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  • 1
    ISSN: 1248-9204
    Keywords: Hernioplasty ; Outpatient surgery ; Prosthetic materials
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Since the first hernioplasty performed by Edoardo Bassini in 1884, all surgical reconstruction techniques have suffered from a common defect: tension on the suture line. This represents the main etiologic factor for recurrent hernia. With the introduction of modern prosthetic materials (meshes and plugs) it is possible to perform all hernia repairs without altering the normal anatomy, as well as avoiding undesired suture line tensions. Between January 1992 and December 1998 1405 open sutureless tension-free repairs were performed for primary inguinal hernia in 1317 patients. The number of patients treated with local anesthesia was 1235 (93.8%), with 63 (4.8%) treated under general anesthesia, and 19 (1.4%) with epidural anesthesia. In this series only 4 (0.3%) cases of intra-operative complication occurred (vagal crisis without consequences for the patients). Nine (0.6%) cases of early postoperative complications were noted, of which 8 involved vagal crisis and 1 hemorrhage. Forty six (3.4%) late postoperative complications occurred: 32 seromas accompanied by 3 massive inguino-scrotal edemas, 4 hematomas, and 10 wound infections without the necessity to remove the mesh in all cases. Six recurrences (0.4%) were noted after primary surgical repair. Mean follow-up time was 4 years (range 1–7 years). The proposed technique is simple, safe, and characterized by a rapid performing procedure giving an excellent outcome. The data presented confirms the experience of others reported in the world literature, with a low complication rate and lower cost for the community.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We have previously suggested that altering the height of the porous-coat segment of a partially porous-coated TiAl6V4 endosseous dental implant would affect the degree of crestal bone loss occurring during implant function by changing the patterns of stress transfer. This conclusion arose from the analysis of data from several different experiments and lacked a direct intra-animal comparison. In the present study we have compared two implant designs varying only in the extent to which they were porous-coated. With one design (type A) the coronal 1.8 mm of the implant root had a machined surface while the remainder of its length was porous-coated with TiAl6V4 beads. The other design (type B) had all but the coronal-most 0.75 mm porous-coated. Two implants of each type were placed in each of 4 dogs and the sites allowed to heal for 4 weeks before re-entry and prosthesis attachment. Monthly the implant-supported bridges were removed and radiographs exposed of each implant using a special film holder connected separately to each implant. These radiographs were analyzed for crestal bone loss using both direct visual and computer-assisted techniques. The results showed that bone remodelled to the machined surface-to-porous coat junction for type B implants and achieved a steady state by 12 weeks of function, whereas a longer time was required to achieve this state with type A implants. Significantly more bone loss occurred with the type A design, and this difference was detectable as early as after the first month of function.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Cockroach allergy is common among inner city children with asthma, and exposure to cockroach allergen is associated with more severe disease. However, there has been little evaluation of educational approaches for controlling cockroach infestations and reducing allergen exposure.Objective An educational intervention to reduce cockroach allergen exposure in the homes of Hispanic children in Los Angeles was implemented and evaluated.Methods Caretakers of 150 children with asthma were randomly assigned to an in-home intervention or comparison group. In the intervention group, peer health educators trained the caretaker to control cockroaches by reducing harbourage and access to food and by applying boric acid, and to reduce allergen exposure by cleaning. Allergen impermeable covers were placed on the child's mattress and pillows. Knowledge, reported and observed behaviour, cockroach counts, and cockroach allergen (Bla g 1) in dust samples from the kitchen and the child's bedding were assessed at study entry and at follow-up 4 months later.Results There was improvement in knowledge and in observed and reported behaviour hypothesized to be associated with cockroach control. The geometric mean cockroach number in the intervention homes at the follow-up visit was 60% lower than in the non-intervention homes (95% confidence interval (CI) 14%, 81%). Geometric mean total cockroach allergen collected from the child's bedding was 64% lower in the intervention group (95% CI 12%, 85%). In homes with heavier initial cockroach infestation, there was a larger reduction in total kitchen dust allergen and concentration associated with the intervention than in homes with fewer initial cockroaches.Conclusions We conclude that reduction in number of cockroaches and in total allergen in bedding dust can be achieved by caretakers of asthmatic children following a single home educational intervention by peer educators.
    Type of Medium: Electronic Resource
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