-
Seminars in Thoracic and Cardiovascular... 2024Partial heart transplantation is the first clinically successful approach to deliver growing heart valve implants. To date, 13 clinical partial heart transplants have... (Review)
Review
Partial heart transplantation is the first clinically successful approach to deliver growing heart valve implants. To date, 13 clinical partial heart transplants have been performed. However, turning partial heart transplantation into a routine procedure that is available to all children who would benefit from growing heart valve implants poses formidable logistical challenges. Firstly, a supply for partial heart transplant donor grafts needs to be developed. This challenge is complicated by the scarcity of donor organs. Importantly, the donor pools for orthotopic heart transplants, partial heart transplants and cadaver homografts overlap. Secondly, partial heart transplants need to be allocated. Factors relevant for equitable allocation include the indication, anatomical fit, recipient clinical status and time on the wait list. Finally, partial heart transplantation will require regulation and oversight, which only recently has been undertaken by the Food and Drug Administration, which regulates human cellular and tissue-based products. Overcoming these challenges will require a change in the system. Once this is achieved, partial heart transplantation could open new horizons for children who require growing tissue implants.
Topics: United States; Child; Humans; Tissue Donors; Heart Transplantation; Heart Valves
PubMed: 38522865
DOI: 10.1053/j.pcsu.2024.01.002 -
Neurology Feb 2015
Topics: Deep Brain Stimulation; Epilepsies, Partial; Female; Humans; Male
PubMed: 25616484
DOI: 10.1212/WNL.0000000000001297 -
JSES International May 2023Partial distal biceps tears can occur in the short and/or long heads, leading to forearm pain and weakness. Yet, the pathoanatomy of atraumatic and traumatic partial...
BACKGROUND
Partial distal biceps tears can occur in the short and/or long heads, leading to forearm pain and weakness. Yet, the pathoanatomy of atraumatic and traumatic partial tears are not understood. The goals of this study are to determine the distal biceps partial tear frequency and tear pattern in a cohort of cadaveric specimens.
METHODS
Fifty three fresh frozen cadavers (average age 70.4 ± 13.8 years, range 32-94) underwent elbow endoscopy to screen for partial tears. The partial tendon tear pattern was classified into either attritional (atraumatic), detachment on the tendon's lateral side, or avulsion (traumatic) rupture of the tendon fibers from bone on both the lateral and medial sides. The specimens were dissected and laser scanned to make 3D models. The tear location, shape, and area were calculated using gross dissection and the 3D models.
RESULTS
Atraumatic partial distal biceps tears were identified in 40% of the specimens, 72% involved both the long and short heads, 14% long head, and 14% short head. In all tears, the tendon fibers were only detached from the lateral side. The greatest tear width occurred near the short and long head junction.
CONCLUSION
Atraumatic partial distal biceps tears are common. The tear originates on the lateral side of the tendon at the short and long head junction. All the tear patterns are attritional and no specimen had surgical treatment. This finding supports the current treatment recommendation of an initial period of nonoperative care for symptomatic atraumatic partial distal biceps tears.
PubMed: 37266172
DOI: 10.1016/j.jseint.2023.01.004 -
Progres En Urologie : Journal de... Nov 2022Surgical techniques of radical and partial nephrectomy have changed over the last 20years. Indications for partial nephrectomy have widened and mini-invasive surgery... (Review)
Review
INTRODUCTION
Surgical techniques of radical and partial nephrectomy have changed over the last 20years. Indications for partial nephrectomy have widened and mini-invasive surgery (laparoscopy and robotic assistance) has become widely used. However, both still have a significant morbidity. The objective of this article is to review complications of renal surgery and their predictive factors and to offer algorithms of management.
METHODS
Recent literature regarding complications of radical and partial nephrectomy was queried using Pubmed engine search. The most relevant articles were analyzed and served as a basis for this work.
RESULTS
The literature on complications of radical and partial nephrectomy has a low level of evidence. There are only retrospective series. The most frequent complications of radical nephrectomy occur during surgery in 5-10% of the cases: wound of the pedicle or of an adjacent organ. The management can often be conservative. Laparoscopy has a similar morbidity compare to the open approach but has greatly increased postoperative outcomes and comfort. Partial nephrectomy has a 20% complication rate. Many factors have an impact on the risk of complications (tumor size, inflammation of perirenal fat, access, surgeon experience, centre volume, comorbidities and age of the patient) and must be taken into consideration before advising partial nephrectomy. The two most feared complications of partial nephrectomy are bleeding (per- or postoperative, 10% of the cases) and urinary fistula (<5% of the cases). Robotic assistance is associated with a lower morbidity in many publications.
CONCLUSION
Complications after partial and radical nephrectomy are quite frequent but have decreased with the improvement of surgical techniques. French urologists should maintain their interest in novel technologies and simplification of perioperative pathway to further improve patients' outcomes.
