The Experts below are selected from a list of 11061 Experts worldwide ranked by ideXlab platform
Warren S Sandberg - One of the best experts on this subject based on the ideXlab platform.
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endobronchial blocker dislodgement leading to pulseless electrical activity
Anesthesia & Analgesia, 2005Co-Authors: Warren S SandbergAbstract:This is a report of a case in which an endobronchial blocker was dislodged, leading to severe air trapping and a brief episode of pulseless electrical activity. Bronchial blockade for lung deflation was successfully instituted during Emergency Repair of a ruptured descending aortic aneurysm. During
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endobronchial blocker dislodgement leading to pulseless electrical activity
Anesthesia & Analgesia, 2005Co-Authors: Warren S SandbergAbstract:This is a report of a case in which an endobronchial blocker was dislodged, leading to severe air trapping and a brief episode of pulseless electrical activity. Bronchial blockade for lung deflation was successfully instituted during Emergency Repair of a ruptured descending aortic aneurysm. During a period not involving manipulation of aortic cross-clamps, end-tidal CO2 decreased precipitously to zero and airway pressures increased markedly, followed by equalization of intracardiac pressures. Prompt deflation of the endobronchial blocker balloon reversed the problem. We hypothesize that when surgical manipulation dislodged the bronchial blocker into the tracheal position, leading to profound air trapping as successive, stacked tidal volumes were forced distal to the blocker.
Fausto Catena - One of the best experts on this subject based on the ideXlab platform.
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Emergency Repair of complicated abdominal wall hernias: WSES guidelines.
Hernia, 2019Co-Authors: B. De Simone, Massimo Sartelli, Federico Coccolini, Luca Ansaloni, Arianna Birindelli, S. Di Saverio, V. Annessi, F. Amico, Fausto CatenaAbstract:In July 2013, the World Society of Emergency Surgery (WSES) held the first Consensus Conference on Emergency Repair of abdominal wall hernias in adult patients with the intention of producing evidence-based guidelines to assist surgeons in the management of complicated abdominal wall hernias. Guidelines were updated in 2017 in keeping with varying clinical practice: benefits resulting from the increased use of biological prosthesis in the Emergency setting were highlighted, as previously published in the World Journal of Emergency Surgery. This executive summary is intended to consolidate knowledge on the Emergency management of complicated hernias by providing the broad readership with a practical and concise version of the original guidelines. This executive manuscript summarizes the WSES guidelines reporting on the Emergency management of complicated abdominal wall hernias; statements are highlighted focusing the readers’ attention on the main concepts presented in the original guidelines. Emergency Repair of complicated abdominal hernias remains one of the most common and challenging surgical emergencies worldwide. WSES aims to provide an essential version of the evidence-based guidelines focusing on the timing of intervention, laparoscopic approach, surgical Repair following the Centers for Disease Control and Prevention (CDC) wound classification, antimicrobial prophylaxis and anesthesia in the Emergency setting.
Reed E. Pyeritz - One of the best experts on this subject based on the ideXlab platform.
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long term implications of Emergency versus elective proximal aortic surgery in patients with marfan syndrome in the genetically triggered thoracic aortic aneurysms and cardiovascular conditions consortium registry
The Journal of Thoracic and Cardiovascular Surgery, 2012Co-Authors: Howard K Song, Mark Kindem, Joseph E Bavaria, Harry C Dietz, Dianna M Milewicz, Richard B Devereux, Kim A Eagle, Cheryl L Maslen, Barbara Kroner, Reed E. PyeritzAbstract:Objective Patients with Marfan syndrome with aortic root aneurysms undergo elective aortic root replacement to avoid the life-threatening outcomes of aortic dissection and Emergency Repair. The long-term implications of failed aortic surveillance leading to acute dissection and Emergency Repair are poorly defined. We compared the long-term clinical courses of patients with Marfan syndrome who survive Emergency versus elective proximal aortic surgery. Methods The Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions Registry is a National Institutes of Health–funded multicenter database and biorepository that enrolls patients with genetically triggered thoracic aortic aneurysms. Of the 635 patients with Marfan syndrome enrolled as of March 2011, 194 had undergone proximal aortic replacement. Patients were grouped according to Emergency (n = 47) or elective (n = 147) status at the time of surgery. Results Patients in the Emergency group were more likely to have incomplete proximal aortic resection; 83% of Emergency procedures included aortic root replacement, compared with 95% of elective procedures. At long-term follow-up (mean, >6 years), the Emergency group had a higher incidence of chronic dissection of the distal aorta and significantly larger diameters in distal aortic segments than elective patients. Patients in the Emergency group had undergone more operations (1.31 vs 1.11 procedures/patient; P = .01) and had lower activity scores on a health-related quality of life survey. Conclusions For patients with Marfan syndrome, failed aortic surveillance and consequent Emergency dissection Repair have important long-term implications with regard to the status of the distal aorta, need for multiple procedures, and quality of life. These findings emphasize the importance of aortic surveillance and timely elective aortic root aneurysm Repair for patients with Marfan syndrome.
