccessful reperfusion by the use of myocardial blush grade in a large consecutive cohort of STEMI patients.

Methods: Our population is represented by a total of 1,548 consecutive patients with STEMI treated by primary angioplasty at our institution.

Coronary stenting and abciximab in primary angioplasty for ST-segment-elevation myocardial infarction.

Advances in anti-platelet therapy and improvement of stent deployment techniques have improved the safety and efficacy of stenting in the setting of ST-segment-elevation myocardial infarction (STEMI). However, in randomized trials, routine coronary stenting does not reduce mortality and re-infarction, compared to balloon angioplasty. Further, the benefits in target vessel revascularization seem to be reduced when applied to unselected patients with STEMI.

The Zwolle global experience on primary percutaneous coronary intervention.

Timely restoration of antegrade blood flow in the infarct-related artery of patients with ST-segment elevation myocardial infarction (STEMI) results in myocardial salvage and improved survival. We describe the Zwolle approach with regard to prehospital phase, the first 15 min in hospital, initial pharmacological therapy, angiography, angioplasty, risk stratification, rehabilitation and secondary prevention. Confirmation of the diagnosis by 12-lead electrocardiography by either general practitioners or ambulance paramedics allows substantial reduction in the time-delay to first balloon inflation, as the hospital and the catheterization laboratory can be prepared in advance, and the emergency room and the coronary care unit with their unavoidable delays can be skipped on the way to acute angiography.

Compliance of Dutch orthopedic departments with national guidelines on thromboprophylaxis. A survey of Dutch orthopedic thromboprohylaxis.

All 110 Dutch orthopedic departments were sent a survey on perioperative thromboprophylaxis protocols, and 79% responded. After hip and knee replacements, all used pharmacological thromboprophylaxis: a low-molecular weight heparin (LMWH) in 87% of departments, which was most often combined with vitamin K antagonists (VKAs). LMWH was usually started preoperatively (91%).

Impact of ST-segment depression resolution on mortality after successful mechanical reperfusion in patients with ST-segment elevation acute myocardial infarction.

The aim of the present study was to evaluate the additional prognostic effect of ST-depression resolution in 610 patients who had ST-elevation myocardial infarction and underwent successful primary angioplasty (postprocedural Thrombolysis In Myocardial Infarction 3 flow and complete resolution of ST-segment elevation). Incomplete resolution of ST-segment depression (<70%) was observed in 50 patients (8.2%).

Impaired myocardial perfusion is a major explanation of the poor outcome observed in patients undergoing primary angioplasty for ST-segment-elevation myocardial infarction and signs of heart failure.

Background: The aim of the present study was to investigate the prognostic implication of myocardial perfusion in patients with ST-segment-elevation myocardial infarction (STEMI) and signs of heart failure, treated with primary angioplasty.

Methods And Results: Our population is represented by 1548 consecutive patients undergoing primary angioplasty for STEMI. Congestive heart failure was defined as Killip class >1 at admission.

Response of preschool children with asthma symptoms to fluticasone propionate.

Background: Many uncertainties remain in the diagnosis and treatment of preschool children with asthma symptoms.

Objective: We sought to determine the subgroups of preschool children (aged 12-47 months) with recurrent asthma symptoms most likely to respond to inhaled fluticasone propionate (200 microg/d).

Methods: Subgroups of pooled data from 2 similar 12-week multicenter studies were analyzed.

Limited hip abduction in the infant.

This article addresses two important questions: What is the relationship between limited abduction and hip dysplasia in infants? Does untreated limited abduction in the infant ultimately lead to developmental dysplasia of the hip? In the authors' population of 683 babies, limitation of abduction had a sensitivity for the diagnosis of hip dysplasia of 69%, a specificity of 54%, a positive predictive value of 43%, and a negative predictive value of 78%. In the group with sonographically proven hip dysplasia, 70 of 226 babies (31%) showed no limitation of abduction, and in the group without dysplasia 210 of 457 (46%) showed manifest limitation of abduction. One hundred thirty-six babies with limited abduction but a normal sonographic examination were left untreated.

Adequacy testing in peritoneal dialysis: a five years experience in a single dialysis center.

Background: An increasing number of patients is treated with peritoneal dialysis (PD). Adequacy testing in PD has gained wide interest because of its shown relation with morbidity and mortality.

Methods: We describe retrospectively the 5 years follow-up (1993-1998) of adequacy testing of our PD patient population on 1 January 1998.

Hypertensive patients and diabetes: a high-risk population.

Rising worldwide rates of diabetes mellitus heighten the need to maintain adequate metabolic control in diabetic patients and to control for other cardiovascular risk factors, such as lipid profile disturbances, high blood pressure, and smoking habits. This is especially the case in diabetic patients who also present with hypertension, a co-morbid state that is present in at least 50% of Type 1 and Type 2 diabetic patients. Cardiovascular disease is present in 75% of all diabetes-related deaths, and the concomitant condition of diabetes and hypertension is believed to act synergistically on elevating the risk for cardiovascular disease.

Effects of inhaled fluticasone propionate administered with metered dose inhaler and spacer in mild to moderate croup: a negative preliminary report.

Beneficial effects of treatment of viral croup with inhaled corticosteroids and administered with a jet-nebulizer have been reported in recent years. To facilitate such therapy at home and avoid hospitalization, the administration of inhaled corticosteroids with a metered dose inhaler (MDI) with a holding-chamber was studied as a potential alternative. In a hospital-based prospective, double-blind, randomized study, 17 children admitted with croup were treated with either fluticasone propionate MDI (2,000 microg with the Babyhaler spacer) or placebo.

Prognostic factors for the outcome of childhood asthma in adolescence.

By the second decade of life asthma symptoms often abate and it may seem that patients with mild asthma have "outgrown" the disease. Unfortunately this is likely to be the exception rather than the rule. Although the severity of asthma symptoms fluctuates with time, the inherited tendency towards respiratory symptoms never disappears and many teenagers who seem to be free of symptoms do, in fact, have persistent asthma.

Clinical evaluation of mandibular overdentures supported by multiple-bar fabrication: a follow-up study of two implant systems.

A retrospective follow-up study was undertaken to assess the clinical condition, complications, and prosthodontic aftercare of two different implant systems over a long period. Thirty-six patients treated with a total of 135 ITI type F endosseous implants, and 37 patients treated with the transmandibular implants and a total of 146 transmandibular posts, were studied during a mean follow-up period of 70 months and 44 months, respectively. The choice of implant type was mainly influenced by a change in financial support by the National Health Insurance Company in The Netherlands in 1987.

Idiopathic scoliosis: prognostic value of the profile.

A study was undertaken to establish the significance of the sagittal shape of the spine in 138 consecutively treated girls with early idiopathic thoracic scoliosis. All were treated in a Boston brace. Two groups were formed: group I consisted of 120 girls whose scoliosis remained stable in the brace, group II of 18 girls who required a spinal fusion for progressive curves despite the brace.

Natural history of ultrasound hip abnormalities in clinically normal newborns.

One hundred one clinically normal newborn hips showed varying degrees of sonographic hip dysplasia according to the classification of Graf. None were treated, and after +/- 6 months, radiographs showed that only four had definite dysplasia. Of these, three had had risk factors such as breech delivery or familial predisposition.

Polyethylene delamination in the PCA total knee. Material analysis in two failed cases.

Two patients had severe polyethylene-wear synovitis after total knee arthroplasty for arthrosis. Full-leg length weight-bearing radiographs were diagnostic. The polyethylene of the tibial components showed excessive delamination.