Topics: Humans; Kidney; Laparoscopy; Nephrectomy; Retrospective Studies; Urinary Fistula
PubMed: 36410865
DOI: 10.1016/j.purol.2022.09.011 -
European Journal of Oral Implantology 2016Single implants and their crowns have high survival rates that exceed the survival rates for fixed partial dentures on teeth and most but not all publications have... (Review)
Review
Single implants and their crowns have high survival rates that exceed the survival rates for fixed partial dentures on teeth and most but not all publications have determined single implants are more cost-effective than 3-unit fixed partial dentures. Both initial root canal treatment and retreatment are more cost-effective than tooth extraction and rehabilitation with a single implant and crown.
Topics: Cost-Benefit Analysis; Crowns; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Humans; Patient Care Planning; Patient Education as Topic
PubMed: 27314112
DOI: No ID Found -
BMC Medical Informatics and Decision... Jan 2020In classification and diagnostic testing, the receiver-operator characteristic (ROC) plot and the area under the ROC curve (AUC) describe how an adjustable threshold...
BACKGROUND
In classification and diagnostic testing, the receiver-operator characteristic (ROC) plot and the area under the ROC curve (AUC) describe how an adjustable threshold causes changes in two types of error: false positives and false negatives. Only part of the ROC curve and AUC are informative however when they are used with imbalanced data. Hence, alternatives to the AUC have been proposed, such as the partial AUC and the area under the precision-recall curve. However, these alternatives cannot be as fully interpreted as the AUC, in part because they ignore some information about actual negatives.
METHODS
We derive and propose a new concordant partial AUC and a new partial c statistic for ROC data-as foundational measures and methods to help understand and explain parts of the ROC plot and AUC. Our partial measures are continuous and discrete versions of the same measure, are derived from the AUC and c statistic respectively, are validated as equal to each other, and validated as equal in summation to whole measures where expected. Our partial measures are tested for validity on a classic ROC example from Fawcett, a variation thereof, and two real-life benchmark data sets in breast cancer: the Wisconsin and Ljubljana data sets. Interpretation of an example is then provided.
RESULTS
Results show the expected equalities between our new partial measures and the existing whole measures. The example interpretation illustrates the need for our newly derived partial measures.
CONCLUSIONS
The concordant partial area under the ROC curve was proposed and unlike previous partial measure alternatives, it maintains the characteristics of the AUC. The first partial c statistic for ROC plots was also proposed as an unbiased interpretation for part of an ROC curve. The expected equalities among and between our newly derived partial measures and their existing full measure counterparts are confirmed. These measures may be used with any data set but this paper focuses on imbalanced data with low prevalence.
FUTURE WORK
Future work with our proposed measures may: demonstrate their value for imbalanced data with high prevalence, compare them to other measures not based on areas; and combine them with other ROC measures and techniques.
Topics: Area Under Curve; Diagnostic Tests, Routine; Humans; Machine Learning; ROC Curve
PubMed: 31906931
DOI: 10.1186/s12911-019-1014-6 -
Journal of Robotic Surgery Jun 2018Reports of surgical outcomes after robotic partial cystectomy are limited. The objective of this study is to review surgical outcomes after robotic partial cystectomy at...
Reports of surgical outcomes after robotic partial cystectomy are limited. The objective of this study is to review surgical outcomes after robotic partial cystectomy at a large tertiary referral center and compare outcomes with patients undergoing open partial cystectomy. Patients undergoing robotic partial cystectomy between 2003 and 2014 were identified. Patients were matched 2:1 based on gender, age, and Charlson Comorbidity Score with patients undergoing open partial cystectomy during the same time period. Patient charts were reviewed for surgical outcomes. Conditional logistic regression adjusted for matching was used to compare outcomes. At our institution, 11 patients underwent robotic partial cystectomy between 2003 and 2014. Median operative time was significantly longer in the robotic group, 214 (IQR 93, 230) minutes, than the open group, 93 (IQR 58, 143) minutes (p = 0.01). There was no difference in median estimated blood loss (p = 0.1). No patient required transfusion. There were no intraoperative complications. Median hospital stay was significantly shorter in the robotic partial cystectomy group, 1 (IQR 1, 2) day, than the open partial cystectomy group, 2 (IQR 2, 4) days (p = 0.01). Median duration of catheterization and complications within 30 days of surgery were not statistically different between the two groups. Median follow-up was 15.5 (IQR 8.6, 19.7) months for the robotic partial cystectomy group and 40.7 (IQR 6.5, 69.4) months for the open partial cystectomy group. Robotic partial cystectomy is safe, effective, and is associated with minimal morbidity when performed in properly selected patients for benign and malignant indications. When compared with open partial cystectomy, robotic partial cystectomy is associated with a longer operative time, but results in a shorter postoperative hospital stay.
Topics: Aged; Cystectomy; Female; Humans; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Robotic Surgical Procedures; Treatment Outcome; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 28601954
DOI: 10.1007/s11701-017-0717-x -
Frontiers in Psychology 2023The past years have seen a drastic rise in studies devoted to the investigation of colexification patterns in individual languages families in particular and the...
