ABSTRACT
We present a case report of a bifurcated aorto-iliac stent graft infection two years after implantation. The initial procedure of implantation as well as the patient's recovery was uneventful. Two years later the patient presented with a growing aneurysmal sac without a detectable endoleak and consequent rupture. Instead of graft explantation, we left the graft in situ and performed thorough debridement and an omentoplasty, because of the poor condition of the patient. A Staphylococcus species grew out of the cultures of the aortic wall. The patient recovered well without persistent infection and is still doing well after 43 months. This conservative approach might be an alternative in patients who are deemed to be at high risk for classic graft explantation and an extra-anatomic bypass or in situ bypass.
Subject(s)
Aorta, Abdominal , Aortic Rupture/etiology , Blood Vessel Prosthesis , Prosthesis-Related Infections/complications , Stents/adverse effects , Aged, 80 and over , Aortic Aneurysm, Abdominal/therapy , Endovascular Procedures , Humans , Male , Postoperative Complications , Psoas Abscess/etiologyABSTRACT
This article presents a stimulation control method using a uniaxial gyroscope measuring angular velocity of the shank in the sagittal plane, to control functional electrical stimulation of the triceps surae to improve push-off of stroke subjects during gait. The algorithm is triggered during each swing phase of gait when the angular velocity of the shank is relatively high. Subsequently, the start of the stance phase is detected by a change of sign of the gyroscope signal at approximately the same time as heel strike. Stimulation is triggered when the shank angle reaches a preset value since the beginning of stance. The change of angle is determined by integrating angular velocity from the moment of change of sign. The results show that the real-time reliability of stimulation control was at least 95% for four of the five stroke subjects tested, two of which were 100% reliable. For the remaining subject, the reliability was increased from 50% found during the experiment, to 99% during offline processing. Our conclusion is that a uniaxial gyroscope on the shank is a simple, more reliable alternative to the heel switch for the purpose of restoring push-off of stroke subjects during gait.
Subject(s)
Electric Stimulation Therapy/methods , Gait Disorders, Neurologic/rehabilitation , Muscle, Skeletal/physiopathology , Stroke Rehabilitation , Adult , Algorithms , Gait/physiology , Gait Disorders, Neurologic/etiology , Gait Disorders, Neurologic/physiopathology , Humans , Middle Aged , Orientation , Stroke/complications , Stroke/physiopathologyABSTRACT
This study describes the predictors for cold intolerance and the relationship to sensory recovery after median and ulnar nerve injuries. The study population consisted of 107 patients 2 to 10 years after median, ulnar or combined median and ulnar nerve injuries. Patients were asked to fill out the Cold Intolerance Severity Score (CISS) questionnaire and sensory recovery was measured using Semmes-Weinstein monofilaments. Fifty-six percent of the patients with a single nerve injury and 70% with a combined nerve injury suffered abnormal cold intolerance. Patients with no return of sensation had dramatically higher CISS-scores than patients with normal sensory recovery. Females had higher CISS scores post-injury than males. Cold intolerance did not diminish over the years. Patients with higher CISS scores needed more time to return to their work. Age, additional arterial injury, site or type of the injury and dominance of the hand were not found to have a significant influence on cold intolerance.
Subject(s)
Cold Temperature/adverse effects , Hypesthesia/etiology , Median Nerve/injuries , Pain/etiology , Ulnar Nerve/injuries , Activities of Daily Living/classification , Adolescent , Adult , Aged , Comorbidity , Disability Evaluation , Female , Follow-Up Studies , Humans , Male , Median Nerve/surgery , Middle Aged , Neurologic Examination , Pain Measurement , Postoperative Complications/etiology , Sex Factors , Surveys and Questionnaires , Ulnar Nerve/surgeryABSTRACT
PIP: The authors review the research on uncontrolled urbanization and compare some of the substantive findings with results of a study conducted in a slum area of West Kingston, Jamaica.^ieng