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replacement of the aortic root in patients with marfan s syndrome
The New England Journal of Medicine, 1999Co-Authors: Vincent L. Gott, Peter S. Greene, Diane E Alejo, Duke E Cameron, David C Naftel, D C Miller, A M Gillinov, John C Laschinger, Reed E. PyeritzAbstract:Background Replacement of the aortic root with a prosthetic graft and valve in patients with Marfan's syndrome may prevent premature death from rupture of an aneurysm or aortic dissection. We reviewed the results of this surgical procedure at 10 experienced surgical centers. Methods A total of 675 patients with Marfan's syndrome underwent replacement of the aortic root. Survival and morbidity-free survival curves were calculated, and risk factors were determined from a multivariable regression analysis. Results The 30-day mortality rate was 1.5 percent among the 455 patients who underwent elective Repair, 2.6 percent among the 117 patients who underwent urgent Repair (within 7 days after a surgical consultation), and 11.7 percent among the 103 patients who underwent Emergency Repair (within 24 hours after a surgical consultation). Of the 675 patients, 202 (30 percent) had aortic dissection involving the ascending aorta. Forty-six percent of the 158 adult patients with aortic dissection and a documented ao...
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Composite graft Repair of Marfan aneurysm of the ascending aorta: results in 100 patients.
The Annals of thoracic surgery, 1991Co-Authors: Vincent L. Gott, Reed E. Pyeritz, E. Cameron, Peter S. Greene, Victor A. MckusickAbstract:One hundred consecutive patients with the Marfan syndrome underwent composite graft Repair of an ascending aortic aneurysm between September 1976 and June 1989. Twenty-two patients had ascending aortic dissection at the time of composite graft Repair; 18 patients also had a mitral valve procedure. There were no hospital deaths among 92 patients undergoing elective Repair. One of 8 patients undergoing Emergency Repair of a ruptured aneurysm died in the operating room. The overall hospital mortality rate was 1%. There have been ten late deaths among the 99 hospital survivors (10.1%). Five deaths occurred among the first 11 patients in this series and five occurred among the last 88 patients (5.7%). Three late deaths resulted from composite graft endocarditis; 3 other patients with endocarditis are alive after aortic root replacement with cryopreserved homografts. Late coronary dehiscence caused death in 1 patient and was successfully Repaired in a second. Actuarial survival for the 100 patients was 92.6% at 5 years and 75.8% at 10 years. Currently, composite graft Repair of Marfan aneurysms of the ascending aorta can be performed with low hospital and late mortality. Marfan aneurysms with a diameter of 6 cm or greater should be Repaired with the Bentall composite graft procedure, even if the patient is asymptomatic.
Chan-gi Park - One of the best experts on this subject based on the ideXlab platform.
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Mechanical and Durability Properties of Latex-Modified Hybrid Fiber-Reinforced Roller-Compacted Rapid-Set Cement Concrete for Pavement Repair
'MDPI AG', 2021Co-Authors: Su-jin Lee, Hyung-jin Shin, Chan-gi ParkAbstract:This study evaluated the mechanical properties and durability performance of latex-modified hybrid fiber-reinforced roller-compacted rapid-set cement concrete (LMHFRCRSC) for Emergency Repair of concrete pavement. Experimental parameters included the blend ratio of the hybrid fiber, which comprised natural jute fiber (0–0.2 vol.%) and structural synthetic fiber (0–2 vol.%). The mechanical performance of LMHFRCRSC of various blend ratios was evaluated in terms of compressive, flexural, and splitting tensile strength. Durability assessment included chlorine ion penetration and abrasion resistance measurements. Compressive and flexural strength values of 21 and 3.5 MPa, respectively, were the set targets after 4 h of curing; a compressive strength of 35 MPa, a flexural strength of 4.5 MPa, a splitting tensile strength of 4.2 MPa, and chloride ion penetration of 2000 C or less were required after 28 days of curing. Our test results confirmed that all mix proportions satisfied the target values, regardless of the blend ratio of the hybrid fiber. Specifically, the mechanical performance of the concrete improved as the blend ratio of the structural synthetic fiber increased. With regard to durability, a greater amount of jute fiber, a hydrophilic fiber, enhanced the concrete’s durability. Additionally, incorporating jute fiber of 0.6 kg/m3 provided excellent chlorine ion penetration resistance. The optimal blend ratio for the hybrid fiber was natural jute fiber at 0.6 kg/m3 and structural synthetic fiber at 13.65 kg/m3 (mix: J0.6 + P13.65); with this mix proportion, a chloride ion penetration amount of 1000 C or less and maximum mechanical performance were achieved
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Effects of Reinforcing Fiber and Microsilica on the Mechanical and Chloride Ion Penetration Properties of Latex-Modified Fiber-Reinforced Rapid-Set Cement Concrete for Pavement Repair
