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During a median follow-up of 0.3years, and compared with LMWH, DOACs were associated with a decreased risk of recurrent VTE (HR, 0.54; 95% CI, 0.36-0.82) and major bleeding (HR, 0.54; 95% CI, 0.31-0.96). We also observed a decreased risk of all-cause mortality with DOACs compared with LMWH (HR, 0.14; 95% CI, 0.09-0.22). Age and sex did not modify the associations.
DOACs were associated with improved effectiveness and safety compared with LMWH in patients with cancer related VTE. Unmeasured confounding probably contributed to our findings on all-cause mortality.
DOACs were associated with improved effectiveness and safety compared with LMWH in patients with cancer related VTE. Unmeasured confounding probably contributed to our findings on all-cause mortality.
In advanced Kienböck disease, unreconstructible lunate should be excised as a salvage procedure. There is a lack of information about the biomechanical approaches evaluating the carpal kinematics after lunate excision. We hypothesized that arthroscopic lunate excision would not break the ring structure of the proximal carpal row, preventing carpal instability. We aimed to investigate changes in carpal kinematics following arthroscopic and open lunate excisions.
We used upper extremities from five fresh cadavers and simulated arthroscopic and open lunate excisions. Arthroscopic lunate excision was performed to preserve the attachment sites of intrinsic and extrinsic carpal ligaments to the lunate. Open lunate excision was conducted with sectioning of the intrinsic and extrinsic carpal ligaments. Using a three-dimensional space electromagnetic tracking device, rotation angles of the scaphoid and triquetrum and the change of scaphotriquetrum distance were measured under axial loading. We compared the rotation angles and the change of scaphotriquetrum distance among intact wrists, open, and arthroscopic lunate excisions.
No Significant differences in the rotation angle of the scaphoid and triquetrum or the change of scaphotriquetrum distance were found between intact wrist and arthroscopic lunate excision. The triquetrum significantly dorsiflexed and supinated in wrists with open lunate excisions compared with intact wrists. Significant differences in the change of scaphotriquetrum distance were found between intact and openly excised wrists and between arthroscopic and open excisions.
Arthroscopic lunate excision potentially prevented kinematic change of the proximal carpal row under axial loading by maintaining the integrity of attachment sites of carpal ligaments.
Arthroscopic lunate excision potentially prevented kinematic change of the proximal carpal row under axial loading by maintaining the integrity of attachment sites of carpal ligaments.
Trochlear dysplasia is highly associated with patellofemoral instability. The goal of conservative and surgical treatment is to stabilize the patella while minimizing adverse effects. However, there is no literature investigating the quantitative influence of different treatment options on patellofemoral stability in knees with trochlear dysplasia. We created and exploited a range of finite element models to address this gap in knowledge.
MRI data of 5 knees with trochlear dysplasia and symptomatic patellofemoral instability were adapted into this previously established model. Vastus medialis obliquus strengthening as well as double-bundle medial patellofemoral ligament reconstruction and the combination of medial patellofemoral ligament reconstruction and trochleoplasty were simulated. The force necessary to dislocate the patella by 10mm and fully dislocate the patella was calculated in different flexion angles.
Our model predicts a significant increase of patellofemoral stability at the investigated fients with symptomatic patellofemoral instability and trochlear dysplasia type B. Vastus medialis obliquus strengthening has a negligible effect on patellar stability at a low total quadriceps load of 175 N.The common marmoset (Callithrix jacchus), a New World monkey, serves as a useful animal model in clinical and basic neuroscience. The present study recorded scalp auditory evoked potentials (AEP) in non-sedated common marmoset monkeys (n = 4) using a noninvasive method similar to that used in humans, and aimed to identify nonhuman primate correlates of the human AEP components. A pure tone stimulus was presented while electroencephalograms were recorded using up to 16 disk electrodes placed on the scalp and earlobes. Oxalacetic acid chemical Candidate homologues of two categories of the human AEP, namely, the middle latency responses (MLR; Na, Pa, Nb, and Pb) and the cortical auditory evoked potentials (CAEP; P1, N1, P2, N2, and the sustained potential, SP) were identified in the marmoset. These waves were labeled as CjNa, CjPa, CjNb, CjPb, CjP1, CjN1, CjP2, CjN2, and CjSP, where Cj stands for Callithrix jacchus. The last MLR component, CjPb, was identical to the first CAEP component, CjP1, similar to the relationship between Pb and P1 in humans. The peak latencies of the marmoset MLR and CAEP were generally shorter than in humans, which suggests a shorter integration time in neural processing. To our knowledge, the present study represents the first scalp recorded MLR and CAEP in the alert common marmoset. Further use of these recording methods would enable valid species comparisons of homologous brain indices between humans and animals.
Hypoxic ischaemic encephalopathy (HIE) is poorly predicted by markers of hypoxic ischaemic (HI) delivery. Repeated examination of infants with HI markers facilitates diagnostic certainty of HIE severity. When infants with HIE are nursed at incubator ambient air-temperature set to achieve normothermia, there is sometimes associated hyperthermia, a predictor of poor outcome. An alternative is to nurse infants without external heat (passive hypothermia, PH). We report a retrospective cohort-study to determine the safety of PH during the assessment of infant eligibility for therapeutic hypothermia (TH).
Inborn infants of gestational age ≥36weeks, less than 6h of age, with evidence of HI delivery were admitted for assessment for HIE. Infants were nursed undressed in an incubator treated with PH and underwent serial neurological examinations to determine eligibility for TH. Body temperature was monitored but no targeted temperature was set. Safety outcomes during PH were minimum and maximum temperatures, minimum and maximum glucose recordings, time to onset of TH, platelet count, maximum and minimum blood glucose concentration.
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