The past years have seen a drastic rise in studies devoted to the investigation of colexification patterns in individual languages families in particular and the languages of the world in specific. Specifically computational studies have profited from the fact that colexification as a scientific construct is easy to operationalize, enabling scholars to infer colexification patterns for large collections of cross-linguistic data. Studies devoted to partial colexifications-colexification patterns that do not involve entire words, but rather various parts of words-, however, have been rarely conducted so far. This is not surprising, since partial colexifications are less easy to deal with in computational approaches and may easily suffer from all kinds of noise resulting from false positive matches. In order to address this problem, this study proposes new approaches to the handling of partial colexifications by (1) proposing new models with which partial colexification patterns can be represented, (2) developing new efficient methods and workflows which help to infer various types of partial colexification patterns from multilingual wordlists, and (3) illustrating how inferred patterns of partial colexifications can be computationally analyzed and interactively visualized.
PubMed: 37397315
DOI: 10.3389/fpsyg.2023.1156540 -
The Journal of Medical Investigation :... 2022Objectives : To evaluate whether virtual partial nephrectomy images could help surgeons identify vascular and collecting system around tumors during actual surgery....
Objectives : To evaluate whether virtual partial nephrectomy images could help surgeons identify vascular and collecting system around tumors during actual surgery. Materials & methods : We retrospectively analyzed 36 patients who underwent robot-assisted partial nephrectomy (RAPN) between 2016 and 2017. Virtual partial nephrectomy images were created from preoperative CT images using computer software, and then analyzed. For analysis, blood vessels and collecting system portions within a 5-mm-thick safety margin around the tumor were examined. During analysis, we predicted whether targeted vasculature around the tumor would require clipping or suturing during surgery, and also whether the collecting system would require opening during resection. Surgical outcomes for virtual partial nephrectomy analyses and actual RAPNs were compared and analyzed for sensitivity and specificity. Results : In 36 cases, 119 arteries and 100 veins were targeted on virtual partial nephrectomy images. Arterial suturing or clipping for hemostasis showed a sensitivity and specificity of 83.3% and 84.5%, respectively. For veins, the sensitivity and specificity were 39.1% and 92.2%, respectively. Collecting system opening prediction sensitivity was 85.7%, and specificity was 65.2%. Conclusion : Virtual partial nephrectomy imaging is useful for RAPN planning, particularly regarding arteries and the collecting system. It is hoped that techniques for visualizing veins will improve. J. Med. Invest. 69 : 237-243, August, 2022.
Topics: Humans; Kidney Neoplasms; Nephrectomy; Retrospective Studies; Robotic Surgical Procedures; Robotics; Treatment Outcome
PubMed: 36244775
DOI: 10.2152/jmi.69.237 -
The Clinical Journal of Pain Nov 2021This prospective study examined risk and resilience predictors of pain and functional recovery in the first 6 months after spinal fusion surgery in adolescents.
OBJECTIVE
This prospective study examined risk and resilience predictors of pain and functional recovery in the first 6 months after spinal fusion surgery in adolescents.
METHODS
Adolescents with adolescent idiopathic scoliosis undergoing spinal fusion surgery (n=100, aged 12 to 18 y, 77% girls) completed assessments before surgery and at 3 weeks, 6 weeks, and 6 months after surgery. Recovery trajectories in pain, health-related quality of life (HRQOL), and objectively registered physical activity were identified. Presurgical pain catastrophizing and pain intensity (risk), and psychological flexibility, and postsurgical pain acceptance (resilience) were examined as predictors of recovery.
RESULTS
Latent growth class analyses revealed 4 distinct pain recovery trajectories (ie, Severe-Moderate [11%, n=9], Mild-No [58%, n=49], Moderate-Mild [24%, n=20], and Moderate-Severe [7%, n=6] pain trajectory), 2 HRQOL recovery trajectories; 2 trajectories characterizing recovery in average daily physical activity at moderate-to-vigorous intensity (MVPA); and 3 trajectories characterizing recovery in total physical activity volume characterized by the average daily number of steps. Subsequent multivariate analyses of variance revealed that presurgical pain intensity (partial η2=0.21, P<0.001) and pain catastrophizing (partial η2=0.13, P<0.01) were both predictive of poorer recovery in HRQOL, and pain catastrophizing additionally predicted poorer pain recovery (partial η2=0.15, P<0.05). Psychological flexibility (partial η2=0.25, P<0.001) and postsurgical pain acceptance (partial η2=0.07, P<0.05) were predictive of more favorable recovery trajectories in HRQOL, and psychological flexibility additionally predicted more favorable recovery trajectories in postsurgical pain (partial η2=0.15, P<0.05). Daily MVPA trajectories were not significantly predicted by any of the hypothesized factors, while presurgical pain catastrophizing levels were predictive of a delayed recovery trajectory in the daily amount of steps (partial η2=0.17 P<0.01).
CONCLUSIONS
Presurgical screening could include assessment of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance to identify adolescents who are at risk for poorer recovery. These are potentially modifiable factors that can be targeted in presurgical interventions to prevent poor and foster adaptive outcomes after major surgery in adolescents.
Topics: Adolescent; Female; Humans; Male; Pain Measurement; Pain, Postoperative; Prospective Studies; Quality of Life; Spinal Fusion
PubMed: 34419974
DOI: 10.1097/AJP.0000000000000971