Hindawi Limited, 2018Co-Authors: Woong Kim, Jong-cha Jeo, Yung-hwa A, Joo-ha Lee, Hae-do Kim, Chan-gi ParkAbstract:This study evaluated the influence of reinforcement fiber type and microsilica content on the performance of latex-modified fiber-reinforced roller-compacted rapid-hardening cement concrete (LMFRCRSC) for a concrete pavement Emergency Repair. Experimental variables were the microsilica substitution ratio (1, 2, 3, and 4%), and the reinforcement fiber (jute versus macrosynthetic fiber). In the tests, compressive, flexural, and splitting tensile strength; chloride ion penetration resistance; and abrasion resistance were assessed. From the compressive and flexural strength tests with microsilica substitution, the 4-hour curing strength decreased as the microsilica substitution ratio increased. From the chloride ion penetration test, as the microsilica substitution ratio increased, chloride ion penetration decreased. The abrasion resistances increased with the substitution ratio of microsilica increase. Based on these test results, microsilica at a substitution ratio of 3% or less and macrosynthetic fiber as the reinforcement improved the performance of LMFRCRSC for a concrete pavement Emergency Repair and satisfied all of the target strength requirements
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Mechanical and Permeability Characteristics of Latex-Modified Fiber-Reinforced Roller-Compacted Rapid-Hardening-Cement Concrete for Pavement Repair
MDPI AG, 2017Co-Authors: Seung-kee Lee, Myong-jin Jeon, Sang-sun Cha, Chan-gi ParkAbstract:This study evaluated the effects of reinforcement fibers on the mechanical characteristics, chloride ion penetration properties and abrasion resistance of roller-compacted latex-modified fiber-reinforced rapid-hardening-cement concrete (RCLMFRRHCC) for use in the Emergency Repair of concrete pavements. The reinforcement fibers tested included macro synthetic fibers (a structural fiber) as well as PVA (polyvinyl alcohol) and natural Jute fibers (non-structural fibers). In the experiment, compressive strength, flexural strength, splitting tensile strength, chloride ion penetrating properties, abrasion resistance tests and impact resistance tests were performed. Test results were compared with traffic open standards of concrete for concrete pavement Emergency Repair. RCLMFRRHCC satisfied all traffic open standards for concrete Emergency Repair. Mixes with reinforcement fibers showed superior results to the mix without, in terms of compressive strength, flexural strength, splitting tensile strength, chloride ion penetration resistance, abrasion resistance and impact resistance. With regard to the reinforcement fibers, the compressive strength, flexural strength, splitting tensile strength, and impact resistance of the mix with macro synthetic fiber showed improved results as a structural fiber compared to mixes containing natural jute and PVA fibers, namely the non-structural fibers. However, using the reinforcement fiber type had little effect on chloride ion penetration resistance or abrasion resistance. Thus, the addition of reinforcement fibers was effective in improving the performance of RCLMFRRHCC. The use of macro synthetic fibers improved the mechanical characteristics of concrete
B. De Simone - One of the best experts on this subject based on the ideXlab platform.
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Emergency Repair of complicated abdominal wall hernias: WSES guidelines.
Hernia, 2019Co-Authors: B. De Simone, Massimo Sartelli, Federico Coccolini, Luca Ansaloni, Arianna Birindelli, S. Di Saverio, V. Annessi, F. Amico, Fausto CatenaAbstract:In July 2013, the World Society of Emergency Surgery (WSES) held the first Consensus Conference on Emergency Repair of abdominal wall hernias in adult patients with the intention of producing evidence-based guidelines to assist surgeons in the management of complicated abdominal wall hernias. Guidelines were updated in 2017 in keeping with varying clinical practice: benefits resulting from the increased use of biological prosthesis in the Emergency setting were highlighted, as previously published in the World Journal of Emergency Surgery. This executive summary is intended to consolidate knowledge on the Emergency management of complicated hernias by providing the broad readership with a practical and concise version of the original guidelines. This executive manuscript summarizes the WSES guidelines reporting on the Emergency management of complicated abdominal wall hernias; statements are highlighted focusing the readers’ attention on the main concepts presented in the original guidelines. Emergency Repair of complicated abdominal hernias remains one of the most common and challenging surgical emergencies worldwide. WSES aims to provide an essential version of the evidence-based guidelines focusing on the timing of intervention, laparoscopic approach, surgical Repair following the Centers for Disease Control and Prevention (CDC) wound classification, antimicrobial prophylaxis and anesthesia in the Emergency setting.